hiv/aids prevention among migrant workers in thailand’s seafood industry presenter: brahm press...
TRANSCRIPT
HIV/AIDS Prevention Among Migrant
Workers in Thailand’s Seafood Industry
Presenter: Brahm PressOrganization: Raks Thai
Foundation
Profile of Fishermen and Related Populations
Ethnic Groups of Myanmar Present in Fishing Industry
• Mon – the majority, primarily fishermen and seafood processors
• Burmese (Burman) – high presence generally, fishermen and on docks
• Tavoy – high presence in the south close to border, mainly fishermen
• Karen – concentrated in specific areas, primarily on docks and as processors
• Rakhine – low presence generally, and in specific areas
Location by Ethnic Group
Language Issues among Migrants in Seafood
Industry• Mon – speak and read own language
(low literacy), learn Thai quickly• Burmese – speak and read Burmese
(low literacy generally)• Tavoy – own language, but can speak
and read Burmese (low literacy)• Karen – own language, can speak
and read Burmese (literacy levels uncertain)
Registration of Male Laborers from Myanmar
2001 & 2003
*Chonburi, Chumporn, Pattani, Phuket, Ranong, Samut Prakarn, Samut Sakorn,
Songkla
Totals All Categories Nationally
Totals All Categories Eight
Provinces*
Total Fisheries Nationally
2001
255,123
84,826
50,523
2003
134,812
45,560
27,465
Numbers of Registered and Estimated Myanmar Males Selected Provinces - 2003
Province All Categories
Fisheries Est. # of Myn
Fishermen
Chonburi 3,142 1,004 -
Chumporn 5,266 2,027 -
Pattani 849 764 10,000
Phuket 8,576 741 7,000
Ranong 7,826 2,603 7,000
Samut Prakarn 4,673 1,216 4,000
Samut Sakorn 13,435 8,769 ???
Songkhla 1,793 111 8,000
Totals for Listed Provinces
45,560 17,235* 36,000*63% of National Total for Fisheries
Registration of Female Laborers from Myanmar
2001 & 2003
*Chonburi, Chumporn, Pattani, Phuket, Ranong, Samut Prakarn, Samut Sakorn,
Songkla
Totals All Categories Nationally
Totals All Categories Eight
Provinces*
Total Fisheries Nationally
2001
193,865
53,319
27,637
2003
112,979
31,938
18,977
Numbers of Registered Myanmar Females Selected Provinces - 2003
Province All Categories
Fisheries•Samut Sakorn makes up 72% of all registered in fisheries
•Women under the fisheries category make up 50% of total
Chonburi 1,489 198
Chumporn 1,744 317
Pattani 218 191
Phuket 4,331 174
Ranong 6,337 3,084
Samut Prakarn 2,781 454
Samut Sakorn 14,072 11,492
Songkhla 966 7
Totals for Listed Provinces
31,938 15,917
Vulnerability to HIV/AIDS
High Mobility of Fishermen
As assessed in the scope of research
Considerations that Increase Fishermen’s
Vulnerability• Extended time at sea – from two
weeks to two months to two years (boat type)
• Docking at various ports - including international (Myanmar, Indonesia, Malaysia, Bangladesh…)
• Perception of risk - different types of sex-workers (karaoke, brothel, waitress)
• “Sweetheart” relations – no condom
Sub-Culture Sub-Culture Norms ofNorms of
FishermenFishermen
Drinking in Groups
SeekingCommercial
Sex
Penis Enhancement
Inconsistent condom use
Beliefs aboutWomen and HIV
Lack of Familiarity - Feeling / Unnatural
Issues of Intimacy and
Trust
Stigma of condoms /
Beliefs about women
Misinformation and beliefs about HIV
Access to condoms
Drunk / forgetting
InconsistentCondom
Use
ProvinceProvince 20002000 20022002Chumporn 3.9% 4.9%
Ranong 7.6% 10%
Phuket 8.9% 9.3%
Songkhla 8.4% 9.4%
Pattani
Samut Sakorn
9.5%
3%
4.5%
-
Sample Rates of HIV among Fishermen
Source: MOPHGeneral prevalence in Thailand was 1.8%; male STI patients in urban areas was 2.5% in 2000. (UNAIDS)
ProvinceProvince DirectDirect IndirectIndirectChumporn 21.1% 7.1%
Ranong - 5.2%*
Phuket 14.8% 3.1%
Songkhla 12.2% 10%
Pattani
Samut Sakorn
23.5%
27%
5.5%
4.6%
Sample Rates of HIV among “Sex Workers”-
2002
Source: MOPH*36% in 2000
Prevalence rates of 6.7% for sex workers in urban areas in 2000. (UNAIDS)
Public Health Service
s
Public Health Service
s
Clinics (Expensive) / NGO Clinic (Limited Services)
No Treatment / Complications
Attitude of Providers
LanguageRegistration StatusFear of
Arrest
Barriers to Health
Location / Transportation
Self-medicate / Traditional Remedies
HIV/AIDS Prevention Interventions
Three Levels of Migrant Programming
Migrant Network Support AMN to Advocate
Rockefeller Foundation
CSEARHAP Advocacy and Capacity Building for
Govt CIDA/CARE Canada
PHAMIT Scale up interventions
GFATM
• Funded by The Global Fund (Round II) • RTF in partnership with: CAR, PATH, MAP, Empower (CM), TBCA, Stella Maris,
and MOPH • Goal: To reduce the number of new HIV
infections among migrant workers in Thailand and contribute towards the
reduction of HIV/AIDS in the sub-region (Thailand, Cambodia and Myanmar).
PHAMITPHAMIT (Prevention of HIV/AIDS Among Migrant Workers in Thailand)
PHAMITPHAMIT Objectives
1. Migrant workers and related populations use condoms consistently during casual sex and practice reproductive health care.
PHAMITPHAMIT Objectives
2. Health system is favorable for migrant workers to receive health prevention and treatment services that are suitable for migrant workers.
PHAMITPHAMIT Objectives
3. There is a supportive environment for migrant workers and their dependents.
PHAMITPHAMIT Objectives
4. Political factors support migrant workers health and treatment at the national and inter-country level
Promote Healthy Behaviors (Condom use and
RH)Activities
• Small group trainings
• IEC / BCC materials• Peer education &
Volunteer networks• Reproductive health
education• Condom distribution
Target Groups• Fishermen• Seafood processors• Sex workers (direct
and indirect)• Youth• Wives of migrants• “Gatekeepers”
Improve Health Service Delivery System for
MigrantsActivities• Health services provided in the
language of migrants • Mobile health activities at
communities and work places• Work with health service providers
to influence attitudes • Work with owners to improve
access to health services
Community Development and Social Supports
Activities• Development and support of
community groups and activities (cultural & social)
• Education activities for migrant children
• Improve sanitation• Develop alternatives for recreation
Influence Policy from Provincial to International
Levels Activities
• Advocate at various levels for changes in policies that infringe on basic rights (health, labor, children…)
• Sensitize government officials and public to migrant issues through media, research, case studies and site visits…