The Kingdom of Lanna and the HIV Epidemic

of orphaned children, and impoverished elderly. Workers, of course, are also consumers, and
the ripple effects of these losses will affect many other sectors of the economy. As Mechai
Viravaidya as pointed out, economic impacts can also be expected in tourism, foreign
investment, and labor remittances from abroad.(19) An economic impact analysis of HIV on
the Thai economy done in 1991, using an estimate of 200,000-400,000 cases (now generally
considered too low), placed the cost of the epidemic at between US$ 7.3 billion and US$ 8.5
billion by the year 2,000, an enormous sum.(19) These costs, again, will disproportionately
affect northern Thailand.
Hope: Community Responses
The people of Lanna have faced numerous challenges in their long history; wars,
foreign occupation, annexation to the Thai state, and, more recently, rapid development,
environmental degradation, and rapid social change. The HIV epidemic is but one more
challenge to this ancient society and its people. The resilience and adaptability of the northern
Thai people have been tested before and will be tested again. There are already encouraging
signs that social responses to the epidemic among the northern Thai will be marked by
compassion and care, rather than fear and isolation.
A fledgling hospice movement has begun in several cities; most have been initiatives
by Buddhist monks. AIDS support groups have been developed by the. Thai Red Cross,
NGOs, and by people with AIDS themselves. In Doi Saket, Chiang Mai province, a group
of widows who have lost husbands to AIDS have begun their own support and income
generating group. The first orphanages for children with HIV infection have opened in the
north. Home care and community based care initiatives have also been started by the Ministry
of Public Health in the upper north. Many of these developments are quite recent, and most
are still quite small both in scope and scale. Yet these programs are cause for real optimism,
especially those that represent true community initiatives. The HIV epidemic does not have
to undermine Lanna culture; traditions of tolerance and compassion may actually be
strengthened by the challenges of AIDS. The status of women, especially as regards women's
ability to determine sexual choices, may also be strengthened by the HIV epidemic. Northern
Thai families may be increasingly reluctant to consign their daughters to sex work in the era
of AIDS, and this can only be applauded. Lastly, while sexual pleasure for northern Thai