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MSF in Thailand, 2006/2007
Field Staff: 161
Reason for Intervention:
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MSF began its first-ever HIV anti-retroviral treatment program in 2000 in Thailand, using generic anti-retroviral drugs. Since then, MSF has worked closely with health authorities and local partners to provide support to people living with HIV/AIDS and improve their treatment and care. By July 2007, 100,000 patients were receiving free firstline anti-retrovirals (ARVs) through the national health system and mainly generated through local generic production. Yet vulnerable groups remain excluded whilst the growing need for secondline medicines - drugs for those who do not respond to treatment on firstline regimens - raises new challenges. MSF’s Campaign for Access to Essential Medicines continues to advocate for large-scale generic production of ARVs and supports the Ministry of Health’s (MoH) use of compulsory licensing to increase access to generic AIDS medicines.
In Kalasin province, northeast Thailand, MSF works in partnership with Kuchinarai district hospital and community groups to strengthen and maintain firstline anti-retroviral therapy (ART) through viral load monitoring and community activities. By July 2007, 180 patients were receiving firstline ARVs and five patients were on secondline ARVs. This pilot project is the only one to offer secondline ARV treatment at the district level.
Providing healthcare to migrants and minorities
In Thailand, health insurance is available only to registered Thai nationals and marginalized groups have limited access to healthcare. MSF has publicized its health concerns for these neglected populations and lobbies the Thai authorities to address their needs.
In Huay Nam Khao camp in Petchabun, northern Thailand, MSF has assisted the Lao Hmong since 2005, ensuring adequate medical care, water supply and sanitation in the camp. In 2006 over 24,000 consultations were conducted, mainly for respiratory infections and diarrhea. MSF liaised with camp leaders and public health authorities to raise awareness about the risk of epidemic outbreaks in this overcrowded camp. In late June 2007, the 7,900 refugees began to be relocated to a bigger holding camp. MSF helped with medical care and food distribution whilst ensuring families were not separated.
The Thai government is now deporting Hmong refugees upon entry to the country. MSF has called on the Thai government to stop the deportation and ensure the safety of the Hmong. MSF has also urged the international community to take a clear stance on the Hmong refugees.
In Mae Sot, on the Thai-Myanmar border, MSF began a tuberculosis (TB) project in 1999 with unregistered migrant workers from Myanmar. In 2006, the MoH gave permission to import treatment for multi drug-resistant TB. Between 2005 and 2006, the number of TB patients in care doubled, reaching a total of 799 people, 70 percent of whom successfully completed their regimen. In mid-2007, MSF opened a malaria project providing early diagnosis and treatment in New Mon State, an autonomous state inside Myanmar. Based in Sangklaburi, Kanchanaburi province, MSF teams support the health facilities in Mon State, situated in the ceasefire zone along the Thai-Myanmar Border, by providing drugs, lab materials and training.
In Chiang Saen and Mai Sai hospital, in Chang Rai province on the Thai-Laos border, MSF offers cross-border HIV/AIDS treatment and care to unregistered minorities from Myanmar and Laos. MSF has also strengthened the capacity of three Lao hospitals so that Lao patients can be referred and treated in their own country. In Phang Nga, thousands of undocumented migrant workers from Myanmar are still crossing the border in large numbers, seeking work in Thailand. The language barrier, fear of arrest, and lack of information prevent them from getting the medical attention they need. Through mobile clinics, health centers and the provision of Burmese speaking medical staff, MSF is assisting them with primary healthcare such as mother-child health and treatment of communicable diseases including HIV/AIDS. In 2006, 3,600 outpatient consultations were conducted at Phang Nga. MSF activities with the Muslim community in the south of Thailand are limited by ongoing violence and the general feeling of suspicion from the government and local Muslim communities towards outsiders. MSF is maintaining a presence in the area with HIV/AIDS education activities to increase AIDS awareness.
Offering care to intravenous drug users and prisoners
Intravenous drug users (IDU) in Thailand are among the highest risk groups for HIV infection. Many of these people suffer from discrimination that prevents them from obtaining proper medical care. MSF runs a weekly clinic in two IDU centers offering general healthcare and treatment of infectious diseases such as HIV/AIDS. This involves accompanying IDUs through hospital procedures and monitoring them closely for treatment adherence and further complications.
MSF also provides HIV prevention and treatment in two prisons in Bangkok in partnership with the Thai government. Thai prisons have high HIV infection rates and suffer from lack of health staff and severe budget constraints. MSF has enrolled 67 patients on ARV treatment since the program’s inception in 2003. MSF’s activities involve treatment of opportunistic infections, training the prison medical staff and covering lab costs. MSF is developing a training curriculum in collaboration with the Department of Corrections that will be used in the future to extend these services to all Thai prisons.
MSF has worked in Thailand since 1983.