MSF Departure Creates Huge Medical Gap in Thailand

After 35 years in Thailand, Médecins Sans Frontières (MSF), one of the world's major humanitarian organizations, announced on Wednesday that it had ended its operations in the country because of interference by the Thai government. MSF provided free medical treatment not only to registered migrant workers and refugees in Thailand, but also to thousands of undocumented migrants who relied on the group's projects for medical assistance. Despite efforts by the Thai authorities to register migrants, it is estimated that between 1.5 and 2 million migrants are still undocumented and therefore not entitled to public health care.

Saw Yan Naing, a senior reporter at The Irrawaddy, interviewed MSF’s head of mission in Thailand, Denis Penoy, about the organization’s withdrawal from the country.

Answer: The decision to close our mission in Thailand is mostly based on administrative blockages we have faced in providing healthcare to vulnerable populations. Despite negotiations with the authorities, we have not been authorized to provide healthcare to undocumented migrants and marginalized populations.

Q: How did the Thai government obstruct MSF’s work in Thailand?

A: We faced some misunderstandings in terms of administrative procedures required to provide healthcare to marginalized populations in Samut Sakhon and Three Pagodas Pass. Despite numerous attempts, it has proved impossible to regularize our administrative situation. Earlier this year we were forced to the close Samut Sakhon and Three Pagodas Pass projects. Maybe the healthcare of undocumented migrants was not their priority.

Q: What will be the possible impact of MSF stopping its work in Thailand?

A: More than 55 000 people have been affected by the closing of the Samut Sakhon and Three Pagodas Pass projects. They are mostly undocumented migrants and people living along the border with Burma who have been deprived from accessing healthcare. The MSF departure will as well mean that there won’t be any independent organization monitoring the healthcare situation of the migrants. 

Q: What work has MSF mainly focused on in Thailand? 

A: In Three Pagodas Pass, MSF provided access to medical care for migrant workers by operating a mobile clinic. We provided ante natal care, vaccinations and primary health care. In Samut Sakhon Province, MSF operated a clinic to provide primary healthcare to migrants.

Q: Who are the undocumented migrants that received MSF medical care?

A: More than 90 percent of the estimated 2 million unregistered migrants in Thailand are from Burma and the rest come from Cambodia and Lao PDR. These undocumented migrants are either new arrivals or they faced difficulties getting documented because of lack of money for the registration or there are no employers willing to get them registered. Some of the undocumented migrants are fishermen who spent their lives mostly at sea, and when they arrive at shore, many of them get arrested by the police on illegal migrant charges.

These undocumented migrants have no health insurance and are subject to arrest by the police or immigration officers. They are afraid to go out of their factories or residences, even in time of sickness, for fear of being arrested. In most cases, they arrive at the hospitals when they are seriously sick, and many times they are too late, so they die. Some of them also do not go to the hospital because they have to pay due to the lack of health insurance.

Because of their lack of legal status, the employers do not care about the labor protection law. If the undocumented migrant workers get sick, they cannot take any days off. If they take day offs to go to the hospital, they will not get paid for those days.