Nursing Fellow Burmese in Thailand Against Many Odds

GENEVA -- Dr. Cynthia Maung doesn't care that much about the high-level Rio+20 United Nations conference on sustainability this week. And it doesn't matter to her that the country she lives in, Thailand, is advancing a green agenda. Dr. Maung, a general practitioner, prefers to see action on the ground to help the refugee and migrant communities living on the border with Myanmar, also known as Burma.

Dr. Cynthia, as her team calls her, is 52 years old, a mother of four and lives in Mae Sot, a Thai border town that is home to one of the largest populations of Burmese refugees displaced in Thailand. She has been running the Mae Tao clinic for the refugees for more than 20 years. The longtime Myanmar opposition leader, Daw Aung San Suu Kyi, who is now a Parliament member, visited Mae Sot earlier this month to address the many challenges in providing adequate health services for these vulnerable populations.

Recent natural disasters, which some experts attribute to global climate change, have plagued the region, worsening the situation for the refugees by increasing food insecurity and the spread of malaria and other diseases as well as limiting access to medical facilities.

The United Nations is working daily to provide life-saving assistance in the areas of reproductive and child health, immunizations, infectious diseases and trauma in partnership with a number of community-based health groups in the region, including Dr. Cynthia's clinic.

"I live just five kilometers from the border with Burma," Dr. Cynthia said in a phone interview with PassBlue. "We work with the displaced to provide health services, pre-natal care and to protect children from severe malnutrition. Many young people are separated from their families and have unplanned pregnancies and unsafe abortions."

Dr. Cynthia also runs several orphanages to help combat the threat of back-street abortions and child trafficking, which run rampant in Mae Sot. Many young migrant workers are coerced into prostitution without condom use and forced to leave their families -- victims of traffickers who take drugs and children across borders for sale.

Born to the Karen ethnic minority group in Myanmar, Dr. Cynthia fled to Thailand in her 30's, in 1988, to escape religious persecution as a Baptist and detention by the military junta during pro-democracy movements in the country. When the military made a concerted push against the Karen, many of her fellow Burmese also fled the country or went into hiding, moving quickly and without possessions. After her escape into Thailand, Dr. Cynthia remained on the border. Though she struggled to survive, she was often asked to provide medical help to the local indigenous communities and began by offering treatments for malaria and pre-natal services for pregnant women.

Many of the people she assisted were fellow Burmese who had crossed into Thailand to seek refuge in towns and villages nearby over decades.The Women's Refugee Commission, an international advocacy group based in New York, estimates that more than half a million Burmese refugees and asylum seekers have gone to live in neighboring countries. Hundreds of thousands of Burmese exist in refugee-like circumstances throughout Thailand, with at least a quarter of a million of them said to have fled human rights violations, though most if not all are treated as illegal immigrants by the Thai government.

Environmental degradation is increasing the plight of the displaced people. "We must protect human rights by monitoring rights as they are linked with the environment," Dr. Cynthia said. "Governments have to listen to the people and make them feel stronger and healthier. Human rights are affected on both sides of the border. Without human rights, there is no such thing as sustainability. The international community should engage with the Burmese and Thai governments to consider border security for the local populations instead of promoting economic needs through dam projects, which are causing environmental harm and spreading disease."

Thailand's prime minister, Yingluck Shinawatra, has agreed to increase investment in green technology and emphasized her country's promotion of environmental protection programs, which include conservation and integrated coastal management. Nevertheless, big business from China seems to be trumping these interests. China, in partnership with Myanmar and Thailand, is aiming to build up Southeast Asia's hydropower capacity in the next few years with billions of dollars souping up hydro dams.

Eager to please their powerful Chinese investors, the Thai government has allowed the building of dams to go unchecked to a point of ruin for many local people. Hydrodam projects on the Thanlwin River, which runs along the border between Thailand and Myanmar, have been widely criticized by Burmese migrant rights groups and environmental activists for forcing changes in water levels and causing downstream erosion.

The World Health Organization has also released studies focused on the links between water resource development projects, like hydro dams, and the frequency and transmission of malaria.

"Local town people are continuously displaced from their homes because the government is coming to make new hydro dam projects. It is a great vulnerability for women and children with no access to health services," Dr. Cynthia said. Man-made reservoirs associated with the dam projects also severely degrade water quality, damage fisheries and create environments suitable for breeding mosquitoes and other disease carriers. In May, The Lancet medical journal published a study on a deadly strain of malaria that appeared to be drug resistant spreading rapidly from the rivers in Cambodia into Thailand and Myanmar. The infection has affected many migrant workers employed on the dam projects.

Dr. Cynthia's clinic and the staff worked day and night to treat patients with the malaria symptoms. She said many cases could have been prevented if there were better systems in place to provide medical facilities for timely treatment as migrants traveled from job to job.

"There needs be a policy to protect indigenous people and the local community," Dr. Cynthia said, "because big projects for hydropower force people to leave their home and be displaced. People can preserve local knowledge and culture and make sustainable agriculture. The government can promote and preserve the environment and empower the people to be sustainable developers of their own community."

By Tala Dowlatshahi

Originally posted on passblue at the UN.