In this time of Covid-19, the migrant and refugee population living along the Thai-Myanmar border have encountered an ordeal, not only from fears of virus spread, but from the tough state measures imposed to contain the disease. There is also an increased risk of exposure.
he closures of borders, following the declaration of emergency decree, means thousands of migrant workers are losing their jobs. Workers on the borders with Laos and Cambodia shared the same plight which goes almost unnoticed.
According to ethnic healthcare providers in Mae Sot, the main precautions of social distancing and handwashing become more difficult especially in harder-to-reach areas in refugee and migrant communities. Lack of access to information, in addition to their lifestyle, is a major challenge, said Marieke Bierhoff, a doctor from the Netherlands, specialising in internal medicine and infectious diseases, currently working at the Shoklo Malaria Research Unit.
"In Mae Sot, not everyone has a computer or internet access so working from home is not always feasible and a lot of people are farmers and can't work from home," Dr Bierhoff said. "On top of this, in the border area, there are people that don't have any savings. This means that if they are not allowed to work they don't get any money and don't get any food that day for themselves or their family. They must then weigh the risk of dying from Covid-19 to the risk of dying from starvation." Confirmed cases of Covid-19 continue to rise, with over 2,000 infection cases all over the country.
Caught between securing their livelihoods and preserving their health, several factories remain open in Mae Sot and migrants continue to go to work. There are thermal checks on workers as they enter and their mobility is being increasingly controlled. Workers are not allowed to gather which limits their ability to bargain for improved conditions.
Tin Zar Lin has been working at Top Form Brassiere (Mae Ku) for the past 18-months as an officer at the Packaging Department. She says her factory will stay open until the end of this month.
Even though she says the factory management informed the employees about Covid-19 and enacted requirements for them to wear a mask and wash their hands, she says factory workers are worried about their families who are working in casinos, bars and restaurants.
"I don't feel safe at work," she says. "Our factory has over 2,000 employees and if one person is infected, others can be infected quickly."
Most recently, the Thai government extended the period for registration to allow migrants to stay without fear of arrest. However, there remains no plan on how to provide these workers with subsidies until the situation improves, according to the director at the Migrant Assistance Program (MAP), Braham Press.
He says the response to Covid-19 by the government has so far has been disappointing.
Labour Minister Chatu Mongol Sonakul told the media last week about the relaxation of rules for migrant workers following the border closure, saying migrants could continue to work beyond the expiry date of their work permits. Nonetheless, Mr Press says MAP remains critical of the response because of the lack of coordination with local groups and abruptness in changes to policies -- which left thousands rushing the border in the first place.
With the prospect of unemployment coinciding with the end of the period to renew their documentation status, many migrants in urban areas were told there would be no work by their employer. Some were told not to return to work, and others were told to go home until "things are back to normal".
With these options, thousands fled to the border and waited hours to return to Myanmar. However, not all had this option and were left in an uncertain situation with limited resources, according to Mr Press.
"It seems no information was given on social distancing or self-quarantine before migrants left, or were in transit. It is unclear if migrants have any understanding of symptoms, how it is transmitted, or how to treat. Testing in Myanmar is non-existent outside of Yangon," he said.
In Thailand, health officials generally have problems reaching migrants, or migrants are reluctant to approach the hospital unless critical, even if they have insurance, Mr Press said.
"Language barriers are part of the problem as are negative attitudes. Without insurance or documents, they are afraid of the consequences, whether it be outright rejection, high fees or possibly notifying the police. Masks and gel are in short supply, so migrants are last in accessing important prevention measures when distributed in the community," he said.
Mae Tao Clinic has been serving the refugee population in Mae Sot since 1989 and has grown to service 75,000 patients a year.
Founder and director, Dr Cynthia Maung says the response to Covid-19 requires a strategic plan that considers the migrant and refugee community in Mae Sot who have less access to information and resources.
The doctor said Mae Tao Clinic has upgraded hand washing facilities and are focusing on hygiene promotion. Staff numbers have been reduced and subsequently so have cases.
All non-emergency procedures have been closed. Mae Tao Clinic relies on a community of volunteers to provide coronavirus-related information to their communities.
"We are monitoring the situation closely and encouraging parents and children not to travel," Dr Maung said.
Over the past two weeks with many migrants returning home because of unemployment or visa security, Dr Maung said they are concerned about their future.
"Social distancing is a challenge and concern when migrants travelling back return to their families. Self-isolating during the required quarantine period is also difficult," Dr Maung said.
Mr Press said the situation is changing quickly and at-risk communities require food and protective measures including masks, hand gel, soap, clean water and space.
"Migrants are always the last to receive assistance. But when it comes to something like contagious diseases, they need to be clearly defined in the response, and that takes representation. Without understanding migrants' behaviour, the government will make plans based on conjecture and security, which is counter to disease control objectives," he said.
Safe migration must be facilitated with health prevention measures in place -- otherwise, the worse is yet to come.
Maggi Quadrini works in communications-advocacy for non-profit on various projects along the Thai-Myanmar border focusing on gender equality.