The scourge of Aids and HIV in Burma is being fuelled by a mixture of ignorance, denial and lack of government action _ a dangerous cocktail that could affect a quarter of the population within the next decade. In the past six months since former prime minister General Khin Nyunt was purged, the situation with regard to the Aids epidemic has begun to deteriorate even further, as the intelligence chief had been one of the few in the regime who understood the enormity of the problem.
Three young Burmese women sit quietly in the foyer of one of Lashio's main tourist hotels. The youngest is barely 13, and obviously very unhappy. A few minutes later a visiting Chinese businessman comes down to meet them, with his Burmese host, and the group go out. The three Burmese women, all in their teens, are prostitutes _ the youngest possibly working for the first time.
''This is common place in any town on Burma's main transport routes,'' a Burmese resident tells me. ''Every hotel has an escort service.''
Lashio is a major commercial town in northern Burma, in Shan State. It is situation on the labyrinth of roads which connect the capital Rangoon, south of the city, to China in the north and India in the west. The roads are used by many buses, cars and trucks.
''A woman is included in the price of a room in most of these hotels,'' I'm told by a Burmese driver who did not want to be identified.
Commercial sex workers are one of the main ways the deadly HIV/Aids disease is being transmitted in Burma, according to UN Aids experts. In Rangoon, international aid workers estimate that more than two-thirds of prostitutes are HIV-positive.
Lashio is already in the throes of a major hidden HIV/Aids epidemic. Three years ago, 17% of pregnant women who were tested voluntarily by the local hospitals were found to be HIV-positive, according to a local health official who wanted to remain anonymous.
On that basis, one in five pregnant women in Lashio are suffering from the Aids virus.
International health experts say this level of infection is consistent with the pandemics of Africa.
''The sample may be skewed as people offering themselves for voluntary testing often have a greater fear they may be affected,'' says Dr Min Thwe, head of Burma's anti-Aids campaign. ''It is not a random sample.''
But anecdotal evidence suggests that in Shan state at least, the disease is rampant. ''The explosion of HIV/Aids in Shan State is frightening,'' according to the American Aids expert, Dr Chris Beyrer. He estimates that more than 10% of adults are now HIV-positive.
''That's the worst ever incidence of the disease in the region,'' he says.
''It's on the level of that which hit northern Thailand a decade ago. The difference then was that the Thai government recognised it and did something about it, whereas the military junta are allowing this one to rage out of control,'' says Dr Beyrer.
Aids-related deaths are nothing new in Burma, especially in Shan state. ''Almost every week then, there was a funeral of someone who had died from Aids,'' a local Burmese development worker confides to me.
Northern Burma has been hit hard by the HIV/Aids crisis. In Kachin state there has also been a dramatic rise in the number of people suffering from the disease. The rebel Kachin Independence Organisation, which signed a truce agreement with the military regime in Rangoon more than a decade ago, says privately that the area is being devastated by the disease.
The former KIO leader Brang Seng, who died several years ago, once told me that he had originally entered into ceasefire negotiations with Burma's military rulers in the early '90s for fear that HIV/Aids was destroying the Kachin people.
''I realised that with Aids there was a very real danger that we might win the battle [against the Burmese army] but lose the war [against the disease].''
Since then, despite concerted efforts by the KIO, the Kachin Baptist Church and international aid organisations, Aids is continuing to spread. Development workers in the state say Aids orphans are now increasingly common.
''The growth of HIV/Aids in areas of Kachin state is becoming increasingly visible,'' says a foreign expert who works in the area. ''There are increasing cases of Aids even in the remotest villages,'' he adds.
The Burmese government does recognise they do have a problem. ''We are doing everything that we can, given our meagre resources,'' says Dr Min Thwe, Burma's leading anti-Aids official.
Over the last few years, Gen Khin Nyunt had tried to galvanise the country into action. ''HIV/Aids is a national cause,'' Gen Khin Nyunt told the pro-government newspaper the Myanmar Times in early 2001. ''If we ignore it, it will destroy entire races.''
Several government-support awareness campaigns have been launched. There are billboards in many of the country's urban centres, especially in Rangoon, warning people of the dangers of HIV/Aids.
There have been large exhibition in Rangoon and other key provincial cities across the country promoting measures to combat the spread of the disease. The government has also organised other awareness activities including walkathons and fun runs. More than 5,000 young people joined the last one on World Aids Day 18 months ago aimed at increasing their awareness of the dangers of the disease.
''We are here because Aids is a big problem and everyone should know about it,'' says a 17-year-old university student as he finishes the three-mile walk.
But despite this new openness, Burma's military rulers are still in a state of denial. Some insist that Burma's culture and religion limits the spread of the disease.
''Another thing,'' the deputy health minister Mya Oo lectures me, ''we have the religious teachings and traditional cultural values because Myanmar [Burma] people do not believe in pre-marital sex, and no extra-marital sex but we know this is not enough.''
Officially there are 330,000 HIV sufferers in Burma. UN officials believe that the number is substantially higher and estimate it to be around 4% of the population.
Officially the UN estimates there are more than a half a million HIV sufferers in the country. Privately though, senior officials at UNAids admit it is certain to be double that. It is much more likely that the figure is around a million, they concede.
One international medical official in Rangoon, who wants to remain anonymous, believes that there may be as many as six million people in Burma with HIV or Aids.
Most government officials dispute any figures higher than 2% of the population. But the head of the country's national Aids programme is far more frank.
''We think the estimated people living with HIV/Aids from blood testing and the reported cases to date are just the tip of the iceberg,'' Dr Min Thwe confides. ''We just don't know the actual magnitude of the problem.''
They constantly point to their sentinel surveys which are conducted with the assistance UN officials. But anecdotal evidence reveals a much greater prevalence of the disease.
Hot spots like ports, transport centres, borders and mining areas are all likely to have a very high incidence of HIV, says a former western aid worker in Rangoon.
Rangoon, Mandalay, Tachilek and Moulmein probably have largely major unreported epidemics, he says.
Several fishing villages along the Andaman Sea have all reported large incidences of HIV, according to local church officials. In one village near the Thai town of Ranong, at least 10% of the male adults were diagnosed as HIV-positive and under medical attention, a Catholic worker in the area said. That was more than four years ago; since then many of them have died he says.
Although the extent of the HIV epidemic in Burma may be unverifiable at present, the evidence is that it is raging out of control, despite the government's belated efforts to cope with it.
In many areas at least 10% of the population are HIV-positive. The rate of growth puts Burma's epidemic on the scale of Africa's pandemic. It is a time bomb that has been ticking away for more than a decade and it is about to explode, a former western aid worker in Rangoon said.
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