Despite the use of the neologism Myanmese, this article is as informative as its predecessors in the SCMP.

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Agents for change
South China Morning Post
15 January 2007

Health workers are running the gauntlet of border guards to cross into
Myanmar, where an Aids crisis is being fuelled by government bans and
ignorance

The article and photograph were provided by a correspondent who could not
be identified because of the difficulties faced in reporting on Myanmar

Lugging an empty vinyl bag in one hand and with a handbag on her shoulder,
 Chong Nunboi crosses into Myanmar every morning among the stream of
Indian traders. To officials on both sides of the border  she's just an
ordinary businesswoman hurrying to shop in the popular Chinese goods
markets in the Myanmese town of  Namphalong.

But as soon as the 35-year-old tribal woman is out of the sight of the
Myanmese immigration officials, she neatly folds the vinyl bag and puts it
in her handbag, before swerving into one of the nearby villages to start
her day's work as a community health worker.

"Every day I meet intravenous heroin users, prostitutes and ordinary
villagers to explain how they could prevent the infection of diseases like
HIV or hepatitis," said Chong Nunboi, a  Myanmese ethnic tribal woman
living in Moreh, a border town in the  northeastern Indian state of
Manipur.

"I also advise people on how to get medical help in Burma or India in case
they get the diseases."

As a growing number of international charities suspend their operations
due to increasing pressure for reform of Myanmar's junta, community health
workers such as  Chong Nunboi do their best to provide basic medical care
to some of Asia's most vulnerable people.

In a country where HIV/Aids and malaria are rife, it's an overwhelming
task for any health worker. UNAids, the UN body co-ordinating the global
fight against the disease, estimates about 620,000 people, aged 15 to 49,
are infected with HIV in Myanmar. But on the border, where the junta casts
its shadow over every section of society, health workers face the
additional burden of risking their lives every morning when they go to
help the ill.

"Sometimes in the villages I also distribute essential medicines supplied
by NHEC," she said, referring to the National Health and Education
Committee, an organisation set up by Myanmese pro-democracy activists in
exile. "Although I'm doing exactly what a community health worker does
elsewhere in the world, I often have to work undercover to save myself
from being troubled by the military."

To maintain her fake identity as a trader in the eyes of the  Myanmese
border police, every evening she carries cheap clothes or consumer goods
from markets in Tamu, south of  Namphalong, for some shops in Moreh.

Myanmese military intelligence officers would not knowingly allow Chong
Nunboi and her colleagues into Myanmar because they work for the NHEC,
which the regime  regards as being linked to what it views as terrorists.

Lamlhing Touthang, a Namphalong-based health worker, recently returned
home after participating in an NHEC-organised, month-long HIV care
training camp in Manipur. On her return she was interrogated for more than
five hours by Myanmese military intelligence officials, who suspected her
of having a role in "anti-national" activities, suggesting she doubled  as
a political agent for the pro-democracy activists in exile.

"From my bag   [Myanmese intelligence officers] got nothing except some
NHEC pamphlets on awareness about Aids and malaria," she said.

"Yet they threatened me not to go out of the country again for 'so long'
in future. Also they asked me not to maintain any communication with the
NHEC."

Now  Lamlhing Touthang and her Myanmese colleagues have officially become
volunteer workers of a small Myanmar-based health NGO,  their new role
helping to keep the intelligence officers at bay.

"Just to avoid troubles in the field our health workers flaunt the
identity cards of some Burmese NGOs," said Aung Kyaw Oo, Indian-based
chairman of NHEC's western region. "But those NGOs operating under many
restrictions under the military regime have no access to the developed
world to import modern care and treatment for the HIV victims in Myanmar.

"Except for a few hospitals in cities, there are no trained government
doctors to handle HIV victims in the rural areas, where as many as 85 per
cent of the carriers of the virus are living.  If the junta allowed the
international medical aid groups to function freely inside Myanmar, the
problem would have not turned that acute for the HIV victims inside
Myanmar."

In the face of pressure from the junta, many international medical
charities are winding up operations in Myanmar. In 2005, Global Fund for
HIV/Aids, Tuberculosis and Malaria cancelled its US$37.5 million programme
in the country, blaming government restrictions on its movements that made
functioning nearly impossible. Me'decins Sans Frontie`res was forced to pull
out of Karen and Mon states last year for similar reasons.

In October, the International Committee of the Red Cross (ICRC) was
ordered to close all of its offices outside of Yangon, after the
organisation reported rampant infection of HIV and other infectious
diseases among inmates in the country's prisons.

Last month, after the move was criticised by many international agencies,
Myanmar hinted it could allow the reopening of ICRC field offices, but
would not allow access to detainees or prison visits by the organisation.

According to UNAids, the western part of the country is most neglected
where HIV and Aids treatment is concerned. The agency reported recently
that not a single Aids patient received free antiretroviral drugs from the
government.

"If the rule book is followed, all HIV-infected children should be given
ART [anti-retroviral treatment]. But not one of the estimated 8,000 to
10,000 children in Sagaing division and Chin state have access to these
vital medicines. It's a horrible example of indifference meted out to its
HIV-positive children by a government," said another Manipur-based NHEC
executive, who wished to be identified only as Dr Thura.

"Many quacks are still spreading HIV dangerously in rural areas and many
villagers - to get common medicines injected - are still receiving help
from intravenous heroin users who use used needles for the injections and
charge half of what it would cost at a doctor's clinic.

"In terms of awareness, most HIV-affected areas [in Myanmar] today
continue to lie in the same phase where neighbouring Thailand or India
were 15 years ago. At least on humanitarian grounds an urgent intervention
is necessary."

Early last year, two workers of the Burmese Solidarity Organisation - a
Myanmese pro-democracy group working with the NHEC - were abducted by
Myanmese military commandos from Moreh.  Concerned NHEC officials then
closed down their medical bases and moved to Indian villages further from
the border.

But despite such threats,  the NHEC is now building two special homes
where orphans of the HIV/Aids crisis in two Indian border districts of
Manipur and  Mizoram will receive refuge once they leave Myanmar. The
orphanages will also function as hospitals where trained doctors will be
on hand.
"With the logistical help of friends in India and some western countries
we are going to start these orphanages-cum-hospitals where we hope to be
able to provide ART on a regular basis as well," said Dr Aung Kyaw Oo. "In
the absence of ART the epidemic is worsening in the country."