*Provide shelter, care, and support for people living with HIV/AIDS in the migrant community
*To limit the progression of HIV in HIV-positive patients through the guaranteed provision of ARV medicines
*To conduct health education, women’s empowerment, and vocational training at HCH
* Capacity for up to 35 HIV+ women and children
In addition to prevention and education activities carried out by SAW’s Health Education intervention, SAW also has a project to respond to the needs of people living with HIV/AIDS
SAW’s Health Care House (HCH) in Mae Sot, currently provides support, care, education and training for up to 35 vulnerable women living with HIV/AIDS from the Burmese migrant community. SAW opened the shelter for women living with HIV in 2005. The HCH opened with 10 HIV+ residents with varying stages of the disease, and has continued to expand annually. HCH provides a home for women and children (2 years – 17 years old) living with HIV/AIDS without anywhere to stay or anyone to care for them.
As their communities have stigmatized many of these women, they are often unable to provide for themselves and become destitute. Because of their perceived lack of worth in society, many women also become depressed, further weakening their vulnerable physical condition. SAW’s shelter aims to provide a place where these women receive the medical treatment, psychological care, and the adequate nutrition they need to improve their quality of life. In addition, these women are given trainings on HIV/AIDS issues so they can become peer educators in their community teaching others about transmission and the effects of HIV/AIDS. SAW provides these patients with food, shelter, trauma counseling, health care, health education, vocational training (like sewing, weaving and knitting), and the Anti-Retro Viral Therapy, especially to those whose CD-4 count is below 200. SAW is able to source ARV medications from Mae Tao Clinic and a few donors, but often this falls short of the total amount needed. This undertaking is tremendously expensive for SAW, as funds for the medications shortfall (which are quite substantial) have to be raised internally.
SAW concentrates on providing holistic support and care for residents so they may lead healthy, fulfilling lives. HCH remains the only centre in Mae Sot where HIV+ women and children can live whilst receiving ARV treatment from surrounding hospitals. At the HCH, residents can support each other to face their disease together and also receive specialised counselling from staff. Women have the opportunity to become peer leaders in SAW’s Health Education Program, and contribute to SAW’s Income Generation Program (IGP) by producing handicrafts and other products in their spare time. In the past, healthy residents have also left the House to find work; last year six succeeded in living independently. HIV+ children are given the opportunity to reach their full potential by attending SAW School or the Thai School.
Because of limited resources and funding, and being the only safe house in Mae Sot dedicated exclusively to supporting people living with HIV/AIDS, HCH can only accept those most in need.
To best serve the Burmese migrant community, SAW works closely with the community and continues to accept referrals from other organisations in the area. The Mae Tao Clinic (MTC), the only health centre dedicated to providing medical aid to Burmese people in Thailand, has referred the majority of HCH residents to SAW. HCH currently works in conjunction with three area hospitals, the office of the United Nations High Commissioner for Refugees (Mae Sot), World Vision (Mae Sot) and other local Burmese run CBOs and workers’ unions, such as the Reproductive Health Network and the Committee for the Protection and Promotion of Child Rights. By working closely with the community, SAW is able to ensure the most vulnerable people living with HIV/AIDS in the Burmese migrant community receive aid.
In 2008, SAW was awarded the prestigious UNDP Red Ribbon Award, in recognition of the organisation’s courage, resilience and strength in responding to the global AIDS pandemic at a grass-roots level. SAW’s holistic, community-based approach to combating AIDS amongst the disempowered and overlooked Burmese migrant community was recognised as an example of effective community leadership and initiative in providing on-going, creative and sustainable treatment, care and support to people living with HIV and AIDS.
HIV/AIDS Risk and Prevalence Factors
HIV+ Burmese migrants in Thailand are often unaware of their infection, leading them to spread the disease among the migrant community. Various factors have led to increased risks of HIV infection amongst Burmese migrants, including their working conditions and their isolation from Thai society, restricting their access to health services, health education and social services. While it has become easier to access the Thai National Health System over the past year, lack of knowledge about how to access the system, language barriers, and cost are prohibitive factors in receiving ongoing treatment. HIV+ Burmese migrants in Thailand remain among the most vulnerable, disadvantaged and invisible populations.
Human Trafficking and the Sex Industry
Many people fleeing Burma do not have the means or knowledge to make it to a neighbouring country, making them prime targets for human traffickers who exploit their desperation. Human trafficking remains one of the most profitable illicit activities globally, and Burma remains a strategic source country for this horrific trade. Traffickers lure victims with offers of well-paid jobs. In reality, the majority of trafficked young women are sold into the sex trade, where they will be subjected to unimaginable physical, sexual and emotional abuse. Burmese victims of human trafficking have an extremely high risk of contracting HIV due to the low condom use in brothels and the dangerous sexual activity they are forced to endure. When trafficked sex workers contract HIV and become ill, they are left to fight their disease alone.
Poor working conditions in factories
The working and living conditions in factories along the Thai-Burma border are deplorably poor. Workers live on the factory floor where poor sanitation and sexual abuse are widespread. Due to the unbearable work conditions and the low and inconsistent pay, women might be compelled to leave the factory at night to earn money as sex workers. The lack of health education puts these women at a high risk of contracting HIV/ AIDS.
HCH Capacity Building
Many HIV+ Burmese people coming to Mae Sot for medical care must remain in Mae Sot to continue receiving ARV medicines to manage their disease. The difficulty of acquiring ARV medicines in Burma, ongoing violence in their hometowns, and the stigma attached to people living with HIV/AIDS makes returning to Burma dangerous and close to impossible for many residents. Furthermore, many have difficulty finding stable work to fully support themselves and their children due to their fluctuating health condition. Unable to return home, and with no means of income, these HIV+ migrants are also unable to stay in Mae Sot to continue receiving life-saving ARV medicines. Similarly, children at HCH are AIDS orphans, HIV+ children with no means of support because they have no relatives willing to raise them after their parents passed away from HIV/AIDS. The HCH responds to the needs of these people – for children, HCH provides a supportive home where they can continue receiving ARV medicines, as well as attend SAW School. Because HIV develops rapidly among children, without the treatment, support and care provided at the HCH, these children would most likely have passed away from their illness. And for the women, in addition to receiving essential medical care, they live in a home where they feel safe, they receive counselling, they are given training on their rights and they receive skills training so that they might be able to support themselves in the future.
Many residents are afraid, worried and upset when they arrive at the HCH, having just recently being diagnosed with HIV, a disease that few had ever heard of before their diagnosis. Many are in a fragile mental state and need time to understand the new lifestyle they must adopt to maintain their health. Many have seen spouses or their children die of the disease, and are petrified they will soon suffer the same fate. Learning about the disease and related health issues through health education can lessen feelings of anxiety and prepare residents to face their future with the disease.
Women who arrive at the house often lack awareness of their rights, and have endured horrific rights abuses that have contributed to their infection, such as deplorable work conditions, being a victim of human trafficking, exploitation as a sex worker, as well as being deprived of the right to education and a basic standard of health care. Empowering these women with rights training is essential to contributing to their feelings of self-worth and self-respect, and ultimately form a part of the holistic care that HCH aims to provide for residents.
Due to their fluctuating health and ability to work, along with limited knowledge of vocational skills that employers seek, many Burmese migrants with HIV and AIDS experience difficulty in securing work to support themselves. To respond to this, SAW provides vocational training to residents, which helps them to establish a source of income that can accommodate their particular life needs. SAW has found this to be an overwhelmingly successful intervention for HCH residents; making them feel empowered and helping them onto the path of independence – which is a tremendous achievement. Finally, SAW has helped some HCH residents to secure Thai work permits. this not only facilitates work, but also gives them access to the Thai national health system which has been an invaluable asset for the residents as they move forward with their lives.