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Wah K’Ler Paw, a 30-year-old refugee from Myanmar, survived for about two weeks without dialysis after US president Donald Trump suspended foreign aid.
“She never complained about what she was going through,” says her husband, Thaw, from the Mae La refugee camp along the Thai-Myanmar border, where the couple had lived with their two-year-old daughter, Thaw Wah.
Despite a pledge from US secretary of state, Marco Rubio, that life-saving assistance would be exempt from the 90-day USAid freeze, for refugees like Wah K’Ler Paw, who relied on care from US-backed organisations, Trump’s decision has been deadly.
Along the border, the US government’s aid freeze has forced countless charities and NGOs providing healthcare and other essential services to refugees from Myanmar to suddenly cease operations or cut back their work. This includes the International Rescue Committee (IRC), which was forced to stop running health facilities that served seven refugee camps.
In the wake of the decision, Wah K’Ler Paw’s husband scrambled to find ways to continue her dialysis, which stopped being provided in early February. Eventually she was admitted to a Thai hospital that could provide dialysis, but by then it was too late. She died on 16 February.
Wah K’Ler Paw is not the only one that has suffered the fatal consequences of the aid freeze.
Earlier in February, Pe Kha Lau, 71, another refugee from Myanmar, died in the Umpiem Mai refugee camp after struggling to breathe. Four days earlier she had been discharged from a healthcare facility in the camp, from which the IRC was also forced to withdraw.
It is unclear why but NGOs such as the IRC, which operate on the Thai-Myanmar border, have not been granted a waiver to continue, despite Rubio’s exemption. The IRC did not respond to request for comment from the Guardian.
Even in areas where programmes have been given exemptions, work has reportedly been halted because the payment system that USAid relies on to distribute assistance has been inaccessible amid the political turmoil in Washington.
The refugee camps that stretch along Thailand’s mountainous border with Myanmar are home to 90,000 people, mainly from the Karen ethnic minority. Most have lived in the camps for decades after fleeing fighting between the military and ethnic armed groups. Others arrived more recently, fleeing the deadly conflict that has gripped Myanmar since the military seized power in a widely opposed 2021 coup. The IRC also funded healthcare for many who live in precarious conditions outside the camps.
The US, the single-largest aid donor in the world, last year disbursed $223.5m in USAid funding to Myanmar, and contributed 31.6% of the country’s humanitarian response plan.
At Umpiem Mai Camp the funding freeze has also derailed basic necessities. Refugees are now building wells because they can no longer afford fuel for generators that power a water pump system once run by IRC, which delivered water to residents for drinking and washing. Waste removal services, also provided by IRC, have stopped with refugees instead burying waste says Bweh Say, secretary of the Karen Refugee Committee. Thai doctors visit the camps to help but can’t come every day.
‘Like I won the lottery but lost the ticket’
In emergency cases, people will be rushed to a local Thai hospital. But those whose conditions are considered less urgent must seek permission and pay a fee to leave the camp, and fund their transport. For refugees who have no right to work in Thailand, it’s unaffordable.
“If you have no means to get to the local Thai hospital, then you don’t receive treatment,” says Kanchana Thornton, founder and director of Burma Children’s Medical Fund, which supports the cost of surgery for children and adults, and is funding patients who were once cared for by IRC.
Her staff are desperately trying to arrange for the transfers from the camps – for patients needing anything from heart to orthopaedic surgery.
Refugees living outside camps have also had care stripped away. Mar Mar Aye, 59, was receiving IRC-funded care for a head injury sustained during pro-democracy protests that erupted after the 2021 coup.
Joining the street protests she had urged the military through a megaphone not to open fire on young protesters, but they ignored her. A group of soldiers surrounded and beat her, hitting her on the head and jaw, before placing her on a truck and sending her to the infamous Insein prison.
The injuries have caused her to lose consciousness, experience memory loss, and suffer from sleeping problems and headaches. The IRC began funding her care in January, which includes multiple medications taken twice daily, and she has been advised to have surgery.
She was due to have an appointment to discuss an operation in February, but it did not go ahead, because of the funding suspension. She is not alone, she says, others have also had surgery cancelled. Another woman, who asked not to give her name, needs treatment for an inguinal hernia, which has caused a large, hardened lump on her stomach. Her medication was covered by IRC, but no longer. “It’s like I won the lottery and lost the ticket,” she said.
Dr Tawatcha Yingtaweesak, director of Tha Song Yang hospital, a Thai government hospital, is helping to manage health facilities in Mae La camp in IRC’s absence. For now, they are coping, he says, but he worries about the future, especially as the rainy season is likely to bring more disease.
“Access to medical treatment is a basic human right - and now they live in a big compound, and it’s like a cage for them,” he says.
Halting the budget so abruptly was not fair, he adds. “It will affect the image of the US, and make the world think that they are heartless.”
