UNICEF Mekong Partnership & Beyond – Priority Countries: Lao PDR

The HIV/AIDS epidemic in Lao PDR is in its early stages compared to most of its neighbours. With the right action now, there is still a chance to contain the epidemic before it reaches the levels seen in Thailand, Myanmar or Cambodia. In HIV/AIDS programming in Lao PDR, UNICEF focusses on building the capacities of implementing organizations at provincial and sub-provincial levels, that have the best access to vulnerable populations and to groups involved in risk behaviours.

A drama show on HIV/AIDS during a festival in Luang Prabang

Prevention efforts prioritize vulnerable youth, and young people. At the same time, UNICEF is developing activities to build acceptance, care and support for people with HIV/AIDS and their families in areas that are already badly affected.

Another priority under the Mekong Partnership and Beyond is to help government agencies bring successfully piloted prevention activities to national scale.

Lifeskills in School

UNICEF supports the Ministry of Education in development and implementation of Likeskills-based healthy living curricula for primary and middle schools, with plans for their incorporation into the national school curriculum through the existing UNFPA population studies. Course materials are also being adapted to include stronger components on acceptance, care and support of people with HIV/AIDS, and to promote equal treatment of ethnic minorities in school.

Lifeskills in the Community

UNICEF is also supporting further expansion of the two-tier community-based youth HIV/AIDS education project implemented by the Lao Youth Union, currently covering 33 districts and 13 provinces. In the project districts, teams of mobile outreach workers and local young village volunteer peer educators divide up responsibility for HIV/AIDS/STI prevention, care and support training and mobilization in the villages. In general, the mobile teams operate in communities that are easy to access, where there is a large target group or understanding about HIV/AIDS is very low. LYU trains young volunteers in hard-to-access communities, communities where knowledge of HIV/AIDS is better or those where the target group is small.

Lao girls learn about healthy living in a community workshop

The year 2000 saw UNICEF supporting training for a further 1,000 young volunteer peer educators trained in eight districts in Saravan and Champassak provinces, bringing the total to around 2,500 volunteers in the 13 provinces

Friends Tell Friends

For rural Lao youth, a job in one of the new factories that have multiplied since the country opened its doors to wider foreign investment brings the promise of a new life. Thousands of adolescents and young people, particularly girls, are exchanging their rural home for a factory dormitory or a rented room in one of the fast-developing cities. The new-found freedom is bringing with it new vulnerability to HIV/AIDS.

Putting Friends Tell Friends into practice at a Vientiane factory

Developed and applied in Thailand by the Thai Red Cross AIDS Research Centre, the Friends Tell Friends workplace HIV/AIDS/STI peer education curriculum has been enthusiastically adopted by the Central Lao Trade Union. In 2000, more than 1,300 young peer educators in 30 of the 51 factories in Vientiane Municipality were trained in using translated and adapted versions of the Friends Tell Friends manual and supplementary reading materials. Each of those 1,300 young workers is an educator and counsellor for 20 of their friends and co-workers.

The project is expanding in Lao PDR, with another 59 core trainers trained in provinces with growing industrialization, construction and infrastructure development: Vientiane Prefecture (outside the city), Savannakhet, Luang Prabang, Oudomxay and Khammouane. The scope of the program is also to be broadened to incorporate messages on alcohol use and on reproductive health and illicit drug and substance abuse (with the cooperation of UNFPA and UNDCP). Links will be established with the condom social marketing activities of Population Services International.

UNICEF support to Friends Tell Friends programming in Lao PDR includes training, technical assistance and materials development and printing.

Reaching Vulnerable Ethnic Minorities

UNICEF supports some key HIV/AIDS initiatives that focus on two large national groups, the Hmong and Khammou, who tend to live in remote areas, be poor and have limited opportunities or access to services. In the cultures of both groups, particularly the Khammou, wide disparities exist in the status of women and men.

UNICEF works with national and local radio stations to incorporate HIV/AIDS messages in Hmong and Khammou-language broadcasts. Radio spots, jingles, traditional songs and poems relating to HIV/AIDS prevention, care and support are broadcast frequently, alongside features and question-and-answer shows with prizes that have found particularly large audiences. This strategy has allowed UNICEF to reach a high proportion of the target groups, and overcomes the logistical difficulties of reaching some highly inaccessible communities.

The HIV/AIDS message reaches the Hmong community thanks to Hmong radio broadcasts

The Lao Youth Union community youth volunteers and mobile community outreach teams focus on these two minority groups in four districts with high population concentrations in the provinces of Luang Prabang (Khammou) and Xieng Khoung (Hmong). UNICEF has also supported updating of audio cassettes for the two groups, which are used and distributed by the community youth volunteers.

Vulnerable ethnic minorities will be a priority for further project expansion of Friends Tell Friends, with special emphasis on training core trainers from ethnic minorities.

Reproductive Health

There is currently only one centre for voluntary HIV counselling and testing centre in Lao PDR, and confidentiality is not always assured. UNICEF will collaborate with WHO, UNAIDS and the NCCA in strengthening and expanding voluntary confidential HIV/AIDS counselling and testing services.

The UNICEF Safe Motherhood project at community and district levels deals with a wide range of health issues, including HIV/AIDS. Activities include the training of mother and child health staff in universal precautions and in raising awareness about HIV and tuberculosis. Areas being explored for expansion of the program include training pharmacy personnel in STI management, as they are often the first recourse of people with STIs.

Reducing Impacts on Children and Families

This is a relatively new area of programming in Lao PDR. Under the Mekong Partnership and Beyond, UNICEF is following a three-point strategy to develop activities:

A rapid assessment of local traditions on care for orphaned children which looks at how these traditions and local government institutions can be strengthened to cope with the inevitable rise in the number of children affected by HIV/AIDS.
Professional attachment of staff from the Ministry of Social Welfare in Savannakhet province and from the central Ministry of Social Welfare to agencies in Thailand that work with affected children and families.
Supporting local initiatives in Savannakhet, Bokeo and, soon, Champassak provinces, targetting families affected by HIV/AIDS.

The Savannakhet Care and Support Project for People with HIV/AIDS is run by the provincial hospital and the provincial youth union. Activities include a monthly meeting of people with HIV/AIDS and their carers at the hospital, during which they receive a health check-up, participate in group activities such as discussions and sing-a-longs, share meals, and are given information on healthy diets and self-care. The project also helps to initiate income-generation schemes to help affected families. Already some members of the group have felt sufficiently empowered to speak in public about their experiences, a critical contribution to community education.

UNICEF will help to incorporate messages promoting family and community care and support into Lifeskills curricula and into the Lao Youth Union's community-based efforts, with special focus on reinforcing traditional ways of caring for sick family members.

People with HIV/AIDS already participate in UNICEF-supported awareness-raising activities, though on a very limited scale. UNICEF looks for opportunities to facilitate and expand their involvement, as has happened in Savannakhet.

With Hope and Help

UNICEF is supporting dissemination of the Lao With Hope and Help film and the facilitator's manuals throughout the country, and training workshops to explain how to use the kit to maximum effect

Buddhist Leadership

The Regional Buddhist Leadership Initiative has supported the development of Lao PDR's first collaborative project on a religious response to HIV/AIDS, Metta Tam, with the Sangha (order of Buddhist monks), the Department of Religious Affairs under the Lao Front for National Construction and UNICEF, Lao PDR. In seminars conducted during Buddhist Lent in 2001, monks and nuns from all over Lao PDR, along with students at the Buddhist University in Vientiane, participated in HIV/AIDS orientation programs run by Thailand's Sangha Metta Project and coordinated by the Metta Tam Project.

The project's next phase includes a study visit to Thailand followed by an action planning meeting for HIV/AIDS activities at local level. Local activities will be supported by a small grant facility where necessary.