The document summarizes the results of a study examining the environmental health factors affecting 155 Burmese migrants living in southern Thailand. It found that most migrants lived in overcrowded housing, with many sharing toilets and water sources. Common health issues included mosquito-borne diseases, alcohol and tobacco use, and lack of access to proper medical care. Income and access to resources were major influences on their living and health conditions.

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Foundation for Education and
Development (FED)
ENVIRONMENTAL HEALTH OF BURMESE MIGRANTS
IN SOUTHERN THAILAND
ABSTRACT
The research at hand aims to explore how Burmese migrants are living in southern Thailand with
specific focus on the environmental factors affecting their health. As such, a questionnaire was
designed with 21 multiple-choice questions in three parts: food and water; housing and shelter; and
health. Interviews were conducted with 155 randomly selected people during the month of August
2009 across the districts of Kuraburi, Phang Nga, Takuapa, Takuaton and Teimung.
Preliminary data showed that 40% of participants have been in Thailand 1-5 years. The majority of
people worked in construction. Nearly half of participants were aged 18-30 years and the male to
female ratio was 75:25.
Results showed most people (69%) bought their food and used gas inside the home (74%) for
cooking, with the majority (93%) steaming their food. Income was the most common influencing
factor in relation to food choices (60%) and cooking habits (35%).
When it came to water, just under half (46%) of participants bought water for drinking and just
over half of participants (52%) said they boiled water to prevent illness. Water for cooking and
showering/washing was most commonly obtained from a well.
The majority of participants lived on rubber plantations and nearly half of participants said their
dwellings were mainly constructed of concrete. The total number of people living in a dwelling
was mostly 5 or more, and 63% of participants shared toilet facilities with up to 10 other people.
In terms of health, 54% of participants used mosquito nets, with fans the next most popular
method of protection. Smoking or chewing was common amongst 63% of participants with 54%
of these people smoking every day. Over half of participants (53%) drank alcohol, although only
5% drank every day and 33% a few times a month. Well over half of participants said they would
go to hospital if they got sick or for childbirth.

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INTRODUCTION
The aim of the research is to gain an insight into how Burmese migrants are living in southern
Thailand, focusing on three main areas: food and water; housing and shelter; and health. The
results aim to assist in the development of future health interventions for Burmese migrants living
in southern Thailand.
METHOD
A total of 155 randomly selected participants across the districts of Kura Buri, Phang Nga,
Takuapa, Takuaton and Teimung took part in the research during the month of August 2009.
Interviews were conducted using the questionannire, which contained 21 multiple-choice
questions divided into three parts: food and water; housing and shelter; and health. Each question
also allowed for a qualitative response. Preliminary data was also collected from each participant,
such as community name, time in Thailand, occupation, age and gender.
RESULTS
Preliminary data
Of the 155 participants, 45 (29%) were from Takuapa district, 41 (26%) from Takuaton, 27 (18%)
from Phang Nga, 25 (16%) from Kuraburi and 17 (11%) from Teimung.

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The majority (n = 62, 40%) of Burmese migrants have been in Thailand 1-5 years, closely
followed by 53 (34%) who have been in the country for 6-10 years. An equal number of
participants (n = 12, 8%) had been in Thailand for 11-20 years. Ten participants (6%) had been in
Thailand for less than one year (the shortest period being two months) and only two participants
(1%) had been in the country for more than 21 years.
In terms of occupation, the majority (n = 50, 32%) of participants worked in construction,
followed by fishing (n = 36, 23%) and then rubber (n = 35, 23%). ‘Other’ occupations, including
shopkeeper, furniture maker, cleaner, sawmill, carpenter, gardener, palm oil, unknown were held
by 34 participants (22%).
Nearly half of participants (n = 71, 46%) were aged 18-30 years, followed by 48 (31%) aged 31-40
years and 28 (18%) aged 41-50 years. Only 7 participants (5%) were aged over 51 years.

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The male to female ratio of participants was 75:25 (116 men to 39 women).
Section 1 – Food and water
Question 1 asked participants what their main sources of food were with options such as grow,
buy, grow and buy and other. This question allowed for multiple responses. Some participants did
not respond to this question. Overwhelmingly, the majority of participants (n = 107, 69%) said
they bought their food. Thirty-three participants (21%) said they grow and buy food. In minority,
eight participants (5%) got their food by other means, such as on fishing boats or from an
employer. A small number of participants (n = 4, 3%) said they grow food.
Question 2 asked what factors influenced the types of foods consumed with options such as,
income, transport, seasons, options (eg. food carts visiting communities), other people and other
(eating on fishing boats, dependent on an employer). This question allowed for multiple responses.
The majority of participants (n = 93, 60%) said income influenced their food choices, followed
equally by transport and options (n = 24, 15%), and equally again by seasons and other (n = 10,
6%). A small number of participants (n = 3, 2%) said other people influenced their food choices.
Question 3 inquired about cooking practices with options including, steam, fry, boil, raw and
other. This question allowed for multiple responses. Most participants (n = 144, 93%) used
steaming as a method of cooking, followed by just over half (n = 85, 55%) who fried food and 60
participants (39%) who boiled food. Only 19 participants (12%) ate raw food.

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Question 4 asked how and where participants cooked food. This question allowed for multiple
responses. The majority of participants (n = 115, 74%) used gas inside the home and 23 (15%)
cooked with gas outside the home. Only 7 participants (5%) cooked on a fire outdoors and 6 (4%)
cooked by other means (eg. on fishing boats). Only four participants (3%) said they cooked on a
fire indoors (a somewhat unhealthy practice), however three of these participants said the smoke
could escape from the home, and only one said the smoke could not.
Question 5 asked whether cooking habits changed due to weather, seasons, transport, income or
access to gas. This question allowed for multiple responses. Some participants did not respond to
this question. Again, income was the most common response (n = 55, 35%), followed by access to
gas (n = 39, 25%) and then weather (n = 35, 23%). Seasons (n = 7, 5%) and transport (n = 3, 2%)
were minor influences on cooking habits.
Question 6 asked participants where they got their drinking water with options of well, buy, rain,
natural (river or stream) and other (municipal water or water cart). Nearly half (n = 72, 46%) of
participants bought water for drinking and a quarter (n = 37, 24%) got their water by other means.
Wells were a source of drinking water for 27 participants (17%); natural sources provided water
for 12 participants (8%) and 8 participants (5%) selected rainwater.
Question 7 aimed to establish if people boiled water for drinking, why they did so, with options
such as better taste, prevent illness, someone told them to and learnt at school. This question
allowed for multiple responses, however only 75% of participants responded, of which just over
half (n = 80, 52%) said they boiled water to prevent illness. Twenty three participants (15%) said

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they did so because it tasted better, eight (5%) said they learnt to at school and only five
participants (3%) boiled water because someone told them to.
Question 8 asked where participants got water for cooking with options including well, buy, rain,
natural (river or stream) and other (municipal water, water cart, spring water tank). Nearly half (n
= 67, 43%) said they used water from a well, followed by other sources (n = 57, 37%), and natural
(n = 18, 12%). Bought water was only used for cooking by nine participants (6%), and only five
participants (3%) used rainwater.
Question 9 asked where participants got water for showering/washing with options such as well,
buy, rain, natural (river or stream) and other (municipal water, water cart, spring water tank). The
most common response was the use of a well (n = 71, 46%), followed by other sources (n = 62,
40%), and natural (n = 20, 13%). Only two participants (1%) bought their water for
showering/washing and only one (0.6%) used rainwater.
Section 2 - Housing and shelter
Question 10 asked participants about the location of their dwelling, with options such as rubber
plantation, construction site, beach, temporary shelter and other (shop, oil plantation, fishing boat,
saw mill, garden). One quarter of participants (n = 39, 25%) lived in a rubber plantation, closely
followed by beach (n = 37, 24%) and then construction sites (n = 35, 23%). Thirty-one participants
(20%) lived in a temporary shelter and 18 (12%) answered ‘other’.

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Question 11 aimed to establish the materials used for dwelling construction, and allowed for
multiple responses as most dwellings observed were built using a combination of materials.
However, it is suspected that participants only selected the main material used. Options included
corrugated iron, wood, bamboo, tarpaulin/plastic and concrete. A total of 64 participants (41%)
said their dwellings were constructed of concrete, closely followed by corrugated iron (n = 54,
35%). Equally, 12 participants (8%) selected bamboo and other (living on a fishing boat). Ten
participants (6%) said their dwelling was constructed of wood and only two (1%) selected
tarpaulin/plastic.
Question 12 sought to determine the average size of dwellings, however only 91 (59%)
participants responded to this question, with a large number of varied dimensions. However, the
average size of dwellings was 3m x 3m to 4.5m x 4.5m, according to 34 participants. It should be
noted that dimensions were dependent on the participant and the interviewer’s interpretation.
Question 13 asked participants the total number of people in their dwelling – one other, two, three,
four, five or more. The most common response was five or more, according to 61 participants
(39%), followed by a household of three people (n = 35, 23%), and then a two-person household
(n = 33, 21%). Eighteen participants (12%) said their household contained four people and only
seven participants (5%) said they lived with one other person.
Question 14 asked participants about toilet facilities with options of no toilet, own toilet and
sharing a toilet with less than 5 people, 5-10 people, 11-20 people or more than 21 people. The
most popular response was sharing a toilet (n = 98, 63%), and then most commonly sharing the
facility with 5-10 people (n = 35), less than 5 people (n = 34). Twenty-five participants shared a
toilet with more than 21 people and 19 participants shared with 11-20 people. Twenty-nine
participants (19%) said they had their own toilet and 37 participants (24%) said they did not have a
toilet.
Question 15 asked participants how far their toilet facilities were from their dwelling (<2.1m, 2.1-
5m, 6-10m, 11-20m, 21-30m, other). The most popular response was 6-10m (n = 42, 27%),
followed by <2.1m (n = 39, 25%), and then 21-30m (n = 26, 17%). Twenty-three participants
(15%) said toilets were 2.1-5m from their dwelling, 18 (12%) said they were located 11-20m and
two participants (1%) specified other.

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Question 16 aimed to determine how far toilet facilities were from water sources (<2.1m, 2.1-5m,
6-10m, 11-20m, 21-30m, other). The most common response was <2.1m (n = 38, 25%), followed
by 21-30m (n = 27, 17%), and then 6-10m (n = 23, 15%). Twenty-two participants (14%) said
toilet facilities were located 11-20m from a water source, 15 (10%) said they were located 2.1-5m
and 4 (3%) specified other.
Section 3 – Health
Question 17 asked participants how they protect themselves from mosquitos and other insects with
options including fans, insect spray, killing the insects, mosquito nets, no protection or other. The
most common response was the use of mosquito nets (n = 84, 54%), followed by the use of fans (n
= 42, 27%), and then other, specifically mosquito coils (n = 35, 23%). Twenty-two participants
(14%) said they used insect spray, 17 (11%) said they killed insects and only 5 (3%) said they had
no protection.
Question 18 investigated the smoking/chewing habits of participants. A total of 97 participants
(63%) said they smoked/chewed, and of these people, 83 (54%) did so every day, 9 (6%) did so a
few times a week and 4 (3%) a few times a month. A total of 54 participants (35%) did not
smoke/chew.

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Question 19 investigated the drinking habits of participants. A total of 82 participants (53%) said
they drank alcohol, and of these people, 8 (5%) did so every day, 23 (15%) did so a few times a
week and 51 (33%) a few times a month. Nearly half of the participants (n = 68, 44%) did not
drink alcohol.
Question 20 aimed to establish what participants do when they are sick, with options including
hospital, seeing someone in the community, not seeking help (due to fear of arrest, lack of money,
work commitments, transport, martial law, location distrust or language barrier), use of Burmese
medicine or other. Well over half of participants (n = 91, 59%) said they would go to hospital if
they were sick. Thirty-three participants (21%) said they would not seek help with the most
common factors being lack of money, fear of arrest, transport, language barrier or location.
Twenty-six participants (17%) used other means, such as a Thai clinic, FED health team, 1st Aid
kit supplied by FED or a local pharmacy. Burmese medicine was used by 20 participants (13%),
and 10 participants (6%) said they would seek help in the community.
Question 21 aimed to establish what participants do in the even of childbirth (for themselves or a
family member). Options included hospital, having the baby at home, help from a friend, seeing a
community member or other. Only half the participants responded to this question. The majority of
respondents (n = 65, 42%) said they would go to hospital, with only 5 (3%) saying they would
have the baby at home and 5 (3%) would seek help from a friend. Three participants (2%) said
they would see a community member.

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OBSERVATIONS WITH RECOMMENDATIONS
A number of observations were made during the research process.
• Substantial soft drink consumption - contributes to dental problems.
• Minimal attendance of adults at health education sessions.
• Cataracts due to working on fishing boats – educate about sunglasses for protection.
• Children injured working on boats – educate parents to find safer work.
• Shared cups in learning centres - unhygienic and spreads disease – Khok Kloi mobile LC
avoids this issue by having names labelled on cups.
• Prevalence of HIV amongst sex workers in fishing villages – educate about using condoms.
• According to Aung Kyi, skin infections are a big problem in places like Kuraburi, and this
may be further exacerbated by the presence of dogs with skin infections and disease in the
learning centre and nursery.
• Medical records kept on paper – medical record system/software, which provides patient
history and can be viewed on a laptop on site.
CONCLUSION & RECOMMENDATIONS
Much time was required from FED staff to conduct the interviews for this research, hence the
reason for multiple-choice questions to help speed up the process. This style of question also
assisted the process of translation. However, it should be noted that qualitative responses and
prompting from an interviewer would provide more in-depth data. It is recommended that
particular areas, such as the specific types of foods consumed (nutritional value) and the
alternatives when income influences food choice and cooking habits receive further attention.
COMMUNITY LOCATION/ACCESS TABLE
Community Location/access to shops
Kuraburi, Nga Mae Kyi, Nan Yun Walking distance to shop & market
Ksaon, Lan Wa, Ban Play, Ban Ton, Phang Car running to market daily
Nga, Wanna
Bang Niang, Parkweep, Thokamin, Khuk Khak, 15 mins drive to market (Mon, Weds, Sat)
Namkhem, Pakarang, Kyi Tin Po
Htan Na, Khok Kloi, Nar Phet, Nar Pel, Nar 10 mins drive to shop
Phwe, Thaplamu, Suan Yane, Ban Wan