People in Karen State, in eastern Myanmar, are slowly recovering from posttraumatic stress disorder, anxiety, and depression, following a decade of brutal warfare targeting the villagers in an attempt to cut the support base of the Karen rebels (Karen Human Rights Group 2013, 2014). In this chapter, I shall describe the humanitarian agencies and their work as a transformative project in which local humanitarians were trying to transform crisis into some form of normality. My hypothesis is that humanitarian assistance – organized locally and from below – played a key role in this effort. Hence, I focus on the politics of humanitarian assistance to the Karen to showcase their ‘humanitarian ecology.’ With the resettlement of a Karen refugee elite to the West in the 1990s, the humanitarian economy expanded to the global level as resettled families sent remittances and donated to civil society, the nationalist movement, and missionary churches back home. While ‘humanitarianism’ is defined as a culture of humanitarian assistance, compassion, and relief, I use a broader definition that includes agency, which encompasses a broad range of services – from emergency health care to advocacy work and human rights documentation. Decades of civil war and repression in southeast Myanmar have created a particular sort of humanitarianism in the borderlands that is characterized by the heavy presence of local and international humanitarian organizations.