A Day with Siam Care: Part 1

Today I was blessed with the opportunity to accompany the Khao Lak Siam Care team on a string of home visits to local families affected by HIV.

Siam Care is a Thai organization with the mission of, "Taking a biblical approach to caring for and supporting disadvantaged and HIV-affected families, individuals, and communities to improve their quality of life." As you can learn from the history section of their excellent website, siamcare.org , Siam Care was developed in response to the dual need for addressing the human casualties of the 1990s Thai economic recession and sudden explosion of HIV. After developing their first center in Bangkok, Siam Care has since expanded into Mukdahan and Phang Nga (Khao Lak), while also increasing their scope of projects beyond those serving HIV/AIDS afflicted individuals to include homecare, prison outreach, women's craft groups, workshops and training programs. 

Nay, Em, and Ying picked me up in the morning and we drove north to Takuapa. A wonderful group of women, they're the staff of the Khao Lak center and I was quite fortunate to have their smiling and gracious company throughout the day. During the short car ride, we introduced ourselves and spoke about the first family we were to visit.

Visiting the families is an important part of the homecare and HIV/AIDS ministries. Not only do the visits provide a social encounter and emotional support for the often ostracized HIV+ individuals, it allows Siam Care to assess their physical, social, emotional, mental, financial, and health needs. As I would learn and experience firsthand throughout the day, Siam Care is an incredible source of support for these individuals. They'll assist with anything from clothing to counseling, and should a health emergency arise, they'll drive to the hospital to provide support and help coordinate their care. I looked forward to seeing this all come to pass in person as we drove to the first stop. 

The pick-up truck pulled up to the curb, and I was excited and somewhat anxious for what awaited me. I dedicated an intensive one month course at Whitworth to the study of HIV/AIDS and retained a very strong interest in it afterward. I was about to face the impact of the disease firsthand, and it was fitting that what awaited me in the house's entryway, partially hidden by the frame of the door, was a 2-year old little girl. 

The little girl, disinclined to part with her pink Disney princess backpack, is not HIV+ but both her mother and father are. The mother was out of the house, but we were able to speak at length with the father about the aforementioned aspects of his life. He seemed to be a very gentle man, and had his eyes trained downwards towards the floor during a majority of the conversation. His 2-year old and 4-year old daughters would periodically interject, alternating between requesting assistance with a snack or testing the hypothesis that his sitting form constituted a jungle gym. Each time he'd gently stroke their hair back, pat their cheek, or make another kind gesture. Currently estranged from his wife, the conversation mostly followed the resulting emotional struggle he was having. 

Nay very kindly translated for me as we spoke with him. She asked me what questions I might have and I inquired about the regimen of medications he was taking. Frequently referred to as a 'drug cocktail,' the medication for HIV is a toxic blend itself and can be both hard on the body and a difficult regimen to follow. My very strong interest in medicine came to the surface as I asked about his treatment and medical history. 

Each day he takes several pills at 7am and 7pm. An Anti-RetroViral (ARV) pill is supplemented by an anti-biotic to  protect against infection and vitamin B. Having lived with HIV for the last 6 years, his principal complications have been a Tuberculosis infection and a struggle with a cytomegalovirus. He has regular access to a physician to monitor his treatment and is able to keep a close eye on his CD4 count through regular testing. Fortunately, his current count is at an only slightly depressed level of 400 (good is 500-1500, bad is anything below 400).

I was quite impressed by the way Thailand is caring for its citizens living with the virus. Once learning of their positive status, individuals can register for monthly government support (500 baht, or, ~$15) and free ARV medication. After extensive research and development when the virus first surfaced, pharmaceutical corporations in India effectively stole the medications that were developed and began producing their own at greatly discounted prices. Thailand then inherited the ability to produce ARVs and is certainly putting that capacity to good use for the betterment of its society, allowing continued access to the absolutely vital treatment. 

In regards to the incidence of HIV in Thailand, 98% of the cases here are derived from sexually-based transmission, and it appears that most families only learn of their positive status upon becoming pregnant and having a blood test performed on the mother. The fetus then has a significant risk of contracting HIV, but quite wonderfully in this instance, neither of the daughters are HIV+. 

Concerning the little girls, I was quite glad to hear that the 4-year old is a recent graduate of the adjacent Step Ahead Child Development Center and the 2-year old is just 3 days into her time there. It was a wonderful and unexpected -though not surprising- affirmation to the extent Step Ahead is also assisting the disadvantaged members of the community. 

After a long, cathartic conversation, our friend bid us farewell and we left the house in search of some lunch before a visit to the next family. Stopping at a nice, air-conditioned restaurant, I elected to try the chicken spaghetti, which I was surprised to learn was tangy and spicy. It was quite tasty, though, and the boiled noodles were a welcome respite from the fried flat-thin noodles and rice to which I've become so accustomed. 

The spicy spaghetti would just serve as the intermission following part 1 of my day with Siam Care, and I had no idea that even more profound experiences awaited me in the hours ahead.