Mae Tao clinic has been working with clients from Burma living along the Thai Burma border for over 25 years. It has worked with local Thai government health and public health since the beginning. There is a massive disparity between health services in Thailand and those in Burma, which is why about half of our clients travel from Burma to access health services. In Burma, there is a similar disparity between health service access availability in the urban and rural areas. Access for rural communities is extremely poor due to both the lack of facilities health workers, as well as prohibitive costs. In Thailand many and migrant workers have come looking for work in Thailand, in order to pay the health bills of family members living in Burma.
When envisioning a nation of healthy citizens in Burma, the social determinants of health need to be addressed and need to feel empowered to address their health needs, by improving living communities conditions such as ending conflict, removing land mines, having access to land, work place sa safe water, safe housing, ising risks and improving access to education, healt legal and social financial services.
At the same time essential health services are not a privilege, but a basic need. People need to know how protect themselves and to promote their own healthy communities. The current proposal for universal Health coverage is not sustainable and does not empower communities. Tax reform may be the first step in revenue generation for building a health system, however, working with communities to empower them to engage with the issues that affect them is a step that must be made at the same time.
In the absence of government health services, and in a context where international aid agencies were denied humanitarian access, indigenous health workers in ethnic minority areas have mobilised to provide life saving care to their communities. With the changing political situation and fledging peace in Burma, these health workers now face new opportunities and challenges. Health has the potential to play a key role as a bridge to peace in Burma.