|A refugee child waits to be treated at the Mae Tao clinic in Mae Sot, Tak province, on the border with Myanmar. Rations for refugees have been cut this month, sparking fears for the health of more vulnerable residents of the camps.|
Refugees face increased hardship as funds dry up ahead of their expected repatriation
With once-isolated Myanmar opening up since 2010 elections installed a civilian government, more international aid has poured into the country and NGOs from the West have rushed to set up headquarters there.
However, around 130,000 refugees - mostly members of the Karen ethnic group who fled a bloody conflict in their homeland in eastern Myanmar - still live in camps on the Thai side of the border.
Both governments, along with refugee groups and the UN High Commissioner for Refugees, have been negotiating their return, although no timeframe has been set. Yet with the funding drying up, aid workers on the border say the situation is become increasingly desperate.
"The funding available for humanitarian support is decreasing," says Sally Thompson, head of The Border Consortium (TBC), a group of 10 international NGOs working in the field. "In 2014 we will still find ways to support refugees, but we have got to do it more efficiently. There are no spare funds."
Many refugees will see their rice rations for December cut as households are categorised according to need. Although the most needy households will receive more rice - alongside meagre rations of split peas, vegetable oil, flour and fish paste - the cuts are driven by reductions in funding for food aid.
Thompson says the protracted nature of the situation on the border, the opening up of Myanmar, and talk of the refugees returning within the next few years, make it increasingly difficult to attract funding.
Many have no wish to return anyway. The first camps opened in 1984, and now more than half the population is aged under 19. "Most of the youth in the camps don't know what a life is like in Burma, they don't relate to a life in Burma," says Thompson. "Their formative years have all been here in Thailand."
In the camps, they have had access to basic healthcare and education provided by international NGOs, as well as vocational training in subjects such as mechanics, hairdressing, baking and tailoring. If they are sent back to Karen state, which lacks even the most basic infrastructure, they can look forward to little more than a life based on subsistence farming.
For decades following Myanmar's independence in 1948, the Karen fought a bloody war for independence or greater autonomy. A ceasefire was signed early last year, but the Myanmar army still maintains a strong presence in the area, prompting fear and suspicion among those who fled the atrocities it carried out.
Although Thai authorities bar residents from leaving the camps, many do find work locally, leaving themselves open to arrest and exploitation. They usually receive less than the minimum wage, and unscrupulous employers often refuse to pay them at all. Young women are especially vulnerable to sexual abuse by employers and authority figures such as policemen and government officials.
Some refugees with an entrepreneurial spirit have found ways to make a living in the camps by selling everything from food to clothing and mobile phones. But to make its limited funds go further, the TBC says it now needs to focus its efforts on those it considers most vulnerable, and is encouraging those who can to take more responsibility for themselves.
"They do a lot for themselves now, they always have done," says a clearly frustrated Thompson at her office in downtown Bangkok. "They haven't been lying around indolently and doing nothing, but on the other hand their choices have been very restricted, so they have been very dependent on what the international humanitarian community has provided."
Admitting that the level of assistance now provided is "extremely marginal", she adds: "We are asking them to take more risks because we don't have the funds. It's not good to have to do that. We are asking people to look at what the risks are and how to protect themselves."
The TBC - formerly known as the Thai-Burma Border Consortium - opened an office in Yangon in August, in preparation for the return of the refugees. Many think this could take place after elections due in Myanmar in 2015, if they go ahead peacefully and are deemed free and fair.
Among the organisations that are feeling the pinch as the funding dries up is the renowned Mae Tao Clinic in the Thai border town of Mae Sot. It was set up in 1989 by Dr Cynthia Maung, an ethnic Karen who fled the fighting in her home country and has since won many awards for her humanitarian work.
The clinic now treats around 100,000 patients a year. Nearly half of these travel from Myanmar to receive treatment, and the rest are migrant workers living in Thailand.
In July, the Australian overseas aid agency AusAID announced that it was cutting its funding to the clinic, and Dr Maung says many donors have yet to commit beyond 2015, when 40 per cent of the current funding runs out.
The clinic's budget is around Bt100 million to Bt120 million a year, including Bt10 million-Bt12 million annually from the British government.
Like Thompson, Dr Maung is concerned that health and education services currently provided by civic organisations on the border will suffer from the cuts, noting that it will take years to build up decent infrastructure in Myanmar.
"We are a big organisation so we have more access to funding than other, smaller organisations, but we are struggling and trying to readjust our programmes," she said. "The big problem is smaller organisations and schools … We worry about the child labour issue if the schools aren't open and there is no access to education."
Dr Maung hasn't been back to Myanmar since she fled in the aftermath of the 1988 student uprising that led to a brutal crackdown by the ruling military, but she says there is a need to build stronger civil society organisations there. She hopes to go back one day, but in the meantime wants to continue her work treating migrant workers and refugees.
"The border is very unique," she says. "We belong to both countries."
Mark Fenn is a Bangkok-based journalist. He has written for publications including the Times of London, The Independent, South China Morning Post and the Far East Economic Review.