In a Rocket Made of Ice

by Gail Gutradt

  For a few months in 1996, Wayne went to the Philippines to work with the indigenous Aeta people living around Mount Pinatubo. Then he returned to Vietnam and tried to start an aid project. He wanted to offer his atonement to the people of Vietnam, but he discovered that the government was not allowing Westerners to live in the villages. He might have administered a project from the city, but he saw many frustrated Western aid workers sitting for hours in bars in Ho Chi Minh City, the former Saigon, drinking beer, and he knew that would not suit his hands-on style. At last someone suggested he go to Cambodia, which had recently reopened to foreigners.

  And so it happened that on Valentine’s Day of 1997, Wayne found himself in Phnom Penh with one slender carry-on bag holding a change of trousers, a fresh shirt and two pairs of black underpants.

  Noise. Filth. Piles of rubble. Homeless amputees, emaciated survivors carrying starving children on their shoulders. Phnom Penh was terrible in those days. Wayne rented a small apartment and began getting to know children who were living on the streets. The kids dropped by when they needed to feel safe or have a little something to eat and Wayne took care of them when they were ill. He had to register with the police, and sometimes they questioned the children as they left Wayne’s house. Once the police were thoroughly convinced that he was not one of the sexual predators who descend on vulnerable countries in the aftermath of disasters, the patrolmen would drop over now and then for tea and a chat.

  The children were living in slums, and, then as now, there was a lot of urban renewal going on. Wayne remembers a night when several children wanted to sleep over at his apartment.

  They were afraid that someone would set fire to their slum community. They told me bulldozers had moved in during the afternoon. The following morning fire broke out and burned the whole place down in minutes. The new Casino now sits near where their home used to be. Two young children who were trapped in their home died.

  Wayne’s first jobs in Cambodia were with the Catholic Office for Emergency Relief and Refugees (COERR), and for a small Phnom Penh orphanage. At COERR he met Vandin San, a quietly charismatic young Cambodian who was training monks to educate villagers in AIDS awareness, prevention and patient care. One day, Wayne remarked that he had seen scant evidence of an AIDS epidemic in Cambodia.

  “Why would they tell you?” Vandin asked. “What do you have to offer them?” Because of the fear and stigmatization faced by people with AIDS, most kept their illness a secret. “Come,” Vandin said. “I will show you AIDS in Cambodia.”

  Thus began a collaboration between an American Christian and a Cambodian Buddhist that was to evolve into Partners in Compassion, a nonsectarian organization dedicated to caring for people affected by HIV/AIDS. Building on five acres of land donated by a Buddhist pagoda named Wat Opot, Wayne and Vandin opened a small clinic and hospice for people dying of AIDS. When COERR left Cambodia they offered Wayne and Vandin some of their supplies and a little money that was left from their operations.

  At first Wayne continued to live in his apartment in Phnom Penh and traveled once a week to the clinic, but soon the growing AIDS epidemic drew him to move full-time to the rural village of Sramouch He. Here he and Vandin trained Home Care teams consisting of monks and laypeople who traveled through villages teaching about AIDS and bringing medical care, food and emotional support.

  Wayne was fortunate to have Vandin for a partner. As a Cambodian, Vandin moved easily in official circles. He worked well with local people and Buddhist monks, and knew far better than Wayne how to engage the many layers of government regulators and bureaucrats. Wayne once told me that Vandin might have been a government minister, but chose instead to work with people with AIDS.

  One day over lunch Vandin told me about his life, and a little about the early history of Wat Opot. Vandin grew up in Cambodia, but during the Khmer Rouge regime he escaped with his parents to live in Vietnam. After the war he returned to Cambodia and took a job with COERR, and they trained him to work in their HIV program. Thailand had a big AIDS problem, and Vandin spoke Thai, so COERR was able to send him to workshops and conferences in Thailand.

  In the early days, Wayne and Vandin worked side by side, caring for the sick and training the monks. Vandin told me that in the beginning the Ministry of Cults and Religion did not approve of the monks’ participation in the AIDS training programs. Traditionally, it was not considered proper for monks to talk about sex. So Vandin lobbied district and provincial governors, who then petitioned the ministry to support the project.

  As a young man, Vandin had hoped to become an architect, and he studied for two years before his money ran out. He designed and built the pa cha, Wat Opot’s crematorium, and the beautiful central dining hall and kitchen, but over the years, as their work grew more complex, Wayne and Vandin assumed different roles in the organization. Vandin’s title is executive director of Partners in Compassion. He has nearly ninety staff members, and today his projects extend beyond the community and beyond HIV/AIDS.

  Wayne tells me that he himself is “just an adviser, but my voice is heard and [Vandin and I] do most of the program planning together. My work responsibility is only to the Wat Opot community,” a self-supporting project. “Vandin carries a much bigger responsibility than I do. He is well known and respected on a local and national level as an honest and very efficient leader. We are equal only in our respect for each other and our commitment to the needs of the Cambodian people.”

  I asked Vandin about how the AIDS epidemic crossed into Cambodia. “Before the United Nations came,” he told me, “Cambodia was mostly a closed society. Only a few people traveled. Before the war, the government inspected prostitutes weekly. AIDS in Cambodia came through Cambodians living on the Thai border, in refugee camps and from UN troops who came with UNTAC.”

  UNTAC was the United Nations Transitional Authority in Cambodia, the UN peacekeeping operation. They arrived in 1992 to replace the Vietnamese army that had beaten back the Khmer Rouge, and to help Cambodia prepare for elections. The UN forces came from many countries. By local standards their salaries were enormous. Cambodia was in ruins. Between the American bombings and the reign of the Khmer Rouge nearly a third of its population had perished. Those who remained did anything to survive.

  UN troops went to Thailand for R&R and returned infected with HIV, and Cambodians say that Vietnamese camp followers also brought AIDS. The disease travels with armies and refugees and is still spread to the interior by truckers who are far from home and visit prostitutes along their routes. In the end UN troops carried AIDS home to their own countries as well.

  The problem with this version of events, however, is that, according to the Cambodia National AIDS Authority, the country’s first cases of HIV were reported in 1991, a year before UNTAC arrived. As it takes years for a patient to manifest symptoms, this suggests that the first infection in Cambodia preceded the arrival of United Nations forces. For most people, contracting HIV was a death sentence. Vandin recalled the cremations in the early days of Wat Opot: “Sometimes two or three patients, adults and children, died in a day.”

  Whatever the sources of the AIDS epidemic in Cambodia, the picture changed radically in 2003 when the Belgian branch of Médecins Sans Frontières opened their clinic in Takeo. Because Wayne and Vandin already had Home Care teams operating in the villages, MSF could rely on them to support their patients with food and information, and to provide patients with transportation to the clinic.

  Because people with AIDS have weakened immune systems, they are more likely to develop full-blown tuberculosis as well. So it is crucial to ensure that patients and their families understand and follow the drug protocols. Missed doses can quickly breed drug-resistant strains of both AIDS and TB, so MSF requires that patients have sponsors, someone competent to supervise their care. Sometimes the Home Care team just helped to train the families, but in some homes there were greater challenges. In families that were too fearful of AIDS or simply too poor or unwilling to invest any
effort in a child they were certain would die, it seemed better to take the children to live at Wat Opot.

  One day Wayne showed me several loose-leaf binders filled with patient histories dating from the early days of the community, long before antiretroviral drugs were available in Cambodia. Each page contained notes about the people Wayne and Vandin treated when they first opened the clinic and hospice. There were records of hundreds of patients, all of whom are now dead. I leafed through the pages, staring at snapshots of modest men and women, posed with their children in front of stilt houses. Sometimes there was also a cow, or a prized possession like a motorbike. Sometimes there was a baby. Wayne told me that many of those babies were infected and later died of AIDS. It was the beginning of the epidemic in Cambodia, and these unfortunate people did not understand what was happening to them or why. The women were good wives and mothers. Perhaps the father, a hardworking farmer, had traveled to Phnom Penh and spent a little of his rice harvest money on a prostitute and brought the sickness back to his wife. The baby would have come before either of them knew they were infected. I contemplated this plague arriving in the wake of all the other horrors Cambodians had already suffered. It was all unspeakably sad.

  Wayne and I talked about this sadness one afternoon. We were sitting at Chhang’s Place, a small outdoor eating pavilion at Wat Opot named for Brang Chhang, a beloved little boy who had died in Wayne’s arms, calling his name.

  Just prior to our conversation Wayne had been writing a piece to send to his former congregation who had cut off funding because of his “heresy.” I was helping him with proofreading. We had been talking about duality, and I had asked Wayne whether he believed that everything really was of God when there are terrible things like war and AIDS and children dying.

  Wayne had replied, “Most people think of AIDS and say, ‘Oh, that’s terrible. How could you stand all the people dying?’ But when you are in the middle of it, it is also beautiful. So it is not the caring and love that people are thinking about, only the sadness and pain.”

  Wayne had written,

  I believe that GOD is Love. From a distance pain and suffering can appear to be acts of an unjust and unloving GOD but when one realizes that those who have suffered the greatest are often those who appreciate life the most, then one begins to understand that pain and suffering are actually gifts from a loving creator. Perhaps your question should be: Why does GOD allow some people to live in comfort? For those who live in the greatest of comfort are often those who find no meaning in life.

  I remembered how my own preconceptions of what Wat Opot would be like had vanished the moment I arrived. Yet the idea of seeing this terrible illness as a gift from a loving God unsettled me at first. Perhaps it is not so much a question of how we see the origin of events, but of how we receive them into our lives. As Holocaust survivor and psychiatrist Viktor Frankl wrote in Man’s Search for Meaning, “We who lived in concentration camps can remember the men who walked through the huts comforting others, giving away their last piece of bread. They may have been few in number, but they offer sufficient proof that everything can be taken from a man but one thing: the last of the human freedoms—to choose one’s attitude in any given set of circumstances, to choose one’s own way.” A few years later when I was diagnosed with cancer I would discover how seeming disasters can bring gifts I had not imagined possible, gifts that bring joy and love and open the heart. But sometimes I wonder, had I not spent this time with Wayne and the children, would my heart have been open enough to receive those gifts?

  Wayne tries to instill in the children a sense of their own worth, that being HIV positive does not make them unlovable. He teaches them that they are beautiful, that AIDS is something they can live with, among the many afflictions of humankind, and still live lives full of aspiration, accomplishment and joy. And he strives to help them develop a sort of moxie to face their trials: “That is what I want, for them to be able to say, ‘Ya, I got AIDS. So what? You got a big nose!’ ” As the first generation of children to grow up with AIDS, they will, he hopes, be the ones who go out and challenge the way the world sees them.

  Wat Opot has a reputation among many other aid organizations as an unusually effective program run on very little funding, and it is a model for raising children infected with HIV and uninfected kids together, as a mutually supportive family. One day, Wayne was visited by a group of high-level program directors from a large international NGO.

  One Vietnamese woman tearfully said to me as she left, “The work you are doing is so great, your children are so blessed to have you. Our HIV children in Vietnam are isolated from the rest of society. If only our leaders could see your program maybe they would change things. Hopefully someday you will come and help us too.”

  A few years ago Wayne attended a UNICEF convention for AIDS workers and NGO staff. It was held in a fancy hotel in Thailand and dozens of organizations sent delegates. Each group was given three minutes for a presentation. Of course, no one stuck to three minutes, and the meeting ground on and on. The presentations were mostly about numbers: numbers of patients served, numbers of staff trainings held—bang for the buck.

  When his turn finally came, Wayne showed a short film he had prepared called Got AIDS? Wayne made the film to show to HIV-positive children, to encourage them and to let them know they are not alone. It is a simple little film, about four minutes long, only a slideshow with captions and music. A boy and his little sister arrive at Wat Opot. “My little sister got AIDS,” he is saying. “Our mother is sick and cannot take care for us.… So they sent us here.” One by one, the children tell the brother and sister that they too have AIDS and are orphans. Other kids reassure them that “having AIDS is not a problem if you take care of yourself, eat good food and take your medicines on time every day.” Two of the older boys with AIDS then invite the newcomers to talk out their problems. And Miss Chan Tevy, as winning as ever, adds, “And if someone causes you a problem … come to me and I will teach you how to charm them.” A group of kids is turning somersaults in a haystack: “The important thing is not to worry about your tomorrows, just enjoy all of your todays!” In the final frame it’s the two new children again, looking relieved. The older brother is saying, “Thanks, guys! I got a feeling everything is going to be just fine.”

  When the film was over, a woman in the audience stood up and began shouting at Wayne.

  “This is precisely the sort of thing we are trying to prevent. These children are orphans. They have no guardian to protect them. And you are exploiting and exposing the ones who have AIDS!”

  Taken aback, Wayne said nothing until the moderator urged him to respond.

  “First of all,” he said, “these children have a guardian. I am their guardian. And I am trying to teach them that they do not have to be ashamed that they have AIDS. It seems to me that your work is with the people who think that AIDS is something to be ashamed of, the ones who would ostracize them. I am trying to teach my kids to live in this world, and to speak for other children with AIDS.”

  Wayne speaks sometimes about the problems facing NGOs. He takes for granted a certain amount of corruption and that officials everywhere expect to find a little money in their palm after they shake your hand. The bigger issue, as he sees it, is waste. While he does not expect everyone to live as he does, a lot more of the funds raised could go to useful projects rather than being spent on fancy offices and oversized SUVs or luxury sedans. He speaks ironically of “international conferences where delegates discuss world hunger while dining on filet mignon.”

  However, some of the greatest day-to-day waste results from duplication of effort and the lack of organizational coordination. Take, for instance, the many different AIDS education pamphlets distributed by NGOs in Cambodia. Each of the hundreds of organizations designs and prints its own version of the same material. Wayne points out that if they would just get together and design one pamphlet with a strong message, and share the costs of printing, they could save a lot
of precious funds. “Then they would have a unified approach where they could really concentrate on printing a message that was needed for this country, in its own language, and it would work well,” he explained.

  Wayne is fond of telling visitors and new volunteers about the early days of Wat Opot. I listened to these stories for months, and the more I heard, the more aware I became that Wayne has a unique skill: the ability to create something from virtually nothing. Unlike many well-intentioned people who are stymied by a lack of funds or institutional backing, Wayne begins modestly, and he tries not to let his projects grow any bigger or more complex than he can manage. Perhaps he has large plans—for instance, he does speak of a master vision for Wat Opot—but he is perfectly happy to tinker along the way, enhancing, beautifying and bringing his corner of the world gradually closer to the image in his mind.

  Unlike programs that depend on imported technology, Wayne tries to base his solutions on labor and materials that are readily available locally. That way, if villagers wish to adapt, emulate or replicate something he has done at Wat Opot, they will be able to do so for themselves.

  Take clean water, for example. It is one thing to come into a village and tell people they ought to drink two gallons of clean water every day. But what if your drinking water comes from runoff from a rusty tin roof and must be stored for months in concrete jars during the dry season, until it turns green with algae? And what if firewood is so costly that people can hardly afford to cook their rice, let alone boil their drinking water?