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Sexual Health Exchange 2004-1
Cambodia
Involving Buddhist monks in prevention, care and support
Buddhism for Development (BFD) is a faith-based organisation that engages Buddhist monks to assist in the provision of care and support for PLWHA. With financial and technical support from KHANA, the Cambodian partner of the International HIV/AIDS Alliance, BFD provides home-based care to 90 PLWHA and children affected by the epidemic.
In Battambang Province, north-west Cambodia, BFD implements programmes to promote sustainable social and economic development. These programmes directly address HIV/AIDS in a number of ways. Each year a six-week long "Peace Development School" trains monks in health and HIV/AIDS awareness and education, vocational skills building and agricultural extension methods. The monks then return to their home villages to apply the teaching. Of the 1100 monks trained in the programme to date, many have established HIV/AIDS associations, which implement prevention, support and home-based care activities.
Home-based care – The home-based care project provides palliative care and psychosocial support to PLWHA in three different communities. The teams are composed of NGO staff, government staff from the health centre, a monk and community volunteers. They train family members on basic health care and nutrition, refer PLWHA to other clinical services such as TB screening, or to community services that provide welfare support or advice on income-generating activities.
AIDS orphan support – Help is also offered to support AIDS orphans, by finding ways in the community to keep the children in school. Further to this, many monks have established centres for orphans and children affected by AIDS.
Self-help groups – HIV-positive people are encouraged to join one of BFD's two self-help groups. Informal, open discussion in these self-help groups helps to build trust and solidarity and provides PLWHA an opportunity to share ideas and knowledge regarding treatment and care. Self-help group meetings focus on one or two relevant issues and groups may discuss topics such as opportunistic infections or how to live positively with HIV/AIDS. Each meeting incorporates Buddhist teaching, meditation and prayer as a stress-relieving strategy. This is provided by local monks who always attend the self-help group sessions.
Prevention education – Buddhist doctrine requires monks to remain celibate and social rules prescribe that sex is not discussed in public. Despite this, the monks still recognise their role in supporting health personnel and NGO staff. Using the concepts of Mahayana Buddhism that forbid sexual immorality, and from their social platform in the community, the monks can indirectly approach otherwise sensitive topics such as the sexual transmission of HIV/AIDS by stressing caring, loving, respectful relationships.
While BFD has developed effective programmes to provide care and support to PLWHA in Battambang, many challenges remain. Involving the monks in home-care teams has made a significant difference for PLWHA but stigma and discrimination still exists. Many individuals remain fearful of the community knowing their HIV-positive status. Consequently some people refuse visits and the care and support offered by the home-care teams.
Also, with the impact of HIV growing, BFD is looking at ways to support the increasing number of children orphaned as a result of AIDS. Presently those children are cared for in the local pagoda, but the organisation is now looking for ways to encourage the community to foster or adopt.
Vicente Salas & Chris Turner, International HIV/AIDS Alliance, Brighton, United Kingdom; tel.: +44-1273-71.89.00, fax: +44-1273-71.89.01, e-mail: vsalas@aidsalliance.org or cturner@aidsalliance.org, web: www.aidsalliance.org
More information: Buddhism For Development, Watt Anlongvil, Sangker, Battambang; tel./fax: +855-53-37.00.41, e-mail: bfdbtb@mobitel.com.kh
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