Helping the Most Vulnerable in a Thai Border Town

Text and photo by Dene-Hern Chen

Tak Province, Thailand – Ask anyone in the Thai border town of Mae Sot for directions to Mae Tao Clinic, and they would instruct you to go towards the bus station on the highway, and look for a crowd of Burmese people. Tucked off the side of the road, this clinic may be modest in size but it serves as a helpline for hundreds of thousands of migrant workers and refugees flooding in from Burma.

Started by Dr. Cynthia Maung in 1989, the clinic attends to roughly 400 patients daily, treating ailments ranging from malaria and dengue to helping landmine victims who were injured by along the border.

In one corner of the compound, about 20 people stand in front of an eye chart with one eye covered, reciting letters out loud. Not far from them, dozens of young parents cradle their toddlers as they wait to see the pediatrician. Further inside, there is an infirmary for long-term patients, as well as a workshop where young trainees learn how to shape prosthetic limbs outfitted for landmine victims.

Dr. Maung arrived in Mae Sot after taking part in the 1988 student protests against the Burmese government. Burma – now referred to as Myanmar because of its new nominally civilian government – was in disarray. Due to violent clashes between the army and the armed ethnic groups, civilians – ranging from ethnic Karen, Mon, Chin, Kachin and Burman – left their homes in droves, trekking through a malaria-ridden jungle before arriving at Thailand’s refugee camps.

Addressing the urgent need for emergency medical treatment was Dr. Maung’s impetus to beginning Mae Tao clinic, with the help of displaced ethnic Karen community

“We just set it up without thinking how many cases we had to treat, because we thought we would be here only three to six months, and then the elections would happen and Burma would change,” she said, speaking to Catalyst Asia at the clinic’s library. “Then the 1990 elections came. And we saw even more people fleeing to the border.”

The most pertinent health issues facing the refugee community in the beginning was malaria, she said. While entirely treatable, malaria can be fatal without the right diagnostic tools or access to clean water and medication. “Within one year, in this whole border area, we saw almost 100 people die because of malaria.”

Today, the community that seeks help from Mae Tao clinic has shifted slightly. Due to Thailand’s economic developments in the 90s, people started entering from Burma to seek work as migrant labourers.

“Initially, we saw war casualties. Now, we see road accidents,” she said.

When migrant workers started bringing their families to the clinic, Mae Tao’s staff realized that it had to make maternal childcare a focus. There was also a growing number of people who sustained injuries working in nearby garment factories and road accidents, and a burgeoning young, uneducated population resulted in unplanned pregnancies.

Since the clinic provides healthcare to the community for a negligible compensation, it sustains itself on aid from international donors and NGOs. Dr. Maung said that since 2012, donors for various community organizations working on the border have started to shift their funds in to Burma through the civilian government because of its promises of democratic reform. But little of this money funnels back to the migrant and refugee community along the border.

The clinic has not yet been directly affected, but Dr. Maung is worried about the donors’ waning interest on border issues, especially since there are still people coming out of Burma to seek better lives.

“As long as the disparity between Thailand and Burma exists – the disparity in health, education, economy – people will try and find opportunity,” she said. “The key message is to continue to strengthen civil society’s role on the border – they are crucial on both sides. If not, these people will be neglected and even more vulnerable.”

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