AIDS threat grows in Laos

SUN JOURNAL

Health: An emerging crossroads is becoming ground zero for an `unseen epidemic' that could decimate hill tribes.

April 14, 2004|By Henry Hoenig | Henry Hoenig,SPECIAL TO THE SUN

MUANG XAI, Laos - This crossroads town has long been a place where people come from the hills to sell tree bark and bamboo shoots and whatever else they can gather from the jungles of this rugged region. Now it is also a place where young hill tribe girls come to sell sex.

As daylight fades, tractor-trailer trucks line up along the main strip. Inside a karaoke club at one of the town's several Chinese hotels, a pretty 14-year- old known only as Noy braces for another night of work.

Like everyone else in her Kamu village, Noy had never heard of HIV or AIDS before she arrived in town just 10 days earlier. She first heard it mentioned, she says, after being coerced into selling her body to Chinese and Laotian truck drivers and businessmen - up to 10 men a night. But she has no idea how a person gets infected.

Many experts use phrases such as "unseen epidemic" and "wholesale destruction" to describe the dangers facing the hill tribes of northern Laos that make up 90 percent of the area's population.

Muang Xai is ground zero, the most dangerous of several potential AIDS "hot spots" identified by the United Nations. No one knows how many here carry the human immunodeficiency virus, but the number is believed to be rising quickly. The only statistics are so outdated that they are dismissed as nearly irrelevant. A study is being conducted, but a lack of money for testing has made it a guessing game.

Up to now, isolation has protected the hill tribes from the AIDS epidemic in neighboring countries. But under plans financed by the Asian Development Bank and member nations, the area is emerging as something of a commercial transport hub, one that eventually will link Kunming, China, to Bangkok, Thailand, and ultimately Phnom Penh, Cambodia, and Ho Chi Minh City, Vietnam. A highway will connect Hanoi to northern Myanmar and the capital, Yangon.

Officials are particularly worried about Highway 3, which runs from Louangnamtha, Laos, near China's Yunnan province, south to Houayxay, just across the Mekong River from Thailand's Chiang Rai province.

These routes will intersect in Muang Xai, bringing to town large numbers of men from areas with some of the world's worst AIDS infection rates. It will fuel the sex trade and create "enormous potential for the rapid spread of HIV," a U.N. Development Program report says.

"We really need to work hard and fast," says Lee-Nah Hsu, manager of the UNDP's Southeast Asia HIV and Development Project, who compared the situation to sub-Saharan Africa. "It will take time before we can get some concrete numbers out. By the time the information gets out, it might be too late."

The hill tribes in northern Laos are especially vulnerable, the poorest and most-isolated people in a poor and isolated country. Many are enduring tremendous upheaval, including forced relocation as part of government efforts to eradicate opium-growing and slash-and-burn agriculture. They are being dragged from a subsistence living into a cash economy but have few ways to earn more.

One result has been an increase in prostitution and the trafficking of hill tribe girls in northern Laos and to China and Thailand. Commercial sex has become commonplace as tens of thousands of foreign workers, mostly Chinese men, have crossed the border to work on new dams and roads, and the number of Chinese and Laotian truck drivers carrying Chinese goods across the border has increased.

Yet AIDS awareness is low, and the area's few hospitals would provide little comfort - never mind medication - to AIDS sufferers if a widespread outbreak were to occur. Until recently, local health officials say, those in Muang Xai known to have contracted HIV generally were told so only after appearing at the hospital with AIDS symptoms. Then they simply returned home to die.

"There is the potential for some of these groups to be both physically and culturally wiped out, because you are dealing with small populations," says anthropologist David Feingold, an expert on hill tribes, trafficking and HIV/AIDS with UNESCO's Bangkok office.

One indication of the potential for an AIDS epidemic is the high rate of sexually transmitted diseases among "service girls" - any young woman working in a restaurant, nightclub or guesthouse - in Vientiane and two lowland southern provinces, where awareness of HIV and condoms is relatively high.

A 2000 survey sponsored by the National Committee for the Control of AIDS found that 39 percent of 800 young women in service jobs had at least one sexually transmitted disease. Not all of the women sold sex -65 percent reported doing so in the previous year - so the rate of sexually transmitted disease infection among those who do is likely much higher. Condom use was found to be rare.

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