by Richard S. Ehrlich
CHIANG MAI, Thailand -- When a
U.N.-sponsored tour about communities with
AIDS led five doctors from Afghanistan into a
risque Thai massage parlour, the men were
thrilled to learn a few tricks of the trade.
Copyright by Richard S. Ehrlich
AIDS and Sex in Thailand
"Do you know what a breast massage is? The
woman massages you with her breasts," one of
the Afghan doctors later exclaimed during
dinner, drawing peals of laughter from his
Afghan colleagues.
"You must get a fatty massage from a fat
woman," another chuckling Afghan doctor said
during the meal.
The next morning, the second doctor solemnly
stressed he had been "joking" about "the
ladies" and insisted: "I am a responsible doctor
from Afghanistan."
The United Nations Development Program
(UNDP), the Thai government's Department of
Technical and Economic Cooperation, and
Chiang Mai University's Faculty of Nursing had
invited a dozen health officials and social
workers from Afghanistan, East Timor and Sri
Lanka for a Nov. 10-21 training course titled:
Community-based Response on HIV-AIDS.
"The aim is to enable the visitors to return to
their home countries with practical means for
community-based responses to combating the
spread of HIV-AIDS," said UNDP Regional
Communications Officer Cherie Hart.
The foreign doctors and social workers learned
how Thailand eventually slowed its spread of
AIDS, why patients live long and prosper thanks
to new medicines, and the way some Thai
communities ended their "stigma and
discrimination" against sufferers of the Human
Immunodeficiency Virus (HIV) which can cause
Acquired Immunodeficiency Syndrome (AIDS).
The delegates studied methods of HIV
transmission, attended lectures, visited
hospitals, met Thai doctors and patients, and
interacted with AIDS survivors who created
cottage industries to finance their treatment.
They also went to a Buddhist temple where
monks taught local students how to use
condoms.
The UN invited a handful of journalists to travel
with the delegates for three days to see how
Thailand's experience in tackling HIV and AIDS
could benefit less-developed countries
wrecked by warfare.
While the representatives from East Timor and
Sri Lanka appeared fairly sedate during the
tour, the Afghan doctors expressed intense
culture shock -- often surprising the media and
their hosts.
The Afghan doctors usually appeared studious
and serious, asking medical questions in halting
English and making notes.
But while travelling together in a separate
mini-van or eating, the five Afghan men often
regaled each other about social behavior in
Thailand where, unlike Islamic Afghanistan,
women do not wear all-encompassing cloth
burqas.
The five Afghan doctors cited Islam as the
reason why the infection rate was low in their
relatively isolated country compared with
bustling, Buddhist-majority Thailand.
"It is because of the religion, because in
Afghanistan all people are Muslim and Islam
does not accept things like Thailand," Dr. Baz
Mohammad Shirzad, Jalalabad-based deputy
director of Afghanistan's Eastern Region Health
Directorate, said in a taped interview.
"Islam says, 'You have a wife and must be
honest to the wife'. Islam does not accept sex
like Thailand's people," Dr. Shirzad said.
In Chiang Mai, Thailand's second biggest city,
the official schedule included a visit to
"commercial sex workers" while accompanied
by a Thai doctor.
"There was one place and the ladies were
sitting there and they had labels and numbers,"
Dr. Shirzad said.
"The first lady was 'superstar'. The rate was
very expensive. And on another side sat other
ladies. For the second line, the rate was
reasonable. And on another side sat some
other ladies and the rate was cheap," Dr.
Shirzad added.
The Thai doctor "told me that in all of Thailand,
especially in Chiang Mai, the HIV risk is very
high because 40 percent of the [sex workers]
are HIV positive," Dr. Shirzad said.
"In Afghanistan, from 1986 to 2000, we had one
[HIV] patient. He was an Afghan man who came
from a foreign country and got it from sexual
contact. He came to Kabul from Europe. From
2000 to 2002, we had seven patients. Today in
Afghanistan we have 15 patients," Dr. Shirzad
said.
He estimated "about 200" people may be
HIV-infected in Afghanistan, though accurate
figures were impossible to obtain.
His colleagues were also intrigued by the
differences in social behavior in Afghanistan
and Thailand.
"Afghanistan's people, if they know about a
woman having sex with another [man] who is
not her husband, they suggest killing her," said
Dr. Shafiqullah Shahim, the Kabul-based Health
Ministry's national HIV-AIDS control program
officer.
"But in Thailand, it is a simple thing, it is a
common thing. Everywhere sex is possible, in
hotels, in restaurants, everywhere. This is the
main cause, I think" for the estimated 700,000
AIDS cases in Thailand, Dr. Shahim said in a
taped interview.
He praised Thailand's recent ability to decrease
the spread of the virus and embrace stricken
patients.
"Thai patients who are living with HIV-AIDS in
the community, they are participating in all
activities of the community. I think they are
successful."
email: animists *at* yahoo dot com
Richard S. Ehrlich, a freelance journalist who has reported news from Asia for the past 25 years, is co-author of the non-fiction book, "HELLO MY BIG BIG HONEY!" -- Love Letters to Bangkok Bar Girls and Their Revealing Interviews.
His web page is
http://www.oocities.org/asia_correspondent