Donald Trump's White House is more than 13,000 kilometres from the Thai-Myanmar border migrant camp Umpiem Mai, but it's where his decision to freeze most US foreign aid funding has had some of the most devastating effects.
The camp just inside the Thai border is home to more than 10,000 displaced people from the conflict-torn country of Myanmar.
Under the US Agency for International Development (USAID), American taxpayer money was, up until last week, being used to pay doctors and nurses to provide everything from basic health care to chronic disease treatment.
"Staff from the International Rescue Committee came and gave an order to shut down the hospital immediately," Sulaiman Mawlawi, a resident of the camp, told the ABC.
"The medical workers left without even taking the equipment and the patients had to return to their homes, including some who had to be carried out."
He said multiple patients who had been relying on oxygen support died.
His account has been backed up by a health worker.
"It was a very tragic moment for us," Salaiman Malawi said.
The International Rescue Committee (IRC) had been running medical clinics serving around 80,000 people in nine refugee camps just inside the Thai border.
But its funding from the US government was abruptly frozen in late January due to a 90-day pause on all foreign aid ordered by Mr Trump, prompting the sudden suspension of the medical clinics.
Mr Trump's cost-cutting tzar, the world's richest man Elon Musk, has said "USAID is a criminal organisation" and "USAID must die," foreshadowing a major overhaul of an organisation that distributes $US72 billion ($115 billion) of American government money around the world each year.
Much of it goes to Ukraine, African, Middle East and central Asian countries such as Afghanistan.
Close to $US500 million ($796 million) was disbursed to South-East Asia and the Pacific in the most recent figures for 2023.
One former health worker described the medical services paid for by the US taxpayers in the migrant camps as "vital" for residents.
"When they suddenly shut the hospital, there were pregnant women and patients with chronic diseases who were discharged," said the woman, who requested anonymity to speak.
"The sudden shock created a lot of distress."
The suspension was walked back a little bit by US Secretary of State Marco Rubio with a waiver on January 28 for "life-saving humanitarian assistance".
However, the medical facilities in the camps remain shut.
USAID staff who deliver the services, such as the International Rescue Committee, remain in limbo.
The White House has ordered stop-work orders for USAID partners around the world, prompting confusion and fear among workers in the organisations providing the services.
On Friday, Mr Trump's administration said it would only keep employing fewer than 300 staff at USAID, out of the agency's worldwide total of more than 10,000, according to Reuters.
The suspension of clinics in the camps is having knock-on effects.
Children needing heart surgery left in limbo
In the nearby town of Mae Sot, Kanchana Thorton from the Burma Children Medical Fund organises transfers of patients to hospitals in Bangkok and Chiangmai for surgery, including dozens of children each year from the migrant camps.
She said there were three children ranging from ages four to eight awaiting heart surgery, who the IRC referred from the camps to be transferred and housed in staffed guesthouses her organisation runs.
With the IRC's operations halted, those children needing surgery have been left in limbo.
"We don't know if they can still travel to Bangkok for heart surgery," she told the ABC from Mae Sot.
"You have a kid who couldn't breathe, couldn't walk, and then after heart surgery, they have a new life.
"Isn't that money well spent? To get a human being back on their feet?"
It's not only health-related services that have been affected.
An NGO organiser only wanting to be known as May said a small grant of 50,000 Thai baht ($2,373) to start a shelter program for LGBT migrants at risk of abuse in the migrant camps was abruptly cancelled in late January.
The USAID partner that had approved the grant, Save the Children, informed her it couldn't go ahead due to the freeze.
May said that initial grant would have made it easier to access funding from other sources in future.
"The idea was to set up several safe houses and train staff, but in order to apply for funding from other groups in future, we needed to get the first project up and running with the grant money to prove it works," she told the ABC.
She said she knew of two other projects aimed at either migrants from Myanmar or for people still inside the country that have also suspended operations.
Save the Children said: "We remain steadfast in our mission to serve the world's most vulnerable children and are working with urgency to minimise the impact on children during this transition. This includes reinstating critical, lifesaving activities for children without delay."
The fallout from Mr Trump's move is being felt across South-East Asia, where everything from tuberculosis programs to infrastructure financing initiatives are being affected.
Funding drying up for critical services in Indonesia
At about $US150 million ($239 million) per year, the commitment to Indonesia from USAID was the second-biggest in South-East Asia after Myanmar.
The organisation's Indonesia Instagram page is a telling sign of the disruption.
After months of posts detailing the achievements of the USAID team in the country, including field visits to multiple provinces, training sessions and high-level meetings, the latest post is a notice cancelling recruitment of three contractor positions.
Among them, an infectious diseases adviser and a project management specialist for tuberculosis.
But not all programs have immediately ground to a halt.
A representative of a tuberculosis organisation that receives money indirectly from USAID partner The Global Fund said her monitoring and testing programs in Indonesia are continuing.
"In Indonesia, a lot of USAID money is used for capacity building, rather than field operations or purchasing tuberculosis medications," Harumi Paramaiswari said.
"Much of it was for what we call technical assistance, such as training strategies on how we communicate with patients."
But she said a meeting of tuberculosis organisations in Jakarta this week involved many health workers who are concerned they might not be able to access further funding once the money already allocated for existing programs has run out.
A representative of a medical group that operates 19 clinics across South-East Asia and has 5,000 patients undergoing HIV treatment said they would continue operating under an order to minimise costs as much possible.
The spokesman, who requested anonymity citing the uncertainty and sensitivity of the issue, said: "we can't even get an answer if our HIV [and] tuberculosis services are covered by the recently issued waiver for essential medicines and medical services".
"Thanks to the support of private donors we are able to navigate this uncertainty at least in the short term," he said.
"Only time will tell what the impact will be in the longer term, and how we will have to adapt to this new reality."
US 'shooting itself in the foot'
The US is by far the world's largest aid donor.
In South-East Asia, it ranks as the fifth-largest development partner, according to the Lowy Institute's South-East Asia Aid Map.
But for aid grants, rather than loans, the US is the third-biggest donor country in the region, after Japan and Germany.
The Lowy Institute's Indo-Pacific Development Centre head Roland Rajah says the US puts a lot of money into health and governance initiatives.
"So in particular areas, the cut to USAID is going to be much more acutely felt," he said.
He says Chinese funding to the region is heavily concentrated in loans for infrastructure projects rather than grants that are more traditionally viewed as aid.
"Definitely there's an opportunity for China to step into some of these civil society, education and health spaces, but it doesn't even necessarily need to," he said.
"What America is doing with these aid cuts is effectively shooting itself in the foot. So that's very good strategically for China," he said.
For now, USAID programs are temporarily paused, not cut, but Mr Musk has said Mr Trump has agreed to shut the agency down, and he has used the X platform he owns to declare "USAID must die".
Mr Trump and his aides say they want to ensure that billions of dollars of humanitarian assistance aligns with his "America First" agenda.
In the meantime, Secretary of State Marco Rubio has listed more "specially designated programs" to exempt from the funding freeze, saying he's looking for initiatives that align with US national interests.
"Those that do not will not continue," he said this week, stressing that many functions of the agency will continue to be carried out.
Some in the aid sector believe programs focusing on climate change, gender, diversity and LGBT issues are unlikely to survive in any overhaul of US funding.
"We know this USAID decision is already impacting climate specific work, and based on commentary from the US we expect those are among many programs unlikely to restart after the pause," said Mathew Maury from the Australian Council for International Development.
Many of the climate change programs are in Australia's immediate region, where low-lying South Pacific nations have long raised concerns about rising ocean levels.
"Australia wants to see these countries prosper and develop, and be stable and secure, so if the US isn't going to do its fair share in terms of supporting that, it's going to leave a gap for Australia to deal with," Mr Rajah said.
But at this stage, it's not clear how much of that gap Australia might be willing, or able, to fill in nearby regions like the Pacific and Southeast Asia.
The Department of Foreign Affairs and Trade (DFAT) would not be drawn on whether Australia had raised any concerns with the Trump administration over the aid freeze.
It also declined to say if the government was contemplating any aid increases to help meet the shortfall, perhaps because it's still watching closely to see exactly how the review plays out.
"The decision to pause United States official development assistance for policy review is a matter for the US Administration," a DFAT spokesperson said.
"Australia's development program is focused on being a partner of choice for our neighbours. This is fundamental to our region's prosperity, stability and security.
"We want to empower our neighbours to ensure the Pacific can meet its own development and security needs."
Back on the Thai-Myanmar border, residents of the migrant settlements find the anger about funding from the new US administration perplexing.
Layla, a 36-year-old mother who relied on USAID-funded medical facilities to deliver her four children, said her access to contraceptive medicine has been cut and was unlikely to be restored.
But she's most worried about what will happen to other pregnant women.
"When I delivered my first child, I was in a critical condition and they admitted me to the hospital and they saved our lives," she said.
"I don't think these services are a waste of money. In fact since the American president ordered the shutdown, we have realised just how valuable these services are."
