Hundreds of others like him criss-cross Myanmar’s impoverished eastern border areas to deliver medicine, treatment and education to Karen and other ethnic minority villagers who lack access to even basic healthcare.
From their base in the Thai border town of Mae Sot, members of the Back Pack Health Worker Team smuggle medicine across the porous frontier — fleeing at any sign of soldiers loyal to the rulers of Myanmar, also known as Burma.
The non-profit organisation, which relies on donations, says that since it was created in 1998 nine medics and a midwife have been killed by regime troops or their landmines, most recently in July 2010. Several others have been imprisoned.
“If we don’t run we will be shot because the regime regards us as an opposition organisation. They don’t see us as health workers,” said 34-year-old Saw Poe Aye, who is from Karen State.
“Our area has lots of mountains and deep forests. Often it takes two or three hours to walk between villages,” the married father-of-one said in an interview at the group’s Mae Sot headquarters.
The organisation has about 300 medics serving a target population of about 180,000 vulnerable and displaced people spread across 320 villages in areas including Karen, Karenni, Mon, Arakan, Kachin, and Shan states.
Each team, made up of about three to five medics, typically returns to Thailand twice a year for training and to collect supplies.
It takes Saw Poe Aye four days to travel by bus, boat and on foot from Mae Sot to the rebel-held area where he works, treating ailments including malaria, worm infestation and diarrhoea as well as war wounds.
Some teams carry surgical tools for trauma patients.
They travel for several months at a time, spending at least three days in each village they visit and covering as much as 1,000 kilometres (about 620 miles) on a single trip.
Sometimes rebel soldiers provide a security escort if the situation is dangerous.
While their links to the armed groups raise questions about their neutrality, the medics say they are simply filling a void left by the absence of international aid groups or state healthcare workers.
“The government and international NGOs can’t reach these areas because they are conflict zones,” said Mahn Mahn, the Thai-based director of the Back Pack Health Worker Team.
“These areas are not stable and civilians are always moving around. Our backpack medics give training so these people can help themselves.”
Myanmar has been plagued by decades of civil war between pro-regime troops and armed ethnic minority rebels, with hundreds of thousands of people displaced.
More than half of all deaths in Myanmar’s eastern conflict zones are from treatable illnesses, with the junta blocking access to healthcare, according to a study published last year. Malaria is the number one killer.
Child mortality rates are nearly double the official national figure, while maternal mortality is three times as high, according to the study by groups including the Back Pack Health Worker Team and Burma Medical Association.
“The health situation is chronic. People do not have access to any regular healthcare,” said Sally Thompson, an aid worker helping Burmese refugees on the Thai-Myanmar border.
“If you fall sick, it’s just lucky for you if a backpack team walks through your area at the time. Otherwise, you’re essentially on your own,” she added.
For serious medical problems, many people in Myanmar’s eastern conflict zones make the long and dangerous journey to Thailand, crossing over illegally to seek treatment.
Myanmar has endured half a century of military rule and while a civilian government is now nominally in charge after a widely criticised election last year, its ranks are filled with former generals.
“At first we thought things would change,” said Saw Poe Aye.
“We thought the country would become a democracy and there would be equality for different ethnic groups. But the situation has remained the same or even worsened since the election,” he added.
Fighting still rages in some areas and a recent call by the government for ceasefire talks has been met with scepticism, while Thailand’s threat to close its refugee border camps has caused alarm among the 140,000 residents.
Human rights abuses continue in the ethnic conflict zones, including attacks on civilians, extrajudicial killings, sexual violence, the recruitment of child soldiers and forced labour, a UN rights envoy said last month.
The regime spends about seven US dollars per person on health each year, among the lowest in the world, according to a 2009 report from the United Nations. Just 1.8 percent of government spending goes into health.
As long as people in their communities are sick and dying from a lack of healthcare, the backpack medics say they will continue their work, despite the risks.
“If we don’t do this no outsider will come and do it for us,” said Saw Poe Aye.