The Burden of Success

This past week I had the opportunity to join Karyn and Wut (a member of the Thai Drug User’s Network – TDN, for short) for two workshops they were presenting to a week long training course conducted by the Asian Harm Reduction Network in Chiang Mai. The sessions included health care and NGO representatives from Thailand, Cambodia, Vietnam, Myanmar, China, Taiwan, Indonesia and Pakistan. They had come together to learn more about issues of health and social care for people using IV and other drugs. Many worked on issues related to access to ARV and comprehensive health care for PLWHA who were current or former IV drug users. After listening to doctors and policy makers for the first part of the week, Karyn and Wut were there to bring the perspective from the ground – Karyn to provide background and history regarding the formation of the Thai Drug User’s Network, and Wut to share his story as an IV drug user, and as a founding member of TDN. As many people remarked after the sessions, they were the first presenters who really brought a clear vision of the challenges of actually doing this work. After all, what good was it knowing about the fifteen different drugs now available for HIV if only a quarter of them were actually accessible to most PLWHA in Thailand? What difference did it make if methadone clinics were set up if the protocols didn’t reflect the lessons that those who had tried methadone had experienced in earlier programs?

That Karen and Wut’s presence at the meeting was important was undeniable. It was critical that their perspective be heard. Yet, like many successful community advocates in the United States, TDN and TTAG are overwhelmed with requests to “tell their story”, so that health care professionals and policy makers can understand “what it’s really like” as they make decisions regarding the community’s future. One of the reasons that Ott founded TTAG was to grow the field of community advocates so that there would be hundreds of people around Thailand able to bring their voices to national and international policy and practice. Yet, there are still not enough. And advocates who are particularly persuasive, and who can speak with passion and clarity, are particularly in demand. In the two weeks since I’ve been in Thailand, Ott and Karyn have received more than half a dozen requests to speak or present. The requests come in from all over the world – the US, France, the Netherlands, Canada, India. They also field daily calls from people visiting Thailand who have heard about their work, and would like to have dinner and talk about what they’ve learned.

Ott and Karyn’s appeal, no doubt, is not only the unique skills each brings to their advocacy efforts, but also the ability they have together to bridge the cultural divide – each of them able to speak both from their hearts, as well as in the language of international program and policy. It is a hard decision each time they are asked to speak. Is there anyone else? How often can they be away without their own work suffering? How much visibility will come of this request? How important is it for achieving their goals? It is their dream that soon there will be many others throughout the world who can speak, so that their phone and e-mails won’t be packed with requests to be – once again – the ones who must tell the story one more time.