1. Community Empowerment for HIV or AIDS Care in Northern Thailand Pikul Nantachaipan Faculty of Nursing, Chiang Mai University, Thailand

2. Enhancing Care Initiative for People Living with HIV/AIDS in Northern Thailand (ECI- Thai)) Faculty of Nursing, Chiang Mai University Communicable Disease Control Region 10 (CDC10) Chiang Mai Provincial Public Health Office AIDS Network Development Foundation (AIDSNet) Church of Christ in Thailand AIDS Ministry (CAM) The People Living with HIV/AIDS Network Supported by ECI - Harvard AIDS Institute

3. Ultimate Goal of ECI-Thai Quality of life among people living with HIV and AIDS : พ Availability of care system พ Accessible to care พ Self-reliance and self-care ability พ Physical, mental, social, and spiritual well-being

4. Strategies of ECI-Thai 1. Enhancing health care institutions :- - Clinical treatment and care - Counseling - referral systems 2. Enhancing home and community care seeking strategy for “Community empowerment”

5. Purpose of the sub-project: To strengthen community empowerment in order to enhance sustainable social support & welfare for people infected with and affected by HIV/AIDS.

6. Setting: 2 districts in Chiang Mai province Methodology - action research People Research & Development (PR&D) ….. a specific research methodology using ‘potential approach’ rather than ‘problem approach’. 6 sub-districts (72 villages)

7. Participants: Community leaders Traditional healers Occupational groups Community health volunteers People with HIV and their families 3-5 persons from 72 villages of 2 districts

8. Participants from one district

9. 1st Step of PR&D process: Introduction to PR&D - the new paradigm of sustainable development self-reliance of the community Knowledge & local wisdom ResourcesManagement learning

10. Assignment at the end of the first meeting ; 1. The data collection guideline history of the village the strength of the village - local natural resource - people resource 2. One month-data collection in the village (by the participants)

11. 2nd Step of PR&D process: Self-realization - the participants reported the results of their survey about their community history and potentials to the 2nd meeting. The report included: the history of their villages, the natural & people resources, the local wisdom and other potentials.

12. 3rd Step of PR&D process: Study trip to the best practice community - the participants took a study trip to visit a model community in another province. The participants were assigned to collect data: the resources (natural & people) the local wisdom management ( the way of thinking and doing )

13. 4th Steps of PR&D process: Summarize the lesson learned - the participants shared ideas about what they have learned from the best practice community - summarize the way of thinking - summarize the method and process of management of the local resources & wisdom - compared the lesson with their own communities

14. 5th Step of PR&D process: Develop the community master plan 1. Identify problems related to health and quality of life of their own village. 2. Making consensus - what would be the first 3 topics to do 3. What kinds of support or help from the ECI-Thai project

15. Results Lesson learned - reported by the community New ways of thinking New ways of doing / re-management Learning process PR&D process can be applied to any kind of problem.

16. Ongoing process of community development in 6 targeted sub-districts (after finishing 5 steps of PR&D) The master plan for the first year of implementation were developed. Results

17. Three projects have been implementing : 1. Traditional care - Thai massage, herbal medicine, & local spiritual care (rituals) 2. Organic farming for the healthy food & environment of the village 3. Village health volunteers - who can provide care and coordinate with health centers and community hospital

18. Organic substance for farming

20. Learning about organic farming

21. Training Course on Thai Massage

22. Learning about herbal medicine

23. Herbal compress and Thai massage

24. Results Lesson learned - reported by ECI-Thai team PR&D is useful tool for empowering community. PR&D is useful for changing paradigm in health care. PR&D process is useful for confronting AIDS and preparing a good ground for home and community care.

25. Community self-reliance is a new approach of sustainable development. It the highest value of human beings and human dignity. SAWASDEE WWW.nurse.cmu.ac.th/~eci