Thailand: Ensure Healthcare for Myanmar Refugees

(BANGKOK, October 26, 2023)—The Government of Thailand should prevent the arbitrary arrest and extortion of Myanmar refugees seeking access to healthcare and provide protective legal status to refugees in Thailand, Fortify Rights said today. A new investigation by Fortify Rights exposes how Myanmar refugees seeking healthcare face arrest and extortion by Thai authorities in the border town of Mae Sot.

“Myanmar refugees in Thailand urgently need protective legal status to ensure access to essential public services,” said Patrick Phongsathorn, Senior Advocacy Specialist at Fortify Rights. “Refugees in Mae Sot are facing predatory practices at the hands of the local police, who act with absolute impunity. The actions of these officials and the lack of legal status for refugees in Thailand are putting lives at risk.”

Since January 2023, Fortify Rights interviewed 38 Myanmar refugees on the Thailand-Myanmar border, including eight women. Fortify Rights also spoke with four individuals with specific knowledge of the healthcare context along Thailand’s border with Myanmar. The names of all eyewitnesses and survivors mentioned here have been changed for their protection against possible reprisals.

“Swe Zin,” 51, from Shan State, Myanmar, was seeking treatment at a Mae Sot clinic for arthritic fingers on May 19, 2023 when local police stopped her.

“It was around 1 p.m. when we were stopped by the police,” “Swe Zin” told Fortify Rights. “The motorcycle taxi driver was also scared when they stopped us. We were very near the clinic . . . We could even see the signboard of the clinic when we were stopped.”

Thai police then arrested “Swe Zin” and her motorcycle-taxi driver, took them to a nearby police station, and questioned them for three hours.

“I have not been to the clinic since then. I know my pain could be relieved from the treatment there, but I don’t want to risk it,” said “Swe Zin.”

“Kyaw Aye,” 46, from Myanmar’s Bago Region, told Fortify Rights how Thai police stopped him three times in one day on June 26, 2023 while seeking diabetes treatment:

The first time was on the way to the clinic. We were stopped at the intersection near the traffic police office . . . We explained that we were going to the clinic, and then they left . . . The second time we were stopped was across the road from the clinic . . . The last time that day was at the Mae Sot market on the way back from the clinic.

Speaking about the impact of police actions on his ability to access healthcare, “Kyaw Aye” told Fortify Rights: “I feel like one day I’m going to die because of all these police checks . . . I won’t be able to get medical treatment on time.”

Fortify Rights spoke with another refugee, “Moe Moe,” 52, from Bago Region, who experienced back-to-back arrests while seeking healthcare in Mae Sot in early 2022:

The first time I was arrested was in February 2022. I’d been having aches on the right side of my body . . . We left our house just after breakfast; we were stopped by the police around 9:30 a.m. at the corner near the clinic right off the main road. They were waiting at the corner and stopped us . . . I was in so much pain.

Thai authorities arrested “Moe Moe” again in March 2022 along with her husband and two children while they traveled back from a clinic to receive the COVID-19 vaccination.

Fortify Rights also spoke with Myanmar medical doctors who fled to Thailand after the Myanmar military junta targeted them. “Maung Maung,” 30, a general practitioner from Yangon Region, provided medical treatment to anti-coup protesters and helped establish clinics in conflict-affected areas in Karen and Karenni states in Myanmar. He and his wife fled Myanmar in March 2022 after their identities were posted on a Myanmar military-affiliated Telegram channel, putting them at grave risk.

When he reached Mae Sot, “Maung Maung” continued to assist the clinics he helped to establish in Myanmar. In March 2023, Thai police raided “Maung Maung’s” residence and confiscated medicine and other equipment he had stockpiled to donate to warzone clinics in Myanmar.

“[The police] searched through my house, then they saw the medicine,” “Maung Maung” told Fortify Rights. “They saw the syringes and vials . . . It was a tragedy.” The police then arrested “Maung Maung” and questioned him at a police station. “They asked me, ‘Are you a doctor?’ I said, ‘No, no, I am not a doctor [in Thailand]. I only support refugees.’ If they knew I was a doctor, they would ask for more money.”

The Thai authorities eventually released “Maung Maung” and returned his medicine and other equipment after he agreed to pay more than US$1,000 in Thai Baht to the local police. Fortify Rights believes the Thai authorities' demand for this payment was unlawful and constituted extortion.

“Maung Maung” was one of multiple refugees who reported being extorted by Thai police in Mae Sot.

Thai police arrested “Kyaw Min,” 38, from Yangon, while returning from a health clinic in Mae Sot where he sought treatment for an eye infection. “The police arrested me on the street, around two kilometers [more than one mile] away from the clinic,” said “Kyaw Min.” He continued to tell Fortify Rights:

The translator [at the police station] explained to me, ‘If you want to go back, you have to pay money’ . . . ‘You have no identification, [so] you have to pay 30,000 or 40,000 [Thai Baht].’ I replied, ‘I have no money, [only] five [or] 6,000 [Thai Baht].’ So, they said ‘8,000.’ I had to pay 8,000 [US$220] to go back [home].

“Swe Zin,” who Thai authorities arrested on May 19, 2023, described her experience facing extortion at the hands of Thai police: “I was going to the [local private health clinic], where I didn’t need to pay for the treatment, so I wasn’t carrying any money on me. I kept telling [the Thai police] just to arrest me because I didn’t have the amount that they were asking for.”

The police eventually released “Swe Zin” with the payment of 5,000 Thai Baht [US$136]. “After that, they just let me go,” Swe Zin” said. “I didn’t need to sign anything, and there was no receipt.”

Refugees in Thailand identified fear of arrest, lack of legal documentation, lack of access to public health insurance schemes, and language barriers as among the reasons preventing them from accessing needed healthcare, especially in public hospitals and healthcare facilities. Faced with these barriers, refugees in Mae Sot often rely on free clinics run by non-governmental organizations.

“Moe Moe” told Fortify Rights how she changed her approach to seeking healthcare for herself and her family following back-to-back arrests in Thailand in 2022:

We try to stock up on medicine at home as much as possible. When my kids get sick, I rely on the pharmacies near our house, which are staffed by Myanmar people. Unless it’s a severe condition, we avoid going to the clinic because we’re scared to get arrested or into trouble.

There are more than 90,000 refugees from Myanmar in nine temporary refugee camps in Thailand, according to the U.N. refugee agency, and an untold number of other refugees are in hiding in Mae Sot and throughout Thailand, especially since the coup in February 2021. As of June 30, 2023, the Thai government reported that more than 40,000 Myanmar refugees had sought refuge in Thailand since the coup in Myanmar, but the government implausibly claimed nearly all returned to Myanmar.

Thailand has a legal obligation under domestic and international law to provide access to healthcare to everyone, including refugees. Article 51 of the Thailand Constitution ensures that, “Every person shall enjoy equal rights to receive appropriate standard public healthcare.”

Thailand is also a state party to the International Covenant on Economic, Social, and Cultural Rights. Under Article 12, Thailand commits to “recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.” Under Article 2 of the Covenant, Thailand also commits to guarantee this right without discrimination, including based on national or social origin.

Although Thailand is not a party to the 1951 U.N. Refugee Convention or its 1967 Protocol, the Convention provides authoritative guidance on refugee protection under international law. Under Article 23 of the Convention, refugees are entitled to the same level of access to healthcare as nationals of the state of asylum.

Without an effective legal framework to recognize and protect refugees in Thailand, refugees face criminal penalties under Thailand’s 1979 Immigration Act, which prohibits unauthorized entry or stay in Thailand. As a result, refugees in Thailand are subject to arbitrary arrest and detention. A lack of legal status in Thailand also means that refugees are unable to get coverage from the public health insurance scheme used by migrant workers.

In December 2019, the Thai government announced the creation of the National Screening Mechanism (NSM), a new mechanism to identify and potentially protect refugees in Thailand. After years of delay, the NSM finally came into effect on September 22, 2023. According to the Office of the High Commissioner for Human Rights, the police reportedly initiated the screening process and indicated that those granted “protected status” will have access to healthcare as well as education and temporary residence permits.

Earlier analysis by Fortify Rights of the regulations supporting the NSM raised concern with provisions that needlessly and arbitrarily exclude certain individuals from accessing protection in Thailand, including migrant workers from Myanmar, Cambodia, and Laos.

Thailand should ratify the 1951 U.N. Refugee Convention and its Protocol without delay and, in the meantime, offer official registration, temporary protective status, and equitable access to healthcare to Myanmar refugees, said Fortify Rights.

“There is a sickness at the heart of Thailand’s approach to people fleeing the crimes taking place in Myanmar,” said Patrick Phongsathorn. “With the Global Refugee Forum approaching, the new Thai government has an opportunity to change this approach. No one should be arrested for being a refugee or seeking healthcare.”

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