Wat Phra Baht Nam Phu - Compassion and the dangers of stigma

In this photo are the ashes of Thai people who died of AIDS. Each bag is a person. Each bag was sent or left by a family.

This alone, is an enormous statement about the stigma against HIV and AIDS. Where are the loved ones of all of these people?

This powerful display was found at Wat Phra Baht Nam Phu, a Buddhist temple in Lopburi province that provides hospice care to AIDS patients.

That was its original mission in the 90’s, before anti-retrovrial therapy came to Thailand. Now, it still provides support to patients suffering and dying of AIDS, but the situation has altered. ARV is available and free of charge through the Universal Coverage - so many patients are leading full lives with HIV. But the stigma remains.

Many of the residents of the Wat find they cannot return home.

The Wat provides them with employment and a community, but it is not the real world, and as our tour guide explained, many long to go back to it.

The patients we interacted with were eager for company, shy, happy, sad, sleepy, young, old....in short, human. These are humans who find that they no longer have a place in society due to a health condition.

For me, this visit was deeply moving and reminded me of an important motivation for my career in healthcare: compassion. What is more basic and important than simply extending a hand of acceptance & caring to our fellow humans?

We might ask ourselves how anyone could treat people the way these people are being treated?

The memory of the time when HIV was a death sentence has faded in the memory of the United States to some degree, and with that, some of the stigma of an HIV/AIDS diagnosis. ARV therapy too, has allowed HIV patients to live regular lives, making them harder to discriminate from the general population, perhaps sweeping some of the still extant stigma under the rug.

But, if the overt discrimination against HIV patients has passed, there are other conditions in which I think the United States could reflect on their compassion, or lack thereof. I can draw parallels to our national rhetoric on substance abuse. There is no denying the deadly nature of this condition, particularly with opiates. Yet, resources for treatment and continuity of care for these patients are scarce and inconsistent. Drug users are isolated and scorned.

I will take a lesson from the generosity of the monks at Phra Baht Nam Phu and the endurance and humanity of their patients to carry with me.

Thanks for reading,
A.J.