Prevention of HIV/AIDS Among Migrant Workers in Thailand

Strategies & Activities

Drop-in Centers


	Drop-in centers are one of the prominently successful strategies being used in PHAMIT. Drop-in centers play a multiple role by providing a place for migrant workers and members of their community to meet and relax, while giving them a central location to access important health and rights information and services. In some locations, drop-in centers even act like community centers.
	Rest and Relaxation
	Because migrant workers are difficult to reach, especially fishermen, who are highly mobile and spread out, relying solely on outreach limits coverage. Additionally, migrant workers, especially fishermen, usually have nowhere to rest except places that serve alcohol. By offering a safe place to relax, drop-in centers attract migrant workers, especially fishermen, and members of the migrant community in greater numbers than if the centers just provided services.
	Drop-in centers fulfill an essential service by providing a safe place for migrant workers to go when they have free time. Most drop-ins have magazines from migrants' countries, board games, sports equipment, as well as movies and karaoke in migrants' language.
				Some drop-ins allow use of kitchen facilities and showers for fishermen who have no place to stay on land, and some provide temporary, emergency shelter for migrants who have suffered a setback or who have been ill and need a place to recuperate for a couple of days. Providing a place where migrants feel comfortable and can relax draws migrants to the drop-in centers on a regular basis, which leads to opportunities for giving information, activities, and other services.
	Health Information and Services
	The main function of drop-in centers is to provide health information and services. All centers supported by PHAMIT provide participatory activities and materials on HIV/AIDS, STIs and reproductive health in migrants' languages. IEC materials come from various sources, including implementers at the site, PHAMIT partner organizations from other sites, as well as organizations from migrants' home countries. Many of the materials produced by PHAMIT partners specifically target migrants by depicting their life in Thailand through drawings or video, and providing information in their language about HIV/AIDS and reproductive health. Free condoms are also made available from boxes placed in locations where migrants (or anyone else) can take them freely without embarrassment, often just in front of the door.
	Drop-in centers provide a safe location for activities without distractions (this sense of security is assured by introducing police and health officials to the centers' functions at the outset). All centers act as a location to provide migrant workers and community members with participatory learning activities on HIV/AIDS, reproductive health and other health or rights issues.
				The convenience of having activities at the centers allows for going into more depth than is possible in the field. Drop-in centers are also used to provide trainings to volunteers, and to bring active volunteers together to meet, discuss and plan activities. In other words, drop-in centers support both in-reach and outreach activities
	Referral to health services is also a primary service available at drop-in centers. When migrants need help in overcoming barriers that limit access to health services, they can come to the drop-in center where volunteers and staff can assist with arranging transportation, and provide translation at the hospital.
				Through partnerships with health offices, some drop-ins provide specialized health activities, such as vaccinations for children or mobile clinics. In other locations, basic health services are available on a regular basis, including treatment for basic ailments, first aid, and family planning consultation. At some locations, advice and services on mother and child health is provided in groups, including ANC services and child development.
	Migrants suffering from HIV/AIDS have voluntarily come to centers seeking help, while others have been sent, or abandoned in some cases, by their employer. PHAMIT drop-in centers assist migrants suffering from AIDS by providing them care, temporary housing, or by assisting them in accessing health services. At some locations, migrant PLHAs can even receive financial assistance for food, or to return home if requested.
	Community and Rights
				Drop-in centers located near migrant communities have expanded their services to include day care and basic education activities for migrant children. Educational activities include teaching Thai language as well as children's indigenous languages. It is essential to teach both languages. Thai is essential for children who may stay in Thailand, as being able to speak, read and write Thai is essential to entering the Thai educational system; while, speaking their indigenous language is necessary to prepare those who may eventually return to their home country. Rudimentary English is even taught at some centers.
	Activities for children also decrease the chances that children will end up working along side their parents, and ensure that children will be supervised while their parents are at work. Children's activities also teach proper hygiene and nutrition as well as track their physical growth. Some centers charge a small fee to the parents for these services to defray the cost of volunteers, food and supplies, and, to encourage the parents to “value” the service.
	Many centers are a place where migrants can go for counseling or assistance when they have a problem related to their work or health. Some centers provide services that assist with life goals such as Thai literacy classes or opening a bank account; other centers promote rights by providing information sessions about the registration system and labor rights, or providing referral to legal counsel.
	Some locations act as community centers, providing a location for community members to organize activities, such as clean-up crews for the neighborhood, or to come together to plan for social or cultural activities, such as for festivals and holidays. In some locations, social activities have brought together migrants and the Thai community by playing sports, contributing to community clean-up efforts, and having small fairs or cultural celebrations.
	Location
	As the key function of drop-in centers is to increase access to information and services, their location is essential to success. Many of the PHAMIT sites have opened drop-in centers close to where migrant workers live and work. Most drop-in centers are immediately adjacent the ports, in factory areas, or close to areas where karaoke bars are located. In other cases, centers are located immediately in or adjacent to migrant communities.
	Migrant volunteers staff most drop-ins. These long standing “volunteers” have already received a high level of training and are able to answer most questions migrants have about HIV/AIDS, STIs and reproductive health; some can even lead activities independently. Able to speak Thai, these volunteers assist with referral services and can explain registration and other basic issues regarding migrant rights. Having someone of their own language group overseeing the center also increases migrants' sense of “ownership” and comfort level, and encourages them to visit the centers freely. In some sites, two distinct language groups are present, such as Cambodians and groups from Burma. Some implementers have even opened two centers to accommodate the different groups. In other cases, the two groups mingle together freely, finding that they have more in common than they think.
Common Characteristics of Drop-In Centers
	The success of PHAMIT drop-in centers has been the ability of the centers to provide essential health and rights services, while serving the social interests and needs of migrant workers and their community. PHAMIT's drop-in centers have been successful because they
	Are located conveniently for target populations to access, such as in migrant communities or adjacent work places; Provide a safe place to rest, relax, meet others, and have recreational activities available; Act as a convenient and safe location to provide information and activities on HIV/AIDS, reproductive health, general health and rights in migrants' language, with condoms conveniently available; Act as a coordination point for volunteers to prepare and organize outreach activities and receive training; Act as a point to assist migrants in accessing general and specific health services for STI treatment, ANC / mother and child health, and family planning; Provide a point for PHA individuals or groups to come for support; Provide a location for migrants to support their community and culture, by cooking traditional foods, organizing social or cultural activities; Provide daycare and educational activities for migrant workers' children; Provide a secure place for migrants to go to support their life goals or when they have a problem and don't know where else to go.
	Summary of PHAMIT Drop-in Centers by Site
	Implementer	Sites by Province			Target Groups		Services Provided
							General Activities include: recreationalactivities; IEC materials; participatory activities on HIV/AIDS, STIs and reproductive health; volunteer trainings and meetings; condom distribution; and referral to health services
	Raks Thai Foundation	Nakkhorn Sithammarat			Fihermen and women in community (groups from Burma)		General activities Children's education
		Pattani 2 centers			Fishermen (Cambodians and groups from Burma); women in community (Burma)		General activities Children's education
		Samut Sakhorn (Mahachai) 3 centers			Fishermen, seafood processors,migrant community and children (groups from Burma)		general activities (3 centers) Reproductive and general health clinic (1 center) STI referral (2 centers) Mobile clinic (1 center) Children's vaccinations (3 center) Children's education (3 center) Cultural activities Legal and rights activities (1 center)
		Samut Songkram			fishermen,seafood processors,migrant community and children (groups from burma)		General activities Referral to border for PLHA
		Suratthani			Fishermen and housewives (groups from Burma)		General activites Children's education
	Center for AIIDS Rights (CAR)	Rayong 2 center			Fishermen and their families (Cambodians and groups from Burma)		General activities Mother and child health&famiplanning Mobile clinic services STI referral Child care and education Rights training/legal clinc Cultural activities Kitchen for cooking Showers
		Chonburi			Fishermen and their families (Cambodians and groups from Burma)		General activities Mother and child health& familyplanning STI referral Child care and education Rights training/legal clinic kitchen for cooking Showers
	Stella Maris Center	Songkla 2 center			fishermen ( 1 center for groups from Burma; 1 center for Cambodians)		General activities Kitchen for cooking Showers Membership cards and rewards Competetive sports with local community Safe house Community festival Children's vaccination
	Empower	Chiang Mai 1 main center 1 satellite center			Sex workers (groups from Burma,hill tribes, Chinese, Thais-all sex workers)		General activities Thai literacy class for mgrants (3 centers) STI monthly referral service General counseling services Volunteer trainings Workshops (3 centers) Model occupational safety roon Safe house
	Map Foundation	Tak (Mae Sot)			Factory workers (groups from Burma)		Lending Library General actvites Workshops Volunteer tranings
	Worlk Vision Foundation of Thailand	Tak (Mae Sot)			Factory workers and related communities (groups from Burma)		PLHA support group Peer trainer workshops Social networker trainings Referral across border for PLHA

	Each month (on average) 18 PHAMIT drop in centers provide services to a total of:					2,830 men 1,870 women 135 children (+ 180 vaccinated) 50+ PHA supported 10+ special cases (PLHA,safe house) 1,000's provided with special events (festivals, cultural events, sports, etc.)