In Thailand’s Surin province, one hospital was directly hit by artillery attack and damaged, and another in the Kantharalak District.

According to the latest report dated July 31, the Ministry of Public Health has recorded an increase in civilian casualties and extensive damage to healthcare facilities amid the ongoing Thailand–Cambodia border conflict. Over 54,000 individuals have been screened for mental health conditions, with findings ranging from severe psychological distress to risk of self-harm. Many have required urgent intervention. Additionally, medical personnel continue to face heightened risks on the ground.

Reports quoted Dr. Varoth Chotpitayasunodh, spokesperson for the Ministry of Public Health, who provided the latest update on civilian casualties in the Thai–Cambodia border conflict as of July 31. The impact includes both serious and minor injuries, as well as fatalities. Many affected civilians have required medical attention.

Healthcare facilities have also suffered amid the conflict. Recent data indicate that around 20 hospitals on the Thai side have been affected. Nearly half have shut down completely, while the remainder have temporarily suspended services.

In addition, over a hundred community health centers have either ceased operations entirely or are functioning at limited capacity. Despite these setbacks, the Thai government, through the Ministry of Public Health has continued to mobilize medical teams to deliver care in high-risk zones. These include Medical Emergency Response Teams (MERT), Mini MERT units, Advanced Life Support (ALS) teams, Joint Investigation Teams (JIT), Mental Health Crisis Assessment and Treatment Teams (MCATT), Special Environmental Health Response Teams (SEhRT), and various standby support units prepared to respond as needed.

On the Cambodian side, the ongoing health crisis has placed additional strain on an already burdened healthcare system. World Vision International has also expressed concern over the impact of the conflict on children, particularly those displaced by the violence. “The recent clashes along the Cambodia–Thailand border has led to the displacement of thousands and the temporary closure of hundreds of schools across affected provinces,” the organization stated. In response, World Vision has launched an emergency operation and is coordinating with local authorities and youth volunteers to deliver life-saving support to affected children and communities in both countries. This effort includes setting up 56 temporary child-friendly spaces in Siem Reap, Banteay Meanchey, and Preah Vihear, providing psychological support and recreational materials to thousands of children, families, and individuals.

Following five days of intense fighting, an “immediate and unconditional” ceasefire was brokered between Cambodian Prime Minister Hun Manet and Thailand’s acting Prime Minister Phumtham Wechayachai, during talks hosted by Malaysian Prime Minister Anwar Ibrahim. The clashes resulted in the displacement of over a quarter of a million people and numerous casualties.

This situation in both countries’ healthcare systems reflects the broader impact of border disputes and civil or political conflicts on public health infrastructure.

Border conflicts expose healthcare vulnerabilities

Healthcare systems in border regions face deep-rooted challenges that are often intensified by conflict and political instability, affecting critical components of a country’s health infrastructure.

Disruptions in infrastructure, supply chains – Armed conflict diverts resources, destroys infrastructure, and displaces medical personnel. Supply chains are disrupted, health facilities targeted, and humanitarian aid obstructed. Violence hampers the safe transport of medical supplies and forces vulnerable groups into areas with inadequate services.

Systemic scarcity in care services- Many public health systems in Asia, especially in rural areas, suffer from chronic underfunding and resource shortages.

Emphasized global health inequities – Border-related health crises widen global disparities, deepening the divide between those with and without access to affordable care. Poorly regulated ground crossings further threaten regional and international health security.

South and Southeast Asia conflicts

Across Asia, healthcare systems in border regions face enduring challenges, including language barriers, lack of identification among mobile populations, and difficulties with medical documentation and follow-up care. Political unrest and regional conflicts often divert resources away from essential services, limiting healthcare access. In Southeast Asia, the cross-border trade in health services is still emerging, and its impact on healthcare staffing remains uncertain. For conflict-affected communities in South Asia, improving access to care, addressing gender-based violence, and strengthening mental health support are urgent priorities.

Border and internal conflicts across these sub-regions have further disrupted health services. The long-standing India – Pakistan dispute, which began in 1947 when both countries gained independence and laid claim to Kashmir, continues to expose communities to security threats, economic marginalization, and limited access to healthcare. These challenges are compounded by geographic isolation and political instability. The 2017 Doklam standoff between India and China, though brief, demonstrated how territorial tensions can destabilize nearby communities and disrupt public services. Doklam is a region claimed by both China and Bhutan, located near the tri-junction with India. In Myanmar, intensifying internal conflict has severely affected access to essential medical care. According to United Nations High Commissioner for Refugees (UNHCR), around 3.5 million people were internally displaced in Myanmar by the end of 2024.

Healthy cardiovascular habits taught to children early on though school-based programmes can keep their lifestyle choices in check and prevent the risk of heart disease. Unhealthy lifestyle habits such as a nutritionally poor diet, sedentary lifestyle, and smoking, all contribute to cardiovascular disease risk; previous studies also point to a relationship between poor cardiovascular health in childhood and poor cardiometabolic health in adults.

However, a multilevel and multicomponent school-based programme involving 50 schools across Spain and the US, saw how early education in children with regards to their cardiovascular health ensured lasting lifestyle improvements.

According to the 10-year results of the SI! Program (Salud Integral — Comprehensive Health), a significant increase in knowledge, attitudes, and healthy lifestlye habits were apparent in more than 3,800 young children after the implementation of a four-month health promotion programme. Children who received more than 75% of the programme were found to have a significant change from baseline in overall knowledge, attitudes, and habits, compared to children who received less than 50% of the same programme.

“Most preschool interventions focus solely on physical activity and diet. The SI! Program breaks down cardiovascular health into four components. Through the first two components, children are learning how a well-balanced diet and physically active life are directly connected to a healthy heart. Next, they learn about emotion management, which seeks to instill behaviour mechanisms against substance abuse – mainly smoking – and dietary decisions later in life. Finally, the children are taught about how the human body works and how it is affected by behaviour and lifestyle,” said Dr. Gloria Santos-Beneit, scientific coordinator of the SHE-la Caixa Foundation, Spain.

The programme itself incorporated assessment tools suited to the maturation of the children, while questionnaires included simple pictures and were modified to the sociocultural contexts of each country.]

For example, to accommodate the learning styles of preschool-aged children, the SI! Program used a heart-shaped mascot named “Cardio” to teach about recommended healthy behaviours, along with the Sesame Street character Dr. Ruster, a Muppet based on the principal investigator of the programme, to introduce and convey messages and activities. Other materials include video segments and printed materials (a colorful storybook, an interactive board game, flash cards and a teacher’s guide).

The activities and messages used were tailored by country, keeping in mind cultural health beliefs or practices related to food, facilities allocated for physical activity, transportation methods to school, meals provided in school, popular songs or stories, and local everyday rituals and celebrations.

“The school environment is a great area to introduce lifestyle interventions, because children are spending so much of their time there,” said Dr. Rodrigo Fernández-Jiménez, group leader of the cardiovascular health and imaging lab at Centro Nacional de Investigaciones Cardiovasculares (CNIC), Spain. “There are specific times in a child’s life when improvements can be made to enhance long-term cardiovascular health status. Our review, and previous studies, suggest that 4-5 years of age is the most favourable time to start a school-based intervention focused on healthy habits.”

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