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Myanmar migrants struggle with HIV in Thailand

Source: Thomson Reuters Foundation - Tue, 10 Aug 2010 13:44 GMT
Author: An AlertNet correspondent
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RANONG, Thailand, Aug 10 (AlertNet) Â? A few months after crossing illegally from Myanmar into Thailand, former political prisoner Aung found out he was HIV positive.

His wife, Lei, was pregnant with their second daughter when he fell sick. He had diarrhoea and could not eat. By the time he was diagnosed, he was skin and bones and his CD4 count Â? white blood cells that attack infections Â? was 26.

Most healthcare providers start life-saving antiretroviral drugs (ARV) when CD4 counts go below 350.

"We didn't even have the money to go to the clinic. We had no one who could help us, no parents or relatives," said Lei, sitting in their small hut in a migrant workers' compound.

With her husband unwell, Lei got a job on a construction site just 45 days after giving birth. Aung, employed on the same site, only stopped working for a month at the height of his illness.

"With a newborn baby, I couldn't afford not to go to work," he said.

Lei has now discovered she is also HIV positive and the couple fear their baby may be as well.

The family were referred to Marist Mission Ranong (MMR), a Christian non-governmental organisation (NGO)working to improve health and education for Myanmar migrants and their children.

Father John Larsen, head of MMR, told AlertNet: "One of the biggest needs we see is for migrant workers struggling with HIV/AIDS" Â? families like Aung's, who need to work every day to make ends meet and yet are unable to do so because of their health.

MMR provides home visits and subsidises the cost of medication for Myanmar migrant workers living with HIV/AIDS.

HIDDEN PROBLEM

Myanmar's military junta, which has ruled the country for nearly five decades, has cracked down hard on political opponents and ethnic minorities, forcing many to flee their homes.

Every year, thousands risk their lives to cross into Thailand, to escape civil strife, political upheaval and economic stagnation.

There are thought to be up to 2 millions Myanmar workers in Thailand, many of them illegal.

Aung, a former student activist, spent seven years in jail in Myanmar. He has a university degree, but as a former political prisoner his opportunities after his release were severely limited.

He and his family decided to flee while he was working at a palm oil plantation in the southern port town of Kawthaung, where he likened conditions to a prison.

Ranong, a lush provincial town, is a 30-minute boat ride from Kawthaung and teeming with migrant workers from Myanmar.

Aid workers estimate there could be up to 200,000 Myanmar workers in Ranong, more than twice the local population, with many more scattered around the province of the same name. Many migrants in Ranong are from ethnic minorities in southern areas of Myanmar who have faced discrimination and repression.

In Ranong the migrants do low-pay work in fishing, seafood processing and agricultural industries.

There are no official statistics on how many migrants are infected with HIV/AIDs because most are fearful of going to hospitals or asking for help due to their illegal status and lack of money.

"It is very difficult to know the numbers and how serious the situation is and it can be frustrating because I don't think we're reaching enough patients," Larsen said.

"My feeling is that we are not hearing about them enough because for most of the people, it is a combination of fear and lack of education."

HIGH COST OF TREATMENT

Many turn up at the hospital or turn to MMR in the last stages of the disease, when they are no longer able to work, Larsen said.

Aung and Lei are lucky. Both are now on antiretroviral drugs (ARV) paid for by MMR. The monthly cost of medication, at around 2,400 baht (about $80), is too much for the couple, who have a combined income of 200 baht a day and are now expecting their third child.

The cost of HIV/AIDS treatment is also a burden to the local health service, which has been funding treatment for 3,000 migrant patients but a lack of funds is preventing them from providing the same service to newcomers.

"They require constant care throughout the patients' lives and it can be quite a strain on the hospital," deputy director of Ranong Hospital Pichet Pitikuakoon said. "So we need to rely on NGOs like MMR to pay for that because we can't pay for the cost of ARV for new patients."

MMR says its aim is to help migrant workers get better so they are able to pay for the medicines themselves, allowing MMR to fund more patients for treatment.

Lwin, a typical Myanmar migrant worker employed on a fishing boat for months at a time, is an example.

Both he and his wife are infected and their 11-month-old son who died recently was also suspected of having the virus.

But thanks to the scheme, Lwin is now fit enough to work again and is paying for 75 percent of his ARV.

(Names have been shortened or changed to protect people's identities)

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