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Thailand: MSF Closes Its Longest Mission
After working in Thailand for 35 years, Doctors Without Borders/Médecins Sans Frontières (MSF) has reluctantly closed its final remaining project in the country.
It has proved impossible to obtain permission to offer medical attention to undocumented migrants and vulnerable people who are not entitled to basic healthcare. In September, MSF came to the conclusion that there was no choice but to close its longest-running mission, which started with the provision of assistance to Cambodian refugees fleeing the Khmer regime in 1976.
1976: Still in its infancy, Doctors Without Borders/Médecins Sans Frontières (MSF) brings aid to Cambodian refugees.
In October 1976, an MSF medical team arrived at the border with Cambodia, where camps had been set up to shelter Cambodians who had sought refuge when the communist Khmer Rouge forces swept into power in mid-1975. Three years later, tens of thousands of Cambodians fleeing starvation and the advancing Vietnamese army crossed into Thailand, in need of assistance.
Thailand became the setting for the development of new techniques and ideas in emergency assistance. It was in the refugee camps in the northeast of the country that MSF designed its first emergency kits and mobile hospitals.
MSF collaborates in the development of a new treatment for malaria.
In 1984, fighting between the Burmese military and the Karen Liberation Army drove an estimated 10,000 Karen from their villages across the border to Thailand. MSF began what was to become 20 years of assistance in the camps along the border.
In Mae Sot, MSF’s collaboration with the Shoklo Malaria Research Unit, of the Mahidol University of Bangkok, led to a critical medical breakthrough in the battle against malaria: the development of artemisinin-based combination therapy, which almost completely eradicated malaria from the camps.
© Stefan Pleger
In 2000, MSF offers antiretroviral (ARV) treatment to HIV patients for the very first time.
At the end of 2000, MSF offered ARV treatment in Thailand, at a time when it was rarely available in government hospitals. The following year, working closely with the Ministry of Health, MSF launched several HIV programs across the country, and introduced ARVs in Mae La refugee camp. MSF also collaborated with Thai civil society in major disputes with pharmaceutical companies over patents, and in campaigns for the local production of generic ARVs.
The consequent reduction in the cost of generic medicines enabled the national ARV program to be extended to thousands more patients, and MSF could therefore focus on high-risk groups of people who were still excluded from treatment, such as drug users and sex workers. MSF also developed a successful model of care for prisons in Bangkok.
© Espen Rasmussen
Tuberculosis (TB) treatment programs for migrants and refugees show that a more inclusive policy can work.
A team in Mae La camp began treating refugees for TB in 1985. MSF later set up a TB program for migrant workers, opening a chest clinic in Mae Sot in 1999 and then a pilot crossborder treatment program. These projects contributed to changes in international policy towards TB.
© Greg Constantine
Hmong refugees are excluded from healthcare and at risk of forced repatriation.
From 2005 to May 2009, MSF was the only non-governmental organization providing medical care, water supplies and sanitation in the camp in Phetchabun, northern Thailand, where Hmong refugees from Laos were living. During this time, MSF repeatedly denounced the Thai and Lao policy of forced repatriation, calling on the UN refugee agency, UNHCR, to oversee a process to ensure the refugees’ safety upon their return to Laos. In May 2009, MSF ended its activities in Phetchabun in protest at the increased restrictions imposed by the Thai military on the program and on access to patients.
© Veronique Terrasse
Medical teams are given training and supplies so that they can work across the border in Myanmar.
Many people living in semi-autonomous Mon state in Myanmar have very limited access to medical services. Based across the border in Sangkhla Buri in Thailand, MSF provided malaria training and essential drugs to Mon medical workers, who then travelled to remote villages in Myanmar to deliver basic healthcare and diagnose and treat malaria. Drawing from this experience, an MSF team in Mae Hong Son also began training ‘backpackers’ to carry out similar activities in the border area.
© Véronique Terrasse / MSF
2011: After offering emergency assistance to flood victims, MSF leaves Thailand
December 2011 marked the end of MSF’s 35 years of medical assistance in Thailand. After failing to get official authorization from the Thai government to work, MSF was forced to close its projects providing healthcare to undocumented migrants in Three Pagodas Pass and Samut Sakhon and suspend its activities with backpackers working in the border area between Myanmar and Thailand. However, a medical team responded to the floods that hit the country in October and November, distributing emergency relief and carrying out medical consultations.
For more on MSF's activities in Thailand in 2011, click here