PHR Library

July 14, 2004

FOR IMMEDIATE RELEASE

Burmese and Hill Tribe Women and Girls without Status in Thailand at Unaddressed Risk of Human Rights Abuses and HIV/AIDS

Despite a program widely hailed as a model of HIV prevention for the region, corrupt and discriminatory law enforcement and failure to protect human rights by the Thai Government have permitted ongoing violations, some by authorities themselves, causing great harm to Burmese and hill tribe women and girls.

A new Physicians for Human Rights (PHR) report released at the XV International AIDS Conference in Bangkok documents how the lack of legal status results in discrimination and exploitation, lack of personal security and inability to access health care and other services. Women and girls from these two vulnerable groups are frequently subject to trafficking and sexual violence and abuse. This denial of fundamental human rights and dignity renders them at an unaddressed, elevated risk of HIV/AIDS, among other serious consequences. The report charges that traffickers, including police and immigration officials, operate with impunity in exploiting these groups.

One of the authors of the report, Dr. Chris Beyrer, highlighted the significance of the PHR study: "The failure to reach these vulnerable communities is not only a failure of human rights, it is a virtual assurance that HIV/AIDS will continue to be a problem for Thailand. From both the perspective of HIV/AIDS research and that of human rights, it is essential that access to prevention, care and treatment be available to all individuals in Thailand, including Burmese and hill tribe women and girls."

Hill Tribe Women and Girls

Many hill tribe women, though born in Thailand, are not Thai citizens and their children are stateless. The PHR report describes how non-citizens cannot register births or marriages, are denied opportunities for education and work, cannot access public health care services through the universal health care ("30-baht") plan and are restricted in their freedom of movement. Financial hardship or loss of farmland often drive hill tribe women from their villages where their lack of legal status thrusts them into unsafe situations. One hill tribe advocate described the denial of this most basic right to citizenship, "They can't help themselves, because of the government system in Thailand - the ID cards. …They have no representation in the system, no place. No ID? No room for you. Traditionally we have an identity when we are born, when we are given a name. [With regard to citizenship] we are not asking for rights, but for responsibility [of the government]."

The hill tribes, minority ethnic groups living in Thailand's Northern and Western highlands, number 600,000 to 1 million people. Thailand has recognized nine hill tribes but has not extended citizenship to at least half of the hill tribe population.

Burmese Women and Girls

In neighboring Burma, the systematic rape of women and girls, part of the military's terror campaign against minority ethnic groups, and the political and economic instability resulting from the State Peace and Development Council's militarization of Burmese society have resulted in mass exodus. There are at least one million Burmese in Thailand, the vast majority undocumented migrants. Once in Thailand and without work or residency documentation, Burmese women and girls lack the most basic rights and access to services, face acute discrimination and are subject to the threat of deportation to Burma. The PHR report emphasizes that temporary status through worker registration is the only means to safely and affordably access the Thai public health system. Most migrant workers are not registered with the government, and the numbers of registered workers have dropped precipitously, from 568,249 registered in 2001 to 110,000 in August-September 2003. Moreover, registration without enforcement and in an environment of impunity and corruption does not provide protection from abuse by Thai employers and authorities.

The PHR report is based on field research that included extensive interviews between March and May in Bangkok, Mae Sot and Chiang Mai. PHR researchers collected 34 individual testimonies from women with direct experience of trafficking, unsafe migration, exploitative labor or sexual exploitation; and conducted 68 interviews with local NGO representatives and volunteers, fieldworkers and researchers from international agencies, policymakers, academics and government officials. The research team was led by Karen Leiter, Senior Research Associate at Physicians for Human Rights, a specialist in women's health and human rights, and Dr. Beyrer, Director of the Fogarty AIDS International Training and Research Program and the Center for Public Health & Human Rights at Johns Hopkins University, and an expert in the epidemiology of AIDS in the region.

Interviews made it exceptionally clear that as part and parcel of the denial of legal status and its protections, both hill tribe and Burmese migrants routinely experience ill treatment from employers, authorities and members of the majority Thai community. Women and girls are exposed to additional risks because of their gender, such as sexual harassment and abuse, rape, unintended pregnancy and unsafe abortion. Women and girls are also the majority trafficked into and sexually exploited in the sex industry. These additional risks and human rights violations are factors for HIV transmission and thus increase the likelihood that hill tribe and Burmese women and girls will become infected with HIV and, given the absence of treatment, most likely develop AIDS.

A 24 year-old woman trafficked into sex work in Mae Sot, Thailand from Mon State in Burma, described her situation:

As soon as she arrived she was badly beaten and for the next few days she was beaten and verbally abused ('those were very bad days'). There were six others in the house - five Burmese and one Karen, all of whom had been there for 8 months [or longer]. …The Muslim woman [who brought her to the brothel] was paid 10,500 baht ($263), which, with food, medicine and housing costs, became part of her ongoing debt. The house owner kept a record on the wall. In her time in the house, no one ever received money. The promised date for arranged transport back to Burma was constantly delayed. …Clients often did not want to use condoms, and though they were able to refuse sex with a client, they were 'fined' 500 baht [the cost for the client].

Exploitation

As undocumented migrants, interviews revealed that many women and girls endure dangerous work conditions without safety precautions; receive low- or no pay; are subject to employer confiscation of essential documentation; are forced to labor many hours and without rest periods; subsist in inadequate sanitary and living conditions; and/or are confined, physically abused, sexually abused and sexual harassed by employers and their agents. For women and girls trafficked into these exploitative situations, the lack of enforcement of existing anti-trafficking laws and policies frequently result in further human rights violations, including repeated trafficking, exploitation by new employers and abuse at the hands of authorities.

Impunity

PHR reports that many traffickers of women and girls are in fact police, border and immigration officials; they and other traffickers enjoy virtual impunity in Thailand, despite a highly-praised national legal framework and the prioritization of anti-trafficking policy by the current Thai Government. According to the State Department's TIP report, only one of 18 police officers charged with facilitating trafficking in 2003 was prosecuted and convicted.

The findings of the study also reveal that the general exploitation of hill tribe and Burmese women and girls is routinely aided and abetted by police harassment, which is a daily reality for all migrants. Burmese with work permits or refugee status are not exempt from the constant threat of detention, arrest, extortion and violence. PHR interviews also illustrated how women from hill tribe and Burmese communities in sex work, whether trafficked or not, are subject to extortion, sexual exploitation and/or sexual assault by police and immigration authorities.

Health Consequences

These human rights abuses have extraordinarily serious health consequences, including physical injury, sexually-transmitted diseases including HIV, pregnancy/abortion complications, malnutrition and mental health impacts. In addition to these and other health effects, the PHR study shows that access to healthcare for Burmese and hill tribe populations is critically limited due to the threat of arrest and deportation, forced confinement, confiscated legal documents, discrimination, lack of financial resources, lack of information and/or language barriers. According to a PHR interview in Chiang Mai, "Pregnant migrants are often fired from jobs, especially construction sites. Access to reproductive services is very limited, condom supplies have decreased, so many women choose unsafe abortion to avoid pregnancy and keep working."

The situation of Burmese migrants and hill tribes in Thailand provides a case study of how denial of rights can have a negative impact on access to healthcare and vulnerability to disease, especially HIV/AIDS. Inability to access reproductive health care services, including HIV prevention education and condoms, clearly increases the vulnerability of women and girls to HIV infection. For example, in HIV sentinel surveillance of high-risk groups, the highest infection rates have been found at Burma's cross border points with Thailand. Should Burmese or hill tribe women and girls become infected with HIV, discriminatory denial of care and treatment virtually condemns them to living with (and quickly dying of) AIDS.

Recommendations

The report calls on the Government of Thailand to:

• Investigate, prosecute and punish those who commit crimes, including human trafficking, against any individuals, including migrants of any legal status.
• Investigate, prosecute and punish the collusion or involvement of members of the Thai police and immigration and military intelligence agencies in human trafficking, other crimes (including crimes against migrants) and exploitative labor practices.
• Rapidly move to implement comprehensive health services and HIV/AIDS programs for Burmese migrants and hill tribes, in particular women and girls. It is essential to expand HIV prevention, voluntary testing and counseling services and condom availability, and to make anti-retroviral therapy available to foreign resident migrants and members of hill tribes on an equal basis with Thais.
• Commit to the revitalization of the free condom distribution program and to ensuring access to comprehensive and accessible health services for sex workers at the local district level.
• Act immediately to confer full citizenship on members of hill tribes born in Thailand and take measures to ensure their full enjoyment, including registry of marriages and births, school graduation certification, land rights, access to health care and representation and participation at the village and district levels.
• Ensure that all children born in Thailand are registered at birth and receive a birth certificate, irrespective of their nationality.

PHR also calls on the United States Government to rapidly move forward with the implementation of funded programs for HIV/AIDS prevention and other health care provision for mobile and migrant populations. It urges USAID to ensure coordination, coverage, sustainability and quality of these services, including through direct involvement by its regional mission and by increasing funding to NGOs serving these populations.

To address trafficking, the report states that the United States Government should maintain Thailand's Tier II Watch List status until it implements a comprehensive anti-trafficking plan and provides appropriate treatment of and assistance to Burmese persons. In particular, Thailand must end the impunity of traffickers and the enabling corruption of its police, immigration and other authorities

The report also calls on the State Peace and Development Council of Burma (SPDC) to immediately take steps to reverse the militarization of Burma and its reign of terror and to hold accountable those responsible for rape, forced relocation, forced porterage and other human rights abuses which continue to force Burma's people, in particular ethnic minorities, to flee their homeland and seek refuge in Thailand and other countries.  

Physicians for Human Rights (PHR) mobilizes the health professions to advance the health and dignity of all people by protecting human rights. As a founding member of the International Campaign to Ban Landmines, PHR shared the 1997 Nobel Peace Prize.