The thread of life: a Buddhist temple in Thailand has opened its doors
to people with
AIDS - and given us all a lesson in how to help others die with dignity
by James Nachtwey & Vanessa Bush
Life
Vol.21 No.2 ( Feb 1998 )
Pp.68-76
COPYRIGHT 1998 Time Inc. All rights reserved
A Buddhist temple in Thailand has opened its doors to people with
AIDS--and given us all a lesson in how to help others die with
dignity. Reporting By Grant Peck
THE THREAD IS A CHANNEL FOR BLESSINGS
On most days at a remote Buddhist temple in Thailand's Lopburi
province, a line of monks can be seen filing along a dirt path in
solemn procession. Between thumb and forefinger they carry a single
white thread linking each monk to the others--and to the body in the
coffin trailing behind them--in a sacred chain of prayers and
blessings. The connection is not severed until the monks reach their
destination: a modest white building where the deceased will be
cremated. Such funerary rites have always been part of a monk's
duties. But in recent years, as temples across Thailand have been
transformed into hospices offering refuge to men, women and children
with HIV, the frequency of these ceremonies has increased. Wat Phra
Baat Nam Phru, where these photographs were taken, is the largest.
Monk Phra Alongkot Tikkapanyo had watched too many patients waste
away in hospitals unable to provide compassionate care. And so, in
1992, he created a place where people could "die peacefully, in a
good way."
A WAY STATION TO THE NEXT REALM
The 400 residents of the temple include some monks who became
infected with HIV, either before taking vows of celibacy or while
breaking them. Most patients came to the temple after their
families, ashamed to be associated with the disease, rejected them.
Surrogate sisters and brothers--seven monks and a sparse medical
staff--have stepped into the void, ministering to patients with
food, medicine and spiritual guidance. In the Buddhist tradition, an
essential part of the caregiving is preparing the mind and body for
death. Patients are encouraged to think positively, remembering the
good karma, not the bad.
AWARENESS RISES, BUT SICKNESS REMAINS
The first case of AIDS in Thailand was reported in 1984, but the
government downplayed its significance, believing the disease was
mainly limited to the homosexual community. Five years later it
became evident that the problem was more widespread, affecting
heterosexuals as it was passed along from prostitutes and their
clients to clients' wives and their babies. Still no action--largely
because the Ministry of Health feared an AIDS awareness campaign
would jeopardize tourism, with its legalized, billion-dollar sex
industry. (For decades, Thailand's tolerance of prostitution,
including girls being sold to brothels by their families, has
attracted tourists from Asia and the West.) By 1990, when rising
infection rates threatened to undermine the economy, the government
finally reacted. It set aside funding for education programs, media
campaigns and condom distribution to commercial sex establishments.
The early hesitation, however, proved costly. Nearly 900,000 of
Thailand's 60 million citizens are infected with the virus. The pool
of workers is shrinking, and each year 20,000 babies are born to
HIV-positive mothers. Today, even though awareness of the disease
has grown, public empathy has not.
A BUDDHIST WAY TO EASE DEATH'S STING
The waiting list at Wat Phra Baat Nam Phru has reached 10,000, for
only 400 openings. The monks and medical workers at the temple do
not have access to the latest equipment or medicines. Food and
drugs, particularly Western ones like AZT, cost nearly half a
million dollars a year. And that figure will soar when the temple's
planned expansion of its hospice facilities is completed in two
years. Yet, as a result of a reduction in the incidence of new
infections, government financing for AIDS programs is being cut
back. To help pay the bills, founder Tikkapanyo has accepted
donations from foreigners, including some in the United States, as
well as from Thai philanthropies. What he will not do is charge the
patients at the temple for staying there. "Buddha teaches us that we
must live together in kindness and mercy," Tikkapanyo says. "The
most important thing is to make the patients' minds strong and
peaceful and give them better health." To that end, those patients
who can are encouraged to be active--to sing, to garden, to play
music and sports. On Saturday nights the HIV Band performs. Every
Sunday there is a group trip into town to go to the movies, the zoo
or shopping. Still, with a thousand funerals at the temple last
year, the specter of death is ever present. A body resting in a
coffin at the entrance to the ward, and within a patient's line of
vision, is barely noticed. Dying residents talk candidly to one
another about the day when there will be no more suffering. For
those with full-blown AIDS, contact with the staff is intimate.
Nurses provide massages and apply hot compresses and balms made with
traditional herbs. Those who can no longer eat with a spoon are fed
with a syringe-like dropper. To patients, the healing that comes
from the hands means more than anything medical science has to
offer. "The temple," says one 42-year-old resident, "nurses my heart
and body."