Condoms and Comedy to the Rescue in Thailand
From USA Today
Dave notes: I have written extensively about the successful condom campaign in
Thailand which should be a model for most of the world. Most HIV in Thailand was
in the "Golden Triangle" - the border area of Thailand, Burma and Laos which has
been called the drug capital of the world in upcountry Thailand. HIV spread via
local brothels, and of course most of all from sharing dirty needles. Studies
have shown very low rates of HIV in the "Entertainment Places" which offer
"special services" which sex tourists go to and are totally legal, while
"prostitution" isn't based on Western moral pressure. But the prostitution laws
are rarely enforced in the local brothel that has been a Thai tradition for
centuries. Only Western moralists decided it was wrong. So they passed long ago
an anti prostitution law and than wisely exempted all the places were tourist
goes (see my Thailand Trip Report). There are also extreme penalties for any
Entertainment Place hiring under aged workers, but it does occur in the local
brothels where is a long held honor for the local peasant girl to work in a
local brothel to help support her family. Often monks praised their work. But
again Western morality insists this is wrong imposing their view on Thai
culture.
Sorry for long into - back to USA TODAY article quotes:
Bangkok - In this sex tourism capital of Southeast Asia, they call him Condom
King. He's Sen Mechai Viravaidya. To many locals he is known respectfully as
Khun Mechai - or must plain Mechai. But to public health authorities, Mechai is
the chain-smoking, wisecracking clown prince of AIDS prevention in Thailand, the
inspirted architect of the 100% condom policy credited with saving 8 million
lives (Dave notes yes even in short term hotels, condoms were at the front
counters and every gal I met had condoms)
He also is the proprietor of a small, non-profit empire involving a restaurant
and resort chain called Condoms & Cabbages — which he would like to export to
the USA and Australia — that mingles family-planning services and gourmet dining
in a tropical courtyard festooned with rainbow-colored condoms in three sizes.
Now, as co-chair of the 15th International AIDS Conference, Mechai is pushing to
re-energize a government AIDS prevention program that for years has been
considered a model for other countries. Thailand was one of a handful of
countries, including Uganda and Senegal, that put the brakes on a potentially
disastrous AIDS epidemic by investing in a massive public education campaign.
The country reduced the annual number of infections from 143,000 in 1991 to
19,000 last year.
Now, many say Thailand's program is mired in complacency, and the country could
face a new wave of AIDS cases. The epidemic, which in Thailand began among
prostitutes and drug abusers, has entered a new phase in which whole new
populations, including adolescents and gay men, are putting themselves at risk.
"I'd call 2003 a year of hibernation," Mechai says. "A new generation has
entered the age of sexual interest without learning much about AIDS. Infection
rates are going up. It's a lesson for everyone."
The meeting of roughly 15,000 researchers from around the world will focus
attention on a range of Thailand's lat est AIDS programs, including a nationwide
effort to prevent mother-to-infant transmission and a $21 million initiative to
supply a government-made trio of anti-retroviral (ARV) AIDS drugs to 50,000
people desperate for treatment by the end of 2004. "The Thai government is
committed to providing ARV to all people who need it through the course of the
epidemic," Prime Minister Thaksin Shinawatra said in his opening address Sunday.
It will also showcase Thailand's approach to prevention. The prime minister
borrowed a page from Mechai's script Sunday when he asserted the importance of
making "condoms easily and readily available to all who need them." During the
AIDS conference, condoms will be handed out at banks, highway toll stations and
airports. "I call it a new kind of airport security," Mechai quips.
A 'wall-to-wall' campaign
Mechai launched the 100% condom campaign in 1991 with the backing of then-Prime
Minister Anand Panyarachun, who appointed Mechai to his Cabinet and put him in
charge of sports, communication and tourism. Mechai, a long-time advocate of
family planning, recognized that Thailand was on the brink of a catastrophic
AIDS epidemic, centered mainly in the country's illegal but thriving sex trade.
He asked Anand for the authority to establish a nationwide prevention program
and set up the command center in the prime minister's office. He lobbied for a
dramatic increase in the AIDS prevention budget, which peaked at $82 million in
1997 with a "wall-to-wall" campaign involving the mass media, the education
establishment and every ministry in government. One centerpiece of the campaign
was a push to require 100% condom use in every commercial sex establishment.
Allan Rosenfield, dean of the Mailman School of Public Health at Columbia
University, who has known Mechai since both worked in family planning in
Thailand in the late '60s, says the Thai program offers a model that could be
used worldwide. He adds that Mechai was so successful at reducing resistance to
condom use that condoms are now known throughout Thailand as the "mechai."
Humor is everywhere in his popular Condoms & Cabbages establishments, along with
festive condom bouquets. "Sorry, we have no mints," a sign at the restaurant
says. "Please take a condom." The gift shop offers "No Glove, No Love" coffee
mugs and "In Rubber We Trust" key chains and T-shirts, the legend backed by a
picture of the U.S. Treasury. Condoms & Cabbages is one of a string of
businesses whose $5 million in annual proceeds Mechai pours into his network of
social, educational and family planning programs — a model for social change
that will be another focus of discussion at the AIDS conference. (Next door to
the Bangkok restaurant is the organization's vasectomy center. Get your tubes
tied and dinner's on the house.)
No humor in the devastation
But Mechai says there's nothing amusing about overburdened families or the
disease he is trying to prevent. "Today's young person is tomorrow's AIDS
patient. We have over 50 million people (worldwide) who are infected or dead.
What are we talking about here?" In Asia, widespread condom use is widely seen
as the best hope of averting an AIDS epidemic that could potentially outstrip
the crisis in Africa. "We live in the most populous region in the world," says
Jordan Tappero, director of the Centers for Disease Control and Prevention's
field office in Bangkok. "If we hit a prevalence of 1% in the general
population, the number of infections will surpass the totals we've seen in
Africa. "One percent of a billion people is a lot of people. In India and China
alone, that's over 20 million infections."
In parts of Indonesia, infection rates have risen to 17% over the last two
years. In some areas of Vietnam, the newest of the 15 countries in President
Bush's Emergency Plan for AIDS Relief, as many as 20% of drug users are infected
and serving as a sexual gateway to the rest of the population. "We have a real
window of opportunity, particularly in Asia. If we don't take it now, it will
shut forever," UNAIDS deputy director Kathleen Cravero said last week when her
organization released its 2004 Report on the Global AIDS Epidemic.
More challenges ahead
In Thailand, the shifting AIDS picture is documented in a new report by the
United Nations Development Programme. AIDS is spreading widely among men who
have sex with men, many of whom see AIDS as a disease of prostitutes and often
don't realize they're at risk. A recent Thai Ministry of Public Health-CDC study
found that the rate of HIV infection among sexually active Thai gay men is 17% —
20 times higher than in the general population. Some of the men don't consider
themselves gay. They engage in homosexual sex for money or as part of racy sex
shows featured in some nightspots here.
Thailand also is home to an unusual group known as the Kathoeys (pronounced CAT-oys),
the "third sex," a group of effeminate men or men who have had sex-change
operations who are accepted in Thai culture because they're believed to be doing
Karmic penance for misdeeds in earlier lives.
Olivier Le Touze, deputy country representative for PSI, a British and U.S.
funded non-profit organization that supplies condoms to Mechai, the Thai
military and to high-risk groups, says one of the challenges he sees is finding
ways to make condoms "cool" for adolescents accustomed to thinking of AIDS only
as a disease of sex workers and drug addicts. No one knows how to make condoms
cool like Khun Mechai, the Condom King. "I'm trying to get Nike to make some
condoms," he says. "Up-market, youth-oriented — they've been saving soles long
enough."
Dave notes how the condom program has proven itself so successful, vs the Bush
of agenda of only funding abstinence only programs worldwide which has been
shown to be a failure even in the U.S., much less in countries where sex is not
such a big moral sin, but just accepted as normal and natural desire for all.