MSF Thailand pullout affects healthcare inside Burma – The Irrawaddy


View from the Thai side of the Mae Sot-Myawaddy border bridge, June 2011 (Photo: Simon Roughneen)

BANGKOK – Médecins Sans Frontières’ (MSF) decision to end its Thailand operation will hamper medics who cross from Thailand into war-torn areas of Burma where people have little or no access to medical treatment.

Denis Penoy, the organisation’s head in Thailand, told The Irrawaddy that MSF has a long history of working with mobile medical teams along the border, notably the Mon National Health Council based in Sangkhlaburi, across the border from Three Pagodas Pass inside Burma.

The Mon medics were supported by MSF in carrying out anti-malarial work inside Mon State, which Nai Hong Sar, head of the New Mon State Party (NSMP), described to The Irrawaddy as “very important for our people, as malaria was so much reduced, and otherwise it was hard to get medical treatment”.

The cross-border support was one component of MSF’s larger health programme in Thailand, which helped migrants living in the country. With an estimated 2-3 million Burmese migrant workers in Thailand, of which around half are thought to be working illegally and therefore unable to access Thai health services, the closure of the MSF facilities is a blow to many Burmese.

Penoy told The Irrawaddy that “our estimated catchment population for clinics is around 55,000 people”. As well as Sangkhlaburi, MSF ran clinics in Samut Sakhon, a fishing port west of Bangkok and home for tens of thousands of Burmese migrants.

Nai Hong Sar added that the MSF clinic in Sangkhlaburi was vital to many Burmese migrants living on the Thai side of the border. “These are people who have not got the money to go to hospital and many are afraid to go to official medical facilities”, he said.

For the past eighteen months, MSF has been negotiating with local health authorities to try re-open the clinics. “When we could not get agreement at local level, we tried central health authorities”, says Penoy, “but after eighteen months of talking, we concluded that we could no longer operate”.

Penoy says that MSF was permitted to continue with health education work, which he says is needed, but for Burmese migrants with health problems, education is secondary to immediate needs. “When you need a doctor you need a doctor”, says Penoy.

MSF has worked in Thailand – a country long-seen as a safe haven for refugees and other vulnerable people from neighbouring countries in southeast Asia – for over three decades. MSF first worked in Thailand helping Cambodians who fled the Khmer Rouge regime, which took power in Phnom Penh in 1975.

On Wednesday October 5, Thai Prime Minister Yingluck Shinawatra visited Burma, meeting with President Thein Sein. In a statement issued since the visit, the Thai PM revealed that she called for the Burmese Government to re-open the bridge linking Thailand’s Mae Sot to Myawaddy on the Burmese side.

The bridge has been closed by the Burmese authorities, since mid 2010, widely-believed to an attempt pressure on Thailand to restrict ethnic opposition groups based in or near Mae Sot and elsewhere along the border. The closure has impeded Thai businesses that export by land into Burma, and has made life difficult for Burmese migrants who cross into Thailand.

In her statement released Friday/today October 7, the Thai Prime Minister said that she “admired the democratic process in Myanmar”, adding that “Thailand would not allow anti-Myanmar government groups to use Thailand as their base to fight the Myanmar government.”

The previous Thai Government, a coalition led by the Democrat Party, along with local officials in border provinces, all made a number statements about repatriating Burmese dissidents and refugees. The Burmese Government has long regarded refugee populations in Thailand as synonymous with ethnic opposition groups.

Delegations representing the New Mon State Party (NMSP) and the Mon State government met on Thursday, but did not make any progress on peace talks. Nai Hing Sar is a lead representative of the United Nationalities Federation Council (UNFC), an umbrella group of ethnic militias that includes the Kachin Independence Army (KIA) and Karen National Liberation Army (KNLA), which have both fought the Burmese army in recent months.

The area inside Mon State around Three Pagodas Pass has seen intermittent fighting in the months since Burma’s November 7 2010 parliamentary election, with thousands of refugees fleeing temporarily to Thailand. Asked whether he thought there was any link between Thai Government promises to restrict Burma’s ethnic opposition groups, and the difficulties faced by MSF in Thailand, Nai Hong Sar surmised “maybe, maybe”.

However, Mahn Mahn, head of the Backpack Health Workers Team, another group of mobile medics that crosses the border into Burma to deliver healthcare to Burmese in conflict zone, said that his organisation, which is based in Tak Province, close to the Mae Sot-Myawaddy bridge, says his organisation “has a good understanding with the local authorities”, and continues to work inside Burma.

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