Whenever I go to Mae Sot I see gradual and slow changes. But on my latest visit, after an absence of almost eight months, I saw evidence of rapid growth.

Everywhere I went, I saw new houses, land development projects, restaurants, gas stations, guest houses-even coffee shops with wireless internet connection had arrived.

I also saw new construction and an expansion of tents at the immigration office near the Friendship Bridge, connecting Thailand and Burma. The tents shelter hundreds of Burmese migrants, many of them women, waiting to be deported. I suspect this is not an uncommon sight in Mae Sot. A few years ago, I witnessed a major crackdown in Mae Sot where thousands of Burmese were rounded up in one day and sent back to Myawaddy. But they sneaked back.

I am sure this group will also find its way back to Mae Sot, even though wages on the black economy are low-a house maid in Mae Sot earns 800-1,000 baht (less than US $50) a month.

Step into Mae Sot’s food market any morning and you’ll see many Burmese strolling around and chatting in their language without fear. Mae Sot is still very much “Little Burma.”

I paid a brief visit to Dr Cynthia’s clinic, known as the Mae Tao clinic, near the airport. She had just finished meetings with donors, and told me her clinic needs 50 million baht ($1.4 million) this year to cover expenses and to treat the around 100,000 patients she registers annually. Yet some donors who attended the meeting told me a more realistic figure would be 75 million baht ($2.1 million).

The clinic faced a serious funding shortage in 2004, and Cynthia and her medics don’t want to experience the same problem again.

More than 300 medical staff are employed at her clinic, treating patients from Burma and locally resident Burmese. I noticed that many I remembered from my previous visits, since 1995, had gone. Many well-trained and talented medical staff had emigrated to the West under resettlement programs. New, younger staff had joined her clinic, but one senior medic there told me that the younger generation receiving training were also looking for opportunities to resettle in third countries.

This presents a serious crisis for many groups along the border-especially in refugee camps, where well-trained and talented refugees who are teachers, medics and community leaders are leaving for third countries. Finding replacements for them is a major hurdle.

Cynthia, known as Burma’s “Mother Teresa,” remains committed to providing medical services to her patients and training for her staff.  Thai Ministry of Health officials in Mae Sot are helpful and admire her work and dedication.

The clinic has come a long way since opening illegally in Thailand in late 1988. It now shoulders much of Thailand’s burden in caring for Burmese patients with malaria, TB and such infectious diseases as HIV/AIDS. Now the clinic is well-established and well- recognized, with a number of dedicated foreign physicians working for her as volunteers.

Cynthia told me most of her patients are suffering from malaria, although increasing numbers of HIV/AIDS cases are being treated.  A pilot project to treat a dozen HIV/AIDS patients with antiretroviral drugs is planned for April in association with Mae Sot hospital. Individual donors from Western nations have also offered financial support for some HIV/AIDS patients, but this is not enough, she said. She also sees increasing number of patients coming to her clinic from inside Burma.

An international donor has offered to finance the construction of a new clinic for Cynthia, which would relieve the increasing pressure on her present premises. Meanwhile,
Dr Simon Tha, a well-known Karen physician and peace negotiator between Karen rebel groups and the Burmese regime, is reported to be opening up a Japanese-financed hospital in Myawaddy, the Burmese town opposite Mae Sot.

I wondered aloud if patients from Burma and Karen State might seek treatment at this hospital when it opens, instead of visiting Cynthia’s clinic. “It depends on how he [Dr Simon Tha] runs his hospital,” a donor told me.

After visiting Dr Cynthia, I dined with a well-known dissident who has been living in the border area for several years. He didn’t conceal his frustration when we talked about Burmese politics and life in exile. “We are just surviving,” he said.

His organization receives grants from some US-based foundations, but he said he and his group were sick of asking for money and answering too many questions from donors.
“I know they don’t read our reports,” he said-and I could sense the pride and frustration in his mind.

At least, he doesn’t have to care for the sick, only about his politically ailing homeland. The struggle for a free Burma needs money, though, and that’s scarce. “With money, we can hold together and regain our momentum.” He told me about funding cuts facing his colleagues and organizations along the border.

“I have committed myself to the revolution for almost 20 years and I have nothing,” he said.

But he wants to hold on for a few more years to see what changes will come to his country and what his organization can do to help. But, with no sign of Burma’s generals relinquishing power in a hurry, he also has to think of a personal exit strategy. “In 2008, I need to think of myself,” he sighed.

His frustration and disappointment are not just directed at the regime. He dismisses Asean as hopeless, Burma’s neighbors as dishonest, and believes that powerful nations are too busy with non-Burma issues. “The US is trapped in the Middle East,” he complained.

“I buy lottery tickets these days,” he laughed. I asked him what he would do if he won. “Well, we will see if we can teach a lesson or two to the regime.”

“Are you going to buy arms?” I asked. He chuckled, but gave me an honest answer: “We can have some good fights or guerrilla warfare. We can try.” Perhaps this is part of his intention to regain momentum, and I fully understand that he could not say this to his donors in the US or Europe. “Don’t worry, you have Rambo in town,” I joked, referring to the new Hollywood movie featuring a rescue raid into Burma.

We finished our drinks, paid up and walked out of restaurant. Mae Sot lay quiet, dark and dead to the world. But in the darkness, I imagined the Burmese hiding in the rice fields, sleeping in small huts or restless behind prison bars. And I saw faces in the faint street lights, smiling and waiting for customers. I suspect they might not agree with me when I say Mae Sot has changed.