Deserted by Families, AIDS Victims in Vietnam Face the Disease Alone

Her son’s forehead wrinkled in pain, and Tran Thi Xuan leaned over to massage his temples. Her fingers moved vigorously despite the weariness in her own face.

“He misses me very much when I go out,” Xuan, a vegetable vendor, said fondly. “He always wants me to stay home, but I can’t.”

Her son, Pham Manh Cuong, was dying of AIDS complications, apparently contracted from a contaminated needle during more than two decades of opium addiction.

He didn’t have medical insurance, enjoyed mainly by those with government or state factory jobs, and couldn’t afford the daily hospital fee of 20,000 dong, about $1.80. No doctor came to call.

Still, Cuong was one of Vietnam’s luckier AIDS patients--his family took care of him until he died. Social workers say most families desert AIDS patients as soon as the disease is confirmed.

In a society that traditionally stresses family ties, the abandonment betrays the terror AIDS inspires. It may also reflect the fact that most of the patients are drug addicts who long ago wore out their families’ patience.

“He is my son, so I must help him,” Xuan said when asked to explain her faithful care.

Vietnam’s biggest holiday of the year was nearing, Tet, the Lunar New Year. She wanted all 10 of her children there, including Cuong. “We want to be close to him,” said Xuan, a widow.

They almost made it. He died four days before Tet, at age 41.

Nearly 3,500 cases of HIV or AIDS infection have been officially reported in Vietnam since the first case was detected in 1990. But health experts believe the true number is several times higher, with most cases going undetected because blood tests are rare.

Over the last two years, the government has undertaken large-scale public education about AIDS through street posters, TV ads and school programs. Worried by the disease’s rapid spread in nearby Thailand and Cambodia, it has promoted condom use with a frankness unusual for an Asian country where talk of sex is normally taboo.

Nonetheless, many people still fear casual contact with AIDS patients. Unlike many Western countries, no public figures have stepped forward to acknowledge having the disease and give it a human face. There is little public sympathy for patients.

The Binh Trieu drug treatment center, one of the few places in Ho Chi Minh City where AIDS tests are routine, is building a new, separate facility for AIDS patients. It’s not to segregate and confine them, authorities insist, but to give them a place to go.

“Once a [regular] hospital knows someone has full-blown AIDS, they try to push them out to another hospital,” said Bui Quang Thuy, a center worker. “They don’t have separate wards for HIV patients, and they’re afraid of driving away other patients.”

Cuong and his mother never told the neighbors why he was ill, unsure of the reaction.

Cuong developed his drug habit in the South Vietnamese Army during the Vietnam War. “I was 18 years old, too young to understand,” he said.

Like many soldiers, Cuong drove a pedicab after the war. He bought opium, grown in Vietnam’s highlands, from dealers who provided needles.

Three years ago, during an anti-vice sweep, police sent him to the Binh Trieu center, where doctors found he tested positive for HIV, the virus researchers believe causes AIDS.

Cuong wasted away slowly after release. He developed a fever and skin lesions. His legs refused to support him.

“I feel as if someone is pulling my head apart,” Cuong muttered. “Especially at night. I can’t sleep.”

He sprawled on a thin straw mat atop a metal bed frame, his limbs poking stick-like from a faded green work shirt and baggy brown pants. From a cassette player came the sound of Willie Nelson singing, “You were always on my mind.”

Tran Minh Hue, a patient at the Binh Trieu center, would give anything to spend his last months as Cuong did--at home.

Like Cuong, he was brought to the center by police and learned there that he had AIDS.

His disease has followed a similar path. Hue lifted his green uniform shirt to show the bluish scars of healed skin lesions.

“These hives are the worst,” he said. “Some people have so many they can’t sit or stand. It feels like insects crawling under your skin.”

But Hue’s experience took a different turn. He wrote home to tell his wife and two children about his illness and ask their support. He hasn’t received a reply.

“We know we can get good treatment here, but we want to be close to our families,” he said. “A counselor from the center went to see my family and asked them to visit me, but they didn’t come. I don’t know what is wrong.”