At Mahachai ( Samut Sakorn Province), there are over 200,000 migrants estimated to be living and working, with over ninety percent coming from Burma. Most all of the migrants working in this area are involved in the seafood industry. They work hard, and at times, it seems that they get no time to rest. In Talad Koong, a shrimp peeling factory, they wake up at three in the morning and sit in front of piles of shrimp, sorting and peeling for up to ten to twelve hours.

Many times migrants who have HIV/AIDS simply keep working until they are on the verge of exhaustion, which may accelerate the onset of symptoms related to the advanced stages of AIDS. The problem is that most of the time migrants aren't aware that they are infected with HIV, much less recognize the related symptoms. In other cases, migrants who are obviously sick from AIDS are abandoned or avoided by others due to stigma and fear. The problem is two-fold: migrants have a low understanding or awareness of HIV/AIDS, and there are no VCT services available in migrants' languages. Even more problematic is the fact that ARV drugs are currently not available to migrants, leaving those who do know to face the inevitable with few palatable choices.

At Raks Thai Foundation's PHAMIT site in Mahachai, project staff and volunteers find migrants suffering from HIV/AIDS on a regular basis. In most all of these cases, the individual is already suffering from advanced stages of HIV/AIDS with opportunistic infections, and may be incapacitated. Many migrant PLHAs are afraid of going to the hospital, either because they have no documentation or because they don't trust or understand Thai doctors. Oftentimes, these people have no one to take care of them. Without ARVs available, these people can only be comforted or transported to a hospice to await their end.

One young Burmese man from Rangoon had been in Thailand for five years and had worked on a long-distance boat for a significant portion of that time. He was 26 years old and single. When he was found he had lost his vision. Raks Thai staff housed him at their drop-in center at Sapan Pla where they washed him, helped him go to the bathroom, changed his dressing and sheets, and provided food. After some time, his conditions cleared up briefly, but his vision never fully recovered and everything remained very blurry. He was finally moved to a Christian Hospice for HIV in “Klong Thip,” where he died soon after. This hospice will come and pick-up patients when called upon, and the Raks Thai drop-in center at Mahachai has referred five people to this hospice. Raks Thai in Mahachai also has contact with hospices in Kanchanaburi Province that take in migrants with HIV – one is a Buddhist temple and the other is a safe-house near the border.

Another man found with advanced AIDS had also just gotten off a long-distance boat. He was 29 years old, of Burmese ethnicity and from Thanbayuziya, a small city in Mon State. Although he had been in Thailand for seven years, he had a wife and child back home. His symptoms included sores, a fungus coating his tongue and throat, and a bad cough with blood. This man simply wished to return to his family. After providing counseling, and informing him of his condition, Raks Thai assisted him in safely returning to the border to go home…Whether he received proper treatment for TB, or has infected his wife with HIV is unknown. The problem is that without cross-border linkages to support systems in source communities, once these people cross the border, their fate is unknown.

One woman, 30 years old from Shan State, was found all alone with sores and coughing. The village leader had found her and contacted Raks Thai Foundation. She had worked in a karaoke bar and then had been a domestic worker previously. She had been living with four Thai women who worked in a factory, but they abandoned her when her condition deteriorated. The Raks Thai staff assisted her to go to the Samut Sakorn Provincial Hospital where she stayed for three days. Since there was little that could be done to treat the woman due to issues of documentation and expense, she was sent away. Raks Thai gave her food and shelter until she was taken to the safe house at the border in Sangklaburi, where she lasted two weeks before she died.

At Mae Khlong in Samut Songkram Province, which is adjacent to Samut Sakorn Province, Raks Thai field officers found a thirty year-old man of Mon ethnicity suffering from AIDS related symptoms. The man was from a Mon community just on the other side of the Burma border and had been in Thailand for eighteen years. He had worked for years on a “Lad Koo” boat (these boats go fishing for a couple of nights and then return to the same port). He had been addicted to heroin for three years but had been able to quit. In addition to having been addicted to drugs, his work had also left him weary. He had previously worked on a boat at the border of Cambodia in Trad Province (Klong Yai District), where there are sex workers from Cambodia available. The boat he was working on at that time had been fishing illegally in Cambodian waters and was arrested by Cambodian police. He and the crew of around thirty others, mostly migrants, spent three years in a Cambodian prison. When he was released he was sent back to Burma. From there he came to work at Mae Khlong where he met a woman and got married. He became a crew leader on a Lat Koo boat, but after about eight months he started having high fevers with a cough. Then one day he had an aneurysm. He spent five days in a hospital before he was released. Raks Thai was informed about this man while they were giving outreach activities in the community. He had been forced out of his home by the owner, so Raks Thai officers took him to a PHAMIT drop-in center for one week, where he was given an IV drip and had his tongue and sores cleaned. He died a couple of days later at the center. It is unknown what became of his wife, or if she even knows of his fate.

Another Mon man from Thanbayuziya was in Thailand for seven years. He had worked on a boat that left from Mae Khlong as well, and then went to work in Mahachai cleaning fish. He has HIV and he knows it. At one point he went back to his home in Burma and took what he believed was ARV drugs that had been obtained from India. He recovered some of his strength and came back to Thailand. The medicine is done, and now he occasionally suffers from opportunistic infections. He contacted Raks Thai Foundation and is now receiving periodic home-based care. Raks Thai Foundation helps him obtain and use medicines for these symptoms. He conscientiously exercises and eats a healthy diet. His wife is with him and she knows his HIV status, but she doesn't know hers. They have a child who is staying with relatives in Burma while they work – a common arrangement for migrant workers with children. As part of their living arrangement, the couple uses condoms and requests a box from Raks Thai every two months.

At one of Raks Thai's PHAMIT drop-in centers in Mahachai, there is a child attending education activities who has been orphaned by AIDS and circumstances. This little girl is 9 years old. Her father died from AIDS two years ago at the center, and her mother is reportedly working in Chumpon but her status is unknown and she has not been in contact with the child. The girl's uncle, who is married and has a child of his own, is taking care of the girl. It is unknown how many migrant children are being orphaned by AIDS, or what is happening to them, but this girl seems to be one of the lucky ones.