11/30/09 4:14 pm
Today I was invited to attend meetings at the Mae Tao refugee clinic in Mae Sot. I was surprised to see that the meetings were being held by the founder of the clinic, Dr. Cynthia Maung. As stated by the ever handy Wikipedia “Dr. Cynthia Maung…is a Karen medical doctor who since 1989 has lived in Mae Sot, on the Thai-Burmese border. She left Burma…and has since run a clinic treating Burmese refugees, migrants and orphans at Mae Tao Clinic in Mae Sot…together with 100 paramedics and teachers…She received Southeast Asia’s Ramon Magsaysay Award for community leadership and she was listed as one of 2003 Time Magazine’s Asian Heroes. Altogether she has received six international awards for her work. In 1999, she was the first recipient of the Jonathan Mann Award…” Dr. Cynthia was also nominated for a Nobel Peace Prize in 2004 for her work as well. Needless to say, I felt very fortunate to attend meetings with Dr. Cynthia and hear her wealth of knowledge she provided during the two meetings. Below I have attached some notes of these meetings which give a different view of the issues surrounding this region of the world.
Meeting #1 10:30am-11am
· About 150,000 migrants in the Mae Sot area
· There are 60 migrant schools
· The Mae Tao clinic has been in operation for 20 years, as of 2009.
· Displacement is more and more aggressive-only 50% of those displaced in Thailand think they will go back to Burma soon while the other 50% have lost family/friends and do not think they will go back very soon
· Every year Mae Tao Clinic services around 1000 pregnant women, but this does not include all the women in the surrounding areas that the clinic did not help. Many babies are born outside of the clinic
· 2008 working on getting certificates for babies born in Thailand
· Network training in the IDP areas is part of the vision of the clinic
· Burma Medical Association (BMA) is professional (registered?) organization the clinic partners with to give medical services inside Burma
· Training and child protection are the #1 visions of the clinic
· Always working on upgrading the existing systems
· Trainers from many ethnic areas of Burma-clinic helps many ethnic groups
· ~40 new people a year receive initial trainings at the clinic to become medical assistants and midwives, then those that have been medical assistants and midwives receive additional training to be upgraded
· 10-20 years ago at the beginning of displacement, no educational programs yet to help people learn the basics, like reading and writing, but now migrant schools/education programs are established to help. Challenge now to still educate those that didn’t receive proper education, still at base level from 10-20 years ago, while still giving proper education to the children.
· ~10,000-20,000 children in these schools
· Nearly all of these people are not registered
· Barriers to the existing education system include school bus fees to send children to school (sometimes the parents can’t afford it) and the children needed at home to help with chores/physical assistance like farming exc.
· Only about 50% of the teachers are trained
· Many of the teachers need an additional job for income/hard to retain teachers
· Less than 1% of those that help in/with the clinic are Thais
· Need to know more of the Thai language and the Thai system of government in order to be a bigger part of it/advocate better
· Question: What are the Burmese Military thoughts of the clinic? The military/high ranking officer became very aware of the clinic and the large number of people who attend the clinic in 1995.
· Burmese military made rule that Burmese nurses and doctors can only visit the clinic a total of 3 times. This was to prevent them learning too much about the hardships of people at the clinic.
· Since 1995 there has not been further discussion about this rule
· Inside Burma medical assistance can happen fast because it is community based and very centralized
· The NGOs hold lots of meetings on health issues but the clinic is only invited to these meetings, not a central player
· On the service level there is a lot of collaboration
· Question: Why can’t the clinic register? Because nearly everyone is not registered that works for the clinic and the doctors and nurses are not properly licensed so the Thai government can’t register a place like this
· Question: After Laura Bush visited in August of 2008, did you see an increase in American help? After the visit, people feel more secure emotionally but financially not a lot has changed, still have to negotiate many ways to get funding-example FDA approval (?). The level of funding feels about the same. May be more money but still a lot of people to deal with.
· Up to 2005 had focused a lot on cross-border support but since 2005 refocused on assistance in Thailand mostly
· The clinic is not controlled by any one organization, instead is helped by several different sources so this makes it easy for the clinic to have leniency to grow due to the diversity of support
Meeting #2 11:30am-12:30pm
· In 2007 a coalition of several surrounding organizations was established
· Forum of community organizations created standardized policies
· Right now the coalition focuses on health, education and advocacy work mostly
· Examples include working on development projects, women’s issues, and children’s issues
· Clinic main medical service provider, serviced ~80,000 cases a year
· Child protection work is a main issue to focus on
· Main roll: to provide emergency/short term services, to create standardized policies and procedures and to work on the long term training needs
· Question: How do the donor relations work? The clinic has ~20 donors in total and 65-70% of the funding comes through grants, some government grants and some NGO grants. There are also independent contributions given on line that can help a lot since the online money is more flexible to use.
· Even though this is helpful, the clinic increases there services about 20% every year.
· Local community medical structure already exists inside Burma so BMA and those structures work together to provide what is most needed. Some of the BMA service providers need to hide in the jungles for 2-3 weeks due to security issues. 30% are displaced to other villages
· 81 teams with BMA, 3-5 teams work in one area. ~300 service providers/health workers
· People in Burma are constantly dealing with a combination of malaria, forced labor, displacement issues so it is always dangerous but it is their life. Still community itself forms their own medical assistance
· The community based orgs do not use the names of the unregistered helpers that provide services and materials from Thailand so that the Burmese militia cannot connect these services to these orgs
· The main implementing orgs are the community orgs
· The non-cease fire areas can be considered the most dangerous because providing medical assistance is considered illegal work
· When a whole community is displaced everything along with it, such as the food, school and hospital structures, disintegrate
· When the clinic started in 1988 it was first formed to help with the emergency medical needs then there was a need to set up cross-border assistance as well so needed to set up a local center in Thailand and coordinate with the community medical centers in Burma
· Question: How has the world recession affected the clinic? See most of the effects in the dry food rations. There is a need for the clinic to support dry food for approximately 3,000 people so approximately 150 baht is allocated per person for the month but when rates of food increase, often the funding does not, so the food rations need to be less per person in order for everyone to get food
· Every (year?) about 800 clients are referred to the Mae Sot hospital
· Often Thai people can get medical attention when needed right away, but those in Burma often need to travel 3-5 or 3-7 days to get to the clinic and receive medical attention.
· Every year the clinic needs to upgrade some of their facilities but this is a problem due to lack of finances so there can become issues with the water system exc.
· An example of an issue: A large scale, multi-year donor had to cut funding by 40% so the support was cut from 4 years to 3 ½ years and in the process also had to cut major funding to programs such as the HIV program
· Always a need to constantly train new people since resettlement often takes those that were trained
· Question: What are the clinic’s challenges? Funding, security (of health workers and social workers), children’s futures-after they receive education, in 10 years, what jobs will they get? What is the education system working towards?
· Question: How are the community organizations and the clinic creating standardized policies? What policies are important to establish? In 2005 a lot of commitment to child protection-standard of care was created for displaced children, now need to work towards how to monitor this. In the future need to have a similar approach to gender issues and human assistant policy.
· Right now main focus is on child protection and other protection elements
· Dr. Cynthia poses the question, how do we get the Thai government to look at the issues of child protection? Registrations? For the new generations need more support from the policy gov’t level.
· Key is the expansion of the militarization, this threatens the children’s lives
· For the clinic, before 1995 mostly assisted the Karen but since 1995 assist lots of different regions
Today I was invited to attend meetings at the Mae Tao refugee clinic in Mae Sot. I was surprised to see that the meetings were being held by the founder of the clinic, Dr. Cynthia Maung. As stated by the ever handy Wikipedia “Dr. Cynthia Maung…is a Karen medical doctor who since 1989 has lived in Mae Sot, on the Thai-Burmese border. She left Burma…and has since run a clinic treating Burmese refugees, migrants and orphans at Mae Tao Clinic in Mae Sot…together with 100 paramedics and teachers…She received Southeast Asia’s Ramon Magsaysay Award for community leadership and she was listed as one of 2003 Time Magazine’s Asian Heroes. Altogether she has received six international awards for her work. In 1999, she was the first recipient of the Jonathan Mann Award…” Dr. Cynthia was also nominated for a Nobel Peace Prize in 2004 for her work as well. Needless to say, I felt very fortunate to attend meetings with Dr. Cynthia and hear her wealth of knowledge she provided during the two meetings. Below I have attached some notes of these meetings which give a different view of the issues surrounding this region of the world.
Meeting #1 10:30am-11am
· About 150,000 migrants in the Mae Sot area
· There are 60 migrant schools
· The Mae Tao clinic has been in operation for 20 years, as of 2009.
· Displacement is more and more aggressive-only 50% of those displaced in Thailand think they will go back to Burma soon while the other 50% have lost family/friends and do not think they will go back very soon
· Every year Mae Tao Clinic services around 1000 pregnant women, but this does not include all the women in the surrounding areas that the clinic did not help. Many babies are born outside of the clinic
· 2008 working on getting certificates for babies born in Thailand
· Network training in the IDP areas is part of the vision of the clinic
· Burma Medical Association (BMA) is professional (registered?) organization the clinic partners with to give medical services inside Burma
· Training and child protection are the #1 visions of the clinic
· Always working on upgrading the existing systems
· Trainers from many ethnic areas of Burma-clinic helps many ethnic groups
· ~40 new people a year receive initial trainings at the clinic to become medical assistants and midwives, then those that have been medical assistants and midwives receive additional training to be upgraded
· 10-20 years ago at the beginning of displacement, no educational programs yet to help people learn the basics, like reading and writing, but now migrant schools/education programs are established to help. Challenge now to still educate those that didn’t receive proper education, still at base level from 10-20 years ago, while still giving proper education to the children.
· ~10,000-20,000 children in these schools
· Nearly all of these people are not registered
· Barriers to the existing education system include school bus fees to send children to school (sometimes the parents can’t afford it) and the children needed at home to help with chores/physical assistance like farming exc.
· Only about 50% of the teachers are trained
· Many of the teachers need an additional job for income/hard to retain teachers
· Less than 1% of those that help in/with the clinic are Thais
· Need to know more of the Thai language and the Thai system of government in order to be a bigger part of it/advocate better
· Question: What are the Burmese Military thoughts of the clinic? The military/high ranking officer became very aware of the clinic and the large number of people who attend the clinic in 1995.
· Burmese military made rule that Burmese nurses and doctors can only visit the clinic a total of 3 times. This was to prevent them learning too much about the hardships of people at the clinic.
· Since 1995 there has not been further discussion about this rule
· Inside Burma medical assistance can happen fast because it is community based and very centralized
· The NGOs hold lots of meetings on health issues but the clinic is only invited to these meetings, not a central player
· On the service level there is a lot of collaboration
· Question: Why can’t the clinic register? Because nearly everyone is not registered that works for the clinic and the doctors and nurses are not properly licensed so the Thai government can’t register a place like this
· Question: After Laura Bush visited in August of 2008, did you see an increase in American help? After the visit, people feel more secure emotionally but financially not a lot has changed, still have to negotiate many ways to get funding-example FDA approval (?). The level of funding feels about the same. May be more money but still a lot of people to deal with.
· Up to 2005 had focused a lot on cross-border support but since 2005 refocused on assistance in Thailand mostly
· The clinic is not controlled by any one organization, instead is helped by several different sources so this makes it easy for the clinic to have leniency to grow due to the diversity of support
Meeting #2 11:30am-12:30pm
· In 2007 a coalition of several surrounding organizations was established
· Forum of community organizations created standardized policies
· Right now the coalition focuses on health, education and advocacy work mostly
· Examples include working on development projects, women’s issues, and children’s issues
· Clinic main medical service provider, serviced ~80,000 cases a year
· Child protection work is a main issue to focus on
· Main roll: to provide emergency/short term services, to create standardized policies and procedures and to work on the long term training needs
· Question: How do the donor relations work? The clinic has ~20 donors in total and 65-70% of the funding comes through grants, some government grants and some NGO grants. There are also independent contributions given on line that can help a lot since the online money is more flexible to use.
· Even though this is helpful, the clinic increases there services about 20% every year.
· Local community medical structure already exists inside Burma so BMA and those structures work together to provide what is most needed. Some of the BMA service providers need to hide in the jungles for 2-3 weeks due to security issues. 30% are displaced to other villages
· 81 teams with BMA, 3-5 teams work in one area. ~300 service providers/health workers
· People in Burma are constantly dealing with a combination of malaria, forced labor, displacement issues so it is always dangerous but it is their life. Still community itself forms their own medical assistance
· The community based orgs do not use the names of the unregistered helpers that provide services and materials from Thailand so that the Burmese militia cannot connect these services to these orgs
· The main implementing orgs are the community orgs
· The non-cease fire areas can be considered the most dangerous because providing medical assistance is considered illegal work
· When a whole community is displaced everything along with it, such as the food, school and hospital structures, disintegrate
· When the clinic started in 1988 it was first formed to help with the emergency medical needs then there was a need to set up cross-border assistance as well so needed to set up a local center in Thailand and coordinate with the community medical centers in Burma
· Question: How has the world recession affected the clinic? See most of the effects in the dry food rations. There is a need for the clinic to support dry food for approximately 3,000 people so approximately 150 baht is allocated per person for the month but when rates of food increase, often the funding does not, so the food rations need to be less per person in order for everyone to get food
· Every (year?) about 800 clients are referred to the Mae Sot hospital
· Often Thai people can get medical attention when needed right away, but those in Burma often need to travel 3-5 or 3-7 days to get to the clinic and receive medical attention.
· Every year the clinic needs to upgrade some of their facilities but this is a problem due to lack of finances so there can become issues with the water system exc.
· An example of an issue: A large scale, multi-year donor had to cut funding by 40% so the support was cut from 4 years to 3 ½ years and in the process also had to cut major funding to programs such as the HIV program
· Always a need to constantly train new people since resettlement often takes those that were trained
· Question: What are the clinic’s challenges? Funding, security (of health workers and social workers), children’s futures-after they receive education, in 10 years, what jobs will they get? What is the education system working towards?
· Question: How are the community organizations and the clinic creating standardized policies? What policies are important to establish? In 2005 a lot of commitment to child protection-standard of care was created for displaced children, now need to work towards how to monitor this. In the future need to have a similar approach to gender issues and human assistant policy.
· Right now main focus is on child protection and other protection elements
· Dr. Cynthia poses the question, how do we get the Thai government to look at the issues of child protection? Registrations? For the new generations need more support from the policy gov’t level.
· Key is the expansion of the militarization, this threatens the children’s lives
· For the clinic, before 1995 mostly assisted the Karen but since 1995 assist lots of different regions
