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Jun 2003 – May 2006

E-mail: cscrayon@loxinfo.co.th

CSC in Rayong is a social centre dedicated to prevention of HIV infections and to the care of HIV/AIDS patients and people and orphans living with HIV/AIDS who are poor, abandoned or rejected. CSC provides prevention training for students and young factory workers, community members and civil servants. It operates a palliative care unit for HIV/AIDS patients and accommodates PLWHA. It also provides a dormitory and classes for AIDS and affected orphans.

Past Experience and Achievements in AIDS work

1. Quality of Life Development through HIV/AIDS Prevention

1. Training on Human Rights and HIV/AIDS for leaders of 25 local associations of PLWHA in 7 eastern provinces, 2 people each.
2. Training on Healthcare for leaders of 25 local associations
3. Training on Counselling for leaders of 25 local associations
4. Support to 25 Local Associations of PLWHA
5. Meeting of the Committee of Eastern Network
6. A Platform of the Eastern Network for 25 local associations with 5 members each
7. Meeting with its partners
8. Training on Knowledge on HIV/AIDS and Human Rights for 15 communities, 15 people from each community, in 7 eastern provinces.
9. Training on Communication Skill for community members in 15 communities, 10 people from each community, in 7 eastern provinces.
10. Dissemination of Information on HIV/AIDS through Media

1. Palliative Care of Adults

   CSC has accommodation for fifteen PLWHA and a palliative care unit with a capacity of 8 beds for the helpless terminal patients. CSC can accommodate about 60 PLWHA. PLWHA who stay at the Centre take part in the prevention training by sharing their experience to trainees or visitors that come to CSC. Those who have stayed at CSC for two weeks will be sent back to their homes and communities after receiving counselling and they are willing to go back.

2. Home for Orphaned Children with AIDS

CSC childcare centre now cares for 30 children. They are all from very poor families; some were rejected and/or abandoned, and eight of these children have died. They are provided with literacy classes.

1. Weekly Meetings
2. Monthly In-service Training
3. Semi-Annual Evaluation

Quality of Life Development through HIV/AIDS Network 2,311,000

Palliative Care of Adults 3,277,200

Education for AIDS Orphans and Affected Children 4,055,740

Monitoring and Staff Development 439,800

= US$

Project Title : Quality of Life Development and Network Building on HIV/AIDS

in Rayong through Holistic Approach

1. Background of the Project Holder: Camillian Social Centre Rayong

   Camillian Social Centre (CSC) was officially opened on January 29, 1996. It is located in Rayong because this province has the highest rate of infection in the eastern region and ranks the third in the country. The work on HIV/AIDS by CSC Rayong began in 1992 in Bangkok to respond to this new alarming situation. Later in November 1993, "Soon Bantaojai" Centre was set up to work with HIV/AIDS people. It was located in Soi Rawadee in Nondaburi Province, north of Bangkok. Due to protests of the local communities in 1996, the centre was closed down. A new location in Rayong was chosen in April 1996 to set up a centre for the work with people living with HIV/AIDS (PLWHA).

   CSC in Rayong is a social centre dedicated to prevention of HIV infections and to the care of HIV/AIDS patients in their terminal stage and people and orphans living with HIV/AIDS. These people are poor, abandoned or rejected. CSC provides training sessions for students and young factory workers, community members and civil servants on HIV/AIDS infections and how to prevent themselves from this fatal disease. It operates a palliative care unit for HIV/AIDS patients who are helpless and in their terminal stage of life. The centre accommodates PLWHA, both men and women, who can still help themselves. It also provides a dormitory and classes for orphans whose parents died of AIDS and children that have been affected by HIV/AIDS.

   The Camillian Social Centre Rayong is part of St. Camillus Foundation. The Foundation works, through its various social centres, in healthcare at Banpong, Ratchaburi, the care of lepers in Prachinburi, the poor elderly in Sampran and Chantaburi, in healthcare with the rural poor in Kanchanaburi and Suanpung in Ratchaburi, the poor street people in Thanyaburi, the ethnic children in Chiangrai, and people living with HIV/AIDS in Rayong. All of them are poor and marginalised people, young and old. The St. Camillus Foundation of Thailand was registered as a legal entity in 1973. Its purpose is to implement more effective charitable and welfare activities for the sick, poor and the marginalised in Thai society.

2. Past Experience and Achievements in AIDS work

   On Prevention

   In the past years, CSC instituted programs and activities on assistance and care of AIDS patients. CSC realised that there was an urgent need for HIV/AIDS prevention. Therefore, it has developed an AIDS prevention project with its target groups through a participatory approach. In this prevention program, it has been trying to raise awareness of the values of human sexuality, sexual inequality related to HIV/AIDS and moral values. It also promoted the sharing of experiences and ideas and to develop the capacity to analyse one’s own risk behaviours. However, due to delicacy and complexity of behaviours of the issue, it needs profound understanding and positive and creative attitudes that are relevant to Thai way of life to foster change towards proper behaviours. Therefore, peer educators and action plan in particular environment with follow-up of peer educators or leaders in their extension are essential to be carried on, so that these prevention activities will go on although the project is completed.

   Given the above commitment in mind, CSC Rayong has worked with the public and private sectors to launch campaigns promoting proper knowledge and understanding on HIV/AIDS by organising and presenting 6-8 monthly sessions of HIV/AIDS prevention training programs to various groups around the area.

   In the public sector, CSC collaborated with the provincial public health office of Rayong and the office of labour welfare and protection of Rayong in giving training on prevention, care and counselling to workers and employees in business enterprises and factories. It provided resource persons to Mabtapud Municipality to give training to housewives, leaders and committee members of local communities. It gave training to personnel of Mabtapud Municipality, police of Huay Pong and Mabtapud Sub-District Police Stations, Ban Chang, Ban Khai, Pluakdaeng and Muang District Stations.

   In the private sector, CSC gave prevention training to over 150 organisations and 3,500 trainees. These were workers and employees in business enterprises (food shops, companies and factories), educational institutions and local communities in Rayong and neighbouring provinces.

   CSC has encouraged and supported 8 factories, 9 schools and 3 local communities to develop their own action plans for the ongoing prevention of HIV/AIDS.

   CSC adopts a participatory approach in its work and always supports all stakeholders in planning, implementation and follow-up of the prevention training and action plan. In the past, it held planning meetings with representatives of 6 companies located in different industrial estates in Rayong. It also held planning meeting with leaders of 6 local communities in Muang District of Rayong.

   CSC publishes a prevention newsletter in a simple format to disseminate and update information on the HIV/AIDS situation at national and provincial level, government policies. Contents of the newsletter include prevention of HIV/AIDS, articles on human dignity and sexuality, quality of life. This newsletter aims at raising the awareness of prevention and promoting positive attitudes in PLWHA. It publishes over 500 copies of each issue. These are distributed to leaders of its target groups and interested people, as well as all related state agencies.

   Every year at the end of November or beginning of December, CSC organises a celebration on World AIDS Day. Normally, it falls on December 1, but for the convenience of our audience who are students and workers, the celebration takes place on a weekday closest to December 1, which has been decided by all stakeholders. CSC promotes active participation of the audience in all the activities. On that day, there will be questions and answers on AIDS, a drawing contest, a speech contest, and a debate. The theme for these activities will be taken from the UNAIDS theme of the current World AIDS Day, which will promote prevention and living together with HIV/AIDS patients. Target groups are workers from business enterprises, students from educational institutions, community members, people in general as well as PLWHA. Each year, over 500 people take part in this celebration, which takes place at CSC.

   CSC always collaborates with various organisations, both public and private, to support them to initiate prevention activities in their organisations and to build network with them in this effort. In the past, it established and strengthened a network of enterprises, educational institutions and local communities in the concerted action to prevent HIV/AIDS prevention.

   On Network of People Living with HIV/AIDS

   The eastern network of people living with HIV/AIDS was set up in 1999. Initially, there were only 9 local associations of PLWHA. Through the diligence of the field workers and the leaders of the network, at present there are 28 local associations with a total membership of over 1,400 people in all the seven provinces of the eastern region. The network develops its own work and defines its own tasks and roles. This has helped to further empower and strengthen the network. It has played an active role in the Thai PLWHA network. This is a national network of PLWHA that has been advocating and proposing guidelines and direction to the government to push Ministry of Public Health to develop a better system of care of PLWHA. For example, it pushed for the Government Pharmaceutical Organisation to manufacture more anti-retroviral medicines. It pushed Department of Communicable Disease Control to help PLWHA all across the country to have greater access to medical treatment with anti-retroviral medicine. It also pushed Ministry of Public Health to include medical treatment of opportunistic infections in PLWHA in its 30 Baht medical scheme. In addition, it has played active part in demanding for termination of patents on medicines, like the case of DDI. Locally, it helped organise buyers’ club to buy cheaper anti-retroviral medicines with ongoing and systematic monitoring and counselling so that PLWHA would have greater access to anti-retroviral medicines.

   The network has organised training activities to provide knowledge and develop capacity and skill of leaders to strengthen local associations of PLWHA. These training topics include knowledge on HIV/AIDS, healthcare, counselling, home visits, and group management. It also organised platforms for the sharing and exchanging of ideas and experiences with PLWHA, HIV/AIDS NGOs, and public health agencies. It has helped develop network organisations through personnel development of its committee members, personnel and leaders, so that they can effectively strengthen and empower local associations to work as a network with common aims. In the past years, it has given greater co-operation to its partners by taking part in their activities, sharing of information and mutual aid.

   On care of PLWHA, people with HIV and orphans and affected children

   CSC has been giving accommodation, assistance, counselling and rehabilitation to poor, rejected and abandoned PLWHA. In the seven years up to the 31^st of December 2002, CSC has provided care for 753 persons living with HIV/AIDS or that have been directly affected by HIV/AIDS. The age distribution of these people is as follows:

   >10 years	11 – 20 years	21 – 30 years	31 – 40 years	< 41 years
   57	44	303	271	78
   8%	6%	40%	36%	10%

   There were 455 male PLWHA and 298 female PLWHA. Of this total, 401 have died, 265 have gone back to live with their families after rehabilitation and 87 are presently still alive and live at CSC. As seen in the graph above, the majority of the persons being infected are in their prime working years.

    

3. Current Situation on AIDS in Thailand and in Rayong

   The Public Health Ministry of Thailand reports that the rate of HIV infection is very critical especially among factory workers, injecting drug users, homosexual people, foreign workers, freelance professionals and pregnant women. It is estimated that each year over 50,000 Thai people will die because of symptoms related to AIDS. Over 90% of deaths because of AIDS will be people at the working age of 20-44 years old, who are the breadwinners of families.

   Thailand has been affected by the HIV/AIDS pandemic since the end of 1984. Relevant figures show that over 1 million Thai people are infected with HIV. Recently in the 8^th national seminar on AIDS held in 2001, the Department of Communicable Disease Control reported that in 2000 there were 984,000 people who were HIV positive. They were 29,000 new infections and 55,000 symptomatic patients. Over 289,000 AIDS patients have died. Among them, 90% were 20-44 years old, or the major working population. When we compare new infections in 2000 with those in 1991 (143,000 cases/year), we can see a decrease of 20%. One of the contributing factors to this decrease is the measure taken on prevention of new infection in risk groups under surveillance.

   Although the situation of AIDS infection has calmed down a bit, it is still critical since the infection has now spread to the public, especial students and members of the young working population. These young people still have risk behaviours. It is found that the infection rate in people at the age of 15-24 has gone up 60%.

   Situation in Eastern Region

   The eastern region of Thailand has the highest rate of infection. Several factors contribute to this, among them: (a) a high number of persons that exhibit risk behaviour, (b) the province of Rayong has been chosen for the promotion of industrial estates. There is a large army of migrant workers from other regions that come to work in the factories. The rapid economic growth spawns the establishment of entertainment places to respond to needs of the people. Most of factory workers are in the younger age brackets and do not have clear marital status. They spend most of their time in their work and the pursuit of pleasure and generally lack information on other aspects of life.

   The local communities still have a negative attitude toward PLWHA. They think that the PLWHA should be separated from their communities and put in a special place designated to them. Therefore, the PLWHA dare not disclose their status to their families and society. The rate of new infections in the eastern region is very high, ranking on the top of the chart of the country.

   Situation in Rayong

   Rayong is a province situated in the eastern region of Thailand. It has been chosen as a hub for industrial development in the region. Over the last decade, it has seen rapid industrial and economic growth. There are several industrial estates and a large army of workers, mainly young people coming from other provinces and foreigners. This province has a big fishing industry and many fruit plantations. It also has many tourist attractions, such as famous beaches and resort islands.

   AIDS and STD Control Desk in Rayong Provincial Office of Public Health reports that since 1994 there are over 1,000 cases of new AIDS patients per year. The highest number recorded was 1,172 new cases in 1998. As of 31 August 2002, the cumulative number of people living with HIV/AIDS is 8,514 cases. They are 6,174 PLWHA and 2,340 symptomatic patients. There have been 1,869 deaths, which is 22% of the group. The highest risk factor is sexual relations at 89.3%. 54.6% of PLWHA are married people. The ratio between men and women is 2.7:1. The group with the highest rate of sickness is those who are 25-29 years old. Among them, 65.1% are in the working population, followed by farmers at 6.9%, traders at 4.2%, housewives at 3.7%, fishery workers at 3.1% and civil servants at 2.4%. There is also significant spread from injecting drug users to other population groups in communities, families, housewives and infants.

   Current Situation on AIDS Related Problems

   Each year, there will be new infections and about 55,000 people will gradually get opportunistic infections due to their low immune system. The national AIDS prevention and solution plan for 2003-2006 requests co-operation from all state agencies, private sector, religious organisations and PLWHA network to help prevent and relieve the suffering of Thai people from HIV/AIDS. It is not only a national campaign launched in the country, but also asks technical assistance and financial support from foreign agencies. Many parties take active parts in reducing the number of new infections, but the crisis of high infection rates still exists.

   In the Thai eastern region in particular, the factors accelerating spread of HIV/AIDS include its location of large and small-scale industries, migrant workers and foreign workers. In addition, it is also a world famous tourist attraction, drawing large number of tourists. This situation brings about diversity in the society and a superficial lifestyle. Factual and updated information on HIV/AIDS problems are not disseminated to every corner of society. People are seriously not concerned to take care of their health. These problems or weaknesses should be tackled at all levels. All parties concerned, be they state agencies, AIDS NGOs, community organisations and PLWHA at the national, regional and local levels, especially PLWHA are significant agents in helping to a certain degree to reduce new infections.

   State agencies and AIDS NGOs have helped launched campaign on AIDS prevention, but the result is not satisfactory. The eastern network of PLWHA also takes part in helping reduce new infections. It tries to support organisation of local associations of PLWHAs to promote proper understanding are to raise awareness on responsibility toward society by not spreading the virus. It also disseminates information on healthcare, physically, mentally and spiritually, and how to live together in community and society. This is one way to help raise awareness on familial fidelity, generosity and care on happy and safe living.

   Economic and social problems

   Economic and social development in the past was focused on development of material, technology, communication, and infrastructures leading to urbanisation. This is reflected in the growth and modernity of the country. Yet, there is no human development strategy in Thai society. As a result, Thai society clearly sees a widening gap between the rich and the poor. Human beings remain lacking development in their spiritual, physical and social dimensions, resulting in a weakening foundation of Thai society. This situation favours the infection and spread of HIV/AIDS, and also drug addiction and crimes. The solution is to turn back to human development. Clear development goal should be defined in empowerment of society with people of all genders, ages, professions and status as the centre of this development. It should also aim at raising the awareness and co-responsibility in society, which will be the driving force in preventing or reducing problems.

   Attitudes

   We have to admit that people living with HIV/AIDS are feeling rejected by their local communities. However, this situation is showing a certain degree of improvement. Some communities now accept and live with PLWHA. However, this does not imply that all communities have adopted this attitude. The eastern network realises this situation and tries to promote proper understanding gradually with smaller groups, be it families and colleagues. This method has seen some successes as well as failures depending on several factors. The most important factor is the thinking, which is a personal right. The stigma of HIV/AIDS, its frightful characteristics and the discrimination has been around for a long time without any clear reason or explanation. Therefore, campaign in this regard encounters a lot of obstacles. It takes time to change negative attitudes in the minds of each individual.

   Impacts of AIDS

   From the experience, PLWHAs suffer many indignities, such as the violation of their human rights by state officials and community members. They do not get proper health service and are discriminated against. They are dismissed from their jobs although they are still strong enough to do the work. They are discriminated against in ordination as Buddhist monks or are obliged to have blood checks when applying for jobs. These violations yield adverse effects on their spirit. Because PLWHAs are affected by stress and confused, their health deteriorates sooner. Their families and relatives are also discriminated against by not being allowed to participate in community and social activities.

   Human rights are the matter that most people in Thailand do not know or understand well. Sometimes, a violation of another’s rights is carried out without being aware that it is a violation, or the violated do not even realise that they have basic rights provided by law. Therefore, adverse impacts brought about by HIV/AIDS are not addressed and the law is not enforced to truly protect the rights.

   Lack of participation of community in care and prevention

   Generally, the situation of problems created by AIDS is not tackled or improved because of lack of systematic participation of PLWHAs, community and public sector. Each party does its work alone. The Public sector gives priority to its work while the private sector also does its own work. Local associations also do their own work. Therefore, prevention outputs, community-based care and campaigns to disseminate knowledge and understanding on living together are not satisfactory.

   Access to OI and ARV Medicines

   In Thailand, PLWHA die sooner than they should because of the lack of access to medical care. There is also lack of information on healthcare and different opportunistic infection. The numbers that have access to Anti Retroviral (ARV) medicines is very small. ARV medicines are expensive and medical doctors do not want to give medical treatment to PLWHA, although opportunistic infections can be cured and ARV medicines can stop the multiplication of the virus. Therefore, PLWHA fall sick very fast.

   PLWHA lack bargaining power

   PLWHA do not take part in community activities as they should due to their own limitations. They dare not disclose themselves for fear of discrimination and rejection and the adverse impact on their family and current jobs. Therefore, the proposition and direction to address the problems and reduce impacts cannot be done easily because the PLWHA face the problems directly. Society in general still believes that the PLWHA do not have any capabilities. Therefore, their human dignity is not respected, hence lack of bargaining power in society.

   Local associations are not strong

   In working with local associations of PLWHA in the eastern region the factors that do not empower these local associations. There are health problems in leaders and members. The rate of turnover is very high due to weak health and death. PLWHAs dare not disclose themselves and joining an association is limited for fear that others will know that they are HIV positive. In addition, public health personnel do not co-operate. If they take part in the association, they will try to dominate the PLWHA thinking. They have authority and do have not trust in the local PLWHA associations of. Most members of local associations are from grassroots level or are marginalised persons. There is little chance that well educated and well-off people will join local PLWHA associations as members.

4. General Objectives

   To help alleviate the situation people living with HIV/AIDS (PLWHA) and those affected by HIV/AIDS the Camillian Social Centre of Rayong (CSC) adopted the following objectives:

   To promote HIV/AIDS prevention through training, action plans and network building.

   To protect and advocate for the rights of persons living with HIV/AIDS (PLWHA)

   To provide community support, and build up a network of PLWHA

   To co-operate with state agencies and NGOs in the eastern region of Thailand.

   To help reduce the pain of the poor and abandoned PLWHA

   To prove palliative care to the needy PLWHA in the eastern region

   To help HIV/AIDS orphans to get medical care and education, and

   To support children affected by HIV/AIDS.

5. Approach

   It was observed over several years that most of the effort expended on AIDS by other agencies was in specialised areas. Three years ago, CSC initiated an integrated program on AIDS work: prevention, PLWHA networking, palliative care and care of orphans whose parents have died of AIDS or children that are HIV positive and children that have been affected by the virus. The current holistic approach covers all aspects and dimensions of HIV/AIDS in its overall program including the physical, mental, spiritual, political, social, cultural and economic dimensions of HIV/AIDS. This approach is very important because CSC is working with "People", not a "Sickness". Because of this, it gives equal priority to prevention, care, counselling, and network building. It invites the participation of all stakeholders to get involved in human rights issues, public policies and advocacy. It also enlists the co-operation of adults and children to treat PLWHA with compassion and allow them to live in human dignity.

    

6. Sustainability

   CSC is aware that the work on HIV/AIDS must be sustainable so that solutions to this problem are effective, efficient and long lasting. It is essential that all stakeholders be actively and sincerely involved in the work on HIV/AIDS. CSC will develop an action plan by the stakeholders to promote and facilitate sustainability. This action plan will include networking among them, training and formation of peer educators and peer groups, and PLWHA leaders. It means organising local associations of PLWHA, increasing the knowledge of its human resources, and regularly monitor and evaluate the programs.

    

7. Gender Role

   Statistics show that women are most affected from HIV/AIDS infection and its impacts. Young mothers get infected and pass the virus to their children. Thanks to the mother-to-child transmission prevention program, this rate of infection has fallen sharply. Yet, they are still the main victims. Therefore, empowering women is essential and indispensable. We need to help them properly know and understand HIV/AIDS, its infection rate and the risk factors. They need to know what they can do to avoid the infection and help the infected to cope with their condition. CSC supports women as one of the main actors and participants in its prevention program, networking and organisation, palliative care, counselling and care of HIV/AIDS orphans and affected children. Women’s role is not to replace the role of men, but both women and men will have their own roles, which complement one another. They share common tasks and responsibilities.

    

8. Target Groups

 

1. Quality of Life Development through HIV/AIDS Prevention

Given the current situation on the spread of HIV/AIDS and its effect on the young working population, CSC Rayong realises that, it is very necessary and urgent to promote and extend prevention activities. The core prevention activities are (a) a learning process on HIV/AIDS prevention, (b) the implementation of an action plan on prevention by young people (workers, employees, students) and (c) the organisation of young people in a network to disseminate the information on HIV/AIDS. A concerted effort on HIV/AIDS prevention requires the co-operation and collaboration of the business enterprises, schools, local communities and concerned public agencies. It is also necessary to co-operate with other private organisations working on HIV/AIDS and the PLWHA network and local associations.

Goal

Development Objectives

• Increase the knowledge of individuals, families and communities on how to prevent the spread of HIV/AIDS
• Increase the participation of individuals, families and communities in promoting the prevention of HIV/AIDS infections.
• Strengthen and empower the society to prevent and tackle AIDS problems
• Curtail the impact of AIDS on the economy and health of the Thai population

The following strategies will be implemented to achieve the above goal:

Communication

Generally, in Thailand, open conversations on sex are unacceptable and impolite as they imply improper desire for sex. In their thinking, improper desire may yield unintentional adverse effects like unwanted pregnancies, sexually transmitted diseases (STD), or HIV infections. However, over 80% of HIV/AIDS infections are caused by sexual relationships. Therefore, the knowledge and understanding of sexuality in relation to HIV/AIDS are essential elements of the prevention training. This training stresses the important issues and links them to other training topics, such as anatomy and explanation on the means of infection in men and women. Topics include the authentic values of men and women, the benefits of marital fidelity and the proper use of a condom. This should raise the awareness of the participants and instil proper attitudes on self-prevention in sexual relations.

Peer to peer education is a proven and effective method of communication that gets the message to the intended receiver. Trainees are made to understand and realise the importance of self-prevention from HIV infection. There must always be a motivator to foster change towards proper and safe behaviour in relationships. The best motivator is a friend or peer as they can communicate on the same level with trust. The opportunities for conversation are more numerous. Our prevention training stresses this method as an effective and concrete method of communication. It must also include methods and ongoing activity with regular monitoring for long-term result.

Specific Objectives

 

1. Develop the knowledge and proper understanding on HIV/AIDS, as well as raising the awareness on the importance of prevention of HIV infection in oneself and others.
2. Raise the awareness and promote positive attitudes to accept, assist and care for people living with HIV at home and in community.
3. Support the target groups or leaders to properly and correctly extend the knowledge and understanding to others, and regularly implement activities and ongoing campaigns on the prevention of HIV infection.
4. Co-ordinate and co-operate with related state agencies and the private sector to provide assistance and welfare and the basic necessities for a living to PLWHA and give training on prevention of HIV infection.
5. There will be open, sincere and clear conversation on matters related to human sexuality.

1. Sensibilisation

   The prevention team will approach decision-makers of business enterprises, school administrators and formal leaders of local communities to the prevalence of HIV/AIDS and its current situation at national, regional and provincial levels, its seriousness, population groups with highest infection rates and risk behaviours. The team will also discuss possible immediate impacts on business enterprises, schools and local communities. In particular, business enterprises will be heavily affected if their key people are infected, which is very possible. The prevention team will finally discuss with these decision-makers that prevention of these impacts and infection is possible and can be done by their business enterprises, schools and communities. The team will encourage and support them to initiate action plan on HIV/AIDS prevention in their immediate environment, which will ultimately and directly benefit them if their people are aware of this serious problem of AIDS and avoid risk behaviours.

   CSC chooses to approach decision-makers in business enterprises in Rayong and neighbouring provinces because the highest rate of HIV infection is found in the young working population and so prevention in them is very crucial, and because of the highest HIV/AIDS prevalence in the province and the eastern region.

   CSC also chooses to approach school administrators because the rate of new infections is rising at an alarming rate in secondary and vocational students. Therefore, awareness raising and dissemination of knowledge on HIV/AIDS are very urgent.

   Local communities play important roles in the context of AIDS prevention, since they are the immediate settings of the people who are easily exposed to risk environment. Their role in prevention and dissemination of knowledge is very essential and indispensable.

   The prevention team will also present a prevention-training program offered by CSC, as well as inviting them to select 25 members of their organisations (workers, employees, executive personnel, students and community members) for prevention training.

   In this way, all parties will participate in the prevention program by initiating action plans and attending prevention training. Their participation and action plans will also be helpful for monitoring and evaluation as well as learning problems and obstacles arising in the course of implementation of their action plans which need to be urgently addressed.

2. Prevention Training

   CSC Rayong will organise one day program of prevention training with starting 9.00 a.m. The training will take place at CSC Rayong as the base for training of its target group. CSC will take about 25 trainees (workers, teenage students and community members) per group, which is a manageable size and it is more effective for sharing and learning.

   The training will provide knowledge and understanding on HIV/AIDS. The training adopts a participatory and holistic approach. For example, it will organise workshops so that all trainees can take part in discussion and sharing of opinions on an equal basis. To facilitate participatory approach, CSC will adopt card methods and propose topics for discussion. These topics will be related to knowledge that the training would like to present to the trainees, and will be proposed by raising questions. This will be helpful for the trainees to think. In addition, CSC will apply a role-play as part of this learning process, which will help the trainees to see realities and can do analysis on HIV/AIDS to get a clearer picture.

   At the end of the training, CSC Rayong will award a certificate to each trainee.

3. Peer Educators and Peer Groups

   CSC will develop peer educators from among the target groups who are trainees in a one-day training at CSC. It will support those trainees who have shown capability and willingness, as well as having good human relationship, trainer and leadership qualities to take up the role of peer educators. It will train and support these peer educators through a method of peer support group, organising local groups or associations, which will regularly carry out activities on AIDS prevention.

   It will also encourage and support each group of trainees to develop action plans on HIV/AIDS. Their action plans should basically aim at initiating prevention campaigns and activities among their fellow workers or students or community members. It should include the dissemination of knowledge and awareness raising to others as well as being leaders in campaigns on HIV/AIDS prevention. Through these peer educators and groups and action plan, HIV/AIDS prevention will be extended further to their immediate friends and family members.

4. Action plan

   To be sustainable in HIV/AIDS prevention, CSC will foster and facilitate peer groups to implement common prevention activities through action plans. These action plans will be signs of commitment of target groups and instruments for monitoring and follow-up. CSC will support these action plans by providing the necessary knowledge, updated information and latest news on HIV/AIDS and risk behaviours to business enterprises, educational institutions and local communities to implement their action plans more effectively and efficiently. This action plan is also an important instrument for monitoring and follow-up, in which CSC will learn problems and needs of peer groups in business enterprises, schools and local communities, which are helpful for it to provide necessary support. The action plan is also an instrument to ensure sustainability of HIV/AIDS prevention at grassroots level, which is also measurable and verifiable.

5. Networking

1. Contact executive personnel of business enterprises, educational institutions and leaders of local communities concerning training program.
2. Co-ordinate with concerned parties to recruit leaders or volunteers to attend prevention training (4 times a month). In this conversation, it will discuss issues to raise their awareness and help them to realise that HIV/AIDS is an immediate problem that need urgent solution and should not be overlooked. This conversation will take about 1-2 hours. The subject matters will include the follow:

1. Promote co-operation with various organisations in the campaign to prevent and solve HIV/AIDS problems.
2. Support co-operation in action plan and concerted action with partner organisations to effectively implement activities on prevention and solution of HIV/AIDS problems.

1. Support organisation of the target groups as peer groups/association.
2. Build closer relationship by visiting leaders and associations to hold meetings, consultation and planning on prevention and solution of HIV/AIDS problems.
3. Support state agencies, private sector and local communities to take active part in implementation of activities to raise awareness and promote participation and good attitudes towards people living with HIV/AIDS patients, such as activity on World AIDS Day and community platforms.

 

1. Contact leaders and association in business enterprises, educational institutions, sub-district administration organisations, health stations, community leaders, community learning centre and Mabtapud Municipality to mutually plan the work on HIV/AIDS.
2. Co-ordinate with members to implement activities in local groups and associations, such as designing format for assessment of risk behaviours, organise water exchange game, exposure and conversation with PLWHA to readjust attitudes.
3. Mutually implement activities with respective organisations, such as mobilisation of community members to address HIV/AIDS problems, preparation of young people before marriage, organisation of platform to discuss HIV/AIDS problems, celebration of World AIDS Day.
4. Organise a platform for panel discussion on HIV/AIDS twice a year for peer educators and leaders in HIV/AIDS work, each session for 36 people.
5. Disseminate information and news on HIV/AIDS and provide resource persons.
6. Publish quarterly newsletter, 600 copies per issue, and distribute to leaders, target groups and interested people.

 

1. Leaders and associations in business enterprises
2. Leaders and associations in educational institutions
3. Community leaders
4. State agencies

CSC is a source of living knowledge garnered through a process of actual work at CSC Rayong, such as palliative care. It is an essential source for those who want to learn real life and practise the care of patients with HIV/AIDS, guidelines on activities for the PLWHA and counselling. This will include the physical work and the spiritual aspect, as well as caring for affected orphans and the eastern network of people living with HIV/AIDS. This centre of learning provides a library of life in which volunteers and interested people in the country and from abroad can come on study trips, exposures and short-term internships. The target groups will be introduced to PLWHA so that they will have a chance to talk and share experience and counselling in prevention in order to build capacity and empower families and communities.

1. Develop a centre of learning/internship for volunteers and interested people in the country and from abroad.
2. The target group comes to be in touch PLWHA to have direct experience, conversation and mutual encouragement.
3. Provide counselling service on the prevention of HIV infection, as well as giving information to workers in business enterprises, students and other interested people on distribution centres of condoms.
4. Seek co-operation for resource persons, documents and other information for training on knowledge in care and prevention of HIV infections.

 

1. Contact and co-ordinate with volunteers and people who are interested to have exposure or study trips or internships at CSC Rayong.
2. Encourage visits and study trips for the development of knowledge and proper understanding on HIV/AIDS so as to develop positive attitude of accepting mutual living with PLWHA, about 30 people per group, 8 groups per month.
3. Provide counselling on physical and mental care, prevention of infection and spread of HIV/AIDS.
4. Distribute condoms to interested people.
5. Provide exposure to HIV/AIDS patients for personal conversation and mutual encouragement.

1. Medial doctors, nurses, nursing students, health personnel in Thailand and from abroad.
2. Volunteers
3. PLWHA

Main Target Groups

• Workers in business enterprises in industrial estates in Rayong and neighbouring provinces, including state agencies and private organisations, altogether 400 people per year, 1,200 people for 3 years.
• Secondary and vocational students both in formal and non-formal education in Rayong and neighbouring provinces, altogether 500 people per year, 1,500 people for three years.
• Community members in 6 local communities in Rayong, altogether 300 people per year, 900 people for 3 years.

 

1. Individuals, families and local communities take part in prevention and solution of AIDS problems.
2. Individuals, families and local communities become more aware of HIV/AIDS situation and change their risk behaviours and adopt positive attitudes.
3. Individuals, families and local communities have a better quality of life.

1. Development of the Eastern Network of People Living with HIV/AIDS

In the majority of the areas, people living with HIV/AIDS (PLWHA) suffer discrimination, as well as being stigmatised and marginalised. To own up to being a PLWHA is to leave yourself open to losing your job, being ostracised from your family and being banished from the village. It’s for these reasons that CSC Rayong fully supports that PLWHA get organised for mutual aid and to protect their rights as Thai citizens. As human beings, they deserve to be treated with human dignity. The eastern network of PLWHA is completely managed and controlled by PLWHA with an assembly of all the members as the supreme body and a committee as its executive arm. Committee members are representatives of the local associations of PLWHA from each of the seven eastern provinces. As of today, the network has 28 local associations and a total membership of 1,400 members. The network co-ordinators and local leaders set up the local associations.

The seven eastern provinces of Thailand form the field area, in particular: Rayong, Chantaburi, Trad, Cholburi, Chachoengsao, Prachinburi and Srakaew.

1. 28 local associations of PLWHA that are members of the eastern network with 1,400 members
2. Partner organisations in and outside eastern region, altogether 50 organisations.
   1. Public Sector: AIDS Division, Regional Office for Disease Control, provincial offices of public health, local hospitals and local administration organisations.
   2. Private sector: HIV/AIDS NGOs, community organisations and civil society.

Strategy 1: Empower local associations and the network in building capacity of people living with HIV/AIDS.

1. Dream team/network committee will visit field areas to talk and gather information from local associations.
2. Take part in activities of local associations.
3. Make telephone calls to talk with leaders and concerned people, such as advisors or associations.
4. Support to Local Associations of PLWHA

1. Meeting of the Committee of Eastern Network

1. A Platform of the Eastern Network

1. There will be exchange of ideas and information between the network and its partners.
2. There will be a common direction and goals for the work in the following years.
3. There will be a plan on mutual aid between the network and its partners.
4. There will be good relationship among members of the network.

1. Training on Communication Skill for Community Leaders

1. Take part in activities on HIV/AIDS in local communities (action plan).
2. Make telephone calls to leaders and concerned people.
3. Dissemination of Information on HIV/AIDS through Media

CSC childcare centre now cares for 30 children. They are all from very poor families; some were rejected and/or abandoned when they were in the final stages of AIDS and eight of these children have died. The children are now all given medicine, especially anti-retroviral medicines to prolong their life. The anti-retroviral medicine is a gift of life. The children are quite weak and it is difficult for them to go to regular schools. They are provided with literacy classes so that when they grow up they will be able to read and write. These classes will also enable them to get a formal educational qualification that can be used to find jobs in the future.

Objectives

1. Volunteers

   Volunteers regularly offer their time to CSC. Volunteers may be local people who will come to the child care centre of CSC regularly, one or two, or more days a week, but stay only for a few hours on each visit. The centre also has foreign volunteers who come for a short stay of a few months and help teach the children every day. The centre also has foreign volunteers who stay for one year or longer terms. The volunteers help to ensure that the children have their meals and take their medicine. They may teach some subjects or accompany the children in the activities held at the centre or in the neighbourhood. They also help take the children to local hospitals if they are sick, need medical attention or when they have their viral load checks. Other volunteers help in the palliative care unit by feeding the more debilitated PLWHA. They help to ensure that the PLWHA are afforded every opportunity to treated with human dignity.

2. Counselling Service

• To train staff members with the necessary skills and capacity to carry out their work more effectively and efficiently.
• To support staff members in their work through ongoing monitoring, sharing of ideas and experience.
• To foster co-operation and mutual aid among staff members.
• To develop the staff members’ conceptual understanding of the holistic approach.

1. Weekly Meetings

   Regular staff meetings are the most effective instruments of monitoring. Staff meetings are platforms where all concerned staff members come together to monitor progress of the work, identify problems and obstacles and search for relevant solutions. They also allow the staff to participate in planning, decision- making and evaluation of the work as a whole. Therefore, CSC will hold a meeting every week for staff members of each program. When necessary, a joint meeting of staff members will be held on specific topics.

2. Monthly In-service Training

   There is a need for ongoing development and training to cope up with new situations and new developments. Members of the prevention team need additional training and development to build their capabilities for the work. It is necessary to provide some training to PLWHA to equip them with knowledge and skills needed for their work.

   The subjects to be dealt with in each session will be on techniques and skills needed for their work, such as project proposal and report preparation, documentation, research, co-ordination and co-operation, network building, monitoring and evaluation, and training techniques. This in-service training programme will be held outside the centre to leave their routine jobs and workplace behind, so that they will be refreshed and are more prepared to learn new skills. Each session will be held at nearby location for a full day every month or more often as deem necessary.

3. Semi-Annual Evaluation

   CSC plans to organise a semi-annual evaluation session all its staff members. Ea