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Private groups create change

By Robert Faturechi

Nov. 30, 2008 11:38 p.m.

BANGKOK, THAILAND “”mdash; Pakronphan Janetti sells candy and cheap jewelry for a living.

The delicate woman owns a stand tucked in a little oasis away from the bustling, hot, smoggy streets of downtown Bangkok.

She chats with customers, smiles at passersby, wraps goods and puts her glasses on when it’s time to count inventory with her business partner, a close friend.

Her days are calm. But she remembers when it wasn’t so.

“I know it’s a miracle I’m alive now,” she said, one of the many times Pakronphan acknowledged her mortality in the span of a few hours on a muggy day during Thailand’s monsoon season.

She wears mid-length sleeves, not hiding the black welts on her arms, one of the few visible symptoms of the HIV positive status she’s lived with for more than a decade.

The HIV/AIDS epidemic took Thailand before other Southeast Asian countries, a reality experts attribute to the nation’s role as a global hub for sex tourism.

Though the virus began its spread in the cities in the mid 1980s ““ where red light districts prosper ““ it didn’t take long before it traveled to the rural zones with farmers heading home after agricultural off-seasons laboring in the cities.

In the villages, where loyalty to the King is strong and rice paddies spot the terrain, the stigma that comes with a virus connected to sex cuts deep.

The strict traditional values prevalent in these small communities has often forced families touched by the virus to disjoint, as those who have tested positive have been forced out of their villages through shame and coercion and sent to fend for themselves in the anonymity of city life.

The reluctance of the Thai government to acknowledge the growing epidemic, in fear that doing so would deflate the nation’s booming tourism industry, prompted nongovernmental groups to take action.

“We had to be brave enough to say, “˜We have AIDS in our country,'” said Praween Payapvipapog, vice president of Population and Community Development Association, which is an organization active in alleviating the HIV/AIDS crisis in Thailand.

Though the Thai government has made significant strides since the epidemic began in the 1980s, nongovernmental groups ““ based in Thailand and abroad ““ still handle a lion’s share of the responsibility.

The give and take ““ and occasional cooperation ““ between the two sides has had a profound effect on the thousands of Thai people infected with HIV and their families.

Almost 600,000 are living with the virus in Thailand, according to an estimate by UNAIDS, a United Nations program.

The poor, experts say, have the most to gain ““ and to lose ““ from the actions these groups take.

Pakronphan, now 47, grew up in a small village north of Bangkok. Her two daughters were just starting grade school when she and her husband divorced and she began seeing men from the surrounding area.

The men, Pakronphan said, came and went, so she never knew from whom she contracted the virus.

The strong network of family and friends she developed after living her whole life in the same village disintegrated after she got the news.

“Everybody in my house ““ they wouldn’t accept it,” Pakronphan said through an interpreter. “They said, “˜We can’t sit at the table with you, we can’t be close to you. We don’t want you to be here.'”

Exiled from her family, single with daughters and unable to find work, Pakronphan set out for sprawling Bangkok, where the only stigma she would have to face was from within.

The government, by then beginning to make steps toward addressing the growing HIV/AIDS crisis, paid her a small sum every month: 2,000 baht a year, which comes out to roughly $55.

Taking a handout from a government she felt was doing so only grudgingly left Pakronphan feeling further degraded.

“The government was giving you this money for free but you didn’t feel like it was out of good will,” she said.

Finding work proved difficult and Pakronphan began to lose hope.

Here at Cabbages & Condoms, a restaurant and resort group in Thailand, condoms are a lot of things: balloons, key chains, belts ““ just about anything that can be stretched, stripped or shaped to break the stigma with which they are associated.

The non-profit serves as the fundraising arm to the Population and Community Development Association, a major Thai nongovernmental organization that focuses on a wide array of issues facing the nation’s poor, including HIV and AIDS.

The organization was started by acclaimed Thai actor and radio personality Mechai Viravaidya, who used his celebrity to tackle what he predicted would be an impending family planning crisis among Thailand’s urban and rural poor.

Since the organization took off in 1974, Mechai’s acclaim as an entertainment icon has been eclipsed by his reputation as the nation’s leading crusader for family planning and sex education.

His organization has worked with, and prodded, Thai regimes for more than three decades, most notably pushing for the enforcement of a 100 percent condom policy at brothels that has been credited with saving millions of lives.

“The government would have done something eventually,” said Isadore Reaud, a planning officer at the association. “But the start would have been much, much, much later.”

Despite the seriousness of the challenges the group faces, Mechai, often referred to as “the Condom King,” has insisted on taking on sensitive topics with humor.

As his condom outreach began, it was common for Mechai to blow up condoms like balloons in front of crowds of children. The gift shop at Cabbages & Condoms is stocked with T-shirts and shot glasses with messages like “A condom a day keeps the doctor away” and “Save energy: have a vasectomy” emblazoned on them.

“When it comes to sex education, people are usually just not that into it,” Isadore said. “The idea was to make it fun.”

The approach drew criticism ““ along with attention ““ and the organization grew to become one of the largest of its kind in Thailand, second in scope only to the Thai King’s own charitable foundation.

Still based in Bangkok, the organization now boasts 12 regional development centers and three smaller rural centers, with more than 12,000 volunteers doling out information and contraceptives in city centers and thousands of villages.

“We want to show people that this is a lifesaver,” Praween said. “A condom is a lifesaver.”

A common theme in many of the organization’s programs is empowerment. For the nation’s poor and HIV positive ““ a community that faces steep unemployment rates ““ the first step is often a steady source of income.

For Pakronphan, the small allowance provided to those with HIV by the Thai government was not enough to make ends meet, and her health had diminished to the point that she was too sick to work.

Pakronphan was forced to seek help outside of what the government was providing.

“At the time, I was getting more and more ill. So I came to PDA,” she said.

Some time after she became involved, the organization began a new program to provide micro-loans to people with HIV so they could start their own small businesses and become self-reliant in a society that often made outcasts of those with the virus.

Pakronphan took a loan out for 12,000 baht. Though her initial business venture ““ a massage parlor ““ failed, she and her business partner redrew their plans and opened a successful stand selling cheap goods in downtown Bangkok.

Paying back 1,000 baht a month, Pakronphan paid off her loan in one year.

“I feel like people see that I’ve put the effort into this ““ that I’ve worked for it,” she said.

The program has been described as the last frontier of microlending, as people with HIV had long been considered risky borrowers.

But the group’s program has been a success.

Of the more than 400 microloans the organization has doled out, roughly 90 percent have been paid on time, according to a United Nations estimate.

The program has shown stunning success in dragging HIV positive borrowers from poverty and setting them on track to stay self-sufficient, Praween said.

Pakronphan, now relatively healthy and running a stable business, is sure her life would have fallen apart without the help of the organization.

“If I had to rely on the government, I’d be long dead by now,” she said. “The reason I’m alive is the medicine, but the reason I have a life is PDA.”

Pakronphan’s experience is one example of thousands in Thailand of the profound effect the relationship between the Thai government and nongovernmental groups can have on the lives of regular citizens.

With the prodding of outside groups, the Thai government showed signs of proactive HIV/AIDS policy in the 1990s, taking steps to secure the sex industry and significantly slowing the spread of the virus.

But since then there have been road bumps.

During the regime of telecommunications millionaire Thaksin Shinawatra, which lasted from 2001 to 2006, the government slashed resources devoted to fighting the virus, Reaud said.

“He approached Thailand as a business, not a country,” Reaud said.

The former Prime Minister’s tenure, halted after a corruption scandal, is still remembered as “the black era” among Thai AIDS activists.

Their mistrust toward outside groups, Praween said, hindered the work of HIV/AIDS organizations.

“They thought NGOs wanted to compete with them,” Praween said. “No. Not only one (group) can kill the enemy.”

Though the effort to alleviate the epidemic has taken a hit in recent years, Praween is confident that nongovernmental groups will continue to make progress in the long run.

“If the government fails, they are overthrown,” he said. “That’s not the case for NGOs.”

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