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Laos: Difference between revisions
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===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
* In | * In Laotian cities and towns, you can find '''condoms''' in many stores and minimarts. You can also buy condoms online from local sellers, like [https://www.facebook.com/VTE5555/ Yes Condom Vientiane], which sells 3-piece packs of Durex condoms for 10,000 kip, 6-piece packs of SixSex condoms for 35,000 kip and 24-piece packs of SixSex condoms for 100,000 kip (as of June 2017). If you send them a message on Facebook, they'll give you more details. Note that online sellers of condoms tend to be more expensive than physical stores. | ||
* You can purchase '''oral contraceptives (birth control pills)''' at pharmacies. No prescription is required. Some of the brands you can expect to see are Anna and Preme, which are both produced by Thai Nakorn Patana (a Thai pharmaceutical company).<ref>[http://contraceptive.ippf.org/search?search.searchtext=&search.component=&search.countrycode=LA IPPF Laos]</ref> Some locals have warned against purchasing medications from China or Vietnam, since they may be lower-quality or unreliable.<ref>[https://www.travelfish.org/beginners_detail/laos/21 Awkward healthcare questions in Laos]</ref> | * You can purchase '''oral contraceptives (birth control pills)''' at pharmacies. No prescription is required. Some of the brands you can expect to see are Anna and Preme, which are both produced by Thai Nakorn Patana (a Thai pharmaceutical company).<ref>[http://contraceptive.ippf.org/search?search.searchtext=&search.component=&search.countrycode=LA IPPF Laos]</ref> Some locals have warned against purchasing medications from China or Vietnam, since they may be lower-quality or unreliable.<ref>[https://www.travelfish.org/beginners_detail/laos/21 Awkward healthcare questions in Laos]</ref> | ||
** One local health care professional says (June 2017): "OC pills are widely available in most pharmacies and from public and private hospitals, even in rural areas. The brands will vary and providers may not stock consistent problems [sic: brands]. This can be an issue because it means that women may not always be able to find the brand that they are used to, especially in areas where the outlet may be bringing the drugs in from Thailand, Vietnam, China, etc. A lot of providers just drive over the border to buy their stocks."<ref>[Online Conversation with Health Care Professional]</ref> | ** One local health care professional says (June 2017): "OC pills are widely available in most pharmacies and from public and private hospitals, even in rural areas. The brands will vary and providers may not stock consistent problems [sic: brands]. This can be an issue because it means that women may not always be able to find the brand that they are used to, especially in areas where the outlet may be bringing the drugs in from Thailand, Vietnam, China, etc. A lot of providers just drive over the border to buy their stocks."<ref>[Online Conversation with Health Care Professional]</ref> | ||
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* According to locals, you should be able to find '''contraceptive injectables''' in Laos, but we need more details.<ref>[Online Conversation with Vientiane Local]</ref> | * According to locals, you should be able to find '''contraceptive injectables''' in Laos, but we need more details.<ref>[Online Conversation with Vientiane Local]</ref> | ||
* According to locals, you may be able to find the '''contraceptive patch''' in Laos. However, while locals report hearing that it's available, there's no confirmation if anyone can directly report seeing the patch available themselves.<ref>[Online Conversation with Vientiane Local]</ref> We'll need more information. | * According to locals, you may be able to find the '''contraceptive patch''' in Laos. However, while locals report hearing that it's available, there's no confirmation if anyone can directly report seeing the patch available themselves.<ref>[Online Conversation with Vientiane Local]</ref> We'll need more information. | ||
* The '''contraceptive ring (such as Nuvaring)''' is currently not available in Laos, as of | * The '''contraceptive ring (such as Nuvaring)''' is currently not available in Laos, as of June 2017.<ref>[Online Conversation with Vientiane Local]</ref> | ||
'''IMPORTANT NOTES from Vientiane Health Care Professional ( | '''IMPORTANT NOTES from Vientiane Health Care Professional (June 2017):''' | ||
* "The only products registered for use in Laos and widely available are copper-T IUDs, Implants, COC and progestin only pills, Injections, EC pills and condoms. If a provider has anything else, they most likely brought it in illegally from a neighboring country." | * "The only products registered for use in Laos and widely available are copper-T IUDs, Implants, COC and progestin only pills, Injections, EC pills and condoms. If a provider has anything else, they most likely brought it in illegally from a neighboring country." | ||
* "All contraceptive commodities should be free at public facilities, but they will charge a small fee for the use of consumables (like cotton, betadyne, etc.). This is usually less then 50,00 kip ($6), but it varies by province. Private sector fees will depend on the provider, usually less than $10 I would say." | * "All contraceptive commodities should be free at public facilities, but they will charge a small fee for the use of consumables (like cotton, betadyne, etc.). This is usually less then 50,00 kip ($6), but it varies by province. Private sector fees will depend on the provider, usually less than $10 I would say." | ||
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===Costs=== | ===Costs=== | ||
* Birth control pills should cost around 5000-10000 kip per month (as of | * Birth control pills should cost around 5000-10000 kip per month (as of June 2017).<ref>[Conversation with health care professional in Vientiane]</ref> | ||
* Contraceptive injections will range from free to 5000 kip every 3 months (as of | * Contraceptive injections will range from free to 5000 kip every 3 months (as of June 2017).<ref>[Conversation with health care professional in Vientiane]</ref> | ||
* Contraceptive implants will cost around 25,000-5000 kip (as of | * Contraceptive implants will cost around 25,000-5000 kip (as of June 2017).<ref>[Conversation with health care professional in Vientiane]</ref> | ||
* IUDs will cost around 25,000-5000 kip (as of | * IUDs will cost around 25,000-5000 kip (as of June 2017).<ref>[Conversation with health care professional in Vientiane]</ref> | ||
==Emergency Contraception (Morning After Pill)== | ==Emergency Contraception (Morning After Pill)== | ||
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Awareness and attitudes towards emergency contraceptive pills among young people in the entertainment places, Vientiane City, Lao PDR]</ref> | Awareness and attitudes towards emergency contraceptive pills among young people in the entertainment places, Vientiane City, Lao PDR]</ref> | ||
According to a health care professional in Laos, there is some stigma around purchasing ECPs: "EC pills are actually pretty widely available from pharmacies and providers. There is not a lot of additional stigma then with the use of regular contraceptives. Generally, stigmas are against unmarried people accessing contraceptives, but this is changing fast in Laos. In some ways, I think providers can have less stigma around EC pills for young people because they are more understanding of an emergency situation (as opposed to a young, unmarried woman having regular sex). This is just my opinion though." ( | According to a health care professional in Laos, there is some stigma around purchasing ECPs: "EC pills are actually pretty widely available from pharmacies and providers. There is not a lot of additional stigma then with the use of regular contraceptives. Generally, stigmas are against unmarried people accessing contraceptives, but this is changing fast in Laos. In some ways, I think providers can have less stigma around EC pills for young people because they are more understanding of an emergency situation (as opposed to a young, unmarried woman having regular sex). This is just my opinion though." (June 2017) | ||
===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
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===Costs=== | ===Costs=== | ||
Emergency contraception pills (ECPs) should cost no more than 30,000 kip ( | Emergency contraception pills (ECPs) should cost no more than 30,000 kip (June 2017).<ref>[Conversation with health care professional in Vientiane]</ref> | ||
==Sexually Transmitted Infections (STIs/STDs)== | ==Sexually Transmitted Infections (STIs/STDs)== | ||
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===Laws & Social Stigmas=== | ===Laws & Social Stigmas=== | ||
In Laos, there are no travel or residency restrictions related to HIV status.<ref>[http://www.hivtravel.org/Default.aspx?PageId=143&CountryId=103 LAOS - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV]</ref> This means that, if you're a foreigner entering Laos, you | In Laos, there are no travel or residency restrictions related to HIV status.<ref>[http://www.hivtravel.org/Default.aspx?PageId=143&CountryId=103 LAOS - REGULATIONS ON ENTRY, STAY AND RESIDENCE FOR PLHIV]</ref> This means that, if you're a foreigner entering Laos (whether as a tourist, student, worker or prospective resident), you won't be asked for a medical certificate certifying your HIV status. Furthermore, if you test positive for HIV in Laos, you shouldn't be deported from the country. However, if you're pregnant and receive prenatal care, or if you're a foreigner who wants to marry a Lao national, you'll probably need to take an HIV test.<ref>[Online conversations with Vientiane locals]</ref> It's typically mandatory in these cases. | ||
There are an estimated 11,000 people with HIV living in Laos.<ref>[http://www.aidsdatahub.org/Country-Profiles/Lao-PDR Lao PDR - Key Facts on HIV]</ref> While this number is lower than neighboring countries, such as [[Thailand]] or [[Cambodia]], HIV rates are on the rise with about 1000 new cases being reported each year, leading to the claim that there's currently a "Lao epidemic." The highest risk groups tend to be sex workers, transgender people, injection drug users, and MSM (men who have sex with men).<ref>[https://www.unicef.org/laos/activities_22357.html Laos - HIV/AIDS]</ref> <ref>[http://www.wpro.who.int/laos/topics/hiv/en/ Lao People's Democratic Republic - HIV]</ref> As the Laotian borders have opened up in the recent years, the country is seeing higher rates of transmission among foreigners, migrant workers and injection-drug users along the borders as well.<ref>[http://www.irinnews.org/report/94374/laos-looming-threat-catching-hiv-prevalence | There are an estimated 11,000 people with HIV living in Laos.<ref>[http://www.aidsdatahub.org/Country-Profiles/Lao-PDR Lao PDR - Key Facts on HIV]</ref> While this number is lower than neighboring countries, such as [[Thailand]] or [[Cambodia]], HIV rates are on the rise with about 1000 new cases being reported each year, leading to the claim that there's currently a "Lao epidemic." The highest risk groups tend to be sex workers, transgender people, injection drug users, and MSM (men who have sex with men).<ref>[https://www.unicef.org/laos/activities_22357.html Laos - HIV/AIDS]</ref> <ref>[http://www.wpro.who.int/laos/topics/hiv/en/ Lao People's Democratic Republic - HIV]</ref> As the Laotian borders have opened up in the recent years, the country is seeing higher rates of transmission among foreigners, migrant workers and injection-drug users along the borders as well.<ref>[http://www.irinnews.org/report/94374/laos-looming-threat-catching-hiv-prevalence | ||
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===Support=== | ===Support=== | ||
* As of June 2017, Sethathirat Hospital has a special section at the back with a new building for patients with HIV, AIDS and TB under Dr Saykham. | |||
* Skin Diseases Clinic (Khou Vieng) - One of the most populars clinics treating venereal disease in Vientiane. | |||
* World Health Organization Representative Office Lao People's Democratic Republic: 125 Saphanthong Road, Unit 5 Ban Saphangthongtai, Sisattanak District Vientiane Capital, Lao People's Democratic Republic. Telephone: (856) 21 353-902 / 3 / 4 . Facsimile: (856) 21 353-905. E-mail: who.lao@wpro.who.int | * World Health Organization Representative Office Lao People's Democratic Republic: 125 Saphanthong Road, Unit 5 Ban Saphangthongtai, Sisattanak District Vientiane Capital, Lao People's Democratic Republic. Telephone: (856) 21 353-902 / 3 / 4 . Facsimile: (856) 21 353-905. E-mail: who.lao@wpro.who.int | ||
* [https://www.theglobalfund.org/en/hivaids/ The Global Fund]: This organization provides a lot of the funding for HIV/AIDS work in Laos. | * [https://www.theglobalfund.org/en/hivaids/ The Global Fund]: This organization provides a lot of the funding for HIV/AIDS work in Laos. | ||
* [http://www.psi.org/country/laos/#about Population Services - Laos]: PSI has taken an active role in HIV/AIDS prevention and condom distribution in Laos. "PSI/Laos has been working since 1999 in the Lao People’s Democratic Republic (PDR) to: Reduce the spread of HIV/AIDS, sexually transmitted infections (STIs), and malaria. Find new cases of tuberculosis (TB). Prevent unintended pregnancies. Reduce undernutrition. Improve overall reproductive health and sanitation among Lao people." | |||
===Costs=== | ===Costs=== | ||
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* "If a woman had a '''UTI''', she might visit a public or private provider, or she may go directly to the pharmacist. Many pharmacists are public providers who have a pharmacy practice on the side; they are often a first stop for people who are sick (especially in rural areas where they may be much closer than a health facility)." - Local Health Care Professional | * "If a woman had a '''UTI''', she might visit a public or private provider, or she may go directly to the pharmacist. Many pharmacists are public providers who have a pharmacy practice on the side; they are often a first stop for people who are sick (especially in rural areas where they may be much closer than a health facility)." - Local Health Care Professional | ||
* There is an '''HPV vaccination''' program (Gardasil) in Laos, launched in 2013 and lead by the Global Alliance for Vaccines and Immunization.<ref>[https://www.voanews.com/a/hpv-vaccine-campaign-in-laos-aims-to-curb-cervical-cancer-rates/1761242.html Laos HPV Vaccine Campaign Aims to Curb Cervical Cancer]</ref> | * There is an '''HPV vaccination''' program (Gardasil) in Laos, launched in 2013 and lead by the Global Alliance for Vaccines and Immunization.<ref>[https://www.voanews.com/a/hpv-vaccine-campaign-in-laos-aims-to-curb-cervical-cancer-rates/1761242.html Laos HPV Vaccine Campaign Aims to Curb Cervical Cancer]</ref> | ||
* There is no | * There is no provider of '''Pre-exposure prophylaxis (PrEP)''' in Laos (as of June 2017),<ref>[http://www.prepwatch.org/ PrEPWatch World Map]</ref> <ref>[Conversation with health care professional in Laos]</ref> but it can be found in [[Thailand]]. | ||
* | * You can find '''Post-exposure prophylaxis (PEP)''' in Laos at hospitals that provide ARV therapy.<ref>[Conversation with health care professional in Laos]</ref> | ||
===Costs=== | ===Costs=== | ||
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* By far, the most menstrual popular option for Laotian women are '''pads/pantyliners''' (especially in urban areas) and '''cloth menstrual products''' (especially among rural or village women). In cities, they can certainly be found in many markets. | * By far, the most menstrual popular option for Laotian women are '''pads/pantyliners''' (especially in urban areas) and '''cloth menstrual products''' (especially among rural or village women). In cities, they can certainly be found in many markets. | ||
* You can find '''tampons''' in certain markets in larger cities, such as Vientiane and Luang Prabang. Some markets that may carry tampons are M-Point marts, Home Ideal, Simeuang Market (opposite the wat) and Pimphone market.<ref>[https://www.travelfish.org/beginners_detail/laos/21 Awkward healthcare questions in Laos]</ref> According to a health care professional, based in Laos, "Tampons are sold in most modern grocery stores in the city. Most Lao women do prefer pads or cloth." | * You can find '''tampons''' in certain markets in larger cities, such as Vientiane and Luang Prabang. Some markets that may carry tampons are M-Point marts, Home Ideal, Simeuang Market (opposite the wat) and Pimphone market.<ref>[https://www.travelfish.org/beginners_detail/laos/21 Awkward healthcare questions in Laos]</ref> According to a health care professional, based in Laos, "Tampons are sold in most modern grocery stores in the city. Most Lao women do prefer pads or cloth." | ||
* Regarding | * Regarding '''reusable menstrual products, organic menstrual products or menstrual cups''', there seems to be very little available resources, other than traditional cloth methods used by village women. There are no known sellers of major menstrual cup brands (such as DivaCup, MoonCup, RubyCup, Lunette, etc) in Laos. However, menstrual cups can be purchased online and sent to Laos, or they can be purchased in other countries in the regions, such as [[Thailand]], [[Vietnam]] or [[Singapore]], and brought back to Laos. According to one health care professional, based in Laos, "There are a few projects for reusable menstrual pads and hygiene. I’ve never seen the cup for sale myself, and most of my colleagues in the city don’t know about this." | ||
'''Organizations working on menstrual issues in Laos:''' | '''Organizations working on menstrual issues in Laos:''' | ||
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===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
The state of abortion law in Laos is in transition. Here's how a health care professional, based in Laos, explains the current situation (as of June 2017): "It is really difficult to figure out what to say in this transition period because what happensin practice is very different than what happens by law:In Laos, abortion is generally available, however, the area around what is legal vs what is available in practice is grey. Safe abortion services are available at provincial and district hospitals, where OBGY providers are generally trained in MVA and Medical Abortion with Misoprostol. Though historically abortion has been illegal or highly restricted except in incidences where a mother's life is in danger or the fetus is impaired, in fairly common practice a woman could also seek abortion services for socioeconomic reasons with a written certificate from their village chief, which confirms that the woman is too poor or has too many children to afford any more children. Misoprostol, a drug that is effective on it's own for abortions, is legally registered and available in Laos under the brand name Ace Miso. Many (but certainly not all) pharmacies routinely stock this drug and some will provide it even without a prescription. Mifepristone, a drug that greatly increases the effectiveness of Misoprostol when taken together, is available through some pharmacies and providers, though it is not yet legally registered or regulated in Laos. | The state of abortion law in Laos is in transition. Here's how a health care professional, based in Laos, explains the current situation (as of June 2017): "There is actually a lot of misinformation about abortion in Laos floating around. A lot of reputable websites do report that it is illegal except to save a woman’s life, but this isn’t true. Abortion is not illegal at all, but until 2016 it was restricted." She continues, "It is really difficult to figure out what to say in this transition period because what happensin practice is very different than what happens by law:In Laos, abortion is generally available, however, the area around what is legal vs what is available in practice is grey. Safe abortion services are available at provincial and district hospitals, where OBGY providers are generally trained in MVA and Medical Abortion with Misoprostol. Though historically abortion has been illegal or highly restricted except in incidences where a mother's life is in danger or the fetus is impaired, in fairly common practice a woman could also seek abortion services for socioeconomic reasons with a written certificate from their village chief, which confirms that the woman is too poor or has too many children to afford any more children. Misoprostol, a drug that is effective on it's own for abortions, is legally registered and available in Laos under the brand name Ace Miso. Many (but certainly not all) pharmacies routinely stock this drug and some will provide it even without a prescription. Mifepristone, a drug that greatly increases the effectiveness of Misoprostol when taken together, is available through some pharmacies and providers, though it is not yet legally registered or regulated in Laos. | ||
Laotian abortion law is also in a state of transition. In 2016, the government went through a process of liberalizing the guidelines for safe abortion services and these changes will become publicly disseminated later in 2017. The penal code still needs to be revised, as it currently does not comply with these new guidelines." | Laotian abortion law is also in a state of transition. In 2016, the government went through a process of liberalizing the guidelines for safe abortion services and these changes will become publicly disseminated later in 2017. The penal code still needs to be revised, as it currently does not comply with these new guidelines." | ||
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===What to Get & Where to Get It=== | ===What to Get & Where to Get It=== | ||
* Police: Call 1191 | |||
* Tourist Police: Call 1192 | |||
* Ambulance: Call 1195 | |||
* [https://www.devex.com/organizations/lao-pdr-women-s-union-lwu-52706 Lao PDR Women's Union (LW)]: "In January 2006, the first women's shelter in Lao PDR was officially opened in Vientiane. The name of this shelter is the Lao Women’s Union Counseling and Protection Center for Women and Children. The shelter was made possible through the dedicated work of the Lao Women’s Union, the Lao Government who donated a plot of land for this shelter, UNICEF, the Asia Foundation, and the Japanese Embassy. The shelter can house up to 50 women and girls who are the victims of domestic abuse, sexual abuse, and trafficking, or are abandoned or homeless. The shelter also has a vocational center that trains the women and girls living in the shelter on new job skills, such as handicrafts, sewing, and basic business management." | |||
* [http://sengsavang.org/en/home/ Sengsavang]: This organization focuses on victims of human trafficking and sexual exploitation, and they have rehabilitation centre. "SENGSAVANG’s rehabilitation centre provides a safe home where the girls receive holistic care during their rehabilitation process and are given hope for a better future. Besides offering accommodation, food, clothing and other basic necessities, we foster the girls’ overall well-being by providing health care, psychological care, and legal support." | |||
* Vientiane Youth Centre for Health and Development: Address: Sithane Rd, Vientiane, Laos. Phone: +856 21 252 886 | |||
'''Comments from health care professional based in Vientiane:''' | |||
* "There aren’t a lot of resources for women in need in Laos, but in general they can contact the Lao Women’s Union for many issues. They run a shelter for domestic violence survivors in Vientiane. There is also Sengsavang shelter and another shelter run by Village Focus International. There is the Vientiane Youth Center, which is a good resources, and a hotline for SRH questions..." - Health care professional based in Vientiane (June 2016) | |||
===Costs=== | ===Costs=== | ||