Inter Press Service
HEALTH-THAILAND: Elderly Carry Burden of HIV/AIDS Families
Teena Amrit Gill
January 29, 2001
CHIANG MAI, Thailand, Jan 29 (IPS) - Yaitum Kornkhamnoi wakes up early every morning to make sure that her young grandson has food to eat and gets to school on time. She thought that in her old age, her children would take care of her and she would lead a quiet life in retirement. But then her son and his wife succumbed to HIV/AIDS, and at the age of 68 she found herself the sole caretaker and breadwinner of the family. "In this family my role is to look after my grandson from morning to night. Caring for the child is my responsibility. It is necessary. If I am not here, I do not know who will look after him," she says. As the HIV/AIDS epidemic in Thailand takes a full cycle more than 15 years after HIV was first diagnosed, many of those who had the virus have died. They left behind young children -- and the elderly who now have to take care of them. In the northern Thai province of Chiang Mai alone -- the number of HIV/AIDS cases is higher in the northern part of the country -- more than 4,000 grandparents are estimated to have had to take on this responsibility. While 300,000 people have already died from HIV/AIDS-related illnesses, there are one million more who live with the virus in Thailand, a country among the hardest hit by the pandemic in Asia. Today the number of new HIV cases has tapered off, but the illness has had a devastating impact across the country, as cases of HIV become full-blown AIDS and begin to claim the lives of people. The impact is especially heavy on the elderly, who find themselves taking care of their sick children and surviving grandchildren, but who have largely been ignored by policymakers and organisations working in the area of HIV/AIDS, say AIDS activists. "It is easier to find funds and assistance for children, who are perceived as the country's future. When it comes to the elderly, it is much more difficult," says Ben Svasti of the Women Against Aids Programme, which provides funds for affected families in Sanpatong district in Chiang Mai. "Older people's needs have been ignored just because they are old, even though they have very important roles to play in their families," Svasti adds. Those like Yaitum Kornkhamnoi have been relatively lucky. For two years now, Yaitum has been participating in a project specially targeting people like her. Initiated by the Zonta International Chiang Mai Club and set up by a group of Chiang Mai academics and professionals, the Grandma Project brings together 30 grandparents like Yaitum to meet once a month to discuss their needs and concerns. There are 300 grandparents participating in the project. They are given information about how to take care of family members with HIV, their grandchildren's health and well being, in addition to keeping fit themselves. They are also advised about their rights to free state medical care and social welfare benefits. "We started doing home care training for self for those who had been infected," explains Somboon Suprasert, the main person behind the Grandma Project. "We moved then to family care because we realised that the family had become the main unit of care. We saw that when those who had been infected passed away, the grandma had taken over the role of caregiver. So that's why the Grandma Project began in 1999," she adds. Projects like this however are few and far between. They can only support a fraction of those grandparents who have been affected, including providing financial assistance toward the grandchildren's education, say activists. Likewise, with the state increasingly pulling out of its responsibility toward the sick and those with HIV, there is often very little option but for the surviving family members to take care of the orphaned children themselves. This has become more difficult in recent years. Since Thailand's economic crisis in mid-1997, there no longer money available to buy drugs to treat HIV patients and their opportunistic infections. Likewise, the few state-run orphanages which did have the facilities to take in children from affected families are now encouraging these youngsters to stay in their homes and communities if possible. "It is undoubtedly better for children to remain in their communities, than in the more alien and sanitised environment of an orphanage", says an activist based in Chiang Mai who did not want to be named. "But the homes these children come from are extremely poor. At the very least, their families should be given some assistance and support." It is estimated that up to 70 percent of those with by HIV/AIDS are poor farmers and wage labourers. While minimal support is available for those infected, this is often given only in the last and final stages of the illness. For the elderly now having to take over the responsibility of running homes which have lost their income-earning members, there is no financial assistance available. They have to depend on friends and other relatives to support them. Existing prevention and control programmes often also bypass the elderly, despite the risks older people face in dealing with HIV/AIDS. Their own physical weaknesses, because of age, makes them more vulnerable to getting the virus, while they themselves may engage in unsafe sexual practices, despite general perceptions that they are not sexually active, concluded participants at a recent meeting organised here by two NGOs, Help Age International and the AidsNet Foundation. What has however changed for the better over the last four to five years is social attitudes toward HIV/AIDS. There is less stigmatisation of families affected by HIV/AIDS, and growing acceptance and understanding by those in the community. But for people like Yaitum, the economic situation remains the most pressing problem. "The situation changed totally after my son died. There was no longer any money coming in. My son used to provide for our family. I have other children, but they live far away," she says. "Everything changed after this boy died. The most difficult was the financial situation," explains Yaitum. "I had to feed my grandson and send him to school. But I am not able to work because I am just too weak." (END/IPS/ap-pr-he/tag/js/01).