CHIANG MAI, THAILAND “”mdash; Six-year-old Wik has spent most of his life in and out of hospitals. He suffers from chronic pneumonia, which causes his oxygen levels to drop to dangerously low levels. Because of his condition, he must be hooked up to an oxygen machine at all times.
Wik was born HIV positive.
When he is well enough, he spends much of his time resting or studying with a personal tutor in an upstairs room at Agape Home, where he has been since 2007.
Agape Home is a nongovernmental organization orphanage in northern Thailand founded by Christian missionaries. Previously, he was in a government orphanage, but later moved to Agape Home at the request of Agape staff members.
“(The government orphanage) couldn’t deal with his HIV anymore. They knew we had the facility and staff to take care of him,” Ellen Conserva, an American missionary and Agape worker said.
Unlike government orphanages, Agape Home has a large staff of nannies, volunteers and missionaries such as Conserva, who have a unique vision for caring for the children in a holistic manner.
“(Kids at government orphanages) are quite separated from other kids. They don’t let them mingle, but here they’re all together,” Conserva said.
Conserva and her co-workers said they believe in the value of emotional, spiritual and physical contact with the children. Staffers at Agape Home work to provide children with personal attention and love, in addition to administering regimental anti-retroviral medication at 7 a.m. and 7 p.m. each day. Workers emphasize demonstrative affection through hugs, and spend extra time massaging babies with baby oil on a daily basis.
“Three out of four babies revert to HIV negative by the time they are 18 months old,” Conserva said. Many babies will test HIV positive at birth because they still possess their mother’s antibodies in their blood, but at around 18 months of age, their own antibodies take over and they test HIV negative.
Conserva said she believes that special attention to children helps this process along. “The reason for this is not drugs, it is just touch and care and love,” Conserva said.
Although all but eight of the 73 children living at Agape Home are HIV positive, their illness is not as visible as Wik’s. The children’s ages range from 15 months to 17 years, and around 60 of them are well enough to attend a regional school.
The green grassy playground outside is filled with children’s laughter as boys and girls play marbles or an impromptu game of tic-tac-toe in the sand. Toothy grins fly by in a high-leaping game of Thai jump rope. Some children watch as a worker builds an aviary for pet birds. Others work on homework with volunteer tutors from nearby universities.
Yet while Agape Home is abuzz with childhood energy, a troubling statistic serves as the backdrop to children’s situations.
Currently, there are about 12,000 to 17,000 children aged 0 to 14 living with HIV in Thailand, according to an estimate by UNAIDS, a United Nations program. In addition, in 2005 there were about 380,000 children in Thailand orphaned by HIV and AIDS, according to UNESCO, a United Nations educational organization.
People living with HIV often suffer from chronic respiratory illnesses such as pneumonia, and are prone to frequent ear infections. Some children at the orphanage have had ear infections since birth.
“It’s something they live with because they just can’t get rid of it,” Conserva said.
Fortunately, death is less of a concern today, as the government recently began providing free anti-retroviral drugs to children.
“We haven’t had any (children) pass away since they’ve been on the ARV drug. The last time someone died was in 2002 or 2003, but they still have health issues.” Conserva said.
The children’s medication alone contributes much of their discomfort.
“The ARV drug is not a friendly drug. It’s a devil drug,” Conserva said. “It helps them as much as far as boosting your immune system, but it does some work on your liver.”
Other side effects include night fevers, bad dreams, stomach aches and lipodystrophy, or the displacement of fat in the body, which causes gaunt faces and bloated stomachs.
In spite of medicinal provision by the government, Conserva said she believes simply suppressing the disease is not enough.
“This is a result of poor decisions by Thai people. The government needs to step up and see that, and take care of this problem, but they’re not,” Conserva said.
On the other hand, Conserva said she believes that the void the government has left in health care allows Agape to be in Thailand in the first place, a presence that Conserva hopes will grow church membership.
“You can make the best situation out of a bad situation, because now, we have all these kids … and we can tell them about Jesus. … We believe these kids are the future Thai church,” Conserva said.
“They have these experiences, that “˜I was once dying in a hospital and somebody came and rescued me … and here I am today to tell you my story. (In the same way), Jesus saved me.'”
Conserva added that she has high hopes for the children: “We want these kids to grow up and be leaders someday in their community and in Thailand,” Conserva said.
“Maybe their next prime minister is here, … so we’re taking (the situation) that nobody wants (anything) to do with and changing it into a huge opportunity for us to help them become great citizens of the world.”
Many children at the home come from families that simply abandoned them. Some were abandoned at birth at a hospital, including Pun, 6, whom Conserva and her husband Michael, another missionary, are in the process of adopting. A 7-year-old boy, Sal, has no last name, and his background is unknown.
Other children have relatives who were unable to care for them, often because they too were very ill to do so. Most of the children contracted the disease through transmission from their mothers at birth, a cause that is mostly avoidable with proper use of prenatal ARV medicine.
“A lot of them still remember their parents,” Conserva added. “Thai Mother’s Day is coming up … and I can’t help but think, “˜What are they thinking?'”
Conserva recalled a situation in which Yat, an 8-year-old boy, asked her to write his name next to his mother’s name on a craft flower. She asked if he remembered his mother.
“He’s holding his flower up to his chest, and says, “˜I can feel my mom’s love in my heart everyday,'” Conserva said. “He had this big grin on his face, and said, “˜Yep, she’s with Jesus now.'”
Conserva says talking to children about their past is important for their healing.
“Most people might not want to go there (and) talk about your dead mom to a little 8-year-old … but I just want to go there … to see what they’re thinking, what they’re feeling,” Conserva said. “So I go there, and I find out, nothing’s sacred, time’s too short, I just want to talk to them and see how they’re feeling.”
Yat’s mother, Daw, stayed at Agape Home’s mother-baby unit, a hospice for women and children who are HIV positive. The hospice was created for mothers to remain with their children until their death. When Yat’s mother died, Conserva went to the hospice with Yat to say goodbye.
“It was a really surreal experience, because death is so right out … here, and there’s no hiding it,” Conserva said. “What do you say to a kid who’s 7 years old, and she looks about 90 (years old) and weighs about 40 pounds?”
Conserva concluded that she would tell him what she would hope someone might say to her own children. She reminded him that his mother was glad he was at Agape Home, and they began talking about his memories of his mom.
“We talked about crying, and how someday you’re going to feel like crying, and it’s okay, you need to cry. But at the same time, I’m telling myself the same thing,” Conserva said. “I’m not a grief counselor … but this is the situation that has been thrown at you, and you just have to run with it. I couldn’t run away from it. … It’s not what you get in America at all.”
Currently, the hospice houses three women living with HIV.
One woman, Jim, 46, lives in the hospice and also works in the Agape Home kitchen. She discovered that she was HIV positive when she was 39.
She shared her story with a group of Americans who were visiting the orphanage, explaining that at one point, she had reached such a point of despair that she saw no point in suffering from her illness. She attempted suicide several times, but the rope kept on breaking. She took this as a sign from God and became a Christian.
Agape Home is currently constructing several housing units on their campus, where they hope to house Thai families who will informally adopt children to live with them as a nuclear family.
Though the future of the orphanage, which relies solely on international sponsorships and donations to fund its projects, seems positive, the children’s futures are largely unknown.
“It’s one of these areas that we just don’t know what’s going to happen, by the time they’re out of school, they might go to technical college but still come back to live here,” Conserva said. “They may want to get a job further away and live outside of Agape, and they can do that if they want to.”
Yet Conserva said she fears the societal stigma that the children might face:
“Just how is society going to accept them? … Are they going to give them jobs? Are they going to be able to rent a home?” Conserva said. “I don’t know, it’s just one of those things that we’re just kind of playing along to see how we go, how things work out.”
Government orphanages generally make children leave their orphanage when they complete school, but as a nongovernmental organization, and a place the children call home, Conserva says Agape Home is different.
“I’m never going to do that. I’ll never say, “˜You have to leave.'”