Your Health & Happiness:
How antiretroviral side effects can change the life of HIV+ people
Health and Development Networks (HDN) hosted a monthly
NGO Forum for non-profit organizations on September 28. The topic of
discussion, suggested by participants from the last NGO Forum, was “ARVs
(Antiretroviral): the problem of side effects, and possible solutions”.
Three panellists, each from the PWHA (People living with
HIV and AIDS) community, the medical and the NGO sectors, were invited to
share their perspectives.
Antiretroviral drugs and related issues such as access to
treatment, adherence patterns and administration of the drugs figured
prominently in the international debate and at this year’s International
AIDS Conference. Several countries, including Thailand, have launched
policies facilitating access to ARV treatment. Currently with a little over
40,000 people regularly receiving some combination of ARVs in Thailand, the
lack of ARVs here is felt less acutely than in other parts of the world.
The NGO Forum began with a hands-on activity aimed to
raise awareness among participants. Everyone was asked to illustrate in a
handout and share with the forum the changes they notice in themselves
and/or others after taking ARVs.
The forum moderator proceeded to summarise relevant
ARV-related developments. ARV treatment was first provided to only 1,500
patients in Thailand as part of the ATC Project. Now, the Napa Project aims
to provide treatment to 50,000 patients by the end of 2004. At the IAC in
Bangkok this year, the Prime Minister announced that ARVs would be included
in the country’s general health insurance scheme by 2006.
On a global scale, the World Health Organisation’s
(WHO) ambitious “3x5” programme aims to give three million people access
to ARVs by 2005.
Currently the only regimen - and the cheapest option -
available to PWHA in Thailand is GPO-VIR, which costs 1,200 baht per month;
the drugs are generics and produced domestically. Other regimens can cost
between 20,000-50,000 baht a month.
There is a growing concern of various ARVs side effects
such as lipodystrophy among people living with HIV/AIDS across the country.
A small but vocal group of affected community members is drawing attention
to this issue.
The panellist from the medical sector noted that in the
past, the typical characteristics associated with PWHA were thinness, newly
grown hair, diarrhoea, skin spots and a grim facial expression. Since many
Thais experience visible physical symptoms at a very late stage, they would
resort to treatment late. Despite being diagnosed as HIV+, some only seek
medical assistance in the final stage, thinking that ARV treatment is the
last resort. Had they known their status sooner, they could have taken care
of themselves better and suffered less pain.
The panellist representing the PWHA community recounted
that she took usual care of herself and took herbs for many years after
being diagnosed as HIV+. She switched to ARV treatment when pain started.
Initially, she stopped having opportunistic infections and gained ten kilos.
However, she started experiencing side effects such as sharp pains, shaky
hands and legs, weight loss, a thinner and darker complexion. She became
stressed out, stayed indoors and began eating more meat and protein. When
her condition improved, her friends sold their cows and other assets to be
able to afford the same food.
The NGO panellist, who is also a nurse, noted that people
who are HIV+ want ARVs, believing them the only solution to curing AIDS.
None considered related issues such as: readiness (one’s own and the
family’s) to adhere to a regimen and adjust to physical changes; side
effects; seeking appropriate solutions to problems.
Participants noted that side effects have changed the
symptoms “traditionally” associated with PWHA to rounder faces and
increased abdominal girth, forcing PWHA to fight against new social stigma
as well as existing government policy. Participants expressed fears that
methadone or TB medication taken alongside the ARV regimen may cancel out
Furthermore, PWHA tend to focus exclusively on ARVs once
they realise that opportunistic infections decrease after taking them. Yet
the information gap increases, as patients fail to realise that side effects
of ARVs are not only physical, but also social and cultural.
In response to a question about the usefulness of herbs,
the medical panellist explained that herbs can be used either as part of
self-care prior to receiving or during ARVs treatment. Although herbs do not
cure AIDS, they can boost the immune system and thus aid in preventing
opportunistic infections. The NGO representative added tips for easing
lipodystrophy such as protein and careful monitoring of food intake, as well
as plenty of sleep and exercise.
Using ARVs means extending one’s life, but “extending
life” does not only mean we continue breathing. It means living with other
people, accepting our appearance and maintaining our overall health. The
question remains: how can we do this successfully?
The next monthly NGO Forum meeting will be held on
Tuesday, October 26. The Forum is open to everyone in the community. For
more information, please contact Health and Development Networks (HDN) by
email: [email protected] or tel. 66 53 418 438.
The Doctor's Consultation:
The 100 percent vegetable
diet to a longer life
by Dr. Iain Corness
The following lifestyle diet was sent to me by an old
friend George Comino, wondering if he should take it up. Here is the proposal:
Q: I’ve heard that cardiovascular exercise can prolong
life. Is this true?
A: Your heart is only good for so many beats, and that’s
it. Don’t waste them on exercise. Everything wears out eventually. Speeding
up your heart will not make you live longer; that’s like saying you can
extend the life of your car by driving it faster. Want to live longer? Take a
Q: Should I cut down on meat and eat more fruits and
A: You must grasp logistical efficiencies. What does a cow
eat? Hay and corn. And what are these? Vegetables. So a steak is nothing more
than an efficient mechanism of delivering vegetables to your system. Need
grain? Eat chicken. Beef is also a good source of field grass (green leafy
vegetable). And a pork chop can give you 100% of your recommended daily
allowance of vegetable products.
Q: Should I reduce my alcohol intake?
A: No, not at all. Wine is made from fruit. Brandy is
distilled wine, that means they take the water out of the fruity bit so you
get even more of the goodness that way. Beer is also made out of grain.
Q: How can I calculate my body/fat ratio?
A: Well, if you have a body and you have body fat, your
ratio is one to one. If you have two bodies, your ratio is two to one, etc.
Q: What are some of the advantages of participating in a
regular exercise program?
A: Can’t think of a single one, sorry. My philosophy is:
No Pain. Good.
Q: Aren’t fried foods bad for you?
A: You’re not listening! Foods are fried these days in
vegetable oil. In fact, they’re permeated in it. How could getting more
vegetables be bad for you?
Q: Will sit-ups help prevent me from getting a little soft
around the middle?
A: Definitely not! When you exercise a muscle, it gets
bigger. You should only be doing sit-ups if you want a bigger stomach.
Q: Is chocolate bad for me?
A: Are you crazy? Hello - Cocoa beans - another vegetable!
It’s the best feel-good food around!
Q: Is swimming good for your figure?
A: If swimming is good for your figure, explain whales to
Q: Is getting in-shape important for my lifestyle?
A: Hey! ‘Round’ is a shape!
Well, I hope this has cleared up any misconceptions you may
have had about food and diets and remember, “Life should NOT be a journey to
the grave with the intention of arriving safely in an attractive and well
preserved body, but rather to skid in sideways - Chardonnay in one hand -
strawberries in the other - body thoroughly used up, totally worn out, and
screaming - Woo Hoo! What a Ride!”
And now the REAL situation
George, my dear old friend, with the suggestions above, you
won’t be a dear old friend much longer. A dear departed old friend more like
it. However, you are not totally incorrect when you mention the 100 percent
vegetable diet for a longer life. Even Dr. Spock turned vegetarian in his
later years and lived to be 95, but he got his vegetables from the garden, not
pre-processed via the cow, or distilled in the vineyards. However, laughter is
always the best medicine, and I enjoyed my dose today.
I will be coming to Thailand in December and I like to rent motorbike and
ride all over your beautiful country. I arrive Chiang Mai and go Bangkok
after two weeks. Is possible? Yes or no? Where do I get the bike? I do not
need big bike as I am small man. I ride Vespa in Paris, so I am OK in the
saddle. Is it with insurance and can I ride with French license? Thank
You have certainly got plenty of questions, especially for a small man, as
you so quaintly put it. I really think that you should sit down on the
seat of your trusty Vespa and think again, Pierre. I have been to Paris
and seen the standard of hair-raising driving there - but, Pierre my
Petal, it is nothing compared to the driving in this country. When you
ride a motorcycle here it is not a case of “if” you have an accident,
it is “when” you have an accident. You don’t meet another Vespa
coming up the Champs Elysee the wrong way, now do you? The gendarmes would
not allow it. Here it is a different story. Going the wrong way down a
one-way street is normal in Thailand. This country has one of the highest
road tolls in the world, and that is just one of the reasons why. Forget
it Pierre. Take a tour bus.
This is a real problem for me, and I do hope you can help (don’t treat
this lightly please, as I have nobody else I could possibly ask, and I
definitely couldn’t ask my husband). One of my former women friends in
the UK, from the same village as me is coming to Thailand next month, with
another couple of her girlfriends. We are all in out 50s, so we’re not
scatty teenagers. She shocked me when she wrote and said they wanted to
see a “sex show” while they are here. Do you think it’s proper for
me to take them to some of the more outrageous places, or what? I’m
really blown away by this. What do you recommend, Hillary?
There is nothing to worry about, my Petal. Everybody knows we don’t have
sex shows in Thailand. The nice man from the Ministry of Fun told me so,
and so did the nice policeman. If you’re really worried, get your
husband to take them.
I love coming to Thailand, it is really such an exciting place to visit.
There are only a couple of downsides for me. Bartering and tipping. Can
you give us some pointers on how to do it, and how much to leave as a tip?
If the establishment charges a “service” fee, should you tip as well?
What do you do as someone living there, for example? I believe that the
wages are not high for some of the people in bars and restaurants and they
need the tips, but I do not want to throw money away either? What’s your
tip about tipping?
Half the fun of coming here on holiday is the bartering side of buying.
Don’t get too hung up about it. They will give you a starting price and
I generally come back with about 40 percent of that. The shopkeeper will
then come down a little, you go up a little and so on. Keep smiling,
it’s a game remember! If you find you are haggling over 20 baht, convert
that to your home currency (30 British new pence or 50 cents US) and see
if it is worth the hassle of continuing. Don’t leave something you want
for the sake of 50 cents!
Tipping? There are two situations here - service charge or no service
charge. If the establishment adds on 10 percent (the usual amount), then
as far as Hillary is concerned - that’s the tip. There are some places
that no doubt pocket the service charge, but that’s not anything of our
doing, nor can we change it. That is something between the employees and
the owners to work out. However, if Hillary feels that the waiter or
service provider has gone well beyond that which could be expected, then I
reward with a little extra something for that person, irrespective. You
know the sort of things I like - a little fawning, grovelling and lots of
compliments. In an establishment that has no standard add on service
charge, then it really is up to you. Small change left over or up to 10
percent is quite acceptable. The Thai people are grateful for anything you
leave them. It all adds up by the end of the day.
I see so many old and ugly expats here running around with beautiful young
girls that it makes me sick. Do they think these girls actually like them?
It’s only their money that they’re after.
Young and handsome
Dear Young and handsome,
Look forward to the day when you are old and ugly too, young man. If you
are clever and have put some money aside, then you too might have a
beautiful young girl to look after you too. Time to live and let live. Are
they doing anybody any harm? Does it matter that they are keeping several
herds of buffalo in luxury? No!
Camera Class: How to improve - the equipment and the basics
by Harry Flashman
In my time I have bought and sold many cameras, including
Nikon, Hasselblad, Voigtlander, Cambo and Minolta. There was also one I threw
away, called a Golden Dream Pigeon. I threw it away, not because it didn’t
work, but because it took lousy photographs. It had also cost 90 baht, including
the film, so I was not losing much!
What I learned from my Golden Dream Pigeon was simply the old
adage - you get what you pay for! Unfortunately, all of us fall into the trap of
the tight fist. Why spend big baht when a much cheaper article will surely do
the same job just as well. I rationalized Golden Dream Pigeon’s purchase in
this way as I did not think that it could be quite as dreadful as it was!
As justification you tell yourself that all you are paying
for is the “name” plus very expensive packaging with the high ticket items.
Unfortunately, in photography, you pay for more than the “name”. You are
paying for that other ingredient called Photographic Quality.
The interesting feature about photography is that the measure
of excellence is always the end result. In other words, the photo says it all. A
clear, sharp and well exposed shot shows the lab did a good job in printing, the
film was top quality, the camera set at the correct exposure, the lens let the
light rays through without distortion and the image was focussed correctly.
So let’s look at some of these basic factors. First,
let’s deal with the camera. What is often not realized is that the principle
function of the camera body is really just to hold the film flat and be able to
alter the shutter speed and aperture required for correct exposure. It’s still
just like a Box Brownie - but smaller with built-in goodies.
The cost of the camera body today depends on the degree of
sophistication in its built-in features. Electronic multi-pattern metering,
motor driven film advance, auto rewinding, DX coding to set the film speed
automatically, different exposure modes, smart cards and memory stick
replaceable electronic gadgetry, LED viewfinder displays, dedicated flash
electronic circuitry and ergonomics in design all add to the cost. None of the
above were available in the Golden Dream Pigeon, by the way.
Next item is the lens. The equipment necessary for the super
sharp snap is the super sharp lens. The sad fact is that no matter how good or
expensive your camera body, you will only get lousy pictures if you use a lousy
lens. A good lens is just as important as a good camera body.
If excellence is your pursuit, look at good quality
“fast” (f 2.8 or better) fixed focal length lenses from the same
manufacturer as your good quality camera body. Sure, you can get a “bargain”
at some camera shops (and Duty Free outlets) who will sell you a Nagasaki 28 -
3000 zoom for your new Nikon or Canon or whatever. Certainly it will be cheaper
outfit than a Nikon lens on a Nikon camera - but in saving a few baht you just
lost out on excellence.
Now let’s look at some very simple fixes for some common
problems. Blurry photographs can be fixed by selecting shutter speeds of 1/125th
second or faster. Hold the camera with two hands. None of this one handed
technique, waving one-two-three fingers with the other hand as a count-down.
There are six simple steps on the road to improvement:
1. Use more film. At least one roll each time, taking notes
to check your results later.
2. Move in closer. Many shots fail by being too distant.
3. Keep it simple. Photos are far more effective with one
subject and no background clutter.
4. Specialize. Take pictures of one subject, say boats or
trees, until it is mastered.
5. Read books on the subject. Kodak “How to ...” books
are instructive and easy to follow.
6. Edit your own work by constantly sorting through your photos and
discarding the failed shots. Be ruthless! And remember just “why” the shot
Dr Byte's Computer Conundrums
by Dr Byte, Citec Asia
In my last column, I promised that I would explore the world
of file sharing on the internet (peer to peer) in more detail and I also
promised some killer applications to think about.
Before I begin, let me state that most file sharing
activities are focused on illegal, unethical, or immoral activity. Downloading
of copyrighted music, copyrighted software, pornographic material, and even
child pornography are the most common uses of peer-to-peer file sharing. It’s
also risky and one of the risks is to unknowingly download a computer virus or
Trojan Horse onto your computer.
Not so long ago, Napster, the grandfather of peer to peer
networking, was simply providing an easy way of sharing music through their own
system. 20 million sharers later, the record industry basically shut down the
company (for making it too easy to share music) and only three years ago,
followed this by mounting legal actions against Music City, Grokster and Kazaa
(sons of grandfather). This suite marked the fourth major legal action to try to
restrain millions of people from sharing copies of songs and movies online.
Within months of this 4th lawsuit, more than 34 million
downloads from just one source (download.com) shows just how many people
recognised the opportunity. Collectively, these and other rivals have kept file
swapping alive and well in Napster’s absence. Analysis company Webnoize
estimated that 3.05 billion files were downloaded using these networks within
months of that lawsuit.
The concept has attracted the attention of companies like HP,
IBM and others. The potential to set up business networks using the same kind of
protocols is obvious. Imagine your company head office in New York simply shares
a folder on their local computer, and you have access to the latest product
updates, brochures and so on (and its available to those with the right access).
Millions and millions of computers (and of-course owners) are
now sharing images, music, movies, videos and files and the US record industry
is having problems policing millions and millions sharing their favorite movie
or sound tracks.
The good news is that recent legal actions failed and a US
Federal Judge handed down a stunning court victory for file-swapping services,
dismissing most of the lawsuits. In essence, there is nothing illegal about use
of the application. Its also noteworthy that when users search for and initiate
transfers of files using peer-to-peer networks, they do so without any
information being transmitted to or through any computers owned or controlled by
the authors of these applications. If any of the authors of these peer-to-peer
applications (clients) closed their doors, users of their products could
continue sharing files with little or no interruption.
Kazaa is an Australian product that most of us have heard of.
Its one of the biggies and they openly admit that it comes with integrated
spyware that monitors your internet activity and reports back on web sites
visited and so on. K-Lite is a light version with no spyware but doesn’t have
the same features. Kazaa changed hands and is now owned by Sharman Industries.
Go to www.kazaa.com for your download. This application is free but only gets 1
Star for paying its way by selling and peddling your personal web surfing
Grokster comes in two versions but do beware, like Kazaa,
Grokster comes with integrated spyware. A paid for US$29.95 Pro version and a
free light version are available. Grokster can be downloaded from
www.grokster.com and gets 0.5 of a Star because it not only pays its way by
spying on you, it also makes money selling its Pro version.
Son of Napster is still around but now it’s highly ethical
and only provides access to licensed music which you have to pay for. Costing
$9.95 US a month you can download Napster from www.napster.com. Napster only
gets 2 stars.
Limewire is another Aussie application and very good too.
There are two versions with a free light version and pay for Pro version. The
light version has constant pop up messages imploring you to buy the Pro version
and get faster downloads etc and I got the feeling (but can’t prove it) the
free version was deliberately slow. Go to www.limewire.com to download either
version. Try the free version first and then maybe buy the Pro version later. 3
WinMx produced by Frontcode is very easy to use, with a
cluttered but easy interface. Download and share any file type, multiple source
downloading, chat, queuing and many other features. This application guarantees
no spyware, no centralised monitoring of shares, bandwidth management and the
list goes on. WinMX finds files very fast and depending on your internet
connection, can download as fast as your connection allows.
WinMx gets 4.5 stars (lose 0.5 for a cluttered look); go and
get it from www.winmx.com
Shareaza is probably the smoothest looking of this list.
Networks to Gnutella2, Edonkey 2000 and BitTorrent, this open source application
has received over 200 updates to improve your file-sharing experience. An
excellent FAQ module simply adds one more reason on top of a long, long list of
features. Completely free, no spyware and more importantly can block unwanted
attention with the help of security block lists, a highly-sophisticated IP and
client filter and has the ability to block malicious companies and clients.
Searching for files was very slow and downloading even slower. Go to
www.shareazaa.com to download and check out. This application gets 3.0 stars.
Last and not least for this week, Neo-NETS Morpheus claims
fast downloads and searches include all other major file-sharing networks with
simultaneous connecting to millions of users of Kazaa, iMesh, eDonkey, LimeWire,
Gnutella, Grokster, G2 and others to find more digital media. Morpheus is the
only American file-sharing software ruled legal by U.S. federal courts. It
protects your privacy with access to public proxy networks and has options to
prevent others from snooping on you; works with your antivirus software to
prevent unwanted malicious files; enables simultaneous searches for all media
file types including MP3 audio, video, games, software, pictures and documents;
returns fast multi-source downloads; provides bitzi anti-spoofing lookups and
contains absolutely no spyware. There are several warnings about Morpheus users
being attacked by hackers, so be warned. Go to www.morpheus.com to download and
get the free. Morpheus gets 4 stars.
In the next column, I’ll be updating you on what has been
happening to Chiang Mai’s internet options since August. And yes, a possible
solution for businesses in the city area.
Dr Byte appears in Chiangmai Mail every 2 weeks and if you
have any questions or suggestions you would like to make, you can contact me at
Dr Byte, Chiangmai Mail.
Letters from Lek
Here is another game, which is especially good for a birthday party.
is very easy, but you are not allowed to let anyone see the preparations,
because that could give them a clue what kind of game it is, and some of
them might even know the game, so that it wouldn’t be fun anymore.
The game is called:
“What is on the Paper?”
at least 10 pieces of paper,
dried orange peals,
small bits of wood,
small bits of cloth,
1 or 2 rubbers, 2 bottle tops
and a small piece of cardboard or other small things.
Stick all the things that are listed above on several pieces of paper (one
item on one sheet). Then hide it at a place where the other children
probably won’t go.
Blindfold a child and take it to the place where you hid the sheets of
There you tell the kid that it has to guess what is on the paper, which it
If they guess right you note down one point (don’t forget to write the
child’s name, too, because you might get dazzled if you have many children
wanting to play the game), if they guess wrong they don’t get a point.
They only have one guess per paper and the person with the most points wins
Joke of the week:
Does somebody live on the moon?
Of course, you can see the light every night!
Alright now, have a nice week!
Mrs. DoLittle’s Corner: How to live with a calculating civet cat
How to live with a calculating civet cat? The best way in
reality is don’t! However, just in case someone, like Mrs. DoLittle, will
find themselves forced by circumstances beyond their control, to share their
abode with one of these mischievous little creatures, here are a few tips.
the civet cat
Yes, these little monsters can actually outsmart you if you
are not careful. It starts from the very beginning. Even the name, Common Palm
Civet, it’s a trick! It implies a normal “civet-lized” sort of an animal
having some kind of relationship with palm trees. Nothing could be further from
the truth! That is only a name that has been derived by scientists, so that
zookeepers will think it is really cute and want to care for it. Once you get
close enough, the little rascal jumps on your face and bites your nose off. By
the time you work out what hit you, the little cutie is sitting on top of the
curtain rod, waiting for you to turn your back so it can jump on your head and
rip your ears off.
Mrs. DoLittle found that the only way to stop the attack was
to pretend it wasn’t happening. Start humming and eventually it dozes off.
Hopefully by the time this happens you are still recognizable and won’t need
Of course something has to be said in defense of the
species. I mean, they don’t really mean to rip your ears off. No, it’s just
that living with humans they don’t get to kill anything. Living in the
forest, every little thing that moves gets jumped on, wrestled and munched.
Living with a civet cat, one has to allow for this.
Civet cats are really smart. They sleep all day and get away
with it by declaring themselves nocturnal. This also means that in the morning
when you are full of energy, ready for a challenge, with some possibility of
winning, they are never around. They are clever enough to know that the best
time to ‘kill’ you is at the end of the day when you are half dead already.
Don’t worry, the nightly ambushes are only a passing phase and also a great
opportunity to test your own pain tolerance level. What other species can offer
It is extremely important to allow yourself to get
‘killed’ during this period of getting to know each other. Learn to play
‘dead’, otherwise it will want to kill you for the rest of its life.
After Mrs. DoLittle outsmarted Happy, her first civet cat
and played dead for approximately three months, it stopped biting. I was still
alive so I was able to enjoy this new period in our relationship. Friends
commented on how normal I looked. Now I was able to sit and read a book and
Happy would just attack the book.
It did leave a lot of missing pages but at least I had my
arms and legs. This is phase two, known as the ‘jealousy stage’. This lasts
the rest of its life. At this point it’s time to give away all your
possessions and dedicate the rest of your life to entertaining your darling
little cat. Civet cats are masters of monopoly. Follow these tips and one day
your civet cat may get to “like” you … maybe.
The moral of this story is: Leave wildlife to go wild in the wild!
Life in the Laugh Lane: Let sleeping dogs lie-die
by Scott Jones
The bravery or audacity of Thai dogs is astounding. They
will try to eat, attack or mate with anything at anytime. And they can sleep
anywhere at anytime: in the shade, in the baking sun, on tables, chairs and
windowsills, in baskets on speeding scooters, but preferably in the middle of
the road. The exact middle of the road. On the line, if possible. It’s not
cool, soft or safe. It’s hot, hard and life threatening. Are they just tired
of their cushy dogs’ life and dream of being with Buddha later on today?
famous Thai species is the ‘table dog’.
How many times have you seen a hound lying on the shoulder,
centimeters from traffic on a busy city street, testing tire treads with his
tail? How many times have I ridden through a sleepy town with an apparent road
kill in the middle of the road and its apparent owners dead to the world nearby
on a bamboo platform? The roar of my motorcycle wakens the canine from its coma
and it barely ambles out of my way. Or decides that my foot could be a tasty
afternoon snack. Or if I stop long enough, mounts my leg for a spontaneous
Chiang Mai friends had visited a bike shop several times in
an attempt to whittle down the price of a big Kawasaki. The resident mutt was
always splayed out on the cement, here or there, anywhere. One day, the dog was
stretched out on his side underneath the desired motorcycle and my friend
remarked in jest, is your dog dead or what? With a flourish, the owner said
something like, “No, he’s fine” and gave it a swift kick. Perfectly
motionless and rigid, the dog slid a half a meter in the direction of the kick.
Dead tired? No, just dead. Rigor Mortis the Dog.
“Gosh, he was such a good dog! Slept all day, hardly ate a thing, never
attacked anything and guarded that spot 24/7. Mai pen rai. We can still use it
as a door stop.”