Shan AIDS

Bay Da said in 2007 he saw about 10 HIV positive patients. That he generally sees “a lot,” and they are typically male, under 40, and soldiers. I don't know why he said “2007” instead of “2008,” unless he hasn't counted up the 2008 cases yet. The first AIDS patient I saw was on February 11. She was, well she still is at the moment, a 52-year-old woman who had been in the week before (although this one looks so shrunken that I find it hard to believe it's the patient they're referring to) with an infected tooth socket. This patient is very wasted, certainly under 100 lbs and probably around 75 lbs, black lips surrounded by sores. Her daughter is with her, a healthy-looking, distressed woman, also a young man and a bunch of same-aged kids who may just be in for the show. The daughter is so upset that she won't let me take pictures, Khang Seng is busy putting her IV in and he looks up to tell me to stop. So I'll wait until the family leaves the In-Patient ward for awhile, if they do at all. The photo is necessary Why is the photo necessary? Because she's part of her people's genocide। Burma has enough money to have kept her safe and well if it wanted to. Her death is a victory for them. Word is, the woman will die within days without medicine, which can only serve to hold her on a little longer, slow the deterioration. That much is probably obvious to anyone. Amy says that her daughter said that this woman's husband died a few years ago. 

“Of the same thing Mom has now.” The next day she's still alive. She has tuberculosis and pneumonia, and what all the medics call “CD4,” which is code for HIV. I ask Homm Noon if people here understand the phrase “HIV.” She says they do. I ask her if they've told the woman's daughter she has HIV. She says no. I ask her if it will embarrass the woman's daughter if they say “HIV.” She says like she always does when I wish she'd be precise. “Yeah sure.” “But they must guess that she has AIDS.” “No I don't think they guess it.” “Why did they bring her in?” “Some abdominal pain."

The air around her bed smells dangerously rotten। A terrible smell around her, but it's not that she's soiled herself. I don't know what can take the nasty smell of death off her body. It's not the same as feces or vomit. It's unnatural decomposition. Like something breathing of a dead body. Anyway. The next morning I come in to take her picture if I can. She's awake. She nods when I show her my camera, and she pushes down the comforter and lifts up her blouse so I can see her emaciation.

Mae Tao Clinic's HIV Program

For the past seven years the Mae Tao Clinic has run a voluntary HIV counselling and testing program. Every month the clinic hosts a get-together for the program members, usually to the Tai Watanaram monastery. Today, about forty patients came, some with their families. They took a yoga class at the foot of the monastery's three-story reclining Buddha while their children ran around.

Naturally the program members are all HIV positive, and many have additional problems like tuberculosis, liver disease and gynaecological problems, but they all look young and healthy. They're in their twenties, many with children. Of course those who are very sick probably don't come to the group outings, nonetheless all the vibrant looking people here are infected.

Saw Than Iwin is the program manager. He's an angular young man from Burma, living here and working for the Mae Tao Clinic illegally. He says that when the program started between 60 and 80 people volunteered to be tested for HIV every month. Over the past few years it's levelled off at 100 at month. Since the Mae Tao Clinic caters to the Burmese border community, it's Burmese who are in this AIDS group. About half of them live in Burma and cross over for treatment, and outings like today's.


“A very small percent knows about HIV and how it's transmitted,” says Iwin of the patients coming from Burma. There is some HIV-AIDS education within Burma, but it is only delivered by NGOs like UNICEF, mainly on TV. “Still not enough,” Iwin says.

Iwin and the program's staff are busy with counselling, explaining treatment and organizing program events. The members are like people anywhere else in the world. They complain if outings aren't interesting, make excuses about not using condoms. As each patient is different (some have other illnesses, some are less diligent about taking the anti-retroviral drugs supplied by the city hospital, some can afford a better diet and more relaxed lifestyle than others) no one can predict how long any of them will live.

The commonest way to become infected in the Mae Sot-Myawaddy area is through sexual transmission, but some others are victims of poisonous blood transfusions. That's how one 14-year-old girl in the group became infected several years ago. Iwin says her family brought her in for testing after she became mysteriously ill following her transfusion. The tests came back negative, but she continued to get inexplicably sick. When the family brought her back for another HIV test they learned she was indeed infected. Still, Iwin says the patients are all counselled not to worry about the future.