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  • Endemic/Epidemic disease
  • Healthcare exclusion
  • Natural disaster

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This is an extract from our latest Activity Report, looking back on our work in the previous year.

2012

In June, deadly intercommunal clashes in Rakhine state, Myanmar, triggered an official state of emergency.

An estimated 75,000 people were displaced and many houses were burned down. Another outbreak of violence in October worsened the crisis, forcing 40,000 more people from their homes. Many ended up living in makeshift camps without sufficient shelter, sanitation, food or healthcare.

Medical care in displacement camps

Emergency teams from Médecins Sans Frontières/Doctors Without Borders (MSF) were able to provide basic medical care in 15 of the largest camps. They treated people suffering from skin infections, worms, chronic coughs and diarrhoea, and made sure those with life-threatening conditions were referred to hospitals.

MSF has long experience – nearly 20 years – of working in remote and neglected Rakhine state, offering basic and maternal healthcare and treatment for HIV and tuberculosis (TB). Malaria is endemic in the region.

Teams have treated hundreds of thousands of people from all ethnic groups, including the Rakhine community and the Muslim minority population known as the Rohingya.

Insecurity, delayed authorisation and repeated threats and intimidation by a small and vocal group of the Rakhine community have hindered MSF’s work.

With access curtailed, MSF was able to treat only 50,000 people between June and December, many of whom were living in camps in Maung Daw, Sittwe and Pauk Taw townships. Many thousands more suffered without being able to obtain the treatment they urgently needed.

A young man co-infected with HIV and TB and his wife meet with an MSF counsellor.

Co-infection of HIV and TB is an enormous problem in Myanmar. A young man co-infected with HIV and TB and his wife meet with an MSF counsellor. © Greg Constantine

Treating HIV and tuberculosis

Despite efforts to increase the healthcare budget, thousands of people throughout Myanmar have no access to medical services.

Coverage for antiretroviral (ARV) treatment for people with HIV is very low: barely one in three of those needing it receives it. MSF, the leading provider of ARV medication in the country, has to make difficult choices about whom to treat.

People with HIV are more likely than the general population to have active TB. MSF runs HIV and TB programmes in the capital Yangon, in Kachin and Shan states and in Thanintharyi region. There is also a programme at Insein prison, Yangon, where 160 patients started ARV treatment and 79 started TB treatment in 2012.

The number of patients with drug-resistant TB (DR-TB), which is harder to diagnose and requires two years of arduous treatment, is growing at an alarming rate.

An estimated 9,300 people contract DR-TB in Myanmar each year, but only a few hundred have received treatment. In 2012, in a pilot programme in conjunction with the Ministry of Health, MSF enrolled 82 DR-TB patients.

In February, MSF released the report Lives in the Balance. It highlighted the devastating impact that cancellation of Round 11 funding from the Global Fund to Fight Aids, Tuberculosis and Malaria would have on the efforts to scale up the provision of treatment to people with HIV and TB in Myanmar.

At the end of 2012, MSF had 1,247 staff in Myanmar. MSF has worked in the country since 1992.

Patient Story

Myek*
33 years old

“I came to the MSF clinic for the first time four years ago and was put on ARVs around three years ago.

"It was my mother who recommended that I come here; personally, I had never suspected my status. After discussing with the counsellor, I decided to take a test. When it turned out positive it was a huge shock for me. I thought ‘that’s it; it’s the end of my life’.

"I talked a lot to my mother and to the counsellor and they really helped. This clinic offers good care and is the only place where I can find free treatment. Because I can’t afford my treatment, it’s really important that it’s free.”

* The patient’s name has been changed.

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