International Rescue Committee UK

Above: (1) The Mae Tao clinic, on the outskirts of the town of Mae Sot in northeastern Thailand, is the only source of medical care for thousands of Burmese along the volatile Thailand-Myanmar border. (2) Unable to pay for his treatment for tuberculosis, Burmese farmer U Mya Aye travelled across potholed dirt roads on the back of a truck to make it to the clinic. Photos: Peter Biro/The IRC

By Peter Biro

Mae Sot, Thailand

When U Mya Aye was diagnosed with tuberculosis, it not only threatened his already fragile health, but the survival of his family. Unable to pay for treatment and in debt after paying for costly chest X-rays, the 53-year-old Burmese farmer was told about the Mae Tao Clinic. Located across the border in Thailand, the International Rescue Committee-supported clinic provides free healthcare to tens of thousands of Burmese refugees and migrants each year.

After two days traversing potholed dirt roads in the back of a truck while severely weakened and coughing blood into his handkerchief, U Mya Aye arrived at the clinic.

"It was not easy to get here, but it saved my life," U Mya Aye says as he recovers in a ward for patients with infectious diseases. "I'm slowly healing and feeling better."

Outside the ward, the clinic's waiting room is filled to capacity. Ragged-looking people line the corridors and squat on the floors. The air is filled with the spicy aroma of chewed betel and smoke from local "cheroot" cigars.

U Mya Aye is just one of hundreds of Burmese who come to the clinic daily to receive treatment. Some have fled ethnic conflict and economic stagnation inside Myanmar, also known as Burma - many are members of the Karen ethnic group - while others are living in Thailand as migrant workers.

Over half a million internally displaced Burmese live on the border with Thailand along with an estimated two million Burmese who live in the border region. Most lack healthcare and education, work menial jobs and live in constant fear of arrest and deportation.

Back in Myanmar the health system is in disarray and prohibitively expensive for the few who can afford it.

"To pay for my lab tests and X-rays in Myanmar, I had to borrow money from my extended family and friends," U Mya Aye says. "I owed 200,000 kyat (£140) before I was even treated."

The Mae Tao clinic, located in the border town of Mae Sot, treats some 150,000 patients a year, half from Myanmar. It is staffed by volunteers and the occasional Western-trained physician who can spend a month or so in residence. The clinic includes an emergency room, 200 hospital beds, surgical, maternity and eye-care wards, a laboratory and a blood bank. There is even a prosthetics workshop which makes and fits artificial limbs for patients who have stepped on one of the many landmines that litter the border area.

The IRC has been providing the Mae Tao clinic with financial and organisational support since 2005 through SHIELD, a project that aims to improve access to primary healthcare and education for Burmese refugees and migrants. The clinic also collaborates with "backpack health worker" teams. The teams, of which there are currently 76, cross the border into Myanmar where they provide medical treatment, community health education, and maternal and child healthcare for an estimated 150,000 people. Another organisation affiliated with Mae Tao is the Burmese Medical Association, a local group that operates 20 clinics in conflict-ridden eastern Myanmar.

Saw Aung Than Wai, a senior health worker for the Mae Tao clinic, says most of the diseases treated at the clinic are preventable and treatable if the patients only had access to proper medical care in Myanmar. Children are especially vulnerable. According to studies conducted by organisations affiliated with the clinic, the infant mortality rate in eastern Myanmar is 91 deaths for every 1,000 births, compared to an average rate of 76 for the rest of the country and only 18 in Thailand.

For adults and children alike, the most common affliction treated at the clinic is malaria.

"A lot of patients live in mosquito-infested forest areas without access to mosquito nets or anti-malarial medicines," Saw Aung Than Wai says. "It is probably the number one killer on the border."

In response, the SHIELD programme has provided large quantities of mosquito nets and malaria test kits to people displaced in eastern Burma.

Nyine Tun lies in a hospital bed hooked up to a drip bottle with saline solution. The frail 34-year old woman says that she contracted malaria two weeks before arriving at Mae Tao from a village deep in eastern Myanmar's interior.

"I had a very high fever for days," she says. "I went to a clinic in my village but they wouldn't treat me because I couldn't afford the medicines."

Nyine Tun ended up going to a traditional healer who prescribed herbs as treatment.

"They didn't help," she explains. "But poor people always treat themselves with herbs."

Nyine Tun finally decided to travel to Mae Tao, hitching a ride on the back of a truck. During the final leg of her journey, she was ferried across the fast-running Moei River, which marks the border, on an inner tube.

While patients like Nyine Tun describe making long arduous journeys to get to Mae Tao, it is the only way many of them will ever receive any form of healthcare.

"This clinic is truly saving lives," says Frank Brewster, a Canadian and one of the clinic's volunteering foreign physicians. "There simply is no functioning public health system in Myanmar."