Seafarers are one of the populations worst hit by HIV/AIDS in the Mekong subregion, with prevalence rates among them reaching as high as 22% in some places. Seafaring communities are becoming extremely vulnerable, while HIV/AIDS is spreading faster from port to port, from country to country and from coastal towns to communities far inland.

A New Approach

The Joint Seafarers Initiative was established by the UNAIDS Regional Task Force on Mobile Populations to identify new strategies and entry points for work with seafarers that respond to the reality of their mobility, life patterns and social networks. UN agencies – with UNICEF taking a prominent role – government agencies, NGOs, community organizations and private businesses have joined forces to design collaborative national and cross-border action plans and implement a range of linked projects and services targetting seafarers and seafaring communities.

A trawler crew relax on board their boat before their next trip

Work Hard – Play Hard

"When they work, they look like elephants – hard working! ... When they sleep, they look like rats [in their cramped quarters]." – Htay Tint, Shore Leave

"Some of us would spend a whole week in the brothel. ... We could spend 10,000 or 20,000 baht (US$220-$440)" – a former Thai seafarer, Shore Leave

The traditional image of seafarers – hardened by back-breaking, often dangerous labour and battling the elements; tireless workers while at sea, rowdy while ashore – still holds true in East Asia and Pacific. Responding to the demand, cheap commercial sex, alcohol and, often, illicit drugs are easily accessible in ports and surrounding communities. Combined with many seafarers' low knowledge of HIV/AIDS prevention, this situation leads to high-risk behaviours.

Myanmar seafarers learn how to use a condom correctly

Seafarers are particularly hard to reach with HIV/AIDS prevention activities. They generally leave school very early, so school-based programs have little impact. They often work and stay far from their home villages – even communities in landlocked Lao PDR have produced generations of seafarers.

The search for employment often takes seafarers to neighbouring countries, where they are undocumented and live with the constant threat of arrest or deportation. Thailand in particular attracts many seafarers from Myanmar and Cambodia, because local people have opportunities for safer, easier and more lucrative jobs.

Rapid Assessment

The first stage of the Joint Seafarers Initiative was a rapid assessment of seafarers' vulnerability in the Mekong subregion, carried out by local government-NGO joint survey teams with support from UNICEF.

The teams interviewed seafarers and their families, sea captains, port authorities, police, sex workers, pharmacists and others in the seafaring network on a range of topics, including:

• Seafarers' routes, schedules and ports of call;
• Their risk behaviours while on shore;
• HIV/AIDS awareness among seafarers, their families, sexual partners and social/professional networks;
• Where seafarers seek health information and care.

The rapid assessment covered four countries – Cambodia, Viet Nam, Myanmar and Thailand – and was supported by UNAIDS-APICT, UNICEF and the UN Drug Control Program, with additional funding from Family Health International and the Ministry of Public Health in Thailand.

Helping seafarers means helping their families too

Action Plans

In September 1999, UNICEF gathered the country working groups in Bangkok at the UNAIDS-APICT Conference on Seafarers in Bangkok, to compare results and discuss the way forward.

Following the Conference, the working groups drafted collaborative action plans for integrated programs on seafarers, HIV/AIDS and drugs. The plans outline the roles of each of the main partners. There are also built-in plans and structures for collaboration between countries, through border committees or sharing between agencies.

Seafarer Projects

The Seafarers Initiative involved collaboration and coordination between a wide range of agencies, guided by the action plans. UNICEF currently supports a number of projects targetting seafarers and seafaring communities in Thailand and Myanmar:

Thailand

In Thailand, UNICEF supports a 12-month project implemented by Raks Thai to review, update and identify the best of existing education materials and training curricula for seafarers (particularly Myanmar and Cambodian) and for the providers of public and private-sector services for seafarers. Raks Thai has compiled and is disseminating materials, assessment tools and research methodologies through training workshops in Thailand and Myanmar. Under the same project, Raks Thai has facilitated the participation of government and non-government agencies in the southern provinces of Songkhla and Pattani in the Seafarers Initiative.

Thai Business Coalition on AIDS (TBCA): TBCA has developed advocacy presentation and support materials for management in seafaring and related industries. The project held consultations in Ranong and Songkhla, and worked closely with the Raks Thai and World Vision Thailand projects.

Seafarers visit a CARE HIV/AIDS information stall at a temple fair in Kawthaung, Myanmar

Myanmar

World Vision Myanmar: A trial of three different approaches to providing care and support to people with HIV/AIDS and their communities, with an emphasis on primary health care. The project sites are Kawthaung, a major Myanmar port opposite Thailand's Ranong, and Myeik and Dawei, two important source communities for seafarers in Kawthaung or further afield. An important activity has been translation and adaptation of the UNICEF With Hope and Help self-care manual, incorporating experiences and advice from people living with HIV/AIDS in Myanmar.

CARE, Myanmar: A range of communication and education activities on HIV/AIDS awareness, prevention and care issues. CARE has joined the travelling circuit of pagoda festival performers with an interactive education stall providing games and information, and a traditional performance troupe. Other activities include training workshops on HIV/AIDS and related issues for families and communities and for organizations working in prevention, care and support.

All of these projects are funded through EAPRO's Regional Grant Facility from AusAID funds.