[an error occurred while processing this directive]
BBC News
watch One-Minute World News
Last Updated: Monday, 5 March 2007, 13:34 GMT
Saving lives on the Burmese border
Dr Cynthia (left) and one of the many children in her care
Dr Cynthia and her clinic now treat 80,000 people a year
In the third of a series of articles from the Thai-Burma border, the BBC's Kate McGeown looks at the medical teams who do their best to help Burmese civilians in the region - sometimes risking their lives in the process.

If you were to trek into the jungle in eastern Burma, and mention the name Dr Cynthia, people would know immediately who you meant.

Cynthia Maung is well-known to Burmese in the border region, because her clinic in the Thai town of Mae Sot offers free healthcare, whatever the circumstances.

Most of the staff - including Dr Cynthia herself - are living in Thailand as refugees, having fled from Burma's harsh military regime.

Her clinic caters for thousands of other refugees, as well as economic migrants, and every year an increasing number of patients also come across the border from Burma, especially for treatment.

Such is the draw of the clinic - and the paucity of Burma's healthcare facilities - that even Burmese soldiers, with access to the country's best medical care, have been known to abandon their posts and turn up at Dr Cynthia's door.

"There is a real need for Burmese people to get access to basic healthcare, because conditions there are so bad," said Dr Cynthia. "We treat everyone we can, and we don't discriminate."

A worker in Dr Cynthia's prosthetics department

Allied to the clinic is another organisation, the Backpack Health Workers Team, which trains and equips local people to provide basic medical services in their communities back in Burma.

Often working in active conflict zones, riddled with landmines, these backpack medics risk their lives for their work - in fact seven have already been killed.

But as one young medic, Sa Muna, put it: "If we didn't do this, people would have no help at all."

'Waiting to die'

Both Dr Cynthia's and the backpack team have their origins in 1988, when a crackdown against pro-democracy demonstrations forced thousands of people to flee the country for Thailand - among them Dr Cynthia and backpack team director Mahn Mahn.

"We began by treating some of the people with us - a lot had malaria and were malnourished," said Dr Cynthia, "but soon we established a proper clinic."

She has never looked back. In 1989 her clinic had 2,000 patients, but last year more than 80,000 people received some form of treatment.

For many Burmese people, going to a Thai medical centre is not an option, partly because of the expense and also - for illegal migrants - it is an unsafe advertisement of their presence in Thailand.

Daniel Tun, a DKBA soldier
Even those fighting against Karen rebels are given treatment
So instead they pour into Dr Cynthia's.

The treatment on offer has revolutionised lives. "First I went to hospital in Burma, and I had to sell all my land to pay for it, but I still didn't get well," said 59-year-old Saw Raymond. "So my two sons brought me here, and I'm feeling a bit better already."

A quiet 34-year-old woman in the corner said she had come to get a supply of anti-retroviral drugs. She recently found out that she had HIV, and her whole village clubbed together to pay for her journey to Dr Cynthia's.

"I couldn't afford any treatment in Burma. If it wasn't for this clinic I'd just be waiting to die," she said.

Treating the enemy

A building at the back of the clinic houses a workshop for Maw Keh and his team, who construct prosthetic limbs for the many landmine victims in the region - a legacy of the long conflict between government and rebel soldiers.

"We often see people who have waited years for a new leg," said Maw Keh, who himself lost a leg to a landmine while fighting for the KNLA (Karen rebel army).

Most staff at the clinic, like Maw Keh, are ethnic Karen, and many openly support the rebels. But they say they will treat anyone who needs help, and true to their word a young soldier from the DKBA ( Democratic Karen Buddhist Army) - a group that split off from the KNLA and now fights on the government side - was being treated at the time of my visit.

"My motorbike hit a landmine, probably set by the KNLA," said 21-year-old Daniel Tun. "I don't know why I was brought here, but these people are good to me."

The backpack medics work under the same principle, although perhaps for them it is even harder to stay true to this creed. Their job is extremely dangerous, and they are often escorted by rebel armies for safety.

"I work in a war zone," said 29-year-old Ehkalu, who is usually based in an ethnic Karen region but is currently in Mae Sot for training. "A gun is an essential piece of my equipment."

Backpack medics in Karen state in Burma
Backpack medics risk their lives for their work
There are now 300 backpack medics, chosen from the communities they serve.

It is obvious how much they are needed. "One day we went to a village, and there were Burmese soldiers there, so it wasn't safe for us to go in," said Sai Lao, an ethnic Shan medic. "The people brought their sick out to us in the jungle, on make-shift stretchers."

But sadly there are sometimes situations that can prove just too difficult.

"Once I had to help a woman who had a difficult labour. Normally it would have been fine, but were in a battle zone, and we couldn't get her to the clinic in time. She and her baby died," said another medic, Sa Muna.

Burma's healthcare system is teetering on the brink of collapse, and more and more ordinary people are looking to organisations like Dr Cynthia's and the backpack medics to help them.

"Even if there are radical changes, the country will need time to rebuild before it can care for its people again," said Dr Cynthia. "We'll be here for many years to come."

In the last piece in the series, Kate McGeown looks at cross-border trade - and the fact that more goods seem to go illegally under the Thai-Burma Friendship Bridge than legally over it.

Please click below for previous articles in the series:

Do you live on the Thai-Burma border? Use the form below to send us your experiences and comments:

When I read this article, I feel really sorry for my people. Wherever we stay, we feel the same feeling. We don't feel safe. I hope one day we can all go back to our own land with peace. I miss my family and I often feel home sick. If I have a chance, I will go back to my home in Burma. Min Suu Mon, Chiang Mai,Thailand

I visited an orphanage for Karen children in the north of Thailand. The stores from these children are heart-breaking. According to Thai law they can remain in Thailand until they are 15. Then they must return to Burma. I hope the future will be brighter for them. James Casey, Chaing Rai, Thailand

I spent my first 12 in Karen State, and then nine years in a Karen refugee camp in Thailand. I came to Canada through World University Services of Canada Refugee Sponsorship Programme three years ago. After reading this article, I feel that I have a great responsibility to carry on the struggle for the Karen who have been suffering human right abuses for more than five decades. I personally think that the British bear a great responsibility for the Karen people. The Karen people were loyal to the British during Second World War and now they are forgotten by their allies. They are just fighting for justice. I really hope that the international community is aware of the plight of Karen people and their struggle. Slone Phan, Canada

I used to teach Burmese refugees in Mae Sot on the Thai-Burma border. I had a class of ten with students from different ethnic groups. I remember my Karen student fondly. He was a tall, plain-spoken man, about 30 years old. His dream was to be reunited with his family and to settle down for a peaceful life of farming in his native land. In fact, he wanted to return home so badly that he was seriously considering giving up his political struggle in the border region. The Burmese junta is waiting for more kind-hearted people like him to lose hope and resign themselves to living without basic human rights. I don't blame the Karen for fighting. Nor do I blame my former student for wanting to give up. When Burma's neighbours choose to engage with one of the worst governments in the world and the great powers cannot muster enough political muscle to improve life for the Burmese, her citizens are often left with no other choice but to engage with the generals, with or without guns. Joshua Wickerham, USA

I used to visit Mae Sot and Mae La camp quite often as a volunteer working in Bangkok. The situation for the political refugees and economic migrants is horrific. After they are caught by the Thai authorities they are often made to wait for days without food and water before deported to Burma. Those deported back to Burma through the Three Pagodas Pass area are subject to more danger, as it is less populated than Mae Sot. I've seen harassment of Karen refugees by Thai police and military not only in the border regions but also in Bangkok, where many Karen come while being processed to a third country. They are subject to searches and bribes when found out by the police. These Karen often hold official UN refugee status identification. Ryan Hughes, Oregon, US

I am from Thailand and I used to work in three different Karen refugee camps on the Thai-Burma Border. There are several NGOs working in those camps to make sure that the refugees have access to basic commodities. It's true that the Thai government has a strict policy towards illegal migrant workers, but it's also the business owners who encourage this practice. At one point there was a call for all illegal workers to register themselves with the government so that they will be on the record. However, most business owners refused to participate in because it's not in their interest to pay proper wages. Thailand will not be able to absorb all these refugees. Also the resettlement programme in third country is a very lengthy process and only special cases will be considered seriously. The only sustainable solution is to make Burma safe for them to return. Preyapan, Liberia

Three years ago, my wife and I attended a dinner party in France, and were seated at a table with a newly-wed couple. She is Burmese and he is British, and they were on their way back to Burma, after their honeymoon in Europe. I was about to ask them how the bride managed to come and go as she pleased, and why would they go back to live under such a regime, when I realized that they were part of the regime. From that point on, I could hardly wait for the meal to end. Were it not for the coddling by a few Western elite, the Burmese elite just might reflect more on their actions. Jonas South, US

I worked in a refugee facility in Mae Sot as a volunteer teacher in 2005. I worked mainly with Karen refugees. I have the tragedies that some of the refugees have experienced, especially children who have lost parents in the struggle and have lived in refugee camps in Thailand for several years. The hopelessness of the situation is daunting, yet the resilience and the confidence of the refugee peoples is both inspiring and humbling. Martin Morris, Australia

Migrants are active in trying to improve their situation in Thailand, both with regards to their working conditions and health care. Many migrants volunteer to be community health workers. Groups of migrants working in exploitative conditions have taken their labour cases through the legal mechanisms in Thailand and through their courage have improved some of these mechanisms. Many of the labour issues faced by Burmese migrants are the same issues faced by local Thai workers and the Thai Labour Solidarity Committee recently petitioned the government to improve the working conditions of migrant workers. Jacie Pollock, Chiang Mai, Thailand


The BBC is not responsible for the content of external internet sites

Has China's housing bubble burst?
How the world's oldest clove tree defied an empire
Why Royal Ballet principal Sergei Polunin quit


Americas Africa Europe Middle East South Asia Asia Pacific