A Thai police officer checks passenger's documents on a linecare headed to Mae Tao Clinic from the Burmese border in Mae Sot, Thailand on June 1, 2013.
A reproductive health training session in a Burmese migrant community in Mae Pa, Thailand on September 16, 2012. A 54 year old woman learns how to use a condom.
A traditional birth assistant demonstrates a method to induce an abortion by "massaging out the fetus" on a friend. In actuality, this practice are more akin to pummeling that is "vigorous enough to displace well-developed foetuses and shear off placentae, causing hemorrhage or uterine rupture."
A woman shows the plant that a traditional birth assistant put up her vagina to end her pregnancy. The plant "poisoned the fetus out " and put her in the hospital and caused her pain for months. Many women in Myanmar and in migrant communities in Thailand cannot afford any more children but with limited contraception access and abortion being illegal, they have very few options.
The official delivery room at Ei Tu Ta clinic in Karen State, Myanmar
Eh Gay Paw, a Karen Department of Health and Welfare worker, checks the heartbeat of an unborn baby.
A pregnant Burmese migrant worker gets immunizations to make sure she has a healthy child at Mae Tao Clinic in Mae Sot Thailand on March 11, 2013. Access to quality care is nearly impossible for many women in rural Myanmar.
Eh Gay Paw, a Karen Department of Health and Welfare worker, teaches a 3 day long course for traditional birth assistants in her village. Some assistants are illiterate and have little to no training or experience.
A traditional birth assisstant (TBA) sits through a 3 day training on reproductive health at Ei Tu Ta camp in Karen State, Myanmar
Young girls put on makeup in the family's bedroom Ei Tu Ta camp in Karen State, Myanmar on February 16, 2014. The girls are daughters and the granddaughter of a midwife named Madleline who has 7 children and 3 grandchildren. Most of the family live together in a 2 room bamboo hut.
Eh Gay Paw, a reproductive health worker at Ei Tu Ta clinic in Karen State Myanmar, listens for signs of life inside Wah Yeh Paw's belly. "I cannot hear a voice," she says sadly. Babies are suppose to move inside their mother after 6 months, Wah Yeh Paw's hasn't and has died.
Wah Yeh Paw lies on a mat stunned and cold after delivering an already dead baby for the 3rd time in Ei Tu Ta camp in Karen State, Myanmar on February 13, 2014.
A Burmese baby with severe birth defects at Mae Tao Clinic in Mae Sot Thailand.
A mobile health worker from the Karen Department for Health and Wellness preforms a prenatal checkup. In Karen State in Eastern Burma, many people are days away from hospitals that they are not able to afford. Completely funded by donors, mobile health workers provide free care and in some cases are the only access to decent healthcare people in villages have. Currently there is about 1 mobile healthcare worker for every 2,000 people in Karen State.
Maa Juu's husband waits nervously for staff to come to transfer his wife to Mae La Oon refugee camp in Thailand for a blood transfusion. The cost of her transfer was around US $100 but to a family that can only afford to eat rice and makes around $20 per month, the cost was impossible. It was assumed she would die but a friend was able to find the money and pay for her passage.
Eh Gay Paw and other clinic staff carry Maa Juu to the river. A boat is waiting to take her to Mae La Oon refugee camp in Thailand for a blood transfusion so will not bleed to death after a miscarriage.
When patients cannot be treated at the clinic, their best option is to be transported by boat to refugee camps on the Thai side of the border. Being that transportation is expensive, and sometimes dangerous, some people are unable to get the care that they need and die.
After an old man dies in Ei Tu Ta's main clinic, patients leave and refuse to go back in because they are afraid of "ghosts" at Ei Tu Ta camp in Karen State, Myanmar on February 15, 2014. A little girl and her family find a bed in the woman's health room.