Reflections of Death Buddhist Hospices & HIV/AIDS

HIV/AIDS Prevention & Care

Thai Temples and AIDS by John Williams

Wat Hua Rin at Tung Satoke, near Chiang Mai, has an unusual feature for a Buddhist temple – a small museum. You walk past oil lamps, a wood-fired kitchen with blackened pots, models of old-style houses and a fishing trap. A giant old television set guards the entrance.

The creation of Abbot Dhannawat, an energy-filled man of 40, the museum’s purpose is to make children and teenagers aware of how people here lived not long ago.

In a broader sense, the museum symbolizes his drive to unite people of all ages and situations -to develop awareness of and compassion for others, and precisely to defeat the AIDS that once ravaged, and still menaces, this rural community.

At a time of rapid social change, he sees young people in danger of losing contact with their traditions. Even more importantly, he sees the risk of a widening generation gap that signals long-term danger.

Older people also need reminding that times have changed. This is especially so today, he believes, as older people are caring for AIDS-orphaned grandchildren. “The changes have been too much for many older people; they are at a standstill,” Abbot Dhannawat says. “They must be helped to understand that in schools today their grand-children learn life skills, how to analyze and how to speak their minds.”

Some years ago, people wouldn’t walk past the house of someone who might be HIV-infected in case they got sick themselves. Abbot Dhannawat helped defeat that, visiting and tending the sick himself. He convinced local donors, unhappy that their new temple hall would host meetings of people with HIV, to change their minds. “He told them that these people are the temple, that they are us,” a local person comments.

“When we started six years ago, “Abbot Dhannawat says, “the problem was on both sides – people who had HIV-AIDS were secretive, while the community would not accept them. Everything was negative, threatening the community’s ability to survive peacefully.

“So we set out to teach people about the importance of solidarity, of helping others – not only in relation to HIV-AIDS, but as a whole. We started groups for women, for children, for young people, for seniors and for people living with HIV. Our first seminar was organized by the Ministry of Religious Affairs.”

Abbot Dhannawat’s anti-AIDS activities are now linked with the Sangha Metta (The Compassionate Society) project run by UNICEF as part of its Thailand country program. Sangha Metta enlists Buddhist monks and nuns, through scripture, in the fight against HIV-AIDS. The Four Noble Truths – suffering, its cause, its cessation and the path leading to its cessation-underpin the program.

The key figure in Sangha Metta is Laurie Maund, 56, an Australian who has lived in Thailand for 32 years – longer, as he likes to say, than most Thais, given this country’s youthful age structure. A Buddhist before he left Australia, Mr. Maund is a former Buddhist monk who studied in India. He is now a professor at the Mahamakut Buddhist University (MBU) in Chiang Mai. From there, he manages Sangha Metta for UNICEF.

Nearly a decade ago, when working part-time as a UNICEF Thai-English conference interpreter, Mr. Maund first learned about AIDS. It was also the time when AIDS was exploding in Thailand; in Chiang Mai alone, 44 per cent of sex workers were HIV infected. Public responses often combined ignorance with hostility towards the infected.

“Thailand then was modernizing rapidly on the western model which emphasizes the individual,” Mr. Maund says. “Buddhism values the non-self, so the collision within society here was severe, especially for the young. We needed more understanding, compassion and community solidarity to deal with the crisis. As these are Buddhist values, and as Buddhist clergy are so widely respected here by all age groups, it seemed natural that the temple should take the lead.”

It began when Mr. Maund set his MBU students a task: learn from physicians about the HIV crisis, think about the foundation that Buddhist scripture might provide in the battle against AIDS, and develop a program for the Buddhist clergy’s involvement within the community. “They did such an excellent job,” Mr. Maund recalls, “that I wrote up a proposal for UNICEF on how the clergy– working with headmen, housewives, everyone– could use the temple as a base to help overcome ignorance and superstition. That’s how Sangha Metta started.”

How is Buddhist doctrine used in teaching the clergy about HIV-AIDS? With the Four Noble Truths, Mr. Maund says, a group of monks or nuns is first asked to consider the spread of suffering-damage that extends far beyond the infected person, to children, family and the broader community, including to the temple, which finds itself dependent upon a more impoverished and dysfunctional parish. These social and economic costs include, for example, higher medical payments; increased school dropout rates and reduced local manpower.

Next, the causes of suffering are analyzed. Here the focus is on the gigantic role ignorance plays in the HIV-AIDS drama, depriving people of the power to help themselves. The clergy learn how HIV is transmitted-and, just as importantly, not transmitted. Speakers include women and men living with HIV, who bring an immediacy to the discussion.

The importance of increased awareness and overcoming ignorance is repeated emphasized. In this context, the Buddha’s own first awareness of suffering, when as a young prince he first left the protected world of his father’s palace, provides an object lesson.

On cessation of suffering, HIV-positive people provide often inspiring examples of what can de done. These are women and men who have overcome opportunistic infections, driving the disease into remission, and who then devote their lives to helping others who are sick. And finally, the paths to the cessation of suffering are discussed-the need to develop appropriate AIDS awareness programs for employers, for women’s groups, for school-children and for the entire community.

The Four Sublime States – Compassion, Loving Kindness, Equanimity and Sympathetic Joy – also underpin the discussions. “Sympathetic Joy is important because it means that you take pleasure in another’s success, that you may sacrifice yourself for the benefit of another – which translates, in modern terms, into helping those with AIDS,” Mr. Maund says.

The course also draws on Buddhist imagery comparing the four growth stages of a lotus to spiritual ripening – and in this case, to awareness of those impacted by HIV-AIDS. Those monks and lay people who remain closed are the lotus stalk in the mud, eaten by fish. As awareness grows, the lotus rises through the water and then breaks the surface. Finally, in the case of those who reach complete awareness about AIDS, the lotus blossoms.

So far the Sangha Metta program has trained 1,500 monks and nuns on AIDS prevention and care within Thailand. Since the first seminar for nuns was held two years ago, they have become increasingly active in work with young women needing help. “As younger and younger kids have sex, resulting partly from increased amphetamine drug use and partly from changed cultural values — reflected, for example, in television – the numbers of girls needing help has grown rapidly,” Mr. Maund says.

This is not the place for an overall review of the AIDS situation in Thailand. But it needs noting that AIDS is on the rise in some places and among certain groups, including pregnant women and children. About 700,000 Thais today live with the virus. UNICEF forecasts that the number of children whose mothers have died of AIDS will rise from 30,000 last year to 430,000 by 2005.

How successful have these temple-centered programs been? These things are always difficult to measure. Certainly much more remains to be done in Thailand, especially outside the northern provinces. More government involvement is urgently needed to develop the program.

Work with school groups is a good test. A recent program at San Kang Pla temple in San Khamphaeng district was typical. It brought together groups from different schools, boys and girls aged 13 to 16. They sat under the shade of teak trees in the temple grounds, receptive and high-spirited.
From a stage with a whiteboard and an image of Buddha in blessing pose, smiling monks expounded on the dangers of multiple sexual partners and of amphetamine use, and on how to resist peer pressure. The teenagers’ answers showed a knowledge of HIV and how it is transmitted far higher than would be found in most other Asian countries.

But that would not be the case everywhere in Thailand. Awareness campaigns, successfully launched by the Anand government, need to be stepped up to combat AIDS fatigue that is evident after so many years locked in battle with the virus

If imitation is a sign of success, then the program is doing well. Outside interest in Thailand’s initiative is spreading. Training programs for Buddhist clergy have been held in China’s Yunnan province and on the Burmese border. Bhutanese monks have visited Thailand, while Laos is getting a program under way. Following a recent visit by its Supreme Patriarchs to Thailand, Cambodia is finalizing a national policy on the Buddhist response to AIDS that soon will be communicated to all temples, a first in the Buddhist world.

Other positive evidence comes from Somya Uthacan, 37, an AIDS widow who herself is HIV infected. This remarkable woman helps organize various groups at Wat Hua Rin that, for example, assist grandparents to care for their orphaned grandchildren and provide small scale jobs for widows and infected women.

“When we first started our group of HIV-positive people here,” she says, ” the numbers increasing very rapidly until we had about 40 members. Some died, of course. We now have 32 members, and that number is stable. We definitely have far fewer new cases these days.”

Abbot Dhannawat and Mr. Maund are old friends. In the afternoon heat we sit together under the fans, watching the simultaneously peaceful and active scene at Wat Hua Rin, the community’s stronghold in the fight against AIDS. Rows of women work on sewing machines. Various community groups meet in shady areas of the grounds. Children play under the frangipane trees. Monks and novices hurry on their duties.

Mr. Maund reveals that he has a small fund from donations to assist the education of needy children in the areas covered by the project. “I can give your temple enough money for 10 children,” he tells Abbot Dhannawat. “I must have 15,” the Abbot counters immediately, and goes away to compile a list. He returns with a list totaling 16 names. Mr. Maund stares at the list, and at the Abbot, who rapidly makes corrections; his new total has 20 names. “This is worse than the night market!” Mr. Maund laughs. But he takes the list.

The Abbot gazes out over the vacant plot of land next door. “I want that land to build a shelter for the sick and for children at risk,” he says. “It only costs 500,000 baht. Please try to get it for me. It would do so much good.”

We talk on. Eventually the Abbot rises, picks up his glass of iced water and ambles off. A group of young novices wait for him on the steps. He hands the empty glass to the nearest boy, and with his other hand slips ice down the back of the boy’s robe.

The boy shrieks. The other novices fall about, giggling. The women look up from their sewing machines, smiling. The centre against AIDS, where a sizeable number of people present are infected, for a moment is alive with laughter.

Mr. Maund and I prepare to return to Chiang Mai. The Abbot calls out a last message – “Don’t forget the money for the land!”

So anyone willing to contribute, please contact Laurie Maund:
Tel/Fax: (66 53) 201 284, Email

John Williams, formerly a senior UNICEF director, is currently a writer based in Bangkok.

Bangkok 10.6.01