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Feature - "Doing Things Differently" in Myanmar

17. January 2013

    "Doing Things Differently" in Myanmar: Religious leaders and people living with HIV start a dialogue


    Towards the end of last year, in the week that the first sitting US President visited Myanmar, another first also took place in the country: A group of religious leaders and people living with HIV met to start a process of dialogue aimed at identifying what religious leaders and people living with HIV can do better together in responding to the HIV epidemic in Myanmar.


    The dialogue, held on 21-22 November 2012 in Yangon, was organized by the Myanmar Positive Group (MPG), the Myanmar Interfaith Network on AIDS (MINA) and the UNAIDS country office.


    “It is exciting to see a methodology that was developed at the international level – in partnership with Global Network of People Living with HIV, the International Network of Religious Leaders living with and affected by HIV and UNAIDS - tested at the national level in Malawi and now Myanmar”, said Peter Prove, Executive Director of the Ecumenical Advocacy Alliance.


    Some 40 people took part in this first face-to-face meeting, with balanced representation of both religious leaders and people living with HIV from the four main faith traditions practiced in Myanmar: Buddhism, Christianity, Hinduism and Islam.


    “This kind of dialogue is really needed here in Myanmar”, affirmed Dr Soe Naing, Social Mobilization Advisor at UNAIDS Myanmar. “While some religious leaders and communities have been providing care, support and other services in response to HIV for some time, this is a first step towards a systematic and - it is hoped - sustained dialogue between religious leaders and people living with HIV.”


    Speaking out when stigma and discrimination happens

    Evidence provided by people living with HIV formed the basis of the dialogue, including the findings of the People Living with HIV Stigma Index research carried out in Myanmar in 2010 with the leadership of MPG. This research shows, for example, that 30% of the people living with HIV in Myanmar report being excluded from social gatherings because of their HIV status in the past 12 months, and some 60% ‘feel ashamed’ of their status - an indication of strong levels of internalized stigma.


    Marginalized groups bear the brunt of the virus. While less than 1% of the general adult population are living with HIV, prevalence among key populations is very high, with estimates of 22.9% among people who use drugs, 9.6% among sex workers, and 7.8% among men who have sex with men. Stigma and discrimination faced by these populations hampers their access to prevention, and for those who are also living with the virus, stigma is an obstacle to their access to care, treatment and support.


    When it comes to faith communities and stigma, Mr Htin Linn Oo, MPG member, testified to both the good and the bad that they can do. “When I was diagnosed with HIV in 2007, it was a Buddhist group that disclosed my status to my family and friends without my knowledge and excluded me from their community”, he said. “Yet, when I was forced to leave my village in search of shelter, food and treatment, it was a Buddhist monastery in Yangon that took me in and gave me love and warmth.”


    “There is much more that we, as religious communities, need to do to address stigma and discrimination,” said Rev Peter Joseph, coordinator of MINA. “We have made a start, particularly under the leadership of MINA and its partnership with MPG and key population networks in Myanmar. We know that the key to success is to do everything in partnership with people living with and affected by HIV.”


    As a first step, religious leaders should not underestimate the power of speaking out about HIV. “I have never once heard a religious leader speak out publicly against stigmatizing and discriminating attitudes and actions towards people living with HIV,” testified Ma Thida, an MPG member. “This would make a difference, not only to me personally as a person living with HIV but also in terms of the attitudes that others in my faith community have towards me.”


    “HIV crosses all boundaries,” stated Imam Islam Shiekabdulla. “Regardless of how people are infected, all should have access to treatment, care and support. This dialogue meeting has reaffirmed my commitment to lift up the experiences of people living with HIV by, for example, using my sermons to denounce HIV-related stigma and prejudice.”


    Joining forces to achieve treatment, care and support for all

    “It would be very powerful if we, as people living with HIV, were to speak out alongside religious leaders to demand access to treatment for all”, said Myo Thant Aung, Chairperson of MPG. “Again and again, we have heard at this meeting of how people living with HIV in Myanmar struggle to have access to treatment as there is not enough to go round. Often we have to wait until someone else dies before we can get on a treatment list, and if a treatment centre closes for some reason, those on treatment have nowhere else to go.”


    While treatment coverage in Myanmar has increased from 12% in 2008 to 32% in 2011, this still means that almost 7 out of 10 people do not have access to the treatment they need.


    “We need to scale-up and decentralize treatment programs”, said Myo Thant Aung. “At the moment, many of us have to travel far and often to get medication and check-ups. This costs money and time, let alone physical and emotional energy,” he said.


    Several religious communities have identified this need and are responding. Asokaram Shwehinthat Yelay, a Buddhist Monastery on the outskirts of Yangon has opened its doors to welcome people living with HIV who come to the city to seek treatment and need a place to stay while their health condition stabilizes. And Fr. Victor Nyan Myint, a Catholic Priest in Mingaladon, has opened his own church premises to provide similar shelter and support.


    Such small-scale, community-based care and support projects currently provide much needed services. And while some are connected to well-organized networks that can provide amplification and advice, such as the Myanmar Catholic HIV/AIDS Network (M-CHAN) as well as MINA, others are often working alone and with little support from their own faith and wider communities. The Abbott of Asokaram Shwehinthat Yelay, for example, spoke of feeling alone and the need for more information, funding and support. He appealed for treatment literacy training as well as guidance in providing livelihoods skills to people staying in his monastery.


    The dialogue process in Myanmar is therefore one vehicle by which such services initiated by religious communities can be linked with the wider response to HIV in the country and thus receive increased technical support as well as recognition in order to ensure that people living with HIV are benefitting from the most effective and appropriate services as possible.


    Committing to more and ongoing dialogue

    Further areas for joint action identified during the discussions included the need to agree on common, non-discriminatory language for talking about HIV, to undertake more research on stigma and discrimination in religious settings, and to develop HIV non-discrimination policies for places of worship and faith-based organizations.


    The meeting also identified areas where further dialogue is needed in order to develop a common approach and identify joint actions. These included issues such as HIV prevention and condom use, sex and sexuality within the framework of cultural and religious beliefs and sexuality education.

    “At this initial dialogue meeting, the beginnings of a foundation of trust were built between the religious leaders and people living with HIV in the room, so that we can continue and deepen our discussions about some of these things,’ said Dr Myat Phyo Kyaw, who works for the large Buddhist organization, Ratana Metta, and was one of the meeting’s facilitators.


    As one member of MPG realistically admitted, ‘this dialogue process will not bear fruit immediately, but with persistence and much effort things may slowly change.”


    And it is true that engaging in dialogue is never easy. Ruth Foley, HIV Campaign Coordinator from the Ecumenical Advocacy Alliance reflected: “Change is always a prospective outcome of any sincere attempt at dialogue, and this can be uncomfortable.”


    Yet, participants at the two-day meeting are positive about the impact and potential of the dialogue process. As one Buddhist monk shared during his reflections at the meeting: “I got goose bumps when I heard the stories of people living with HIV attending this meeting. It has given me the inspiration to act and work for change, and I know that other monks will act too when they meet and hear from people living with HIV.”


    In closing the meeting, all participants committed to joint actions and ongoing dialogue, including engaging more senior religious leaders in the process. Undoubtedly, the recent news that Aung San Suu Kyi, Nobel peace prize winner and Member of Parliament in Myanmar, has taken on the role of UNAIDS Global Advocate  for Zero Discrimination, will give added momentum and credibility to these efforts.


    Background for editors

    The process for preparing, initiating and maintaining dialogue in Myanmar is based on a methodology developed at the international level by the Ecumenical Advocacy Alliance, the Global Network of People Living with HIV, the International Network of Religious Leaders living with and affected by HIV and UNAIDS. The methodology follows a simple timeline of: 1) familiarization of stakeholders of evidence on experienced and perceived stigma by people living with HIV (PLHIV), in particular the PLHIV Stigma Index; 2) understanding faith-based responses to HIV in the country and perceptions and experiences of stakeholders towards each other; 3) engaging in dialogue to determine what are areas of collaboration, areas where further dialogue is needed, and developing a joint action plan; and ultimately 4) maintaining dialogue in a systematic and long-term approach.


    The dialogue meeting in Myanmar was the second pilot test of this methodology, officially called ‘A Framework for Dialogue between Religious Leaders and People Living with HIV at the National Level’. The first pilot test took place in Malawi in June 2012. Based on the input from the Malawi and Myanmar experiences, the methodology will now be revised and adapted with a view to launching the finalized Framework for Dialogue in the first half of 2013.


    The concept of the Framework for Dialogue grew out of the High Level Religious Leaders Summit on HIV held in March 2010 in The Netherlands, and as part of efforts to support religious leaders in fulfilling the Personal Commitment to Action that was drafted at the Summit and has subsequently been signed by over 450 religious leaders around the world. Thirteen more religious leaders signed the personal commitment at the dialogue meeting in Myanmar.


    For more information contact:
    Sara Speicher,

    sspeicher@e-alliance.ch, +44 7821 860 723.

     


The Ecumenical Advocacy Alliance is a broad international network of churches and Christian organizations cooperating in advocacy on food and HIV and AIDS. The Alliance is based in Geneva, Switzerland. For more information, see http://www.e-alliance.ch/

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