I had come to Northern Thailand to work on an AIDS information project. It was one way of seeing the country.
AIDS ON TOUR, the sign on the back of the truck read (in English). It is parked outside the temple walls on the edge of the village. Beyond the temple ricefields fan out, meeting the distant hills in a fringe of bamboo. Behind us a narrow road winds back through the village, shaded with huge leafy old trees and with more recently planted teak saplings. In the middle distance we can see clusters of red roofs, the suburban housing estates that are replacing the villages.
By the temple small children are crowding around a pen containing three goats and three sheep. Next to the pen, a monket on a lead is hanging off a tree. These animals are the stars of tonight's show, the "Aids circus'. Led by ringmaster Nitat they will go through their simple tricks - jumping barriers, walking across a plank bridge, unlatching a gate with their teeth (a trick the goat took a year to learn). The AIDS content in in the commentary and the painted slogans which adorn the barriers, the plank bridge, and all the props;
CONDOMS PREVENT AIDS
BE FAITHFUL TO YOUR WIFE AND FAMILY
AVOID DRUGS
The sun sets in a blaze of pink and yellow. Hawkers set up handcarts selling barbecued meatballs and sweet pork dumplings. Villagers are arriving in large numbers - young children, secondary school pupils still in their uniforms, young mothers, older women and men. Young single men are conspicuously absent. It is harvest time, and they may bee too tired after a long day in the fields. They may be still at work doing 'O' - overtime shifts at the local factories. Or perhaps they have left the village to find work in Bangcok. There aren't many young single women, either.
The crowd sits patiently through several badly deteriorated videos on the theme of AIDS, and the show finally begins. As the animals go though their tricks Nitat does his AIDS education spiel. "This goat," he declaims, pointing at a large and handsome spotted creature, "Is called HIV. HIV is the virus that causes AIDS. The HIV Virus is not easy to catch, brothers and sisters, not easy at all. " Nitat makes a grab for HIV, who eludes him with practiced ease. "HIV will now do a lap of the stage. There are three ways HIV is transmitted, friends: perhaps someone in the audience can tell me the three ways?"
Yes, someone can. This is not surprising. Prevention education in Thailand has been extremely efficient. Every schoolchild can tell you the three ways HIV is transmitted. Every village headman can tell you - the chances are that he's been to at least three government training sessions on the topic. The youths can tell you because the president of the local youth group is almost certainly a volunteer with the Nonformal Education Program, where students are marked on their participation in a community AIDS education scheme. Armed with a pack of AIDS information cards and a notebook in which to record their activities, NFE students go round the village seeking friends, neighbours or family members with a spare moment so they can run through the "facts" on HIV/AIDS.
Between the six government departments which currently include AIDS in their area of responsibility the facts have been well covered. Too well covered. Some "facts' would have been better left out. If Nitat had asked, for example, the same schoolgirl who told him the three ways that AIDS is transmitted could have told him that oral thrush, chronic diarrhea and terrible skin diseases are the signs of third-stage AIDS.
From my work in Sydney I knew that the terms first, second and third stage AIDS are no longer used in Aids work because experience has shown their enormous potential for misunderstanding. We found the hard way that anybody who's learnt these 'facts' feels quite confident in diagnosing that this woman doesn't have oral thrush and thus can't have AIDS, or that this man with an allergic rash must be third stage and has only a few months to live. In Thailand, too, the results of these misunderstandings are beginning to emerge, and AIDS organisations are starting the switch to "symptomatic" and "non-symptomatic".
HIV (the spotted goat) is finally persuaded to walk up its ladder and over a narrow plank. He pauses before descending.
"Looking around, ladies and gentlemen," Nitat says softly, "To see if anyone in the crowd here is HIV positive... But, as you know, you can't tell from the outside." The goat pauses on the top step. "It could be any one of us here, right?" The audience shifts uneasily. AIDS has hit this village hard. Many families here have members who have died recently, or are sick. Many others are positive.
Nitat's show has changed quite a bit in the few weeks since I first saw it, up in the hills with the Hmong hill tribes. Then, his message was purely prevention; AIDS is a fatal disease, there is no cure but it is preventable. He still does prevention,. of course, and one of the comic highlights of the show is his putting-a-condom-on-a-banana shtick, but now his message is that people with HIV can live a long time if they look after themselves and are given moral support. "AIDS causes great loss, brothers and sisters, and it is preventable." This tour has been a revalation for him, too; for the first time he is pitching his message at an audience that includes people who are HIV-positive.
Here and in Australia, prevention educators tend to assume that their audience is 100% HIV negative. Our messages can create a gulf between "us", the uninfected, and "them", the infected. This both isolates people with HIV and works against prevention goals. When people with positive tests are seen as 'the other', as different and strange,audiences are at pains not to identify with them, and can't perceive the risk behaviours they have in common with them.
A middle-aged man steps into the ring looking rather uncertain. Nitat introduces him. "Tonight we have a very special guest, bothers and sisters, mums and dads. A very special guest, a man who is courageous enough to come and talk to you tonight about how he feels about being HIV positive. A big hand for Mr. Chai!"
Chai's own health is still good, but his wife died of AIDS a short while ago leaving him to look after <name>, their two-year-old daughter, who is just now becoming symptomatic. To set the scene Nitat asks him a few questions about the necessity of support and good friends. "Mr. Chai's a housepainter, so if you need your house done up, call him - right, Mr. Chai?" <Name> is being carried by a Care International volunteer; Nitat walks over with his monkey. "Isn't she cute, ladies and gentlemen? Peekaboo! You can't get HIV from carrying someone with AIDS, right? Or from kissing them or cuddling them!" The little girl points at the monkey. "Doggie!" she says.
"Now, as we all know," Nitat says, "HIV is not transmitted through sharing utensils. Mr. Chai, would you like a drink of water?" The painter takes two sips from the glass and passes it to Nitat, who drinks. "See, HIV is not transmitted by sharing utensils. Who among you, friends, would like to demonstrate this by drinking from this very glass?" He steps towards the audience with the glass in his hand, and the front row of schoolchildren shrinks back as if he's waving a red-hot poker. I begin to wonder what sort of intervention can save Chai from another round of rejection, but a tall dark man steps out of the crowd, drains the glass, and just as rapidly disappears again into the crowd.
"Mr. Chai, do you have a message for the audience?"
"Yes, I do.". Chai's voice grows stronger as he grips the microphone firmly. "I just want to say to all the young blokes out there, use condoms, every time." Nitat leads a round of applause and Chai leaves the stage.
It's half-past eight. The crowd melts away instantly to get home and catch the latest hit TV program, a Chinese historical program about a judge. Chai stays around while his daughter watches the monkey and the sheep and HIV being led away to their pen for the night. Then he kneels, his little girl climbs on his back for a piggyback ride, and he walks away as she sings sleepily to herself. The temple gounds are quiet again, except for the occasional bleats of the sheep having supper after the show (they perform best on an empty stomach, Nitat tells me).