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Saving Burma’s children

Australian-trained nurse, Kanchana Thornton provides much needed healthcare to Burmese refugees on the Thai-Burma border. By Linda Belardi.

In the West of Thailand and sharing a border with the civil war-ravaged Burma is the bustling industrial town of Mae Sot. As the main gateway between the two South East Asian countries, Mae Sot is the destination for thousands of Burmese migrants – both legal and illegal – who regularly cross the border into Thailand.

Failed by a Burmese health system which ranks by WHO standards as the worst in the world and unable to access Thai public healthcare, thousands of Burmese refugees and migrants are forced to rely on local and international NGOs for access to basic healthcare.

Operating out of Mae Sot since 2006, is the Burma Children Medical Fund (BCMF), founded and operated by Australian nurse, Kanchana Thornton (pictured above). Every year the organis-ation provides often life-saving medical treatment and surgery to hundreds of Burmese migrant and refugee children.

Thornton, who trained as a nurse at the University of Technology, Sydney, volunteered at the renowned Mao Tao Clinic, also on the Thai Burma border, before recognising a need to fund and secure treatment for children arriving with more complex conditions.

She first visited the Mae Tao clinic in 2000 on holiday with her journalist husband and began volunteering soon after at the request of the clinic’s founder, Dr Cynthia Maung.

At the clinic’s facilities, Thornton worked in the children’s outpatient department and because of her Thai language background was able to co-ordinate a regular system of referrals between the clinic and the local Thai hospital.The Mae Tao clinic now sees over 75,000 patients each year.

The children present to the Mae Tao clinic with various health conditions, including cardiac problems, congenital birth defects and complex forms of cancer. The complexity of the cases exceed the resources of Dr Cynthia’s medical clinic and the local Mae Sot hospital and require treatment at one of Thailand’s larger hospitals.

Upon arriving at the clinic, Thornton assesses the child’s healthcare needs and negotiates for them to receive treatment at the large tertiary hospital in Chiang Mai, some 300km from Mae Sot.

“Some of the children will have come from inside Burma – from the jungle, they might have travelled three or four days with their families to get to the border,” Thornton tells Nursing Review.

“In the last year we have seen children with profound hearing impairments, with cataracts causing blindness, orthopaedic cases, club foot and year-old fractures that have to be reset.”

There are currently 200 children on the program. Patients are roughly on the program for between six months to two years, depending on their condition.

“We receive patients from the Internally Displaced Persons (IDP) or refugee camps, as well as referrals from local and international NGOs working in the region. Some also arrive at the clinic from the China or the Indian border.

“Some of the kids are really sick and because they are so fragile it can be too dangerous to operate. While they build up their strength they are treated at the clinic to prepare them for operations such as open-heart surgery. “

In addition to assessing the child’s medical need and rate of survival, Thornton determines the commitment of the family to the sometimes-long journey ahead. Last year, the Medical Fund raised over 3 million baht ($99,000) for medical treatment, which she negotiated with the hospital at a discount of 40 per cent. At Chiang Mai hospital open heart surgery costs $5000 to perform and a heart valve replacement requires fundraising of $7000. Thornton relies heavily on community donations.

While Thornton says the vast majority of the patients are given access to medical treatment, limited funding also requires sensible and pragmatic decisions to be made.

“If the illness that we need to treat is expensive and it will not significantly improve the quality of life for that child, then we won’t do it. Eye cancer, for example, is hideous. We will investigate all options but if the family has come too late, then we will have to send them home,” says Thornton.

As the fund has developed a reputation, Thai paediatricians and other hospitals have begun referring cases to Thornton.

Travelling the 300km to Chiang Mai

“A soon as they get into the program we cover all of the costs of the treatment process – from the cost of the mini-van transfer to Chiang Mai until their return to Mae Sot, post- treatment.” In some cases, Thornton says the family will linger around the clinic for a few days following treatment because they have used all their money in making the journey to the border and now require funds to return to the community.

In each bus trip, Thornton transports up to five children and a carer. Often this means working 15 hour days to travel the distance to Chiang Mai, work at the hospital for five hours and then make the return trip home.

To safely transport the children and their carers to Chiang Mai, Thornton must negotiate with several Thai authorities including police, immigration officials and the local army for access, as well as lobby the local hospital to perform the surgery at a discounted price.

“It’s never easy to negotiate with the Thai authorities. I have to be on my toes. I have to know who is the new commander in the area in Mae Sot and to work on building local relationships and networks.”

Over the years, Thai authorities have had to walk a fine line between assisting international non-government organisations to carry out their humanitarian work, while trying not to encourage high numbers of Burmese refugees to make the trip over the border.

In late September, the medical charity Medicines Sans Frontiers (MSF) announced it was withdrawing its entire operation in Thailand citing co-operation difficulties with Thai officials. The organisation said that after 30 years working in the region, it was unable to gain ongoing permission to provide continued support to the refugee population.

Thornton says she has had little contact with MSF in recent years as the organisation had stopped working in Mae Sot and nearby refugee camps about two years ago.

Since then the Mae Tao Clinic has been working very closely with World Vision and Thai public health to deliver treatment to tuberculosis patients in the area.

In the absence of a functioning public health system in Burma, Thornton is committed to providing Burmese refugees with the care they deserve.

“We are giving these children the right that they are supposed to receive in Burma but the government is not providing it for them. They are the future of Burma. If we don’t help them, they will die and sometimes they will suffer for a long time before they die. We can’t sit back and do nothing.”

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