Thailand

In early June, world leaders and global health officials gathered at the United Nations for a summit meeting on HIV/AIDS. Among the outcomes was a new treatment target, a plan to get 15 million people living with HIV/AIDS on antiretroviral (ARV) treatment by the year 2015.

After months of negotiations and discussions with Thai authorities, it has proved impossible to get permission to provide health care to undocumented migrants and vulnerable populations.

Thai authorities have begun expelling 4,000 Hmong remaining in the Huai Nam Khao camp in Thailand's Petchabun province back to Laos. No third-party organization is present at the site. Doctors Without Borders/Médecins Sans Frontières (MSF) which left the camps in May 2009 following military pressure, had denounced the forced repatriation policy.

During the rainy season, which would coincide with the hunger gap—the time just before the next harvest when food stocks dwindle—we would treat more than 1,200 severely and moderately malnourished children every week. Because of this great need, we refused to allow anything to interfere with our activities.

Over the past four months, the Thai military has used heightened restrictions and coercive tactics to pressure some 4,700 ethnic Lao Hmong refugees, who claim to have fled violence and persecution in Laos, to renounce their claims for protection and accept a forced return to Laos.

MSF denounces the growing pressure applied by Thailand’s army to force the 5,000 Hmong refugees living in Huai Nam Khao camp, in northern Thailand, to return to Laos. Increasingly restrictive measures have forced MSF to put a stop to its assistance activities after some four years of presence in the camp.

Weak, dehydrated, and traumatized, the Rohingya people who arrive on Thailand’s shores, after crossing the Andaman Sea from western Myanmar, come with alarming stories.

Some of the world’s leading photojournalists worked alongside our medical teams throughout 2008, documenting our work and following the lives of our patients and their communities. At the same time, some of our own staff captured unforgettable moments that we are pleased to include in this Year in Pictures issue of Alert, which brings together some of the most moving and telling photographs of the crises to which we responded in 2008.

Bangkok/Paris, June 25, 2008 —An estimated 800 ethnic Lao Hmong refugees were forcibly returned to Laos by the Thai government on Sunday, June 22, and the Thai authorities have stated publicly that they intend to proceed over the coming days with further repatriations to Laos from among the remaining 6,700 refugees in the Huai Nam Khao camp in Thailand’s Petchabun Province. The international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) is calling once again on the governments of Thailand and Laos to immediately stop all forced repatriations of the Hmong refugees.

On Friday, May 23, a fire destroyed close to 60 percent of the houses in the Huai Nam Khao refugee camp in Petchabun province in northern Thailand. The blaze took hold after a week-long demonstration in the camp, which is home to nearly 8,000 Lao Hmong refugees, to protest the arrest of a community leader and the imminent threat of a forced return to Laos.

Nearly 8,000 ethnic Lao Hmong currently confined to a guarded, barbed-wire enclosed camp controlled by the Thai military in the village of Huai Nam Khao in Petchabun province in northern Thailand face the imminent threat of a forced return to Laos. Many of these refugees have told MSF, the sole nongovernmental organization working in the camp, of a life in Laos spent fleeing violent attacks and persecution, witnessing the murder of family members, suffering rape, surviving bullet and shrapnel wounds, and enduring malnutrition and disease.

For patients with advanced HIV, complications from CMV retinitis— most notably blindness—are preventable. However, screening and treatment are out of reach in many places where CMV retinitis is prevalent.

On Wednesday, February 27, 2008, four ethnic Hmong families from the Huai Nam Khao refugee camp in Thailand were sent back to Laos. This confirmed fears expressed by Doctors Without Borders/Médecins Sans Frontières (MSF) in October 2007 with respect to the Thai government’s plans to forcibly repatriate 8,000 Hmong before the end of 2008. The refugees are currently confined to this camp in northern Thailand’s Petchabun province and claim to have fled violence and persecution in Laos.

Geneva/Bangkok, December 1, 2007 – Failure to diagnose and treat cytomegalovirus retinitis (CMV) in people with AIDS is leading to unnecessary blindness, according to a paper published today in the journal PLoS Medicine. The authors found in pilot studies that CMV retinitis, which has been dramatically reduced in wealthy countries since the advent of antiretroviral therapy, occurred in 23%, 27%, and 32% of patients with advanced AIDS in Cambodia, Myanmar and Thailand respectively. By training clinicians to screen and taking steps to make the best treatment affordable, the authors argue that CMV diagnosis and treatment can easily be integrated into existing AIDS treatment programs.

Bangkok/Paris, October 31, 2007 - MSF calls on the Thai government to halt all forced repatriation proceedings against the 7,500 ethnic Hmong refugees from Laos who are currently confined to a camp in northern Thailand's Petchabun province. The refugees, who claim to have fled violence and persecution in Laos, are deeply fearful of being returned to their country.

More than 7,000 Hmong refugees at the Huai Nam Khao camp in Phetchabun, Thailand, are in danger of being returned to Laos, where they fear political persecution for cooperating with the United States government during the US-Vietnam War. To this day, the Hmong continue to hide in the remote jungles of Laos, and thousands languish in squalid camps where conditions are crowded and epidemics are a constant threat.

By Dr. Tido von Schoen-Angerer
Executive director
Access to Essential Medicines Campaign
Doctors Without Borders

Dr. Buddhima Lokuge
U.S. manager, Access to Essential Medicines Campaign

Press teleconference on Thailand's compulsory licensing of an HIV/AIDS treatment, Abbott's response, and the coming crisis in availablity of second-line HIV drugs in developing countries.

By David Wilson
Medical Coordinator, Doctors Without Borders/Médecins Sans Frontieres

Although Hmong populations face unhealthy and near prison-like conditions at the Huai Nam Khao camp in Thailand, they are even more frightened by the prospect of being returned to Laos because they fear for their lives there. Emmanuel Drouhin, Doctors Without Borders/Médecins Sans Frontières (MSF) program manager for Thailand, provides an update.

Bangkok/New York/Geneva, 15 March 2007 — The international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) today denounced Abbott Laboratories' decision not to market its new medicines in Thailand. The Chicago-based multinational pharmaceutical company has cited Thailand's use of compulsory licenses as a reason for taking the drastic measures. MSF notes that the use of compulsory licenses to improve access to essential medicines is consistent with international laws, and is concerned that patients will bear the brunt of Abbott's harsh decision.

MSF expresses concern over the US intervention in the decision by the government of Thailand to issue a compulsory license on patents for the AIDS drug efavirenz, and explains why the US government should refrain from such actions.

Bangkok/New York, November 29, 2006 — Thailand today for the first time announced it will issue a compulsory license for use by the government to improve access to a key HIV/AIDS medicine, efavirenz. The international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) welcomes this important move and urges the government to issue such licenses for the production of other essential medicines.

Bangkok, January 11, 2006 — As talks take place in Chiang Mai, Thailand, this week on the intellectual property provisions of a proposed US-Thailand Free Trade Agreement, the international medical organization Doctors Without Borders/Médecins Sans Frontières (MSF) warns that acceptance of the US proposal could restrict access to essential medicines in Thailand and endanger the country's national HIV/AIDS treatment program.

31 January 2005 - A little over one month after the tsunami hit Southeast Asia, Doctors Without Borders/Médecins Sans Frontières (MSF) is publishing a detailed report of its emergency relief activities to assist the victims of the disaster. Since the beginning of the crisis, over 200 international MSF volunteers and 2,000 metric tons of supplies have been sent to the region. Today, 127 international volunteers are helping in Aceh, Indonesia, 36 in Sri Lanka, and 6 in India, working side by side with national staff.

December 28, 2004 - Doctors Without Borders/Médecins Sans Frontières (MSF) emergency medical teams are assessing the needs of populations in the areas hit hardest by the earthquake and tsunami in South Asia. MSF is airlifting more than 60 tons of medical, surgical, and water-and-sanitation equipment to Sri Lanka and Indonesia. Currently, MSF teams are on the ground in India, Indonesia, Malaysia, Myanmar, Sri Lanka, and Thailand.