BBC News - Wednesday, 30 October, 2002
Alice Donald, BBC East Asia Today

China, Thailand, Burma, Cambodia and Vietnam have all felt the full force of the Aids epidemic.

Yet so far, Laos itself has largely escaped the disease.

United Nations data says the number of people in Laos living with HIV at the end of 2001 was about 1,500 or 0.05% of the population.

The HIV rate among women working in the nascent sex industry in Laos was about 1%, much lower than equivalent figures in neighbouring countries.

So why has Laos been so successful at keeping the epidemic at bay?

Safely cut off

One factor is the isolation of the country in recent decades.

Laos has not seen the kind of large scale migration which has caused much social dislocation in other parts of East Asia.

Laos also has virtually no recorded use of intravenous drugs - a key factor in transmitting HIV elsewhere.

The Lao Government has won much praise for recognising the threat of HIV-Aids early on, and for acting swiftly to educate its population.

Imaginative education

The Lao authorities, supported by international agencies, have used imaginative means to get their message to even the remotest villages, from mobile puppet shows to elephants draped with condom adverts.

During the World Cup in June 2002, condom advertisements were flashed on the television every few minutes to reach the mobile male population who are considered at most risk of spreading HIV.

But there is growing concern that, as Laos opens up to the outside world, its record as one of Asia's Aids success stories could be at risk.

Laos is building roads to connect itself to the rest of the region.

Major all-weather routes are under construction linking Kunming in southern China to the northern Thai city of Chiang Rai.

Also planned is an East-West economic corridor linking Thailand to Vietnam via Laos.

Unwanted imports?

And soon it will be possible, for the first time, to drive the length of the country from north to south on a single highway known as Route 13.

It is all part of the Lao Government's efforts to sell itself as "land-linked" rather than land-locked. The aim is to attract tourism and investment.

But this is not all the roads could bring in.

"What these roads will carry are drugs, girls and viruses," says David Feingold, one of the HIV-Aids co-ordinators for the cultural section of Unesco in Bangkok.

He says the expected influx of construction workers from southern China and Thailand, along with prostitution and intravenous drug use, could overwhelm a country which is ill-prepared to cope with such dislocation.

"Laos is a country of minorities," he adds. "Many of these minorities have been relatively isolated for centuries.

"Now you have road building crews coming in, they're without women, and they are able to entice local women because they have good economic resources. People are not prepared to deal with the threat that that poses.

"This is not necessarily an argument to say we should keep people in some sort of pristine nature reserves. But it is saying that if you build roads, you have to be careful not only of the environmental degradation that roads can cause but also the human degradation," he says.

The international lending agencies who are funding the projects have agreed to provide HIV-Aids education to the migrant workers who build the roads and the truck drivers who will use them.

But many fear their efforts are too little, too late.

"Organisations like the Asian Development Bank, like the World Bank that finance these large infrastructure projects have social impact studies," says David Feingold. "But these often get shoved in a drawer and ignored."

The leading Aids campaigner in Laos is Dr Chansy Phimphachanh, who heads the National Council for Control of Aids.

She has done much to ensure that the international aid given to Laos to combat Aids has been spent wisely, no mean feat in a political culture where corruption is endemic.

Increasing awareness

Dr Chansy's approach is energetic and decidedly low-tech.

She thinks nothing of producing a bunch of bananas to demonstrate to a group of young Lao men how they should put on a condom.

These days, she's a worried woman.

"We really have to prepare our communities to be HIV resistant," she says. "We have to prepare them to raise their awareness so they can protect them from HIV-Aids."

But she insists that for Laos, remaining isolated is not an option.

"For the development of the country, we mustn't be selfish. For the wealth of the country, we have to open ourselves up. But at the same, we don't blame anybody. We have to really teach our people to understand everything."

021030
BB021022

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