Sociocultural and religious norms and values at the foundation of repression and violence towards people who use drugs in Kachin State, Myanmar.

Magali Bouchon, Nu Nu Lwin, Seng Nu Pan, Mélanie Quétier

BACKGROUND
Myanmar is the second largest producer of opium in the world. The number of injecting drug users is estimated up to 93.000 with a HIV prevalence of 34,9%. Kachin State has one of the highest burden of problematic drug use, yet harm reduction programs are facing strong resistance from the local community. People Who Use Drugs (PWUD) are exposed to violence from community-led anti-drug militias that are running forced-detox camps and jeopardising HIV prevention efforts.
The objective of the participative study was to analyse the perceptions of the general population on drug use, drug users and harm reduction in Kachin State.

METHODS
Applying qualitative methods, a series of semi-structured individual interviews (35), focus groups (2) and ethnographic observations (3) in detoxification camps were held. Convenience and snowball sampling were used to include a wide range of participants (local and religious leaders, students, PWUD and their family and neighbours). Data were triangulated to crosscheck the results and to validate the analysis-based interpretations rigorously.

RESULTS
The prejudices and stigma faced by the PWUD are strongly rooted in a sociocultural and religious context of strong moralization and normalisation of behaviours. There is a great lack of understanding of drug dependency, and the poor empathy towards PWUD reflects the dominant projection of PWUD as criminals with bad moral values, weak and unable to change. This vision justifies the violence and coercive measures. The consequences of drug use are perceived as a major threat for the future generation and for the whole community.

CONCLUSION
In-depth understanding of social representations of PWUD is essential as perceptions are key factors that influence their social integration or exclusion. It is important to deconstruct these perceptions through practical interventions as capacity building, social mediation and building a community-based strategy to foster their integration and acknowledgment as equal citizens.