Day Nine

Akiko and I spent most of the day with the medics who are on the front lines of the Mae Tao Clinic's response to the HIV/AIDS epidemic in the migrant community. These medics operate out of the Reproductive Health Department, where their mission is to prevent the spread of the virus to the unborn baby. Unlike the rest of the medics at Mae Tao, they operate more like counselors as they attempt to influence people to be tested for HIV/AIDS, break the bad news if the results are positive, weigh the consequences of informing the partner, and then take on the medical care of the patient for as long as the patient remains active at the clinic.

The structure is 10 medics who work in Voluntary Counseling and Testing (VCT), two of who are also Home Based Counselors. There are also six peer counselors who are HIV/AIDS positive patients themselves, who have been trained to visit and support about eight families each. Three of these counselors regularly cross the border into Burma to deal with Internally Displaced families.

We met with Son Than Lwin, the medic in charge of the Home Based program, and four of the peer counselors this morning. Once again, we were struck by the spirit of these people who have not only been driven from their homes in Burma, but are living the precarious migrant existence with a terminal illness. They cited the benefits to their patients that they could talk with someone who was having the same medical experience, and the benefits to themselves that they had a purpose in life.

This afternoon we met with five of the VCT medics. They cited the magnitude of informing patients that they were positive, the strain of dealing with patients who don't want to disclose their status to their partners, and HIV/AIDS patients who come to Inpatient Department to die a lonely death, with no family or money for food or a funeral. They shared feelings and frustrations and were very eager to have an opportunity to continue this process on a regular basis.

Akiko has agreed to meet regularly with these groups through her stay at the end of August. She and I could be in contact via email and we could determine whether there would be a need for a training on specific issues when Peggy and I return in the fall.