The struggle to help some of Asia's most vulnerable people

But as soon as the 35-year-old woman is out of the sight of Myanmar's immigration officials, she neatly folds the vinyl bag and puts it in her handbag before swerving into one of the nearby villages to start her day's work as a community health worker.

“Every day, I meet intravenous heroin users, prostitutes and ordinary villagers to explain how they could prevent the infection of diseases like HIV or hepatitis,” said Ms. Nunboi, a Myanmarese ethnic tribal woman living in Moreh, a border town in the northeastern Indian state of Manipur.

“I also advise people on how to get medical help in Burma [the former name of Myanmar] or India in case they get the diseases.”

As a growing number of international charities suspend their operations because of pressure from the junta, community health workers such as Ms. Nunboi do their best to provide basic medical care to some of Asia's most vulnerable people.

In a country where HIV-AIDS and malaria are rife,
patient care is an overwhelming task for any health worker.

(UNAIDS, the United Nations body co-ordinating the global fight against the disease, estimates that about 620,000 people between 15 and 49 years old are infected with HIV in Myanmar.) On the border, where the junta casts its shadow over every section of society, health workers face the additional burden of risking their lives when they go to help the sick.

“Sometimes, in the villages, I also distribute essential medicines supplied by NHEC,” Ms. Nunboi said, referring to the National Health and Education Committee, an organization set up by Myanmarese pro-democracy activists in exile.

“Although I'm doing exactly what a community-health worker does elsewhere in the world, I often have to work undercover to save myself from being troubled by the military.”

To maintain her fake identity as a trader in the eyes of the Myanmarese border police, every evening she carries cheap clothes or consumer goods from markets in Tamu, south of Namphalong, for several shops in Moreh.

Myanmarese military-intelligence officers would not knowingly allow Ms. Nunboi and her colleagues into Myanmar because they work for the NHEC, which the regime believes is linked to terrorists.

Lamlhing Touthang, a Namphalong-based health worker, recently returned home after participating in an NHEC-organized, month-long HIV-care training camp in Manipur.

On her return, she was interrogated for more than five hours by Myanmarese military-intelligence officials, who suspected her of having a role in “anti-national” activities, suggesting she doubled as a political agent for the pro-democracy activists in exile.

“From my bag, they got nothing except some NHEC pamphlets on awareness about AIDS and malaria,” she said. “Yet they threatened me not to go out of the country again for ‘so long' in future. Also, they asked me not to maintain any communication with the NHEC.”

Now, Ms. Touthang and her Myanmarese colleagues have officially become volunteer workers for a small Myanmar-based non-governmental health organization, with their new role helping to keep the intelligence officers at bay.

“Just to avoid troubles in the field, our health workers flaunt the identity cards of some Burmese NGOs,” said Aung Kyaw Oo, Indian-based chairman of NHEC's western region.

“But those NGOs, operating under many restrictions under the military regime, have no access to the developed world to import modern care and treatment for HIV victims in Myanmar.

“Except for a few hospitals in cities, there are no trained government doctors to handle HIV victims in the rural areas, where as many as 85 per cent of the carriers of the virus are living. If the junta allowed the international medical aid groups to function freely inside Myanmar, the problem would have not turned that acute for the HIV victims inside Myanmar.”

In the face of pressure from the junta, many international medical charities are winding up operations in Myanmar.

In 2005, Global Fund to Fight Aids, Tuberculosis and Malaria cancelled its $37.5-million (U.S.) program in the country, blaming government restrictions on its movements that made functioning nearly impossible.

Médecins sans frontières (Doctors Without Borders) was forced to pull out of Karen and Mon States last year for similar reasons.

In October, the International Committee of the Red Cross was ordered to close all of its offices outside of Rangoon after the organization reported rampant HIV and other infectious diseases among inmates in the country's prisons.

Last week, the Red Cross announced that it will close down two of its field offices outside the capital as part of its reduction in medical activities in the military-ruled country.

The junta's move was criticized by many international agencies, and Myanmar has since hinted it could allow the reopening of ICRC field offices, but would not allow the Red Cross access to detainees or prisons.

“In terms of awareness, most HIV-affected areas today continue to lie in the same phase where neighbouring Thailand or India were 15 years ago,” said another Manipur-based NHEC executive, who wished to be identified only as Dr. Thura. “At least on humanitarian grounds, an urgent intervention is necessary.”

In January, 2006, a group of Burmese commandoes crossed the border and abducted Burmese pro-democracy activists from the Indian border town of Moreh. Concerned NHEC officials then closed down their medical bases and moved to Indian villages further from the border.

But despite such threats, the NHEC is now building two special homes in two Indian border districts of Manipur and Mizoram where orphans of the HIV-AIDS crisis will receive refuge once they leave Myanmar. The orphanages will also function as hospitals where trained doctors will be on hand.

“With the logistical help of friends in India and some Western countries, we are going to start these orphanages-come-hospitals where we hope to be able to provide ART [antiretroviral drugs] on a regular basis as well,” Dr. Oo said. “In the absence of ART, the epidemic is worsening in the country.

”Shalom, another Manipur-based medical NGO working in the field of HIV and AIDS, is also in the process of setting up two hospices in the Indian border towns of Moreh and Champhai.

Dr. Oo fears the planned HIV relief projects run by the NHEC in Indian border states could still face risks from the Myanmarese junta.

“When the SPDC [State Peace and Development Council, the ruling junta] cannot allow an organization as apolitical as the ICRC to serve the Burmese people freely, it can never tolerate us because it thinks we are spies and a part of a Western network engaged in attempts to overthrow the military government,” he said.

Sources: THEGLOBEANDMAIL