Médecins du Monde intervient en Birmanie auprès des exclus des soins afin de leur apporter une aide humanitaire et un soutien médical © Sophie Brandstrom

Myanmar

220,000

people in Myanmar are HIV-positive

70%

of new HIV infections are affecting the communities most at risk

45%

of those infected have no access to antiretrovirals

A humanitarian emergency in Myanmar: the need for medical assistance

The health issues affecting local communities are alarming. The HIV epidemic and risks associated with drug use are particularly pressing emergencies which must form part of any medical assistance plan for Myanmar.

 

HIV, an epidemic affecting the most vulnerable

Myanmar has one of the largest HIV/AIDS epidemics in Southeast Asia. Of the 220,000 people living with HIV, around 126,500 who are in urgent need of antiretrovirals don’t always have access to treatment. Geographical isolation, the limited capacity of public institutions, punitive legislation and discrimination are among the obstacles encountered in tackling AIDS and HIV in Myanmar.

A twin-track medical assistance plan is needed in Myanmar, addressing access to treatment and community awareness-raising.

 

Humanitarian emergency in Myanmar: an epidemic compounded by drug use

HIV particularly affects people who inject drugs – 35% of them are infected nationwide. These alarming figures contribute to the need to implement a humanitarian emergency plan in Myanmar. In the rural Kachin State in northern Myanmar, access to HIV prevention and treatment services is all the more difficult since people who use drugs face multiple discrimination. In particular, discrimination comes from religious anti-drug communities known as ‘Pat Jasan’. These groups organise rehabilitation camps for drug users which amount to forced imprisonment. Drug users are compelled to endure withdrawal with no form of medical support.

The restrictions and lockdowns imposed by the authorities have had damaging consequences

Furthermore, 14.6% of sex workers and 11.6% of men who have sex with men (MSM) are affected by the epidemic. Also subject to significant discrimination, these people are rarely reached by awareness-raising, screening and treatment programmes.

The health and social crisis triggered by the Covid-19 pandemic has further increased the fragility of these key groups which experience daily isolation, stigmatisation and limited access to the healthcare infrastructure. For example, the restrictions and lockdowns imposed by the authorities have had damaging consequences for sex workers, as their livelihoods depend largely on both them and their clients being able to move around freely. For drug users, access to treatment or harm reduction measures has also become complicated.

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

Our humanitarian support in Myanmar

As part of its medical assistance plan in Myanmar, Médecins du Monde aims to promote equal access for all to health and rights. In Myanmar, our harm reduction programmes provide prevention, treatment and support services for key groups, such as sex workers and men who have sex with men in Yangon and people who inject drugs in Kachin.

 

Supporting sex workers in Yangon

Médecins du Monde France has been working with the sex worker community and men who have sex with men in Yangon, in southern Myanmar, since 2000. This is a humanitarian mission based on partnership working in Myanmar. Through a network of community-based peer educators, Médecins du Monde’s HIV/AIDS prevention activities have provided support to thousands of individuals potentially at risk of infection. The teams also established a static clinic which treats over a thousand people every year. In addition to HIV testing, treatment and support, service users can access counselling and get tested for other conditions, such as tuberculosis and sexually transmitted infections.

Through its humanitarian mission in Myanmar, Médecins du Monde is also working in collaboration with other organisations and peer support groups. In 2020, several online advocacy and awareness-raising campaigns were organised through webinars and social networks. The teams focus their energy on providing medical assistance and improving the everyday lives of the key communities affected, to enable them to access HIV services and exercise their rights. In partnership with another organisation, SWIM, Médecins du Monde also organised the distribution of food vouchers to support the sex workers who have suffered the greatest economic impact as a result of the health and social crisis.

Rangoun
Rangoun

In 2020

We helped to protect those who are overlooked and left behind by:

  • meeting with and supporting 4,490 sex workers and men who have sex with men
  • supporting 1,076 people with antiretroviral treatment and support and care services
  • distributing over 361,000 condoms for the most at-risk groups in Yangon

 

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

Medical assistance in Myanmar: supporting people who inject drugs

In Kachin State, in the north of the country, Médecins du Monde works with people who use drugs who are particularly affected by infectious diseases. In some of the places where we work over half of people who inject drugs are HIV positive and, of these, 70% are also infected with hepatitis C.

Médecins du Monde is developing medical assistance in Myanmar with a focus on harm reduction. The organisation works in three townships and through outreach activities, supported by a network of community workers. This community-based model means a wide range of services can be offered to people who inject drugs, including HIV testing, counselling and treatment; primary healthcare; hepatitis B vaccination and screening for hepatitis C; screening for and treatment of STIs and tuberculosis; and referral to healthcare and support services. Médecins du Monde also offers access to substitution therapy using methadone. Prevention supplies are distributed (condoms, sterile syringes, water and alcohol swabs) and health education workshops and antiretroviral treatment are offered to get people who use drugs involved in prevention activities.

In 2020, in order to maintain access to healthcare services despite the Covid-19 pandemic and the associated lockdown measures and movement restrictions, Médecins du Monde increased its outreach sessions and prevention efforts. Humanitarian activities were therefore able to continue in Myanmar. The peer volunteers trained by Médecins du Monde carried on delivering prevention activities directly in the villages, while liaison workers distributed harm reduction supplies to people who use drugs. Meanwhile the authorities also authorised organisations including MdM to provide people who use drugs with methadone doses to take at home for periods of 7 to 14 days – rather than the usual single day doses. MdM arranged for treatment to be provided for several days at a time to drug users who fulfilled the stability criteria, which was the majority of those on our list.

Rangoun
Rangoun

In 2020

We reached out to people who experience discrimination:

  • 3,108 people who use drugs had access to prevention services
  • 2,141 people received antiretroviral treatment
  • over 4 million needles and syringes and 673,386 condoms were distributed
  • around 2,650 people who use drugs had access to methadone
  • 752 people received treatment for hepatitis C

 

 

our institutional support

Budget: €2,637,000
Le Fonds mondial de lutte contre le sida, la tuberculose et le paludisme soutient Médecins du Monde
History
1994
First HIV project in Kachin State. Prevention activities for people who inject drugs.
2000
Opening of a programme in Yangon for sex workers.
2002
Opening of the first medical care and treatment centre. Provision of antiretroviral treatment.
2006
Médecins du Monde obtains authorisation to provide methadone.
2008
Cyclone Nargis: emergency intervention in the Pyapon delta. Improvement in care and treatment for mothers and children.
2013
Intervention for people displaced by the internal conflict in Kachin.
2014
End of programme for displaced people in Kachin.
2016
Launch of a programme in partnership with the Metta Development Foundation in Kachin.
2020
Strengthening outreach sessions and prevention efforts to address the spread of Covid-19

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