Nearly 100,000 displaced persons in Thailand’s four border provinces have lost access to healthcare services after the US government suspended financial support for the International Rescue Committee (IRC) for 90 days late last month.
The IRC runs seven camps for displaced persons in Thailand’s Ratchaburi, Kanchanaburi, Tak, and Mae Hong Son provinces. Hospitals in these camps have temporarily halted medical care after the US government ordered a three-month freeze on foreign aid.
Five Thai state hospitals in these border provinces have stepped in to provide essential care to sick, injured, or pregnant displaced persons.
This move offers a short-term solution, but a long-term plan to ensure Myanmar's displaced persons have continued access to medical care is still lacking.
Rush to mobilize support
Public Health Minister Somsak Thepsuthin noted that the medical crisis on Thailand’s border is now under a global spotlight, with the World Health Organization (WHO) expressing concern about medium- and long-term public healthcare management amid a possible surge of displaced persons fleeing Myanmar’s civil war.
Ratchaburi, Kanchanaburi, Tak, and Mae Hong Son border ethnic regions of Myanmar that have suffered some of the fiercest fighting since the 2021 military coup.
“The WHO has expressed willingness to work with our ministry in providing humanitarian care to the displaced persons,” Somsak said after holding talks with senior WHO officials earlier this month.
Somsak is seeking $3 million in funding from the world health agency to help state hospitals under his ministry provide medical care to displaced persons from the camps.
The WHO pledged to consider his request.
Dr. Somsak Chunharas, chairman of the National Health Foundation, said healthcare challenges on Thailand’s border with Myanmar stem from limited resources and the complex relationship between the two countries.
“When an elected government was in power in Myanmar, healthcare cooperation improved somewhat,” he said. “But following Myanmar’s latest coup, serious problems hit the border zones.”
Somsak said the Thai government must now consider new approaches to displaced persons' healthcare, such as creating a tripartite international initiative to strengthen medical services in border areas.
“Three parties refer to Thailand, Myanmar, and international organizations,” he said.
Under the tripartite collaboration, hospitals in Myanmar under ethnic Karen jurisdiction could share the burden of displaced persons' care with Thai hospitals that are already overwhelmed.
Somsak emphasized that healthcare is a humanitarian issue that should transcend political conflict. He added that while humanitarian aid has mainly come from Western countries in the past, Asian countries such as Japan and China may now be more willing to step in.
“If we can secure new countries for funding, they could also help in finding structural solutions [to crises],” he said.
Medics on the frontline
Dr. Cynthia Maung, founder of the Mae Tao Clinic, which provides free treatment for Myanmar's displaced persons and migrant workers in Tak’s Mae Sot district, said the U.S. government’s aid freeze had led to a 30% cut in funding for her clinic. However, she counts her facility—which treats 400-500 people a day—as one of the lucky few.
“Smaller organizations that rely on a single [funding] source must have been harder hit,” said the winner of the Magsaysay Award, often referred to as Asia’s Nobel Prize.
She noted that Thailand would also be affected by the U.S. aid cut, with more Myanmar people seeking medical help from the country.
Dr. Nuttagarn Chuenchom, an infectious disease specialist at Mae Sot Hospital, said the responsibility for caring for displaced persons should not fall solely on border medical facilities and personnel.
“The care for displaced persons is a national issue, which needs national-level management,” she said.
She urged Thai authorities to allocate a budget to hire Myanmar doctors who took care of displaced persons before the aid freeze so that they could continue their mission as they waited for new funding.
“Pushing the burden onto state hospitals means that Thais living in border provinces must share health resources with displaced persons. They have to wait longer for treatment,” she said.
Mae Sot district is only allocated enough state doctors to cover its registered population of 200,000, Nuttagarn noted.
“But in reality, the district also houses between 200,000 and 300,000 migrants.”
This means that the doctor-patient ratio in Mae Sot is 1:5,000—more than double the national average in Thailand of 1:2,000.
After struggling under a heavy workload for years, Nuttagarn recently made the difficult decision to resign after the hospital mandated that she also treat Myanmar's displaced persons.
Mae Sot Hospital is the largest and best-equipped medical facility on the Thai-Myanmar border. As such, it is assigned to care for displaced persons with infectious diseases such as tuberculosis and HIV, as well as those in need of dialysis.
Dr Tawatchai Yingtaweesak, director of Tha Song Yang Hospital in Tak, said his facility takes care of general outpatients and emergency cases, including pregnant women in labor.
A third hospital in Tak, Mae Ramat Hospital, has been assigned to care for displaced persons and migrants with non-communicable diseases like diabetes, hypertension, and mental disorders.
“We think we can handle the situation for now. But in the long run, we may need to review this approach,” said Dr. Pitakpong Chandaeng, chief of the Tak Provincial Public Health Office.
Pitakpong said his agency will ask for financial support from non-governmental organizations as well as international agencies to sustain the medical care of displaced persons.
‘Basic human right’
Human rights lawyer Surapong Kongchantuk, former chair of the Lawyers’ Council of Thailand’s committee on human rights for ethnic groups, stateless people, and migrant workers, said that displaced persons should be provided with healthcare as a basic human right.
Their camps should integrate medical services and have in-house doctors, he said.
“Necessary support should be provided because delayed access to medical services is a matter of life and death,” he said.
The camps on the Thai-Myanmar border have been operating for more than 40 years, fed by displaced persons fleeing conflict between the Myanmar military and ethnic groups seeking autonomy for their homelands. The largest of them is Mae La camp in Tak, which houses 40,000-50,000 mainly Karens.
