Ono Hiromi (Japa Vietnam's staff)

The citizens' group "Japa Vietnam" that was established in 1990 has been assisting, for the last 12 years, small programs in Vietnam that lead to the reconstruction and economic self-sufficiency of the people. Most of the programs include the improvement of basic structures in poor rural areas and needed human services for slum dwellers in the city of Ho Chi Minh. We continue collaborating with two groups in Ho Chi Minh that support the residents of slums and take care of street children.
About 10 years ago AIDS begun to become a social problem in Vietnam. In the cities people living in the slums and the street children are easily infected with HIV. This is especially true of sex workers and drug addicts, the ones most seriously affected by AIDS. Time ago, the group of Mr. Van, perceiving the impact of AIDS, took immediate action and runs a preventive education program for poor slum dwellers, besides taking care of Aids patients. On the other hand, street children and poor young people become easily victims of HIV and, in order to rebuild their lives, the group of Tao Dan started in the year 2000 a new "House of Hope" to provide mental care and vocational training.
I present here the activities of the above two organizations concerning their fighting against HIV/AIDS in the poor sectors of the city of Ho Chi Minh.

The first public report concerning AIDS patients was issued in the USA in 1981. The history of AIDS is only 22 year old.
Two years later, in 1983, the virus producing AIDS was discovered in France and in the USA. In 1985, the antibody medical examination, i.e. an examination to find out an infection of the HIV virus, was developed. Medically speaking, the AIDS disease was fast made clear and the medicine to control it has been already developed.
The cause of the HIV/AIDS infection and the ways it spreads (by blood transfusion, sperm, vagina's secreting fluid and breast milk) are also medically clear. It is a disease very easy to prevent. Anybody with a right knowledge and a life style that follows preventive behavior should be, easily, able to defend oneself from HIV infection. On top of that, the infection of HIV virus is not strong at all.
HIV has spread very rapidly everywhere and the international community has also taken fast action against it. The first International AIDS Congress took place in 1985. The UN started in 1996 a combined AIDS Program as a sign of a global commitment.
It is estimated that at the end of 2001 there were 40 million people infected with HIV/AIDS and over 20 million persons have died of AIDS. Why is it that HIV infection, that could be so easily prevented and brought to control with new developed medicines, has spread so widely during the past 22 years, without being able to stop it?
Africa is the continent where HIV/AIDS has shown explosive developments followed by Asian countries. The reasons for it vary from country to country, but lack of preventive practical education in many developing countries, as well as the superficial knowledge regarding the dangers of AIDS are serious problems. On the other hand, the low rate of compulsory education and the lack of human rights' awareness exert great influence.
A different problem is that HIV infection is mainly caused by sex practices and it is very difficult to change them, due to the traditional sexual customs, moral standards and life practices. For instance, in some African countries there is a social custom of well considering those women that bear many children, and this is a hindrance to the wide use of condoms. Young Japanese today have become open to sexual activities and, since their awareness has not changed much, the cases of HIV infection among the young have increased.
It is believed that, in order to solve the AIDS problem, there is a need to reform the social system and customs. This requires a step by step long way.
From the medical point of view, the situation surrounding HIV patients differs enormously according to the economic levels of each country. In Japan and other industrial countries the so-called cocktail method was developed in 1996 and the possibilities to control the outbreak of AIDS through pills developed quite drastically. In these countries AIDS has changed from incurable, leading to death, to a chronic disease. There, HIV patients are getting accustomed to just survive with the disease. It is different for the patients of developing countries who are not blessed with good medical systems, for whom the outbreak of AIDS leaves them without hope of living long.
From the points of view of preventive awareness and medical systems there is a clear gap, concerning AIDS, between the industrial and developing countries, as numbers show. When one considers a human ideal that medical innovation technology is a property of humankind and, thus, should also be used to cure all patients suffering from HIV/AIDS infection, the realities surrounding us lead us to reflect on the injustices and absurdity of our world.
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According to the official figures given by the government in December 2001, there were 41,622 HIV infected and 6,251 AIDS patients. About 3,421 persons died of AIDS. Compared to Japan, the number of infections in Vietnam is 10 times higher. According to some opinions, the reality is ten times more than the numbers given, but it is very difficult to know the objective situation.
The use and overuse of needles for drug injections count for about 60 per cent of all the infections in Vietnam. The cases of HIV infection among sex workers have gradually increased, especially in the southern provinces. Many of them, as well as drug addicts in Vietnam, live in poor areas and HIV/AIDS hits them badly. Nowadays, people of other social ranks, like new soldiers and police officers, teachers, housewives and university students are also starting to be affected by the HIV infection.

In the city of Ho Chi Minh 7 hospitals perform charged HIV medical examinations.
Pregnant women consulting a doctor are free to have HIV examination, but it is compulsory for new military personnel and prisoners that are drug addicts. Some public hospitals in Ho Chi Minh have a section for HIV/AIDS, but that is out of reach for the poor and the daily experience shows that many hospitals refuse to treat AIDS patients.
Last June a new HIV preventive medicine, made in Vietnam, was developed, but people have to pay 350 yen a day for it. Since patients have to drink it daily and the average monthly incomes of slum dwellers are about 5,000 yen, they can not afford the cost of the medicine.
The UNAIDS, a UN-sponsored Program, runs through WHO various projects for which Japan, USA, Germany, Canada and Australia provide funding to run workshops, blood examinations, and to buy medical machines and automobiles in different countries. Such foreign assistance is channeled through the Vietnamese government and it does not reach the people.
On the other hand, ordinary people do not participate in activities regarding AIDS. Catholic Sisters, mainly, and some volunteer medical personnel are taking care of AIDS patients, but it is by no means enough.

The Vietnamese government produced a 10-year Communication Program that tries to create social awareness regarding AIDS, among the youth and decided to tackle the problems of high-risk sectors, like sex workers and drug addicts. The government has made a network of several official organs, like the Social Welfare and Labor Departments, the Social and Invalids' Committees, the Police Department etc., to deal with the problems of AIDS. Nevertheless, the fast increase in the numbers of HIV infections has provoked a frightened campaign to arrest, as soon as possible, all HIV suspects, in order to bring to an end the whole issue.
During my visit to Vietnam last August I heard the news that, from a year ago, the government had declared a national campaign, under the slogan of wiping out drug addicts, sex workers, homeless and street children, all kinds of criminals. As a result, only in the city of Ho Chi Minh 17,000 persons were put in 12 jails, but for lack of space they were planning to open more jails.
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When our team of Japa Vietnam visited Ho Chi Minh City on 11 August of this year, Mr. Van told us that he would like us to meet a young person.
One of the activities of the group working with Mr. Van is with street children. Some of those children collaborate also with the group as volunteers. Truong (his nickname), now 18 years old, was one of them. At the beginning of the year and due to the new control policy, he had problems with the police and was arrested. Mr. Van's group looked around for him but they could not find him. Later on, the group realized that Truong was put in a jail of Binh Thuan, the next Province. They visited his mother, who is psychologically weak, but she did not inform them about the whereabouts of her son. In fact, they found out later that she did not go to visit him for already half a year. In the mean time, Truong got dystrophy and was unable to walk and the police transferred him to a hospital in Binh Thuan province to die.
Truong was a drug addict infected with HIV. When Truong was brought to the hospital he could still remember the telephone number of Mr. Van and asked the doctor to call Mr. Van and inform him where he was. Mr. Van's group could finally detect him and went to visit him. They made immediate arrangements to bring him to a hospital in Ho Chi Minh and just 10 days before our arrival they moved him by car to the city. The first hospital where they interned him refused him after a few days. Just two days ago he was moved to a new hospital.
After telling us the story of Truong, Mr. Van asked us whether we would like to pay a visit to him in the hospital. Three of us, Miss Kato, Fr. Ando and myself followed Mr. Van to the hospital. We bought some foodstuff in the shops of the hospital and while we were there Mr. Van told us: "The first time I met Truong again, after several months, he had changed so much that I was totally caught by surprise." Mr. Van is always caring for incurable AIDS patients in the slums and he, seldom, shows in his face any emotion, but this time his lips were trembling.
We entered the patients' room where Truong was lying in bed. The only thing he had was a mat beneath his body. The bed was surrounded with some bars, like a fence. We saw handcuffs hanging down from there. They told us that he was not yet released. One of the collaborators of Mr. Van's group was taking care of Truong in the hospital. There were old newspapers on the floor and also on the mat where he was lying. Mr. Van spoke first with him and afterwards we also exchanged words of encouragement with him, under the curious surprise of several people who gathered in the corridor, near the window of the room. When Truong entered the hospital the other patients looked at him with discrimination, but Mr. Van's group talked often to them and they gradually showed a friendly attitude towards him. We waited for Truong to calm down and then we offered him some food. He drank the soup and ate bananas with much joy.
On August 19, a day before coming back to Japan, we asked Mr. Van to meet with Truong again. We were told, then, that the hospital had refused to keep him and he was back home. Mr. Van's group brought him to their office and we met him there. They said that it was also good for Truong to go out from time to time.
Truong, drawing in his arms and legs, bones covered by skin, was lying on the floor with vacant eyes. When I watched him I worried very much, because he seemed to have lost all energy and was unable to move, but then, when Mr. Van's staff woke him up and we could see him reacting with his head to their questions, I felt relieved. Truong could not recognize any more his former friends. They showed us an album of photos with Truong when he was still healthy, but there was almost no similarity with the young one we had in front of us. Yun, one of the staff members encouraged him, "Truong, you have to eat much more and get healthy again". Truong, pointing at his insensible feet, answered back, "I eat but I can not get strong".
When we saw him off, Ando told him, "Next time we come back we want to see you recovered". I shook his hand and I still feel clearly how, unexpectedly, Truong held my hand strongly. His deep desire to live together with his lack of all hope touched painfully my heart.
Back in Japan I couldn't forget him and after discussing the matter with Ando we decided to provide the needed funds for his medical treatment and medicines. I didn't want him to die and I was, just, praying that he could recover again.
On October 3, Mr. Van sent us an e-mail message; "The sad news is that Truong died yesterday. We lived with him and took care of him for about two months". Mr. Van's group had tried all means to save him. The police had caught him and they could not find his whereabouts for more than half a year, but finally, after they could contact him, they were able to accompany him for, at least, 2 months.

My first reaction was, "what a pity, it was too late". Normally, it seems that when a person is infected with the HIV virus it takes from 5 to 10 years to get AIDS, provided that no treatment is given. Truong had been in jail, under very poor conditions, during 7 months and, due to his HIV infection, his body lost all immunity and became very weak. If the police would not have arrested him, he could have lived with health for many more years. The vacant face expression of Truong I saw when I met him at Mr. Van's office remained vividly printed in my mind, since then.
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In August of this year, we met with a group of about 30 persons at the "Condom Cafe". The participants, some over 60 years old, were mainly young collaborators of the group of Mr. Van and belonged to 4 slum communities. Since they live in far away places, they seldom come together. We gathered together with them and shared our opinions and the activities we ordinarily perform.
They introduced themselves one after the other: "I'm teaching 12 street children". "I participate in the study group of Mr. Van and teach AIDS awareness and basic education of how to read and write". "I distribute condoms in District 7 and bring sick women to the Health Center".
All of them were ordinary residents of poor slum communities who usually participate and cooperate with Mr. Van's group. Many have used drugs before or have among the members of their families drug addicts or AIDS patients; some of them have relatives that died of AIDS. Slum dwellers that have AIDS suffer from discrimination less than other citizens, according to Mr. Van. People of poor communities confront AIDS and other problems supporting mutually each other and living together in communities. Mr. Van's group promotes the use of condoms to the sex workers and invites drug addicts not to use in common injection needles.

Meeting at the Condom Cafe
They showed us a Video program with their activities. All of us enjoyed the show in which the volunteers visited a school in a nearby province to perform a program about AIDS, recreation activities for street children and a relaxation picnic for families that had lost relatives because of AIDS. Some persons appearing in the Video had already died of AIDS. I feel the interest of Mr. Van's group to record the human drama of each one of those persons who, after being drug addicts for a long time, become HIV positive and end their lives as victims of AIDS. Here it is still impossible to prolong life by using medicine, but the AIDS patients are friendly accepted and the volunteers try to build communities with them.
The day before departure we paid a visit to the "House of Hope". Eleven young persons that are HIV positive live there and attend vocational schools outside. Almost half of them already graduated from school are looking for jobs. Some can not continue their studies and drop from school and since it is difficult to find a job, some children try new skills, like learning how to use a computer.
The volunteer staff makes all efforts to confront the hardships of the children who, accustomed to live in the streets, have strong personalities and get easily into a fight, but at the same time have lost all confidence in themselves. In August, the government organized in Hanoi a national conference with children suffering from HIV/AIDS and some participated exposing their opinions there. That helped them to gain confidence. In the center they made them write their impressions of the conference and, among many other trials, they also teach them musical instruments. We received a very good impression of our visit to the children of the House of Hope. The children looked happy and they were respectful.
One can say that the people in the slums and the children of the House of Hope that are supported by the group of Mr. Van are certainly lucky. It is impossible to know how many HIV/AIDS victims are left abandoned without any treatment and care, because volunteer people, like Mr. Van's group, are physically unable to assist them. That's why sad incidents that surpass all imagination tend to occur, almost daily.
People do not expect anything from official policies, but put their expectations in the activities of groups like Mr. Van's and the House of Hope.
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