IDP CLINIC PROPOSAL – KAREN STATE

Photos of conditions for IDPs inside Burma

Photos of murdered IDPs from Free Burma Rangers (Caution, these are graphic. They are not suitable for children.)

Note: the building in the photo to the right is a medical clinic that has already been established for a camp that serves both soldiers and villagers. It has an operating area, a recovery area, and also six bamboo platforms for patients, each one of which is large enough to hold two patients if required. The clinic anticipated in this proposal would be smaller.


Background: The Karen are an ethnic group of some seven million people who occupy the mountains that border Thailand and Burma. They have their own language and call their homeland Kawthoolei, or the Land of Light. Many Karen are Christian, having been converted by English missionaries. Others are Buddhist, Muslim and Animist. The political organization for the Karen is the KNU, or Karen National Union. The military arm of the KNU is the KNLA, or Karen National Liberation Army.

IDPs are internally displaced persons. They are people who have been driven from their homes, and cannot return. Karen IDPs are also prevented from entering refugee camps in Thailand, since the Thais will not allow these camps, which already hold some 130,000 people, mostly Karen, to take any more. The IDPs are forced to live in the forest and forage what they can. Many suffer from malnourishment, diseases such as dysentery and malaria, and also wounds received from the Burmese Army or from accidents while on the run.

About us: At present we are a small group. There is a great need for medical assistance for the IDPs across the border in Burma from the area between the Thai villages of Bong Ti and Suan Phung (west of the towns of Kanchanaburi and Ratchaburi). We are now organizing to provide this assistance. We already have some supplies – mainly medicine – through donations and our own finances. We have provided some of this to local KNLA soldiers to assist the IDPs in this area.

We now wish to expand this project to provide assistance to the IDPs on a regular basis. This can only be achieved with a static clinic, with backpack medical teams using the clinic as their base. Due to the constant threat from Burmese Army troops, the medics will be accompanied by a KNLA escort. The soldiers will also act as guides to lead the medics to the areas where the IDPs are hiding.

Two trained and experienced medics have volunteered to work in the clinic and on the mobile teams.

A brief history of the area: Since an offensive by the Burmese Army in 1997, very little support for the IDPs has been available. Also, following the problem with the God’s Army group, the Thais have been very strict in this area. (In 1999 a group of Burmese dissidents took control of the Burma embassy in Bangkok. Following negotiation, they were flown by helicopter to the border and subsequently took refuge with the God’s Army, a local Karen militia formed by two young twin boys. The God’s Army has since disbanded, and the twins themselves are now in a refugee camp in Thailand, having been granted special dispensation.)

There are many IDPs, but they are afraid to come near the border. In desperation, some of them try to cross into Thailand illegally, to work on farms, but they are regularly rounded-up and then deported back into Burma.

The clinic will be built near the border. It will be a semi-permanent structure, and its contents will be arranged such that they can be moved on short notice. Should the Burmese Army arrive in the area, the medicine and other equipment will be moved leaving only the structure behind. Through such logistical planning, little supplies should be lost. There will also be an evacuation plan in place, to move bedridden patients to a prearranged secondary position.

February 2003 Update: Funding has been secured for the clinic proposal described herein. This clinic is now operational. The following are two photos of the clinic's activities.


Prenatal care.




Pediatric care.

Material requirements - nutrition for patients and staff:

- Rice: approximately one-half kilo per person per day
- Salt
- Chili peppers
- Fish paste
- Sugar
- Spices
- Tea and coffee
- Tins of sardines
- Fresh vegetables, fruit and meat

Vitamin tablets and injections:

- Multivitamins
- Iron tablets
- Vitamin B complex
- Folic acid
- Vitamin C
- Rehydration salts

Kitchen and other supplies:

- Cooking pots, steel plates, spoons and forks, small and large knives, cups, water containers
- 40kg waterproof containers for the equipment and medicine
- Blankets and mosquito nets
- Plastic floor mats
- Two Icon radios for communication with the backpack teams
- Hammers and nails, saws
- Heavy-duty plastic sheeting for the roof

The clinic building will be approximately 8x8 meters and made from local materials. The roof, at least initially, will be of plastic. The clinic will house the two medics, up to six bedridden patients, and a cooking area.

Medicine - anti-malarial and general:

- Quinine sulfate
- Quinine I.V.
- Chloroquine
- Paracetamol
- Co-proximol
- D5S I.V. 1 liter packs
- Analgesic I.V./I.M.
- Pain ointments (for malaria joint pain)

The clinic will not have a microscope, so the specific type of malaria protozoa will not be diagnosed. Because of this all malaria cases will be treated with quinine sulfate. This may lead to quinine resistance in the future, but due to operational necessities there is no alternative.

Antibiotics:

- Ampicillin 250mg
- Amoxicillin 250mg
- Amoxicillin I.M.
- Amoxicillin powder (oral form for children)
- Penicillin V tablets
- E.E.S. penicillin solution
- Penicillin I.M. and H2O vials
- Tetracycline 250mg
- Metronidazole 250mg
- Doxycycline 250mg

Wound cleansing:

- Alcohol
- Hydrogen peroxide
- Povidine solution
- Iodine
- Gauze
- Cotton wool
- Cotton swabs
- Sutures
- Cyclocane (local anesthetic)
- Syringes, disposable needles
- Plastic forceps (disposable)
- Dressings and bandages
- Scalpel and blades
- Micropore tape
- Plasters
- Surgical gloves
- Kidney dishes

Extra items:

- Immodium
- Laxatives
- De-worming pills
- Hydrocortisone cream
- Eye drops
- Conjunctivitis cream
- Ear drops
- Patient hygiene: soap, toothpaste, toothbrush, shampoo, comb

Medic personal equipment:

- Uniform
- Boots and socks
- T-shirts and undershorts
- Belt
- Hammock
- Sleeping bag
- Mosquito net
- Backpack
- Water bottle
- Jungle knife

Medic pack:

- Small bag
- Scalpel and blades
- Forceps
- Artery clamps various sizes
- Large and small scissors
- Stethoscope
- Blood pressure gauge
- Thermometers
- Notebook, pen, disposable camera (for documentation)
- Torch

Porter equipment:

- Uniform
- Boots and socks
- Hammock
- Sleeping bag
- Mosquito net
- Backpack

Porters will also be used to help carry equipment on the medics’ trips.

Proposal and budget:

The budget for the clinic, in Thai baht, to establish it and run it for a period of six months, is as follows:

Medicine: 60,000
Two Icon radios 14,000
Clinic setup 10,000
Six months operation 50,000
Other expenses (truck hire, travel) 10,000

Total 144,000

At the current exchange rate of 41 Thai baht to $1, this is approximately $3,500. We also hope to arrange additional funding to keep the clinic running for the foreseeable future.