Myanmar Karen
© Corbis
As Myanmar's isolation eases, ethnic Karen who fled worry they may be forced to return

Slowly Myanmar's isolation is fading. In November the regime held a general election, admittedly heavily circumscribed but the first in two decades. It then released the opposition leader and Nobel laureate, Aung San Suu Kyi. A formal transfer from military to civilian rule took place last month. No one doubts that the soldiers are still in charge. But more countries are loosening policies designed to shackle the regime. The European Union has relaxed some sanctions. America, which has appointed a special envoy to Myanmar, wants to engage. The UN's point man on Myanmar has just paid a rare four-day visit to the country. And now the ten-member Association of South-East Asian Nations (ASEAN) says it may give Myanmar the ASEAN chair for the first time in 2014 - assuming "steady progress and political developments" continue on their present course.

Comment: And so we see, it only requires the appearance of change for the EU and US to quietly remove sanctions. Business as usual, now that the world is no longer watching.

The progress may yet prove a chimera. At the moment, though, it is beginning to worry some of the chief victims of decades of military repression: the 140,000 or so refugees who huddle just inside Thailand's border with Myanmar. These people, mainly from the Karen ethnic group, have sought sanctuary in Thailand for years. They are victims of a civil war between the Karen and the government that goes back to Burma's independence from Britain in 1948. The new era of official glasnost towards the regime leaves Karen in the camps feeling vulnerable - and the NGOs who look after them are increasingly concerned about their future.

The refugee camps were first set up in 1984; there are now nine of them, settlements of bamboo-built houses behind barbed wire spread out not far from the border town of Mae Sot. They are rife with boredom and crime.

Thai officials have been making noises recently about how it is time to close the camps. One provincial governor proposes a programme to get people to return voluntarily. To a degree, he and other officials are merely parroting longstanding Thai objections to the Karen refugees. Now, with a thaw in the world's relations with Myanmar, their proddings will carry more weight.

Yet nobody who works in eastern Myanmar, where most of the refugees would have to go back to, believes that the conditions remotely exist for their safe return. Indeed, the region gives the lie to the notion that the country really is making ASEAN's "steady progress" towards the sunny uplands of democracy and peace.

For a start, the low-level guerrilla war that has rumbled on between small groups of armed Karen and the Myanmar army has if anything got nastier since the election. The Thailand Burma Border Consortium, the main NGO looking after the refugees, estimates that conflict has made a further 70,000 people homeless in Kayin (formerly Karen) state in the past year, with 113 villages cleared. Often, the army orders villagers off their land to allow for mining, logging and other resource exploitation. In all, Burmese who have been internally displaced are reckoned to number over 500,000. In the past few weeks hundreds more have been fleeing over the border.

One awful consequence of the long conflict has been a proliferation of landmines, frequently maiming villagers. A much bigger killer is malaria, accounting for about a quarter of all deaths in eastern Myanmar. Diarrhoea is also lethal. The region has some of the world's ghastliest health statistics, much worse even than other parts of Myanmar and more comparable to countries like Sierra Leone and Niger. Maternal mortality is 721 per 100,000 compared with 240 in the rest of Myanmar - and just 48 in Thailand. Although refugees get reasonable care in the camps, in Myanmar the government spends only about 1.8% of total outgoings on health.

Comment: "Our government annually spend about 40 percent of our GDP on the military and barely two percent on health and education combined," - Aung San Suu Kyi

Under these conditions, few refugees want to return voluntarily. In recent years a resettlement programme to other countries, notably America, has been a great success. About 70,000 refugees have found new homes abroad. Yet it has barely dented the numbers in the camps, where girls often become mothers in their early teens. Most refugees will just have to sit tight, hoping they won't have to return until real change comes to Myanmar.