Gammy has Down syndrome. “But I think this is not a bad karma ... it’s good karma that make us be together,” she says from her village in Chonburi province in northern Thailand. “I would like to tell Thai women – don’t get into this business as a surrogate. Don’t just think only for money ... if something goes wrong no one will help us and the baby will be abandoned from society, then we have to take responsibility for that.” Ms Pattharamon’s family were struggling to pay off debts last year when she was offered the equivalent of $11,700 to be a surrogate mother for an Australian couple who could not conceive a baby. “I asked the agency, ‘Did I have to sleep with the man?’ I was an innocent young girl and I don’t know about this business," she says.

"The agent told me, ‘We are going to make a glass tube baby,’ but I didn’t understand. “My husband agreed because we didn’t have money to pay our debt and I didn’t need to have sex with another man.” Ms Pattharamon says three months after a doctor injected the Australian woman’s fertilised egg into her uterus, she discovered she was having twins. The agent promised her an additional $1673 to have the second baby. Four months into the pregnancy, doctors doing routine checks discovered one of the babies had Down syndrome. They told the Australian parents, who said they did not want to take the boy, according to a source familiar with the case.

“They told me to have an abortion but I didn’t agree because I am afraid of sin,” Ms Pattharamon says, referring to her Buddhist beliefs. When the babies were born the agent took the healthy girl and left the boy with her. Ms Pattharamon never saw the Australian couple. Under the threat of not being paid, she lied to an official of the Australian embassy in Bangkok about the circumstances of the births, which allowed the Australians to take the healthy baby. “But the agent never paid the rest of the 70,000 baht ($2341) owed to me,” she says.

A “Hope for Gammy” campaign (gofundme.com/bxci90) to raise money for a series of desperately needed operations and to help Ms Pattharamon care for the boy is under way in Bangkok, after the Thai Rath newspaper revealed their plight. Some officials of the Australian embassy in Bangkok are supporting the campaign. “Greedy, selfish people,” Nicole McCafferty, who has two surrogate children, wrote on a gofundme.com site. An Australian donor wrote on the Thai Surrogacy Forum: ‘‘... to leave a twin behind? Like a toy you bought from a shop you picked the one you wanted and ripped away the baby from its twin. Will they tell the healthy twin [she] has a brother that oh, we decided to leave behind and ignore and never supported, not even financially.” Senior Thai health and legal officials threw Thailand’s booming surrogacy business into crisis on Wednesday when they declared that, according to Thai law, the only legal surrogacy cases were those in which a married couple cannot conceive a child and engage a blood relative to carry their child in an altruistic surrogacy arrangement.

They declared as illegal any surrogacy arrangement commissioned by an unmarried couple or a couple whose marriage is not legal in Thailand, such as a same-sex couple. Any arrangement in which money was provided to the surrogate to carry the child was also illegal, they said. And any foreigner removing a child from its mother to another country permanently without permission from Thailand’s Ministry of Foreign Affairs would be violating the country’s human trafficking laws. Sam Everingham, director of Families Through Surrogacy, an organisation that runs best-practice conferences for surrogacy, said the declaration placed ‘‘hundreds of Australian and other foreign parents in a very difficult position’’. “Many of them had taken on trust the advice of Thai doctors and agents to enter into surrogacy arrangements in Thailand on the understanding that this was a reliable pathway to parenthood,” he said.

“Already Australian parents leaving Thailand with children via surrogacy are being asked for additional proof that their surrogate was not compensated for carrying their child.” Mr Everingham said Gammy's case showed ‘‘the need for couples to be counselled before they go into any surrogacy, to ensure they know the risks they may be faced with that could lead to these situations". "It’s a really sad story but not the first case we have seen in this area,” he said. “There have been recent tragic cases of foreign parents not accepting disabled children born through surrogacy.” Mr Everingham said commercial surrogacy was not generally accepted in Thai society and had been conducted discreetly for years. But he said operators who had arrived in Thailand to take advantage of the industry’s growth had crossed the line and were exploiting surrogates and would-be parents, and were not respecting local culture.

Some clinics were not certified by the Thai Royal College of Obstetricians. Stephen Page, one of Australia’s leading surrogacy lawyers, said although it was illegal for people living in Queensland, NSW and the ACT to undertake commercial surrogacy in Thailand, “this has not stopped the deluge’’. Mr Everingham said that at any one time there were about 20 Australian couples in Thailand for the birth of their child or children. “It is a very significant market for Australia – particularly the same-sex couple market,” he said. “We have hundreds of Australian couples in our forums at the moment because they are worried about the security of surrogacy arrangements they have entered into.” Thai authorities have also signalled a crackdown on clinics that use IVF procedures that allow selection of a baby’s sex, which brings dozens of Australian couples to Bangkok every month.

The procedures are banned in Australia. Commercial surrogacy has been largely unregulated in Thailand.