Seven years ago, in her small Myanmar hometown, Tha Zin, 30, a garment factory worker, watched as one of her closest friends - a girl just a few years younger - sickened and finally died of an AIDS-related illness.
As her condition worsened, most people in the community stayed away but Tha Zin, much to the chagrin of her parents, continued to visit her dying friend, comforting her as best she could, despite her own uncertainty over whether she could be at risk.
Tha Zin, then 22, didn't really know what caused the condition, though the rumours in the neighbourhood were that it had to do with her friend's relationship with a certain 'sugar daddy'. "At that time, I didn't know much about this disease and how it could be transmitted, but I thought that I had a pure heart so I should be okay."
Today, she has a far better grasp of HIV transmission. In the Thai border town of Mae Sot, where she arrived 3 years ago in search of work, she has attended several AIDS awareness sessions organised by the charity, World Vision, as part of a US$12 million, 5-year project to help foreign migrant workers in Thailand reduce their risk of contracting the virus.
Tha Zin is now an informal peer educator in the factory where she works, sharing her newly acquired knowledge with other workers, mainly younger Burmese women who have come to Thailand alone.
Talking about HIV to these young women is a tough task. "It's very difficult to share awareness and knowledge," she told IRIN/PlusNews. "When I explain, some people look down on me. They think, 'she knows everything about this disease, so she must have been a prostitute'. In their experience, they think the disease is only from sex workers and drugs. They don't know you can get it from needles and bleeding."
Low levels of knowledge and awareness
Thailand is thought to have nearly 2 million foreign migrant workers, mainly toiling in low-paying jobs in factories, on farms, construction sites, and fishing boats - the so-called "three Ds", for "dirty, dangerous or degrading" - jobs many Thai's are unwilling to do.
Most foreign workers live in highly concentrated areas like Mae Sot, a town on the Burmese border that has become a centre of the Thai garment industry, and Samut Sakhon, 28km southwest of Bangkok and a hub of the labour-intensive seafood processing industry.
While precise figures on the number of migrant workers in Thailand are not available, the overwhelming majority - an estimated 90 percent - are from neighbouring Myanmar. In Myanmar, the highly conservative military junta publicly recognised HIV/AIDS as a threat to its population only about six years ago, after years of insisting that the country had no such problem.
|Behaviour is changing. It's not enough, but its changing.|
The regime still tightly controls efforts to raise awareness about the disease: non-governmental organisations (NGOs) have complained of limits on the number of people who can attend HIV workshops, and prohibitions on their operating in many parts of the country, particularly sensitive ethnic minority areas.
This means most Burmese workers arrive in Thailand with little understanding of HIV/AIDS or how to protect themselves when they move away from their families and find themselves at greater risk of HIV. Similarly, migrants from Cambodia and Laos, coming from the poorest regions of their countries, often also have a poor understanding of the virus.
HIV prevalence statistics for migrant workers are not available, as the Thai government does not survey migrants separately, but sample reports, primarily among foreign fishermen and sex workers in border towns, showed high but fluctuating prevalence rates between 2002 and 2004, according to the Prevention of HIV/AIDS Among Migrant Workers Project (PHAMIT) in 20 of Thailand's provinces.
For example, in 2004, HIV prevalence among fishermen, who are mainly Burmese, was 9.6 percent in Chumpon Province, and 5.6 percent in Phuket Province; among the mainly Burmese sex workers in Ranong, a major port in Ranong Province, which borders Burma, HIV infection rates stood at 28 percent; and among the mainly Cambodian sex workers in the province of Trad, bordering Cambodia, it reached 38 percent, the health ministry said.
PHAMIT, funded by the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria, consists of NGOs and works with the Ministry of Health to increase foreign labourers' knowledge about HIV/AIDS.
As part of the project, the Global Fund has financed the development of information, education and behaviour-change communication material in Burmese, Cambodian and several ethnic minority Burmese languages to help migrants understand issues like HIV, reproductive health and family planning, and how to access Thai health care.
Reaching out to migrants
Yet, even with the support of the Thai health ministry, efforts to reach out to foreign workers have been beset with difficulties, mostly stemming from their precarious position, given their illegal status, constant risk of deportation and often gruelling work schedule.
Photo: Amy Kazmin/IRIN
|An HIV/AIDS poster in Myanmar. The overwhelming majority - an estimated 90 percent - of migrant workers in Thailand are from|
Although Thailand depends heavily on foreign workers, around half of them are unregistered and, technically, illegal, leaving them vulnerable to police harassment as well as serious exploitation by their employers, according to labour rights organisations.
In Mae Sot, where World Vision and other humanitarian groups have sought to train women in every garment factory to serve as informal peer counsellors, many of the women, who are in Thailand illegally, are forced to work six days a week and late into each night, with some getting only a single day off each month, which gives them little or no free time to attend training sessions on health or other issues.
To conduct all-day in-depth trainings, charities have to appeal directly to factory owners to release some of their workers for a day. Many are reluctant to do so, or agree, only to change their minds on the day of the planned training.
"It's up to the employer," said Mie Mie, a Burmese HIV/AIDS coordinator with World Vision. "Sometimes they say, 'Yes, you can come and do counselling,' but on the day we come, they say, 'we have so many orders'." The charities also have to pay the women for the wages lost during training time.
Dr Ei Ei Khin, a Burmese physician and technical advisor to World Vision's migrant worker projects in Thailand, said even when workers understood how to protect themselves from HIV, their more immediate fear was the risk that they would be arrested and held in immigration detention centres before being either freed or deported, thus losing many days of work and wages.
This often deters garment workers in Mae Sot from leaving their factory compounds, where they normally live, and restricts access to condoms unless charitable groups supply them to directly to the workers quarters in the compound. "If there is no NGO working for that factory, it's very difficult for the workers to get access to condoms," Khin said.
In recent years, the authorities' attitudes towards the migrants, especially in some provinces, have been hardening, with new restrictions being introduced to curtail the mobility of migrant workers. In several provinces, local authorities have prohibited migrants from using mobile phones, riding motorbikes, being out after 8 p.m., or gathering in groups of more than five.
Despite these hurdles, Khin believes the message is slowly reaching Thailand's foreign labourers. "Behaviour is changing," she said. "It's not enough, but it's changing."