US President Donald Trump's abrupt suspension of USAID funding has left more than 80,000 refugees in Thailand adrift without essential medical care. Clinics have shut their doors. Medicines are running out. Lives are now hanging in the balance.
Overnight, they face illness without treatment, infections without medicine and childbirth without proper care.
For 30 years, Thailand's nine refugee camps relied on international aid. Now, due to the Trump administration's decision, the International Rescue Committee -- which ran hospitals in seven camps across Ratchaburi, Kanchanaburi, Tak and Mae Hong Son -- must halt operations, cutting off nearly all displaced individuals from healthcare.
With this lifeline gone, the urgent question is: Who will step in?
Following a period of uncertainty, Public Health Minister Somsak Thepsuthin finally outlined a set of measures to ease the humanitarian crisis on Feb 9.
Among them are: weekly mobile medical teams to visit refugee camps, a centre to coordinate border hospitals and monitor daily situations, telemedicine to reduce hospital visits, quick emergency referrals, extra budgets for hospitals to manage increased patient loads, stockpiled medicine, improved camp sanitation and stronger disease control.
While crucial, these measures still fall far short of addressing the full scale of the health crisis in refugee camps.
Healthcare is a fundamental human right that should be provided without exception. Proper medical care also prevents the spread of infectious diseases. The Ministry of Public Health must take responsibility for healthcare in refugee camps to safeguard both refugees and Thai communities.
With medical needs arising daily, a weekly mobile clinic visit is inadequate. Permanent healthcare facilities and full-time medical staff in refugee camps are crucial. Border hospitals, key to supporting these efforts, need more doctors, funding and equipment. Any delay could cost lives.
Beyond healthcare, sanitation, clean water and waste management in camps are equally vital. The ministry must oversee these services. Enlisting refugee health volunteers, similar to Thailand's village health volunteers, is another necessary step.
Mr Somsak insists Thailand will not fully provide healthcare in camps. But as resources dwindle, more people will get sick and flood hospitals.
Last year alone, camps reported over 13,800 patient transfers to hospitals. If medical services inside the camp collapse, that number will rise sharply. Costs for Thai taxpayers will soar, and risks of infectious disease will grow.
Mr Somsak has promised talks with the United States and the United Nations for aid. But should Thailand keep relying on uncertain foreign support for a crisis spanning three decades?
A long-term strategy is overdue. Thailand must stop treating refugees as a temporary issue that can be patched with foreign aid. Instead, it must integrate them into its healthcare system.
Long-term refugees need access to medical services without excessive red tape. Border hospitals need better infrastructure to handle more patients without being overwhelmed. Preventive healthcare in camps is also necessary to stop outbreaks before they spiral out of control.
But the problem extends beyond healthcare. These camps were never meant to be permanent, yet they have existed for 30 years. Many born there know no other home. With resettlement options dwindling and return to home countries like Myanmar unlikely, Thailand must ask: How long can it keep these people in limbo?
One approach is to allow eligible refugees to work under controlled conditions. Of the 80,000 refugees, about 30,000 people are of working age -- a tiny fraction compared to Thailand's demand for over 3 million migrant workers.
Allowing them to work helps ease Thailand's labour shortages. Keeping tens of thousands of capable, willing workers idle benefits no one.
The outlook for refugee children is even bleaker. After two decades, the policy to provide refugees with basic Thai education still has not materialised. Without language skills or resettlement options, they remain trapped and vulnerable to exploitation.
Investing in their education is not charity -- it prevents future social and economic crises. If they stay in the country, they must be given the tools to contribute, rather than becoming a lost generation with nowhere to go.
For years, Thailand has hosted refugees while keeping them at a distance, relying on foreign aid while avoiding commitments. But the world is changing. International funding is unreliable, and Myanmar's conflict has no clear end. Pretending otherwise will not make the problem disappear.