Railways and AIDS Prevention, Myanmar

Summarised from the article " Railways and AIDS prevention: the Myanmar experience" by Dr Kyaw Wynn, Chief Medical officer, Myanmar Railways, published in AIDS Watch, the newsletter from WHO South-East Asia Region on STI, HIV and TB. May-August 2000.

For further information, contact AIDS watch, HSI and STB Unit, WHO, Regional Office for South-East Asia , World Health House, IP Estate, New Delhi 110 002, India. Tel: +91 11-331 7804 to 331 7823. E-mail: aidswatch@whosea.org. Website: http://www.whosea.org

The railways are a major mode of passenger transport in Myanmar. Many of the railway staff have to travel long distances and are away from their families for a long time. This leads to a tendency among some to engage in risky behaviours that might lead to HIV/STI transmission.

It was therefore decided to initiate a programme with the objective of promoting awareness and knowledge of HIV/AIDS and reducing the risk behaviour related to HIV transmission among railway workers and their partners.

The programme began with advocacy and orientation sessions with key functionaries of the Railway ministry at the headquarters and thereafter in different departments. After gaining commitment and support at the policy and management level, a training of trainers' workshop was held for 30 participants. These core trainers, selected from various departments, further trained 300 peer educators.

The peer educators were selected on the basis of good inter-personal and communication skills, aged between 25 and 35 and their ability to command respect from colleagues.

At the start of the project , a training manual, focused on the workforce, was developed by the railway authorities in collaboration with the National HIV/AIDS project. Also, a baseline survey was conducted to ascertain the knowledge and risk behaviour levels among railway employees before the programme began.

The baseline survey showed that awareness about HIV/AIDS was very low, at about 17% and there were many misconceptions among the workers. A post peer education survey revealed that awareness had increased to above 85% and the misconceptions were greatly reduced. Over 95% of the workers interviewed could say that use of condoms, having only one sex partner, sterilising needles and screening blood before transfusion could prevent HIV/AIDS.

The project covered 20,000 workers, and 5000 families indirectly received messages on HIV/AIDS. Posters and other communications materials were used. A short film on HIV prevention in the railway setting is being produced. This project provides a good example of intervention at the workplace, something other countries in the region may consider applying in their own settings.