HIV-free children bring hope to parents
August 30 - September 5, 2010
MA Ni cried for days when she found out she had contracted HIV from her husband, an injecting drug user, three years ago. But when the 37-year-old North Dagon township resident unexpectedly found out she was pregnant, she stopped worrying about her own health, fearing only that her daughter would be born HIV-positive.
She was among the first batch of expectant mothers to enrol in the Myanmar Anti-Narcotics Association’s (MANA) Prevention of Mother-to-Child Trans-mission (PMCT) project, launched in 2008 and funded by the United Nations Population Fund.
“When my daughter was one-and-a-half years old, I took her to Waibargyi Infectious Diseases Hospital to take a blood test [to find out if she was HIV-positive],” she said last month, her eyes filled with tears. “I dared not listen to the result and asked my friend to speak to the doctor. When I found out the test had come back negative for HIV, I couldn’t believe my ears. I can’t describe how happy I felt.”
Ma Ni said the birth of her daughter encouraged her and her husband to take better care of their own health.
“Before my daughter was born, we were so thin because the infection left us feeling hopeless, so we didn’t eat or sleep properly. Today we look after ourselves and are healthy again because we have hope for the future, for our daughter,” she said.
Ma Ni was one of 30 HIV-positive pregnant women in the PMCT project’s first batch, said Dr Maung Maung Lwin, a project consultant with the MANA, a local non-government organisation established in 1994 that works closely with the with the Central Committee for Drug Abuse Control.
“In the first year of the project, 18 of the 30 children were HIV-negative [when tested at 18 months of age],” he says. “We then increased the number of participants to 40 in 2009 and 60 in 2010.”
According to the World Health Organisation, an estimated 430,000 children were newly infected with HIV in 2008, the vast majority of them through mother-to-child transmission, which can occur during pregnancy, labour and delivery or breastfeeding. However, mother-to-child transmission is “almost entirely preventable where services are available”, the WHO says.
Dr Ohnmar, an official from MANA, says women enrolled in the association’s Prevention of Mother-to-Child Transmission project are provided with counselling, information on infant feeding practices, pregnancy care, home care and both nutritional and medical support. The Department of Health also provides participants with anti-retroviral (ARV) prophylaxis drugs, which are the major factor in reducing mother-to-child HIV.
“In the training, we encourage mothers to start breastfeeding within one hour after childbirth,” Dr Ohnmar says. “Staff from the project visit pregnant women at home and provide them with iron and vitamin supplements. After the birth, we discuss birth spacing with the women.”
Dr Ohnmar says the women were recruited because their partners were attending one of the seven drop-in centres for drug users that the association runs nationally with funding from the Three Diseases Fund, a five-year, US$120-million multi-donor trust fund.
“Our association focuses on drug awareness, and the Prevention of Mother-to-Child Transmission program is targeted at the wives and relatives of drug users,” Dr Ohnmar said.
When Ma Ni found out she was pregnant, her husband was attending the association’s centre in Tarmwe township.
After enrolling in the program, she was taught “how to take care of myself while I was pregnant and after the birth”.
“I followed the doctors’ instructions carefully … the doctors and nurses cared for me very much. There was no discrimination,” she said.
In late December 2008, she gave birth to a daughter at Thingangyun San Pya General Hospital.
Ma Ni now works as a cleaner at Waibargyi Hospital. “I encourage HIV-positive patients at the hospital and share my knowledge. If any of the women get pregnant accidentally, I tell them about the PMCT project,” she said.
However, not all women in the program fall pregnant unexpectedly. Ma Zar Chi, 33, from North Dagon township, said she and her husband were determined to have a child despite both being HIV-positive.
“Once I was pregnant, I discussed with township medical doctors how to prevent HIV transmission to my child. The doctors told me about the PMCT project and I attended the training,” she said.
Ma Zar Chi gave birth to a daughter in North Dagon General Hospital in October 2008 – just months after her husband died of AIDS.
“Because my husband is dead I have to take all the responsibility for my daughter. I take care of my health, to make sure I don’t catch any infectious diseases, such as tuberculosis or diarrhoea,” she said.
“When my daughter was six months old, she suffered from diarrhoea and I was so worried, I thought she had contracted [HIV] from us. But when she was one-and-a-half, I was able to get a blood test and it came back negative.”
Infants cannot be tested for HIV infection until 18 months of age. Ma Aye Aye, 29, from Hlaing Tharyar township, participated in the 2009 program and believes her six-month-old daughter is free from HIV.
“I have followed the instructions of the doctors. There are many successful examples for us women in this year’s program, like Ma Ni and Ma Zar Chi,” she says.
Ma Aye Aye contracted HIV after she was trafficked to China in 2006 and forced to work in the sex industry.
“A friend of mine in a nearby township told me she would find a job for me and I went with her to China but I was made to work in the sex industry,” she says. “One day I ran away and went to a police station. Thankfully I was deported to Myanmar.”
But Ma Aye Aye’s bad luck didn’t end there. Six months after returning to Myanmar, she took a blood test at Waibarbyi Hospital after suffering from diarrhoea and herpes.
“The result showed I was HIV positive. I was shocked; I thought I was going to die very soon. At first I didn’t dare tell my parents because I was so ashamed,” she said.
Finally, Ma Aye Aye told her mother about the infection and was encouraged by her support. At that time she also met the man who would later become her husband.
“I told him about my problems and he comforted and sympathised with me,” she said. “He used to be a drug user. … We came to rely on each other and got married in 2008.”
Like many HIV-positive women, when she got pregnant Ma Aye Aye was worried she would pass on the infection to her unborn child. “I didn’t want to increase the HIV population. Fortunately, my husband was attending one of the MANA drop-in centres and so I joined the [Prevention of Mother-to-Child Transmission] project.”
She said her husband’s cooperation and understanding played an important role in her successfully completing the program. “We attended the training offered by the MANA together. We just wanted our child to be born free of HIV.”
