(Information for this article was compiled from material made available by the DRAMARAKSANIWESANA PROJECT)
                        
BUDDHIST HOSPICE CARE IN THAILAND

1.Program Summary            
            
Since September of 1992 the International Network of Engaged Buddhists - INEB has been working towards setting up hospices for AIDS patients. A pilot project was set up with a temple offering to take in AIDS patients. The temple is called Wat Prabatnampu and it is located in Lopburi province. The monks and volunteers at this monastery offer sanctuary for AIDS patients giving them holistic care and spiritual encouragement. The patients and their families also receive care from doctors, nurses and caregivers.
            
Initially, the Ministry of Public Health allocated a budget for seminars and training for the hospice project and the Australian International Development Assistance Bureau offered a grant to set up the program in that monastery. Individuals and patients are encouraged to give a donation whenever possible. The INEB aims to encourage other temples in Thailand to offer hospice care as well. The INEB hopes that monks and volunteers will take the initiative and make themselves aware of the AIDS crisis and offer a Buddhist approach to this worldwide epidemic. The monks and volunteers are in an ideal position to provide very much needed moral and ethical education for prevention of the further spread of this disease; as well as teaching understanding and compassion for those who are suffering from AIDS and their families.


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Contact the DRAMARAKSANIWESANA Project           
            
Modern medicine and technology has yet to come up with a cure or vaccine for AIDS. So many people suffering from AIDS symptoms are spiritually in need of great assistance. When a person is diagnosed with AIDS it is essential that they receive unconditional love and support. The INEB encourages temples to take on the necessary role as in today's Thai society people look to them for guidance and solace. The monks and many of their volunteers live exemplary lives and by showing compassion and concern for others it is hoped that lay people will follow their example.
            
Hospice is a comprehensive philosophy of care which takes into full consideration the individual, their family and friends, as well as their physical, psychological, social and spiritual needs. There is an emphasis placed on improving the quality of the sick person's life. Psychological help and support are constantly needed from all areas since many suffering from AIDS are so young. A network of careers is needed: doctors, nurses, social workers, care workers, volunteers, monks, nuns, family, friends, and lay people, all have special and essential skills they can offer.
            
Every patient receives a diagnosis and consultation from a doctor. Counseling is offered by nurses, monks and volunteers offering both Buddhist philosophy and hospice care. Hospice care is free of charge, and there is no discrimination based on race, religion, or sex. Services at the hospice facility are available on a 24 hour, 7 days-a-week basis, enabling family members to visit whenever they can.
            
With some agencies quoting statistics that claim 800,000 people in Thailand have HIV it is obvious that Thai society needs to address the AIDS crisis and it must seek to provide ways of coping with this epidemic situation. Hospice care at this project tries to do this and it is for anybody who needs sanctuary.
            
Some Thais detest AIDS and the mere mention of the word makes them cringe. They tend to judge those who have contracted the disease very harshly. Many families have a hard time coping with the stigma of having a family member stricken with the deadly disease.Often, AIDS sufferers will not stay in their family home as they do not wish to be a financial or social burden to their loved ones. Many times families also cannot give the necessary care and support for their sick family member.
            
Hospices can offer an alternative and respite for many having trouble getting settled because of the problems that are associated with the disease. It is sometimes very difficult for the AIDS patient to find a hospital bed, job and accommodation. Friends are often fearful of contact, and so the person is isolated, and depressed.
            
The INEB thinks that everyone has a part to play in resolving this crisis. Thai society is mainly Buddhist with 250,000 monks, 10,000 nuns, and 30,000 temples, so the Buddhist community is in a very good position to offer compassionate humanitarian care.
            
4. Project Objectives
            
The provision of temple hospice care can provide:
+ A caring environment where compassion and consideration for people with AIDS will help them to live humanely in a village atmosphere.
+ A situation in which the process of training, educating, and establishing a hospice will enhance community acceptance and facilitate active support
+ A place where Buddhist philosophy and practice can be integrated with other counseling approaches to provide practical and spiritual support for AIDS.
+ Increased knowledge and awareness for family members and other villagers in caring for people with AIDS
+ Temporary respite care in order to support families and individual careers and provide necessary medical assistance.


5. Project Implementation
            
a) Training/education for four different regions:
                
Four seminars are planned for different target months. The main purpose of the seminars is to educate about the AIDS crisis, self-prevention, and awareness on the AIDS epidemic. Furthermore, the seminars will cover the issue of hospice care, Buddhism and dying/death, and ways in which the Buddhist community can help care for people who are suffering from AIDS.

b) Seminars for eight districts in Lopburi:

The main purpose of these seminars is to create a positive attitude and support for the establishment of Buddhist hospices in Thailand. The seminars will cover a variety of issues including increasing the general awareness of AIDS and other diseases, addressing the AIDS crisis, the hospice idea and hospice visits, and Buddhism and how it relates to AIDS.


c) Training program for caregivers:

The occasional intensive training will be provided for caregivers-monks, volunteers, nurses and lay-people. Trainers will be those individuals who specialize in these specific fields and issues. The topics that will be covered include:

                + AIDS awareness
                + Self-preservation from the AIDS epidemic; and living with people with AIDS.
                + Universal precautions for caregivers in hospices
                + Hospice philosophy of care
                + Psychology in working for the hospice
                + Basic counseling skills in dealing with AIDS patients
                + Holistic care concept and skills
                + Hospital visits

Note: Before training begins, potential caregivers will be carefully screened by hospice staff to evaluate their emotional, spiritual, and psychological readiness and maturity in relation to working with people with AIDS.

d) Patient referral and assessment:

The project will work very closely with local health-care facilities, which will serve as referral sources for the hospice. After a referral has been made, representatives of the project will visit the individual and their family to assess the person's needs, describe the program, and develop a care plan, while taking into consideration their physical, psychological, social and spiritual needs. Afterwards, a physician will diagnose the extent of the illness. A number of doctors will serve as consultants to the hospice and they will visit when necessary.

Establishing a working relationship and understanding with local hospitals and physicians is of the utmost importance; for if one of the individuals staying at the hospice requires hospitalization for acute care the hospice wants to ensure that the comfort, dignity and control the person experiences in that hospital's setting is consistent with the hospice's philosophy. This helps to ensure the continuity of care for the individual.

e) Activities/Trainings for AIDS Patients

The hospice will provide necessary activities and training on holistic care for AIDS patients, including orientation, vocational skills, as well as natural and musical therapy.

f) Patient and Family Visits

Sometimes, for a variety of reasons, families cannot cope with their family members who are stricken with AIDS, so the hospice will work hard to try and establish goodwill and constructive relationships between the patients and their families.

            For further info contact the Dramaraksaniwesana Project c/o:
            Wat Phrabatnampu, Kaosamyod
            P.O. Box 83
            Lopburi, Thailand
            15000

            Website - http://www.aids-hospice.com

            Tel & Fax : (036) 413805
            Mobile: 01-942-5479; 01-3533154; 01-495-3838; 01-944-4373
     

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