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Background:
Northern Thailand is home to over half a
million ethnic minority people, people who have distinct languages and
cultures that often keep them from being fully integrated into the Thai
society in which they live. In 1991, missionary nurse Kim Brown was working
in a hospital in Mae Sariang. She observed that
while the Thai government had done an excellent job of disseminating AIDS
information, it was apparent that the ethnic minorities were not able to
understand the materials that were being presented. There was also a lack of
concern about the disease, typified by one person from an ethnic minority who
said, “AIDS is a Thai disease - I never see a tribal
person in any of the pictures that tell about AIDS. Tribal people cannot get
it.” Because nurse Kim Brown was aware of practices that
would put the ethnic minority group at an increased risk to AIDS, together with
another nurse from Mae Sariang, Amnuaypron
Jirakun, she spearheaded an AIDS education program
specifically for ethnic minorities that would be culturally and
linguistically relevant.
The Thai government recognizes at least nine groups of ethnic minorities (chao khao, literally “mountain people”) in Thailand:
Karen, Hmong, Mien, Lahu,
Lawa, Khamu, Akha, T’in and Lisu.
Since 1991, the Health Project has worked with and produced materials for the
Akha, Hmong, Lawa, Lahu, Lisu,
and two groups within the Karen ethnic minority group, the Pwo Karen and Sgaw Karen.
Currently, there are Ahka, Karen, Lahu, and Lisu health teams at
the Health Project.
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There are several factors that put ethnic minorities at
risk for AIDS:
- Illiteracy can mean
many are not able to understand Thai educational materials on AIDS.
- Decreased farm land
due to increased reforestation means some villages cannot produce enough
rice to feed their families, and families must go to cities to do
construction work, or send daughters to work in the entertainment
industry.
- Drug use and needle
sharing are common practices.
- Extensive body
tattooing and infant ear-piercing are practiced without proper attention
to sterilization.
- "Barefoot
doctors", quacks who visit remote villages giving shots of sugar
water as a cure-all, are popular with the ethnic minority people. Often,
the same needle and syringe are used for each unsuspecting patient.
- As more students from
the minority groups come into the cities for education, they often adopt
more promiscuous sexual practices.
- Within tribal
villages, it is the men who share news and the women frequently have
less understanding of information. Husbands sometimes visit prostitutes
in the city, thereby establishing a means for HIV to be transmitted to
their wives and children, yet the women are ignorant of how AIDS can
affect them.
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