HIV Awareness raising in prisons and communities

With the generous support of donors, and the green light from the prison authorities, Siam-Care staff go to visit several prison every week.
One of these prisons has quite a number of HIV positive prisoners and monthly group meetings are held with them.
These groups are attended by up to 50 women at a time, and various topics are discussed. Last week a nurse from HIV-NAT (HIV-Netherlands-Australia-Thailand) Research Institute came along to give some more in-depth background on HIV medication. 
The morning just flew by as there was so much to discuss, so many questions to be answered and also since this is a kind of social time-out for the prisoners who get the day off work, they enjoy just talking with the staff about the 'out-side world'.
To help with adherence the HIV-NAT nurse had brought some alarm clocks to give out as prizes, but sadly these were not allowed by the prison authorities (too many little pieces that could potentially be dismantled and used for other purposes?)
The extra nutrition and sweets that were brought in were very much welcomed and gladly accepted!

In the afternoon there was time for individual counseling and talks and reports on relatives and children that had been followed up at home during the past month.
Many of the women in prison are from a very poor background and their children will not be able to visit them as it would cost too much for transportation.  Also a day’s leave would have to be taken, which for school going kids or working relatives is not always possible. Therefore they rely on getting news from home by letter or from reports from the Siam-Care team. 

Some women only learn about being HIV positive when they are inside and are hungry for information for their own health care and that of their children at home.

Another very encouraging story of the prison work undertaken comes from Siam-Care's links with other NGOs worldwide. Recently a sick man finished his long prison term in Thailand, and was due to go to his home country. After almost 20 years here he had lost contact with his relatives in his home country and because his health was so poorly we were very worried how he would do once back home. Through networking with others in this particular African country the man was received at the airport in his home country, given a place to stay for the first couple of days and he was helped to find his relatives once again. He is now reunited with his family and his health has improved dramatically, which is no surprise. 

There is a lot of loneliness, hopelessness and desperation behind prison walls.  Being able to go in and take some news of loved ones, give a human touch, or personal attention, and generally just be a breath of fresh air can make a difference between someone willing to go on, or giving up. Thank you for helping Siam-Care care for the many behind the walls!

I was a bit anxious about visiting a prison.  I had never been in one before.  I was told they would take my passport, that I couldn’t take anything in with me and that the gates would be securely locked behind me.

When one pictures a prison for drug users in Thailand one thinks of dank and dirty dungeons, over-crowded, smelling of urine and a sense of threat and aggression hanging over everything.  I couldn’t have been more wrong.  We went through one gate which was locked behind us.  The lady guards politely put our bags in a locker and took our identity papers.  We were then shown into a lovely, flower filled garden in which women in brown and blue prison outfits of a blouse top and a sarong skirt, were busy weeding, washing, ironing and carrying water.  There was a sense of calm activity.  I was introduced to the immaculate lady nurse who showed us to a table and coffee, water and a roll were quickly placed in front of us.

While the nurse went over the health records of some women with HIV who were about to be discharged, and others who had recently been found to be positive, I had a chance to look around me.  We were in a covered area with rows of seats.  There was a medical room close by.  There were large water tanks with an ultra-violet water filter producing drinking water.  The laundry was next door with women busily washing and ironing the uniforms and sheets.

After coffee we went into a large room with chairs around the edge, which was full of women prisoners.  There were about 50 of them.  I later realised they were all those who were HIV +.  The prison does not automatically screen for HIV so that this is only found when the women attend the clinic with some illness.  So some of the women had only found out recently that they were HIV+ even though many of them had been in prison for quite some while.  As this is a prison for drug offenses, I found this a bit strange as drug users are one of the at-risk categories.  However, of course, many of these women are not drug users.  Their offense has been to carry drugs for the agents.  Many poor women get lulled into this activity to raise much-needed extra cash for their families.  They are told they won’t get caught, but it seems the catch rate is quite high.

What really impressed me about the women in that room was how normal they looked.  Their ages ranged from, I would guess, mid 20s to 60s, although the majority looked in the 30-40 age range.  They looked healthy, none looked as if they were about to die of AIDS, and they smiled and laughed and interacted with each other.  The Siam-Care staff were obviously known and liked by the ladies and the especially like having a token male there – probably the only one they see on the monthly visit.  The SC staff started with a game, where a blind-folded lady had to get directed up the room, feel and object and then draw it.  This raised lots of laughs and giggles.

There was then a roll playing activity in which one women played a person with a problem and four played the part of various counselling friends.  The group had to decide which was the best advice and attitude to give to someone with a problem.  This was followed by splitting into groups and having a discussion and a question and answer session.  The three groups were: one with three ladies who had just heard that they were HIV+, another larger group for those who had recently found out and were given advice on how to look after themselves and the third group was for long term HIV women.  I sat with the middle group while Peaw explained the way the ladies could keep healthy in spite of the virus.

Gradually the ladies left to go to their various duties.  Many worked in the prison factory, others had more clinical jobs.  At one point I went to watch the clinic – here the nurse examined those inmates with medical complaints.  I noticed that the women had to kneel before the nurse in a markedly subservient manner.  I found this rather demeaning for them.  Our group had interacted much more freely, even joining the women on the floor for the group discussion.

Our visit finished with a nice lunch of Thai soup, rice, noodles and prawns.  I asked if the inmates got this and I was told, No. 

As we left the prison, the inmates were queuing up for their lunch in a huge dining area with long tables and benches.  I realised we had met a tiny proportion of the prisoners and that there were large areas we hadn’t seen, so I have no idea of the conditions of the cells or the other work areas.  However, the major impact for me was that women who were prisoners, drug users or traffickers and who were HIV+ all looked like any other woman you would pass in the street – pleasant faces, smiles, chatter.  It made me realise you can never take people at face value, but also, we should never judge people by their circumstances.