Photo: Steve Sandford/IRIN Saw Kwe, a medical officer with the Democratic Karen Buddhist ArmyMUN RU SHAI, 24 December 2010 (IRIN) - Saw Kwe, a medical officer with the Democratic Karen Buddhist Army, pulls out a cardboard box full of Artesunate from among the rolls of gauze and drugs used for clotting war wounds.
The 15-year veteran, who has been shot and nearly blown up in past fighting, says the most common killers of civilians are found off the battlefields - not on them.
"The most deadly is malaria," says Saw Kwe, as he hands a packet of pills to a young mother in the Burmese border village of Mun Ru Shai. "We often use up our supplies of Paracetamol to help relieve fever and pain for the sick."
The drugs are much in demand for the steady stream of displaced civilians who have hiked - sometimes for weeks - to border areas in eastern Myanmar to escape the escalating fighting between government troops and ethnic armies following the 7 November elections, the country's first poll in two decades.
In Karen state, conflict and death have become a part of life in fighting that began more than 60 years ago, but deaths from military clashes account for only 2.3 percent of mortality, according to a recent report, Diagnosis: Critical.
The indirect health impacts of the conflict are much more severe, with preventable loss of life accounting for 59.1 percent of all deaths and malaria alone responsible for 24.7 percent, according to the report, compiled by the Mae Tao Clinic.
Often, the villagers caught up in the battle zones are forced to flee with little more than the clothes on their backs and a few bits of food.
Without proper shelter and lacking clean water and food, the most vulnerable - the young and old - become susceptible to preventable illness such as pneumonia and diarrhoea, which can prove fatal if left untreated.
In fact, malaria was responsible for nearly a third of deaths in children under five, while diarrhoea was responsible for 17 percent of fatalities in this age group, states the report.
Caught on the border
Hundreds of families remain displaced and in hiding on both sides of the border, afraid to go home but unable to seek protection in Thailand.
"Right now, there are no official camps for those displaced so it is very difficult to provide even clean water and proper sanitation," says Man Nah, director-general of Backpacker Health Care Workers (BPHCW), a mobile medical unit that travels across the border to provide medical care.
According to recent estimates by BPHCW, nearly 4,000 people regularly flee to Thailand from Karen State areas opposite Kanchanburi and Tak provinces, where government attacks have escalated in recent weeks.
Photo: Steve Sandford/IRIN: Thousands of ethnic Karen are regularly displaced by the fighting, many of them children The mobile medical teams have set up three emergency clinics providing medical assistance to civilians having sought shelter in Thailand, particularly the more vulnerable, such as pregnant women, children and the elderly.
The increase in internally displaced persons has exacerbated an already hazardous situation in eastern Myanmar where nearly half a million people are on the run, according to the Thailand Burma Border Consortium.
In cases where the patient is in a serious condition, they will be often transported across the border to the Mae Tao clinic in Thailand, which offers free basic healthcare for refugees, migrant workers and others needing medical aid.
For more complicated cases, arrangements are made between NGOs and provincial hospitals in the region.
Over-crowding
In the bustling emergency ward of the Mae Sot hospital, the burden is all too clear.
Some patients lie on makeshift beds and benches erected in the crowded hallways, an all too common scene that hospital director Ronnatrai Rueangweerayut says will continue as long as there is conflict in the neighbouring country.
"Mae Sot hospital is a government hospital that is [a] non-profit organization," Ronnatrai said. "As you know, if you have no money, you can do nothing. It means that we have to arrange the budget as well as possible so we can treat all the patients in the same manner."
http://www.irinnews.org/report.aspx?ReportID=91440
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