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Myanmar: New policy requires HIV groups to register

HIV Information for Myanmar (HIM) has written an article regarding the recent change of policy in the formation of informally named groups of People Living with HIV (PLHIV) Network.

The author attached a letter from Deputy Director-General of Disease Control Unit under the Ministry of Health addressing to Head Doctors under the Prevention and Control Team for Sexually Transmitted Diseases and HIV.

PLHIV Networks are being formed in different States and Divisions in order to help with the prevention and treatment of HIV/AIDS. In doing these tasks, it is necessary for PLHIV Network Group to work under the supervision of Prevention and Control Team for STDs and HIV, and thus, does not need to carry a separate name. If the Group wants to operate under a separate name, it will need to register step-by-step at the Township, Province, and State/Division Peace & Development Councils, and the Ministry of Home Affairs, in accordance with the laws of forming an organization.

An anonymous reader left the following comment:

If the gov is really on the path toward democracy, just love their people first. Participation is very critical to real development. How many NAP's staff around the country? Do they have enough manpower to reach 240,000 infected people (what they wrote, might be higher : who knows?). Do you have any evidences to code that PLHIV are involved in political matters? Eventually, they were just seeking the options to have access to ART through different channels.

Another reader left a comment explaining about the health situations in Myanmar. He also wrote about the condition of HIV patients in Myanmar:

There are many HIV infected patients or people living with HIV in the Union of Myanmar. Many HIV patients cannot afford any HIV medications and some lack of HIV medication because their respective NGO stopped providing them with many reasons. People in Burma or in the Union of Myanmar are indeed helpless. People in Burma have no human-rights at all and no voice at all. They are same like prisoners in their own country no matter they live in the jail or not.

Some are worried that the new government policy of requiring HIV groups to register could be used to “control” or undermine the independence of volunteer groups in Myanmar. Another reader also voiced his concern in his comment regarding the challenges faced by NGOs after the Saffron Revolution in 2007.

…. Self helping and supporting each other is a very basic  value and basic rights of man kind which by no means require any permission from any one. Encouraging and facilitation for formation of self help groups in a response to HIV response is internationally recommended best practice and best use of people living with HIV as resources for care and treatment programs. Every medical professional understands that any restriction on access to  assistance for individuals’ health is kind of breaching the code of ethic of medical profession. The international non government organizations implementing health programs has been in a silent crisis for almost a half decade, particularly after September 2007. Their MOUs have been under pending if they do not follow the advice to reduce their project sites. The NAP used to be quite OK to pretend active in working with international and local NGO in developing National Strategic Plan for HIV/AIDS and accomplishing targets in prioritized townships together with stakeholders. After the September movement, all health programs are looked from military's security perspective. Not bother to care for anyone's any issue, but greater care for their security. More and more INGO and Local NGO are asked to reduced their operating areas. It was quite difficult for the medical professionals to convey the unethical advices to their counter parts , the humanitarian IGNOs. However, the recent restriction letter looks like that Medical professionals from DOH are more confident and comfortable issuing such unethical orders to the people living with HIV/AIDS, their patients. They no longer see people living with HIV/AIDS as their patients, but as threats to their security, the livelihood security of the staff from the DOH…..

According to a  press release from Doctors Without Borders (Medecins Sans Frontieres) in November 25, 2008, an estimated 240,000 people are thought to be living with HIV/AIDS in Myanmar. Among them, 76,000 are in urgent need of anti-retro-viral treatment, yet less than 20 percent of them are currently able to access it.

  • David W

    I’m sure it is no coincidence that they are requiring this on the heels of an article about Burmese with democracy aspirations channeling their energies into nonprofit work. Specifically, a story in the Washington Post on August 24th entitled “Strategies of Dissent Evolving in Burma: Activists Find Political Breathing Room in Humanitarian Nonprofit Groups”. No doubt, the regime leaders read the American papers, and this innocuous line may have set them off:

    “There is still room to change at the small scale,” said an AIDS activist, sipping juice in a teashop.

  • David W

    The order predated the article; however, the two issues (grassroots communication through nonprofits, and the order for HIV educators to register with the government) are linked through the regime’s paranoia.

  • freedom

    Dear Sir / Madam,

    It is a very good news that many countries and many organizations would like to help Myanmar citizens. Due to the primitive society in Myanmar, many HIV infected patients dare not come to the right center for medical treatment. Society in Myanmar has not modernized yet so that people avoid HIV infected patients. Society, neighbors, environment put HIV infected patients out in the cold. HIV infected patients need moral support as well as medication support. Due to the very poor medical treatments by local doctors, some die without any proper reason. Local doctors, nurses, hospitals, centers, etc., provides very unfriendly atmosphere to all patients. Some even hostile to the patients.

    Medications for HIV patients are very complicated. Physicians need to check HIV patient with a great care and decide which level of HIV medication is suitable for that particular patient (according to the HIV blood test –cd4 result for each patient). Medication for one HIV patient and other HIV patient may not be the same.

    ARV medication is just a general name for HIV patients. Same level of ARV medication cannot treat for all HIV patients. All HIV patients must take medication at least twice a day and 12 hours time difference. HIV patients cannot miss even a single dose of the medication and a great care to take twice a day with only 12 hours time difference. Maximum 15 minutes can be late to take the daily medications. All HIV patients must take the medication for life long period.

    HIV medications are very costly so that it is hard for anyone to pay for the medications for life long. As far as we know, one type of HIV medications is directly imported from U.S.A. to Thailand and the other type of HIV medications is from under license companies in Thailand (for example, Reyataz atazanavir medication, GOP-VIR medication, etc). HIV medications from under license companies in Thailand are cheaper. It cost THB or Baht 20, 000 (Baht twenty thousands) per month in government hospitals, according to a HIV patient in Bangkok. One can say that it is expensive enough for a Thai people in Thailand too. No wonder that it is very hard for any single person to afford taking HIV medications for life long period especially where he or she is living in a third world countries or from a developing countries.

    All kind of insects can be sharply harmful to all HIV infected patients. All HIV infected patients must stay away from insets’ bite –including mosquitoes. Hygienic is essential for HIV patients. HIV patients are not suggested to take hot-shower because they have sensitive skin. They are advised to stay in an air-conditioned room.

    Moral support to HIV infected patients is also essential because some of them even have “depression”. When HIV patients are deeply upset, disappointed, unhappiness, etc, their health condition is dramatically go down. That is why, they need not only medication, but also happiness.

    In Thailand, people can buy condoms even in convenience stores like 7Eleven, family marks, am pm, etc which opens 24 hours. Where to buy and how to buy condoms in Myanmar? Can local people afford to buy one or not? Do they have knowledge to use it or not? HIV virus can spread not only from having sex without condom, but also from blood transmission, from hair-cut blade, from oral sex, from dental-clinics, from lip-kiss, from knife which is used in operation-theaters of the hospitals, from drug-addicts, needles from syringes, etc, etc.

    There are many HIV infected patients or people living with HIV in the Union of Myanmar. Many HIV patients cannot afford any HIV medications and some are lack of HIV medication because of their respective NGO stopped providing them with many reasons. People in Burma or in the Union of Myanmar are indeed helpless. People in Burma have no human-rights at all and no voice at all. They are same like prisoners in their own country no matter they live in the jail or not.

    Life is very cheap in Myanmar. Many people there are lack of education, knowledge and dare not speak openly to what they feel to their doctors, clinics and the medications. Corruption is everywhere and every level in Myanmar. Least number of medications will go into the hands of infected patients and the rest may sell out in the black market. Even NGOs are not reliable at all. But patients can get at least some help from NGOs (something is better than nothing). We heard that HIV medications supplied by NGOs are just off and on time period. Whenever there is a shortage of medications or lack of fund, patients must stop taking medications.

    Is there any hope for anyone to get a NGO job especially in Burma? We heard that although they post job vacancies on the net, they already had selected job applicants to fill the positions. They only employ those who know them very well like family members, relatives, closed friends, someone special, etc. NGOs job posting on the net may be only for publicity. Actually job vacancies may not open to ALL.

    One breast cancer patient for example, was taken medical treatment in the city of Rangoon, one of her breast was cut without doing even mammogram or X-ray in one of the private hospitals in Yangon. She then went to Thailand for further treatment. She is an engineer and a government officer. Thai doctors do not know what to do with her because she could not submit her past medical record and she cannot submit the tissue or paraffin wax of the tissue of the breast she cut off in Myanmar.

    In Myanmar, many local LABs are totally useless and not at all dependable and reliable. As I said above, the tissue must keep in the paraffin wax and it must keep in a lab at least for one year long (international standard), but in Myanmar, no lab keep that even for three months long.

    There are not at all modern medical technology machines, equipments, etc in throughout Myanmar (Example, Mammogram machine, digital radiation machine, etc). All the money from selling out jewelries, teaks, natural gas, crude oil, all kind of metals, all kind of natural rsources like seafoods, sands, etc are going into government fund for buying weapons. We are so ashamed to say that Union of Myanmar now is completely like a “banana republic”. Military force is very strong in South-East Asia, but apart from Military force, all other sectors like health, education, technologies, etc are far behind or still very out-dated. All sectors need foreign countries help, but when they get helped, they grabbed in their own pockets as much as they could.

    Although there are many medical doctors in Myanmar who graduated from UK or other Western countries or elsewhere in the world, they are very careless and they do not have any medical ethic. Even the Local doctors with overseas degree themselves are not at all up-to-date with modern medical technology. For some instances, the diagnosis of the patients does not match the medications given by a doctor.

    We are sure that in other countries, family members, relatives, etc of the patients take a legal action against the doctor if their love ones die with the careless of the doctor, but in Myanmar, because of the religious teachings, family members, relatives, etc of the patients do not sue or take the legal action against the doctor even if their love ones die with the careless of the doctor because they can easily forgive to the doctor. They believe that whatever they put a spite on the doctor, they cannot get their love ones back with life again. That forgiveness unintentionally encourages the doctors to do more and more careless and accidently to commit more and more crimes in future.

    Patients who cannot afford to go abroad for medical treatment are same like guinea pigs in Myanmar. Only 15 percents of the total population in Myanmar can afford to go abroad for medical check-up, for education, for holidays, etc. The fate of the rest are just depends on their own “Karma”.

    We read many news, magazines, etc for swine flu or A H1 N1 infected virus. We know that there is a medication to prevent that virus from spreading only. We haven’t read any article that people who already infected A H1 N1 virus can 100% cured. Is there anyone who cured fully from infected A H1 N1 virus? Kindly advise us.

    State-run television in the union of Myanmar broadcasted that some A H1 N1 infected patients cured fully and already discharged from the respective hospitals. According to the most recent news, 16 patients who are infected by A (H1N1) virus cured 100% at the State-run hospitals and they even already discharged from the hospitals. Can it be possible? We believe the whole world will be laughed and astonished to hear such kind of ridiculous news which is produced by dictatorship government source. The media never announce that it is swine flu. It only mentioned that it is a kind of world human flu. It said consumption of pigs is not at all harmful to people with regard to A H1 N1. Is it right?

    Is the Union of Myanmar is the first and the only country in the world that can 100% cured some A H1 N1 infected patients and can even discharged from the respective local hospitals? Please advice.

    These poor conditions really existing in the most developed city in Myanmar called Yangon. So, what about and how about of the patients who live in the provinces?

    Many villages do not even have first aid clinic / center and no village library at all. In Irrawaddy division for example, the villages between Nga Ting Chaung town and Lay Myat Nhar town (except I tha byu town) — which is only a half-day trip by bus from Dagon Aye Yar Highway Bus Terminal; located in Hlaing Tar Yar Township, Yangon — do not even have a first aid center and there is no power supply at all. Each hat (each family) does not have own toilet. A few numbers of hats have to share one toilet.

    Since there is no power supply, village people cannot have an opportunity to watch health education which is broadcasted by TV. Daily papers, weekly journals cannot reach many villages in Myanmar so that village people cannot have a chance to read it. Many villagers are uneducated or have only a primary school level education or some are even illiterate. Some women living in urban areas and many Village women in Myanmar do not have the knowledge to use menstruation-pad for themselves and diapers or nappies for their babies. Without wearing menstruation-pad —some women living in urban areas and many village women look very awful / ugly when having period, blood stain on their serong (longgi or htee mee) look very dirty and the odor from the blood stain welcome many flies (insects) follow them wherever they go. Some blood even dropped down through the legs.

    Without wearing diaper for their babies — some babies who are living in urban areas and many babies who are living in rural areas look very dirty when they produce urine and feces anytime at everywhere. Some babies produce such dirty things on their parents, some produce on the floor of the house where they visit (it must be very sorry to the host), some produce on the pagodas, in the Churches, some produce in the public park, some produce on the public bus, highway bus, some produce in the metered cubs, etc. It is not at all appropriate manners for the environment and also to the society.

    Married families do not have the knowledge to prevent child by taking anti-pregnancy drugs or they don’t know how to make a family plan. Many poor families have many children, but parents cannot take care of their children in proper way. Children have to work in the fields to earn money for their families. So, child labor is just a normal thing or like a lawful thing in the villages of Myanmar.

    There is no electric stove, gas stove, oven, micro-wave, etc in all rural areas or villages in Myanmar. People have to use cut wood to burn it for cooking. It leads to deforestration. They have to use candles for light at night.

    Income per capita of many villages in Myanmar is just only Ks. 700 (less than US$ 01). There is no job or very less job vacancies in rainny season. The poor quality rice is about Ks. 600. Village people eat a lot of rice, but there is no money left to buy for meats, vegetables, fruits, etc for balance diets. Furthermore, there is no money left to buy for such menstruation-pad, diapers, clothes, under-garments, tooth-paste, tooth-brush, etc. Even the living standard of Urban area is very low compared to neighboring countries like Thailand. So, whatabouts and howabouts of the living standard of Rural areas or villages in the Union of Myanmar?

    Lowest income per person in Yangon is just Ks. 15, 000 (Fifteen Thousands Kyats only) for unskill full-time house-maid. For factory workers in Yangon, each could earn Ks. 1, 000 (One Thousand Kyats only) as their daily wages. For semi-white collar jobs and some white collar jobs, they could earn maximum Ks. 100, 000 (One Hundred Thousands Kyats only) per month. There are many unemployment problems both in Yangon, many other urban areas as well as in many rural areas and villages in the Union of Myanmar.

    Due to the language barrier, foreigners cannot speak directly to the local people or infected patients or even if he or she does, he/she cannot get right answer from them because local authorities (government as well as NGOs) already shouted them what to say to the foreigners. People who live in the province are very timid type compared to the city dwellers. Saffron Revolution for example, military men raided “Lwei Kyar Yan” monastery in South Okkalapa Township which is located suburb of Yangon and monks from that monastery were immediately replaced by special monks selected by dictatorship government to answer the questions which is asked by UN investigation team.

    Still now, many local people in Myanmar and many foreigners do not know how many NGO HIV treatment centers in Myanmar and Please advice if there is a website to see the location or address of the NGO HIV treatment centers existing in Yangon and throughout Myanmar and how the effective treatments given to the patients. Many NGOs give the reason that they have shortage of medications, funds, etc.

    All kind of fresh meats, fish, livestocks, etc in Myanmar do not have any health certificate (International Standard or ISO certified) — which stated that the fish, meat, etc.. are healthy and suitable for human consumption. There is no medical check-up at all for all kind of animals, fish, etc before they are sent to butchers.
    There is no international standard hospital or ISO certified in Myanmar. We cannot say that a hospital with international standard is just in-terms of the decoration of the hospital rooms only. The Hygienic, doctors and nurses treatments to the patients, hospital rooms’ service, food service rendered by the hospitals, hospital equipments, services provided by all level of hospital staff, etc, etc are also counted. Some people who live in urban areas and many people who live in rural areas can afford / can rely on only tradition medicines/herbs/leaves, etc because it is cheap and they can read the description of the medications easily because it is written in Burmese language. 95 percent of the tradition medicines/herbs/leaves, etc are not at all internationally recognized or ISO certified.

  • Ajay

    I have a story on Myanmar. In their Ministry of Railways there is a Deputy Minster, U Pe Than. This department recently has been a on a buying spree for upgrading their Railway network. Now let us see how he helps to benifit the country or should we say his own pocket. He buys 3 Concrete Sleeper Plants claiming that the Chinese are the best suppliers of this material. Then, even before they have installed a single plant he buys 2 more plants from them. Claims he negotiated a good price with them. Now why did he do that? On paper for the good of the country but really speaking without having a plant installed how was he sure their plant would work after all the last plant hey installed the Chinese company ran it themselves with Myanmar Railways officials not being allowed in there. But, did he inform is his bosses that he had rented out his house in Yangon to this company at a crazy ly high rent and taken money under the table too.
    Now lets go to another story about U Pe Than, He recently wanted to purchase Rail Gang Cars. A Chinese company quoted the lowest approx 50% of the rest of the sellers, but they quoted for a Shunting Locomotive. Not a Rail Gang car. The deputy Minister is an Engineer and must know both the equipments perform two different tasks! But then why did he want this particulars companies equipment? The real reason is he had taken money in advance for an order for Rails but the officials from MOD received a better price and had asked Myanmar Railway to place an order with the other company. Now U Pe Than had taken money already , so the next best way to compensate this company, UREC was to make sure they receive the order for Rail Gang Cars even if this is not what the Railways required. With the strong feedback system the rulers of the country should know that the deputy Minister is only making money and taking their country for a ride and the biggest loser are the people of this poor country. Thus is the story of U Pe Than, the Deputy Minister of Railways, Myanmar. Where is his money kept, with his son who is abroad.

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