A Buddhist Temple for Dying AIDS Patients

Copyright March 1997 by Richard S. Ehrlich

LOPBURI, Thailand -- More than 200 small cloth sacks, containing ashes of deceased AIDS patients, are stacked in front of a serene statue of Lord Buddha.

Most of these cremated remains were rejected by family members, who feared becoming social outcasts, because their ignorant neighbors might link the disease, even indirectly, to surviving relatives.

The growing pile of bags include a few marked, "Return to Sender," after some families even refused to accept the post office's delivery of the burnt residue.

Abandoning the ashes and charred bone shreds of a family member is heresy in Thailand, where the dead are honored, and protected, by elaborate rituals and ancestor worship which mix Buddhism and earlier animist beliefs.

But throughout this Southeast Asian nation, AIDS victims are often spurned by their families, kicked out of hospitals, and shunned by neighbors, landlords and employers.

Mothers who are HIV-positive often dump their newborn infants in the street or at institutions, worried that their babies will also have the disease and be a unnecessary burden to keep.

To fill the gap in Thailand's health care, a controversial monk has opened the gates of his sprawling Wat Phrabat Nampo monastery to dying AIDS victims.

In doing so, Alongkot Tikhapanyo, 44, has created this nation's biggest AIDS hospice.

But his money-minded approach to AIDS victims often appears in conflict with the altruism of Buddhism.

"I decided to take infected people to my temple and look after them until they die peacefully," Alongkot said in an interview.

More than 1,500 people have died at this religious facility.

"I bought a crematorium in 1995 from America," the head monk added, gesturing toward a stainless steel, Cleveland-made, trailer-sized oven.

"It cost about seven million baht (280,000 US dollars). It can burn a person in a short time, in two or three hours.

"Our patients die every day, sometimes three, four or five people a day.

"Our old crematorium could burn only one a day, and it used wood. This new one uses gas."

As if on cue, a coffin containing a gaunt, wide-eyed male corpse, fortyish, was wheeled to the crematorium.

The body was lifted out of the coffin and into the crematorium, while a group of visiting Thai schoolchildren stared in awe.

Of the more than 5,000 patients who have passed through the hospice since he founded it in 1992 -- most of whom drifted home to die after a respite at the temple -- about 90 percent became infected through sex, the monk said.

Alongkot says he has a waiting list of 10,000 additional sufferers.

The monastery offers sanctuary amid Buddhist prayer halls, shrines and other religious settings, but the overall ambiance stresses a business-like approach to managing AIDS patients' health needs.

A hospital-style ward offers rudimentary care to about 20 of the worst cases, including skeletal men and women whose bodies are so thin, their protruding bones appear to be made of bamboo reeds.

Patients who are well enough to live on their own have separate, one-room chambers dotted along a hillside.

Contrary to Buddhism's hands-off-cash philosophy, attracting big money to the monastery seems to be one of Alongkot's major obsessions.

Construction crews built huge, five-star auditoriums and other facilities, complete with chandeliers and audio-visual projection rooms -- but these are for visitors and potential patrons, not for AIDS patients.

According to the Public Health Ministry, about 800,000 Thais are infected with the Human Immunodeficiency Virus (HIV), which causes Acquired Immune Deficiency Syndrome (AIDS).

The disease is expected to soon be Thailand's number one cause of death.

Thailand's 60 million population is vulnerable mostly because of a widespread, illicit sex industry, which depends on females drawn from cities and villages throughout Thailand, as well as from neighboring Burma, Laos, Cambodia and China, where AIDS rates are also soaring.

Thai health officials, supported by international agencies, boast of progress in spreading advice about safe sex, and slowing Thailand's rapid escalation in new cases.

But prostitutes complain that customers often refuse to wear condoms, or that the rubber's friction makes it too painful for females who must service several men in the same evening.

It is common for Thai males in all walks of life -- from landless peasants to wealthy urban executives -- to enjoy frequent trysts with prostitutes at ubiquitous massage parlors, bars, brothels and clubs.

Such care-free attitudes come to a halt, however, when a person is diagnosed with HIV.

"I got AIDS because I went with prostitutes, so many prostitutes," said Bonchu, thirtysomething, as he prepared to pray at the temple's main shrine.

His body was covered with bright pink circles, as if his dark brown, parchment-dry skin had been repeatedly burned by cigarettes.

"I had fun," he said in an interview.

"I've had AIDS for several years, but I'm strong because I eat well and stay active.

"I was in the army, but I never killed anyone, or did the bad, sinful things. So when they shot at me, they would miss me.

"Even if they aimed here, at my shoulder, the bullet would go here, over my shoulder."

Such magical, superstitious thinking is normal among many Thais. When combined with a popular belief in fate, some people believe they can also disregard warnings about ways to avoid AIDS, because their future is actually being decided by spirits and other supernatural forces.

The misery of AIDS, meanwhile, is ironically increased in the minds of many Thais who believe the disease is brought to them by their personal "karma" -- a spiritual system of rewards and punishments which decrees that a person suffers or enjoys because they deserve it, after doing bad or good deeds in this lifetime, or in past lifetimes.

Alongkot said, "I always tell people, 'Don't visit the prostitutes, don't have sex with a woman who is not your wife.' But most like to visit the prostitutes."

Critics allege the monk is actually more interested in attracting donations and living a relatively luxurious lifestyle instead of providing the best possible health care -- or even maintaining his Buddhist vows of austerity.

Unlike the monastery's sweltering ward where AIDS victims languish, powerful airconditioners were installed in the two main halls where the public can gather -- and donate money.

In comfortable surroundings, visitors are offered a horrific slide show of patients contorted in pain, including gruesome close-ups of faces eaten away by AIDS-related illnesses.

Patients' diseased torsos and genitals flash on a huge screen.

A narrator explains the social and medical implications to a transfixed, mostly male audience.

Infected musicians at the temple, who formed "The HIV Band," meanwhile play for visitors and sponsors.

They also toured universities in Thailand, with Alongkot, while he lectured and received donations.

As each member of the band died from disease, new musicians were approached to join. Monks at the monastery wrote the songs.

Govind Vithal, a nutritionist from India who worked at the monastery until he became disillusioned by the alleged stress on attracting cash, said in an interview, "The diet here is totally murderous.

"Deep fried, spices, lots of canned stuff, pork, meat, oily stuff. Normal people could fall sick from it."

The nutritionist said the monastery scrimps by hiring health givers who are poorly paid personnel with little medical experience.

The treatment available is certainly unusual.

Shortly after Vithal spoke, a nearby patient suddenly suffered an epilepsy-like attack near the main ward.

Alongkot appeared, and repeatedly slapped the victim on the head -- in an attempt to bring him around -- while the man frothed and writhed on the ground.

When the patient's eyes eventually rolled back, and it appeared he might be dying, the startled monk suddenly began talking to him in a soothing tone.

The patient recovered, for the time being.

"I don't like medicine," Alongkot said after slapping the patient.

"If it is not necessary, I don't offer it. If the patient has a good mind, exercises every day, and rests enough, and prays every day, and meditates, they can live for a long time.

"I use the general medicine. They don't eat AZT and other special medicine.

"When medicine came from the foreign countries, and many people asked me to use the medicine for the patients, I told them, 'If the patient likes to eat the medicine, OK, they can buy'."

But the price of imported medicine is too high for most Thais, and the monk refuses to spend donated money to purchase it.

As a result, those people who do end up in the monastery are usually left to the mercy of the temple's staff and basic pharmacy.

The monk also defends his refusal to spend donated cash to pay a normal salary for doctors and nurses.

"I can pay, but I want the nurse who wants to work for the social reasons. If they want the money, they will not look after the patient."

Foreign doctors occasionally volunteer from France, Belgium, Canada and elsewhere, staying about six months at a time.

"The patients are also my staff," Alongkot added.

"Most of my workers are my patients," he said, gesturing to the temple's construction projects and other facilities.

"Some patients come one time a month, or one time a week.

Alongkot said, "My biggest expense is construction, second is the medicine, and third is burning their bodies."

Website, more Asia news by Richard S. Ehrlich plus the non-fiction book of interviews, documentation and investigative journalism, titled: "Hello My Big Big Honey!" Love Letters to Bangkok Bar Girls and Their Revealing Interviews

at: http://www.oocities.org/asia_correspondent