<< Buddhist monks from the Thai capital, Bangkok, visiting AIDS patients at the Phra Baht Nam Phu Temple in Lop Buri, 75 miles north of Bangkok (File Pic)

Today, this prototype sits outside an orphanage for HIV-infected children in central Thailand, spitting out footballs with a force that could lift its residents off their tiny feet.

The orphanage is part of a wealthy charitable empire built by Alongkot Dikkapanyo, 54, a celebrated Buddhist monk who began caring for Aids patients in 1992, when most of his compatriots still shunned them. His empire has two parts: this remote, 1,200-acre complex, which is home to more than a thousand children, including many HIV-positive orphans; and Wat Phra Baht Nam Phu, or “the temple of Buddha’s footprints”, built into a parched hillside 50 miles away, where about 200 HIV-infected adults live and about 10,000 have died. Across Thailand, the temple’s name is synonymous with suffering and death, an image that has allowed its abbot to raise the equivalent of millions of pounds. Photos of the temple’s sick and emaciated patients adorn posters and donation boxes nationwide.

Anti-retroviral (ARV) drugs, which allow HIV sufferers to live longer, now threaten to undermine this fundraising rationale and shake up the temple’s finances. Not even the proud inventor of Soccerbot can quite understand why the abbot has bought it. “I came here expecting to see a team of 30 or more players,” says Puttachai Rattanalangkan. “But there’s nobody. Just these kids.”

Donations to the temple are tax-free and come mainly from tourists, Thais and westerners, who visit the temple in their thousands every week. Today, the resident guide Max, 37, who is HIV-positive, leads a group of middle-aged Thais to the first stop on the tour: the Life Museum. “Take a look inside,” he urges through a megaphone. “You don’t have to take off your shoes.”

Inside are dozens of the mummified corpses of dead Aids patients, who had agreed to donate them before they died. These illustrate “how death affects all of us, leading us to the truth that in life we must do good for others”, says a sign. One insect-nibbled body still has two globes of silicon suspended from the chest by skeins of flesh. A sign lists the owner’s former occupation as “Singer, Sex Worker (Lady Boy)”.

We pass the crematorium – the temple has eight incinerators, notes Max – and a garden of crude sculptures made from the pulverised bones of more dead patients. Then we stop outside a one-storey building. “This building is for people who are in their final stage,” announces Max. “If you want to take their photo, please ask them first.” The tourists file in. There are 31 men and women in the ward. They ignore the tourists. Some totter about in nappies, their faces smeared with talc to hide cancers and other skin diseases. Others are curled up in bed, lost in pain and torpor; one man is being eaten to death by a rectal carcinoma. Some patients are blind, 11 others – including five skeletal forms in a poorly quarantined side-room – are fighting tuberculosis. Stray cats and dogs stroll at will through the ward.

The tourists file out. The final stop is a large Buddha statue surrounded by a wall of sandbags; these contain the ashes of the dead, hundreds and hundreds of them, vainly awaiting collection by relatives. Then the tourists are given Buddhist pamphlets and an opportunity to donate. A large party of school children is right behind them.

Death and tourists: these have been constants for Michael Bassano, a Catholic priest from upstate New York who is the temple’s longest-serving volunteer. Bassano is a fit-looking 59-year-old who has spent four years caring for HIV patients – bathing their fragile bodies, massaging their diseased skin, holding them in their final moments. “It doesn’t matter what their history is, what [sexual] orientation they are – they’re one of us,” he says. “They’re human beings. Let’s treat them as though their life has value and meaning.”

At least 1m Thais have been infected with HIV since the first reported case in 1984. More than 400,000 have died. Thailand was one of the few developing countries to successfully curb its epidemic with awareness campaigns, and later pioneered the widespread distribution of cheap ARVs. In the 1990s, up to 100 patients died at the temple every month. By the time Bassano arrived in 2003, there were less than 15 deaths, and ARVs soon reduced them to single figures. Bassano feels it’s now time to change the temple’s morbid image. “Yes, people still die of Aids, but with this new medicine we can encourage them to keep on living,” he says.

“This is a temple of life, not of death.”

Some patients come to the temple voluntarily. Others are abandoned like rubbish. One night, recalls Bassano, a car with its lights off pulled up at the temple gates, and a man was pushed out. He died two days later. He also remembers a patient who had been so neglected at home that his left leg had been paralysed for seven years. “One day he said to me, ‘I want to walk,’” says Bassano. And with the priest’s help he did. “He walked every day for the next five months. Then the disease hit his digestive tract and he was gone. But for a while he was the happiest man alive.”

This inspired Bassano to “do the simple things that bring people back to life”. A 28-year-old woman with HIV called Amphan arrived six years ago and fell in love with another patient. When he died in 2003, Amphan threw herself from the top of a four-storey building, shattering her pelvis. She has been bedridden ever since.

Every day the priest takes her in a wheelchair to the Life Museum, where the corpse of her boyfriend is preserved. “She finds it reassuring as she talks to him,” says Bassano. “Otherwise she sits in that bed all day and nobody talks to her.”

The Thai staff oversee the suffering but are “not really hands-on”, says Bassano. He partly blames the Buddhist notion of karma. “When anyone’s near death, usually the staff will tell me, ‘Don’t bother with them. The next life will be better.’” When one dying man screamed like an animal, some Thai staff believed he was being punished for his former profession: he had worked in a slaughterhouse.

Patients also believe HIV is a karmic death sentence. Chukiat Sungsorn, 51, a former engineer, was shocked to discover he had the disease after taking a blood test during an Aids-awareness campaign. “My wife had it but never told me,” he says. “I don’t know how she got it.” And he never asked. “I wasn’t angry. Bad karma is following me. I did something bad to my wife in a past life, so I must pay for it in this one.” Chukiat looked after her at home until she died and, when neither family nor friends would do the same for him, took himself to the temple six years ago.

The staff are also poorly paid (3,500 to 7,000 baht, or £55 to £110, a month) and poorly trained for what is gruelling work. “I work 12 hours a day,” says Wilaiwan Khantiwong, 26, the slender, no-nonsense woman who runs the ward. “Often I can’t do much for the patients and I feel like giving up. But if I leave, who will take care of them?” Wilaiwan is a licensed nurse who has worked here since she was 17. “I do every job, from cleaner to doctor,” she says. Today, she carries not a stethoscope but a tube of Toblerone, a donation from a Swiss tourist. Paracetamol is her strongest painkiller. “We have some morphine, but it might have expired by now. Without a doctor around, I don’t dare use it.”

Ideally, the temple should have two doctors and three registered nurses, says Bassano. The last doctor to work here was a Belgian volunteer named Paul Yves Wery, who left in 2004. He wrote a parting account of his years at the temple, describing it as unsanitary, ill-equipped and mismanaged. Wery calls the staff “slaves” and the tourists “cannibals”; the abbot is an ambiguous figure who runs “what has become a death factory [like] a small family enterprise”. After Wery’s book was published, all foreign volunteers except Bassano were asked to leave.

These days, patients see a doctor only once a month, when they are taken to a hospital in the nearby town of Lopburi for a routine check-up and a fresh supply of ARVs. The rest of the time they depend on Nurse Wilaiwan. “Once we had a medical emergency and I wasn’t here, only the cleaner, who didn’t know what to do,” she says. “Sometimes patients die on the way to hospital.”

Hours later, one of the temple’s tour guides collapses and Wilaiwan rushes him to the hospital. He is dead on arrival.

Many HIV patients get Aids dementia, a degenerative brain disorder that can make them moody, incoherent or violent. Due to the lack of staff, unruly patients are sometimes kept in steel cages next to the shower area. When I visited, one cage was occupied by a patient who had been ripping up the ward’s mosquito nets. Some people are caged for their own protection. One dying woman screamed so much that she was beaten and gagged by other patients.

Fewer than 17,000 infections were reported in Thailand in 2006, compared with 143,000 in 1990, according to UNAIDS. But the infection rate could climb again. HIV prevalence among intravenous drug users and male sex workers remains high, while condom use among Thai teenagers is shockingly low. Thailand must now try to re-educate the public about a horrific and incurable disease.

The temple claims to be doing just that. But could its tours also be sustaining the prejudices that make it so hard for HIV sufferers to remain in Thai society? Bassano believes so. “Some kids come through with their hands over their mouths,” he says. “Sometimes they pass through this 33-bed ward without even saying hello.”

A patient called Sanoer Soiwan, 39, a former grilled-chicken vendor, hates the tours. “I only stay here because society doesn’t want me; people are disgusted when they find out I have HIV.” After eight months at the temple, Sanoer feels healthy enough to seek work outside, but nobody will hire him. “I think all day and all night about how I can get out of here.” For now, he earns 20 baht (30p) a day changing other patients’ nappies.

As a rule, only adults live at the temple. About 1,300 children live on a separate compound called the “second project”, which includes the orphanage. But not all are orphans – many are children of poor local farmers – and only 140 have HIV; about the same number of infected adults live here too. Apart from the school and a small factory producing framed photos of the abbot, most buildings on the second project’s vast compound seems deserted and in disrepair. The Soccerbot sits outside a building that houses 74 orphans. Those with HIV have their own dorms, indicated by the signs “Bedroom for Infected Boys” and “Bedroom for Infected Girls”. Children – some emaciated, some as young as three – wander the cheerless hallways or wordlessly rummage through boxes of bric-a-brac.

The lone adult supervisor is Nuanchan Hassanam, 43, a weary-looking woman with a “Love Forever” tattoo on her arm – an unwelcome reminder of the estranged husband who gave her five kids and HIV. Nuanchan says raising orphans is like “trying to keep crabs in a bucket”. They are short of staff and basic clothes. “The children need vests, underwear and shoes,” she explains. So why has £80,000 been spent on a football machine? “I don’t know,” she shrugs. “The abbot wants the children to exercise.”

Famous Thai monks have almost rock-star status. They are courted by politicians and celebrities and are lavished with donations. In the booming 1980s and ’90s, new temples were built of Italian marble and abbots were chauffeured around in limos. Alongkot’s followers – who include the Thai tennis star Paradorn Srichaphan and at least two former prime ministers – talk reverentially of his barami, or spiritual charisma. A 70-year-old devotee, Sister Pok, credits the abbot for her longevity. “Ever since I’ve worked with him I’ve never been sick.”

An engineer by training, Alongkot returned from studying in Australia with plans to set up a giant litter-recycling plant. Instead, he joined the monkhood (because of a “broken heart”, explains Sister Pok), moved to Lopburi, and met a local man with HIV. “I held his hand, and he died then and there,” Alongkot relates on the temple’s website. “It was a moving experience.” The hospice he created alarmed the locals. Fearing infection, many refused to put food in the monk’s bowl during his morning alms round.

Thai monks generally prefer audiences to interviews. So, one Sunday morning, I join dozens of tourists at the temple kneeling before Alongkot in a room crowded with Buddha statues. (The ward is a stone’s throw away.) Many people clutch photos or amulets of him to sign or bless. His words are sometimes lost in the crash of donation boxes being emptied in the room.

Alongkot reckons about 4m people have now visited the temple. He defends the tours, claiming they raise awareness and improve patients’ self-esteem. “Patients now feel they can say, ‘I am infected, I have Aids.’ So when they have visitors they can talk to them, like they’re close friends,” he tells me. Bassano says patients “come to life” when Alongkot visits the ward. But those visits are now rare – Nurse Wilaiwan says the abbot still forgets her name, even after eight years.

Alongkot says the temple has tried and failed to recruit medical staff. “Thai doctors prefer to work at private hospitals. Even the government ones don’t have enough medical staff.” It still seems inexplicable that, in a prospering country of 65m, there is not a single Thai doctor for hire.

ARVs have brought new hopes and challenges, he continues. “People used to come here and die. We cremated them and that was that.” Now hundreds survive and – estranged from or rejected by their families – must be fed, housed and clothed, he says. There are more kids, too. Before, they died quickly; now they live longer and relatives prefer to give them to the abbot, believing his care is better. (The second project will eventually house 2,000 children.) All this places a growing financial burden on the temple. “We’re wondering how we’ll survive,” says Alongkot.

Yet the temple hardly seems in dire financial straits. Pradit Yingyong, the temple’s PR officer, says the abbot plans to build a sports centre (cost: the equivalent of £1.6m) and carve a meditation path through the hill above the temple (£8m).

“There’s lots of money coming in,” says Bassano. “But how it’s distributed, who benefits, who gets what – I have no idea.” Why, he asks, build the Aids Human Body Part Museum – a room in which hands, feet, hearts, kidneys and other organs are kept in perspiring jars of formaldehyde – when the temple has no ambulance? “And the neglect of the kids… Not just the kids, but the adult patients as well.”

It is hard to ask a celebrated monk about money without seeming to accuse him of dishonesty. But then this is one reason why the finances of Thai temples are traditionally so opaque and donations so easy to misappropriate. (“Half for the temple, half for the temple committee,” goes an old Thai song.) It costs 4m to 5m baht (£64,000 to £80,000) a month to run the temple, excluding the second project, says Alongkot, and the temple receives “the same” in donations. The finances are not made public. “It’s not our duty to make a public declaration,” he insists, “but we have a good [accounting] system.” Alongkot suggests I ask at the secretary’s office to learn how much is spent on the temple. I am then shuttled between four offices before being given a print-out with a totally different figure from the abbot’s. Pradit gives me another figure, a committee member yet another. Nobody can explain how the second project, which includes the orphanage, is funded, never mind the sports centre or meditation path.

When Alongkot took in his first HIV sufferers, it was an act of compassion before its time. Sixteen years later – with hundreds of thousands of Thais visiting, and the temple’s coffers spilling over – the patients seem overlooked, even as their very public plight keeps the money rolling in. With ARVs getting cheaper and more effective, the strategy might not last much longer. “How will they get money if people look healthy?” asks Bassano. “You’re going to have to do something, because people are getting better. You can’t stop this process. The ARVs are here to stay.”

Bassano has now left the temple to prepare for his next posting. He is going to Tanzania, where the prevalence of HIV/Aids in adults is almost six times that of Thailand. His patients miss him. “If I could walk,” vows Chukiat, the former engineer, “I’d go with him.” Even as Bassano was packing his bags, a new doctor and nurse arrived. They are not Thais funded by temple money, but a Cambodian and an Indian paid for by an American charity. The Cambodian doctor declined to be interviewed: he doesn’t yet have a licence to practise medicine in Thailand, so his much-needed work is technically illegal. He would say, however, that the temple lacks even basic drugs and medical equipment.

Back at the orphanage, a dozen or so very young children have finished lunch and will soon head for their afternoon naps. But before they leave the table they sing a prayer for the abbot, referring to him by his formal monastic name, which means “full of loving kindness”:

Thank you, thank you,

The Right Venerable Monk Udom Prachatorn,

For giving us food today.

Thank you from our hearts for your kindness.

We are so happy.

Thank you, thank you