Asian Harm Reduction Network

A man receives TB medicine through 'directly observed treatment short-course' service (DOTS)   ©AHRN

24 March 2012 - Drug-users in Burma/Myanmar find that they are stigmatised and discriminated in society, this understandably leads to them developing a distrust for regular health services. As a consequence, they mainly only access specific services that are tailored to their needs and with those they trust.

This is a need that the Asian Harm Reduction Network (AHRN) tries to fill in Myanmar through its harm reduction services. AHRN’s focus from the beginning was directed towards HIV-related interventions due to the high prevalence of HIV among drug-users. It nevertheless became quickly clear through the medical interventions and other activities that tuberculosis was also a serious health issue within this target group and needed to be addressed. Furthermore, TB and HIV co-infection among drug-users is higher than in the general population, and is the main cause of death amongst people with HIV.

AHRN therefore began operating TB services (including screening, treatment and adherence follow-up) for drug-users and injecting drug-users in 2010, thanks to funding from the Three Diseases Fund.

The following story is one of those stories that shows the need for a comprehensive service package on HIV and TB. Since the start of the project AHRN has screened 3,754 clients for TB and 712 of those received anti-TB treatment. Voluntary counselling and testing is also offered to all TB positive clients; 169 of the 323 who accepted tested HIV positive. They now also get HIV care services. Those who test HIV negative are able to receive prevention education to assist that their status is maintained.

When I used to take drugs I would regularly go to the nearest city to find drugs. This was in Laukkai, northern Shan state. One day I got talking to someone from the Asian Harm Reduction Network (AHRN) at a drug dealer’s house. He told me about their primary healthcare services for drug users in Laukkai, supported by the Three Diseases Fund.

It did help to get some information and assistance from AHRN. Their drop-in centre allowed me to receive medical services, especially symptomatic drug treatment, which really helped reduce the amount of drugs I used. Unfortunately, after some time I relapsed and I stopped going to the drop-in centre as I felt embarrassed about going back onto drugs.

I developed a severe cough and gradually lost weight. My friends suggested I return to AHRN clinic. A Myanmar proverb says “cry out for your mother only when you stumble”. I hadn’t been back to my home for years but I was feeling ill, so I had to cry out. My friends were a great help as I went back again to the clinic. I expected the staff to blame me and be angry, but amazingly they welcomed me warmly. AHRN also gave me the opportunity to test for HIV. This was voluntary. Fortunately I didn’t have HIV, but I did have TB since I was suspected of having that and was screened. When I was on TB treatment they also taught me more about how HIV is spread among drug users and what I can do to avoid it. The problem was my drug habit was so strong that I discontinued my TB treatment when I started feeling better.

My problems and illness continued and I needed to be hospitalised for TB. My seventy-year-old mother would come to visit me, and I was very happy to see AHRN staff come to give me support. They would give me nutritional provisions from the World Food Programme and additional symptomatic drug treatment. Treatment for TB is not easy and AHRN helped me through it.

Battling with TB really focused what I want in life. Now cured, I am looking to better support my family and try to live without drugs even when meeting my drug-using friends. The only thing on my mind now is that I have to support my family.

I owe a big thank you to AHRN staff and the Three Diseases Fund for the way they have supported TB clients in Laukkai.

For more information:
James Howlett
Communications Officer, Three Diseases Fund
This e-mail address is being protected from spambots. You need JavaScript enabled to view it +95 1 534498 ext 209