Refugee hospitals on the Thai-Myanmar border affected by US aid freeze

Refugee camp, Thailand

Mae La Refugee Camp, Mae Sot, Tak, Thailand. Flickr photo by Mikhail Esteves, CC BY 2.0

This article by Sicha Rungrojtanakul and Sorawut Wongsaranon was originally published by Prachatai, an independent news site in Thailand. An edited version has been republished by Global Voices under a content-sharing agreement.

Chaos has ensued among civil society organizations working with refugees on the Thai-Myanmar border after the US government under President Donald Trump implemented an executive order immediately halting foreign aid for 90 days, resulting in the closure of hospitals in refugee camps which receive funding from the US government.

At Mae La and Umpiem refugee camps, hospitals funded by the International Rescue Committee (IRC) were closed. Pornsuk Kerdsawang, who works for an NGO in the border area, said that every patient has been asked to leave the hospital, while women in labor have to find their own way to a Thai hospital. Projects on community health, mother and child health, as well as vaccination, sanitation, and waste management projects inside the camps, which receive funding from the US, have also been affected.

A doctor working on the Thai-Myanmar border, speaking anonymously, also said that some of their organization’s programs have been suspended due to the executive order and that support for food and medication has stopped in some places. The staff are also no longer being paid.

Some camps have “stopped functioning,” said the doctor, who said that some patients have been transferred to Thai hospitals, though most returned home. Some critically ill patients also remain in the camps.

Meanwhile, funding from the US Agency for International Development (USAID) for NGOs working along the border has stopped, raising concerns among civil society.

Thai hospitals stand ready

Hospitals on the border in Tak province are preparing for an influx of patients from the refugee camps. Dr Worawit Tantiwattanasap, Director of Umphang Hospital in Tak, said that the rising number of patients due to the closure of camp hospitals is unlikely to be a major issue since patients from these camps only make up around one-third of its total number of patients. Public health NGOs are also still working in coordination with the hospital, which he said improved the situation.

He said that hospital directors from the five districts on the Thai-Myanmar border in Tak met with Tak’s provincial governor and provincial public health doctors on January 28. They agreed that hospitals must follow humanitarian and human rights principles and care for patients whether they are being supported by an NGO worker or not, and that they must treat emergency cases that could result in death or disability, including labor and delivery, accidents, or other serious illness such as strokes, without charging a fee.

Each district has been asked to conduct a survey of patients at refugee camps in the area and come up with a plan of what needs to be done to care for them and how they might divide up critical patients among government hospitals.

Dr. Worawit also proposed that the Ministry of Public Health set up a national fund for humanitarian aid because Thailand is being affected by policies implemented by a more powerful nation, which has a worldwide impact and is something out of its control. He said that Thailand has received funding from foreign donors and support from NGOs and companies. He added that while NGOs can only do so much, their primary healthcare support helps, and only severe cases are referred to hospitals along the borders.

Dr. Worawit said he is happy that public health personnel have united to support border hospitals and patients and that the hospitals are not left to handle things alone. He noted that they are following a policy implemented by Tak’s provincial governor, its public health office, and the Minister of Public Health.

Civil society left in limbo

Pornsuk said that the situation in the field and among civil society workers has been chaotic because the executive order freezes all funding and halts all activities that have expenses. It is unclear whether medical workers will be able to keep doing their work.

“If staff are going to take care of patients, my personal thought is that it should be possible, but now there is fear … so no one really knows what to do. The idea has emerged that everything is prohibited,” Pornsuk said.

Pornsuk is concerned that humanitarian work along the borders will be significantly affected if the US does not change its policy since most humanitarian funding for health services, food, and shelter in refugee camps comes from USAID.

“It won’t stop immediately because they have other sources of funding, but a lot of their overall budget will disappear, and it has to have an impact this year,” Pornsuk said.

Pornsuk said that several projects run by Mae Tao Clinic, a clinic for migrant workers in Mae Sot, have been suspended because they were funded by the US. Other organizations funded by USAID, including internally-displaced persons camps in Myanmar and Karenni groups’ education projects, could also have their funding cut in the future.

Time to close the camps?

Following the hospital closure, Fair Party MP Kannavee Suebsang suggested that it is time to close the camps and allow the refugees to integrate into Thai society. He said that this is a solution to the humanitarian issues that have been discussed for a long time because the refugees in these camps cannot return to Myanmar due to the ongoing violence that has persisted since the 2021 coup, and they have almost no chance of going to a third country. Several generations have now been born in the camps.

Pornsuk said that civil society organizations working in the camps know that one day foreign funding will be cut, so they want the Thai government to start seriously considering closing the nine refugee camps.

Actually, in the long run the refugees want that. The funding cut this time might play a part in making the Thai government think seriously that [the refugees] don’t want to live like this. They haven’t wanted to rely on others for everything.

Pornsuk said that solving these issues requires a lot of management and that the refugees themselves want to be part of the process. She noted that the refugee committee previously played a larger role in managing the camps, but they have slowly been pushed out. Meetings are now mostly for Thai government officials and foreign NGO workers, while the refugee committee has to ask to sit in on them. She believes that this is because the Thai government feels that it is easier to go through large NGOs.

[The refugee] are being excluded. It became just NGOs and the Thai state. In the past, [the refugee committee] had more power than now to take care of themselves, and they were stronger than this. They said that it’s also time that they were given back their role.

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