Progress Report

MAM started its operations in Myanmar on the 1st of June 2009 with the opening of a clinic in Hlaingthayar township in Yangon Division. The clinic provides a mix of activities including mother and child care, family planning, reproductive health including treatment of sexually transmitted diseases, testing and counselling for HIV and treatment and care for people with HIV/AIDS. The clinic started with 2 doctors, 3 nurse/counsellors, 1 laboratory technician, 1 logistic staff, 2 guards and a cleaner. Over 50% of the staffs time is spent on the patients with HIV/AIDS because they are more seriously ill and treatment and care for them is labour intensive. Since the opening of the clinic 523 persons (117 men and 406 women) were tested for HIV and 128 tested positive (54 men (46% posotivity) and 64 women (16% positivity). 192 pregnant women were tested, 5 tested positive and 5 had a discordant result. (positivity rate 2.6 – 5.2%). 5 pregnant women are receiving antiretroviral combination treatment to prevent transmission of HIV from mother to child. Of 77 female sex workers, 28 (36%) tested HIV positive. The number of consultations for people with HIV/AIDS (PHA) in the first 4 months was 1053 and the number of consultations is increasing rapidly. Thirty-nine patients with HIV/AIDS, 35 adults and 4 children, have been enrolled in the ART programme. Many patients were severely sick because MSF Holland, which is the main provider of ART in Myanmar, stopped new enrolment of patients in their ART programme since 2007 and these patients were in need of ART already for a long time. Patients with severe disease were admitted in the day care ward for re-hydration with IV fluid, therapeutic feeding and treatment of opportunistic infections (‘day-care’ only because patients are not allowed to stay in the clinic over night from the authorities). Several patients in the day care had to be treated for 14 days consecutively with IV amphotheracin for cryptococcal meningitis. Two adult patients died after initiation of ART. They were both in a very advanced stage of AIDS when they presented in the clinic and the treatment could not prevent a further deterioration of their disease. Another 99 HIV (+) patients are regularly attending the clinic and are waiting to start ART soon. Future plans 1. Increase the clinic staff to be able to deal with the increasing workload. 2. Try to improve preventive action among female sex workers. A female sex worker is hired to improve communication with female sex workers. 3. Set up income generation activities in the clinic for PHA who do not have a job. 4. Increase the number of HIV patients on anti-retroviral treatment (ARV).