Border hospitals face refugee care funding crunch as Tak seeks 72m baht

In 2025, US President Donald Trump announced a suspension of foreign development assistance. At the start of 2026, the United Nations (UN) – an organisation comprising 193 member states – warned that it was at risk of facing “imminent financial insolvency” as several members had yet to pay their assessed contributions, with the bulk of arrears owed by the United States. 

Although Washington has recently begun paying the first instalment of its outstanding dues, this is expected to take several weeks to materialise.

The situation has led to the partial suspension of funding for the International Rescue Committee (IRC), which has been providing healthcare services to displaced persons in temporary shelters in Thailand. All support is scheduled to end on March 31, 2026, unless an extension is granted.

Seven camps across four provinces shelter over 80,000 people

Thailand hosts seven temporary shelters for displaced persons along the Thai–Myanmar border in four provinces:

• Ban Mae La Temporary Shelter, Tha Song Yang district, Tak (the largest centre)
• Ban Umpiem Temporary Shelter, Phop Phra district, Tak
• Ban Nu Po Temporary Shelter, Umphang district, Tak
• Ban Mai Nai Soi Temporary Shelter, Mueang district, Mae Hong Son
• Ban Mae Surin Temporary Shelter, Khun Yuam district, Mae Hong Son
• Ban Ton Yang Temporary Shelter, Sangkhla Buri district, Kanchanaburi
• Ban Tham Hin Temporary Shelter, Suan Phueng district, Ratchaburi

There are approximately 81,363 refugees in total, with Tak province hosting the largest number at 48,626.

However, Tak is also home to a significant non-Thai population beyond those in the camps. An estimated 426,725 foreign nationals reside in the province, accounting for around 44% of the total population believed to be living in Tak.

Of these, 143,732 individuals are registered and covered by health insurance, while 282,993 remain unregistered. This figure includes refugees in the camps, who account for around 10–15% of the total non-Thai population in the province.

Tak expects to secure 72m baht a year

Dr Purichat Yingrangsan, deputy chief medical officer at the Tak Provincial Public Health Office, said the province now faces the challenge of providing medical and public health services for residents in Tak after overseas funding to support refugee camps was suspended. 

The Tak Provincial Public Health Office, working with clinics, has stepped in to oversee care and organise service delivery.

Over 11 months in 2025 (February–December), the cost of referring patients from the shelters to hospitals totalled about 42.1 million baht. The breakdown was:

• Mae Sot Hospital: about 9.14 million baht
• Mae Ramat Hospital: 0.79 million baht
• Tha Song Yang Hospital: 15.15 million baht
• Phop Phra Hospital: 7.26 million baht
• Umphang Hospital: 9.05 million baht

If Tak must continue supporting services in the shelters, the province estimates it will need around 72.9 million baht a year in 2026, comprising:

• Support costs for treatment, health promotion and prevention: about 6.69 million baht
• In-hospital medical treatment costs: 51.7 million baht
• Operating costs: 4 million baht
• Personnel costs: 10.5 million baht

“Our next concern, once the public health authorities know we will be responsible for delivering effective healthcare services without placing an excessive burden on the budget, is that while we worked over the past year to improve the medical system in the camps, what we have done less of — and what remains a key challenge — is health promotion,” Purichat said.

He added that access to children’s healthcare and vaccinations in particular remains limited compared with Thai citizens, and stressed the need to expand access for non-Thai groups. “If we can increase access, it will also help protect Thailand,” he said.

Mae Sot Hospital sees funding fall by 20m baht

Dr Ramet Wongwilairat, director of Mae Sot Hospital in Tak, said the refugee healthcare system relies on community hospitals as the frontline for screening and treating patients in the displaced persons’ camps. 

Cases beyond their capacity are then referred to Mae Sot Hospital, which supports all four community hospitals with staff, medicines and medical supplies.

He said Mae Sot Hospital previously received about 30 million baht in overseas assistance, but in 2025 that fell to around 10 million baht — a drop of roughly 67% — and this year the hospital is likely to receive no foreign funding at all.

“This has forced us to adjust how we work, strengthening screening at the community-hospital level and having Mae Sot Hospital step in to provide support at the next stage, so we can use our limited resources as efficiently as possible,” Ramet said.

In the short term, border-area hospitals will receive assistance from the Japanese government, which is preparing to allocate US$2.8 million — about 100 million baht — through the World Health Organisation (WHO). 

The funding, planned for the next two years, will be used to develop disease surveillance data systems and support operations at hospitals in border areas.

Proposal urges 200m baht a year for refugee healthcare

Dr Supakit Sirilak, director of the Health Systems Research Institute (HSRI), said the decline in international development assistance has forced essential humanitarian programmes to scale back, reducing migrants’ and displaced people’s access to healthcare while placing an unprecedented burden on Thailand’s public health facilities along the border.

He said healthcare in the camps was previously managed in a structured way, with in-camp hospitals providing basic treatment and referring cases beyond their capacity to Thai district or provincial hospitals, such as Mae Sot Hospital. The International Rescue Committee (IRC) covered most of the costs, even if not 100%.

With that support now disappearing, he said the full burden of care will inevitably fall on Thai state hospitals under the Ministry of Public Health. 

From a humanitarian and human-rights perspective, Thailand cannot allow refugees to fall seriously ill and die in the camps. Yet the budgets hospitals receive under the universal healthcare scheme are calculated only on the number of eligible Thai citizens, and do not cover non-Thai populations or refugees.

Supakit said the impact goes beyond treatment costs. He warned of sanitation and environmental problems inside the camps, as funding shortfalls affect access to clean water and waste management. 

This increases the risk of outbreaks and illness, which would further raise workloads for medical staff in border areas who are already working under difficult conditions and experiencing fatigue.

He proposed that the government set aside a dedicated budget to support healthcare for all refugees in the camps. Based on preliminary estimates, he said an annual allocation of around 200–300 million baht would be enough to stabilise the situation. 

He argued the amount is modest relative to Thailand’s fiscal capacity and smaller than budgets for many other programmes, yet would deliver significant benefits and enhance Thailand’s credibility internationally.

He added that stepping in to fill the gap left by US cuts would demonstrate Thailand’s humanitarian stance and reinforce its leadership in public health in the region. It would also ease pressure on border hospitals, allowing staff to work fully without worrying about unrecoverable medical debts, and help sustain the border public health system.

“Thailand would be able to say to the world, with pride, that we do not abandon our fellow human beings under humanitarian principles, even without financial support from a major power,” Supakit said.

Shifting from displaced persons to workforce integration

Thailand has been mapping out its next steps and needs to adjust its approach to fit a changing context. After more than 40 years of providing humanitarian care for displaced people, the focus is now moving towards promoting self-reliance.

This shift particularly targets working-age groups, who make up nearly 50% of the population in the shelters, so they can enter the labour market and join the health insurance system, alongside continued access to standard public health services. 

The Cabinet passed a resolution on August 26, 2025, allowing displaced people to work outside the shelters on an exceptional basis. The move is intended to help them enter the health insurance system and become more self-sufficient, supporting the long-term sustainability of healthcare and easing the state’s budget burden.

In Tak, the Provincial Public Health Office has already begun implementation, carrying out health checks and facilitating job placement for nearly 1,000 people who have been able to take up work in other provinces. 

However, many working-age people remain in the shelters — estimated at around one-third of the camp population. If more people can be supported into employment, they would have the income to pay for their own health insurance, and the health system could use those contributions to improve service provision.