HIV: One more burden for Thai migrants

Life for a migrant worker living with HIV in Thailand isn't easy. They have to set aside Bt1,070 (S$42) a month to buy anti-retroviral drugs, while facing problems from advantage-takers and abusive employers.

The Raks Thai Foundation is urging that the obligatory insurance package for migrant workers should also cover those living with HIV so they can access anti-retroviral drugs as well.

Thirty-four-year-old Myanmar worker Miew (not her real name), who seven years ago sneaked through Tak's Mae Sot to find a shrimp-peeling job in Samut Prakan's Muang district, recalled she had to pay a total of Bt20,000 to agents. "Throughout the time I worked there, I had only Bt500-Bt600 left, but I was provided with lunch and dinner. I was told that my salary was deducted from what I owed for my travel and job-finding expenses," she said. She fled the factory after police busted it for employing foreign workers.

Following a period of hard work and then the HIV diagnosis, Miew met a Myanmar worker who she married and moved to Trat with. He didn't know she had HIV until her frequent sickness led to a blood test at Trat Hospital a year later.

Her husband's blood test result, however, was HIV-negative because she always insisted they use a condom when having sex.

"I have to pay Bt1,070 a month to buy the anti-retroviral drug… I can only do a less-physically demanding job now," said Miew. She thanked the Raks Thai Foundation for helping her get treatment while she recovered from complications.

Miew now receives the Social Security Office package for migrant workers. She welcomes the plan to hike the annual fee so it can cover the anti-retroviral drug, as this would lessen her husband's burden.

Mahachai-based Cambodian worker Lin (not her real name), 38, has a husband with HIV. She said it was fortunate the national health security programme had provided her with an anti-retroviral drug every three to six months since she became HIV-positive six years ago. The couple had two non-HIV-positive children. Her husband works on a fishing boat and is still strong and does not take anti-retroviral drugs. Lin is provided with Bt10,000 by her husband and her working-age child to cover expenses, she added.

Trat-based Cambodian worker Sri (not her real name), 51, said she got the virus from her late husband. She had been on the anti-retroviral drug for 13 years now but had no symptoms. She and her new husband use condoms and he is HIV-negative. She said they wouldn't move back to Cambodia as living costs there were high and jobs rare and a hospital trip could cost Bt3,000. Under the national healthcare scheme, she was provided with the anti-retroviral drug for free from Trat Hospital, she said.

Fishing folk most affected

Raks Thai Foundation's Myanmar-speaking field co-ordinator Khiew Khiew Min said the HIV/Aids epidemic often affected fishing-boat workers and fishery workers. Coming ashore after a voyage that could last for five to 10 days, many workers would visit a brothel, which often fronted as a karaoke bar and employed Myanmar or Cambodian women. The campaign for these workers to use condoms or even receive free condoms was still not enough to remove all risk.

Promboon Panitchpakdi, head of the Raks Thai Foundation, said it provides HIV/Aids care for immigrant workers, but can cover and educate only about 300,000 out of some 2-3 million migrant workers here.

There was also an issue that Thailand couldn't use tax money to take care of foreign workers, so funds for campaign materials came from other countries. The situation improved after the migrants' nationality identification and registration were in place to usher them into the social security system, he said.

The remaining foreign workers could voluntarily buy health insurance under the Health Ministry, whose annual fee would lift from Bt1,300 to Bt2,200 to cover anti-retroviral drugs. A problem was if there were not enough workers who buy insurance, the fund may fail. So the government must promote workers to buy it, he said.

There were 400,000 workers who could benefit from this insurance, while the remaining 1-2 million had to be in the social security system. Of these, some 800,000 had so far got a passport but only a quarter of these were in the social security system.