Thailand

THAÏLAND - Burmese-Thai border

KEY PROGRAM DETAILS

»FIELD LOCATION
Office in Bangkok
Bases in Umphang and Mae Sot
3 camps: Nupo, Umpiem and Mae La

»BENEFICIARIES
91,000 in the three camps
Health Messenger users: 2,930 health care personnel

»A.M.I. TEAM
15 expatriates: 1 program manager, 1 medical coordinator, 1 administrative and financial coordinator, 1 logistics coordinator, 3 project managers (1 for Mae La, 1 for Nupo and Umpiem and 1 for the HIV/VCT programs, training and mental health), 1 publication manager, 1 logistician/water specialist, 2 medical advisers, 1 OPD Outpatient Department physician, 1 Inpatient Department physician (in Mae La), 1 psychologist, 1 nursing adviser Local staff member: 65 in the bases and 491 in the camps (physicians, nurses, laboratory technicians, logisticians, administrative personnel, etc.).

»FUNDING
ECHO, EuropeAid, United Nations High Commission for Refugees (UNHCR), International Rescue Committee (IRC).


THE SITUATION IN THAILAND

Since 1984, thousands of people have fled Burmese territory to find refuge in Thailand. Today, over 150,000 people, for the most part ethnic Karen, but also Karenni, Mon, and others, live in nine camps along the Burmese-Thai border. These men, women and children do not possess refugee status as defined by the Geneva Convention of 1951. Their rights are extremely limited, and with rare exceptions cannot circulate or travel outside the camps. They are unable to meet even the most elementary needs independently and depend upon the support of international solidarity organizations. Other displaced persons live in the vicinity of the camps, in equally precarious conditions, without official recognition.
For the past few years, a process of “relocation” initiated by international organizations and other nations has enabled the inhabitants of the camps to emigrate to other countries. However, these countries give priority to qualified workers, and tend to select trained, local A.M.I. staff members. This situation intensified in 2006, and again in 2007 and 2008, in the three camps where A.M.I. operates. A.M.I. teams must therefore replace their personnel.


A.M.I. OPERATIONS – BACKGROUND

Since 1995, A.M.I. has conducted programs for the benefit of the inhabitans of camps along the border.
These beneficiaries number approximately 91,000, in three camps in the province of Tak: Mae La (44,000), Nupo and Umpiem (18,000 each) and neighboring villages (11,000).


ACTIVITIES AND ACHIEVEMENTS IN 2008

A.M.I. programs are focused mainly on primary health care, with both preventive care (exclusively in the Mae La camp) and treatment, but extend also to more specific activities of prevention and monitoring of epidemics, programs to improve access to drinking water, and publications.

» Training
The training of local health care personnel, both basic and continuous, is an integral part of A.M.I.’s health care programs. Its aim is to consolidate the skills and independence of local health care teams. Training sessions are provided to laboratory technicians, midwives, medics, nurses, etc. Continuous training, supervision and monitoring supplement these training sessions.
Due to the increase in the number of inhabitants of the camps in 2007 and 2008, training was intensified in 2008. Refresher courses were organized for home care providers and mental health specialists.

» Preventive care
The preventive care sector of our activities, in which special attention is given to pregnant women and young children, includes vaccination campaigns, growth monitoring, nutrition, post-natal care, health education sessions and demographic monitoring.

» Treatment
A.M.I. teams provide primary health care together with the personnel of the camps. This includes not only consultations with general practitioners and medical examinations for newcomers to the camps, but also consultations with specialists: gynecologists, dentists and ophthalmologists, as well as laboratory analyses.
Care is provided in two types of structures: IPDs (Inside Patient Departments) in each camp, and OPDs (Outside Patient Departments), two in Mae La and Umpiem and one in Nupo, which have been restored, equipped and adjusted by A.M.I. Cases which are not treatable in A.M.I. health care structures are referred to hospitals in the vicinity.
In addition to the above, epidemiological and animal monitoring is carried out in the three camps, with capability for response to requirements.

» Additional activities
Two additional health care programs, part of the treatment aspect of A.M.I. operations, were carried out in 2008, as follows:
> prevention of HIV/AIDS (awareness sessions and voluntary testing), treatment by antiviral drugs for HIV-positive patients, elimination of discrimination against the HIV-positive
> mental health (psychosocial support for those suffering from trauma due to displacement and living conditions, from discrimination due to mental conditions and support for and victims of violence).

» Water supply
In the Mae La camp, A.M.I. is carrying out a water supply program, providing drinking water treatment and analysis. The program was transferred to the NGO Solidarity in November 2008.

» Circulation of Health Messenger magazine
Health Messenger (HM) Thailand has been in circulation since 1995. This training tool is distributed in the nine camps along the Burmese-Thai border. It is part of the package of training tools designed and put into operation by A.M.I. In 2008, two issues of Health Messenger, “technical cards”, were published in Thailand.


Perspectives for 2009
Within the framework of relocation, which enables trained and experienced members of A.M.I. teams to leave the camps for other countries, A.M.I. will be continuing its efforts begun in 2008 to improve in quality and quantity the primary health care teams in the camps. The objectives for 2009 will thus be focused on maintaining and consolidating the following activities:
> training of health care personnel in the camps
> epidemiological monitoring and response system
> medical information system
> relations/protocols with partners
> medical structures
> specialized health care (psychology, ophthalmology, care for HIVpositive patients, dental care and laboratory analyses).
A.M.I. teams will focus on:
> limiting expenses relative to hospital referrals
> seeking funding for A.M.I. publications
> continuing to capitalize on knowledge and know-how, consolidate working relationships among local and expatriate team members
> considering innovations for the enhancement of current health care projects.
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Project definition in Thailand

Localization

- Administrative representation in Bangkok. Bases in Umphang and Mae Sot
- Refugee camps in the province of Tak on the Thai-Burmese border: Nupoe camp [district of Umphang] since 1997, Umpiem camp [district of Pophra] since 2001 and Mae La camp [district of Tha Song Yang] since 2005

Beneficiaries

- Population covered: 98,195 people
- Direct beneficiaries: 88,667 beneficiaries [78,612 refugees and 10,055 village residents living near the three camps]

AMI’s team on this project

- 18 expatriates: doctors, psychologist, logistician, midwife, head of mission, medical coordinator, project manager, nurse, etc.
- 343 local staff [Thai and refugees] : doctors, nurses, lab-technicians, logisticians, administrative staff, etc.

Sources of Funds

United Nations Children’s Fund [UNICEF], United Nations High Commissioner for Refugees [UNHCR], European Community Humanitarian Office [ECHO]

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