An increase in the death rate is most likely due to the quality of care. The [him] moderator won't comment on the confusion about prevalence figures. Are the IOM and IMNA getting enough technical assistance?
[him] moderator
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June leaves Mon State with unprecedented HIV-AIDS death rate
Rai Maraoh and Roi Mon
Independent Mon News Agency
1 July 20019
The International Organization for Migration (IOM) reported more than a
100 percent increase in HIV-AIDS deaths in Mon State in the last two
months.
Responsible for supplying over 200 HIV-AIDS patients with antiretroviral
(ARV) medicines, the organization told reporters that the number of new
and developing cases may still be on the rise.
"At the end of June we had a meeting to review our work?this month [June]
11 of our patients died, which has never happened before," said one IOM
staff member who works in Mudon Township. In contrast, 5 patient deaths
were reported in May.
Since early 2007, when IOM began its medicine distribution in Mon State,
workers told IMNA that there has been a variance in whether or not there
will be recorded deaths in any given month, but that this number is
startlingly high.
In fact, this development occurred in light of the IOM?s doubling of the
number of HIV-positive patients issued the medicine in April and June?from
100 to 200.
?Most HIV and AIDS patients need ARVs, though many don?t get enough
[oftentimes none at all]. But some of them didn?t take the drugs
regularly, and that?s [part of the reason] why the patient deaths have
increased this month [June],? said another member of the IOM staff.
This explanation is puzzling, and some feel that amidst the rainy season
and its high levels of fever, flu and diarrhea, many residents seek other
available medicines, some traditional Mon plant- and root-based, to deal
with immediate symptoms rather than the longer term HIV-AIDS.
The IOM operates in 6 Mon State townships?Moulmein, Thanbyuzayat, Mudon,
Kyaik-ma-yaw, Bee-lin, and Ye?and sometimes distributes food along with
the medicine, though they feel the inherent limitations in what they can
do for such a rampant problem.
A 2008 UNAIDS/World Health Organization report on the global AIDS epidemic
estimates that Burma had 240,000 people living with AIDS in 2007, noting
that this number could be as high as 370,000. According to an April story
by the Burmese media source Weekly Eleven Journal, only 14,000 people in
Burma with HIV are receiving antiretroviral medicines.
Though the latter figure is likely more of an approximation than hard
science, if it were accurate, this would indicate 226,000 Burmese
residents currently live with HIV and AIDS and receive no suitable
treatment.
Robust currents of sexual trafficking/sex workers and intravenous drug-use
strongly contribute to these figures, along with a lack of available
condoms and universal sexual education.
The International medical group Doctors Without Borders estimated that in
2007, 25,000 people died of AIDS inside Burma.
http://www.monnews-imna.com/newsupdate.php?ID=1464
Right! Good thinking, Anonymous. IOM would not have taken action to decrease leakage, improve its transparency and accountability, support IMNA staff in their journey to journalistic respectability, and would not give public stakeholders the information they need to respond to the epidemic. In short, we would all be swimming in a pool of ignorance, a condition in which some people prefer us to be. The [him] moderator would love to continue this online discussion ...
And if HIM had not posted the article, we would most likely have never known that some of the figures were incorrect......
IOM is not sure if or how IMNA verified any of the information that appeared in their recent article, nor why [HIM] felt it appropriate to comment on the quality of care or technical assistance needs of an organisation based on unverified reports, however we would like to point out that IOM did not “report” any such figures and that the information presented in the article is factually and contextually incorrect. IOM will be asking IMNA for a retraction and correction of the article.
IOM in fact reported 13 HIV-related deaths in June, which was an increase from deaths reported in the previous 2 months, HOWEVER, the average number of HIV-related deaths per month in 2009 is 9.This clearly does not indicate a significant deviation from expected deaths.
As with many HIV services provided in Myanmar, a significant proportion of patients only present at an advanced stage of disease which accounts for a high number of deaths each month. This is particularly so in IOMs work with migrants and mobility impacted communities who often register after return to their home communities.
Contrary to the [HIM] moderator’s unfounded and unhelpful comments that “an increase in the death rate is most likely due to the quality of care”, the average death rate amongst PLHIV registered with IOM has actually decreased since 2007.
IOM began supplying ART to patients in 2008 and currently does so to 104 patients. This number has NOT doubled in April and June as reported in the article. During this entire period (2008-2009), only 11 IOM-patients on ART have died, including just 2 patients in 2009.
Overall, IOM’s programme has registered and assisted over 800 PLHIV in its operational time, of which almost 200 have died. This is the harsh and sad reality, that scores of HIV positive persons in Myanmar continue to die despite nutritional support, treatment for opportunistic infections and comprehensive care and support programmes. Only with adequate ART access and provision, encouragement of VCCT, and targeted evidence based prevention programmes can we begin to stem the tide of HIV related deaths. IOM is unfortunately the only organization providing ARV outside of Mawlamyine in Mon state, but as in the case of all other organizations operating in Myanmar, is limited by funding made available by donors.
It is regretful that the information quoted by the Mon News Agency is incorrect, and your own very condescending comments do not do honor to the amazing contributions in the fight against HIV/AIDS by all the hard-working IOM staff in Mon State. IOM would like to propose that you check with the organization in question before you uncritically bring news from other sources, and at least give them the opportunity to react before drawing your own conclusions and sharing them with the whole world. We would request that you forward this response to the HIM mailing list ASAP.