May 22, 2008
Thailand 2007 © Greg Constantine
“I will never go back to Laos. I would rather die here than go back to where so many of my family died.” BV, a 20-year-old woman in the Huai Nam Khao camp
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 the international medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (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.
Recent actions taken by the Thai and Lao governments—including the involuntary return to Laos of 11 refugees in the camp—have heightened the anxiety, psychological distress, and fear among the camp population. Four of the refugees have attempted to commit suicide since January 2008. Some refugees receiving psychological care have told MSF that facing the Thai military during the screening process—even anticipation of the meeting—has triggered flashbacks and nightmares recalling abuses suffered in Laos. This state of desperation has been fueled by the Thai military’s near constant threats to the refugees of an imminent return to Laos.
Out of grave concern for their safety and well-being, MSF is calling upon the governments of Thailand and Laos to immediately stop the forced repatriation of these Lao Hmong refugees without independent monitoring and guarantees for their safety.
MSF began providing humanitarian aid to this group of refugees in July 2005. During medical and psychosocial consultations, MSF has found extreme fear and psychological distress among this population, which has only been exacerbated by the threat of a return to Laos.
Refugees have told MSF field staff about recent abuses suffered in Laos, which are consistent with reports by human right organizations1 and independent journalists2 who have visited the areas of Laos (Borikamxai, Xieng Khouang, Xaisomboune, and Vientiane provinces) where many of the Hmong refugees have fled. At least 181 refugees in the camp bear physical scars, such as bullet and shrapnel wounds, from alleged abuses in Laos.
The Thai government proceeded in December 2007 and January 2008 with a screening process without the participation of any third party and its results have not been communicated to UN High Commissioner for Refugees (UNHCR). The purpose of this operation was to separate refugees fleeing persecution in Laos from those migrating for economic reasons. Despite repeated requests, UNHCR has not been allowed to access the camp or to monitor the screening process at any point over the last three years3.
The repatriation process agreed upon by Thailand and Laos seriously threatens the legal and fundamental right of non-refoulement—whereby people fleeing persecution must not be sent back to countries where their lives or liberty would be threatened4.
The government in Laos has continually prevented nongovernmental organizations and international organizations from monitoring and assessing the safety of Lao Hmong returnees. Since December 2005, more than 370 Hmong have been forcibly returned to Laos. Some of these individuals have been held in arbitrary detention, and there have been credible reports of torture5. The Lao government has made the firm demand that no third party should be included in the repatriation process. This was made a condition of any negotiation with Thailand on the issue of Hmong returns.
Additionally, MSF also requests that the ASEAN presidency and members, key regional stakeholders, and the French and US governments to ensure that Thailand and Laos resolve this issue in accordance with international standards for the protection of refugees.
Thailand 2007 © Greg Constantine
The Hmong refugees that MSF assists in Huai Nam Khao in northern Thailand are originally from Laos. According to the Lao government, more than 450,000 Hmong live in Laos, constituting 8 percent of the population and making them the third largest ethnic group in the country after the Lao and the Khmou. Ethnic Hmong also live in Cambodia, southern China, Thailand, and Vietnam.
During the Vietnam War, certain Hmong were recruited by the Central Intelligence Agency (CIA) of the United States to support the American army in Vietnam and Laos. In the first decade following the US departure in 1973, approximately 300,000 people6, including many Hmong, fled Laos to Thailand where they sought refugee status. The majority resettled in third countries, particularly in the US, which received some 250,000 Lao people between 1975 and 19967, more than half ethnic Hmong.
Because of the involvement by some Hmong with the CIA-trained army, the Communist government in Laos has treated this group with suspicion since it came to power in 1975. Thousands of irregular Hmong soldiers retreated to inaccessible forest areas with their families out of fear for their safety. According to people living in the camp and human rights organizations, up to a few thousand Hmong, including women, children and elderly people, still live in the jungle today and continue to be subject to attacks and persecution by the Lao military. As a result, Hmong have continued to flee Laos since the end of the war.
In May 2005, Thailand closed a Hmong refugee camp, prompting approximately 15,000 to seek refuge at the Wat Tham Krabok Temple in Saraburi, central Thailand. The US government eventually agreed to accept roughly 15,000 Hmong for resettlement.
In late 2004, a portion of the current refugee population of Huai Nam Khao camp – an estimated 4,000 to 5,000 ethnic Hmong – began fleeing from Laos across the Mekong River into Petchabun province in search of safety from what they claimed as violence and persecution in Laos.
Thailand 2007 © Greg Constantine
Many of these refugees first lived in the forest on the village’s outskirts and were provided food by local residents. Some worked on local farms to support their families. Others used the little money or resources they had to buy or trade for food at the local market. In June 2005, local Thai authorities allegedly began forcing the Lao Hmong refugees to leave the forests surrounding Huai Nam Khao and started pressuring the village residents to stop assisting the refugees.
During the first week of July 2005, MSF learned of their plight through several articles published in the Bangkok Post. MSF dispatched a medical and logistical team to assess the situation, where approximately 5,000 to 6,000 refugees were now settled on both sides of the town’s main road. The refugees had little access to shelter, food, safe drinking water, or health care. The MSF team immediately opened an outpatient clinic.
By mid-2007, with new arrivals, the population of the makeshift camp in Huai Nam Khao had grown to approximately 7,800 people. These arrivals included an estimated 1,000 Hmong from the former refugee camp in Wat Tham Krabok. In June 2007, the refugees were relocated to a new site, approximately three kilometers from the village center. The new camp, roughly 20 hectares (49 acres) in size, is enclosed with barbed-wire fencing and lies on a hillside. Access is controlled by the Thai military. The refugees have better living conditions, but their movements are confined to the camp and there are no adequate educational facilities for the children or employment opportunities for adults. According to an MSF registration from April 2008, at present there are 1,451 families and a total of about 7,850 people living in the camp.
Thailand 2007 © Greg Constantine
Having completed its screening process, the Thai government continues to refuse any independent monitoring or review of the protection claims made by Lao Hmong refugees. On February 27, 2008, four Hmong families—11 individuals—were sent back to Laos.
According to Thai authorities, the four families were registered on a list of voluntary returnees. But statements given to MSF from witnesses in the camp do not corroborate this account. On that day, Thai soldiers examined their registration cards and screened them. They then separated 12 people from the group and had them board military vehicles. According to these witnesses, several people were clearly being forced to board the vehicles.
A woman with 5 children, ages 2 to 15, was compelled to leave even though her children were still in the camp, making the claim that she was returning voluntarily to Laos doubtful. She managed to escape and her whereabouts remain unknown. She is still separated from her children in the camp.
Thailand 2007 © Greg Constantine
MSF was able to interview four families registered that day. None of them expressed the desire to return to Laos. Indeed, they fear for their safety if they return. A 27-year-old man registered on the list told MSF, “I never said I wanted to go back to Laos—no one has told me why I’m on this voluntary list. I don’t want to go back to Laos—I’m afraid of what will happen to me if I go back there.” A 50-year-old man who is the head of a family of 9 said, “I don’t know why I’m on this list, but I do not want to go back to Laos. If I return to Laos they’re going to kill me.”
On April 10, 2008, another 67 Hmong were again allegedly voluntarily returned to Laos. However, their protection claims were never reviewed by any third party. These incidents, in addition to the repeated denial of any involvement of an independent third party, challenge the legitimacy of Thai government’s screening process. UNHCR has not been allowed to enter the area since the beginning and despite numerous official requests the agency was not allowed to assess the conditions of the refugees, review their claims for protection, or take part in the screening process. The Lao government has made the firm demand that no third party should be included in the repatriation process. This was made a condition of any negotiation with Thailand on the issue of Hmong returns.
Thus the forced repatriation process may continue without any monitoring of the humanitarian conditions or respect for individuals’ rights—a prospect that has increased the level of fear and anxiety among the population and caused families to regularly flee the camp since August 2007.
Thailand 2007 © Greg Constantine
The alleged abuses perpetrated against Lao Hmong refugees who have been forcibly returned to Laos have intensified the stress and anxiety among an already traumatized population. In December 2005, 27 Lao Hmong children (5 boys and 22 girls) from Huai Nam Khao were arrested by the Thai police and sent back by force to Laos. Twelve of the girls managed to come back to Thailand and join their parents in the camp in May 2007. They told MSF staff of enduring repeated beatings, rapes, and other abuses during their detention in Laos. Ten girls and five boys are still in Laos, their whereabouts and fates unknown.
Such incidents have only heightened anxieties among the population living in the camp. Following a mental health assessment in the camp to obtain some indicators of the prevalence of psychological disorders among the Hmong refugees, MSF began providing mental health counseling in November 2007 to the most traumatized refugees.
The adults interviewed presented various psychological disorders as well as a high level of psychological distress: pathological mourning due to death or disappearance of multiple family members, psycho-traumatic disorders due to exposure to numerous highly traumatic situations (being forced to hide, flee under dangerous conditions, live under constant threat of attack and sexual violence), anxiety disorders due to the uncertainty of their future, and the inability to control their present living conditions.
In clinical interviews, patients presented several symptoms related to post-traumatic stress disorder as well as anxiety-related depressive disorders. Their main symptoms are persistent sadness, anxious mood, crying easily, sleeping disorders, recurrent nightmares of traumatic events, feelings of hopelessness, difficulty concentrating, and somatic complaints such as headaches and other chronic pains.
Thailand 2007 © Greg Constantine
For nearly three years, MSF has been providing medical care to the refugees living in Petchabun, a population completely dependent on outside aid. The main need voiced by the Hmong refugee population is protection from forced repatriation to Laos. MSF patients say they are extremely afraid about the prospect of a forced return to Laos. For many of them, this situation produces intense stress and psychological suffering. Though the MSF team provides psychological support for this population, it cannot respond to the real need the people are voicing; the need to be protected from a forced return.
As the sole international organization present in Huai Nam Khao camp, MSF is urging the governments of Thailand and Laos to immediately halt all repatriation proceedings against the Lao Hmong refugees living in the camp and to allow an independent third party to monitor and assess the fears of the population, ensure that guarantees for their safety are in place, and any repatriation to Laos is voluntary and secure. International standards state that repatriation cannot be forced or imposed on individuals fearing for their safety and any repatriation must remain linked to guarantees for safety upon return. For the Lao Hmong refugees, none of these conditions have been met by either the governments of Thailand and Laos.
Additionally, MSF urges the ASEAN presidency and members, key regional stakeholders, and the French and US governments to ensure that Thailand and Laos resolve this issue in accordance with international standards for the protection of refugees.
Thailand 2007 © Greg Constantine
The stress of life in the camp for refugees who report a long personal history of traumatic events in Laos continues to intensify in the face of ongoing uncertainty about their future and lack of any economic opportunity. So far, 96 patients have been seen for psychological consultation. MSF staff living in the camp report there are many more whom suffer symptoms of stress but are not yet referred. Nearly every day, new faces come to the consultation room door and ask to be seen. Of those seen, 93 percent report a lifetime of loss, torture, running, hiding, and starving in the mountainous jungles of Laos. Patients present extensive documents showing photos of the dead and relatives in military uniforms, papers showing the family’s connection to the CIA, and maps of hiding places and routes of escape from attacks. While many details differ, the elements are quite consistent.
Of the 96 patients seen for consultation nearly 50 percent threaten suicide if they are forced to return to Laos. They make statements that vary in intensity, from: “I would rather die in this camp than return to Laos” to: “If I am forced to go back to Laos I will kill my family with a knife and then hang myself.” Or, “I will force the soldier to shoot me.” One patient who tried to kill himself by drinking wood staining liquid reported that he was tortured by thoughts of the past suffering in Laos, humiliated by his present circumstances of being poor and unable to provide for his family, and hopeless about the future, convinced he will be killed anyway if he is sent back. “At least I can choose my time to die and join my father (who recently was reported killed in Laos)”. Another male patient expressed suicidal thoughts and a plan to kill his family if forced to return: Since I was a small child, my life has been running from the war, hiding and starving in the jungle, and seeing my family killed. Now I am afraid of being sent back to the same suffering, and I have to beg for protection. I thought I would find a better life.
A pervasive fear stalks the Lao Hmong refugees in Huai Nam Khao camp because of the prospect of a forced return to Laos. In testimonies provided to MSF staff, many of these refugees tell of facing a daily struggle to survive targeted attacks, witnessing the murder of family members, suffering rape, and surviving bullet and shrapnel wounds, as well as malnutrition and disease. They endured these hardships and acute stress for prolonged periods with little or no access to any health-care services or medicine beyond herbal remedies harvested from the jungle. During these interviews, many of the refugees repeatedly stated to MSF staff members that they feared death, torture, and imprisonment if returned to Laos. Further attesting to the intense and overwhelming stress felt among the refugees, some of the interviewees expressed suicidal thoughts when asked about being sent back to Laos.
YH, 22 years old, used to live in the forests of Xieng Khaouang province in Laos. She fled to Thailand in May 2005 after five cousins and two sisters had been 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. We were chased by the Lao and Vietnamese soldiers all the time. All my family members were killed by soldiers. Sometime 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. Sometimes the soldiers would accidentally kill one another, and some of the adults would see their bodies and the uniforms that they were wearing. During one attack, one of my younger sisters breathed in poisonous gas and she passed out. My mother had to carry her. Eventually, all her teeth fell out.
My husband decided we could no longer stay in the forest. He thought we should try to come to Thailand. We were still constantly being chased by the Lao and Vietnamese soldiers. When we finally made it to the Mekong River my husband paid a fisherman to take across the river. Then we paid some more silver to a driver and my husband told him to take us where the Hmong were living. He dropped us in Huai Nam Khao. All we had when we arrived was my husband’s Hmong knife that he used to dig for roots. Some of the Thai Hmong in the village let us live with them. Then we were forced to live with the other Lao Hmong along the roadside. We started to receive food from MSF. Ever since we fled Laos our life has gotten better 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. If I think about it too much I faint. I don’t want to be sent back to Laos to be killed. Everyone is saying we are going to be sent back.”
KL lived most of her life in the forest in Laos’ Xieng Khouang province. Her father fought alongside other Hmong who were allegedly trained by the Central Intelligence Agency of the U.S. government. She and her family were later captured by Lao soldiers and sent to a camp. She was repeatedly raped by the soldiers and later escaped to Thailand.
“In 2002, the Lao military surrounded the area where my family and I had settled in the forest. The soldiers arrested me and my husband. Our four children were also brought to the camp. The soldiers took us to a village and we stayed there for about one month. Then, the military took my husband and another man into the jungle with them to try to find other Hmong groups. I never saw my husband again. About five months later, the soldiers asked me where my husband had gone. I told them I did not know and they beat me. Two days every week the soldiers would march me to the local commander’s compound for questioning. They would rape me. When the soldiers realized I was pregnant from the rape they put me in jail. My children stayed back in the camp.
I knew if I stayed in the jail that I would be killed. I had no choice but to runaway from the jail and leave my children behind. When I fled into the jungle I came across the rotten body of the other man who had been taken into the forest with my husband. His throat had been cut. I assumed they had done the same to my husband, but I couldn’t find anything to indicate if he was alive or dead. I fled to Vientiane. Some people told me that the army was looking for me. I asked them what I should do and they told me to take a boat across the Mekong River and travel to Petchabun province in Thailand where other Hmong were living. When I got to the Mekong River I went into labor and delivered my daughter. I just wrapped her up in cloth. Even though she was born out of rape, she is part of my blood and I really love her. The military keep on scaring us that they will send us back to Laos. I don’t want to go back to Laos. I cannot sleep at night. I am always scared. And as long as we have food to eat we will stay here. When we lived in the forest we didn’t have much to eat. I had never tasted rice before coming here. We were just eating the insides of trees. Everyday, I prayed to heaven but nobody could hear me. Now that I have told my story I hope someone can help me.”
CY is 18. She is originally from Bolikhamxai province in Laos. She arrived at Huai Nan Khao refugee camp on October 4, 2006, accompanied by her three-year-old brother.
“Laotian soldiers attack us regularly, at least four or five times a year, particularly during the dry season. Laotian helicopters fly over the jungle to find groups of Hmong. Failing that, they drop troops down close by and the soldiers search for us, surveying the area for several days. To find us in the jungle, the military look out for signs of us, particularly marks made by machetes on the vegetation - so we try to leave as few traces as possible. When there is an attack, we separate, and we normally get together again a few days later, in a predetermined place. Generally, the soldiers systematically kill the men and capture the women. To defend ourselves, some of our group were armed [one weapon to 3 or 4 men], some groups possess a few machine guns (M16s); in my group we only had a few old rifles, but it is very difficult to obtain ammunition. ‘Since my childhood, several of my cousins in my group have been killed. In 2002, one of my elder brothers was killed by soldiers when he was out collecting fruit with my cousins. One day in 2004, at around 8 in the morning, Laotian soldiers found our camp. That day, my mother and two men from our group were killed, the soldiers set fire to our camp, but my father, my two younger brothers and I managed to escape.
We later found the rest of the group; we use a sort whistle made of leaves to find each other after we have dispersed. ‘In March 2006, soldiers attacked us again and my father and I had to separate, each taking one of my younger brothers. We had arranged to meet at a place. I waited for my father for two days but he never arrived; I was terrified, alone with my brother. Then I decided to walk and, after a day and a night of walking, I came upon a Hmong village on the edge of the jungle. The village chief introduced me to some cousins [among the Hmong, the same surname means you are from the same clan, i.e. cousins; two people with the same surname cannot marry each other].
I stayed there for eight months, working, but the village chief then asked me to leave as he considered it too dangerous for him and for the village if the Laotian authorities discovered me there. He told me there was a Laotian Hmong camp in Thailand, where I would be safe.”
In December 2005, 27 Lao Hmong children (5 boys and 22 girls) from Huai Nam Khao were arrested by the Thai police on their way to celebrate Christmas and sent back by force to Laos. Since then, in May 2007, 12 of the girls managed to come back to Thailand and join their parents in the camp.
Their testimonies collected directly by the MSF team attest to the harsh treatment those children had endured during their detention in Laos. PHY is one of the girls who returned to Huai Nam Khao. Her statement was taken in the presence of two other girls, PKY, 16, and MY, 16, who were also among the group sent to Laos. During the interview, they occasionally added details and information regarding their own experience. Ultimately, all three girls endured the same situation.
PHY describes their experience after being deported to Laos.
“Six policemen arrived and started asking us questions, beating us at the same time. They questioned each girl privately (one girl after another in different rooms). They asked, ‘Where do you come from and what are you doing?’
We answered that we were from Huai Nam Khao in Thailand and that we were telling the truth, but the police wouldn’t believe us and they beat us even more. They asked us our religion and we told them that we believed in Jesus. They asked who the priest at Huai Nam Khao was and if he was an American priest. They asked if we had been sent by the Americans or the Thais to talk to other Hmong about Jesus. The police also tried to force us to say that we were being paid by Thailand or the Americans to go to Xieng Khouang province to find other Hmong. They also asked who the leader of our group was, but we told them that we didn't have any leaders. They accused us of trying to meet the Hmong who live in the jungle to start a war in this country. They accused us of being spies and things like that.
The more we said no, the more they beat us. They hit us in the stomach, grabbed our hair and beat our heads on the floor. They tore our clothes and touched our private parts, saying they wanted to make sure that we weren’t hiding anything. One of the policemen held my legs while others raped and beat me. They did that for an entire day, one man after another. There were six rooms in the prison. Every day, we would experience the same treatment. They would beat us until we were nearly unconscious, let us recover, sometimes for a day, and start over again. They also terrorized us with a revolver. The policemen told us that the boys had already confessed and so it would be a good idea for us to tell the truth.
They made us listen to a recording. You could hear each boy being beaten, crying and answering, “Yes, yes,” to the questions the police were asking. They asked, “Were you going to Xieng Kouang? Were you going to the market to take the money the Americans gave you to support the war in the jungle? Are you from Xieng Kouang?” The boy was just crying, and saying, “Yes, yes, yes.”
Thailand 2007 © Greg Constantine
Since November 2005, MSF has been the only international humanitarian agency providing medical and relief assistance to the Lao Hmong refugee population in Huai Nam Khao. Besides providing medical care, MSF also runs the water supply system and sanitation services, distributes relief items (blankets, plastic sheeting, cooking sets, charcoal, and soap), runs an immunization program, and provides reproductive health services (antenatal care, family planning, and safe birthing services).
In mid-2006, in order to prevent the deterioration of the nutritional situation, MSF began providing targeted food distributions to children under five and pregnant and lactating women. This was later expanded to a general food distribution of a full ration, which now serves 1,451 families in the camp. Patients requiring emergency medical services or specialized tests or examinations are referred to local health facilities. These comprehensive services and activities have helped to maintain the health of the refugee population and prevent the outbreak of epidemics.
In June 2007, the Thai government relocated the refugees to a new site approximately three kilometers north of the village. The camp, roughly 20 hectares (49 acres) in size, lies on a hillside with only one access point that is controlled by the Thai military. The camp is enclosed with barbed-wire fencing. MSF was allowed to build an outpatient clinic and logistical warehouse inside the camp in order to continue providing assistance to the refugees as well as designing and implementing the water supply and sanitation system at the new site. Living conditions in the new camp are much improved. There is more space, better access to proper drinking water, better sanitation, and better shelter. Health services have also been improved, notably by MSF’s provision of 24-hour maternal health services.
Thailand 2007 © Greg Constantine
Every day, the MSF medical team provides around 100 consultations, including nearly 15 antenatal consultations. The maternal health team manages about 25 births per month. The main pathologies are upper respiratory tract infections (30 percent), diarrhea (15 percent), skin and eye infections (9 percent), and dental problems (7 percent). Since MSF started to provide tuberculosis treatment (mid-2006), 24 patients have been registered and 22 have successfully completed their treatment and one died due to complications, leaving only 1 patient currently under treatment. On average, MSF refers 115 patients per month to the district or provincial Thai hospitals for consultation or admission.
MSF maintains the EPI (Expanded Program on Immunization) program in Huai Nam Khao camp. A vaccination survey done in May 2007 shows that the coverage is very good; 100 percent of the children have vaccination cards, and the average coverage among children is above 95 percent. MSF provides a full monthly food ration of 2,200 calories per person per day; this ration is composed of rice, soybeans, dried fish, salt, sugar, oil, and chili peppers. Since MSF initiated the monthly food-ration distribution, the level of malnutrition has dropped significantly. As of March 2008, only 5 people were receiving treatment for malnutrition. MSF also provides non-food items such as charcoal, soap, plastic sheeting, blankets, cooking pot and stoves. And the MSF logistical team manages appropriate water supply and sanitation services (latrines, drainages, elimination of domestic waste and vector control activities). The cost of this operation for 2007 is €1,560,000.
© 2013 Doctors Without Borders/Médecins Sans Frontières (MSF)