Australian funding cuts for a refugee clinic in western Thailand threaten to affect up to 400,000 people nearby in bordering Myanmar.
A federal government decision to cut $420,000 from the aid given to the Mae Tao Refugee clinic has affected its long-term ability to provide assistance, says the clinic's director, Cynthia Muang.
The cut, which became effective on January 1, represents 25 per cent of the clinic's budget.
"This is really disappointing and very stressful because of this talk of (having) enough (funding) for all the staff and patients. It's very stressful," Dr Muang told AAP.
The clinic, established in 1988 to provide health care for Burmese students fleeing a military crackdown in Yangon, now has a case load of 150,000 patients a year, with a staff of 700.
Hardest hit by the funding cuts is the cross-border mobile health program - or backpack workers - whose outreach services cover about 400,000 people living in the Myanmar states of Karen and Mon, bordering Thailand, says Dr Muang.
The mobile health workers have long played a key role in providing vital services to communities often with little immediate access to health care, and in past years, in the midst of fighting between the military and Karen fighters.
Nowadays, the backpackers' work centres on providing treatment for mosquito-borne diseases such as malaria and dengue fever, as well as public health advice.
Dr Muang said Australian funding had supported the mobile health program, but now "it is challenging for the border group". The teams also provide training and aid to internally displaced people from conflict with the Burmese Army. "So this (funding cut) affects our network and our partners as well," she said.
The Federal Government announced in 2013 cuts in the Department of Foreign Affairs and Trade (DFAT) budget of $4.5 billion in overseas aid over the next four years.
Dr Muang, in Australia in November to receive the Sydney Peace Prize Award, said appeals to Australian officials failed to have the budget cut reversed.
The Australian Embassy in Bangkok has provided a grant of A$10,000 to assist in the clinic's work in child-protection programs along the border regions.
Dr Muang said the immediate funding crisis had been averted following a "private" donation from an overseas benefactor.
"For 2014 the (clinic) can manage funding or other funding sources, but for the long term it will be more challenging," she said.
"But we're still struggling with (efforts to) improve other facilities, or building (improvements). But for the running costs we should be OK this year (2014)," she added.
International donors are increasingly placing funding directly into Myanmar through Yangon since the country undertook political reforms but there is often little adequate infrastructure to reach communities in border regions.
But Dr Muang says the workload is continuing to increase for the clinic despite the political changes.