International Federation of Red Cross and Red Crescent Societies - 12 November 2002
Sushila Kukathas in Laos

The achingly thin, grey-faced father now watching over his children bears little resemblance to the man in the photo. Ravaged by the HIV virus, he has been transformed him into shadow of his former self. And now, he says, he wants everyone to know.

"Just a few days ago I told my in-laws that I'm HIV positive," said Poom Mah. "My wife was against this for a long time, but I want my status out in the open."

Laos is one of the countries in the Asia-Pacific region that will benefit from an agreement on combating HIV/AIDS signed on 12 November by the International Federation and the Organisation of Petroleum Exporting Countries (OPEC) Fund for International Development.

Projects will focus on care and support for people living with HIV/AIDS, prevention and challenging stigma and discrimination - a key reason for the spread of the disease. Poom Mah's quiet village of Huey Que sits on the upper reaches of the mighty Mekong in northern Laos. He was once the well-respected director of Paktha district's Forestry department. Now, illness keeps him at home and his days are spent minding the children.

In the early days of his career, Poom Mah thought nothing of travelling to neighbouring Thailand for regular 'visits' with sex workers. About a year before his marriage, he decided to put an stop to these trips. Contented, with a young family and promotion to the head of the government branch where he worked, news of his disease came as a massive blow.

Poom Mah said frequent headaches, stomach aches and the appearance of skin lesions signaled something was drastically wrong. "My health deteriorated. And it didn't help that the government kept posting me to different places for work," he said.

A check up at Vien Kheng hospital across the border revealed about his condition. Still, Poom Mah suspected it might be HIV/AIDS. "I wanted to know and contacted my brother in Vientiane. He arranged for a blood check and three weeks later I found out I was positive."

News of a peer education programme run in his village by the Bokeo branch of the Lao Red Cross prompted Poom Mah to contact Anouxy Bounthaleuxay, the project's HIV/AIDS officer. During their very first meeting, Poom Mah offered to be a volunteer for the local HIV/AIDS programme. He believes people need to be better informed about the dangers of HIV and would like to play a part by sharing his story with them.

Further downriver in the village of Phonetong, 30-year old Tongwan Konta inspects the herb garden that he hopes might one day spell a difference to his health. "These herbs are from Chiang Rai, used by HIV-positive people in Thailand to improve their health. Let's see if they help me," he said.

After the death of his first wife, when Tongwan was diagnosed HIV positive, he noticed some of his close cousins no longer visited him. Some, particularly those new to the village, have ostracized him. "It's up to people what they think, but I'm open about my disease. Of course, I take precautions like using a mosquito net," he said.

Good friends continue to treat him well, but Tongwan maintains he sees a difference in how he is viewed. "Sometimes, when we drink they joke about my disease and tell me not to work so hard," he said. "I'm not sure if they really think badly of me or not." Tongwan believes these remarks may be and indication of fear - of a disease even close friends cannot really understand.

Official HIV infection rates are relatively low in Laos, but the remote nature of many rural areas mean that many of these figures are the result of guesswork. Its proximity to several countries with high rates of infection mean that the number of people living with HIV is rising rapidly. The remoteness of many communities and the diversity of languages mean that health education is often a considerable challenge.

In three years with the local Red Cross branch, Anouxy believes he has seen changes, particularly in the attitudes of young people towards HIV/AIDS.

"Students in (the provincial capital) Xuey Xai now talk openly about sex and HIV/AIDS with their friends," he said. "Our local radio station, Radio Zone, helps by airing segments on topics like HIV and sexually-transmitted diseases three times a week . It reaches about 10,000 people."

Anouxy added that his job had made him a familiar face in the three districts where he works - well known even to police manning checkpoints along the Mekong. Even the occasional request for condoms no longer surprises him.

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