Published on 13 November 2025
This article is an extension of our special issue “Aid in danger: after the shock of 2025, the consequences and the response” published in November 2025. According to the author, forty years after their creation, refugee camps on the Thai-Burmese border reveal their Achilles heel: a deadly dependence on external funding. American budget cuts are causing a health crisis there and forcing a rethink of a sclerotic humanitarian model.
In January, Mahn [1]For confidentiality reasons, the name was changed. was repairing a roof in the Mae La Thai refugee camp on the Thailand-Myanmar border. He fell and suffered a head injury that required urgent medical care. In normal times, the Thai medical centre would have admitted the man at no cost. But only a few days before, the new US Administration had abruptly cut foreign aid. The hospital required his family to pay and while they were trying to find the money, he passed away.[2]This is one of the stories gathered from interviews conducted during a qualitative research project in Mae Sot, Thailand, between February and April 2025. This tragic incident was one of the many stories I heard during three months of field work, in Mae Sot, at the Thai Myanmar border, from February to April 2025. It shows the direct impacts of the suspension of foreign US aid, starting in January 2025. With 34% of all humanitarian aid[3]US Secretary of State Marco Rubio, “Making foreign aid great again”, US. Department of State, 1 July 2025, https://statedept.substack.com/p/making-foreign-aid-great-again; Oxfam, “After Trump … Continue reading stopped, funding cuts has direct consequences for human security, leaving millions of people enduring dire emergencies without access to humanitarian aid worldwide.[4]Oxfam America, “What USAID does, and the impact of Trump’s cuts on foreign aid”, 23 May 2025, … Continue reading Trumps’ executive order also marks the end of an era, as the world is shifting, a geostrategic climate change, disrupting long-standing international norms.
Myanmar, once again under military governance since 2021, was ranked among the most conflict-affected countries globally.[5]Armed Conflict Location and Event Data, “Myanmar”, 4 November 2025, https://acleddata.com/methodology/myanmar Thirty-seven per cent of the population needs humanitarian assistance,[6]United Nations Office for the Coordination of Humanitarian Affairs, “Myanmar Humanitarian Update No. 45”, ReliefWeb, 1 March 2025, … Continue reading as civilians are facing violence and deteriorating living conditions, with limited access to basic needs. Thailand, one of the primary “escape states” in the region since the 1980s, currently hosts at least 5,2 million Myanmar nationals, with more than a third living irregularly in the country, and 110,000, living in nine “temporary shelters”/refugee camps, at the border.[7]International Organization for Migration, “Bridging the Gap: Optimizing the Contribution of Labour Migration for Thailand’s Social and Economic Transformation”, IOM Thailand, 1 January 2024, … Continue reading People living outside the camps, considered irregular, are not legally allowed to work or to travel around Thailand. Worse, to be irregularly present is an arrestable offence.[8]Kingdom of Thailand, Immigration Act, B.E. 2522, 30 May 1979, Chapter 2. This legal framework makes irregular migrants more dependent on the provision of aid.[9]International Organization for Migration, “Overview of Myanmar nationals in Thailand”, IOM, 1 January 2025, … Continue reading Its abrupt withdrawal has deeply impacted the protection of Myanmar civilians in Thailand where in 2024 alone, 90% of humanitarian aid provided came from the US.[10]Financial Tracking Service, “Thailand 2024”, UNOCHA, January 2024, https://fts.unocha.org/countries/222/summary/2024
This article results from my observations during three months of fieldwork in Mae Sot and is based on thirty qualitative interviews. It offers a snapshot of a pivotal moment in the history of humanitarian assistance. It examines the impacts of the recent cuts on Myanmar migrant populations living along the Thai border, and highlights how they expose the shortcomings of a local humanitarian system still overly dependent on external support and on the cooperation of the hosting state.
The making of an “ad vitam aeternam” system of assistance
Although large-scale international humanitarian intervention in Thailand started in 1979 in response to the Cambodian refugee influx, a major turning point came in 1984, when the first Myanmar refugee camps were established in Tak Province to shelter Karen fleeing ethnic persecution and conflict perpetrated by the Myanmar military. At that time, camps provided “self-sufficient” assistance to Myanmar refugees through village-style shelters, where residents could freely move in and out.
However, following cross-border incursions in the late 1990s, Thai authorities began consolidating smaller camps into larger ones, transforming these self-reliant settlements into fenced, town-like camps with restricted mobility for their residents. Over time, the aid system became increasingly bureaucratized, further curtailing refugees’ agency and fostering greater dependence on external assistance. As was criticised then, “once again a short-term emergency is turning into a long-term problem”.[11]The Border Consortium, “40 Years working together with displaced communities along the Thai-Myanmar border”, March 2025, … Continue reading Now, almost forty years later, the camps still exist, constituting one of the largest protracted refugee situations in the world. This situation of encampment has become a “modern purgatory, between the hell of rootlessness and the heaven of integration”.[12]Vincent Bernard, “Migration and displacement: Humanity with its back to the wall”, International Review of the Red Cross, 2017, 99 (1), p.1–11. While camps were initially set up in response to waves of displacement, keeping them open on a long-term basis only raised human, social and security problems, without providing people with future opportunities. It is living like “a pig in a fence,” said a 28-year-old interviewee, who had been living in the camps for 18 years. Solutions that were initially conceived as temporary endured and became frozen in time. Within a restrictive setting marked by limited mobility, aid recipients in the camps grew increasingly dependent on a system originally designed as an emergency measure. The 2025 US funding cuts starkly revealed this dependence, exposing the extent to which the entire system had only been relying on external support.
From solidarity to scarcity: How aid cuts impact their beneficiaries
The cuts have both short and long-term impacts on Myanmar nationals staying at the Thai border. The severity of these impacts varies depending on the individuals’ legal status. Those able to secure more “legible” forms of status, such as student or work visas, are better positioned to navigate Thai society and less likely to face exploitation, compared to undocumented individuals who remain structurally marginalised.[13]Royal Thai Government, Thai Immigration Act BE 2522, Section 54, 1979. Human Rights Watch, ““I’ll Never Feel Secure, Undocumented and Exploited: Myanmar Nationals in Thailand”, HRW, 14 July … Continue reading
Short-term impacts
Within the temporary Thai shelters, the immediate consequences of the cuts included a reduction in access to food and medical support. The International Rescue Committee (IRC), for example, a major actor in the camps, relied on US agencies for 75% of its funding.[14]International Rescue Committee, Inc and Subsidiaries, “Consolidated Financial Statements”, IRC, 30 September 2024, … Continue reading Following the cuts, the IRC experienced disruptions across all its activities.[15]International Rescue Committee, “U.S. aid cuts put millions in peril”, IRC, 28 February 2025, https://www.rescue.org/article/us-aid-cuts-put-millions-peril At Mae La camp, hospitals funded by the IRC were closed, forcing patients to leave.[16]Prachathai, “Refugee hospitals on the Thai-Myanmar border affected by US aid freeze”, Global Voices, 4 February 2025. … Continue reading In January, after the cuts, several camp residents passed away due to their medical care being halted: a 38-year-old mother with dialysis, and two elderly patients with breathing problems whose oxygen tanks had been removed.[17]Shoon Naing, “Burmese refugee dies after discharge from shut US-funded clinic, says family”, Reuters, 11 February 2025, … Continue reading After the cuts, camp residents in need of urgent medical treatment have been forced to seek access outside the camps, in either public or private hospitals. Furthermore, while migrants in Thailand were previously covered by the M-Fund, a low-cost, non-profit health protection scheme for Burmese migrants, funding cuts have reduced hospital care to only the most extreme cases, leaving groups such as pregnant women without essential support.[18]Panu Wongcha-um, Shoon Naing and Poppy Mcpherson, “Myanmar refugees face sudden discharge from Thai hospitals shuttered by US aid freeze”, Reuters, 29 January 2025, … Continue reading This was the situation of a pregnant relative of one interviewee in Mae La, who was unable to afford a cesarean no longer covered by the M-Fund: she had to cross illegally into Myanmar to give birth in a hospital offering free care.
Since January, food provision has also been massively reduced. On 31 March, The Border Consortium (TBC), the main organisation distributing food in the camps, announced cuts to food card assistance.[19]The Border Consortium, “Statement: Reduction in Food Support to Refugees”, TBC, 31 March 2025, https://www.theborderconsortium.org/wp-content/uploads/2025/03/Reduction-statement-revised-V4.jpg Over 80% of residents (70,000 people) saw a substantial reduction, with support now largely limited to the vulnerable, such as the elderly or sick. One interviewee living in Mae La complained: “There is not enough money, so you need to go to the forest and cut bamboo and sell it, but we are being banned from leaving, we cannot do anything, we have no income for living or for giving a future to our children”.
Long-term impacts
The long-term impacts of the recent cuts are already becoming visible. Access to education and opportunities for development are under threat, while rising unemployment is deepening the vulnerabilities. As explained by one interviewee, “competition for available opportunities has intensified insecurity”. Interviews point to growing cases of depression and alcoholism, alongside a general decline in psychological well-being. This distress is not only tied to the loss of employment, but also to the burden of responsibility many workers carry, as they continue to support dependents either in Thailand or back in Myanmar. Reduced employment also means fewer remittances, which are vital for families and communities. In 2022 alone, over half of all remittances received in Myanmar came from Thailand. Furthermore, increasing employment insecurity implies more people will look for informal employment, “under the table work”. While already 52% of the employment is informal,[20]National Statistical Office, “The informal employment survey 2023”, National Statistical Office, https://www.nso.go.th/nsoweb/storage/survey_detail/2023/20231218155504_43190.pdf people will be more exposed to sudden contract terminations, lower wages, dangerous working environments, or even forced labor and human trafficking.[21]International Organization for Migration, “Overview of Myanmar nationals in Thailand”, IOM, 1 January 2025. So far, education initiatives in the camps have been relatively unaffected, as ZOA Refugee Care Thailand, the main provider of funding for schools, is financed by European governments, notably the Netherlands, Belgium, and the European Commission.[22]ZOA Refugee Care, “ZOA Annual report 2023”, ZOA, January 2023, p.59, https://www.zoa-international.com/sites/default/files/assets/files/Jaarverslagen/ZOA%20annual%20report%202023_pages_web.pdf However, many of these donors have also announced cuts to their foreign aid budgets in the coming months.[23]Michael Sheldrick, “Foreign Aid is Shrinking: What Happens Next?”, Forbes, 25 February 2025, https://www.forbes.com/sites/globalcitizen/2025/02/25/foreign-aid-is-shrinking-what-happens-next; … Continue reading The shortage of funds is most likely going to cause educational disruptions and shortages of basic educational material.
Humanitarian Aid Under Pressure: Between Money and Politics
The funding crisis has highlighted two critical issues. First, it has raised new questions: how can this humanitarian disruption be resolved? In what ways should the system be rebuilt, with which resources and actors? Second, it has exposed the limitations of the humanitarian model, dependent on foreign aid and the cooperation of the hosting state.
Firstly, while international stakeholders attempt to rethink a new global humanitarian model, people who depend on assistance continue to face growing daily struggles and remain outside of the discussion. This research has shown that the local context and specific needs are often overlooked, with general approaches based on donors’ requirements applied instead, and beneficiaries portrayed as “victims” rather than decision-makers of their futures. Such practices risk reinforcing the gap between humanitarian strategies and the realities on the ground. This has been criticised by Naw Ta Mla Saw, the Secretary General of the Karen Women’s Organisation: “Sometimes, international norms are not defined clearly, translated well into our language, nor put into context to fit our living conditions […]. Often, as refugees, we are not the decision makers of how we live. Sometimes we see an “international issue just pushed onto the community”.[24]The Border Consortium, “40 Years working together with displaced communities along the Thai-Myanmar border”, March 2025, … Continue reading
Interviewees noted that after the cuts, outside communities donated medicine, and Myanmar nationals funded aid with personal savings. Locals assert their agency despite humanitarian failures, embodying the Karen principle of Ma doh ma ka, (helping each other). These acts highlight community-driven humanitarianism, filling gaps left by formal aid and challenging top-down relief.
Secondly, the crisis has shown that reliance on Western donors and on the host state has undermined, rather than enhanced, the humanitarian situation. Short-term humanitarian aid has become a permanent substitute for genuine solutions. The Thai national framework has acted as a catalyst for the crisis by not allowing irregular migrants to move freely or work, increasing dependency on humanitarian assistance. Because of the crisis, the Royal Thai Cabinet approved a resolution, on the 26th of August, that will be granting refugees living in the shelters the right to work, from October on.[25]United Nations High Commissioner for Refugees, “UNHCR welcomes Royal Thai Government resolution providing long-term refugees the right to work”, 26 August 2025, UNHCR Press, … Continue reading However, the implementation of this measure is likely to be slow and temporary and people living irregularly outside of the camps, the majority of Myanmar irregulars, will remain without legal authorisation to work.
What this crisis reveals is a nonsymbiotic system under perfusion, where the Thai legal framework has further increased beneficiaries’ dependency on aid. Although historic[26]The Border Consortium, “Statement on the announcement of work opportunities for refugees in Thailand”, TBC, 28 August 2025, … Continue reading and likely to lessen the immediate effects of funding cuts, this decision was taken as a last resort measure to prevent the situation in the camps from worsening. The living conditions of Myanmar irregulars living outside the camps remain, however, strongly unstable.
Other countries, such as Kenya, facing similarly protracted refugee situations, have adopted comparable measures, encouraging refugees in camps to live and work alongside host communities.[27]Joseph Maina, “Refugee entrepreneurs in Kenya’s Kakuma camp struggle to survive aid cuts”, The New Humanitarian, 7 August 2025, … Continue reading However, whether other countries in similar circumstances will take steps to support their irregular residents remains uncertain. Nevertheless, such initiatives are crucial for improving conditions and mitigating the global impact of reductions in US funding.
Picture credit: ©CICR Thang Khan Sian Khai
