Donations to the temple are tax-free and come mainly from tourists, Thais and westerners, who visit the temple in their thousands every week.
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The staff are also poorly paid (3,500 to 7,000 baht, or £55 to £110, a month) and poorly trained for what is gruelling work. “I work 12 hours a day,” says Wilaiwan Khantiwong, 26, the slender, no-nonsense woman who runs the ward. “Often I can’t do much for the patients and I feel like giving up. But if I leave, who will take care of them?” Wilaiwan is a licensed nurse who has worked here since she was 17. “I do every job, from cleaner to doctor,” she says. Today, she carries not a stethoscope but a tube of Toblerone, a donation from a Swiss tourist. Paracetamol is her strongest painkiller. “We have some morphine, but it might have expired by now. Without a doctor around, I don’t dare use it.”
Ideally, the temple should have two doctors and three registered nurses, says [long-standing American volunteer and priest Michael Bassano]. The last doctor to work here was a Belgian volunteer named Paul Yves Wery, who left in 2004. He wrote a parting account of his years at the temple, describing it as unsanitary, ill-equipped and mismanaged. Wery calls the staff “slaves” and the tourists “cannibals”; the abbot is an ambiguous figure who runs “what has become a death factory [like] a small family enterprise”. After Wery’s book was published, all foreign volunteers except Bassano were asked to leave.
These days, patients see a doctor only once a month, when they are taken to a hospital in the nearby town of Lopburi for a routine check-up and a fresh supply of ARVs. The rest of the time they depend on Nurse Wilaiwan. “Once we had a medical emergency and I wasn’t here, only the cleaner, who didn’t know what to do,” she says. “Sometimes patients die on the way to hospital.”
Hours later, one of the temple’s tour guides collapses and Wilaiwan rushes him to the hospital. He is dead on arrival.
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[Abbott Alongkot Dikkapanyo] says the temple has tried and failed to recruit medical staff. “Thai doctors prefer to work at private hospitals. Even the government ones don’t have enough medical staff.” It still seems inexplicable that, in a prospering country of 65m, there is not a single Thai doctor for hire.
[Antiretroviral drugs] have brought new hopes and challenges, he continues. “People used to come here and die. We cremated them and that was that.” Now hundreds survive and – estranged from or rejected by their families – must be fed, housed and clothed, he says. There are more kids, too. Before, they died quickly; now they live longer and relatives prefer to give them to the abbot, believing his care is better. (The second project will eventually house 2,000 children.) All this places a growing financial burden on the temple. “We’re wondering how we’ll survive,” says Alongkot.
Yet the temple hardly seems in dire financial straits. Pradit Yingyong, the temple’s PR officer, says the abbot plans to build a sports centre (cost: the equivalent of £1.6m) and carve a meditation path through the hill above the temple (£8m).
“There’s lots of money coming in,” says Bassano. “But how it’s distributed, who benefits, who gets what – I have no idea.” Why, he asks, build the Aids Human Body Part Museum – a room in which hands, feet, hearts, kidneys and other organs are kept in perspiring jars of formaldehyde – when the temple has no ambulance? “And the neglect of the kids… Not just the kids, but the adult patients as well.”
It is hard to ask a celebrated monk about money without seeming to accuse him of dishonesty. But then this is one reason why the finances of Thai temples are traditionally so opaque and donations so easy to misappropriate. (“Half for the temple, half for the temple committee,” goes an old Thai song.) It costs 4m to 5m baht (£64,000 to £80,000) a month to run the temple, excluding the second project, says Alongkot, and the temple receives “the same” in donations. The finances are not made public. “It’s not our duty to make a public declaration,” he insists, “but we have a good [accounting] system.” Alongkot suggests I ask at the secretary’s office to learn how much is spent on the temple. I am then shuttled between four offices before being given a print-out with a totally different figure from the abbot’s. Pradit gives me another figure, a committee member yet another. Nobody can explain how the second project, which includes the orphanage, is funded, never mind the sports centre or meditation path.
When Alongkot took in his first HIV sufferers, it was an act of compassion before its time. Sixteen years later – with hundreds of thousands of Thais visiting, and the temple’s coffers spilling over – the patients seem overlooked, even as their very public plight keeps the money rolling in. With ARVs getting cheaper and more effective, the strategy might not last much longer. “How will they get money if people look healthy?” asks Bassano. “You’re going to have to do something, because people are getting better. You can’t stop this process. The ARVs are here to stay.”
Bassano has now left the temple to prepare for his next posting. He is going to Tanzania, where the prevalence of HIV/Aids in adults is almost six times that of Thailand. His patients miss him. “If I could walk,” vows Chukiat, the former engineer, “I’d go with him.” Even as Bassano was packing his bags, a new doctor and nurse arrived. They are not Thais funded by temple money, but a Cambodian and an Indian paid for by an American charity. The Cambodian doctor declined to be interviewed: he doesn’t yet have a licence to practise medicine in Thailand, so his much-needed work is technically illegal. He would say, however, that the temple lacks even basic drugs and medical equipment.
