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In Myanmar, only sickest HIV patients get drugs

By Margie Mason

Associated Press

Published: Saturday, Oct. 20 2012 6:30 p.m. MDT

"It's very difficult to see those kind of situations," says Kyaw Naing Htun, a young doctor with a K-pop hairstyle and seemingly endless energy, who manages the organization's busy clinic in Insein. He says about 100 patients who should be on drugs are turned away every month in Yangon alone. "It takes a lot more resources when they come back sicker. It's a lose-lose game."

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Aung first learned about the virus living inside him in April. He had dropped weight and wasn't sleeping well, but figured it was the TB and diabetes running him down.

When the test came back positive for HIV, he was shocked and scared: How? Why?

"I wanted to commit suicide when I found out the results," he says softly, looking away. "What upset me most was my wife. She says I shouldn't die now because we have children."

The questions swarmed and consumed him, followed by a flood of worry and guilt that he had possibly infected his spouse. Then the bigger concern: What's next?

Unlike many living in a country closed off to the world for the past half century of military rule, Aung, an Army staff sergeant, had some firsthand knowledge about HIV.

He had watched the disease rot one soldier from the inside out, punishing him with a cruel death. But he also saw another get on treatment and live a normal life, despite the military kicking him out.

With the images of those two men locked in his head, Aung decided to fight to save himself and ultimately his family. No one but his wife could know, or he would lose his job and their home on the military base because of the deep fear and discrimination surrounding the disease. Drugs were his only chance to keep the secret.

"If I get the medicine, and I can stay in this life longer, I will serve the country more and my family will not be broken," he says. "My family is invaluable."

At the clinic in Insein, an area of Yangon better known for a notorious prison, Aung, who is using another name to protect his identity, waited nervously for the results of his first blood test.

CD4 count: 460. Low enough for drugs in the U.S., but well above the 150 cutoff in Myanmar. He was given TB meds and told to come back in three months.

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Many of the 200 people crammed into the two small buildings of an HIV center just outside Yangon are simply waiting to die.

Beloved opposition leader Aung San Suu Kyi visited patients there in November 2010, just days after being freed from house arrest, appealing to the world for more medicine. She also spoke passionately in July about the stigma of HIV via a video link to the International AIDS conference in Washington, saying, "Our people need to understand what HIV really is. We need to understand this is not something that we need to be afraid of."

There are no doctors or nurses stationed at the hospice supported by Suu Kyi's National League for Democracy party, forcing patients to care for each other. One man hangs a drip bag on a plastic string from the ceiling over an emaciated body. Other caregivers — many of whom are also infected — wave paper fans beside their loved ones for hours, providing the only relief they can offer.

Infected children whose parents have already passed away play barefoot in the stuffy, crowded rooms. Bodies, some nothing more than breathing corpses, are stacked side by side on bamboo slats above dirt floors.

Another room is packed with 20 women stretched out on straw mats crisscrossing the wooden floor. A young mother sobs in one corner as she breast-feeds a 7-day-old baby girl. She did not take HIV drugs until late in her pregnancy, and now must wait up to 18 months to know for sure whether her only child is infected.

"The funding is limited for the enormous number of patients," says newly elected parliament member Phyu Phyu Thin, who founded the center in 2002 and was jailed by the former government for her HIV work. "Waiting to get the medicine under the limits is too risky for many patients because they can only get it when their health is deteriorating."

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