Important note: Information in this article was accurate in 2003. The state of the art may have changed since the publication date.
Bangkok Post - July 22, 2003
"How can I take care of my child with no money, no work, nowhere to live?" she said, tears welling up her eyes. "I'm so confused. I don't know what to do."
Like many other female migrant workers, the 24-year-old Shan woman became pregnant because she did not have access to family planning services and information. Now in the last week of her pregnancy, she has never gone to a doctor for prenatal care. Fear of arrest and repatriation stops underground workers from seeking reproductive health services.
The situation is not much better for female workers who are registered. Although they are entitled to use the 30-baht medical care services, few do, owing to language barriers, high transportation costs, and employers' unwillingness to accord them time to go to the hospital.
Many choose to end the pregnancies through primitive methods, with folk healers or quacks. Many suffer serious complications. Many have died from unsafe abortions.
Lack of information about safe sex, and lack of and health services, has also led to an increase of HIV and Aids infection among immigrant workers. And without access to Aids medicines, they suffer lonely deaths.
It was not how Mi Shan, 35, wanted to end her life. A housewife, she contracted the virus from her husband, who worked on fishing boats. Before her last days, friends donated a sum of money to send her back to Burma so she could die back in her home village as she wished.
There are no accurate figures on unplanned pregnancies, abortion or HIV infection among immigrant workers, most of whom live and work underground. But the scant information available in scattered places is alarming.
In the coastal province of Samut Sakhon, for example, it is estimated that about three to nine percent of the Burmese migrant workers on fishing boats are HIV positive. Condoms are not used within marriage so wives easily contract the virus.
At the Mae Tao Clinic for migrant Burmese in the border town of Mae Sot, the proportion of teen pregnancies among migrant Burmese women has risen from 18.8 percent in the first half of 2000 to 26 percent in 2002. Meanwhile, cases involving complications from abortions comprised over one-third of normal deliveries in 2002. HIV infection is also rising steadily among patients - from 0.8 percent to 1.5 percent, while syphilis has risen from 1.2 percent to 2.7 percent.
Another health organisation put HIV infection rates among the predominantly Burmese sex workers in Mae Sot at 20 percent. Nationwide, Dr Sanchai Chasombat of the Aids Division, Public Health Ministry, estimated HIV infection among migrant sex workers at 15 to 50 percent.
There are no available figures on mother-child HIV transmission or on sexual and domestic violence. But many migrant workers have sad stories to tell about people they know - or about themselves.
Khamtann, a Shan former sex worker, still has black eyes from her Thai husband's violent temper. Her body is bruised and blue. She is three months pregnant.
"I often thought about going home to see my mother," she said, lifting her head to prevent the tears from falling. "But I can't."
Stuck in limbo, Khamtaan, as an illegal migrant, cannot go out anywhere and must be confined in a small room in Bangkok, living in fear - not only of the police but also her own man.
Fear of arrest also stops her from seeking prenatal care during pregnancy.
In another corner of the country, but stuck in the same limbo, Hom comforted herself that she is at least still more fortunate than many of her Shan sisters.
"My friend Oo was sold to a brothel in Bangkok. She was forced to sleep with more than 30 men a day. If she refused she got beaten.
"She finally succeeded in running away back to Chiang Mai. She called me. I was shocked. I just couldn't recognise her. She had become so pale, so thin, and she was hysterically crying all the time as if she had lost her mind.
"She didn't know where she was in Bangkok. But the brothel was full of Shan women. My friend came to Thailand because her husband left her with a small child and she needed to support the family.
"She missed the child, and her mother. She cried and cried, saying all she wanted was to see them again. I don't know what happened to her. I have never heard from her since."
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