Burma confronts taboo, educates villagers about HIV prevention

February 19, 2004

Wayagyaung, Burma -- In late afternoon, the Love Boat docked at this small delta village, bringing the promise of adventure and romance.

Yet the bright green, 90-foot ship was not on a frivolous voyage. Instead, the Love Boat sought to educate villagers about the lethal disease that is sweeping their country of 42 million people.

"AIDS is not a nuclear atomic bomb," said Yarzar Nay Win, a popular Burmese actor in a video shown by Population Services International, a nonprofit group based in Washington, D.C. "The moment you go wild, use protection for your health. Let me remind you, the best thing is to control your mind."

Bringing along a screen and audio-visual gear, the Love Boat showed several hundred villagers videos and a movies featuring a promiscuous boatman and a karaoke "entertainment girl," all with elements of melodrama and slapstick comedy.

Such public events would have been unthinkable in recent years. As late as November 2000, police were still confiscating condoms to use as evidence of prostitution. Until 2002, the military junta that rules this nation made AIDS a taboo subject.

But the junta changed after AIDS gained a major foothold in Burma because of poor health care and striking ignorance about reproduction. Life expectancy is just 55 years, compared with 63 in the rest of Asia.

By mid-2002, 177,279 people were living with HIV in Burma, according to government records, a figure that falls far short of a 1999 study by Johns Hopkins University, which suggested that at least 687,000 Burmese, or almost 3. 5 percent of the country's adult population, were infected with the AIDS virus. That study included pregnant women, soldiers, sex workers, gay men and blood donors, but it excluded the nation's estimated 1.4 million drug users.

Fearing that transient populations such as migrant workers, truck drivers and boatmen could spread the disease to the general population, the government relented, allowing local and international health organizations to become more active in the fight to contain the virus.

Workers from Population Services International instruct pedicab drivers and migrant workers how to use condoms, train university students to become health educators in rural villages and show Buddhist monks how to use their religion's precepts to discourage people from using drugs or having premarital sex. In November, Burma held its first exhibition on HIV and AIDS prevention in Rangoon, the capital.

The group also has produced -- after long negotiations with the government -- the first national TV soap opera called "Happy Travelers," which featured a character infected with the virus. Early this year, Population Services International began filming a second soap opera about life and love in the age of HIV.

Because 70 percent of Burma's population lives in the countryside and many people lack television sets, the U.S. group decided to bring the films to them via three Love Boats, and one car dubbed the Love Bug. The boats can seat up to 300 to 400 villagers for onboard showings during the rainy season and sets up outside in dry weather.

Wayagyaung village -- with its bamboo, thatched and tin roof homes, and oxen that pull wooden carts in its fields -- looks like an insolated hamlet free of such modern menaces as AIDS. But its 1,200 residents are vulnerable, health workers say.

Wooden long-tail boats that ply the nearby Ayeyarwaddy River trading goods and services carry people who could potentially bring HIV to the village.

The AIDS videos were the biggest event in months, equaling attendance at Buddhist festivals. Residents watched the films while seated on woven plastic mats in a dusty clearing near the local monastery.

Under the crescent smile of the honey-colored moon, a young man twisted balloons into animals for children, vendors hawked sticky rice and barbecued pork, children danced to music pounding from speakers in front of an ox shed, and their parents puffed on cheroots.

Khin Mar Cho, a 38-year-old housewife, said she didn't know anyone infected with the virus but understood that AIDS was a threat to her country.

"We now know about how deadly this disease is, and how we should use protection," she said. "Married couples, single people have started using condoms."

Along the main dock, posters on shop walls advertise Aphaw, or "trustworthy friend," the subsidized condom wholesaled by Population Services International. At retail, the condoms sell for 2 to 11 cents each, depending on the markup -- affordable in a country where the annual per capita income is just $300.

Despite making inroads in the fight against AIDS, Population Services International and other foreign-funded health programs in Burma have critics. They say such projects free the military junta from health spending, allowing them to buy more arms and use the money on itself.

The junta's interest in AIDS, the same detractors say, is a ploy to bring back international aid that slowed to a trickle after the military refused to allow opposition leaders to take office after winning the 1990 parliamentary elections and suppressed protesters in a bloody crackdown in 1988.

"The regime's practices have deprived the Burmese people of health and education services that most of the world takes for granted," said Debbie Stothard, head of Alternative Asean Network of Burma, a regional human rights group in Thailand. "Now, the military regime is trotting them out and saying, 'Give us money.' "

In May, junta-backed thugs attacked hundreds of political opposition members and placed pro-democracy leader and Nobel Peace Prize winner Aung San Suu Kyi under house arrest after her speeches drew large crowds. In response, the United States levied economic sanctions in July that banned the import of Burmese products, froze assets of senior junta officials and banned remittances to Burma.

Burma, which receives no bilateral or multilateral aid, is expected to receive about $60 million from the United Nations and nongovernmental organizations this year.

That's a "tremendously low" sum for a country of Burma's size, said Charles Petrie, representative of the United Nations Development Program in Burma. "The fact that the government may be underspending on health is one issue that needs to be addressed," Petrie said. "But it shouldn't be tied to the issue of helping people in extreme situations. It's a mistake to put them together."

Back in Wayagyaung, villagers eagerly watched a music video featuring Burmese singer Akyin Nart Thomas as she belted out a ballad called "Tender Warm Hearted Care."

"Going to die soon. That's definitely sure. There's no chance of appeal," she sang. "The sun will set very soon ... Please encourage and take good care while still living in this world."

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