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MSF in Thailand, 2004
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In Thailand, HIV/AIDS affects an estimated 1.5 percent of the population and is the leading cause of death. MSF's work there is increasingly focused on helping those who are HIV positive. MSF works closely with the ministry of public health, which aims to provide life-extending antiretroviral (ARV) medicines to 50,000 people in 800 public hospitals across Thailand by the end of 2004. As part of the "Access Network" supporting the plan, MSF gives training, supervision and technical support to staff at comprehensive care centers in 100 hospitals across Thailand's six regions. Currently, about 1,100 people are receiving ARVs supplied by MSF.
MSF is also providing comprehensive AIDS care in seven district hospitals in four provinces as part of a pilot project to decentralize HIV/AIDS treatment. MSF works in the provinces of Nonthaburi, Petchaburi, Kalasin and Surinas well as in two provincial hospitals in the provinces of Surin and Maharasakam.
In Bangkok, MSF runs a home- and community- care project for people living with HIV/AIDS who have limited access to existing health services, such as women prisoners and migrant workers. Activities include palliative care and crisis intervention, as well as follow-up for those taking ARVs. Community care is offered in partnership with hospices and shelters in the capital city.
Because children living with HIV/AIDS in Thailand have been identified as a population in need of better care, MSF began a pilot project in late 2002 targeting those living in Petchaburi province. Together with local partners, MSF provides training, technical support and medicines to the pediatric department of the provincial hospital. MSF aims to treat 100 children with ARVs through this program by the end of 2004. Elsewhere, in Surin and Maharasakam, 79 children have received ARVs through MSF.
MSF's first projects in Thailand targeted refugees living along the border with Laos, Cambodia and Vietnamese "boat" refugees. Work with refugees continues today. In Maela camp in Tak province, MSF provides basic health care to 38,000 refugees, primarily members of the Karen ethnic minority. MSF runs two inpatient and two outpatient health facilities and manages the water supply. MSF also provides food to people who are sick and to pregnant and breastfeeding women, and has set up a therapeutic and supplementary feeding program.
People living with HIV/AIDS in Maela camp have access to ARVs through MSF. Currently 15 people are receiving such treatment. In Tham Hin camp, in Ratchaburi province, MSF provides water and sanitation for the 9,000 Karen refugees and carries out more than 2,000 health consultations per month. In both camps, MSF works to prevent and respond to epidemics that are a constant concern due to overcrowding. Finally, MSF has extended tuberculosis (TB) treatment from Maela camp to the surrounding communities, particularly to the migrant workers who live in this border region and have little access to health care. In 2003, MSF reached 493 TB patients, including some with multidrug-resistant strains. MSF is working closely with the Thai authorities to improve access to the medicines needed to treat this type of TB.
MSF has worked in Thailand since 1983.