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 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 no

t 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