On the road to legal employment in Thailand, Cambodian migrant workers are being made to undergo check-ups that have them cough, strip and give blood and urine samples to prove they are physically and mentally sound enough to work in the country.
Obtaining a workers’ permit, Thailand’s junta has announced, is contingent upon passing compulsory, 500-baht ($15) health screenings and buying 1,600-baht insurance.
The health stipulations aren’t new – in fact, the rates are reduced – but the efforts to strictly enforce them have taken on a novel fervour since the military government announced its social reforms to stymie rampant trafficking and abuse of foreign labourers.
Yesterday, Thailand’s 22 newly launched “one-stop service centres” began registering fleets of foreign workers, the acceptance of each applicant incumbent on background checks, medical screenings and permit requests, each step processed in the same paperwork- and labourer-swamped office.
According to the World Health Organisation, the Thai Ministry of Health has ordered workers seeking yearlong permits to be screened for amphetamine abuse and major illnesses, including syphilis, leprosy, filariasis, and, through a chest X-ray, tuberculosis. Female migrants are also given a pregnancy test, and if found to be pregnant, the policy stipulates that they be sent home. Since there is no translation, workers’ consent to the whole barrage can only be assumed, said Omsin Boonlert, or Plaii, a Chang Mai-based research officer for the Mekong Migration Network.
“It’s not voluntary, but the workers aren’t told what will happen once they cross the border or what the doctors will do,” Plaii said. “It’s a violation of the workers’ rights to bypass properly informed consent.”
But no one seems to know what all the workers could be consenting to. Upon crossing the border, a labourer’s trek back to Thailand begins with an 80-baht temporary identification card doled out at newly created coordinating centres. Employers then retrieve the freshly arrived workers from the checkpoint, and within 60 days must take them to a one-stop centre to request a longer-term permit, where the requisite tests are undertaken and fees levied.
After the health check, migrants are filtered into one of three categories: pass with no health issue; pass with controllable illness; or fail due to being unfit for work, infected with a contagious disease, demonstrating signs of alcoholism or amphetamine addiction, or affected by a mental disorder.
The policy stipulates that sick workers “will be referred to receive treatment before further coordination with other relevant authorities for deportation”, according to Aree Moungsookjareou at the WHO.
But in reality, treatment isn’t always so duly meted out.
“[The failed workers] aren’t issued a permit and will not be allowed back to where they were living in Thailand. They are immediately deported,” said Plaii. “There’s no consultation, no follow-up scheduled and no treatment arranged. They just check, and charge.”
The whole system also has little interest in patient privacy: The prodded and pricked workers have no choice over male or female doctor, and a nurse hands out the results in a Thai printout that is passed around to other government agents and indiscriminately shared with employers, who don’t always take the news lightly.
“Sometimes, employers will terminate a contract based on medical results,” Dr Nang Sarm Phong of World Vision International Thailand said. “It’s not legal … but it still happens.”
In addition to the lack of informed consent, migration and public health monitors worry that the cost of the compulsory health check and health insurance is still prohibitive for recently crossed and often penniless migrants, and may prove a continued barrier to the new legalisation incentives. The screening, insurance and permit alone run a total 3,000 baht, or more than one month’s wages for some workers.
“Taken in isolation, it’s not so expensive, but it’s still an additional cost … the passport, the visa, the transportation, the broker fee, the identification card, the health insurance … those are all expenses 100 per cent borne by the employee, not the employer,” Bangkok-based migrant expert Andy Hall said.
But if workers don’t have insurance or undergo health checks, the state ends up footing the costly burden for migrants’ health. In 2012, Thailand’s Public Health Ministry estimated it shouldered 300 million baht worth of unpaid migrant worker hospital fees.
“Everyone, including the migrant workers who helps fuel the country’s economic growth, should have health coverage. It’s just a question of who pays for it,” said Hall.
And for now at least, Thailand is continuing to direct the bill to its foreign workers.