Wah K’Ler Paw, a 30-year-old refugee from Myanmar, survived for about two weeks without dialysis after The US president, Donald Trump, suspended US foreign aid.
“She never complained about what she was going through,” says her husband, Thaw, from the Mae La refugee camp along the Thai-Myanmar border, where the couple had lived with their two-year-old daughter, Thaw Wah.
Despite a pledge from US secretary of state, Marco Rubio, that life-saving assistance would be exempt from the 90-day USAid freeze, for refugees like Wah K’Ler Paw, who relied on care from US-backed organisations, Trump’s decision has been deadly.
Along the border, the US government’s aid freeze has forced countless charities and NGOs providing healthcare and other essential services to refugees from Myanmar to suddenly halt operations or cut back their work. This includes the International Rescue Committee (IRC), which was forced to stop running health facilities that served seven refugee camps.
After the decision, Wah K’Ler Paw’s husband scrambled to find ways to continue her dialysis, which she had been receiving twice a week at a Thai hospital until it was stopped in early February. Eventually she was admitted to a nearby hospital for dialysis, but by then it was too late. She died on 16 February.
Wah K’Ler Paw is not the only person to have suffered the fatal consequences of the aid freeze.
Earlier in February, Pe Kha Lau, 71, another refugee from Myanmar, died in the Umpiem Mai refugee camp after struggling to breathe. Four days earlier she had been discharged from a healthcare facility in the camp, from which the IRC was also forced to withdraw.
A letter seen by the Guardian suggested the IRC has now been granted an exemption to use US funds to provide some services inside refugee camps, including primary care, immunisations, and HIV services, but that it cannot pay to refer patients for treatment in Thai district hospitals, or provide services such as mental health. The IRC did not respond to request for comment.
The refugee camps that stretch along Thailand’s mountainous border with Myanmar are home to 90,000 people, mainly from the Karen ethnic minority. Most have lived in the camps for decades after fleeing fighting between the military and ethnic armed groups. Others arrived more recently, fleeing the deadly conflict that has gripped Myanmar since the military seized power in a widely opposed 2021 coup.
The IRC also funded healthcare for many who live in precarious conditions outside the camps. It is not clear if their care is included in the exemption.
The US, the single-largest aid donor in the world, last year disbursed $223.5m in USAid funding to Myanmar, and contributed 31.6% of the country’s humanitarian response plan.
‘Like I won the lottery but lost the ticket’
Thai hospitals and other health NGOs that do not receive US funding have rushed to fill in the gaps left by the funding freeze.
Emergency patients over recent weeks have been rushed to local Thai hospitals. But those needing treatment for a condition that is not considered urgent have to seek permission to leave the camp, pay a fee, and fund their transport. This is unaffordable for refugees, who have no right to work in Thailand.
“If you have no means to get to the local Thai hospital, then you don’t receive treatment,” says Kanchana Thornton, founder and director of Burma Children’s Medical Fund, which supports the cost of surgery for children and adults and is funding patients who were once cared for by IRC.
Her staff are desperately trying to arrange transfers from the camps – for patients needing anything from heart to orthopaedic surgery in Thai hospitals.
Refugees living outside camps have also had care stripped away. Mar Mar Aye, 59, was receiving IRC-funded care for a head injury sustained during pro-democracy protests that erupted after the 2021 coup.
Joining the street protests she had urged the military through a megaphone not to open fire on young protesters, but they ignored her. A group of soldiers surrounded and beat her, hitting her on the head and jaw, before placing her on a truck and sending her to the infamous Insein prison.
The injuries have caused her to lose consciousness, experience memory loss, and have sleeping problems and headaches. The IRC began funding her care in January, which includes multiple medications taken twice daily, and she has been advised to have surgery. She was due to have an appointment to discuss an operation in February, but it did not go ahead, because of the funding suspension. She is not alone, she says – others have also had surgery cancelled.
Another woman, who asked not to give her name, needs treatment for an inguinal hernia, which has caused a large, hardened lump on her stomach. Her medication was covered by IRC, but no longer. “It’s like I won the lottery and lost the ticket,” she said.
Dr Tawatcha Yingtaweesak, director of Tha Song Yang hospital, a Thai government hospital, helped to manage health facilities in Mae La camp in the IRC’s absence. He worries about the future, especially as the rainy season is likely to bring more disease.
“Access to medical treatment is a basic human right – and now they live in a big compound, and it’s like a cage for them,” he says.
Halting the budget so abruptly was not fair, he adds. “It will affect the image of the US, and make the world think that they are heartless.”
