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Commentary: Burma epitomizes conspiracy of silence on AIDS


Commentary: Burma epitomizes conspiracy of silence on AIDS

May 11, 2005       

A UMNS Commentary
By The Rev. Donald E. Messer*

Few places on earth more epitomize the conspiracy of silence that propels the global HIV/AIDS pandemic than Burma. Renamed Myanmar by its military dictatorship, a silent epidemic of explosive proportions is escalating behind the Teak Curtain.

Governmental denial in the past decade has been pervasive. The junta claimed United Nations’ estimates were exaggerated. Certainly the disease never would spread due to the conservative culture and behavior of the people. Condom usage was not only discouraged, but mere possession sometimes deemed a reason for arrest.

Extreme poverty exacerbates the AIDS crisis among the 50 million people of Burma.    Poverty is both a cause and a consequence of HIV/AIDS. During its 42 years of dictatorship, the Burmese leaders have squandered the country’s resources, and their nation now is classified as one of the least economically developed countries in the world.  

Struggling to survive and serve behind the Teak Curtain are faithful Christians, who for the past 10 years have worked ecumenically to combat the HIV/AIDS pandemic, though they have received little support from the outside world. United Methodists have an opportunity to respond.

Belatedly, Burmese government officials have broken their silence and announced a nationwide HIV/AIDS campaign. The Ministry of Health welcomed Thailand’s gift of generic anti-retroviral medicine to treat 200 patients for a year, plus a million condoms.

Attending a meeting late last year with theological educators in Rangoon (now called Yangon), I saw far more public billboards warning citizens to “beware of stooges” advocating democracy than alerting them to the imminent threat of an international terrorist called HIV. When I asked a well-educated, 19-year-old Burmese student whether he had received any education about global AIDS, his crisp response was, “Never.”

LINK: Click to open full size version of image
A UMNS photo courtesy of Don Messer

The Rev. Donald Messer (far left) discusses the growing problem of HIV/AIDS during a visit to Myanmar (Burma).
Silence inevitably leads to more disease and death. Since the government tightly controls all information, and the health infrastructures are extremely limited, no one really knows precisely the prevalence of HIV/AIDS in ethnically diverse Myanmar. Government statistics released in 2003 citing 45,968 infected people proved radically lower than UNAIDS estimates of 330,000 and possibly 620,000.

Epidemiologist Chris Beyrer of John Hopkins University has estimated that 687,000 Burmese, or nearly 3.5 percent cent of the adult population, were HIV-positive in 2003.   Hidden are any numbers of AIDS-associated orphans but some projections suggest 40,000.

Factors fueling Burma’s pandemic highlight behavior elsewhere in Asia but with acute intensity in Myanmar. First, the practice of men who buy sex is more widespread than generally acknowledged.  Commercial sex opportunities flourish openly in Yangon, and at least 50 percent of all sex workers in Myanmar are believed already to be HIV-positive.

Second, few Asian countries have reliable estimates of the number of people who inject drugs, but it is known there is widespread needle-and syringe sharing.  At the heart of the Golden Triangle, Burma not only is the world’s leading exporter of opium and heroin, but also has the highest injected drug-associated HIV/AIDS rate in the world.
Third, education about safer sex practices is not encouraged. Silence combined with ignorance about how HIV is transmitted helps create a “kaleidoscope of risk” since human behaviors interact in various ways. A man, for example, may be infected by HIV from drug injections, and then unknowingly pass it on to his wife or a sex worker.  In turn, that person may later have an unprotected same sex or a heterosexual relationship that transmits the disease.

Persons living with HIV/AIDS in Burma face an impossible dilemma. Traveling to the outskirts of Yangon one evening, I sat on the floor of a wooden shack literally sharing bread and water with persons living with HIV/AIDS. For them, international talk of getting anti-retroviral drugs to the poor is a cruel hoax. No matter how low the price, they could not afford it.

As I bade farewell to my hospitable HIV-positive host, holding his 5-year-old daughter and 15-month-old son, my broken heart pondered their future and the fate of hundreds of thousands more like them throughout Burma.

Without a breakthrough in the foreseeable future, the Burmese AIDS pandemic will prove unstoppable and the genocide by indifference of Sub-Sahara Africa will be replicated in South East Asia.

Some Burmese Christians and Buddhists are breaking the conspiracy paralysis and discovering ways of reaching out in programs of prevention and ministries of mercy.  World Vision and the Myanmar Council of Churches, for example, have dared to reach out to persons living with HIV/AIDS, providing programs of awareness and education.  Faith-based groups lack funding but form a trustworthy cadre of committed persons scattered throughout the country. 

Some Christians are exorcizing their fears and expressing their faith by confronting stigmatization and discrimination. Theological educators from the Methodist seminary and other theological schools are working to incorporate HIV/AIDS education into the training of pastors. 

Some even are daring to examine some of the theological taboos that have prohibited open sex information and education. Moving beyond a simplistic AIDS theology equating disease with personal sin, focus has shifted to the complexities of those “sinned against”—people imprisoned by poverty, political oppression, gender inequality, and other societal structures over which they have no control.

While diplomatic wheels grind slowly toward a just political solution, hopefully humanitarian interventions can be found to empower faith-based groups to cope with this catastrophic crisis. The Burmese church lacks full freedom to function, but its leaders and organizations provide an important link to the outside world. By identifying Christian leaders of integrity and courage, financial, educational, technical and prayer support can be provided for their ministry.

Burma provides United Methodists an opportunity to partner ecumenically and with inter-faith groups of Buddhists and Muslims. Working not only with denominational groups, but also the Myanmar Council of Churches, the Association of Theological Educators of Myanmar, and the World Council of Churches, United Methodists can strengthen efforts at incorporating HIV/AIDS education into theological curriculums and continuing education programs aimed at prevention and pastoral care. 

Using our political contacts, United Methodists can continue to be advocates for freedom and democracy in Burma, while at the same time urging creative diplomatic ways to get desperately needed health care to the impoverished. We can incarnate the injunction in Proverbs 31:8-9 to “Speak up for those who cannot speak ... and defend the rights of the poor and needy.”

*Messer is author of Breaking the Conspiracy of Silence:  Christian Churches and the Global AIDS Crisis (Fortress, 2004) and Henry White Warren Professor of Practical Theology and President Emeritus at Iliff School of Theology in Denver, where he directs the Center for the Church and Global AIDS.

News media contact: Tim Tanton, Nashville, Tenn., (615) 742-5470 or

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