VII. CAPTIVE PARTNERS: FORCED PROSTITUTION AND HIV/AIDS
For the majority of Burmese women and girls trafficked into Thailand for the purposes of forced prostitution, the human rights abuses they experience will ultimately prove fatal. Of the nineteen Burmese women and girls we interviewed who had been tested for HIV, fourteen were found to be infected with the virus, which causes the deadly acquired immunodeficiency syndrome (AIDS). (168) This rate of infection is roughly three times higher than among prostitutes more generally in Thailand. (169) In our view, the high rate is directly attributable to the Thai government's failure to protect the Burmese women and girls against trafficking, forced labor, and other abuses and to investigate and prosecute the abusers, including Thai officials.
This section documents how sexual enslavement of Burmese women and girls, through debt bondage, physical coercion and psychological intimidation, leads to their HIV infection. Brothel owners and their accomplices who compel Burmese women and girls to have involuntary and often unprotected sex with numerous partners every day are in effect enforcing a dangerous game of sexual Russian roulette: it is only a matter of time before the women and girls contract HIV.
We also examine the range of abuses suffered by women and girls on account of their suspected or actual HIV infection, abuses often perpetrated in the name of AIDS prevention and control. Burmese women and girls are tested by brothel owners and by public health officials for HIV without their informed consent, sometimes without even their knowledge. Those who are aware of the purpose of the HIV test are often denied the results of their own tests, even as the outcomes are made available to brothel owners, immigration officials and others. The breach of confidentiality not only violates the right of the Burmese women and girls to privacy but may have dangerous consequences for their treatment at the hands of the SLORC after deportation.
A. ABUSES THAT LEAD TO HIV INFECTION
Awareness of AIDS among potential customers has driven the Thai sex industry to supply more and more young girls from remote villages that are perceived to be untouched by AIDS. Brothel owners employ various means of control already discussed -- debt bondage, illegal confinement, use or threat of physical force, and psychological intimidation -- to keep the Burmese women and girls in sexual slavery until their debts are repaid. The Burmese are powerless to negotiate any terms of sex, such as condom use, that might protect them from HIV infection, just as they have virtually no choice of customer, no say over how many customers to accept in a given day or the type of sex in which they will engage.
Young girls, sometimes only thirteen or fourteen years old, may be particularly at risk. Not only are they often too intimidated even to attempt to negotiate the terms of sex, but preliminary medical research suggests that the younger the girl, the more susceptible she may be to HIV infection for physiological reasons. (170) (The average age of the trafficking victims we interviewed was seventeen.)
Burmese women and girls who attempt to refuse customers often face retaliation. Sometimes, the owners and pimps threaten them with physical harm, or allow the customers to do so.
"Tar Tar" had been moved around to different brothels since she was sixteen years old. In some of them, condoms were available, but it was up to the men if they used them or not. Most did not. At one brothel, Dao Kanong, the owner did not supply condoms, so she bought them herself. If the client refused, she tried to argue, but the owner forced her. Once, he threatened her with a gun and told her not to leave the room again. Many of her customers were uniformed police and soldiers.
"Kyi Kyi" worked every day and had at least four to five clients a day. If she did not agree to a client or his demands she was beaten by the owner. She tried to escape in 1991, but the owner caught her and took her to the kitchen and beat her with a very thick wooden stick. The owner told her if she tried to escape again, he would shoot her with a gun. He then took a pistol out and put it to her head and said, "Like this."
Five days after arriving at the brothel, "Myo Myo" had to take Thai clients. At that time, she tried to escape. The client slapped her and held her back. She finally ran out of the room. Two pimps and the owner caught and beat her. Thu Za [wife of the brothel owner] told her to be quiet and try to do what she was told so she would not get killed.
Other times, owners simply remind the girls that they are trapped until they work off their debt.
When "Tin Tin" was first brought to the Sanae brothel in Klong Yai, she was told to go into a windowed room and given a number. Then she realized it was prostitution and she did not want to do it. For a month, she tried to refuse. During this time she saw others slapped in the face and hit hard. She knew she had no choice. The owner and pimps were always saying, "If you want to go home then you've got to work or you'll never pay back your debt." Then she was given a client and sold as a virgin. That month she had four clients all paying for her virginity. She was always kept in a special room for the virgin period. She never dared to say no to a client or leave him once in the room. She saw other girls come out before a client and the pimps beat them. She did not want to agree to anything. It was all forced.
After the initial period when the girls are sold as virgins to just a few men, the number of customers multiplies, sometimes to as many as ten to fifteen a day, any of whom could be a source of infection. As a result, a majority of Burmese girls who start out as young, "clean" virgins become infected after working in the closed brothels after about six months. (171)
What emerges from our interviews is a pattern of transmission from male customers to young girls that shatters the common perception that prostitutes are the "source" of HIV/AIDS. To be sure, once infected, the Burmese girls in the brothels are likely to infect their customers. But whereas their clients can choose to use condoms and to abstain from sex, the women and girls have no such choice; they are captive partners.
B. THAI GOVERNMENT ACCOUNTABILITY
The Thai government is well aware of both the plight of Burmese women and girls trapped in forced prostitution and the danger posed by the AIDS pandemic. But it has consistently failed to investigate and prosecute police officers and other traffickers who are implicated in the illegal trade in women and girls. Moreover, the government's two-fold strategy for combatting AIDS -- law enforcement and health intervention -- for the most part targets Burmese women and girls as illegal immigrants and vectors of transmission, while largely exempting procurers, brothel owners, pimps and clients from punishment under the law. As indicated by the girls' extremely high rates of infection, the strategy has utterly failed to put an end to human rights abuses that result in the Burmese women and girls becoming HIV-infected.
The central government has long been aware of the existence of illegal brothels but has been slow to address the health risks to the women and girls in them. Until 1991, the Thai government resolutely ignored the problem. For example, in 1990 then Prime Minister Chatichai Choonhavan refused to chair a 1990 AIDS conference because he feared it would create panic. His administration also tried to prevent concerned groups, including NGOs, from addressing the spread of AIDS publicly. (172) This was motivated in part by denial, since AIDS at first was perceived as a "foreigners' disease."
A more reprehensible reason for official inaction was a desire to protect the tourism industry, of which sex tourism is a major component, against a slowdown in demand stemming from fears about HIV/AIDS. The sex industry constitutes a wealthy and powerful lobby group whose interests cannot be easily ignored in the formulation of official policy regarding trafficking and prostitution. Political pressures aside, by attracting visitors who bring in foreign exchange, sex tourism has been a significant source of income for the Thai government itself, not just the traffickers, brothel owners, and individual complicit officials. (173)
Beginning in 1989, the Ministry of Public Health adopted an aggressive policy of seeking to place "a box of one hundred condoms in every bedroom of every commercial sex establishment, especially low-fee sex establishments, at no charge." (174) But it was not until Chatichai was deposed by a military coup in February 1991, and an interim administration established under then Prime Minister Anand Panyarachun, that the government began a serious and aggressive AIDS prevention and education campaign. Anand took several important steps to control HIV/AIDS. He created the AIDS Policy, Planning and Coordination Bureau within the Prime Minister's Permanent Secretary's Office to coordinate HIV/AIDS prevention. Anand also appointed Mechai Viravaidya, a leading proponent of AIDS education and condom use, to the National AIDS Committee. Finally, his administration formulated an inter-agency approach, with technical and human rights guidelines, to control the pandemic which is laid out in the "National AIDS Prevention Plan for 1992-1996." (175) Anand Panyarachun was only the second head of state in the world to decide to chair a national AIDS committee.
Since the restoration of a democratically elected government in September 1992, the national HIV/AIDS program appears to be undergoing further change. Leadership of the program has reverted back to the Ministry of Public Health and budget allocations for AIDS prevention to other ministries have been scaled back, with still unclear results. The National AIDS Committee has not met since 1991. (176)
In any case, until the Burmese women and girls are freed from sexual bondage, the government's large-scale condom distribution campaigns are of no help to them. Condoms are irrelevant where no capacity to negotiate sex exists. For condoms to aid in the prevention of HIV transmission, they must be used during every act of intercourse. In addition, the women and girls have to be able to negotiate the number of customers accepted each day. Otherwise, the use of condoms could heighten the probability of HIV infection. When girls are forced to have sex with many customers each day, condom use often leads to friction sores which may facilitate viral transmission. (177)
Moreover, the effect of attempting to address the health concerns of the women and girls unaccompanied by a vigorous campaign to free these women and girls who are held in the brothels through bondage, illegal confinement and threats or use of physical force, and to prosecute their abusers to the fullest extent of law, amounts to the state winking at sexual slavery.
The failure of the central government to enforce the law puts local health officials in a difficult position. If they refuse to enter the brothels, they may be knowingly contributing to the spread of a grave public health hazard and failing to provide medical care to those in need. If they enter in their official capacities and declare the women and girls either "clean" or "infected," they appear to be rubberstamping an illegal industry. Many of the health officials are motivated by good intentions and carefully avoid any actions that might further jeopardize the well-being of the girls. But the ethical dilemma is a stark one: if they remain silent so as to avoid antagonizing the brothel owner and maintaining access to the women and girls in the brothel, they are failing to publicize abuses in the brothels and the danger of AIDS in a way that might prevent more cases from developing. (178)
That provincial health officials have to make the onerous choice between providing health care and exposing human rights abuses is intolerable. The national Crime Suppression Division and local police should be vigorously enforcing the anti-trafficking and rape provisions on the books so that health personnel would not have to make ethical compromises. Absent genuine law enforcement, there is little incentive for health officials to report suspected abuses. They cannot expect the police to conduct impartial investigations, given the known extent of police involvement in protecting prostitution rings.
Given the reality that the brothels will not be easily nor quickly eradicated, we do not advocate that all attempts to address the health concerns of the women and girls, including HIV testing, should cease. However, the Thai Ministry of Public Health must take all necessary measures to ensure that no further testing is conducted without the voluntary informed consent of the Burmese women and girls, that their test results are treated in the strictest confidence by authorized health personnel, and that the patients are told their test outcomes upon request. As of January 1994, this was not the case.
C. ABUSES ARISING FROM PERCEIVED OR ACTUAL HIV STATUS
Notwithstanding greater openness in Thailand's official efforts to address the AIDS pandemic, the government's treatment of Burmese trafficking victims suspected or known to have HIV/AIDS has resulted in further violations of their basic human rights.
Mandatory HIV testing
HIV testing of Burmese women and girls in the sex industry is conducted not for the purpose of estimating general HIV prevalence levels, (179) but rather to identify individuals who may be HIV positive or who have AIDS. It is frequently imposed on a mandatory basis, without informed consent, on women and girls working in Thai brothels, in detention at Pakkret, and reportedly by SLORC after deportation. Mandatory testing without informed consent is explicitly prohibited by both World Health Organization (WHO) Guidelines (180) and the Thai National AIDS Plan. (181)
Mandatory testing for HIV has no basis in either international or Thai law. On the contrary, it constitutes an unjustifiable interference with the individual's basic right to privacy. (182) The right to privacy is not absolute under international law. Governments may derogate from that right in order to protect public health, (183) but only if three stringent conditions are met. There must be "a specific law which is accessible and which contains foreseeable standards as opposed to administrative policy or individual discretion not based on legal rules." The law must be shown to be strictly required to serve a legitimate purpose of society for which there is a pressing need. And finally, the measures adopted must be the least intrusive and strictly proportional to the urgent purpose they are designed to serve. (184) Mandatory testing of the Burmese women and girls for HIV/AIDS fails to meet any of these conditions.
To begin with, Thai law does not authorize mandatory testing of prostitutes. In 1991, AIDS was purposefully dropped from the list of notifiable diseases in the Infectious Diseases Act of 1980, which authorizes public health officials to take draconian measures to control the listed diseases. (185) Additionally, the Thai AIDS Plan explicitly rules out compulsory testing under any circumstances unless informed consent is given by the individual concerned or by her/his legal representative. The only exception are military and police officials who have to enter into combat situations or confront dangerous persons. (186)
Mandatory testing is neither strictly required nor effective. Public health experts appear to have reached a consensus that mandatory HIV screening is not an effective means for slowing the spread of this infection. (187) For the Burmese in brothels, knowledge of their HIV status has no remedial value as long as they are living under conditions that amount to slavery. The most effective way for the Thai government to protect these girls from HIV acquired through forced prostitution is to secure their release from the brothels and ensure their safe passage home.
By opting to test on a compulsory basis all the Burmese who were "rescued" and placed in Pakkret and some of those in brothels, the Thai government has selected one of the most intrusive and least effective measures for AIDS control. Prosecution of specific traffickers, brothel owners, collaborators and customers would be more effective, as would public education (which does not depend on knowing the target audience's HIV status). Thus far, government-sponsored AIDS information campaigns have completely bypassed the Burmese and other foreigners.
HIV testing is an extension of an earlier system, predating the AIDS pandemic, that was created by the Ministry of Public Health to monitor Thai prostitutes. Provincial health officers were to test Thai women working in "entertainment places" about every three months for sexually-transmitted diseases. (188) With the onset of the AIDS pandemic, HIV testing was added in 1989; the women and girls reportedly are not allowed to refuse the test and must show their health card in order to work in these registered places.
HIV testing was later rescinded through the 1992-1996 National AIDS Plan which, on paper, embodies greater human rights protections. However, due to inadequate monitoring, mandatory testing continues in ways that violate not only the right to informed consent, but also patients' medical confidentiality and right to know their own health status.
The health card system was originally limited to Thai women in registered "entertainment places." But it appears that, over time, some local officials have expanded the system at their own initiative to include some Burmese prostitutes in illegal brothels. Despite the official termination of the entire health card system in September 1992, there are credible reports that health cards continue to be used at the local level. (189) Some of the Burmese we interviewed in January 1993 referred to their cards.
Testing in the brothels
As noted above, the Thai government policy banned mandatory testing in the 1992-1996 National AIDS Plan, which introduced guidelines for safeguarding human rights, including a ban on compulsory testing, a requirement of pre- and post-test counselling, and strict confidentiality of medical records. (190) But because monitoring is inadequate, forced testing of women and girls in brothels without their informed consent continues to depend on the inclinations of local authorities and brothel owners. Some of the women and girls we interviewed did not know why their blood was extracted, and only realized after they were lectured about AIDS at Pakkret that they had been tested for HIV at the brothels.
The operator of the brothel where "Nu Nu" worked took her to the doctor. She did not know who paid the medical bill, but she had to pay for her own medicine. She had a pink health card from the clinic she visited and the doctor tested her blood, but she was never told her results or what kind of medicine she was given. The doctor gave her health card directly to the brothel owner. She never had access to her own health records let alone the opportunity or ability to get them translated. She knew of AIDS from television. She thinks she contracted syphilis once, but she does not know if she has AIDS.
"Nyi Nyi" (one of the women described in Chapter II) was tested for AIDS once in the teashop-cum-brothel and once in Pakkret. She was never told the results. She only knew at the time we interviewed her that she used to weigh fifty kilograms and now she weighed thirty-six kilograms. She was often sick but only learned about AIDS at Pakkret. She was afraid of the doctor and injections.
"Thazin" was tested for AIDS four times in the brothel, but she had not known anything about AIDS before she got to Pakkret. They never told her the results of her test. She had never been to the doctor before [arriving in Thailand].
Testing in official custody
The majority of Burmese girls and women who are "rescued" from the brothels by Thai officials are sent directly to local police stations. While twenty-four of the thirty Burmese women and girls we interviewed were later sent from the local police station to Pakkret and two directly to emergency shelters, this does not reflect the general trend. The majority of Burmese women and girls are arrested as illegal immigrants and sent to an immigration detention center (IDC). At the IDC no routine health care is provided, and girls and women are only allowed to receive medical care when they can show visible signs of a serious health emergency. These is no routine testing or treatment for STDs nor the HIV virus. However, when girls and women are sent for emergency health services, it has become routine practice to test for the HIV virus without informing the patient, requesting their consent or informing them of the results.
As noted above, approximately 150 Burmese women and girls who were "rescued" from the Thai brothels by the central Crime Suppression Division, largely during the government crackdown on forced prostitution during June and July 1992, were sent to Pakkret reformatory as part of an official repatriation. They were systematically tested there by public health personnel, even though this is not recommended by the National AIDS Prevention Plan, much less legally codified. They were mandatorily tested and although they received AIDS information, the testing was done without pre- and post-test counselling, and usually without being told their test outcomes.
"Nu Nu" had her blood tested three times at Pakkret without being informed of the results, but she, along with other girls there, were told a lot about AIDS. She does not know what will happen to her once she is deported back to Burma.
"Tar Tar" was tested for AIDS in Pakkret. The matrons told them they were all HIV positive and to use condoms with anyone they loved. She did not know if it was true or if the matrons at Pakkret were just trying to scare them.
"Thazin" was also tested at Pakkret and again at an NGO shelter in Chiangmai, but was never given the results.
Testing at the Temporary Shelters
Several hundred of the Burmese women and girls who are "rescued" from the brothels have been placed under the temporary care of nongovernment emergency shelters. While receiving medical care, they are also tested for HIV at these shelters. From the perspective of the NGO shelter staff, testing is needed because the girls are living in close quarters and the "house parents" should know their HIV status in order to take the proper precautions.
No Voluntary Informed Consent
Mandatory testing is conducted without informed consent. Eleven of the thirty women and girls we interviewed reported having been required by the brothel owners to undergo screening at least once, either at the brothel or at a clinic. All nineteen who were sent through Pakkret said that they were tested while detained there.
"Aye Aye," aged nineteen, who was sold to an agent at the age of fourteen, said that the brothel owner took her and other girls to be tested. He never told her the results, but she never got sick. She was also tested at Pakkret.
"Nwe Nwe," a fourteen-year-old, said a doctor took her blood every week at the brothel, and she was also tested at Pakkret without being told the results.
"Chit Chit" was tested four times in the first brothel in Chiangmai where she worked. Then she was tested twice while in another brothel in Bangkok. After her arrest by plainclothes policemen, she was tested again in Pakkret. She was never given the results from any of the tests.
"Tar Tar" was tested for AIDS three times in the brothels (twice in the Hotel See Tong brothel and once in Dao Kanong brothel). After her blood was taken she never saw the doctors again and never heard the results.
Breach of Medical Confidentiality
After being forcibly tested, the Burmese women and girls are routinely subjected to the further indignity of having their own test results withheld from them, even when they are aware that they have been tested for HIV and request to know their status. Knowledge of one's HIV status may be expected to enhance personal responsibility on the part of the Burmese women and girls, if not in the brothels where there is no freedom of choice, then after her escape or release from the brothels.
The testimony of "Tar Tar" and others described above is echoed by many others. All the Burmese women and girls we interviewed had been tested for HIV by, or at the behest of, the brothel owner, Pakkret reform house staff or the personnel at one of the emergency shelters. In all thirty cases, the women and girls themselves were never informed of their official test results. As a result, some may have received inaccurate unofficial information. For example, one girl was given her status off-handedly while her blood was being drawn in the brothel, but before the serum sample was even analyzed. Another learned of her status through a rumor circulated by non-medical staff at Pakkret. At least one girl was told casually that she was HIV negative when, in fact, according to an NGO, her health card indicated that she was positive.
Although the results were withheld from the women and girls, public health staff and at times, government officials, had the medical records. While there is no substantive Thai law on privacy, health professionals can be held criminally liable under the Thai Penal Code for breaching patient confidentiality. Section 323 of the Penal Code states:
Whoever discloses any private secret which became known or communicated to him by reason of his functions as a competent official or his profession as a medical practitioner shall be punished with imprisonment not exceeding six months, or fine not exceeding one thousand baht, or both. (191)
Moreover, both internationally-accepted guidelines as well as the National AIDS Plan emphasizes confidentiality as an imperative ethical norm in dealing with HIV/AIDS. According to the U.N. Centre for Human Rights and WHO, "a policy permitting or requiring the disclosure of the results of HIV tests to third persons without consent...amounts to an interference with privacy." (192) The Thai National AIDS Prevention Plan contains a similar injunction against revealing HIV status without the full and explicit consent of the infected person. (193)
In flagrant violation of these legal and ethical standards, Thai health officials fail to hold the HIV test results of the Burmese in the strictest confidence. Rather, they occasionally share them with people who have no medical reason to know. It is particularly reprehensible that brothel owners, who have repeatedly demonstrated their callous disregard for the women and girls' health, are sometimes given the test results of the Burmese under their control. (194)
Under the health card system, the HIV test results of women in registered "entertainment places" were required to be recorded on individual color-coded cards: pink if HIV negative, brown if positive. "HIV" (along with other STDs) are also stamped in large letters on these cards, which are accessible to brothel owners, health personnel, customers, and others. In the case of Thai prostitutes, brothel owners have exploited their knowledge of the women's HIV status in one of two ways: to maximize profit from "clean girls" by charging higher prices for them, or to expel those found to be infected.
The health card system, which continues in some places despite its official cancellation in November 1992, also invites abuses because few health officials take it seriously as an effective weapon against AIDS. So they either do not vigorously enforce mandatory testing, or are easily bribed into ignoring it. Brothel owners rarely have trouble negotiating a certificate of good health. Some even "have fun with pink cards" by arranging to have them arbitrarily stamped every week or month to "verify" that the girls are "clean." (195)It is a criminal offense under Thai law to falsify official documents when such an act is likely to have harmful consequences. (196) In practice, the customers rarely ask to see the cards. But when they do, the girls or brothel operators can show any card they want. In some of the more restrictive brothels, if a girl tests positive she continues to work but is simply no longer sent for screening. (197)
At the time of our research, Burmese women and girls who were placed under the care of temporary shelters after being "rescued" also were not told their test results by the staff of the NGOs. This has been a difficult decision for the NGOs to reach, and was made primarily because they feel that there is very little that either they or the Burmese girls can do with the information after repatriation.
Condoms were illegal in Burma until the end of 1992. (198) Health services in Burma are believed to be rudimentary, and Thai NGOs are well aware of reports of discrimination against and abuse of HIV positive persons in Burma. Those NGOs have no resources to hire and train Burmese interpreters and staff in AIDS intervention and counselling.
These concerns must be weighed against the merits of disclosure. In addition to respecting the Burmese women and girls' right to know their own test results, policymakers should fully consider the roles that women and girls working as prostitutes have beyond the brothel. At the 1989 International Conference on the Implications of AIDS for Mothers and Children, the assembled ministers of health stressed the importance of ensuring "that all HIV infected women receive appropriate information...so that they can personally make informed decisions about child-bearing". (199) According to one doctor, "full disclosure -- ideally with Western blot confirmation -- permits self-protection, the protection of others, and the possibility of treatment should future therapeutic breakthroughs occur." (200)
Discrimination
Mandatory testing also amounts to de facto discrimination against prostitutes. (201) Individual doctors may have different reasons for conducting mandatory testing, but the official policy, which has its origins in the STD/HIV screening system, is primarily intended to make female prostitutes safe for their clients.
According to Dr. Saisuree, the health certificates placed all the burden on prostitutes to look after their health and made male customers complacent about the need to protect themselves from contracting AIDS. (202) This is most clearly illustrated by HIV testing at Pakkret. Against all established international and national guidelines, female prostitutes who are sent there are systematically tested, often repeatedly. Yet, the customers, pimps and brothel owners associated with the brothel from which the women are "rescued" are not subjected to mandatory screening, even though male-to-female transmission of HIV is at least three times as efficient as female-to-male transmission. (203) We do not argue that the men should be tested without voluntary informed consent, but rather that all testing that does not conform to WHO guidelines, and that only targets certain populations, must stop immediately.
The different medical confidentiality standards that apply to prostitutes versus men at STD clinics who are selected for national sentinel surveillance also have a disparate impact on women, who are the overwhelming majority of prostitutes. Under the National AIDS Plan, men who attend STD clinics are tested on an unlinked anonymous basis, providing the highest assurance of confidentiality. In contrast, prostitutes, in theory, are tested on a voluntary confidential basis. (204) In practice, they are not guaranteed even this much.
The health card system, too, mirrors the government's discriminatory tendency to blame prostitutes for infecting their customers. Thai prostitutes who test positive are supposed to be encouraged to abandon the sex industry and be escorted back to their home village by the police. (205) Even though the customers are participating in a business euphemistically called "entertainment," Thai authorities apparently believe that they deserve to be protected at government expense from further risk of infection. By contrast, no HIV/AIDS care or alternative employment opportunities are guaranteed by the government to the women who are returned home.
The above violations fly in the face of a growing international consensus among many public health experts that the public health and human rights interests are mutually reinforcing in the fight against AIDS worldwide. (206) Respect for the human rights of people with HIV or AIDS contributes to the achievement of public health objectives -- limiting the spread of HIV, treating those with HIV or AIDS, and finding a cure -- by creating a safe climate for people to seek medical counselling and voluntary testing.
Conversely, mandatory testing drives people who may be infected and most in need of counselling underground, away from health care providers. Moreover, mandatory testing instills a false sense of security by giving the misguided impression that all those infected can be identified, and that everyone else is safe. (207) If this leads to a relaxation of personal vigilance against infection, the spread of HIV/AIDS may be accelerated.
D. WITHHOLDING INFORMATION ABOUT HIV/AIDS
Despite the central government's official position of greater openness in acknowledging and addressing the AIDS pandemic through mass media campaigns in the last few years, foreigners from neighboring countries -- a majority of whom are Burmese -- have not been a target audience.
While the Burmese women and girls in the closed brothels are trapped in virtual slavery, unable to negotiate any aspect of their situation or count on police protection, information on AIDS is admittedly of limited practical use. Nonetheless, it is one of their only remaining lines of defense against contracting and transmitting the AIDS virus. AIDS education for the Burmese will help them assert some control over their lives by informing their decisions about marriage and children when they are eventually repatriated to their home villages. And information for the general public, including potential male customers, may hopefully deter some from high-risk behavior. Both the World Health Organization's Global Program on AIDS and the Thai National AIDS Prevention Plan lists public information and education as critical elements of the fight against AIDS. (208)
The Thai government has thus far failed to summon the necessary political will and financial resources to reach Burmese women and girls in closed brothels. Brothel operators are allowed to dictate the terms of access for health educators. At the same time, the language barrier remains a major obstacle: most Burmese women and girls do not speak or read Thai; many are illiterate even in Burmese. There are no official educational materials in the Burmese language, whether written pamphlets or public service announcements for television or radio, the latter two being the most common sources of information for our interviewees.
Our findings indicate that only a small percentage of the Burmese women and girls have any knowledge about HIV/AIDS. They are the approximately two hundred who were sent through Pakkret between June and August 1992. One interviewee, "Nilar", who worked in a Bangkok brothel for seven months, said, "the girls talked about it [AIDS] at the brothel, but it was like a rumor." It was not until "Nilar" was placed in Pakkret that she was told how serious AIDS is, saw pictures and got a full explanation. Most of the Burmese women and girls who have been routinely charged as illegal immigrants and jailed in immigration detention centers reported not knowing anything about HIV/AIDS except for rumors or radio spots all in Thai which they do not fully understand.
An independent 1992 study by Hnin Hnin Pyne revealed many misconceptions about HIV/AIDS among Burmese prostitutes in Ranong:
One group of women explained that the virus has little horns and is very "quick" and "strong." Another added that it cannot even be killed in boiling water...Some women believed they are protected from the virus, because they receive "injections" every three months. This is not unusual since it is a common belief among most Burmese villagers that a "shot in the arm" is a cure all. (209)
The Thai government's record in educating the Thai public about AIDS is considerably better. Even so, local officials in some areas have suppressed attempts by public health personnel to disseminate AIDS information.
Given the extreme rates of HIV infection among Burmese women and girls forced into prostitution, and Thai police complicity in protecting the trafficking rings, the Burmese deserve far more public health attention from the Thai government than they currently receive.
E. TREATMENT ON RETURN TO BURMA
The ordeal of the Burmese women and girls continues on the Burmese side of the border. In addition to fears of punishment by SLORC for unauthorized emigration and involvement in prostitution, both of which are prohibited under Burmese law, the returnees also have reason to be concerned about persecution against persons with HIV or AIDS. According to a report by the Burmese Department of Health in collaboration with WHO, UNDP and UNICEF, some population groups in Burma are tested on a mandatory basis, including "Myanmar [Burmese] citizens returning from abroad..." The report concludes:
Not only are these practices not in accordance with individual rights and WHO regulations to which the Government of Myanmar [Burma] has subscribed, but they are also detrimental to the [AIDS] Program efforts to limit the spread of HIV among the Myanmar population... The Review would like to stress that there is no technically justifiable reason for mandatory testing (except for blood donations) nor for active case finding of HIV infected persons. (210)
Among its recommendations for implementation of Burma's sentinel surveillance program, the Review Team stressed that "case finding is only justified for diagnostic purposes, or on request by the individual itself, provided that strict confidentiality or anonymity are guaranteed." (211)
The group of ninety-five Burmese women and girls who were deported under the official bilateral agreement on September 15, 1992 were mandatorily tested for the AIDS virus by SLORC officials after their arrival in Burma. As noted above, thirty-two women (and one baby) were found to be HIV positive. These women were given a special lecture and told to return every month, even though some came from poor families living far away from the academy. On November 19, 1993, Burmese Deputy Foreign Minister U Nyunt Swe claimed that fifty-two women who were uninfected had been returned home. The rest remained at the Police Academy for unspecified medical treatment. We learned in September 1993 that all were subsequently released.