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This article reports on a longitudinal case study, which included site visits in Thailand from 2014 to 2015, and participant follow-up to mid-2018. It documents the lived experience of children from Syria, Sri Lanka, Pakistan, Vietnam, and Myanmar in two different locations in Thailand: Bangkok and Mae Sot (a district close to Thailand-Myanmar border with a long history of economic migrants and refugees from Myanmar). It documents perspectives of children and the adults in their lives while in exile. It presents an analysis of the children's perspectives on needs and how unmet needs for safety, basic materials, health care, and education put them at risk of arrest, detention, abuse, and exploitation, and impact their psychological development. Contextual factors such as available services, existing policies and laws are also discussed in relation to the Convention on the Rights of the Child (CRC). [ABSTRACT FROM AUTHOR]

This research note presents the findings of a project aimed at understanding the life and livelihood experiences of displaced Myanmar women in Thailand. Since the 2021 Myanmar military coup, thousands of people, including women of diverse socio-economic backgrounds, have fled Myanmar to neighbouring Thailand, where they are living as undocumented refugees with restricted livelihood opportunities. The results show that, in displacement, the lived experiences of these women vary according to their status and backgrounds. What is common, however, is that the displacement experiences of these women begin from a position of loss. Thereafter, their trajectories differ in terms of the way they seek to overcome the challenges of displacement and the associated traumatic experiences. [ABSTRACT FROM AUTHOR]

Introduction: Improvings utilization of antenatal care is one of strategies for achieving Millennium Development Goal of decreasing the maternal mortality. Thai Government health facilities provided same Maternal and Childcare services for migrants as Thai citizens. However, migrants' utilization of ANC services was still challenged by many factors. There was limited information about Myanmar migrants ANC services utilization in Thailand Myanmar border among all five border districts in Tak province, where thousands of Myanmar migrants are living and working. Method and Materials: Myanmar migrant women who had been living in the five border districts of Tak province, Thailand and delivered in one of the health facilities in five districts in September 2017 to March 2018 were interviewed face to face with a structured questionnaire during 12 weeks after delivery. Result: In this study, 73.2% of migrant women received adequate AN care (at least four ANC visits), but only 29.9% received early and adequate AN care (the first antenatal visit was in first 12 weeks of pregnancy and at least four ANC visits). The study found that women who lived in other districts (AOR = 5.13, 95% CI = 3.32-7.94), had higher likelihood to get antenatal care than those who lived in Mae Sot district. The women with sufficient health literacy (AOR = 7.46, CI = 4.49-12.42) were also found to have more likelihood to get adequate and early antenatal care. Discussion: Antenatal care utilization was associated with health literacy level, location of stay, duration of stay, household income, planned pregnancy or not, watched television and having health insurance. The results suggest that, as the vulnerable population at the border area, the migrant women should be targeted for bespoke health education messages on maternal health, especially the importance and necessity of antenatal care visits, especially in Mae Sot District. Promoting health insurance for the migrants would be another effective way to encourage migrant women having adequate and timely antenatal care utilization. [ABSTRACT FROM AUTHOR]

In March 2011, the Myanmar Government transitioned to a nominally civilian parliamentary government, resulting in dramatic increases in international investments and tenuous peace in some regions. In March 2015, Community Partners International, the Women's Refugee Commission, and four community-based organisations (CBOs) assessed community-based sexual and reproductive health (SRH) services in eastern Myanmar amidst the changing political contexts in Myanmar and Thailand. The team conducted 12 focus group discussions among women of reproductive age (18–49 years) with children under five and interviewed 12 health workers in Kayin State, Myanmar. In Mae Sot and Chiang Mai, Thailand, the team interviewed 20 representatives of CBOs serving the border regions. Findings are presented through the socioecological lens to explore gender-based violence (GBV) specifically, to examine continued and emerging issues in the context of the political transition. Cited GBV includes ongoing sexual violence/rape by the military and in the community, trafficking, intimate partner violence, and early marriage. Despite the political transition, women continue to be at risk for military sexual violence, are caught in the burgeoning economic push–pull drivers, and experience ongoing restrictive gender norms, with limited access to SRH services. There is much fluidity, along with many connections and interactions among the contributing variables at all levels of the socioecological model; based on a multisectoral response, continued support for innovative, community-based SRH services that include medical and psychosocial care are imperative for ethnic minority women to gain more agency to freely exercise their SR rights. [ABSTRACT FROM AUTHOR]

Background: Migrants are known to be predominantly poor population which are predisposing to social and health problems, particularly infectious diseases including tuberculosis (TB). TB itself and effect of treatment may further result in substantial morbidity and lowering the quality of life. This study aimed to assess the changes in health-related quality of life (HRQOL) within six months of anti-TB treatment initiation, and the associated factors in Myanmar migrants under anti-TB treatment within this border area.Methods: This was a prospective cohort study of adult Myanmar migrants with new TB who were within two months of treatment initiation in two TB clinics in Mae Sot, a Thai-Myanmar border area between September 2019 and July 2020. Eight individual domain scores of the HRQOL and Physical and Mental Component Summary (PCS and MCS) scores measured by SF-36 were calculated at month-2 (T1) as baseline, and at the month-4 (T2) and month-6 follow-up visits (T3). Generalized estimation equation models were used to assess the longitudinal changes in PCS and MCS scores of HRQOL.Results: Of the 155 patients recruited, 93 (60.0%) and 65 (69.9%) completed the month-4 and month-6 follow-ups, respectively. Both the PCS (+ 6.1) and MCS (+ 6.3) scores significantly improved between T1 and T3, with the lowest scores being general health, with the least improvement in social function (+ 1.5) compared with the other domains. Migrants with ethnic origin of Burmese or other were associated with higher PCS and MCS. Those living with family and having higher numbers of initial TB symptoms were associated with lower PCS and MCS scores. Those diagnosed during routine medical checkup were positively associated with PCS scores, whereas patients diagnosed during active case findings were negatively associated with MCS scores. Patients who received residential TB care had higher PCS scores than those with OPD-based TB care.Conclusions: Continuous improvement in quality of life was found among Myanmar migrants with TB during treatment but their quality of life is still low. Patients with low mental health, especially in the social domain, requires further attention. Active screening policy and supportive strategies during treatment are essential to TB migrants. [ABSTRACT FROM AUTHOR]

This study describes sex trafficking and associations with violence and health among female migrants in the sex industry in Mae Sot, Thailand. The mixed-methods study included a qualitative interview phase (n = 10), followed by a cross-sectional survey phase (n = 128). Entry via trafficking (force, fraud, or coercion [FFC], or as minors) was prevalent (76.6%), primarily FFC (73.4%). FFC was associated with inconsistent condom use, inability to refuse clients, poor health, and anxiety. Past-year violence was normative including client sexual violence (66.4%), client coercion for condom nonuse (> 95%), and police extortion (56%). Working conditions enabled violence irrespective of mode of entry. Profound unmet needs exist for safety and access to justice irrespective of trafficking history. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to determine the prevalence of Alcohol Use Disorders (AUDs) among Myanmar male migrant workers (> 15 years) living in Mae Sot, Thailand, and their patterns of drinking. Design/methodology/approach: A cross-sectional survey was administered to 512 participants to measure AUDs and drinking patterns. ANOVA and χ2 analyses were performed to assess demographic differences between abstainers, harmful and hazardous drinkers (HHDs) (those showing signs of AUDs) and non-harmful drinkers. Findings: Results showed that 12.3 percent of male Myanmar migrants were HHDs, a rate only slightly higher than in Thai men (9.1 percent), but much higher than in men still living in Myanmar (2.7 percent) (WHO, 2014). Also, 19 percent of alcohol-consuming Myanmar male migrant workers reported patterns of heavy episodic drinking, which is markedly higher than in alcohol-consuming Thai (4.7 percent) and Myanmar men (1.5 percent) (WHO, 2014). Originality/value: Given the health risks associated with AUDs and heavy episodic drinking, the findings of this study suggest a need for appropriate alcohol-related health education and intervention for Myanmar male migrant workers. [ABSTRACT FROM AUTHOR]

This paper focuses on the recent emergence of regional production networks and border industrial zones, the labor migrations they are generating, and their consequences for 'surplus populations' in the Greater Mekong Subregion (mainland Southeast Asia). In this region the textile and garment industry is employing increasing numbers of workers in border areas on flexible and highly precarious work 'contracts'. To understand these emergent labor formations we focus on three scales of analysis through a case study from the Thailand-Burma border. We focus on initiatives led by the Asia Development Bank, accompanying subregional political groupings which aim to facilitate capital flows and trade by reducing transaction time and cost, and a case study of labor recruitment and employment practices in one border town. In examining these three scales, we question the value of characterizing such trans-national, state-led, authoritarian, and racialized labor formations as neoliberal. [ABSTRACT FROM AUTHOR]

To investigate the host genetic factors affecting the clinical course of falciparum malaria, polymorphism of the tumor necrosis factor-α (TNF-α) promoter region was analyzed in patients with cerebral malaria. Two hundred and forty-three Myanmar patients with falciparum malaria at Mae Sot Malaria clinic and Mae Sot General Hospital located at the border between Thailand and Myanmar, were included in this study. Among the patients (128 from Karen, 115 from Burma), 200 were uncomplicated and 43 had cerebral malaria. The TNF-α 5′- flanking region showed biallelic polymorphic sites at -238, -308, -857, -863, -1031, and there were 7 alleles (TNFP-A, B, C, D, M1, M4, M7) found in the patients from Myanmar. We found that the TNFP-D allele was significantly associated with cerebral malaria in the populations from Karen (P c<0.0001, OR=124.86) and Burma (P c<0.0001, OR=34.50). TNFP-D showed no significant linkage disequilibrium with any alleles of HLA-B or HLA-DRB1, suggesting that TNFP-D was primarily associated with cerebral malaria in Myanmar. [ABSTRACT FROM AUTHOR]

Awareness of danger signs in pregnancy, after delivery and newborn baby among mothers lead to seek immediate health care and consequently reduce maternal and neonatal mortality. Thailand has accepted about 3 million blue-collar migrant workers from neighboring countries mainly from Myanmar. Understanding the level of knowledge of migrant mothers and its associated factors would be helpful for health agencies to implement suitable health promotion programs. Myanmar migrant women who had been living in the five border districts of Tak province, Thailand and delivered in the health facilities in five districts during September 2017 to March 2018 were face to face mother interviewed after 12 weeks after delivery with structured questionnaires. Among 723 migrant women, only 125 respondents (17.29%) could mention 8 or more danger signs and 218 participants (30.15%) knew only less than 4 danger signs out of total 16 danger signs. The level of health knowledge on danger signs were significantly associated with resident district (χ2 = 17.52, P<0.001), mother education (χ2 = 17.06, P=0.002), health insurance status (χ2 = 9.52, P=0.009),household income (χ2 = 26.92, P = <0.001), location of home in factory compounds or in villages (χ2 = 18.94, P=0.001), watching TV regularly (χ2 = 15.25, P<0.001). The migrant mothers in this study showed low health knowledge on danger signs. The organizations working for migrant health in Thai-Myanmar border should focus the provision of pregnancy and newborn healthcare messages to the illiterate mothers with low family income without health insurance in living in agricultural farms and factory. [ABSTRACT FROM AUTHOR]

Since Myanmar transitioned from direct military rule in 2011, successive governments have attempted to decentralize the primary and higher education systems through top-down "federalizing" initiatives. However, these efforts have largely failed. However, following the February 2021 military coup, the absence of a credible central education authority has led ethnic armed organizations (EAOs) and non-state actors, including local communities, to provide education to up to one million of the most vulnerable and conflict-affected children. This represents a new "federating" moment for education in Myanmar, where capacity and alliances are built from the bottom up and which could potentially endure after the ongoing conflict ends. This article explores Myanmar's complex and contested education system since the coup, analysing the difference between "federalizing" and "federating" approaches. It compares the pre- and post.-coup approaches to illustrate the importance of an adaptive, bottom-up approach based on local ownership and resilience. [ABSTRACT FROM AUTHOR]

While several scholarship opportunities are available to Myanmar migrants and refugee students in Thailand, many students face difficulties finding affordable and convenient ways to prepare for university entry requirements. To provide lifelong learning opportunities for these marginalized young adults, flexible online learning programs can play a significant role. This exploratory qualitative case study presents the challenges hindering the implementation of an online learning program in Mae Sot, a Thai town on the border with Myanmar. The study also reports suggestions of the participants in dealing with challenges of online learning for migrant students. Nine administrators and teachers of migrant learning centers (MLCs) in Tak province participated in this study. Semi-structured interviews and document analysis were methods applied. Although the migrant community acknowledges the benefits and opportunities of online learning, MLCs have not yet fully implemented eLearning as a mode of education. There are particular challenges to effectively implement the online learning program in the migrant community. Six challenges are identified: accessibility, support services, attitude, networking, contents, and accreditation, along with solutions proposed by the participants. This study claims that lack of accessibility, attitude and networking in the community are the major barriers among the other challenges in the migrant community. In dealing with challenges, three main recommendations proposed by the participants were: to develop courses for the beginner level, to establish an online learning study center with suitable infrastructure and resources in the migrant community, and to have regular communications with the migrant education providers. [ABSTRACT FROM AUTHOR]

The Sustainable Development Goals (SDGs) emphasise the importance of partnerships in achieving targets like Universal Health Coverage. But how can partnerships between non-state and state actors be established, and what development and political ramifications might they have, within protracted conflict situations? In Myanmar's Kayah State and Kayin State, decades-long conflict resulted in parallel health systems operating under Ethnic Armed Organisations. In recent years, non-state and state health workers in both areas have forged partnerships to implement an Expanded Programme on Immunisation (EPI). These endeavours demonstrate that partnerships are permeated with power relations and development programmes can become the site of political struggles in contested states. Linking national development plans with the SDGs can enhance non-state actors' positions in contexts where state and international actors have limited implementation capacity. Comparing Kayah State and Kayin State EPI activities demonstrates the importance of recognising political dynamics of partnerships in conflict situations. In Kayah State, when non-state actors were not recognised as leaders of development in their areas, EPI activities had negative impacts, fuelling local grievances. Conversely, in Kayin State, when state and international actors acknowledged political sensitivities and empowered non-state actors, EPI activities built a 'working encounter' with positive development and peacebuilding outcomes. [ABSTRACT FROM AUTHOR]

Plasmodium vivax (Pv) accounts for over 50% of malaria cases in Latin America and Asia. Despite a significant reduction in Pv transmission in Thailand, the parasite remains endemic to the border areas. This study aimed to investigate the genetic diversity of the parasites and the host factors, as well as their relation to parasite density in Pvisolates, along the Thai–Myanmar border. Genetic variations in Pv markers, specifically the ookinete surface protein Pvs25, and host genes, including Toll-like receptor 6 (TLR6), TLR9, TIR Domain-containing adaptor protein (TIRAP), Toll-interacting protein (TOLLIP), Duffy antigen receptor for chemokines (DARC), and intercellular adhesion molecule 1 (ICAM-1), were investigated using polymerase chain reaction (PCR) with restriction fragment length polymorphism (RFLP). A total of 548 PCR-positive Pv samples collected from Tak and Kanchanaburi provinces during two periods (2006–2007 and 2014–2016) were included in the study. Pvs25 exhibited four haplotypes, with H1 (EGTKV) being the most prevalent in both provinces. Kanchanaburi isolates exhibited greater genetic diversity than Tak isolates. No significant deviations from neutrality were observed for Pvs25 in either area. ICAM-1 and TOLLIP s3750920 heterozygous carriers had greater median parasite densities than homozygous mutants. The TLR9 rs187084 T genotype had a significantly higher parasite density than the non-T genotype. The findings underscore the significant association between the rs3750920 C/T, rs5498 A/G, and rs187084 T genotypes and high parasite density in patients infected with Pv, highlighting their potentially critical role in malaria susceptibility. [ABSTRACT FROM AUTHOR]

Background: Artemisinin resistance in Plasmodium falciparum threatens global malaria elimination efforts. To contain and then eliminate artemisinin resistance in Eastern Myanmar a network of community-based malaria posts was instituted and targeted mass drug administration (MDA) with dihydroartemisinin-piperaquine (three rounds at monthly intervals) was conducted. The prevalence of artemisinin resistance during the elimination campaign (2013–2019) was characterized. Methods: Throughout the six-year campaign Plasmodium falciparum positive blood samples from symptomatic patients and from cross-sectional surveys were genotyped for mutations in kelch-13—a molecular marker of artemisinin resistance. Result: The program resulted in near elimination of falciparum malaria. Of 5162 P. falciparum positive blood samples genotyped, 3281 (63.6%) had K13 mutations. The prevalence of K13 mutations was 73.9% in 2013 and 64.4% in 2019. Overall, there was a small but significant decline in the proportion of K13 mutants (p < 0.001). In the MDA villages there was no significant change in the K13 proportions before and after MDA. The distribution of different K13 mutations changed substantially; F446I and P441L mutations increased in both MDA and non-MDA villages, while most other K13 mutations decreased. The proportion of C580Y mutations fell from 9.2% (43/467) before MDA to 2.3% (19/813) after MDA (p < 0.001). Similar changes occurred in the 487 villages where MDA was not conducted. Conclusion: The malaria elimination program in Kayin state, eastern Myanmar, led to a substantial reduction in falciparum malaria. Despite the intense use of artemisinin-based combination therapies, both in treatment and MDA, this did not select for artemisinin resistance. [ABSTRACT FROM AUTHOR]

Using the lenses of agency and precarity, this article examines how young migrants and refugees negotiate legal and social marginalisation growing up along the Thailand-Myanmar border. It explores the pervasive insecurity, vulnerability and uncertainty characterising the young people's worlds, and the ways they strive to manage their circumstances and protect themselves from despair. The study on which the article is based involved 44 semi-structured qualitative interviews with 35 young men and women who were either born in Thailand to migrant or refugee parents, or had arrived from Myanmar, with their families or alone, before the age of 12. A social constructionist epistemology and qualitative case study methodology underpinned the research, chosen to facilitate a bottom-up, person-centred approach, and prioritise the young people's perspectives within their cultural contexts. The findings capture the everyday precarity of the young people, living as 'illegal aliens' under Thai law. Arrest, detention, abuse, labour exploitation, and restricted access to state services, including accredited education and affordable healthcare, are daily challenges. However, the young people are far from passive victims of their circumstances, and resist reduction to those terms. As agentic social actors, they are both cognisant of their constraints and actively – relentlessly – engaged in managing them. [ABSTRACT FROM AUTHOR]

This article explores 'health as a bridge to peace' in Myanmar's Kayin State. It focuses on an Auxiliary Midwife training programme, which has created partnerships between actors historically divided by decades-long conflict. Drawing on ethnographic research, the article highlights the agency of community-level service providers, who are often overlooked in conventional approaches to peacebuilding. It demonstrates that community health workers are challenging top-down liberal approaches to peacebuilding and advancing an alternative approach to development and peace in their areas – one that emphasises systemic change and recognition of non-state governance systems. The shared lexicon and standardised practices of healthcare create 'working encounters' – encounters that 'work', because they enable actors historically divided by conflict to carve out an 'apolitical' space in an otherwise highly politicised context, while still allowing for different perspectives and agendas. These 'working encounters' in turn facilitate the development of understanding, trust and collaboration across conflict divides. Yet community-level actors face structural limitations, which are often underestimated by proponents of 'health as a bridge to peace'. Nevertheless, this case study highlights significant contributions that community-level 'working encounters' can make to wider peace processes, as well as the need for hybrid and emancipatory practices of peace formation. [ABSTRACT FROM AUTHOR]

Background: Polymorphisms of Plasmodium falciparum chloroquine resistance transporter (pfcrt), Plasmodium falciparum multi-drug resistance 1 (pfmdr1) and Plasmodium falciparum kelch 13-propeller (pfk13) genes are accepted as valid molecular markers of quinoline antimalarials and artemisinins. This study investigated the distribution patterns of these genes in P. falciparum isolates from the areas along the Thai-Myanmar border during the two different periods of antimalarial usage in Thailand. Results: Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) were used to detect pfcrt mutations at codons 76, 220, 271, 326, 356, and 371 as well as pfmdr1 mutation at codon 86. The prevalence of pfcrt mutations was markedly high (96.4–99.7%) in samples collected during both periods. The proportions of mutant genotypes (number of mutant/total isolate) at codons 76, 220, 271, 326, 356 and 371 in the isolates collected during 1993–1998 (period 1) compared with 2002–2008 (period 2) were 97.9% (137/140) vs. 97.1% (401/413), 97.9% (140/143) vs. 98.8% (171/173), 97.2% (139/143) vs. 97.1% (333/343), 98.6% (140/142) vs. 99.7% (385/386), 96.4% (134/139) vs. 98.2% (378/385) and 97.8% (136/139) vs. 98.9% (375/379), respectively. Most isolates carried pfmdr1 wild-type at codon 86, with a significant difference in proportions genotypes (number of wild type/total sample) in samples collected during period 1 [92.9% (130/140)] compared with period 2 [96.9% (379/391)]. Investigation of pfmdr1 copy number was performed by real-time PCR. The proportions of isolates carried 1, 2, 3 and 4 or more than 4 copies of pfmdr1 (number of isolates carried correspondent copy number/total isolate) were significantly different between the two sample collecting periods (65.7% (90/137) vs. 87.8% (390/444), 18.2% (25/137) vs. 6.3%(28/444), 5.1% (7/137) vs. 1.4% (6/444) and 11.0% (15/137) vs. 4.5% (20/444), for period 1 vs. period 2, respectively). No pfk13 mutation was detected by nested PCR and nucleotide sequencing in all samples with successful analysis (n = 68). Conclusions: The persistence of pfcrt mutations and pfmdr1 wild-types at codon 86, along with gene amplification in P. falciparum, contributes to the continued resistance of chloroquine and mefloquine in P. falciparum isolates in the study area. Regular surveillance of antimalarial drug resistance in P. falciparum, incorporating relevant molecular markers and treatment efficacy assessments, should be conducted. [ABSTRACT FROM AUTHOR]

Primarily driven by conflict, displacement and economic pull factors over the past three decades, a homegrown system of mother-tongue-based education for migrant children from Myanmar has been developed in Tak Province, Thailand. This network of Migrant Learning Centers depended mainly on external organisations for teacher professional development (TPD), with few Centres having opportunities to develop school-based models. This paper documents learning from creating the ‘teacher leader’ role to build school-level capacity to sustain TPD by giving new responsibilities to 31 teachers as peer coaches during the pandemic. Mixedmethods analysis used Hofstede’s Cultural Dimensions Theory, specifically, Power Distance, Individualism – Collectivism, Uncertainty Avoidance and Long-Term Orientation to frame sensemaking and the extent to which teachers’ perceptions of the new role were consistent with its implementation. The teacher leader role contributed to a perceived reduction of power distance between teachers and promoted long-term orientation regarding TPD. Its emphasis on collaboration allowed collectivist ideals to be played out practically without disturbing the status quo. The prioritisation of reflective practice and teacher-level collaboration improved coaching self-confidence and teaching competencies. Teacher-led peersupport systems within and across schools assisted in the retention of institutional knowledge. [ABSTRACT FROM AUTHOR]

With a prominent focus on military conflicts in Myanmar, international media coverage has tended to emphasize the divisiveness of ethnicity in the country. This article, by contrast, looks at interpersonal ties and formations of solidarity amongst an ethnically and religiously diverse body of workers from Myanmar, now residing in Thailand. Drawing on in-depth interviews conducted with Myanmar workers, the central argument of this article is that shared socio-economic grievances have served as salient bases of cohesion and collective action within this multi-ethnic, multi-religious migrant labour context. [ABSTRACT FROM AUTHOR]

Background: Published literature on surgical care in refugees tends to focus on the acute ('emergent') phase of crisis situations. Here we posit that there is a substantial burden of non-acute morbidity amenable to surgical intervention among refugees in the 'chronic' phase of crisis situations. We describe surgery for non-acute conditions undertaken at Mae La Refugee Camp, Thailand over a two year period. Methods: Surgery was performed by a general surgeon in a dedicated room of Mae La Refugee Camp over May 2005 to April 2007 with minimal instruments and staff. We obtained the equivalent costs for these procedures if they were done at the local Thai District General Hospital. We also acquired the list (and costs) of acute surgical referrals to the District General Hospital over September 2006 to December 2007. Results: 855 operations were performed on 847 patients in Mae La Refugee Camp (60.1% sterilizations, 13.3% 'general surgery', 5.6% 'gynaecological surgery', 17.4% 'mass excisions', 3.5% 'other'). These procedures were worth 2,207,500 THB (75,683.33 USD) at costs quoted by the District General Hospital. Total cost encountered for these operations (including staff costs, consumables, anaesthesia and capital costs such as construction) equaled 1,280,000 THB (42,666 USD). Pertaining to acute surgical referrals to District General hospital: we estimate that 356,411.96 THB (11,880.40 USD) worth of operations over 14 months were potentially preventable if these cases had been operated at an earlier, non-acute state in Mae La Refugee Camp. Conclusions: A considerable burden of non-acute surgical morbidity exists in 'chronic' refugee situations. An inhouse general surgical service is found to be cost-effective in relieving some of this burden and should be considered by policy makers as a viable intervention. [ABSTRACT FROM AUTHOR]

Background: Millions of women give birth annually without the support of a trained birth attendant. Generally and globally, countries provide maternal health services for their citizens but there is a coverage gap for undocumented migrant women who often can't access the same care due to their legal status. The objective of this investigation is to explore undocumented migrants' experiences and perceptions of maternal healthcare accessibility. Methods: We held focus groups discussions with 64 pregnant women at 3 migrant health clinics on the Thailand–Myanmar border and asked how they learned about the clinic, their health care options, travel and past experiences with birth services. In this context undocumented women could sign up for migrant health insurance at the clinic that would allow them to be referred for tertiary care at government hospitals if needed. Results: Women learned about care options through a network approach often relying on information from community members and trusted care providers. For many, choice of alternate care was limited by lack of antenatal care services close to their homes, limited knowledge of other services and inability to pay fees associated with hospital care. Women travelled up to 4 h to get to the clinic by foot, bicycle, tractor, motorcycle or car, sometimes using multiple modes of transport. Journeys from the Myanmar side of the border were sometimes complicated by nighttime border crossing closures, limited transport and heavy rain. Conclusions: Undocumented migrant women in our study experienced a type of conditional or variable accessibility where time of day, transport and weather needed to align with the onset of labour to ensure that they could get to the migrant clinic on time to give birth. We anticipate that undocumented migrants in other countries may also experience conditional accessibility to birth care, especially where travel is necessary due to limited local services. Care providers may improve opportunities for undocumented pregnant women to access maternal care by disseminating information on available services through informal networks and addressing travel barriers through mobile services and other travel supports. Trial registration The research project was approved by Research Ethics Committee at the Faculty of Medicine, Chiang Mai University (FAM-2560-05204), and the Department of Community Medicine and Global Health at the University of Oslo—Norwegian Centre for Research Data (58542). Plain Language Summary: Undocumented pregnant migrants have difficulties and limitations in accessing maternal health care services. Although the governments have tried to provide maternal health care services to all, there is still a gap in coverage among this population. This study explores how undocumented pregnant migrants perceive their ability to access maternal health care and share their experiences when utilizing it. We used focus groups to interview 64 pregnant women at three migrant health clinics on the Thailand–Myanmar border. We asked how they learned about the clinic, their health care options, travel, and past experiences with birth services. The results showed that they usually knew about care options from community members and trusted care providers. The limitations for the choice of alternate care were due to a lack of services close to their homes, limited knowledge of other services, inability to pay hospital fees, and difficulty traveling from their residence to the clinic. Therefore, we anticipate that undocumented migrants in other countries may also experience difficulties in accessibility to birth care, especially where travel is necessary due to limited local services. Care providers may improve opportunities for these migrants to access maternal care by disseminating information on available services through informal networks and addressing travel barriers through mobile services and other travel supports. [ABSTRACT FROM AUTHOR]

The Myanmar military staged a coup against the elected civilian government in February 2021. Since then, the country has been in a state of emergency and ruled by a military junta. Resistance to the coup was swift and widespread, beginning with the Civil Disobedience Movement that has now morphed into the People’s Defense Forces. A state of civil war has remained for well over two years now, reversing the previous trend toward democratic transition. Nonetheless, the democratic interlude has spawned strong resistance to military rule. The armed conflict and contestation for power looks set to continue into the medium term and may eventually lead to domestic political changes toward democratization. [ABSTRACT FROM AUTHOR]

This article explores the notion and nature of penal duress, illustrated through analysis of martial, penal practice in Myanmar. We examine prison labour and pone-san (a demeaning, defamatory and coercive control of prisoners' bodies) to show how these two enduring practices of domination, subjection and constraint – understood, drawing on Ann Laura Stoler, as relations of duress – animate penal practice in powerful, productive and problematic ways. Resisting the urge to view imperial forms through a peripheralising northern lens, or solely in terms of continuity and discontinuity, we pursue an understanding of penal duress as a ubiquitous, yet distinctly situated and relational phenomenon that has taken form through local colonial experiences and their afterlives. In sum, we attend to 'processes of partial inscriptions, modified displacements and amplified recuperations' to discuss how relations of penal duress are endured and enduring in Myanmar today. [ABSTRACT FROM AUTHOR]

Background: Child maltreatment is a global public health crisis with negative consequences for physical and mental health. Children in low- and middle-income countries (LMIC)–particularly those affected by poverty, armed conflict, and forced migration–may be at increased risk of maltreatment due to heightened parental distress and disruptions to social support networks. Parenting interventions have been shown to reduce the risk of child maltreatment as well as improve a range of caregiver and child outcomes, yet large-scale implementation remains limited in low-resource displacement settings. This study will examine the impact of an entertainment-education narrative film intervention on reducing physical and emotional abuse and increasing positive parenting among migrant and displaced families from Myanmar living in Thailand. Method: The study is a pragmatic, superiority cluster randomized controlled trial with approximately 40 communities randomized to the intervention or treatment as usual arms in a 1:1 ratio. Participating families in the intervention arm will be invited to attend a community screening of the film intervention and a post-screening discussion, as well as receive a poster depicting key messages from the film. Primary outcomes are changes in physical abuse, emotional abuse, and positive parenting behaviour. Secondary outcomes include caregiver knowledge of positive parenting, caregiver attitudes towards harsh punishment, caregiver psychological distress, and family functioning. Outcomes will be assessed at 3 time points: baseline, 4 weeks post-intervention, and 4-month follow up. A mixed methods process evaluation will be embedded within the trial to assess intervention delivery, acceptability, perceived impacts, and potential mechanisms of change. Discussion: To our knowledge, this study will be the first randomized controlled trial evaluation of a film-based intervention to reduce child maltreatment among migrant and displaced families in a LMIC. An integrated knowledge translation approach will inform uptake of study findings and application to potential scale up pending evaluation results. Trial registration: The study was prospectively registered with the Thai Clinical Trials Registry on 22 February 2023 (TCTR20230222005). [ABSTRACT FROM AUTHOR]

To approach the taxonomy of large and complex animal groups it is of advantage to focus on species groups with shared derived character state. We investigate the composition, morphological characteristics and relationships of and within the Schistura cincticauda species group, whose members are small freshwater fishes that inhabit streams and rivers in eastern Myanmar and western and southern Thailand. A phylogenetic analysis using molecular genetic markers demonstrated the monophyly of this group; a combined genetic and morphological analysis revealed the inclusion of at least twelve species. They share the presence of a pair of black marks on the lower lip, one on each side of the median interruption (these marks may be reduced to few melanophores or even missing in some individuals). Additionally, all species share a small body size (max. 60 mm SL), an incomplete lateral line reaching at most to vertical through anal-fin base, and the absence of sexual dimorphism. Each of the 12 species is diagnosed by a unique combination of character states in fin ray numbers, anus position, presence/absence of an axillary pelvic lobe, and colour pattern. The distribution areas of several species overlap and five cases of syntopic occurrence are known. Five unnamed species are described herein. [ABSTRACT FROM AUTHOR]

A taxonomic revision of Fernandoa Welw. ex Seem. (Bignoniaceae) in Thailand is presented. Two species, F. adenophylla (Wall. ex G. Don) Steenis and F. collignonii (Dop) Steenis, are enumerated with updated morphological descriptions, illustrations and a taxonomic identification key, together with notes on distributions, distribution maps, habitats and ecology, phenology, conservation assessments, etymology, vernacular names, uses, and specimens examined. The collection of Wallich Cat. 6502A from Myanmar, Ava at G [G00133642] is designated here as the lectotype of F. adenophylla in a second step lectotypification. F. collignonii has a conservation status of Endangered [EN]. The leaf, stem, and wood anatomy and pollen morphology of F. adenophylla are also reported in this study. [ABSTRACT FROM AUTHOR]

This study is a case-study research that explores the anatomy of Myanmar's border security governance using the Myawaddy Township as an exploratory case study. To explore how the Burmese borderlands, represented by Myawaddy, have been governed, the policy--regime approach is adopted as a conceptual framework to illustrate the idiosyncrasies, including relevant parties and their interactions. It was found that the following actors are involved in the security governance of borderlands: ethnic armed organisation, local bureaucratic agencies, Border Guard Forces (BGFs) and foreign interest groups. Prima facie, civil government agencies have performed their duties of overseeing border activities; however, they appear to have only de jure authority, serving as soft infrastructures for the lawful border economy. Contrarily, Karen BGF leaders, appointed by the Tatmadaw (i.e. Myanmar armed forces), have held de facto authority, controlling and benefiting from the border's shadow economy--which is marked by gambling businesses--as well as from running protection rackets. Still, the BGF units in Myawaddy have retained a considerable degree of autonomy without necessarily following the Tatmadaw's order. In a nutshell, border security governance in Myanmar's Myawaddy consists of several governing modes existing in parallel and, hence, it is prismatic in nature. [ABSTRACT FROM AUTHOR]

Freshwater mussels belonging to the tribe Pseudodontini (Bivalvia: Unionidae: Gonideinae) play a keystone role in riverine and lacustrine environments throughout Southeast Asia. Many of them are narrowly endemic and habitat specialists, which need special conservation efforts. Unfortunately, the systematics of this group is rather poorly understood. Here, we show that Pseudodon inoscularis, the type species of the genus Pseudodon, belongs to the eastern clade of the tribe (Southeast Asia, east of the Salween Basin), and, more certainly, clusters with members of the genus Monodontina. Hence, the latter genus becomes a synonym of Pseudodon, while the subtribe Pseudodontina (=Pilsbryoconchina syn. nov.) should be used as a name for the eastern clade. In turn, the genus Indopseudodon stat. rev. and the subtribe Indopseudodontina subtr. nov. must be applied as valid names for the western clade of the Pseudodontini (Ayeyarwady to Salween). We present a revision of the genus Indopseudodon with an updated synonymy and a description of a new species, I. indawgyiensis sp. nov. We also link four species-level genetic lineages from the Mekong to available taxonomic names in the genera Pseudodon and Sundadontina (Pseudodon cambodjensis, P. vagulus, Sundadontina harmandi, and S. sulcata). Based on morphological features, we revise the taxonomic position of several recent and fossil species that were traditionally placed in the Pseudodontini and transfer them to the genera Parvasolenaia, Pseudodontopsis, Ptychorhynchus, Simpsonasus nom. nov. (a new name for Nasus Simpson, 1900) (Gonideinae: Gonideini), Pseudobaphia (Unioninae: Unionini), Balwantia and Lamellidens (Parreysiinae: Lamellidentini). [ABSTRACT FROM AUTHOR]

Background The northwestern border of Thailand is an area of low seasonal malaria transmission. Until recent successful malaria elimination activities, malaria was a major cause of disease and death. Historically the incidences of symptomatic Plasmodium falciparum and Plasmodium vivax malaria were approximately similar. Methods All malaria cases managed in the Shoklo Malaria Research Unit along the Thailand-Myanmar border between 2000 and 2016 were reviewed. Results There were 80 841 consultations for symptomatic P. vivax and 94 467 for symptomatic P. falciparum malaria. Overall, 4844 (5.1%) patients with P. falciparum malaria were admitted to field hospitals, of whom 66 died, compared with 278 (0.34%) with P. vivax malaria, of whom 4 died (3 had diagnoses of sepsis, so the contribution of malaria to their fatal outcomes is uncertain). Applying the 2015 World Health Organization severe malaria criteria, 68 of 80 841 P. vivax admissions (0.08%) and 1482 of 94 467 P. falciparum admissions (1.6%) were classified as severe. Overall, patients with P. falciparum malaria were 15 (95% confidence interval, 13.2–16.8) times more likely than those with P. vivax malaria to require hospital admission, 19 (14.6–23.8) times more likely to develop severe malaria, and ≥14 (5.1–38.7) times more likely to die. Conclusions In this area, both P. falciparum and P. vivax infections were important causes of hospitalization, but life-threatening P. vivax illness was rare. [ABSTRACT FROM AUTHOR]

Background: Fever is a common reason to seek healthcare in Southeast Asia, and the decline of malaria has complexified how is perceived, and what actions are taken towards it. We investigated the concept of fever and the determinants influencing health-seeking behaviours among migrants on the Thai-Myanmar border, where rapid economic development collides with precarious political and socio-economic conditions. Methods: We implemented a mixed-methods study between August to December 2019. Phase I used a qualitative approach, with in-depth interviews and focus group discussions. Phase II used a quantitative approach with a close-ended questionnaire based on Phase I findings. A conditional inference tree (CIT) model first identified geographic and socio-demographic determinants, which were then tested using a logistic regression model. Results: Fever corresponded to a high diversity of conceptions, symptoms and believed causes. Self-medication was the commonest behaviour at fever onset. If fever persisted, migrants primarily sought care in humanitarian cost-free clinics (45.5%, 92/202), followed by private clinics (43.1%, 87/202), health posts (36.1%, 73/202), public hospitals (33.7%, 68/202) and primary care units (30, 14.9%). The qualitative analysis identified distance and legal status as key barriers for accessing health care. The quantitative analysis further investigated determinants influencing health-seeking behaviour: living near a town where a cost-free clinic operated was inversely associated with seeking care at health posts (adjusted odds ratio [aOR], 0.40, 95% confidence interval [95% CI] [0.19–0.86]), and public hospital attendance (aOR 0.31, 95% CI [0.14–0.67]). Living further away from the nearest town was associated with health posts attendance (aOR 1.05, 95% CI [1.00–1.10] per 1 km). Having legal status was inversely associated with cost-free clinics attendance (aOR 0.27, 95% CI [0.10–0.71]), and positively associated with private clinic and public hospital attendance (aOR 2.56, 95% CI [1.00–6.54] and 5.15, 95% CI [1.80–14.71], respectively). Conclusions: Fever conception and believed causes are context-specific and should be investigated prior to any intervention. Distance to care and legal status were key determinants influencing health-seeking behaviour. Current economic upheavals are accelerating the unregulated flow of undocumented migrants from Myanmar to Thailand, warranting further inclusiveness and investments in the public health system. [ABSTRACT FROM AUTHOR]

Teacher education is the very first step for preparing quality teachers and it is crucial to provide quality teacher training. This research aims to analyze and compare pre-service teacher education policies and programs in Myanmar, the Philippines, and Japan, focusing on secondary science teachers. A case study research design was employed by utilizing Technological Pedagogical and Content Knowledge (TPACK) framework. The result shows that TPACK components found in national education policies and programs in Myanmar were Content Knowledge (CK), Pedagogical Knowledge (PK), and Pedagogical Content Knowledge (PCK). On the other hand, TPACK found in the Philippines and Japan were CK, PK, Technological Knowledge (TK), PCK, Technological Content Knowledge (TCK), and Technological Pedagogical Knowledge (TPK). In all three countries, limited provision of Technological Pedagogical and Content Knowledge (TPACK) was found. It is interpreted that provision of a balanced and sufficient knowledge of TPACK is essential to well equip pre-service teachers with required knowledge and skills considering internationalization and transnational education. This research uncovered the general patterns and trends in pre-service teacher education for science in three Asian countries as well as their uniqueness and best practices. [ABSTRACT FROM AUTHOR]

Glyptothorax prionotos, a new species of sisorid catfish from the Salween drainage in southern Myanmar and western Thailand, is described. It differs from its Indochinese congeners by a combination of colour pattern, thoracic adhesive apparatus morphology, dorsal spine morphology, and morphometry (with particular regards to the head, body depth, adipose and caudal fins, and caudal peduncle). The taxonomic status and identity of G. chavomensis is also briefly discussed. [ABSTRACT FROM AUTHOR]

Background: Artemisinin resistance, linked to polymorphisms in the Kelch gene on chromosome 13 of Plasmodium falciparum (k13), has outpaced containment efforts in South East Asia. For national malaria control programmes in the region, it is important to establish a surveillance system which includes monitoring for k13 polymorphisms associated with the clinical phenotype. Methods: Between February and December 2013, parasite clearance was assessed in 35 patients with uncomplicated P. falciparum treated with artesunate monotherapy followed by 3-day ACT in an isolated area on the Myanmar- Thai border with relatively low artemisinin drug pressure. Molecular testing for k13 mutations was performed on dry blood spots collected on admission. Results: The proportion of k13 mutations in these patients was 41.7%, and only 5 alleles were detected: C580Y, I205T, M476I, R561H, and F446I. Of these, F446I was the most common, and was associated with a longer parasite clearance half-life (median) 4.1 (min-max 2.3-6.7) hours compared to 2.5 (min-max 1.6-8.7) in wildtype (p = 0.01). The prevalence of k13 mutant parasites was much lower than the proportion of k13 mutants detected 200 km south in a much less remote setting where the prevalence of k13 mutants was 84% with 15 distinct alleles in 2013 of which C580Y predominated. Conclusions: This study provides evidence of artemisinin resistance in a remote part of eastern Myanmar. The prevalence of k13 mutations as well as allele diversity varies considerably across short distances, presumably because of historical patterns of artemisinin use and population movements. [ABSTRACT FROM AUTHOR]

Three hundred and forty-four tick samples were collected from vegetation at Taksin Maharat National Park, Tak province, northwestern Thailand. They were morphologically identified and molecularly confirmed by 16S rRNA and COI genes as Dermacentor laothaiensis (n = 105), D. steini (n = 139), and D. auratus (n = 100). These ticks were examined for the spotted fever group rickettsiae (SFGRs) using PCR and DNA sequencing of six genes; 17-kDa, gltA, 16S rRNA, ompA, ompB, and sca4. Of these ticks, 6.10% (21/344) gave positive results for the presence of SFGRs. Phylogenetic analyses of the SFGRs clearly indicated that a novel genotype assigned as Candidatus Rickettsia takensis was detected in D. laothaiensis (19/105) and at lesser frequency in D. steini (1/139). Furthermore, Candidatus Rickettsia laoensis was also found at a low frequency in D. auratus (1/100), the first record in Thailand. Although, the pathogenicities of these SFGRs remain unknown, our findings suggest potential risks of SFGRs being transmitted via ticks near the border between Thailand and Myanmar, a gateway of daily migrations of local people and visitors both legal and illegal. [ABSTRACT FROM AUTHOR]

This article follows the history of the Dawei special economic zone (SEZ), a port, industrial zone, and logistics project located in Myanmar's southern borderlands. Suspended in 2013 due to financing shortfalls and public criticism, the Dawei project's implementation has been far from straightforward. This article dwells on the non-linear temporality of the project, focusing on the problem of financing. It is there, above all, that project proponents continually entertain both prospects of progress and frustrating obstacles. This story of financing shows, I argue, that frontiers are temporal projects, constituted by fits and starts, slowdowns and accelerations, and periods of deferral and delay. Beginning with the project's origins and moving through recent attempts to revive it, I foreground three moments of labor in and of time – three timescapes, in short – which I describe in terms of futurity and deferral, boom and bust, and suspension and renewal. The complex temporality of the project raises doubts about the notion that capitalist modernity consists of a singular, abstract, homogeneous time – defined by acceleration, speed, or time–space compression. On this frontier, rather, the inter-mingling of multiple times suggests not vestiges of the premodern, but the heterogeneous timescapes – unstable, unruly, uneven – that compose capitalist modernity itself. [ABSTRACT FROM AUTHOR]

The article focuses on a survey conducted by the International Rescue Committee on the refugee status of Burmese people living outside the refugee camps in Chiang Mai, Mae Hong Son and Mae Sot in Thailand. It reports that Burmese refugees in Thailand are entitled to international assistance and protection but are not able to avail them. The Thai authorities consider the Burmese living outside the refugee camps as economic migrants, who are subject to deportation. It informs that more than 50% of respondents in both Chiang Mai and Mae Hong Son reported forced labour, violent abuse or the forced appropriation or destruction of their property or livelihoods as reasons for their flight.

This article critically assesses state–market relations through a comparative firm-level study of state-led development in the China–Myanmar border region. It develops a framework that foregrounds how market building is a contingent and multi-scalar process that underpins the reproduction of stable state rule. The framework is utilized to examine state-led attempts in Ruili, a border city in Yunnan province, to attract Yinxiang, a privately owned firm, and Beijing Automotive Industry Holding Corporation (BAIC), a state-owned enterprise (SOEs), to launch flagship manufacturing projects. The contrasting performance of these firms—Yinxiang successfully captured its target market in Myanmar while BAIC did not even commence production—foregrounds a pronounced tension in the ongoing market reforms. On the one hand, attempts at giving market actors more autonomy in resource allocation through supply-side structural reforms continue to be shaped by the institutional legacy of reciprocal accountability. On the other hand, the Chinese state's willingness to allow BAIC's investment to fail suggests it is serious about subjecting both local governments and SOEs to demand-side discipline. These findings collectively generate one distinct contribution to existing research on state–market relations: market activities are embedded within state-building processes in place-specific and often unpredictable ways. [ABSTRACT FROM AUTHOR]

Modern Karen education began in the early 1800s when introduced by British and American missionaries at roughly the time the British colonial powers arrived from India. After independence from Great Britain in 1948, Burma faced revolt from ethnic groups including the Karen, in large part, over issues of language and cultural self-rule. This led to the forcible closing of Karen-language schools by the military junta beginning in the 1960s and the re-establishment of Karen schooling by the Karen National Union (KNU) in independent self-rule territories, often near the Thai border. In this context, beginning in the 1980s, Karen-medium language spread into the highlands of Burma and into Thai refugee camps where Karen had been living for nearly four decades. Karen medium education is an important element establishing what Benedict Anderson called the "imagined community". With mass Karen literacy, a national consciousness emerged, particularly in areas where schools were sustained. This separate consciousness is at the heart of the Karen of Kawthoolei. The Karen Education and Culture Department (KECD) was established in 1947 by the KNU. Karen schools provide mother-tongue-based education. Much of the development of the Karen medium curricula was undertaken by the KECD, and it is significantly different from that of the Burmese government's curriculum, particularly in terms of language medium, literature, and history. Karen schooling reflects the Karen political consciousness, which will be at the heart of any peace agreements negotiated in the still-ongoing Burmese Civil War. [ABSTRACT FROM AUTHOR]

Habitat loss, degradation, and fragmentation following intensive agricultural expansion, and both legal and illegal logging, have contributed to the rapid decline of the Green Peafowl (Pavo muticus) over mainland Southeast Asia. Dry forest habitat in the Bago Yoma range (Myanmar) is considered one of the region’s last remaining strongholds for the species. However, the area has been fragmented over the past years, mostly due to large-scale teak (Tectona grandis) plantations. This study aimed to estimate the Green Peafowl population in the Bago Yoma range with a particular focus on the use of large-scale teak plantations as possible complementary habitat for the species. The survey was conducted over 47 line transects located in the natural forest and teak plantations. The average estimated density, using distance sampling, was 0.800 calling males km–2 across the whole survey area. Estimated densities were similar within the natural forest and teak plantations (0.825 and 0.866 calling males km–2, respectively), suggesting an extensive use of this crop by Green Peafowl. The remaining suitable habitat covered an area of 8,554 km² divided into 8 large forest patches (>40 km² ). When including large-scale teak plantations in the landscape matrix, more suitable habitat fragments could be connected to each other, with the remaining suitable habitat grouped into 6 large forest patches. These results suggest teak plantations could be used for connecting remaining forest patches and improving fragmented natural habitats for Green Peafowl. [ABSTRACT FROM AUTHOR]