Cablegate: A Rangoon Hiv/Aids Clinic

This record is a partial extract of the original cable. The full text of the original cable is not available.





E.O. 12958: N/A


1. (U) SUMMARY: This NGO clinic, in a government-developed
slum, provides organized health care despite primitive
conditions, thanks to the education and dedication of the
doctor and the support of MSF-Holland. It provides a glimpse
of the terrible health conditions faced by the vast majority
of Burmese, most of whom do not have access to NGO-supported
Clinics. Ironically, this clinic is only a short drive from
newly constructed high rises intended for those better-off.


2. (U) On October 21 EAP/BCLTV Director and Poloff toured an
MSF-Holland HIV/AIDS clinic in the Hlaing Thaya Township
slums located in a swamp across the river west of Rangoon.
The GOB established this township following the 1988 uprising
with the aim of resettling troublemakers to an inhospitable
area. At each of their three Rangoon-area HIV/AIDS clinics,
MSF-Holland also runs a Maternal and Child Care program, a
nutrition program, and a counseling service for people living
with HIV/AIDS (PLWHA). The nutrition program feeds about 40
to 60 malnourished children and about a dozen acute care
adults a day. Besides malnutrition, the clinic's patients
commonly suffer from TB, diarrhea, STDs, and HIV/AIDS. The
Maternal and Child Care program has registered 54,000
patients since it opened in August 1994, and provides
prenatal care, family planning, STD treatment, STD
counseling, commercial sex worker treatment and counseling,
Males who have Sex with Males (MSM) and male STD care, and
HIV/AIDS care and support to about 100 patients a day. The
clinic's Burmese director, Dr. Myiet, also noted that the
clinic had seen cases of cholera.


3. (U) The clinic's director related how the GOB made it
illegal for foreigners to test for HIV/AIDS. Only government
labs can do so. However, if a GOB clinic or lab does the
test, confidentiality is not provided. As a work-around, NGO
clinics will draw a blood sample, assign a random
identification number, and then send the sample to the GOB
clinic or lab to be tested. Patient confidentiality is
thereby maintained.
4. (U) Another problem related to confidentiality is
involuntary HIV/AIDS testing. Government hospitals and
medical clinics routinely test suspect patients for HIV/AIDS
without the patient's knowledge or permission. If they test
positive, the GOB clinic merely informs the unsuspecting
individual, then leaves them to cope on their own with the
aftermath. MSF-Holland has developed a special counseling
service in their Hliang Thaya Township HIV/AIDS clinics to
help these new PLWHAs adjust to the shock of being HIV
positive, how to prevent transmission to others, and help
them develop a family support plan.


5. (U) In April this year, MSF-Holland implemented a
three-drug-cocktail Anti-Retroviral Treatment (ART) drug
therapy program with the target of supporting 100 PLWHAs in
Hliang Thaya Township. ART is exponentially higher in cost
than any other drug therapy, such as treatment for malaria.
To prevent GOB clinics from packing the program with
relatively wealthy, well-connected patients who can bribe
their way into treatment, the MSF-Holland clinic mutually
decides with the referring GOB clinic who actually enters the
program. MSF-Holland also requires that candidate patients
for the program must already reside in the Hliang Thaya
Township slum.


6. (U) Following the implementation of the U.S. import ban,
the clinic director, Dr. Myeit, had expected an increase in
new sex workers showing up at the clinic for treatment and
counseling. However, she admitted she had not yet seen any
sex workers who had previously worked in a garment factory.

7. (SBU) COMMENT: The clinic director, not unlike some NGOs
based in Thailand, had since July expected to see an influx
of new ex-garment factory workers enter the sex trade. This
shows that the GOB's anti-U.S. sanctions propaganda campaign
has been quite successful by claiming that the U.S. was
forcing garment factory workers into the sex industry.
However, according to the clinic director's finding, this
does not seem to be happening yet on any noticeable scale.
On the contrary, according to two Korean factory owners who
have recently fired most of their workers (reftel), the women
have returned to their home villages or, for the few who
could afford to stay in Rangoon, are pursuing legitimate

8. (SBU) The MSF-Holland clinics provide the only medical
support for Hlaing Thaya Township, and it is very evident
that humanitarian NGOs operating just in Rangoon alone are
saving thousands of Burmese children and adults each year
from preventable extreme malnutrition and from TB, STD, or
AIDS-related deaths. But it is only a drop in the bucket.
The humanitarian situation outside the reach of the few NGO
clinics is a very different story. END COMMENT.

9. (U) This message was cleared by EAP/BCLTV Director Judith

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