缅甸: March 2011的归档



 It's hard to say for sure how Kyaw Lin's battle with HIV/AIDS would have gone had doctors here been able to give him the medicine he needed earlier. But it's difficult to imagine it could have been much worse.

 Mr. Kyaw Lin, a factory worker from small-town Myanmar, was diagnosed with HIV four months ago. His family, suddenly reviled and isolated in their hometown, hired a car for the four-hour drive to Rangoon, the only real metropolis in this impoverished country, where they'd heard there were people who knew how to treat the virus that levelled the 33-year-old in his prime.
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 They found doctors from Médecins Sans Frontières in Rangoon who knew what Mr. Kyaw Lin needed: antiretroviral medicines which slow the progression of symptoms, now in use worldwide to treat AIDS sufferers. But in Myanmar (formerly known as Burma) there aren't enough antiretroviral medications to deal with an AIDS crisis that continues to grow, in large part because of the country's imposed isolation from the outside world.

 While Mr. Kyaw Lin was clearly ill and in need of drugs when he arrived in Rangoon last fall, his CD4 count - a test used to measure the strength of the immune system that HIV attacks - wasn't low enough to qualify for a course of the limited number of antiretroviral drugs available. Instead, he was told to go home and come back when the disease had progressed.

 Now he is far, far sicker. By the time Mr. Kyaw Lin began his antiretrovirals on Jan. 19, he was suffering from an undiagnosed brain illness that leaves him silent and staring for much of the day, except for the occasional burst of unsettling laughter. His skin is covered in sores that he scratches at with a blue comb while his mother and sister - who have moved with him into a bare-bones shelter for AIDS patients on the outskirts of Rangoon - look on with evident worry.

 "We didn't have adequate medications for everyone. Even though he needed ARVs, he needed to wait - we only have enough for those who need critical treatment," explained a social worker at the shelter where Mr. Kyaw Lin and his family are staying, sleeping on straw mats in a room filled with three other AIDS sufferers and their families.

 When it comes to HIV/AIDS, Myanmar is doubly cursed. At a time when worldwide infection rates are slowing, and in many cases falling, front-line workers here are still overwhelmed by new patients who come in every day, often collapsing as they reach the clinics at the end of long overland or river journeys from small villages in the country's poorly connected regions. Many had never heard of HIV until their doctor told them they were infected with it.

 While Myanmar's AIDS crisis is not yet of the scale that some countries in Africa are facing, the country lags far behind in its ability to deal with the spread of the epidemic. International aid organizations estimate there are some 242,000 people (or just under 1 per cent of the adult population) with HIV, of whom as many as 120,000 currently need antiretroviral treatment. But there's medicine for only 20,000.

 That access rate is believed to be the worst in the world, a crisis even when compared with sub-Saharan Africa, where after years of neglect even the region's poorest countries are now able to provide antiretrovirals to upward of 50 per cent of their AIDS sufferers.

 In Rangoon (also known as Yangon), there are international aid organizations present and therefore some hope of receiving treatment, though it sometimes comes too late. In the farther-flung corners of the country - particularly the areas near Myanmar's borders with Thailand and China, where fighting regularly flares between the army and ethnic militias opposed to the junta - the only option is often a cash-strapped government hospital with no access to modern HIV/AIDS medicines. (AIDS-related illnesses are the country's second biggest killer, after malaria.)

 The shortages mean that only those with a CD4 count of less than 200 are eligible to receive antiretroviral medications from MSF and the other groups distributing them. By that point, it's often too late as the immune system has been ravaged to the point that the sufferer is easy prey for tuberculosis and other diseases. The World Health Organization recommends that anyone with a CD4 count of less than 350 should receive antiretrovirals.

 Those helping fight Myanmar's AIDS crisis split their anger between Myanmar's military government and what some call an informal international ban on aid to Myanmar that has left humanitarian workers short of cash and hamstrung by impractical restrictions that forbid them from having any contact with the same Ministry of Health they're trying to support.

 "The government's health budget is much too low, and the amount of foreign assistance is much too low," said Andrew Kirkwood, country director for Save the Children. "Should the international community punish the people who need ARVs just because their government is not spending enough on health? To me, that's a very perverse conclusion to make."

 It's not just antiretrovirals that are lacking. At an informal shelter run by the Phoenix Association, a small and independent charity run by volunteers, there's no money for even the most basic supplies for the two dozen people currently in their care.

 "We don't have enough mosquito nets, pillows or mattresses. We can't even provide our patients with food. They have to buy their own and cook for themselves," said Thiha Kyaing, founder of the Phoenix Association.

 To illustrate the toll the lack of funding takes, he pulls out the records book for the Phoenix shelter on the edge of Rangoon. The numbers for 2010 were grim: 202 patients received, 60 funerals. "People die every day because of the criteria [for receiving antiretroviral medication]," said Mr. Thiha Kyaing, his soft voice barely audible as an infected two-year-old boy in the same room wails from a high fever.

 Speeding the epidemic's spread is widespread ignorance in Myanmar about the virus, especially beyond Rangoon. Particularly vulnerable is the country's vast community of sex workers, who often work in anonymous massage parlours and "beauty salons" off the radar and beyond the reach of the few trying to spread the message about condoms and disposable needles.

 Those who contract HIV-AIDS find themselves isolated and alone. Among the patients at the Phoenix shelter are a husband and wife who are expecting a baby any week now. The 24-year-old husband was immediately dismissed from his post as a soldier in Myanmar's army when his commanding officer found out he had contracted HIV, likely from a hospital blood transfusion. "They were afraid he would infect the whole regiment," his 24-year-old wife said. The couple will now have to raise their child on his military pension of $9 a month.

 There is some hope on the horizon. After prolonged negotiations, the Global Fund to Fight Aids, Tuberculosis and Malaria entered Myanmar in early 2011 with a budget of $105-million (with tighter than usual monitoring because of corruption concerns). But even that injection of money - which will be spent on education and prevention as well as treatments - will be far from enough. Even if the Global Fund achieves its own goals for distributing antiretrovirals, the number of HIV/AIDS sufferers receiving the treatment will still be less than 50 per cent.

 For the Global Fund, it's the second try at tackling Myanmar's HIV/AIDS crisis. The fund withdrew from the country in 2005, citing government restrictions that impeded its ability to monitor how grant money was being used.

 "The international community, particularly the folks working on HIV/AIDS, are frustrated with the lost time [because of the 2005 pullout]," said Elmar Vinh-Thomas, regional team leader for Asia and the Pacific at the Global Fund. "The funding gap in Myanmar is growing because the disease burden is growing."


Orgnization: Médecins Sans Frontières Phoenix Association



      Kyaw Lin



   在仰光他们找到无国界医生(MSF)组织,能够为Kyaw Lin先生提供他所需要的治疗:抗逆转录病毒药物能帮助延缓病症的发展,目前全世界都在利用这种药物治疗艾滋患者。但是在缅甸,有限的抗逆转录病毒药物无法满足迅速发展的艾滋危机,而导致这个局面的最大原因是缅甸被迫与世界隔离。

     去年秋天当Kyaw Lin先生抵达仰光时,他已经病得不轻,急需治疗。但是检查结果表明他的CD4计数--一种用来测量艾滋病毒侵蚀下免疫系统能量的方法--却达不到可以接受有限的抗逆转录病毒药物治疗的标准。

     Kyaw Lin先生只得回家等候。直到119他终于获得抗逆转录病毒治疗时,他已患上一种无法确诊的脑疾,每天大部分时间他都两眼无神、沉默不语,只是偶尔会爆发一阵令人不安的狂笑。

    "我们无法给每个患者提供足够的药物。即使他需要抗逆转录药物(ARVs),也只有等。我们只能为那些病入膏肓的患者提供治疗",Kyaw Lin先生和他的家属所寄居的庇护所的一名社工表示。








政府的卫生预算非常低,国外的援助资金也很少。"救助儿童会国家协调人Andrew Kirkwood表示,"难道国际社会要因为缅甸政府没有在卫生健康方面投入足够的资金而惩罚那些需要抗逆转录病毒治疗的人吗?对我来说这是非常不合理的理由。"

   现在的局面不仅仅是缺乏抗逆转录病毒药物。凤凰协会(Phoenix Association所经营的一个非正规庇护所--一个由志愿者管理的小型的独立慈善团体表示,目前该机构急缺资金,甚至无法为二十人提供最基本的护理服务。

  "我们没有足够的蚊帐、枕头和床垫。我们甚至无法为病患提供食品。他们不得不自己购买食物并且自己烹饪。" 凤凰协会的创始人Thiha Kyaing说。

  在缅甸,加速艾滋病毒传播的罪魁祸首是公众对病毒的漠视,特别是在仰光以外的地区。这个国家的性工作人群尤其脆弱,她们在一些不知名的美容所、发廊工作,这些地方相当隐秘, 难以对其进行使用安全套和一次性针头的宣传。



  "国际社会,特别是那些致力于抗艾的工作人员在很长一段时间感到非常绝望(由于2005年的撤出)" 全球基金亚太区域工作组组长Elmar Vinh-Thomas表示:"在缅甸,由于疾病的负担越来越重,因此资金缺口也在逐渐增大。"

Asia Report 翻译



组织:Médecins Sans Frontières
  凤凰协会(Phoenix Association


Phoenix Association--缅甸凤凰协会

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缅甸凤凰协会(Phoenix Association)是一个社会组织,成立于2005年,协会大部分成员是艾滋病毒携带者(PLHIV)。最初,凤凰协会因受到无国界医生组织荷兰办事处的资助而成立,协会为病患提供医疗服务,为他们重建信心以及更好的未来。凤凰协会希望通过自己的努力,帮助病患解决他们的社会性、经济需求。我们认为这个目标的达成不能没有艾滋病毒携带者本身的参与。



1.       为艾滋病毒携带者提供社会和精神支持;

2.       帮助病患实现经济独立;

3.       帮助病患重建积极向上的生活。



1.  社会支持项目

2.  护理和支持项目

3.  生计项目

4.  筹款和教育项目






地址:No.158 (D), Htee Hlaing Shin Housing, Kyansitthar Lane 1, 8th Ward, Hlaing Thar Yar Township, Yangon, Myanmar.

电话 : 95-9-8-502991, 95-9-5059172, 95-9-5112566, 95-9-5098734

e-mail : info@phoenixmyanmar.org


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MYANMAR health care workers have undergone a course on simple ancient healing skills in order to help soothe the body and minds of HIV/Aids patients.

Some 20 nuns, lay people and a Muslim who care for HIV/Aids patients attended the 'Capacitor training' course at the Catholic Religious Conference of Myanmar compound, Yangon February 12-13.

The Myanmar Catholic HIV/Aids network (MCHAN) organized the two-day program.

Sister Eileen Brady, a Maryknoll nun and capacitor trainer from Timor Leste said physical and psychological health is continuously affected by trauma, violence, weather, diet and environment.

We taught the participants simple healing techniques such as controlled breathing, as well as head, neck, and hand massage and meditation, she said.

"Patients with HIV suffer a lot physically, but they also suffer more psychologically due to discrimination and stigma, said Maryknoll Sister Mary Grenough, the coordinator of MCHAN.

"So I decided to do something for them and organized this course which I believe will help us interact with HIV/aids sufferers and provide patients with renewed energy and better health," she added.

Aung Naing Win, a Muslim care worker and the founder of the Interfaith Youth Coalition on HIV/Aids said his organization has been working for more than a decade and has over 50,000 members but had never used any of these healing.

"I quickly realized that these techniques would be very useful for our work especially when patients are experiencing trauma and depression," she told ucanews.com

Weblink: http://him.civiblog.org/blog/_archives/2011/3/6/4764142.html

Organization:Interfaith Youth Coalition on HIV/Aids




地址:#211, 7th Floor, Bosunpat Street, Pabedan Township, Yangon, Myanmar

电话: 095-9-8023955


联系人: Mr. Shine Aung Naing Win

缅甸 仰光

在一个对穷人面临巨大挑战的国家,一位不寻常的领袖:Naw She Wah所持有的愿景却给人们带来了一丝光亮。作为一个寡妇和单身妈妈,她战胜了人生道路上的种种困难,目前她正积极致力于改进缅甸女性艾滋病毒携带者和艾滋病感染者的生活。

"病毒不请自来,我无处可逃,我们必须直面它。"Naw She Wah坚定地说出了她的任务和使命。"大多数人认为感染者都是一无是处的废人,但我并不同意。我尽自己最大努力来支持其他受感染者。" 丈夫去世后,Naw的公婆立刻把责任推卸到她身上。"我失去了所有的财产,也丢了工作,而且还得照顾两个孩子。"从那一刻起,她决定致力于妇女事业,"直到我生命的尽头"她说。

目前,Naw She Wah是缅甸感染者小组(Myanmar Positive Group)的项目负责人。 这是一个由卫理公会联合救灾委员会(UMCOR)支持的艾滋病毒携带者互助网络,该网络包含80个自助小组,以及来自全国77个乡镇的1600名成员。整个项目通过全球教会服务亚太区(Church World Service Asia Pacific)的合作伙伴来管理。


Naw She Wah说:"在过去1617年间,我必须独自面对很多问题。但当我进入艾滋病社区工作,我发现那里有很多人面临着和我一样的挑战。"在开展项目的这几个月中,缅甸感染者小组通过强化自助小组的网络来提高大众对预防艾滋病的意识,减少对感染者的污名,并提高治疗质量。

通过在当地举行研讨会,缅甸感染者小组力求增加受感染人群的知识,帮助他们能够更好地管理自身健康状况,并减少病患和医务人员之间的鸿沟,增进交流。另外,Naw She Wah也通过研讨会了解和分析妇女的需求,最终发现最常见的问题是缺乏收入。"因为大部分妇女缺乏知识,她们完全依赖丈夫。一旦丈夫去世,她们不得不解决很多问题。"她补充道:"我也有很多负担,和她们一模一样。"

Naw She Wah希望缅甸感染者小组能够扩展的工作领域之一是为妇女提供小额贷款,这样她们就能够开始自己的小生意,挣钱养家。Naw She Wah表示现在她很荣幸也很高兴能有机会来支持别的妇女。这对她来说是一份沉甸甸的责任,"我们必须活下来。我们必须为自己,也为我们的社区而活。"她说。

Asia Report 翻译



"I am not useless"

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YANGON, Myanmar, February 23, 2011--In a country where the challenges for the poor can seem unfathomably complex, one of the brightest spots can be found in the vision of an unlikely leader: Naw Shé Wah. As a widow and single mother in Myanmar, she beat the odds of her circumstances and now works to improve the lives of women living with HIV and AIDS.

"The virus came to me and I cannot run away. We have to face it," exclaims Naw Shé Wah with a certainty about her mission and message in life.  "Most people think that positive people are useless persons. As for me, I do not believe that I am useless. I try as much as I can to support other positive people."

After her husband passed away, her husband's parents immediately blamed her. "I lost all of my property. I lost my job. And I had to look after both of my children," she shares. It was at that time that she decided to commit herself to working with women "until the end of my life."

Naw Shé Wah works as a project officer with the Myanmar Positive Group, an informal network of self-help support groups for people living with HIV. The network, supported by the United Methodist Committee on Relief (UMCOR), brings together close to 80 support groups with 1,600 participants in 77 townships across the country. The overall project is managed through a partnership with Church World Service Asia Pacific.

In Myanmar, there are close to 240,000 people living with HIV, according to 2009 estimates by UNAIDS, a joint United Nations program on HIV and AIDS. In addition, some 18,000 people die each year from a lack of treatment.

"The last sixteen or seventeen years, I had to face a lot of problems alone," says Naw Shé Wah. "But when I work in the HIV community, there are a lot of people with the same challenges as me."

Over the past several months of the project, MPG has worked to strengthen its network of self-help groups in order to raise further awareness on prevention, reduce stigma and improve people's treatment literacy.

Through local workshops, MPG has sought to increase knowledge for people living with HIV to better manage their health status and to decrease the gaps between people and medical service providers. In addition, Naw Shé Wah also worked to assess and analyze the needs of women through the workshops, finding that the most common challenge is a lack of income.

"Because most of the women have a lack of knowledge, they are dependent on their husbands. After their husband passes away, they have to handle a lot of problems," she notes. "There are a lot of burdens for me - the same with them."

One of the areas that Naw Shé Wah hopes that MPG can expand is extending micro-loans to women so that they can start their own businesses and begin to earn an income to support their families.

Today, Naw Shé Wah says she is happy and honored to have the opportunity to support other women. It is a burden and responsibility that weighs on her regularly. She says, "We have to stay alive. We have to do it for us and for our community."


Organization: UMCOR

YANGON, 1 March 2011  - The international community should make better use of local NGOs and community-based organizations in Myanmar, while at the same time building capacity among them, aid officials say.

"Local NGOs... have local knowledge, contacts and they don't have to worry about getting permission on planning and resources from a central head office. They also have little problem accessing different parts of the country," said Walter Davis, programme manager for Paung Ku, a consortium of 11 international and local organizations established in 2007 to strengthen civil society in Myanmar.

But as things stand, most donors continue to funnel money through international NGOs (INGOs), which at times compete with local groups.

"INGOs need to change to do more capacity building. The rules of engagement still see local NGOs as subcontractors because their capacity is weaker," said Aung Tun Thet, a senior adviser to the UN Resident Coordinator in Myanmar.

"INGOs need to decide whether they are in direct competition with [local organizations] or whether they are here to mentor local NGOs," he added.

Post-Nargis growth

Cyclone Nargis in 2008 spawned hundreds of civil society organizations to cope with the humanitarian crisis that killed a reported 140,000 and affected another 2.4 million, by UN estimates.

"Nargis was a catalytic push for the mushrooming of local NGOs. There were 50 times as many NGOs as before," said Aung Tun Thet.

"Faced with the magnitude of Cyclone Nargis, donors needed to find a way to give money and not go through the government - the elephant in the room," he added.

Local groups were a natural funding vehicle as they reacted most quickly when the tidal surge hit.

But when the government declared an end to the tsunami's emergency phase in 2010, many of these same NGOs collapsed or turned to development activities - often lacking basic capacity to carry out the work.

"With such rapid evolution [of NGOs activated by Cyclone Nargis], the rigor required of NGOs did not accompany this expansion. These groups have good intentions but lack basic rudimentary management skills," said Aung Tun Thet.

Too often, local groups have been recruited and supported to serve the project needs of INGOs, but not beyond, said Ingeborg Moa, Myanmar director of Norwegian People's Aid, which has supported dozens of local groups since 2004.

"If more funding could be [made] available for organizational development, capacity building and support for initiatives that aim to strengthen local organizations' overall capacities, not just their capacity to 'deliver services' as implementing partners of international organizations, this would be a big step in the right direction," said Moa.

Removing barriers

Focusing on so-called shortcomings in local accounting and management systems may be misguided, according to a December report by Paung Ku, which includes Save the Children, Oxfam and CARE, as well as local groups.

Receipts, for example, are often difficult to obtain in Myanmar, leaving many organizations unable by international standards to account for resources and unable to qualify for international funds, Davis said.

"Myanmar has a long history of using accountability mechanisms related to religious donations, with Buddhist monks playing a key check and balance role. Strengthening these existing frameworks may ultimately be more effective in building accountability than continuing to use imported concepts," said Davis.

A cumbersome government NGO registration process is an additional obstacle for local groups to tap international funds.

"The government would not allow any group without a [memorandum of understanding] to accept donor funds. What is needed is a more transparent registration process," said Aung Tun Thet.

An official at the local relief NGO, Aung Yadanar, based in the town of Pyapon in southern Myanmar, said he applied for registration soon after he co-founded the NGO in 2008 - but has yet to receive any news.

"In the meanwhile, we have to keep [a] good relationship with township authorities so that we can do our job."

Even without being formally registered, the group still receives funding from the UK Department for International Development, which also provides technical assistance along with the Ministry of Agriculture.

There are an estimated 300 NGOs working in Myanmar, of which a maximum 10 percent are registered, according to the UN Myanmar Information Management Unit (MIMU).


Organization:Paung Ku


Paung Ku

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Paung Ku 2007年成立于缅甸,是一个由11家国际和本土NGO(包括乐施会、救助儿童会、CARE等)联合组成的国际工作团队。Paung Ku的宗旨是:通过创新来增强缅甸公民社会。


地址:Save the Children, Wizaya Plaza, 226 U Wisara Road, 1st Floor, Bahan Township,Yangon, Myanmar

电话:375 791, 375 801, 375 739, 375 796, 375 747, 537 387, 536 732, 537 092


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Pang Ku团队经理瓦尔特·戴维斯表示:"本土NGO掌握在地知识,和当地资源联系更密切。他们不用为了得到中央政府对项目规划和资源利用的许可而担忧,而且他们去缅甸任何一个地区也没有限制。" 2007年,本着加强缅甸公民社会力量的目的,11个国际和本土组织联合成立Pang Ku团队。


联合国驻缅甸总协调处高级顾问Aung Tun Thet表示:"国际NGO需要做出改变,多做一些能力建设。本土NGO由于能力较弱仍然只能承担项目次承包的角色。"他补充道:"国际机构需要考虑他们是要跟本土机构竞争,还是来这里为当地机构提供指导咨询的"



Aung指出:"纳尔吉斯风暴直接造成本土NGO灾后雨后春笋般出现,新增数量达过去的50倍之多。" 他进一步表示"在面对纳尔吉斯风暴这样巨大的灾难时, 捐赠人应该寻找一种合适的赠款方式, 而不是全部让政府来经手,这是大家心知肚明的。"


Aung Tun Thet指出,"纳尔吉斯风暴激起了NGO迅速地发展。然而, 本着严谨的态度,这种激增并不受到鼓励。虽然这些组织都带着良好的愿望,但是却缺乏基本的管理技能。"

挪威人民援助(Norwegian People's Aid)缅甸项目主任英格博格·摩尔表示:"本土组织常常只是按照国际组织的需要来执行项目。"该机构从2004年开始支持了数十个本土组织。"如果能提供更多资金来支持本土组织的机构发展、能力建设,以及培养本土机构的首创精神,加强本土机构的全方位能力,而非仅仅停留在作为国际组织的项目实施伙伴,为其提供服务,这对于本土NGO的发展将是一个质的飞跃。"


包括救助儿童会、乐施会、国际关怀(CARE)、以及众多本土组织的Paung Ku团体在其12月的报告中指出:把重点放在关注所谓的传统会计和管理系统的缺点也许会误入歧途。



Aung Tun Thet表示:"政府不允许任何缺少谅解备忘录的组织获取捐赠基金。我们需要一个更透明的注册程序。"

Aung Yadanar就职于缅甸南部璧棒(Pyapon)镇的一个本土救援组织,在2008年机构建立之初,他就已申请注册,但到目前为止仍未获得任何消息。他说:"与此同时,为了能够开展项目工作,我们必须与镇政府保持良好的关系。"


根据联合国缅甸资讯管理部(MIMU)的统计, 在缅甸的NGO组织达到300家,其中最多只有10%的机构正式注册。

Asia Report翻译

: Paung Ku




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