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Myanmar

Programme de Médecins du Monde en Birmanie. © Sophie Brandstrom

Myanmar

70,000

children die every year without access to healthcare

50,000

HIV-positive people have no access to antiretrovirals

28%

of sex workers are screened for HIV

Background

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le h4 est arrivé

Aids, an epidemic which affects the most vulnerable

Burma has one of the biggest Aids epidemics in south-east Asia. Of the 190,000 people living with the virus, almost 50,000 who are in urgent need of antiretrovirals, still have no access to treatment.  

People who use drugs are massively affected by HIV: at national level, a quarter of them are infected. In Kachin state, access to prevention and treatment services is even more difficult for them than elsewhere because of the armed conflict and the discrimination which they suffer. Almost half of them are infected with HIV. Sex workers are the other group of people most affected by the epidemic. They also suffer a great deal of discrimination and are rarely included in awareness building or screening and treatment programmes. So, in certain towns and regions, the rate of screening for Aids amongst sex workers is only 28%, and inclusion in prevention activities is 15%.

A beneficiary suffering from tuberculosis. © William Daniels
A beneficiary suffering from tuberculosis. © William Daniels

What we do

People exposed to risks

Helping sex workers

Since 2014, Doctors of the World has worked with the sex worker community in Rangoon. The association operates with peer educators in mobile clinics to prevent, screen for and treat HIV. It has also set up a fixed clinic where over one thousand sex workers are seen every year. In addition to antiretroviral treatment, they can receive counselling and be screened for other diseases such as tuberculosis.  

Doctors of the World also works with other local organisations and peer support groups to offer nutrition activities to sex workers, as well as income generating activities for those who wish. Otherwise, the association works closely with the Ministry of Health to support its decentralisation policy and the national plan to combat HIV. 

The State of Kachin
The State of Kachin

In 2016

We helped:

  • 2,600 sex workers (male and female) who had access to prevention activities

  • 700 sex workers (male and female) who had screening tests

  • Around 1,300 people who received antiretroviral treatment

  • Over 1 million condoms were distributed

A peer educator is instructing sex workers about the various precautions to be taken in a guest house. © William Daniels
A peer educator is instructing sex workers about the various precautions to be taken in a guest house. © William Daniels

 

At risk populations

HELPING DRUG USERS
 

In Kachin state, in the north of the country, Doctors of the World works with people who use drugs, who are particularly susceptible to infectious diseases. They are provided with prevention material (condoms, sterile needles). There is screening for HIV, Tuberculosis and Hepatitis. Educational workshops on health and antiretroviral treatment are provided to try to involve users in prevention activities.

Doctors of the World currently manages four clinics in collaboration with a team of health professionals and peer educators. There, the association conducts prevention and awareness raising activities and provides substitution treatment by methadone. 

It also reinforces its training activity with the local authorities and civil society stakeholders. The objective is to develop harm reduction activities in Kachin, to reduce violence against drug users and to promote the methadone substitution programme.

 

Rangoun
Rangoun

In 2016

We helped:

  • 10,000 people who use drugs have had access to harm reduction activities

  • 1,300 people who use drugs have been placed on substitution treatment (methadone)

  • 1,200 people who use drugs receive antiretroviral treatment

CAPACITY BUILDING OF LOCAL PARTNERS ON HARM REDUCTION AND ADVOCATING FOR ACCESS TO HARM REDUCTION SERVICES

 

In May 2016, Doctors of the World, in partnership with the Metta Development Foundation, launched an innovative programme based on the respective areas of expertise of the two organisations. Thus Doctors of the World will build the capacity of Metta with regards to harm reduction and they in turn will support our teams in community approaches to prevention. This will allow a larger number of people to be reached in the areas where we work.

To do this a joint training centre has been set up. Prevention and awareness raising activities have been implemented in order to promote attendance at harm reduction services by the communities.   

Medical consultation. © Sophie Brandstrom
Medical consultation. © Sophie Brandstrom
History
1991
Initial contact with the country, ad-hoc surgical assignments.
1994
First HIV project in the State of Kachin. Preventive measures carried out for drug users by injection.
1994
First HIV project in Kachin state. Prevention activities with injecting drug users.
2000
Opening of a programme in Rangoon with sex workers.
2002
Opening of the first medical care centre. Provision of antiretroviral treatment (ARV).
2006
Doctors of the World obtains authorisation to issue methadone.
2008
After the Nargis Cyclone, an emergency operation was carried out in the Pyapon delta.
2013
Intervention with people displaced by the independence conflict in Kachin.
2014
End of the programme with displaced people in Kachin.
2016
Launch of joint programme with the Metta Development Foundation in Kachin.

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