IN MYANMAR, A CONSERVATIVE SOCIETY

[tun@xxxxxxxxxxxxxxx]

Subject: IN MYANMAR, A CONSERVATIVE SOCIETY TAKES ON AIDS

  <DATE> 94/03/10 18:39:14
  IN MYANMAR, A CONSERVATIVE SOCIETY TAKES ON AIDS
  By PHILIP SHENON
  c.1994 N.Y. Times News Service
     YANGON, Myanmar  In a ward of Yangon's Infectious Diseases
  Hospital, Myo Tun tried to shake hands with a visitor, but he was
  so weakened by AIDS that the muscles of his hand and arms had all
  but disappeared. He barely had enough strength to hold the prayer
  beads that are his final comfort.
     ``I used heroin with my friends, and we always shared the
  needles,'' said Myo Tun, 24, as he drew a green cotton blanket
  beneath his bare feet. ``Even today my friends do not worry about
  AIDS. They are not sick yet.''
     Dr. Rai Mra, a hospital physician, said he had no access to AZT
  or any of the other specialized drugs that might slow the ravages
  of the disease in Myo Tun and several other AIDS patients in the
* hospital, a center for AIDS treatment in Myanmar, formerly Burma.
     ``We don't have the facilities that other countries have,'' he
  said with the shrug that is second nature to Burmese doctors, such
  is their chronic shortage of modern medicines and equipment. ``Any
  help would be welcome.''
     One of the world's most isolated and secretive nations is
  opening up enough to admit that it has fallen victim to a medical
  catastrophe: an AIDS epidemic that is likely to ravage this country
  as it is now devastating Myanmar's neighbors.
     Doctors and health workers say a disastrous mix of factors  a
  large population of intravenous drug users, a migration of
  prostitutes, a grave shortage of condoms and testing equipment, and
  a conservative social structure that makes AIDS education difficult
   means that Myanmar faces an AIDS crisis as serious as that now
  found in neighboring Thailand and India.
     But unlike its neighbors, Myanmar is the target of sanctions
  that have choked off most of the international aid for health
  projects that might control the spread of the disease.
     ``Cutting off aid has hurt both the innocent victims of the
  epidemic and the potential victims,'' said Albina du Boisrouvray,
  founder of the Association Francois-Xavier Bagnoud, one of the few
  Western charities to support AIDS projects in Myanmar. ``They don't
  have enough condoms. They don't have enough testing kits to test
  the blood. I'm flabbergasted by what they don't have.''
     Estimates from international health organizations place the
  number of people in Myanmar infected with HIV, the virus that
  causes AIDS, at 150,000 to 450,000 in a population of about 43
  million. The infection rates found in tests of intravenous drug
  users  nearly 80 percent are HIV positive  are the highest
  recorded anywhere.
     Myanmar's neighbors are a big part of the problem, especially
  Thailand, where thousands of Burmese women are working as
  prostitutes, many of them in conditions that amount to slave labor.
     ``What the Thais do is horrible,'' said a foreign health worker
  in Yangon, the Burmese capital. ``They recruit Burmese girls  and
  they are girls  and tell them that they will work as maids or
  waitresses. When they get to Thailand, they are forced into
  prostitution. And when they get AIDS, they are pushed back across
  the border.''  
     Foreign health workers generally have few kind words for
  Myanmar's military government, which has an abysmal human rights
  record. But on the issue of AIDS, they say, the government appears
  to understand that it has a disaster on its hands, and to be doing
  something about it.
     ``We realize this is one of the major health problems in
  Myanmar,'' said Dr. Myo Thet Htoon, the manager of the AIDS program
  of Myanmar's Ministry of Health. ``We know it could reach the whole
  population if we are not intelligent enough to prevent it.''
     According to the World Health Organization, the first HIV
  infections were detected in Myanmar in 1988. In 1992, the last year
  for which full-year figures are available, 1,640 people tested
  positive for the virus out of 75,000 tested.
     Initially the principal transmission route for the virus was
  needle-sharing among intravenous drug users. But increasingly it is
  spread by sexual contact among heterosexuals, duplicating a pattern
  found in Thailand, where 800,000 are now estimated to be HIV
  positive out of population of 57 million.
     Thailand's AIDS-prevention program  with its distribution of
  free condoms, widespread testing and vast public education program
   is considered a model for the developing world.
     But across the border in Myanmar, one of the world's poorest
  countries, with a per capita income of less than $900 a year, the
  government says there is no money for a comparable effort.
     Nearly a third of the blood supply goes untested for the HIV
  virus because of a shortage of test kits, which cost as little as
  70 cents apiece.
     International aid groups donated about 1.2 million condoms to
  Myanmar last year, but that is not nearly enough to meet demand.
  Outside large cities, condoms are often impossible to find, and
  they carry a price  about 10 cents each  that is out of the reach
  of the very poor.
     The United Nations has stepped in to help with education. In
  1991, UNICEF produced a 60-minute film for Burmese television,
  ``Poisonous Love.'' The central character in the film is a young
  man who contracts HIV from a prostitute. He then goes on to infect
  his wife and, possibly, his newborn child.
     It took UNICEF a year to persuade the Burmese junta to show the
  film, and there was a long struggle with government censors, who
  insisted that a scene showing condoms be cut because it might
  offend many in this deeply conservative Buddhist country.
     The scene was left in only after UNICEF made a direct appeal to
  Lt. Gen. Khin Nyunt, the head of Burmese military intelligence and
  the man often described by diplomats as the first among equals in
  the junta.
     ``Khin Nyunt's wife is a physician, thank goodness,'' a Western
  health worker said. ``Otherwise, it might never have gotten on the
  air.''