Migrant Workers Deserve Better Access....

Migrant Workers Deserve Better Access to Healthcare Efforts to Improve their Access to Healthcare Must Be Stepped Up
MSF

19 December 2007
News
Bangkok, December 17, 2007 - The International Medical
organisation Médecins Sans Frontières
(MSF), today called on the Thai government to step up
its efforts to improve access to healthcare to the
millions of migrants workers living in Thailand.

"The Thai government has recognised the barriers to
healthcare for migrants and has adopted a
comprehensive policy on migrant health," says MSF's
head of mission in Thailand Paul Cawthorne, "but
policy implementation is slow in some provinces and
the Ministry of Health should ensure that it is
implemented in all public health facilities".

In Phang Nga, where MSF has been working with this
marginalised population for nearly 3 years, few have
access to basic healthcare.
"The main barrier these people face is the complex and
long registration process which then allows them to
get a health card," explains Richard Veerman, MSF
Migration Coordinator for Thailand "without the card,
they have to pay the full cost of their medical care,
but most can't afford it as they have very low-paid
jobs".

In order to improve migrants' access to health in all
provinces, MSF strongly recommends the registration
process is made simpler and cheaper, and that all
migrants are eligible to a health card independently
of their registration status.

Nearly three years after the Tsunami, Phang Nga
province is undergoing an impressive economic recovery
in tourism, agriculture and fishery industries,
towards which migrant workers have been widely
contributing. Yet few can reap the benefit of their
work, even in terms of basic human rights like access
to health.

Besides the language barrier and a general lack of
knowledge regarding health issues, the constant fear
of being arrested and deported also prevents migrants
from seeking adequate care.

In Phang Nga, this situation has even worsened. A
provincial decree introduced in June 2007, has
restricted the movement of documented migrants and
strengthened the implementation of the arrest and
deportation policy for undocumented migrants. Migrants
have to respect a curfew and the decree forbids them
to own a mobile phone or gather in groups of more than
5 people outside their living compounds.

These measures have compounded the atmosphere of fear
and mistrust between the migrants and the local Thai
community.
"Some of our patients in need of urgent medical
treatment have even refused to come to the hospital
for fear of being arrested or harassed by the police
or the local Thai population," regrets Richard
Veerman.

As a result, migrant workers often seek medical
assistance when their health problem has reached an
advance stage. TB and HIV prevalence are estimated to
be higher among migrants than among Thai nationals.
Vaccination coverage among migrant's children is low
and the knowledge of reproductive health is limited.

MSF began working with migrant workers in Phang Nga
following the Tsunami in December 2004. Since then, an
estimated 10 000 migrant workers have been offered
free healthcare in three sub-districts of Phang Nga
province. Two Primary Health Care Unit Mobiles clinics
are regularly visiting fishery, rubber plantations or
construction sites where migrants are working, to
provide health education. MSF is also facilitating
relationship between medical staff at the district
hospital level and the migrant community by offering
free translation services and counselling in hospitals
and health stations. Whenever possible, MSF is helping
migrants obtaining health insurance cards and delivery
certificates for migrant babies.
MSF also follows up patients with HIV/AIDS and TB
through home visits and provides anti-natal care for
pregnant women as well as vaccinations for newborn
babies.

Prachatainews