and HIV/AIDS Care - A Buddhist Approach
What is Life?
of Buddhist teachings on life and the origins of disease is necessary
when applying the Buddhist approach to caring for people with HIV/AIDS.
Sutta explains life as being the Pancakhandha, the Five Aggregates,
or the five causally conditioned elements of existence forming a being
or entity. These are:
The Pancakhandha can be described as the body and the mind. Theravada Buddhism stresses the importance of the mind as the seat of wisdom and the inducement for actions.
As the Buddha has
said, "It is the mind that heads the Dhamma. For the Dhamma, the
mind is of utmost importance. Success is achieved through the mind.
A person whose mind is impure will speak impure words and perform impure
acts. For that person, suffering will surely follow just as a cartwheel
follows the footprints of an ox."
places emphasis on the mind, it does not ignore the importance of the
body. This can be seen in a discourse recorded in the Digha Nikaya where
the Buddha says, "Those who would know the truth should not say
that the body and the mind are separate, just as they should not declare
the body and the mind to be one. It can be compared to two beams that
are supported by each other. If one were to be removed, the other would
The Abhidhamma states
that illness is partly physical, being related to the four elements,
namely earth, water, air and fire, and partly mental. Phra Dhebavedhi
has noted that disease has four characteristics:
Care for People with HIV/AIDS
the Tripitaka, such as the Visuddhi Magga and the Mahawong, state that
during the Buddha's time herbal medicines were used to balance the four
elements (earth, water, fire, air) of ailing monks. In addition to the
physical care, emphasis was also placed on the importance of Dhamma-based
care (Dhamma Osoth), particularly to reduce stress and anxiety.
In his treatise
"Buddhadhamma", Phra Dhebavedhi states that physical illness
can give rise to stress, anxiety, restlessness, etc. which, in turn,
can cause loss of mental calm and peace. Mental care is, then, an essential
part of treatment. Knowledge of the Bojjhangas (enlightenment factors)
is necessary when caring for people with HIV/AIDS as they can be used
to reduce stress and anxiety. The Buddha himself recommended meditation
on the Bojjhangas as a way to overcoming stress and anxiety arising
from physical discomfort.
The Seven Bojjhangas
An example of the
importance of meditation on the Bojjhangas is seen in the case of the
ailing Phra Maha Kassapa who was visited by the Buddha. The Buddha inquired
as to his health, asked if there had been any improvement and if he
were able to endure the condition. Phra Maha Kassapa replied that his
condition had not improved and that it was difficult to endure. The
Buddha then instructed him on the Bojjhangas and advised him to meditate.
Later, Phra Maha Kassapa regained his health and praised the benefit
of meditation on the Bojjhangas as taught by the Buddha.
On another occasion,
the Buddha was approached by an elderly householder who spoke of how
his body had become tormented will illness over the passing years. The
Buddha told him that nobody could escape illness or the decay of the
body. He reminded him that it was the body that was ill, not the mind,
and that the mind should be calm and controlled.
stresses the importance of the relationship between the body and the
mind. When a person becomes physically ill, the mind will be weakened.
Meditation on calmness can help to overcome physical suffering. A person
with a strong morale will have a strong immunity. Meditation can help
to cure or reduce the effects of illness. Phra Dhammabidhaka has explained
the three states of the relationship between the body and the mind.
In the first state, the body is ill at ease and the mind is also ill
at ease. In the second state, the mind can determine the effect the
illness is having on the mental well being or the morale; and in the
third state, the mind can prevent the illness from affecting the mental
well being as well as establishing physical comfort.
From the above,
we can see the importance of mental care when looking after people with
Even the Buddha
himself combined mental care with physical care when he was ill. At
one time, he asked Phra Maha Chunta to recite the Bojjhangas for him
when he was ailing. After hearing the recital and contemplating on it,
he recovered from his illness.
Meditation on the
Bojjhangas is focussing the mind on one spot or one emotion and keeping
it so focussed. When the mind is relaxed, stress and anxiety will be
replaced with feelings of peace and calm. This has a good effect on
the body and can help strengthen the immune system so that it is able
to fight against disease. (Praves Wase)
can help people living with HIV/AIDS overcome any feelings of depression
they may have due to their condition. Mindfulness of breathing, observing
each in and out breath, is mentally calming, costs nothing and brings
many benefits such as reducing stress, anxiety and fear.
teaching important to HIV/AIDS care is the teaching on the Brahma Vihara,
the four Sublime States. These States, which should be developed and
practiced towards all beings, comprise:
These states already exist in all humans, but they should be nurtured and practiced towards others. Metta, or loving kindness, is especially important when caring for people living with HIV/AIDS. It will make the person feel cared for which in turn will help to reduce their fears and worries. This will help to overcome stress and anxiety, which will have a good effect on the physical well being.
The Sangahavatthu, the bases of sympathy; the acts of doing favors; are also beneficial to people living with HIV/AIDS and HIV/AIDS care-workers are encouraged to develop and practice them. They include:
This Buddhist teaching supports integration and communal living and is important for people working with HIV/AIDS to apply it to their work. It helps to develop compassion and consideration towards people living with HIV/AIDS and arises spontaneously when people have developed the Brahma Vihara, or the Four Sublime States. When the Sangahavatthu have been developed, people will recognize that HIV/AIDS sufferers are also human beings who, just like themselves, crave physical and mental comfort.
Angels in White
It has long been the common view that a woman becomes a nun to escape a broken heart, to run away from personal problems, or because she has difficulty fitting in with the mainstream of life. And, once in the temple, her place is in the kitchen and her role is to look after the monks and novices.
This attitude is
now changing, however, as a large number of nuns become actively involved
in social and community work.
In addition to formal
and non-formal education, the centers also provide handicraft and skills
training so that the girls, after graduation, can find gainful employment
and not only support themselves, but also their families.
To assist them,
the Sangha Metta Project recently conducted a three-day seminar on The
Role of Buddhist Nuns in HIV/AIDS Prevention and Care.
The seminar, conducted
in collaboration with the Thai Association of Buddhist Nuns and supported
by UNICEF, was attended by more than 50 nuns from central, northern
and northeastern Thailand.
During the seminar,
nuns were given up-to-date and accurate information on HIV/AIDS, as
well as the socio-economic impacts. Experts from different organizations
were invited to address the participants, and a group of women living
with HIV talked about their personal situation, problems they had encountered
as HIV+ women and how they had overcome those problems. Using the participatory
approach, the nuns were given the opportunity to appraise the HIV/AIDS
situation in Thailand and identify roles they can play in solving the
problem. Working in groups, they developed strategies for carrying out
At the end of the
seminar, the nuns concluded that they could help prevent the spread
of AIDS by educating women and girls on HIV/AIDS. They could help women
living with HIV/AIDS by providing care, counseling and meditation. To
help alleviate the socio-economic impacts, they could provide vocational
and skills training for HIV+ women and reduce the problem of orphans
by caring for girls whose parents have died of AIDS.
The nuns who participated
in the seminar have not forgotten their role. They have now become actively
engaged, and are performing a variety of activities in their areas.
For example, nuns
from Wat Nam Bo Luang in San Pa Tong District, Chiang Mai have made
contact with the Nam Bo Luang Support Group for People Living with HIV/AIDS
and can be seen at their regular monthly meetings providing counseling
and advice. They also join monks in religious ceremonies and give donations
Nuns from Wat Ram
Poeng (Wat Taphotharam), Muang District, Chiang Mai have been giving
meditation instruction to members of the Clear Skies Group in Chiang
Mai. They have also made contact with the Community Health Group, an
HIV/AIDS support group in Mae Rim District, Chiang Mai, and plans are
being made to give meditation and counseling to group members.
from the Thai Association of Thai Buddhist Nuns are setting up education
programmes in northeastern provinces while nuns from the central region
are organizing education programmes and skills training activities for
people in their areas.
The work they are
doing is extremely valuable at a time when more and more women are being
identified as being HIV+. Most of these women have a husband who is
ill with, or who has died of, AIDS. Their time is spent taking care
of their husband, who is the main breadwinner, or their orphaned children,
leaving them little time or resources to care for themselves.
The Sangha Metta
Project recognizes and appreciates the contribution that nuns are making
to HIV/AIDS prevention and care in Thailand. To help develop their role,
the Sangha Metta Project plans to run more seminars and workshops and
it is hoped that the network of this valuable resource can be expanded
in the New Year.