HCMC ARCHDIOCESE EXPANDS HIV/AIDS ACTIVITIES

UNCLAS SECTION 01 OF 02 HO CHI MINH CITY 000564

SIPDIS

SENSITIVE
SIPDIS

E.O. 12958: N/A
TAGS: PHUM PREL KIRF SOCI PGOV VM
SUBJECT: HCMC ARCHDIOCESE EXPANDS HIV/AIDS ACTIVITIES

REF: 05 HCMC 1311; B) 05 HCMC 1152

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1. (SBU) Summary: Over the past 18 months, the HCMC
archdiocese has steadily expanded its efforts to provide
community-based assistance to HIV/AIDS victims. The church
continues to operate a government-approved HIV/AIDS clinic
within the Trong Diem drug rehabilitation center. With the
apparent tacit support of the HCMC government, the archdiocese
also has developed a multi-tiered community outreach and
treatment program for people living with HIV/AIDS, including
health clinics and counseling services. The church funds these
initiatives through a mix of domestic and international support,
including from CARE International. The increasing acceptance of
HCMC officials of the archdiocese's HIV/AIDS initiatives is
noteworthy and should be encouraged. End Summary. End Summary.

Background
--------------


2. (SBU) In December 2004, HCMC Department of Labor, Invalids,
and Social Affairs (DOLISA) opened an HIV/AIDS clinic at HCMC's
Trong Diem Rehabilitation Center - the first clinic of its kind
within a rehabilitation center in Vietnam. (Note: The
Rehabilitation Centers, known as 05/06 Centers, are
administrative detention centers for drug addicts and sex
workers. Trong Diem is one of HCMC's 21 centers. It is likely
that 50 percent of the centers' 30,000 residents are HIV
positive. End note.) Previously, DOLISA had been unable to find
qualified medical professionals to work with terminal AIDS
patients. In response, provincial authorities invited the HCMC
Archdiocese to provide doctors and nurses for the clinic. The
staff of 30 caregivers, consisting of both lay and religious
workers with health care credentials, provide opportunistic
infection treatment, physical therapy, HIV/AIDS and spiritual
counseling. The center averages 50-60 terminal AIDS patients a
month with 3 to 5 deaths unofficially reported per week. In
2005, Trong Diem's Catholic caregiver staff protested
malfeasance and lack of cooperation of the center's
administrators (ref B) and threatened to withdraw from the
center. However, senior city officials reaffirmed their
commitment to ensure continued religious worker involvement in
the center and in other HIV/AIDS activities. In April 2006, we
visited the Archdiocese's point man for HIV/AIDS, Pastoral Care
Project Manager Father John Dinh Toai to review the status of
the Church's activities in this area.

Trong Diem Rehabilitation Center In Transition
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3. (SBU) Father Toai told us that conditions for church workers
have improved at the Trong Diem center following the city's
intervention with the center's management. However, the HCMC
government now plans to transform the Trong Diem rehabilitation
center into a hospice for terminal AIDS patients for the city's
21 rehabilitation centers. The city has not told the
archdiocese what role it might play in the hospice, but the
church is prepared to continue or expand its activities there,
Father Toai said. Father Toai noted the expected change has
lowered the morale of the Trong Diem staff, which expects to be
transferred elsewhere or laid off. Current residents also fear
that a transfer to another facility may result in longer periods
of confinement. Consequently, there have been a number of
attempted escapes including eight residents who successfully
scaled the center's walls in May 2006.

Pastoral Care's Multi-Layer Support Network
--------------


4. (SBU) Father Toai told us that the Pastoral Care's
home-based "continuum of care program" for People Living With
HIV/AIDS (PLWHA) in HCMC begins with three volunteer groups of
physicians, nurses, and social workers. These groups conduct
home visits, provide basic nursing care, supplemental
nutritional and hospital fee support, and bereavement care.
They also act as a referral service for the diocese's two
unofficial clinics. The three volunteer groups also can
mobilize volunteers to assist ailing HIV/AIDS patients at Pham
Ngoc Thach hospital, Tropical Infectious Disease Hospital, and
the Trong Diem Center.


5. (SBU) At the community level, Pastoral Care manages the Mai
Khoi and Xom Moi HIV/AIDS clinics. Although the city has not
formally recognized or approved these clinics, the authorities
have turned a blind eye to their operation. Mai Khoi and Xom
Moi are staffed by a volunteer group of Catholic medical
professionals who are government hospital employees during their
normal working hours. The two clinics counsel and treat
approximately 30 clients per day. The clinics also function as
day care centers and shelters for HIV/AIDS infected homeless
mothers and children. The centers currently provide shelter for
four or five persons a month.


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6. (SBU) The archdiocese also operates a community
reintegration and care center for released rehabilitation center
and other city residents. The center has been open since June
2005, and is staffed by four church volunteers. It has an
annual budget of USD 5,000, which it receives from the NGO CARE.
The clinic assists approximately 50 people per month with
anti-retroviral treatment, medications, baby formula, vocational
training, and HIV/AIDS awareness and prevention counseling. The
center's patients are referred by word of mouth in the Catholic
community or through the Mai Khoi and Xom Moi clinics. The
center also shelters on average 15 homeless residents, including
nine orphaned children ranging six months to eight years of age
infected with HIV/AIDS. Father Toai noted that the
overwhelming majority of women seen at Mai Tam are not
commercial sex workers, (they have documented only two cases of
HIV-infected prostitutes in 2005),but women who contracted
HIV/AIDS through their regular partners. According to Father
Toai, 50 percent of these women are the wives or girlfriends of
current 05/06 center residents.


7. (SBU) According to Father Toai, ward officials recently
threatened to shut down the Mai Tam center unless it received
formal government approval. Within days of the ultimatum, the
city Department of Health notified ward officials of its support
for the Mai Tam clinic and asked that Father Toai submit formal
requests for certification as an HIV/AIDS center to DOLISA and
the HCMC Committee on Population, Family, and Children. Father
Toai noted that there has since been no more harassment; formal
certification for Mai Tam was currently pending.


8. (SBU) Since October 2005, Pastoral Care has been pushing to
establish an "integrated holistic center" for PLWHA in HCMC,
which it intends to open within two years. The proposal that
the archdiocese submitted to HCMC government calls for the
center to provide medical services for 250 orphans, pregnant
women, and rehabilitation center graduates with HIV/AIDS.
According to Father Toai, the city government has indicated its
support "in principal" for this initiative. The city asked the
church to submit a more detailed proposal for further
consideration. The archdiocese is conducting site surveys for
the center in HCMC's District Two.

Pastoral Care's Funding
--------------


9. (SBU) Father Toai said that Pastoral Care operates on a mix
of funding from domestic and international sources. In addition
to the USD 5,000 per year for the Mai Tam clinic, the
organization also receives USD 500 per month from local private
donations and nearly USD 90,000 annually from Catholic Relief
Services.


10. (SBU) Comment: Although formal recognition of the Church's
HIV/AIDS efforts is lagging, HCMC has quietly allowed the
archdiocese to expand significantly its HIV/AIDS effort over the
past 18 months. Father Toai is optimistic that city officials
at all levels are increasingly accepting about the church's
efforts to combat the HIV/AIDS epidemic. End Comment.
Winnick