Leave No One Behind: Migrant and Drug User Health in Thailand/Myanmar

In 2019, Canadian and French photographer Jennifer Chan was commissioned by Dreamlopments, a Bangkok-based social enterprise founded by former MSF Dr. Nicolas Durier, to document migrant and drug user health in Thailand.

Jennifer Chan

Labor migration in the Greater Mekong Delta area has been accelerating since the 1990s. Thailand is the regional hub that hosts 60% of the total migrants, roughly 3 million, 80% of whom are from Myanmar. Most migrants work in low-skilled jobs and have no health coverage. 

In 2017, Dreamlopments created the M-Fund, a low-cost (US$3/month) health insurance for migrants along the Thai-Burmese border. As of 2021, over 30,000 migrants are members of the M-Fund, allowing them to access affordable healthcare from a network of clinics and hospitals in the region.   

Together with the M-Fund team, I visited the villages, factories, and clinics, capturing Burmese migrants’ life in their contexts. A collection of migrant portraits as well as M-Fund staff members at work have been used for communication and educational purposes on Dreamlopments’ webpage as well as fundraising purposes.

Dreamlopments also pioneered the the first community-based model of care for the diagnosis and treatment of hepatitis C in people who inject drugs (PWID) in Thailand. Research shows that up to 80-90% of PWID have been infected with the virus, yet few seek testing and treatment due to cost barriers and stigma.  

The C-Free project has been highly successful in providing nearly 900 PWID with free hep-C testing, half of whom started on treatment with 94% success rate.  

I had previously researched on AIDS Activism and had interviewed PWID networks in Thailand and other countries. HIV and hep-C co-infections are extremely common within this highly vulnerable population, yet stigma, discrimination, and punitive laws continue to impede effective access to testing and treatment. Working with Dr. Nicolas Durier’s team in this photographic assignment allowed me to see the clinical side while trying to capture these images of project clients with anonymity and confidentiality.