Along Thailand’s border with Burma, tens of thousands of refuges have few health-care options. At one key clinic, health care workers offer advice for expectant mothers, dental emergencies, prosthetic limbs and medicine to ward of the effects of HIV.
在泰国接近缅甸的边界地区，数以万计缅甸难民仅有不多的医疗照顾选择。那里一个诊所的医护人员为孕妇提供建议，为病人处理牙科急诊，安置假肢，并提供减少艾滋病毒影响的药物。
Mae Tao clinic
At the Mae Tao clinic in the Thai border town of Mae Sot, each week children receive vaccinations, especially for hepatitis B, for infants as part of the health care program.
在泰国边境城市美索的梅道诊所里，孩子们每个月接受一次免役注射，特别是预防乙型肝炎的疫苗。这是婴儿健康照顾项目的一部分。
The clinic, which provides care for more than 110,000 Burmese refugees each year, faces growing challenges to assist HIV and tuberculosis patients after the halt of an AIDS antiretroviral program sponsored by Doctors Without Borders (Medecins Sans Frontieres - MSF).
这家诊所每年为110多万缅甸难民提供照顾，但他们在援助HIV感染者和肺结核病人方面面临着越来越大的挑战，因为医生无国界发起的艾滋病抗逆转录病毒项目被暂停了。
Doctors Without Borders shut down its ARV program on the border before announcing in October this year its complete withdrawal from health-care activities in Thailand, after 35 years. The group said it was leaving after it failed to gain permission from Thai authorities to provide health care for undocumented migrants and “vulnerable populations” in Thailand.
医生无国界在泰国进行了35年的健康医疗活动后，于今年10月宣布完全从泰国撤出，之前他们就已经关闭了这一HIV药物治疗项目。这个医生组织说，他们撤离是因为得不到泰国当局的许可，允许他们为那些在泰国没有身份、没有记录的难民和那些“脆弱人口”提供医疗照顾，因此他们只能选择离开。
The 20-year Mao Tao clinic says, in its latest annual report, its ARV patients face increased difficulty in obtaining medicine directly from the Mae Sot Thai hospital, because its ARV program was already full.
已经执业了20年的梅道诊所在最新的年度报告中说，接受抗逆转录病毒药物的病人在直接向美索的泰国医院索取药物时，面临越来越大的困境，因为抗逆转录病毒项目已经满员了。
Main challenges
The director of the Mae Two clinic, Cynthia Muang, says the highly mobile refugee population poses difficult challenges for health-care workers.
梅道诊所的主任辛西娅.曼说，流动性极强的难民人口给医疗工作者带来了艰巨的挑战。
“HIV is still one of the big challenges because of the population mobility and vulnerability and economic opportunity, especially for Burma," said Muang. "HIV is still a big challenge because, according to our information or data here, the HIV prevalence among pregnant women is gradually increasing.”
她说：“艾滋病毒仍然是个巨大挑战，因为这些人的流动性、脆弱性和经济机会等问题，特别是对缅甸来说更是如此。HIV仍然形成巨大挑战是因为，根据我们得到的信息和数据，HIV在孕妇中感染有逐渐增加的趋势。”。
Muang began assisting Burmese students fleeing the Burmese military’s 1988 crackdown. The clinic now plays a vital role in border community health care system. It also includes villages inside Karen State and supports refugee schools in Thailand. In addition to reproductive health care, the clinic also provides dental care and prosthetics for victims of land mines in Burma.
这座诊所目前在边界社区健康照顾系统中发挥着至关重要的作用。它还负责克伦邦的村庄并且支持在泰国开设的难民营学校。除了进行抗逆转录病毒方面的治疗，这座诊所还提供牙科治疗以及为缅甸遭受地雷伤害的人员安装假肢。
She says conflict and subsequent social instability between Burma’s ethnic communities and government forces have taken a toll on child welfare and health.
她说武装冲突以及随之而来的缅甸少数民族和政府军之间的冲突造成儿童福利和健康方面的代价。
“Like nutrition, childhood nutrition, malnutrition, and psycho-social problems because of abuse and drugs," added Muang. "Psycho-social problems have become a challenge and burden because people do not feel safe and they are traumatized. So when we talk about health you really need to promote psycho-social health.”
她说：“例如营养问题，儿童营养明显不足，心理问题已经变成了挑战和负担，因为民众没有安全感，他们都受到了创伤。因此我们讨论健康时，重要的是要提升心理健康。”
Workload
British volunteer doctor Mary Boullier says the clinic’s workload focuses on treating respiratory infections, such as pneumonia, and severe diarrhea and vomiting as well as blood disorders. Boullier says families travel hazardous distances to ensure their children receive health care.
英国志愿医生玛丽.布利尔说，这家诊所主要治疗呼吸道疾病，例如肺炎、严重腹泻 及呕吐，同时也治疗血液疾病。布利尔说，很多家庭不顾劳累，长途跋涉也要让孩子接受医疗照顾。
“Patients here are very strong and resilient and the amount they go through to get their children to the clinic," said Boullier. "It is only when you start asking questions that you realize how difficult it is even being for them to bring their child to the clinic and the care - the count of sacrifice the parents make for their children here is amazing.”
她说：“这里的病人都有非常坚强的信念和弹性，他们可以付出一切让自己的孩子到诊所看病。只有在问寻了他们得情况后，你才能了解到他们把孩子带到这里看病要付出多大的艰辛。孩子的父母为孩子看病作出了巨大的牺牲。”
Clinic director Muang says the clinic hopes to ensure on-going support for the communities, as well as promoting sustained development and a safe environment for those people facing life’s uncertainties along the Thai and Burmese border.
诊所主任辛西娅.曼说，这座诊所希望能保证持续对社区进行支持，同时也要为这些在泰缅边界面临生命安全不确定的民众，提升持续不断的发展和一个安全的环境。
Last week, Burma’s newly formed Human Rights Commission has also warned of thousands of children in Kachin state displaced by fighting in recent months are suffering from psychological trauma, while adults face mounting insecurity because of the on-going conflict. |