‘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
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Drug use in Myanmar
Population size estimate for injecting drug users:
2007 => 60,000 - 90,000
2009 => 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
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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)DUs-
both males & females
and their sexual families
and partners.
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:
1 Outreach site in
Kachin State (e.g.
Nam-Sam-Yam)
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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.
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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”
Jade Mines and drug use
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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;
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AHRN DICs data at a glance
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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
754
Number of DUs
receiving STI
Treatment
18
Number of DUs
receiving OI
Treatment
236
Number of DUs
receiving ART
8
Number of clients
screened for TB
429
Number of TB
treatment
55
Client’s Profile from Kachin State (Occupation)
Cultivator;
5%
Drug
dealer;
2%
Driver; 6%
Gold
Miner;
8%
Jade broker;
13%
Migrant
worker; 15%
Others; 2%
No income;
5%
Student; 2%
Yay Masay;
42%
Male
Cultivator;
5%
Drug dealer;
12%
Gold Miner;
4%
Jade broker;
3%
Massage girl;
8%
Migrant
worker; 20%
No income;
39%
Sex Worker;
3%
Student; 6%
Female
Client’s Profile from Kachin State (Age)
10-20;
13%
<10; 10%
21-30; 36%
31-40; 22%
41-50; 9%
51-60; 6%
61-70; 3%
Female
10-20; 4%
<10; 2%
21-30; 40%
31-40; 36%
41-50; 14%
51-60; 3%
61-70; 1%
Male
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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
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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
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And Now………
still more young people
keep migrating to the area
chasing fake dreams forced
by poverty in a further
degrading national socio-
economic 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…
Acknowledgement
UNAIDS and IHRA for Registration Scholarship
MSF (Holland)
AHRN Myanmar for financial support
AHRN Team in Myanmar
All our drug users
