Child Abandonment and HIV/AIDS in Northern Thailand (Part Two)

Northern Thailand Rice Field, Wikimedia Commons
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Author’s Note: In 1993, during the peak years of the HIV/AIDS epidemic in Thailand, I planned and conducted an independent investigation on child abandonment and HIV/AIDS in northern Thailand, as part of my doctoral program at School of Public Health, University of Hawaii at Manoa, with support from the East-West Center research institute in Honolulu, USA, UNICEF Thailand, and Mahidol University School of Public Health in Bangkok.

The fieldwork incorporated epidemiological and anthropological methods as well as participatory urban and rural appraisal techniques over a nine-month period. I applied computerized data analysis to assess the nature and magnitude of problems within a context of rapid social and economic change, and proposed options for prevention and community based management of abandoned children. The findings were published in a major collaborative study to assist national and regional planning and policy development.


Chiang Mai

Across from Central Shopping Complex, my apartment in Chiang Mai, Thailand’s second largest city, was new and comfortable. The rent was cheap, the building was clean and a public pool was just a short walk away – through choking, dust-filled, traffic snarls.

It also happened to be home to a host of local ‘kept’ women – the ‘minor wives’ (mia noi) of wealthy Thais, their Mercedes and BMWs regularly arriving to pick up and drop off these beautiful women, in some instances with small children – comprising ‘second families.’

My other hangout was a health station on the outskirts of the city where I was hosted by a community health nurse and her son in a peaceful, rural setting, but within a short pickup truck ride to the city. As with many of the peri-urban districts near Chiang Mai, ours had been hit hard with HIV/AIDS and was therefore one of my primary data collection sites.

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“Yao”, a community health nurse at her district health station near Chiang Mai, Thailand

Almost daily, and for months, local funeral processions made their way to the crematorium directly across the road from our health station. The men were dying from AIDS, and tragically, it would only a matter of time before their wives and girlfriends would follow.

In one neighboring sub-district, fully 30% of pregnant women had tested positive for HIV. These women, as so many others like them, had been infected with HIV by their only sex partner – their husband. Widespread unprotected sex in the many commercial sex venues frequented by single and married Thai men, was the principle driver of the epidemic.

In many cases, the husband was already dead – the child as well, and many of these young housewives would be left utterly alone – rejected by neighbors, friends and family, and unable or unwilling to safely confide in anyone except the local health worker or counselor due to the widespread fear and stigma towards people infected with HIV.

Others, particularly the poor who worked in the widespread commercial sex industry would eventually die as well. Having lifted their families out of poverty – a nice house, perhaps a new pickup truck parked out front – but the daughter (or son) was dead.

Conducting field research in northern Thailand where HIV/AIDS was ravaging the countryside.

It was devastating, and I was forever humbled by the tireless dedication of the many fine individuals in the medical, social welfare and counseling professions – including Yao, the most junior of the eight community health nurses assigned to her health station. She was often the only one who would provide home care for people living with HIV and AIDS, and eventually was the only one who would close the eyes of the deceased.

She also quietly supplied the local ‘gay’ temples with condoms, and tried unsuccessfully to convince the local Abbot – a respected figure and HIV-positive – to ‘come out’ to promote better prevention. Buddhist temples have traditionally taken in young boys as novices, often from poor families wanting a better future for the child, including free education, shelter and financial support.  But without proper oversight, sexual abuse has become a reality, both among the older and younger novices as well as between monks and novices.

However, as the epidemic progressed, many Buddhist temples also became important refuges for the HIV-positive homeless – who had been rejected by their families, and hospices for end-of-life care for people living with HIV and AIDS.

Land of Smiles

Back at the apartment in town, my neighbor Bill was seated in the downstairs lounge reading a paperback, his hulking mass squeezed into a lounge chair – waiting, as always for his phone to ring with the next job.

A former coal miner from somewhere in northern England, he now made a living running contraband between various Asian ports. His large, scarred head was covered with sparse patches of brown stubble. He looked up and flashed a cheerful grin through broken teeth.

“Off somewhere?” he asked.

“Headed to the beach for a few days – need a break from this madhouse, dust-ball of a town.” I replied.

“Good idea! I just got back from Japan – I’m set for money now.  But while I was gone, me woman and two of her friends hocked the TV and stole me clothes, me money…  Bloody headache the damned bitch.”

“Why do you put up with her?” I asked.

“Aw, she’s not a bad girl really. A hell of a lot better than the last one – at least here the girls treat a bloke with some decency.  Back in London if I say hi to a girl on the street she’ll tell me to fuck off.”

Orange Crush

My field research in Thailand was winding down, so Yao and I boarded an overnight ‘VIP’ bus in Chiang Mai and headed south to Bangkok, and then to the beach. Out on the open road, the bus charged into the darkness of the night.

The air conditioner was turned too high and the video at the front of the bus was playing so loud it hurt.  When I went forward to ask the driver to turn down the volume, a collective sigh of relief followed among the mostly Thai passengers, as if to say “thank goodness that foreigner made the awkward request.” Thais typically avoid confrontation at all cost.

I tried to catch some sleep in the swerving bus as it hurtled through the night, but the headlights of on-coming traffic flashing by seemed much to close for comfort. Vivid scenes of wrecked buses along the roadside – sheered lengthwise – came to mind. Horrible road accidents were common on Thailand’s two lane highways, and the local orange-colored buses were jokingly known as “orange crush.”

Indeed, it was prudent to sit in the middle so as not to be crunched in the front or the rear, and on the opposite side to the on-coming traffic. I was seated in the middle, but on the wrong side and couldn’t sleep for fear of waking up with an oncoming bus in my face.

TrafficInBangkok Thomas SD Wikimedia
Traffic in Bangkok, Public Domain, Wikipedia Commons

Pulling into Bangkok’s early morning traffic, the day was already heating up into a stifling haze. The city groaned with the sound of vehicles – a gray urban skyline stretched out before us and disappeared into the haze. Then, crammed into a ‘backpacker special’ minibus for another overnight near-death experience at the hands of a reckless driver – miraculously, we arrived safely in the southern town of Surat Thani.

Ko Tao Wikimedia, Roma Neus
Koh Tao in the Gulf of Thailand, Wikipedia Commons CC BY 3.0, by Roma Neus

Stretched out on the smooth salt- and weather-worn deck of a converted fishing boat,  we headed to the islands of Samui, Pha-Ngan, and finally to Tao Island (Koh Tao) and soaked up three lovely days of pleasant, breezy walks through coconut groves and jungle-clad mountains, snorkeling in the clear, silky waters decorated with soft and hard corals, brightly colored fish, giant manta rays, diving on a wreck, and enjoying plenty of fresh seafood. It was wonderfully refreshing to finally unwind a bit, and to get rested and healthy again.

Stay tuned for more stories, coming soon!

You can read more about Jim’s backstory,  here and here.




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