Yet again, we arrived at our first destination, the United Nations, extremely early. The bus drove us to the Grand Palace area just down the road and we had time to have a look around and take a few photos. Since 1792, the palace has been the official residence of the Kings of Siam, the Royal court and the administrative seat of government.
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| United Nations Building, Rajdamnern Nok Avenue, Pranakorn, Bangkok 10200 |
Upon entry we were required to go through security, have our bags x-rayed and hand over our passports in exchange for a name and security pass. We made our way to a small board room within the UNAIDS department and had the pleasure of meeting Steve Kraus. Yes, Steve Kraus, the Director of the Regional Support Team for Asia and Pacific, a pretty big deal! We were all buzzing and in that moment I felt so privileged to have such an opportunity. He also gave praise to Australia's financial and technical involvement and support of UNAIDS, outlining that many interventions have so far proven successful, e.g. safe injection sites and opiate substitution therapy.
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| VIP for a day |
*there is an abundance of information about HIV/AIDS in Asia and the Pacific and regarding strategies to decrease new infections, reduce stigma and increase education, but I will just outline some basic information that I learnt during my visit*
HIV and AIDS estimates in Thailand in 2011:
- Number of people living with HIV - 490,000
- Adults aged 15 to 49 prevalence rate - 1.20%
- Adults aged 15 and up living with HIV - 480,000
- Women aged 15 and up living with HIV - 200,000
- Deaths due to AIDS - 23,000
- Orphans due to AIDS aged 0 to 17 - 250,000
- 70% of new HIV infections happen in 27 provinces (Source)
Epidemic is concentrated among key populations:
- People who inject drugs
- In some geographical locations, over 50% of PWID are living with HIV
- Female sex workers
- Clients of female sex workers
- Men who have sex with men
- 7-31% of MSM are HIV+, and this % is on the rise especially in large cities and popular tourist locations
- Male sex workers
- There is generally a higher % of male sex workers with HIV than female sex workers, and is as high as 18% in geographical hotspots
- Transgender and Transgender sex workers
- There is currently no data on population sizes and limited data on HIV prevalence
- Where there is data, it indicates high prevalence in cities
UNAIDS 10 TARGETS AND COMMITMENTS
- Reduce sexual transmission of HIV by 50% by 2015
- Reduce transmission of HIV among people who inject drugs by 50% by 2015
- Eliminate new HIV infections among children by 2015 and substantially reduce AIDS-related maternal deaths
- Reach 15 million people living with HIV with lifesaving antiretroviral treatment by 2015
- Reduce tuberculosis deaths in people living with HIV by 50% by 2015
- Close the global AIDS resource gap by 2015 and reach annual global investment of US$22-24 billion in low- and middle-income countries
- Eliminate gender inequalities and gender-based abuse and violence and increase the capacity of women and girls to protect themselves from HIV
- Eliminate stigma and discrimination against people living with and affected by HIV through promotion of laws and policies that ensure the full realisation of all human rights and fundamental freedoms
- Eliminate HIV-related restrictions on entry, stay and residence
- Eliminate parallel systems for HIV-related services to strengthen integration of the AIDS response in global health and development efforts
Division of labour:
UNAIDS brings together the resources of 11 UN system organisations for coordinated and accountable efforts to unite the world against AIDS. A division of labour guides the support offered to ensure that countries receive the best technical support and avoids duplication of work in specialised areas.
- UNHCR - The Office of the United Nations High Commissioners for Refugees
- UNICEF - United Nationals Children's Fund
- WFP - World Food Programme
- UNDP - United Nations Development Programme
- UNFPA - United Nations Population Fund
- UNODC - United Nations Office on Drugs and Crime
- UN Women
- ILO - International Labour Organisation
- UNESCO - United Nations Educational, Scientific and Cultural Organisation
- WHO - World Health Organisation
- The World Bank (Source)
Stigma and discrimination still remain to be large barriers impeding effective HIV responses. So what is being done?
- Since 2010, China, Fiji and the Republic of Korea have all revoked travel restrictions for people living with HIV
- India, Indonesia, Papua New Guinea and Thailand have implemented programs to ensure that law enforcement does not pose as an obstacle to HIV treatment and prevention
- In Thailand in 2011, more than 60% of people eligible for antiretroviral therapy were receiving it
- The government is funding more than 84% of the HIV response with domestic resources
- Objectives include: support schools to teach sex education and promote safe sex for sexually-active youth; improve access to condoms; screen donated blood for HIV and appropriately used blood and blood components in treatment; provide treatment and holistic care to people living with HIV, their families and other affected people; create opportunities for learning and training to improve understanding about basic human rights and sexual rights among service providers and the general community with the aim of reducing stigma and discrimination; empower key affected populations so they know about their rights and can access protection services; and change attitudes of society in Thailand. (Source)
"Today, we have a chance to end this epidemic once and for all. That is our goal: Zero new HIV infections, Zero discrimination, and Zero AIDS-related deaths."
United Nations Secretary-General Ban Ki-Moon, at the United Nations General Assembly High Level Meetings on AIDS, June 2011.
"Don't be afraid to be a change agent."
Steve Kraus, at the meeting with 20 University of Technology Sydney students, 11th July 2013.
I found this presentation extremely interesting and educational and I will take a lot of this knowledge with me. I believe that my role as a Registered Nurse when caring for patients infected allows me to be supportive and reduce stigma and discrimination, thus aiming to reduce barriers to accessing and adhering to treatment. Despite developing countries having a higher prevalence of HIV/AIDS, Australia has seen a notable rise in HIV infections in the last year, reiterating the worldwide need for increased awareness and education, access to holistic care and treatments, and well-equipped health professionals free from stigma.
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| The first REAL coffee of my trip at the UN! |
Thai Red Cross Society
The TRCS was founded in 1893 with the objective of alleviating suffering. In 1920 it became recognised by the International Committee and quickly became the largest humanitarian society in the country.
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| 4 Chang Wat, Bangkok 10330 |
We were welcomed immediately upon our arrived at the Thai Red Cross Society (TRCS) and had a few group photos taken. We were then led to a meeting room for a presentation on the TRCS and the work they do in responding to disasters in Thailand. Wanpen Inkaew and Somjinda Chompunud delivered presentations to us containing the following information and more.
The TRCS functions in four main areas:
The TRCS functions in four main areas:
- Medical and health care
- Disaster preparedness and response
- Blood transfusion services
- Quality of life promotion
Disasters in Thailand
Natural: flood, drought, storm, landslide, tsunami
Made-made: fire, chemical and hazardous material incidents, transport hazards, sabotage threat
TRCS response to the 2011 floods
Between 25 July and 9 December 2011, the Department of Disaster Prevention and Mitigation reported that as a result of tropical storm "Nock-Ten" a total of 65 provinces were affected - in 684 districts, 4,917 sub-districts, 43,600 villages - affecting 13,570,873 people, 680 people died and 3 people missing.
- On 13 December 344,012 relief kits and 324,944 packs of bottled water were distributed
- Between 22 September and 2 December, 4 mobile relief kitchen units prepared 439,830 meals for affected people in 8 provinces
- Between 1 October and 9 December, 2-4 mobile medical units traveled by flat bottom boats to reach 13,393 affected people in 7 provinces. Each unit consisted of a doctor, pharmacist and nurse.
- 22 flat bottom boats evacuated 78,680 flood-trapped people in 13 provinces between 6 September and 10 December
- Between 6 September and 10 December, 8 water purification units were sent to 6 provinces and produced 5,160,000 litres of water for 258,000 affected people
- 448 shelter box sets were distributed. Each box supported a family of 5 people and consisted of a tent with a raised floor, bedding, kitchen utensils and daily necessities
- 20 floating toilets were provided in Pranakom Sri Ayutthaya and Nonthaburi provinces
- 583 boats were distributed to affected people in 9 provinces
- 48,000 ready-to-eat meals were distributed to 7 provinces
The Thai Red Cross College of Nursing
The College was established in 1914 as a contribution of Queen Sripatcharintra - Wife of King Rama V and the first present of the Thai Red Cross Society. It is recognised as the first nursing school that offered a general nursing practice program in Thailand and initially offered a three-and-a-half year nursing and midwifery program up to 1964. Currently the Bachelor of Nursing Science program and post-graduate programs are offered at the college with 700 students enrolled, of which only 5% are male students. The college offers onsite dormitory living to female students. To date, over 8,571 Registered Nurses, 976 Nurse Specialists and 1,687 Practical Nurses have graduated from TRCN.
Disaster education
There is no official disaster nursing course in Thailand's educational system (and certainly not in Australia's educational system either, well, at least not that I know of!). TRCN's current curriculum incorporates 3 credits of disaster nursing (2 credits of theory and 1 credit of practical demonstration) and integrated content of emergency/community health nursing in the third year of study. Supportive teaching materials include magnetic models of disaster situations and interactive computer games for triage care during earthquakes, floods and fires.
Costs
- The BNS tuition fee for full-time study is approximately 20,000 baht per semester
- Approximately $8,422 AUD for the entire degree
- Accommodation costs 20,000 baht per semester
- Approximately $2,105 per year
- Scholarships, awards and financial assistance from the college and the government are available to eligible students
I was quite impressed by the all the work the TRCS does in response to humanitarian crises and they appear to be well equipped. In operation is a Disaster Health Training Centre where child protection is its first priority and creates safe places for children separated from their parents or orphaned. The centre trains people to be capable and resourceful volunteers, and these volunteers are looked after during and after their volunteer work through activities such as yoga and meditation to alleviate stress. The TRCS are also very focused on improving disaster care education and are currently working on improving the nursing syllabus and textbook. I hope that one day I am able to return to Thailand and participate in volunteer work; perhaps with the TRCS or another organisation that helps people in crises in rural and remote areas!
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