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International Activity Report 2009

Thailand

For decades Thailand has been a magnet for economic migrants and asylum seekers fleeing poverty or political unrest in the surrounding regions. The country introduced a Universal Health Coverage Scheme in 2001, and although the national healthcare scheme was extended to include registered labor migrants, it does not cover those who are undocumented. These people make up more than three-quarters of the total migrant population and usually cannot afford treatment. MSF has been working to help such migrants, and has been continuing to give medical assistance to displaced people and marginalized ethnic minority groups.

Cross-border activities

MSF continued to support people living in New Mon State (Myanmar) throughout 2009. Along the border with Thailand, the area enjoys semi-autonomy and has its own health authority but it lacks drugs and equipment. The Mon people live in small, scattered and remote villages. The MSF program focuses mainly on treating and preventing malaria, which is endemic here. Teams train village malaria workers and support local health centers. In 2009, MSF distributed more than 1,400 bed nets and carried out 3,700 consultations.

In March 2009, drawing on its experience in New Mon State, MSF began training Thai medical staff operating in the remote areas of Kayah State, eastern Myanmar, near the border with Thailand. These staff have direct contact with isolated ethnic minorities hiding in the jungle who have no access to healthcare. MSF also donated malaria treatment and diagnosis kits.

Hmong refugees

Having worked in the refugee camp for four years, MSF ended its activities in May 2009 because the Thai army attempted to empty the camps by forcibly repatriating the Hmong people to Laos. In addition the army increased restrictions on access to medical treatment and food to pressure refugees to return, which reduced MSF’s ability to work.

MSF repeatedly denounced the Thai and Laotian government’s policy of forced repatriation and called for an independent third party (the UN High Commission on Refugees – UNHCR) to be involved to help guarantee the refugees’ rights and safety upon their return to Laos.

Before leaving, MSF had conducted 11,200 consultations, mainly for respiratory infections, Diarrhea and skin infections, and provided psychological support to people suffering from stress, anxiety and depression. MSF also provided family planning and immunization programs for pregnant women and children.

After MSF’s departure, camp activities were handed over to a local non governmental organization with the support of UNICEF. At the end of 2009, the Thai government forcibly repatriated more than 4,000 Hmong from the camp, without involving UNHCR.

HIV handover

2009 marked the end of MSF’s HIV/AIDS projects with the handover in July of its last program in Phang Nga, southern Thailand.

Patient story

YH, 22 years old, used to live in the forests of Xiangkhouang province in Laos. She fled to Thailand in May 2005 after five cousins and two sisters were killed during attacks on her family. She lives with her husband and their three-year-old daughter in Huai Nam Khao.

‘I lived all my life in the forest in Laos. Lao and Vietnamese soldiers chased us all the time. Soldiers killed all my family members. Sometimes the planes attacking us would drop bombs that produced a poisonous, yellow-colored gas. We would have to run and hide among the trees. I saw a lot of people die. During one attack, one of my younger sisters breathed in poisonous gas and she passed out. My mother had to carry her.

‘My husband decided we could no longer stay in the forest and that we should come to Thailand. All we had when we arrived was my husband’s Hmong knife that he used to dig for roots. We started to receive food from MSF. Ever since we fled Laos our life has improved because we have had food to eat and we don’t have to hide from attacks. But I am so afraid that we will be sent back to Laos. I don’t want to be sent back to Laos to be killed. Everyone is saying we are going to be sent back.’

MSF has been working in Thailand since 1976.

MSF Projects 2009