Work in the North East

This work began in the province of Mukdahan as Siam-Care realised that many of the cases in Bangkok came from this poor area of Thailand. Something had to be done in order to educate those who were likely to migrate to Bangkok about the dangers of aids, to reduce the flow of migrants and also to prepare the communities to accept those from Bangkok who, when terminally ill, wanted to return home. It was in this region that families of those who were ill could often be found, thus it was from these people that support and the future care of the children could be derived. Following much research, it was discovered that there were no organisations working in the region and that the hospitals and Department of Health were open to Siam-Care’s work, so the project began in April 1999.

The province of Mukdahan has a population of around 300,000 and is a very rural area. It borders the Mekong river so there are many migrant workers who come into Thailand from Laos during planting and harvest season. After the season, many of the resident people of Mukdahan must also leave to find work so often only the children and elderly are left at certain times of the year. Due to migrant nature of the area, ‘high risk behaviour’ is very prevalent.

A Home Based Care Project is run in Mukdahan along the same lines as in Bangkok. Since there is a strong sense of community and families are closely knit, it is often more straightforward to involve those around the people who are ill. Also a Child Sponsorship Programme is run. A People With Aids Group (PWA-group) was set up which provides peer-support and advice on jobs. On the local radio there is a weekly half hour programme on issues surrounding Aids and health care; the script and information being provided by Siam-Care workers.

Educational project

Siam-Care runs an aids Educational project in the area high schools. This focuses on training student leaders in each school about aids Awareness, sexuality and responsible life choices. It equips them to teach others and be leaders on their campuses. Through teaching young people about the reality of hiv/aids, much of the fear and prejudice that comes from not knowing the truth about hiv can be eliminated.
It was rapidly realised that children in the province are at risk of becoming school drop-outs by the end of primary school, in order to find work. This meant that they not only miss all the sexual health education that was being given in the secondary schools but they are also part of a high-risk group as they search for work, usually ending up in Bangkok. Siam-Care responded by going into primary schools and giving sexual health classes to children in their final year.

Another aspect of the work in the northeast has been to try to co-operate with the local communities to tackle the migrant problem and to reduce the numbers of people migrating. One such solution was to set up a sewing project in a village. The women can earn money by sewing and have therefore been able to remain in the village. Some men quickly followed suit, and with the support of Siam-Care, they set up a mushroom farm. Siam-Care supported the building of an information centre on health, work and social issues in one of the villages.

The work in the northeast was well accepted by the government and local community, and has now expanded into the neighbouring provinces such as Nakhon Phanom, Amnat Charoeun and Yasothorn.