U.S. President Donald Trump’s foreign aid freeze is reportedly wreaking havoc along the Thai-Myanmar border, where medical clinics serving around 100,000 refugees, most of them from Myanmar, could soon be forced to close their doors – if they haven’t already.
Among the flurry of executive orders that he issued after taking office last week, Trump ordered a 90-day pause in foreign development assistance pending a review of whether it conforms with his “America First” foreign policy. The State Department subsequently announced that all foreign assistance programs via the Department and U.S. Agency for International Development (USAID) would be suspended until the review was complete.
According to a Reuters report published yesterday, this order has already forced the closure of healthcare centers serving tens of thousands of refugees on the Thai-Myanmar border. Citing a local official and two members of camp committees, the news agency stated that the International Rescue Committee (IRC), which funds the medical clinics with U.S. support, had told them to shut by January 31. This has forced Thai officials to transfer the sickest patients to other facilities in Thailand.
There are nine refugee camps based along Thailand’s borders with Myanmar, which host around 100,000 civilians who have fled the long-running conflicts in Kayin (Karen) and Kayah (Karenni) states. Over the decades, they have developed into more or less permanent settlements whose healthcare, education, food and water distribution, sanitation, and other basic services are dependent on aid from international donors. The numbers in the camps have increased since the military coup in Myanmar in February 2021, which has inflamed the country’s long-running conflicts.
The Irrawaddy reported separately yesterday that the aid freeze had “so far forced hospitals to close in five refugee camps” along the border as of yesterday. Among them was the Mae La refugee camp, the largest of the camps along the Thai-Myanmar border, which is home to around 34,000 people. According to the Irrawaddy report, Mae La announced earlier this week that IRC-run healthcare services at the camp would be suspended from Tuesday. “The suspension covers both outpatient and inpatient treatment, reproductive and child health services, and other health departments,” it stated.
Reuters quoted Bweh Say, a member of the refugee committee at Mae La camp, as saying that the IRC had already discharged patients from its camp hospitals and stopped people, “including pregnant women and people with breathing difficulties dependent on oxygen tanks,” from using their equipment and medicine. The camp’s water distribution and garbage disposal systems have also been impacted by Washington’s order.
The Irrawaddy quoted one ethnic Karen man with contacts in the camps as saying that “the hospitals are no longer accepting patients. Camp officials and Thai authorities are holding emergency meetings. Arrangements are being made to transfer some critical patients and pregnant women to the public hospital in a nearby town.”
Given that Washington is the largest single donor of aid in the world, disbursing $72 billion in assistance during fiscal year 2023, the order had an immediate impact, plunging USAID and its scores of partner organizations into uncertainty.
Amid the chaos, Secretary of State Marco Rubio issued a waiver for “life-saving” humanitarian assistance, which it defined, in Reuters’ paraphrase, as “core life-saving medicine, medical services, food, shelter, and subsistence assistance, supplies and reasonable administrative costs as necessary to deliver such assistance.”
While this waiver would seem to cover the medical clinics along the Thai border, facilities that are by definition “life-saving,” Reuters reported that it was “not immediately clear” what impact it would have.
Until the situation becomes more clear, the Thai government has pledged to support the healthcare of refugees while the U.S. aid suspension is in place, Public Health Minister Somsak Thepsutin told the press on Tuesday. “We cannot abandon or chase them away since they have lived here in the camps for a long time,” Somsak said, according to the Bangkok Post. He added, “no matter who they are, we have to take care of them.”
Even if the hospitals and clinics along the Thai-Myanmar border are eligible for the State Department’s waiver, the current uncertainty points to the massively disruptive repercussions of Trump’s aid freeze – to say nothing of any cuts that might result from his administration’s review. The Trump administration has also reportedly canceled USAID’s Lincoln Scholarship Program, which has provided scholarships to “approximately 135 young Myanmar leaders from diverse backgrounds.”
How much more of its programming in support of democratic reform in Myanmar, which Rubio claimed strongly to support during his time in the Senate, will be affected would appear to turn on the question of how the administration defines the U.S. national interest – and whether bureaucratic inertia will impact its stay the swinging of the axe.