Friday, December 20, 2013

As donors focus on Myanmar, clinic for Burmese in Thailand faces funding pressures

In a 2010 file photo, a boy from Myanmar sits near slippers outside the Mae Tao Clinic in Mae Sot, in northwest Thailand. The clinic offers free medical care for people from Myanmar after the country's longstanding political crisis forced millions across the border in search of a better and safer life. REUTERS/Chaiwat Subprasom

BANGKOK (Thomson Reuters Foundation) - Like many organisations working with Burmese in Thailand, Mae Tao Clinicknew that the changing political situation in Myanmar would impact their donors’ decisions. Then came the first blow in July.

The Australian government - whose A$500,000 ($443,000) in annual assistance covers about 85 percent of the Mae Tao’s maternal health services, as well as its outpatient care and eye clinic - decided to stop funding beyond 2013.

Mae Tao asked Australia’s Department of Foreign Affairs and Trade (DFAT) to reconsider, but last month, heard back that the answer was still no.

After evaluating its programmes, DFAT decided that future support would “focus on preparing refugees to return home when conditions permit”, a DFAT spokesperson told Thomson Reuters Foundation by email.

The funding proposal by Mae Tao “did not align with the objectives of the new program and its services do not reach as many refugees as those of successful applicants”, the DFAT email said.

Australia’s decision highlights the predicament Burmese groups and organisations on the Thai side of the border are facing - as impoverished Myanmar opens up after half a century of brutal military rule and donors shift support to projects within the country or those that assist the 130,000 refugees along the border to return to Myanmar.

Mae Tao - which is located in Mae Sot in northwestern Thailand along the border with Myanmar and provides free healthcare to tens of thousands of Burmese every year - counters that it is too early for repatriation and the needs in the border areas are still too high. 

“The ceasefires and monitoring of the peace process have not been enforced. There is ongoing displacement and land confiscation. It’s not easy for people to go back home and rebuild their communities,” said Dr Cynthia Maung, founder of Mae Tao and winner of the 2002 Ramon Magsaysay Award for Community Leadership, the region’s equivalent of the Nobel Prize.


Mae Tao was established in 1989 after Maung, an ethnic Karen, fled Myanmar following the military’s bloody crackdown on the 1988 pro-democracy uprising.

Starting with only four beds, it has grown into a full-fledged clinic with inpatient services, surgery and trauma care, dental care, vaccinations and HIV prevention. It also supports four small clinics inside Myanmar and is constructing new buildings in another new location. 

Last year, the main clinic in Mae Sot saw 73,000 patients - both Burmese migrant workers living in Thailand and people crossing from Myanmar, where the health infrastructure is poor. The clinic delivered an average of seven to 10 babies a day in 2012, on par with the Thai government-run Mae Sot hospital and twice as many as the Myanmar government hospital across the border.

Yet despite the recent changes in Myanmar, the clinic’s annual caseload has not decreased, said Maung.

Meanwhile, DFAT - which took over the functions of the Australian Agency for International Development (AusAid) in October - said the Australian government will provide $8 million over two years for aid agencies to provide food, shelter, healthcare, education and vocational training for refugees, but Mae Tao is not one of them.

The clinic is feeling similar pressures from other big donors, who mistakenly believe that Myanmar will be able to offer for its citizens the services that organisations like Mae Tao provide here in Thailand, says Yasmin Ahammad, fundraising and grants manager at Mae Tao.

“I think somehow there’s a lack of understanding of the role that Mae Tao clinic plays on the border, not just for Burmese migrant workers but for people inside Burma who still don’t have access to government health services,” she told Thomson Reuters Foundation in a phone interview.

“And there is a lack of understanding that health services won’t be ready to take on that caseload any time soon.”

Donors are looking at 2015 as a big year, with possible general elections in Myanmar, the beginning of regional integration efforts under the Association of Southeast Asian Nations bloc and the deadline for the Millennium Development Goals, Ahammad said.

“Coincidentally that is when our main grants are expiring from our other government donors, so we’re a bit concerned about what our funds would be from 2015 onwards.”


The border town of Mae Sot, where the clinic is located, is home to thousands of Burmese refugees who fled conflict and violence as well as to tens of thousands more migrant workers, many of whom are engaged in low-skilled, backbreaking jobs.

Some donors have made it clear that they are funding Mae Tao to support patients who come from Myanmar but not migrant workers, who are seen as economic migrants, even though it is difficult to know why exactly they left, Ahammad said.

“Mae Sot is becoming a special economic zone. It’s going to attract more migrant workers, and these people remain marginalised, so they won’t necessarily be earning proper salaries. They are vulnerable to exploitation, so we feel that we have to be here and that the Thai system won’t necessarily be able to absorb them,” she added.

In addition, the much-lauded reforms in Myanmar have yet to trickle down to ethnic areas, Maung said. 

“Government expenditure in health and education is still very low, compared to neighboring countries. Without addressing these issues and continuing monitoring of the reform process and displacement, there will be ongoing problems for our patients,” she said.

Fortunately for the clinic, three weeks ago a new donor - a private foundation - has stepped in to fill the substantial gap left by the Australian government.