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MSF in Myanmar, 2010
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Low national and international investment in the health sector combined with tensions and low-intensity conflicts limit access to healthcare in many areas of Myanmar.
Myanmar remains largely isolated on the international stage and faces severe restrictions from the international aid community. Despite the return of the Global Fund, the country continues to suffer from a chronic lack of resources to tackle diseases like HIV/AIDS, tuberculosis and malaria.
Working closely with local communities, MSF offers lifesaving treatment to people living with HIV/AIDS, basic healthcare, health education and reproductive healthcare, including antenatal and postnatal care, and nutritutional assistance. MSF has been providing healthcare in Shan, Rakhine and Kachin states as well as in Yangon and Tanintharyi regions through a network of HIV/AIDS clinics and health centres. MSF teams conducted nearly 660,000 general consultations across the country in 2010.
More than 240,000 people are living with HIV in Myanmar, and an estimated 120,000 are in need of lifesaving antiretroviral (ARV) treatment. However, treatment is currently available to only 21,000 people, and MSF was treating18,300 of these people in 2010. Staff also provided symptomatic and palliative care and managed common opportunistic infections, which patients suffer from as a result of their compromised immune systems.
In Yangon, MSF operated four HIV clinics. In addition to treatment, staff offered health education, especially to high-risk groups such as intravenous drug users, men who have sex with men and sex workers, and helped prevent the transmission of HIV through voluntary testing and counselling and mother-to-child transmission prevention services. MSF continued to work in close collaboration with the Ministry of Health and other agencies in building up the technical capacities and resources of the various HIV/AIDS care programmes in the country.
Tuberculosis and HIV
Myanmar ranks among the 22 countries with the highest burdens of tuberculosis (TB) in the world. The national TB programme is underfunded and the lack of adequate regulation of the private sector means that there is no proper regimen for treatment, which leads to high levels of treatment failure and increased drug resistance.
TB is the most common opportunistic infection and the main cause of death for people living with HIV. MSF provides TB treatment within the context of its HIV programmes and is currently giving free treatment and counselling to 2,540 TB patients across the country, most of whom are also HIV positive.
In Dawei, in the south of Myanmar, MSF runs an HIV and TB clinic for a local population consisting mainly of migrant workers and fishermen. Staff also conduct outreach activities in the surrounding district, going out in the community to test people and see patients who may not be following their treatment regime.
In Yangon, an MSF pilot project offers treatment and care for multidrug-resistant TB (MDR-TB) in partnership with the Ministry of Health. This is the first programme in the country offering treatment for MDR-TB. In 2010, 44 patients enrolled in the programme. In October, MSF set up an HIV and TB programme in Insein prison in Yangon.
Malaria is one of the leading causes of mortality in Myanmar. MSF clinics provide free diagnosis, treatment and prevention measures in areas where the disease has high prevalence rates. In Rakhine state, for example, MSF tested more than 400,900 people and treated more than 122,380 patients for malaria in 2010.
Cyclone Giri hit the west coast of Myanmar in November. In its aftermath, MSF conducted around 17,000 medical consultations through mobile and fixed clinics and distributed food as well as construction kits to help rebuild affected communities.