Richard S. Ehrlich: Aids & Sex In Thailand

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.

"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."

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.geocities.com/glossograph/

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