E-newsletter Issue 53 | January 2007

PROJECT REPORT FROM EUAN BEAMONT, THAILAND

Imagine a site gathering around 6,000 people with no medical care, no clean drinking water, limited access to food and no provisions for sanitation or shelter. That was the situation in Ban Huay Nam Kao a small Thai Hmong village in the Petchabun Province, North Central Thailand when Hmong refugees arrived from Laos at the end of 2004. The Hmong are an ethnic minority originally from China but now spread throughout SE Asia. In Laos some of the Hmong people have fought with the CIA against the communists during the Vietnam War. But since the end of the war in 1975 and the establishment of the communist government in Laos the Hmong live in hiding in the Laos jungle and suffer continuing persecution by Laos authorities.

The camp is situated on the edge of Huay Nam Kao. The Hmong have lived in this area for decades and are officially known as Thai/Hmong but still keep the Hmong traditions alive and well and many of the refugees have relatives living in the area. The main form of industry is agriculture with crops such as ginger, cabbage, corn, and some rice grown, almost everyone has pigs and or chickens. Families are quite large with the Hmong man able to have more than one wife and its not unusual to see 10-15 people living under the one roof.

International Rescue Committee (IRC) was first on the scene, providing essential shelter in the form of plastic sheeting, a chlorination plant for drinking water and general camp sanitation however their tenure was for only a few months so MSF took over in July 2005. I arrived in February 2006. At that time we were running an Out-patient department (OPD) and log store from the school in the village. There were 3 international staff, a doctor, nurse-field coordinator and logistician. The OPD staff are Hmong refugees and the logistical team were a mixture of Hmong refugees and Thai/Hmong, who lived in the area.

Medically, the clinic was doing around 500 consultations per week with the principal illness being respiratory tract infections, diarrhoea and skin infections caused mainly by the close living conditions and poor ventilation in the houses. During my second month in the camp, the OPD team started screening the ‘Under 5s’ for any malnourished children. We found approximately 80 who were moderately to severely malnourished and immediately put them on a ration of rice, beans, chilli, salt, eggs and oil. Over the next four months these children were screened every week, as well as looking for any more children at risk and it was good to see that over time their condition improved and they were putting on weight.

The situation in the camp was a little confusing. There were genuine refugees from Laos but also there were some who had been in Thailand for a number of years in other camps and even some who had some sort of legal Thai identification and could come and go they please. Despite where they came from they were all here with the same hope...to be taken by a third country. The US took some 80,000 people since the end of the war, however now that the US and Laos have a trade agreement they have closed the door and have stated they will not take anymore refugees.

At first there was minimal security within the camp with the local District Office assuming the role, however the surrounding area was known for amphetamine production and the military took over the security of the camp to ensure that the Hmong were not trading drugs. Another reason for the increased security was that human traffickers were operating between Laos and the camp. Prices ranged from 3,000 to 30,000 Thai Baht ($100-$1,000 AUD) so checkpoints were installed at the entrances to the camp as well as soldiers patrolling in the jungle around the camp to prevent this.

With the military, came an order for us to move from the school as our operations were disturbing the school children. No problem, when did they want us to move....? Today! So we rented a couple of houses in the village, one for the OPD and one for the logistics store while we employed local contractors to build a new OPD and Store. The contractor was a good operator and had the roofs on quickly and the team worked very hard to wall and fit out both structures so we were able to move in within the month.

Another big project was the installation of a drainage system within the camp. During the wet season there was a real risk of landslides and of children being washed away in the main gully running through the camp, so the plan was to slow down and reduce the flow of water. This included digging a big drain above the camp to catch and divert the water, construct concrete dykes and catchment boxes and install over 100 metres of 60cm concrete pipe to direct the water straight to the river. This was a huge project, taking eight weeks to complete by hand. I was blown away by the ingenuity of these people and it was great to see the technical knowledge of MSF mixing very well with the practicality of the local people. 

NEWLY ARRIVED REFUGEES JAILED
Unfortunately, the Thai Government has not signed the UN’s Geneva conventions on refugees, so the Hmong are treated as illegal immigrants and the policy is to return the genuine refugees to Laos and an uncertain future. Therefore, security in the camp was tightened. One day very soon after the arrival of the military they held a new registration and 300 new arrivals were arrested and taken to local jails where conditions were much worse than the camp. It was like a scene out of a movie, they bought open-topped trucks into the camp and these people were loaded in and driven away. We believe that this was a show of force to deter any new arrivals coming to the camp. Since then there were no more arrests but there was constant pressure on both the refugees and MSF to supply information about the number of new arrivals, something we were very careful not to do.

Access to food was a big issue - all shops within the camp were closed, and people were not allowed outside the camp to forage or work and were restricted to visiting the local village market to just two days per week. The food situation was that bad that one morning we had a protest in front of the OPD where people would not move until we heard their complaints. There were no starving people, however food was getting scarce and we viewed this protest as a cry for help. MSF could not take charge of the general food distribution, so we decided to implement a “Blanket Feeding” distribution, which consisted of providing only part of the total food requirement of the people but focusing mainly on children and pregnant women. Meanwhile we emphasised that Thai Government, the relevant UN agencies and other NGO’s should take responsibility and contribute to the provision of assistance.

For me, the food distribution was a highlight - we decided on a ration of rice, fish, oil, chilli, sugar, salt and beans. The organisation and distribution process was very interesting and there was a real sense of satisfaction to see the people receiving the food with big smiles on their faces. This first distribution was done in my last week in the camp and coincided with the arrival of the new logistician.

My time in Thailand was a very good experience and I think a good training ground to learn the procedures of working with MSF. However, leaving a mission comes with disappointments: even though I spent six months working with these people and trying to improve things the situation for these people has not changed a great deal overall. Speaking to people still within the project it seems that the numbers have increased to around 8,000 and there is still no firm decision on their future. It is likely that they will be moved to another site and MSF is encouraged to follow, but with this comes the responsibility of starting everything again with no visible outcome in sight which leaves you feeling a little impotent. At least MSF is there and these people have a voice through them.

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