Introduction
Myanmar is a third world country beset with a major social and health issue in the form of HIV/AIDS. The epidemic in Myanmar is largely concentrated in key cities such as the Kachin State in the North, Shan and Kayin State in the East, and Mon State and Tanintharyi Region in the South. Recognized as a huge health problem by the Ministry of Health, about 270,000 adult people in Myanmar are infected with HIV. While some studies claim that the number of infected people is declining, there are also concurrent reports that say HIV prevalence has spread in other parts of Myanmar. In the Asian region, Myanmar has the highest prevalence and caseloads recorded as it follows behind Cambodia and Thailand. Those who are particularly at high risk of contracting the communicable disease are women who engage in the sex trade and their clients, men who engage in sex with high risk men, intravenous drug users, and partners of these groups of people.
Objective
The needs assessment on HIV/AIDS in Maynmar is being done to determine the state of HIV/AIDS in the country. The purpose of the study is to assess the needs of a third world country in terms of information dissemination and communication for the prevention of HIV/AIDS. Additionally, there is a need to assess what communication materials are available for the people and evaluate the usefulness and efficiency of whatever strategies are available for the prevention of HIV/AIDS in Myanmar. This can be done by assessing the level of information and knowledge of the people on the subject. Finally, the paper will offer suggestions and strategies on how information dissemination about HIV/AIDS can be done in the most effective and efficient manner that will guarantee that the community understands the importance of the information, encourage the community to have a change in attitude and thinking about the subject, and promote behavioral change.
Health Issues in Myanmar
Myanmar has a total population of more than 51 million people and is bordered by countries such as Thailand, China, Laos, India, and Bangladesh. Currently, the country is experiencing major social, economic, and political changes considering the lightening of the international and economic rulings worldwide. Myanmar was once ranked as among the countries with the poorest and worst health systems due to the government’s non-specific support on healthcare, rural services, and road infrastructure, which could have helped in delivering health services to the people.
The World Health Organization mentions the following as specific health issues that the country currently faces (Burnet Institute):
Low life expectancy rates – males live up to 64 years of age, while females live up to 68 years old
High death rate for children under five years old – for every 1,000 live births, 51 children die before reaching the age of five
High mortality rate for birthing mothers – for every 100,000 live births, 200 mothers die during childbirth
Malaria-related deaths is 5.4 people per 100,000 population
60 percent of the population live in malaria-infested areas
High incidence rate of people with HIV/AIDS – there is about 220,000 documented cases of HIV in the country, with an estimated 10 percent co-infected with HIV and tuberculosis
There is extensive poverty, malnutrition, lack of proper sanitation and water supply, and poor health awareness
This needs assessment paper will focus on the proliferation of HIV/AIDS in Myanmar and what can be done to lessen, if not totally eliminate, the communicable disease in the country.
The humanitarian organization, Doctors Without Borders/Medecins Sans Frontieres (MSF), reported in 2008 that thousands of people in Myanmar are dying due to lack of HIV/AIDS treatment program in the country. The organization shared that it can no longer respond to the needs of the people using MSF’s resources alone, thus, the need for more government involvement and support in responding to one of Asia’s worst HIV/AIDS problems. There is an estimated 240,000 people infected with the HIV/AIDS virus, and of this number, about 76,000 people are in critical need of antiretroviral therapy (ART) (“Myanmar: Urgent Lack of HIV/AIDS Treatment Threatens Thousands” 2008), but less than 20 percent of these people have access to ART. MSF further notes that in 2008, about 25,000 people died of AIDS related illnesses, which can be the same fate of others that have been diagnosed with the disease (Cairns 2014).
Based on the report of AIDS Data Hub, there are now 210,000 people infected with the disease, with 8,700 new cases detected. Of this population of HIV/AIDS afflicted individuals, about 70,000 are women, where 79 percent of HIV-infected pregnant women have received valuable health advice from WHO on how to prevent parent-to-child transmission of the disease (Cairns 2014).
Of these, 85,626 people are on ART treatment, which is roughly 40 percent of the population of people with the virus, while about 10,000 people have died because of it (AIDS Data Hub n.d.). The number of new HIV infections have decreased considerably from 1990-2014, which has reached a peak of 30,000 new cases in 2000. However, from 2000 to the current year, the number has steadily decreased with less than 10,000 new cases being reported now. Considering the statistics from 2008, MSF has been single-handedly providing the majority of ART treatment in Myanmar but with the increase in new cases that year, MSF was forced to “make the painful decision to drastically reduce the number of new patients it will treat” (“Myanmar: Urgent Lack of HIV/AIDS Treatment” 2008) pointing out that the Myanmar government and non-governmental organizations (NGOs) must also actively take part in taking the responsibility of ensuring that adequate treatment needs are provided to the people and not put the whole burden on MSF.
With the huge treatment gap in terms of the number of HIV/AIDS afflicted people in Myanmar, there is a definite shortage in terms of funding, which is the main reason only a small percentage of them are under the ART treatment program. From almost 30,000 people in 2010 to almost 54,000 HIV/AIDS afflicted individuals in 2012 who were receiving ART treatment, the numbers now is steadily increasing with almost 86,000 people in the program in 2014. This is largely due to the increasing financial support Myanmar is receiving from donors and the government. However, it still remains that more than 90 percent of the funding comes from international donors, whereas the Myanmar government only handles about 10 percent of the total for AIDS spending (AIDS Data Hub n.d.).
Strategies in Assessing the Real Needs in Myanmar
Based on the information presented above, it was found out that the problem on HIV/AIDS infection in Myanmar is something that the government should not ignore. It is a societal problem as it can also lead to discrimination and stigma of having contracted the communicable disease. Those who have been infected with the virus could shun physician visits or consultations especially if they have been identified as one of those who are infected.
Considering the number of infected people, it is vital that they all be accounted for to minimize the spreading of the virus. Thus, following are strategies that the government should consider:
Prevent the transmission of the HIV virus through sexual means such as unsafe sex practices and use of drugs through injection
Ensure continuous care and treatment for HIV/AIDS afflicted people
Alleviation of impact on patients’ families especially if they live in the same dwelling
Use an identification system for those engaged in prostitution or in the sex trade
Other interventions through education
As the strategies have already been laid out above, the community’s support can be drawn upon through constant education about the HIV/AIDS virus and how people can contract the infection. It would also help if through these educational sessions, attendees will be shown movies or educational materials that explain the effects of the disease on the individual, their families, and society in general. The media can be of help as well if they will tackle the issue on television, radio, print, and even in social media. Advertising companies can create slogans, posters, and advertisements that depict the perils of the disease and its effects on the community. There must be a systematic approach on how people will be educated about the subject that would encourage them to be open and accepting of those who have been infected.
Have access to informational materials about the disease
Have informational materials that are available in Myanmar’s national language and in English
Make a commitment to attend the regular educational sessions
Develop a clear understanding of the disease and its effects on the patient and other people
Help the institution or organization in spreading awareness throughout the community and in other parts of Myanmar
The program must also have very competent teachers who can clearly explain the disease and how it affects the individual and other people and health professionals who have the compassion to help and understand the afflicted. They must also be constantly exposed to trainings and conventions about communicable diseases so that they are always up-to-date about new virus strains found or possible cure for the disease. Additionally, program organizers must have high quality literature that people can use and refer to, a media center where people can read books or papers about HIV/AIDS or watch videos depicting the disease, and have access to information technology tools such as computers and the internet (Toe & Kwan n.d.).
In terms of documentation, a website on HIV/AIDS in Myanmar can help spread awareness to the Burmese and the world. With regard to the needs assessment program, it can be put up on the internet and would contain updates on the state of Myanmar’s HIV/AIDS program and the people afflicted with it. The website can also contain articles and pictures regarding the patients themselves, including information on how the government, private organizations, and the patients are working together in combating the HIV/AIDS problem of the country. Hopefully, with the website, more financial support will come in to help the people with HIV/AIDS.
Importance of this Needs Assessment Approach in Coming Up with a Strategic Plan
Based on the above information, it appears that there is a lack of clear understanding of what the HIV/AIDS really is as well as a comprehensible plan to control the spread of the disease not only in Myanmar, but also in cross-border sites such as Vietnam and China. This needs assessment approach will help the government, including the private sector and international funding groups, have a good grasp of the status of HIV/AIDS in Myanmar. They can show that with proper care and handling, HIV/AIDS will not be transferred from one person to another unless the individual explicitly have sexual relations with an HIV/AIDS infected person or use drugs intravenously, among others. This needs assessment guide can also serve as a means for private organizations to come up with their own plans and strategies on how they can be of help to Myanmar in combating the disease. Being a third world country, Myanmar lacks the necessary facilities for HIV/AIDS infected people and a support system that will encourage people to be more careful with their sexual relationships. Hopefully, with this needs assessment method, a comprehensive action plan can be developed that is appropriate for the locals. It must be a culturally appropriate solution that is feasible and effective not only geared for Myanmar, but also of other nations beset with the same problems.
References
AIDS Data Hub. (n.d.). Key Facts on HIV. [online]. Available at: http://www.aidsdatahub.org/Country-Profiles/Myanmar
Burnet Institute. (n.d.). Myanmar (Burma). [online]. Available at: https://www.burnet.edu.au/countries/2_myanmar_burma
Cairns, Gus. (2014). What are the Barriers that Could Stop HIV Treatment becoming HIV Prevention. [online]. Available at: http://www.aidsmap.com/What-are-the-barriers-that-could-stop-HIV-treatmentbecoming-HIV-prevention/page/2919697/
Myanmar: Urgent Lack of HIV/AIDS Treatment Threatens Thousands. (2008). [online]. Available at: http://www.doctorswithoutborders.org/news-stories/press-release/myanmar-urgent-lack-hivaids-treatment-threatens-thousands
U.N. Aids. (n.d.). HIV and AIDS Estimate. [online]. Available at: http://www.unaids.org/en/regionscountries/countries/myanmar
Toe, Win Naung, & Kyaw, Moe. (2014). Myanmar to Provide Free Treatment to Half of HIV/AIDS Patients by 2016. [online]. Available at: http://www.rfa.org/english/news/myanmar/aids-12032014132854.html
