Aid workers in Myanmar's northern Kachin State have expressed concern over the health of thousands of internally displaced persons (IDPs) along the border with China.
Preventable illnesses caused by unsanitary conditions and colder weather are taking their toll on the more than 45,000 IDPs in two dozen IDP camps as sporadic fighting between government forces and the Kachin Independence Army (KIA) nears almost eight months, they say.
"Many of the children in the IDP camps suffer from diarrhoea and stomach parasites because they have to drink dirty water. When they go to the toilet, there aren't enough," May Li Aung, director of Wun Pawng Ninghtoi (WPN - "Light of Kachin"), a volunteer group comprising eight local NGOs and charity groups, told IRIN.
In one camp, aid workers report just five latrines for more than 1,200 people.
"A few people in the camps have already died from this and we are worried that diseases will spread," she said.
While much of the water supply is trucked into the camps, many of the displaced while on the run have to drink directly from streams or boil pond water
The WPN assists 16 camps under KIA control in the southern part of Kachin State, where about 20,000 IDPs are housed in temporary bamboo shelters, but there is a growing strain on volunteers and resources as the conflict continues.
In the north, another 20,000 IDPs are housed in camps also under KIA control, with about 10,000 in the government-controlled area around the border town of Myitkyina.
"Women in the camps can use the clinics there; however, many women are not getting the midwife or family support they need," Shirley Seng, a spokeswoman for the Kachin Women's Association of Thailand (KWAT), based in Chiang Mai, said. "Many women feel insecure and at risk of possible assault by Burmese troops."
"The problem that we face right now is that many women who are pregnant are having miscarriages," explained nurse Di Di Ah Hkaw.
The pregnant women have no choice but to run from their homes to a safe place while many of their husbands are fighting on the frontline. Many of the women are carrying their household possessions with them, she explained.
"In December we had three women in our clinic who miscarried," Di Di Ah Hkaw added.
Meanwhile, as the political dialogue between Myanmar and others in the international community slowly moves forward, international relief groups are calling for faster action to better address the needs of the displaced.
Earlier this month, Refugees International released a report calling for increased humanitarian aid to coincide with a string of recent political reforms by the country's first nominally civilian government in decades.
At the same time, Bill Davies of Physicians for Human Rights (PHR) described a recent UN inter-agency mission to the KIA-controlled town border town of Laiza in December - which delivered essential household items to the displaced and conducted an initial assessment of the situation – as a positive step, but stressed the need for stronger assistance and access.
The UN and its humanitarian partners have repeatedly expressed their readiness to support all those affected by the conflict, and the most vulnerable in particular, a statement by the UN read at the time.
"There needs to be consistency and more access for bigger organizations to go in and provide better technical support for the people on the ground.
"Something as simple as diarrhoea could kill someone as the dehydration leads to the immune system breaking down which could lead to respiratory problems and pneumonia - and eventually death," the health worker warned.
On 9 June 2011, the 17-year-old ceasefire that had been in place between the government and the KIA broke down, in part because the KIA rejected orders to transform into a single border guard force under Burmese military control. Others still cite the military's desire to widen its control over areas with Chinese energy projects.