By Harry
Saw Eh Wah*, a 37-year-old Karen from Myanmar, living in a refugee camp in Tak District on the Thai-Myanmar border, often suffers from severe abdominal pain.
He usually has to rush to the camp’s hospital for treatment, and only then does he find relief, he said. On January 27, once his pain became severe, but this time he unexpectedly found the hospital closed.
“I didn’t know how to do. So, I took some medicine I had at home and had to wait and see how things went.”
But it didn’t work, and his condition worsened. That’s why he traveled for nearly three hours through the Moei River to reach a hospital in the jungle, where intense battles often erupt between the Myanmar Army and resistance groups.
On January 20, after U.S. President Donald Trump immediately paused all international aid for 90 days, all those in need of health care in refugee camps along the Thailand-Myanmar border, including Saw Eh Wah, faced difficulties.
Lack of Healthcare services on illegal Myanmar ethnic refugees in Thailand
There are nine refugee camps on the Thai Myanmar border, housing around 108,000 refugees who have fled Myanmar according to The Border Consortium (TBC). Mae La refugee camp, where Saw Eh Wah resides, has over 37,000 refugees.
These refugee camps have been established since people from Myanmar began fleeing to Thailand nearly 50 years ago due to the civil war in Myanmar, Saw Pwal Say, the secretary of the Karen Refugee Committee (KRC), said.
Thailand, which has not signed the 1951 Refugee Convention, recognized the refugee camps as temporary shelters and these camps received support from international aid organizations.
Following the President Donald Trump’s stop work order, hospitals within the seven camps including Mae La Camps, operated by the International Rescue Committee (IRC) and funded by United States Agency for International Development (USAID), were abruptly closed, Saw Pwal Say said.
Residents and camp officials reported that when the camps’ hospitals closed, emergency patients had to make their own arrangements to go to nearby Thai hospitals, resulting deaths due to lack of medical treatment, and having to go to jungle clinics within Myanmar battel field.
While he was resting at that hospital in jungle, around 9 AM on January 30th, he experienced a Myanmar military drone attack on an office of Karen National Union (KNU), which is only about the distance of a football field away from the hospital, and he had to flee, he said.
“When the drone arrived, the sound was very loud, so I was startled. The nurses called the patients out of the hospital and made us run and hide in the forest on the mountain.”
After leaving the jungle hospital, he returned to the camp.
Aid Suspension Costs Lives
“I never thought we would encounter something like this,” said KRC Secretary Saw Pwal Say, referring to the suspension of USAID, which led to the sudden closure of hospitals in the Thailand-Myanmar border refugee camps.
A woman residing in the Umpiem camp, which has a population of over 10,000, said, “The camp official immediately sent back all the people in the camp’s hospital. They also sent back all the hospital staff and the patients, even those who were in emergency situations. “
A later waiver, issued on January 28th by the US government, excluded “life-saving humanitarian assistance” from the aid stoppage. However, many organizations assisting refugees along the Thai-Myanmar border have not yet benefited from these waivers according to Amnesty International’s statement on Feb 13.
In the Umpien camp at least four people have died as a result of not receiving oxygen provided by the hospitals, Amnesty International stated.
U Win Myint, 73, living in Umpiem camp, suddenly had difficulty breathing while the hospital was closed. He did not receive any medical treatment and died on February 7, his friend said.
“We relied on him greatly for the education of the children in the camp. He taught English to those taking the General Educational Development (GED) exam. If the hospital had been open, he could have been treated in time and survived. He should not have died.”
Another refugee in Umpiem camp, a 71-year-old woman died after being discharged from the hospital, he said.
Limited aid of Thai Authority
After numerous discussions between civil society organizations, camp officials, and Thai authorities, hospitals in the camps were temporarily reopened in the second week of February, with limited assistance from the Thai Ministry of Public Health.
According to a volunteer from the camp, Thai doctors visited the hospitals within the camp during the day on a rotating basis, while the staff worked voluntarily without receiving any salary.
However, due to the uncertain circumstances regarding the return of USAID, the medic shortages and lack of medicine continued to pose challenges in providing long-term healthcare within the refugee camps, according to the camp officials and the refugees.
On February 3, a specialized infectious disease doctor at the Maesot hospital posted on Facebook that Thai medical staff should not be tasked in providing healthcare to Myanmar refugees, as they are also facing a shortage of health workers, resulting in long waiting times for Thai nationals to receive treatment.
She further emphasized that the Thai central government should allocate a budget to hire the Myanmar doctors, who were already familiar with the clinics, rather than overburdening Thai doctors with additional responsibilities.
Thai health minister stated that the Ministry of Foreign Affairs will seek assistance from other international organizations, and work towards establishing sustainable healthcare for refugees.
Where are Long-term Solutions for Myanmar Refugee?
Border-based health organizations, refugee aid groups, and public policy experts suggest that Thailand needs a long-term perspective because it is the nearest destination for refugees fleeing the ongoing conflict in Myanmar.
Thailand could ease the healthcare burden for Myanmar refugees on its borders by effectively employing the skills of the thousands of Myanmar medics who entered to the country following the 2021 Myanmar Military Coup, they pointed out.
According to the Health Ministry of the National Unity Government (NUG), which is a parallel government opposing the Myanmar junta, 45,278 medics have still been participating in the civil disobedience movement against the coup since 2021.
“The government of Thailand needs to consider how to re-utilize skilled professionals, whether they are CDM doctors with international qualifications or others. Restrictions should be made more flexible to facilitate this. Aid organizations should also take this into account,” said Dr. Sai Kyi Zin Soe, a policy expert affiliated with the Centre for Disability Research and Policy at the University of Sydney.
However, if the Thai government is pressured too strongly, this solution is unlikely to materialize, especially since Thailand is not a member of the Refugee Convention, he observed.
On February 24, the IRC reopened hospitals in refugee camps under a three-month program, according to KRC Secretary Saw Pwal Say. However, a diabetes patient from the camp stated that the hospital cannot operate at full capacity like before.
“There are no medicines, and there isn’t enough care. Then, they can only provide paracetamol and send you back. When I went to check for diabetes, they told me to come back later and schedule an appointment for another day because they don’t have the necessary equipment.”
Currently, she is relying on the home clinics that have been set up in the volunteers’ houses for her diabetes care.
The Thai Border Collaborative (TBC) stated in a statement issued on February 27 that it is not a long-term solution for refugees in Thailand to rely solely on international aid. Instead, it emphasizes the need for policy changes in Thailand to enable refugees to integrate into Thai society.
TBC proposed policy adjustments to allow refugees to work legally, to collaborate more with community-based refugee aid committees and to recognize refugees as productive members of society rather than as a burden, as part of a long-term integration strategy.
Saw Eh Wah, who frequently suffers from severe abdominal pain, is unable to work and leave the camp due to a lack of documentation and relies entirely on the camp hospital’s free medical services.
“When I’m not in pain, everything is fine,” he said. “But when I’m in severe pain, I worry about no hospital in the camp.”
* Nickname for the safety
