Refugees living in camps along the Thai–Myanmar border are facing a deepening humanitarian crisis as food and medical aid is sharply reduced, even as they gain the long-denied right to work legally outside the camps. Decades-old assistance systems have been disrupted by Donald Trump’s major cuts to USAID and other humanitarian funding, leaving more than 100,000 refugees struggling with food shortages, declining education access, and collapsing healthcare services. Monthly food credits have been suspended for most families, forcing many to rely on dwindling savings or informal work, while only the most vulnerable continue receiving limited rations. Clinics once run by international agencies are now barely functioning, with severe shortages of medicines and trained staff. Educators warn hungry children may drop out of school to work illegally. Amid this hardship, Thailand’s decision to allow refugees to work legally offers a rare lifeline, restoring dignity and self-reliance: it could fill a migrant labour shortage after the conflict with Cambodia in July triggered an exodus of Cambodian workers. Yet fears of exploitation, family separation, and limited job opportunities remain, underscoring the fragile balance between hope and desperation.