Just over two months ago I threw myself headfirst into Urban Light. My first working day was something out of the ordinary. Well first of all it wasn’t even a day, but a night, and it took place at one of the bars where Urban Light is regularly doing outreach. We were having an onsite clinic there, and I was the medical doctor. The room I used as my examination room was situated on the second floor, above the bar, where normally sexual services are provided. The furnishings in the room were easily counted; an AC unit, a dimmed lamp, a bed, a toilet paper roll and a trash bin. All of it painfully pointed towards the room’s real purpose, but after having brought in a proper lamp and a couple of chairs it actually suited our purpose quite well.
The first person to enter the room was one of the boys who would normally provide sexual services to male customers in this establishment. However, on this particular day he stepped into that room for something completely different – a medical check up. He was in his early twenties, had a cool haircut and I would describe him as a good, and healthylooking young man. His only health concern was that he was worried. He was very worried about HIV. He had taken an HIV test at an Urban Light clinic in February this year, which was negative, but had since then had a lot of customers who had refused to use condoms. I drew some blood from him and dropped it into a rapid HIV test. In 5 minutes we would know. While waiting I did a general health check up. Everything was normal except for his heart that was beating at a very fast rate of 120 beats per minute, which was probably linked to his anxiety for the upcoming test result. He told me that he was planning to leave the establishment and Chiang Mai just the next month. As he was telling me about his plans for the future I could, from the corner of my eye, see how a dreaded second line was appearing in the result window of the HIV test. I knew too well what those two lines meant. The virus that this young man feared the most, had entered his body… and now I had to tell him. And I knew that there were a dozen of other boys waiting for me outside the room. All of them bringing their own fears, health problems and plans and hopes for the future. And that was the beginning of my first day, I mean night, at Urban Light.
Since then I’ve continued with Urban Light and helping the boys, a couple of days a week, with whatever health problems they show up with at the centre. And believe me, they encounter every problem you could possibly think of and surprisingly many that you would never think of. For example, I’ve learned that if a wound is not healing in a normal way it might be because the boy is pouring fish sauce in it every day to try to speed up the healing. Other, more common, health problems that we deal with at the centre are scabies, sexually transmitted infections, cuts and burns, respiratory infections and musculoskeletal problems.
In the midst of all these less dangerous illnesses, boys also show up with very serious conditions. One example is a boy who recently complained about weight loss combined with pain in his mouth and throat. Knowing that all of these boys are at high risk of contracting HIV I performed a test, which unfortunately turned out to be positive. As I examined him further I saw that his mouth was full of thrush that seemed to continue down in his oesophagus, indicating that he was already in the stage of AIDS. My heart breaks every time I discover things like this.
Another example of a case that could have ended really badly if Urban Light did not exist, is Peace*. Peace is one of our younger boys, only 14 years old. One Friday afternoon he came into the centre and we could hardly recognize him. He was very pale and his whole body was awfully swollen –like a Michelin man! He told me that he had been feeling very sick the last couple of days and that he could not go to the toilet normally. I found that he had an ugly, infected wound on his leg, a fever, extreme widespread enema and had gained 8 kg(!) in just a couple of days. This, of course, was nothing that we could take care of at the centre, so our social worker and I took Peace to the hospital. There he was acutely admitted due to acute kidney failure, which was probably triggered by the infection. He was assigned a bed at the paediatric ward, in a room with three other children. The other children all had at least one parent by their side. Our social worker made countless phone calls, but still she could not find one single adult in Peace’s life who could come and stay with him during this difficult time. Once again my heart broke when the evening came and I had to leave a very scared and sick boy all alone in the hospital bed. Even though he tried to hide it I could see tears rolling down Peace’s cheeks, which is a very rare sight among our boys. My own tears were also rolling as I drove home;ome to my own children, who were waiting safely, in our house, with a caring father. Life is just too unfair! But at least Peace was in the hospital, and not dying on the street as he probably would have if he had not stumbled into Urban Light’s drop in centre that afternoon.
* Peace is a fictive name, used to protect the identity of the boy