No Papers, no Health Care – Stories from Children in Northern Thailand

On a field visit to Northern Thailand, I get a front row seat to a drama being performed by a group of children who live among the orange plantations. They tell us that they will re-enact a common story from their village.

The children are not much older than my own child, they’re in costumes, they are doing quite good impressions of parents, and I get lulled for a few moments into thinking I’m watching the type of entertaining drama my son and his friends would put on. But then the child playing the pregnant woman in the drama starts to mimic the pains of a medical emergency.

Between the loud cries she instructs her children not to call the doctor. They don’t have the money to pay – and they are scared to come out from hiding in case they all are sent back across the border to the place from which they have escaped. The mother miscarries.

For those who are “off the system” in Thailand in terms of documentation on nationality or immigrant status, getting documented is a lengthy and difficult process that even government officials struggle to explain.

Mina, now a teenager, has been trying to work out the process since she can remember: “I am stateless. I have no papers. I cannot get papers because I have no parents and I don’t know where I am from. I was abandoned as a child, and the old lady who found me took me to a hospital where I was diagnosed with TB. I have been sick all my life.

Now I have an illness which is damaging my kidneys and my bones. I do not have the right to state medical coverage because I am stateless. I can’t afford the treatment. I don’t know why I don’t have the same rights other people have.”

There are hundreds of thousands of Minas in Thailand, stateless children who have nowhere else to go but cannot claim their rights in the only country they really know.

Through connections made by Save the Children and our local partners, the children are provided a rare opportunity to share these stories direct with government officials and decision-makers. There is genuine concern, and the government representatives describe some the initiatives that have been started.

For example, a government notice has gone out stating that the duty of hospital staff is only to care for patients and not to report undocumented people to immigration officials (but, the children noted, undocumented people are still scared to travel to hospital because of the many checkpoints on the roads where they live. Going to hospital may reveal their presence to authorities even if it does not immediately lead to their deportation).

Another government notice permits hospitals in exceptional cases to waive the payment of fees by undocumented people (though none of the children there knew anyone who has benefitted from this, and Mina’s and others’ stories showed that it wasn’t effectively working).

Partnerships between Government and NGOs, including Save the Children, are helping government to reform how authorities work with migrant and stateless children, but Thailand still exempts itself from its full obligations under the UN Convention on the Rights of the Child when it comes to stateless and migrant children. So there is some progress, but the laws and rules still leave rights not fully guaranteed and fears only partially allayed.

One evening I meet Ohn, a young migrant mother, in the dusty factory where she earns about three dollars for each twelve hour day making wooden toys, and sleeps in a shack set up on site amid the unending noise, and hazard, of the machines.

On a different occasion her life story would have me thinking about everything she didn’t have. But as we talk, and as her baby boy, Gems, tries to pull my ear, I find myself thinking instead, “if only every one could be as fortunate as Ohn and Gems”. Because Ohn was able to secure all the right documents, because she was registered “properly”, she was able, under Thailand’s almost-free health care system, to get proper ante-natal care, have her baby in a hospital, and – she states proudly – has had all his vaccinations done too. And to have had all that is – in this context – to be among the lucky ones.

Only if we succeed in our campaign will that instead be the minimum guarantee, the bottom line beneath which no one will be left to fall. Only if we succeed in our campaign will we ensure that when children start to act out a play about their village it won’t end in a pregnant woman crying out in pain, telling her children not to call the doctor.

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