*Lucinda Lai  is a Gates Cambridge Scholar doing an MPhil in Sociology. For more information about her work, click here. Picture caption: As part of a camp-based mental health workshop, a student's sketch of the drug and alcohol problems that she observes in her community of refugees at the Thai-Burma border.
Refugee camps are supposed to provide shelter from conflict and persecution, but, for Burmese refugees in Thailand, life in camp introduces a whole new set of dangers. These refugee camps have become a fertile breeding ground for drug and alcohol addiction.
I visited the Thai-Burma border camps last year as part of my work with a non-profit organisation that is dedicated to building up mental health services for refugees. I found that individuals turned to drugs and alcohol as a way to cope, however dysfunctionally, with the stress of protracted confinement in a place completely lacking in the opportunities for productive or meaningful living.
Alcohol is the most commonly abused drug in the camps. It is cheap and readily available in the form of homebrewed distilled rice liquor. These home brews can be fairly toxic with things like pesticides, fertilisers and rubber thrown in to make the concoction more potent or ferment more quickly. Research has shown that alcohol is used not only for recreation, but also as self-medication for pain and to cope with the boredom of life in camp, the depression and anxiety associated with the loss of traditional social structures and the stress of adapting to unfamiliar and austere living conditions.
In interviews with residents of the largest of the Thai camps, Mae La, some men revealed that they resort to substance abuse because they feel deprived of their typical means of livelihood. "We have only alcohol," one man said, "It's like being in a farm [...] surrounded by a fence." Many of these disenfranchised young men felt that they had no other avenues to express their frustration. "There is only alcohol to get release," said one.
Male respondents lamented the loss of their normal roles as providers for the household. Female respondents described the effects of alcohol abuse as adding stress and pressure on their families. Gender-based violence, crime, the serious neglect of children and the costs of alcohol and substance use on the family's finances all pose significant challenges to mental health. One camp resident put it this way: "The majority of addicts are men. Because of this, women are mentally ill."
On the other hand, camp-based drug and alcohol recovery programmes gather hope from their work, seeing it as an expression of non-violent resistance against the former military dictatorship. Indeed, Burma (also known as Myanmar) stands out as a major source of methamphetamine pills and opiates in Southeast Asia today, according to a report by the United Nations Office on Drugs and Crime. Burma is the second largest opium grower in the world after Afghanistan.
Almost all of the opium Burma produces is grown in the eastern part of the country, in the states of the Shan and Kachin ethnic minorities. This area is also the site of long-standing conflicts between the minority groups' armies and the central government's military. The instability caused by these conflicts fuels the growth of opium and heroin production and is suggestive of a link between the highly profitable drug trade and the current plight of Burmese refugees.
One community-based recovery programme, DARE Network, has had remarkable success in the treatment of addicts in camp. They are a local organisation that developed in response to the urgent need to bring an end to the drug problems. DARE Network makes use of Burmese herbal medicines, acupuncture, herbal saunas, traditional massage and culturally appropriate therapies in their detoxification and rehabilitation programmes. They are guided by the belief that "recovery is a powerful weapon against those who benefit from the drug trade". Recovery from drug and alcohol addiction returns people to their communities, and healthy communities are more resilient to manage whatever political and economic transformations are yet to come.
At the individual level, addiction is directly related to feelings of powerlessness. But, there is also the growing realisation that addiction plays a role in the bigger story of Burmese refugees: persecution, armed conflict, instability, a profitable drug trade and undemocratic rule. It is only by supporting those who are trying to break free from the cycles of addiction that full and inclusive participation in the creation of a free Burma for all will be possible.