Wednesday, September 22, 2010

A Town of Widows



In a country where the government provides minimal general health care, citizens must take up the fight against HIV infection themselves.

A relatively prosperous transport hub for family-run trucking businesses, Kyaukpadaung’s high incidence of Human Immunodeficiency Virus (HIV/AIDS) among its population is a major downside to the township’s heavy dependence on the transportation industry.

With the 1,500-meter peak of Mt Popa nearby bringing cooler breezes and water to an otherwise arid region of eastern Mandalay Division, Kyaukpadang’s location at a major crossroads near the geographical center of Burma favored the town’s development as a trucking center. With larger businesses operating up to 100 trucks, many of the town’s residents are employed in the industry, spending weeks at a time on the road.

On Burma’s roads at night, teenage students are known to flag down trucks with flashlights, hitching rides and lifting skirts, passing from truck to truck, leaving sordid memories and sexually transmitted diseases.

Even if the drivers are aware of the problem and want to protect themselves, condoms are often unavailable in rural stores dimly lit by oil-lamps, where snacks, tobacco and liquor are sold along with the services of garishly made-up teenagers in a tin hut out back. As a result, when men return to their families in Kyaukpadaung, they often take HIV/AIDS with them.

Kyaukpadaung was an ideal place for our group to put our HIV/AIDS prevention and care training into action. As youth members of the National League for Democracy, we had been selected by NLD leader Aung San Suu Kyi to train at the UN Development Programme office in Rangoon.

On my first visit, I went to the town to help organize assistance from our group. By working with Kyaukpadaung’s people, we helped them to learn how to confront the disease as a community. They have become aware of how HIV is spread and are now more adept at preventing infection among newborn infants and children.

Those infected by HIV/AIDS now encourage each other to be open about their affliction, and many are willing to talk about their disease and have formed their own support group to assist each other.

They are ready to help others experiencing difficulties, such as when antiretroviral medicines fail to arrive on schedule due to supply problems in Rangoon or breakdowns in Burma’s antiquated transportation. Those who have remaining stocks of medicine willingly share with those who have run out and will be repaid in kind when new supplies arrive.

When one member suffers from an ailment such as diarrhea, another will help out at his or her home for the whole day if necessary, washing clothes, providing rehydration fluids and performing essential chores, often returning home late at night.

In many places it creates a stigma to announce HIV infection, but in Kyaukpadaung, not only do infected residents make themselves known to each other, they openly announce that they have been “bitten by A,” a local idiom meaning they are HIV positive, and they have no qualms about talking to the media or seeing their names in print.

If HIV victims in other towns could be as open as those of Kyaukpadaung, it would be a significant step in preventing the spread of the disease. The network that started in Kyaukpadaung has spread to Wundwin Township in Mandalay Division, and to Aunglan (Myayde), Magwe, Taungdwingyi and Yenanggyaung townships in Magwe Division and to some parts of Rangoon.

Shortage of funds exacerbated by the general poverty endemic in Burma is a constant problem. Network members must work hard to raise money to pay for treatment for fellow members or help new victims.

The HIV group in Yenanggyaung has even managed to raise enough surplus funding to open a grocery stall in the market, where HIV network members work in rotation. Two network members supervise the shop, managing its finances and assisting with travel expenses for infected patients who need to go to Rangoon for treatment.

Because the government spends so little money on health and education, support groups are usually the only means available for maintaining health among HIV victims and preventing more infection.

Of the self-help support groups set up so far, the Kyaukpadaung group is the most effective. I went to the town to teach but found I learned from its people. They were the only group that dared openly invite me, an NLD member the military government brands as an “infamous political activist.”

On my second visit, I went there on a pilgrimage, as well as to evade the authorities, who were trying to arrest me. The locals took me to various places around town, including the homes of some residents who may have been providing financial help to Kyaukpadaung’s HIV/AIDS network.

Before I left town, I overheard some youths in a tea shop cajoling each other to make sure they took condoms if they went to a karaoke bar. A sign on the outskirts of the town said, “Bon Voyage,” and I remembered the words of one HIV patient.

“Ma Phyu,” he said, “every second house in my town is the home of a widow.”

Phyu Phyu Thin, 37, has cared for HIV and AIDS patients since 2002, providing counseling and education, sending them to clinics and providing accommodation in Rangoon to those coming for treatment from outlying areas. Due to her political affiliation and strong support for the NLD, she faces harassment in her work and has been arrested and jailed on several occasions.

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