US embassy cable - 02RANGOON1648

C O N F I D E N T I A L SECTION 01 OF 02 RANGOON 001648 
 
SIPDIS 
 
STATE PASS AID/ANE, HHS FOR OGHA - STEIGER 
STATE FOR EAP/BCLTV, EB, AND IO 
PHNOM PENH FOR AID - CAROL JENKINS 
CINCPAC FOR FPA 
BEIJING PASS CHENGDU 
 
E.O. 12958: DECL: 12/25/2007 
TAGS: EAID, SOCI, ECON, BM, Human Rights, Ethnics, NGO 
SUBJECT: NGOS HARD AT WORK IN KACHIN STATE 
 
REF: A. RANGOON 1585 
 
     B. RANGOON 1571 
 
Classified By: DCM RONALD MCMULLEN FOR REASONS 1.5 (B,D) 
 
1. (SBU) Summary:  International NGOs (INGOs) are working 
well in Kachin State.  Though few in number, they are 
providing urgently needed programs for HIV/AIDS, malaria, 
tuberculosis, and rural health care.  There are some types of 
aid programs, and geographic regions, that remain out of 
reach for the INGOs.  However, if the INGOs' good relations 
with local officials persist, additional progress is likely. 
End summary. 
 
HIV/AIDS:  Good News and Bad News 
 
2. (SBU) INGOs in Kachin State (Burma's northernmost state, 
with a population of about 1.2 million) are focusing almost 
exclusively on health care -- testing, basic provision, and 
education.  On the HIV/AIDS front, there is some good and bad 
news.  On the positive side, the INGOs working most directly 
on HIV/AIDS agree that there is increasing acceptance and 
usage of condoms by sex workers.  Furthermore, pimps are in 
many cases now taking the side of the sex workers in trying 
to convince clients to use condoms. 
 
3. (SBU) Despite these positive indicators, INGOs report that 
sex workers are still willing to go without condoms if the 
money is better or if the sex worker "like" the client. 
Also, because of the combination locally of very high poverty 
and a small class of very wealthy Burmese and Chinese 
business people, the population of sex workers in Kachin 
State is growing as quickly as in Rangoon.  HIV infection 
rates are also very high among sex workers.  One INGO 
estimated a HIV infection rate of around 50 percent among a 
population of sex workers in a local disco. 
 
TB: Cases Up, But So Is Treatment 
 
4. (SBU) On the tuberculosis front, there also seems to be a 
mixed bag.  One INGO that is active with TB testing and 
treatment says that it is finding more cases of TB, but that 
more and more people are coming in for testing and treatment. 
 The problem of TB is compounded, INGOs agree, by the 
slumping economy as many people do not have enough to eat, 
and are thus more susceptible to TB (and other debilitating 
diseases) and slower to recover. 
 
Good Cooperation with the Authorities -- So Far 
 
5. (C) INGOs report that relations are good with local 
government authorities in Kachin State.  The local health 
director has given tacit permission for NGOs to provide 
services that the government is supposed to be providing, but 
does not (for example TB testing and treatment).  Usually, 
local health officials are frightened of taking any 
initiative to allow NGOs to provide any parallel services 
(even if the government in fact is not providing these 
services).  Relations are also good with the Northern 
Military Command's chief medical officer (who apparently 
speaks English quite well and is a fan of the BBC).  However, 
the military has not allowed INGOs access to the military 
hospital in town. 
 
6. (C) A true test of the local authorities' willingness to 
let the INGOs provide essential services will come in the 
area of intravenous drug use (IDU) intervention.  This is a 
very sensitive proposition in Burma, with needle exchange and 
substitution programs still illegal.  In Kachin State, one 
INGO operates a very unofficial and subterranean needle 
exchange program in Mogaung (about 50 miles from Myitkyina), 
which relies on the local police turning a blind eye.  The 
INGO is trying to start a similar exchange program in 
Myitkyina, but is facing more police scrutiny.  There is 
clearly much potential, and need, for an expansion of harm 
reduction in the Myitkyina area, but there must be 
significant discussion beforehand with the various local 
authorities. 
 
Neediest are out of Reach 
 
7. (SBU) Despite the successes and access they have had, the 
INGOs agree that the remotest 25 percent of the state (along 
the border areas controlled by Kachin cease-fire groups) has 
the most urgent need for humanitarian assistance.  However, 
these regions are still mostly out of their reach.  Of the 
INGOs, World Concern seems to have the best access to the 
remoter areas.  However, funding problems have forced it to 
scale back its operations.  Some of Kachin State's indigenous 
NGOs may also be getting to these areas, but not to provide 
health care services.  There are also rumors that 
church-based NGOs operating in China,s Yunnan Province 
occasionally cross the border to provide some services (of an 
undetermined nature) in neighboring Kachin villages. 
Comment 
 
8. (SBU) Kachin State would be an excellent laboratory for 
any expansion of U.S. humanitarian aid programs -- especially 
for building the capacity of local NGOs.  The INGOs in place 
are well-established, have clear and reasonable objectives, 
and have good working relations with the necessary 
authorities (without relying upon them).  Likewise, the local 
NGOs in Kachin State, unlike their cousins in Rangoon, seem 
to be comparatively independent of government control and 
influence.  Part of this is certainly the result of the 
current personalities in key government positions in Kachin 
State.  Another important factor is the relative unity of the 
Kachin people, and their leaders' so far successful balancing 
act of keeping good personal relations with the government, 
while retaining a relatively independent program of community 
development.  End comment. 
Martinez