One Way Ticket to Hell for young migrant drug users in Myanmar

Transcription

1 One Way Ticket to Hell for young migrant drug users in Myanmar Thinzar Tun, Willy De Maere, Dr.Thein Han, Jar Aung Asian Harm Reduction Network (AHRN) Myanmar

2 Drug use in Myanmar Population size estimate for injecting drug users: 2007 => 60,000-90, => 75,000 Drug users using other routes of administration is not included (6 drug users for every injecting drug user is estimated); HIV prevalence among IDUs: 34%, although in high risk groups in hot spots 70% or higher; Drug users are as such a priority target group in the National Strategic and Operational Plan for HIV and Tuberculosis. (Source: Size Estimation Workshop 2008) Background Myanmar under military rule Lowest international humanitarian aid Major producer of opiates and ATS Jade, ruby, sapphire mines and gold panning 2

3 Service provisions at AHRN DICs Outreach activities: NSP, condoms distribution, health education session; Medical interventions: Primary Health Care, Symptomatic Drug Treatment (Tramadol) Referrals (MMT and Detox, Rehabilitation ) Screening, diagnosis & Treatment of TB, Malaria, STIs and OIs; Psycho-social support interventions: Case management counseling of drug use, health issues-primarily linked with HIV, TB and other blood borne infections, VCT and nutritional Support in partnership with WFP; Black Sheep Peer Support Group: Peer education sessions on key topics linked with treatment adherence, recovery and relapse prevention etc. AHRN-Myanmar Operational in Myanmar since 2003; MoU with Ministry of Health Donors: Three Diseases Fund (3 DF), PSI, GFATM Round 9 (operational in early 2011); Objectives: Health Promotion among (Injecting) Drug Users, family & partners through Harm Reduction service-provisions; Target population: (I)DUsboth males & females and their sexual families and partners. 3

4 AHRN Projects Drop-in-Centres & Outreach Program (DIC/OPO): 3 DICs in Northern Shan State (e.g. Lashio, Kone Nyaung and Laukkai) 3 DICs in Kachin State (e.g. Hpakant, Seng Taung and Bamo) Outreach Program: All the sites are identified as having a high prevalence of drug use by joint assessments of UNODC and the Central Committee for Drug Abuse Control (CCDAC) and are situated mostly in border areas and mining areas. 4 1 Outreach site in Kachin State (e.g. Nam-Sam-Yam)

5 Land of the Jade : Pharkant, Seng Taung (Kachin State) Located Kachin State close to Chinese border Famous for its jade and gold mines Sensitive areas Attracts many migrant workers especially young ones, because of high unemployment in their natives Endemic use of opiates and ATS Many shooting galleries Sex work /massage parlors Hell on earth 5

6 Jade Mines and drug use 6

7 Service provisions at AHRN PK/ST DICs Outreach : NSP, condoms distribution, HE session; Medical interventions: Primary Health Care, Symptomatic Drug Treatment (Tramadol) Referrals (AZG ) Screening, diagnosis & Treatment of TB, Malaria, STIs and OIs; Psycho-social support interventions: counseling of drug use, health issues, VCT and nutritional Support in partnership with WFP; 7

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9 AHRN DICs data at a glance Services Jan-Dec 09 Services Jan-Dec 09 NSEP (Given) 1,464,379 NSEP (Returned) 1,264,802 Condoms 46,307 Number of DUs accessing DICs 3,686 Outreach contacts made with DUs 15,429 Frequency of Primary Health Care services 31,984 Number of DUs accessing VCCT Number of DUs receiving OI Treatment Number of DUs receiving STI Treatment 18 Number of DUs receiving ART 8 9 Number of clients screened for TB 429 Number of TB treatment 55

10 Client s Profile from Kachin State (Occupation) Male Female Yay Masay; 42% Cultivator; 5% Migrant worker; 15% Drug dealer; 2% Driver; 6% Gold Miner; 8% Jade broker; 13% Sex Worker; 3% No income; 39% Student; 6% Cultivator; 5% Drug dealer; 12% Migrant worker; 20% Gold Miner; 4% Jade broker; 3% Others; 2% Massage girl; 8% Student; 2% No income; 5%

11 Client s Profile from Kachin State (Age) Female Male 51-60; 6% 61-70; 3% 41-50; 9% 10-20; 13% <10; 10% 31-40; 36% 31-40; 22% 41-50; 14% 21-30; 36% 21-30; 40% 51-60; 3% 61-70; 1% 10-20; 4% <10; 2%

12 The Curse of Young Migrant Workers Driven by poverty, many young people come with dreams of jade/gold riches All types of drugs (Heroin, ATS, opium) are easily available and cheap No riches found, only drugs found Factors conducive for using drugs: pain (physical, mental), hopelessness, boredom, homesickness, peer pressure, easy availability 1 2

13 One Way Ticket to Hell Chronic Addiction Severe Health Problems (HIV prevalence > 40%, HepB/C,TB, Malaria, vein damage, no ART, no MMT ) Financial Challenges (Debts, no money to go back home) Dying sick and in despair 1 3

14 And Now still more young people keep migrating to the area chasing fake dreams forced by poverty in a further degrading national socioeconomic climate no paradise for them but a one way ticket to hell? How more have to die while Government, donors and civil society look on 1 4

15 Acknowledgement UNAIDS and IHRA for Registration Scholarship MSF (Holland) AHRN Myanmar for financial support AHRN Team in Myanmar All our drug users