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By Phaisythong Chandara (Laos), Sam Rith (Cambodia),
Van Anh (Vietnam), Chheang Bopha (Cambodia) and Panyasith Thammavongsa (Laos)

PONG HAI VILLAGE, Chiang Mai – A 23-year-old hill-tribe woman in this remote northern village married her husband despite knowing he had HIV and would die soon. When asked why she would do that, the woman said, “I love him very much and I’d like to die with him.”

Tassanee Srimongkol, the northern project director of Planned Parenthood Association of Thailand, tells that story to show how difficult it is to educate the ethnic minorities in northern Thailand.

HIV is ravaging many hill tribes, already claiming 10 of 297 residents in the Lahu village of Pong Hai alone, leaving orphans to be cared for by their grandparents.

Nineteen have tested HIV-positive here, giving Pong Hai an infection rate of 6.5 percent, more than twice the rate in Cambodia (2.6 percent), which has the highest rate in Asia. Even more alarming, 40 percent of those who volunteer for blood tests come back HIV-positive. The epidemic here has been fueled by lack of education, grinding poverty and risky, cultural habits such as premarital sex without protection and multiple sex partners for men after marriage.

Northern Thailand is home to about 15 hill tribes, many of which migrated here from China. When HIV first arrived here about a decade ago, many highlanders thought people were dying because they had done something to make the spirits or ghosts angry.

When Tassannee’s team first asked the nearby Hmong to use condoms, for example, they compared them to umbrellas that would protect only the head from rain, “while the other parts of the body get wet.”

Even with some education, Tassannee said the situation remains serious in villages like Pong Hai because ethnic minorities don’t get enough help from the government, and Lahu men aren’t interested in learning how to protect themselves from the virus.

She explains that men have the “power” in the community, and women can’t force them to use condoms or be faithful.

“Especially at the New Year’s festival there is a good opportunity to spread the virus among the hill tribes because most of them come from different places and join in eating and drinking together, and having sex without protection,” she said.

Among the Lahu, it’s also customary for teen-age girls to begin having sex as soon as they have their first menstrual period.

Nithal Rattanithat, a Planned Parenthood volunteer in Pong Hai, said 80 percent of those infected are female.

Poverty, he said, forces villagers, especially women, to leave their homes to find jobs, often selling sex at karaoke clubs or bars in Chiang Mai and other provinces.

The topic is taboo, however. Lahu instead say their daughters left home to work at a “restaurant.”

Men working construction also bring back HIV from prostitutes. During a recent visit to the village center, the burden on the elderly was immediately apparent.

Na Si Jo, 48, cradling her grandson to sleep, said she had lost two daughters to AIDS. “They used to be the bread winners in my family,” she said.

Na Kha, 65, said she had lost two sons and two daughters and now is taking care of their three children.

“I cannot work because I am getting old,” the nearly toothless woman said. “I cook for them and take care of them as much as I can.”

Each orphan receives 500 baht a month from a government fund, but otherwise Na Kha must rely on support from her surviving children.

Nhahar Na, 56, has a similar story. Sitting on a wooden bench with her sleeping grandson on her thigh, she said her oldest daughter died five years ago, leaving the boy. She grows lychees, but said she can’t make much money because of the low price. "I was very shocked when my daughter died of AIDS,” she said. “Anyway, my daughter left her son with me, so I have to try my best to look after him."

There does appear to be a glimmer of hope. Planned Parenthood is working hard to educate young people about HIV and safe sex, and one of the trainers said it is catching on. The elderly also are helping. Na Kha and Na Si Jo are two of many community educators who meet every month and try to persuade young people to use condoms. Na Kha said her message is simple. “If you do not use condoms, you will die.”

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