I first met Ms. Shilpi (pseudonym) in Dhaka last spring. Dejectedly sitting on her bed, she described the brutal physical violence she experienced abroad as a migrant worker. Having lost her father at 15, and her husband at 23, Shilpi made the decision to leave Bangladesh for the promise of working abroad.
However, the circumstances were such that she could only survive three months and returned home with a severely fractured leg, a wounded mind and dashed hopes. Upon her return, she was denied any kind of compensation from the recruiting agency.
Like Shilpi, thousands of migrants who have been exposed to various diseases and physical harm return to Bangladesh every year with severe health issues. The abusive and exploitative behaviour of sponsors, occupational fatalities or workplace injuries, and the chronic diseases that develop over the years abroad etc. cause their health to deteriorate and sometimes lead to total breakdown of the immunity system.
On top of that, lower skill sets and limited bargaining capacity does not allow them to access basic health facilities or benefits. And most often, migrant countries do not have any long-term plans in place to redress the issue.
According to the latest report of the Ministry of Expatriates Welfare and Overseas Employment of Bangladesh, 207 migrant patients received medical treatment in 2020-21. However, it is not clear how many people applied and which criteria were used to shortlist those who received assistance. There is no comprehensive database of migrant workers returning to the country with ailments and it raises the plausibility of many incidents remaining uncounted.
The Emergency Support Team of the BRAC Migration Program recently counted that 933 women have returned to the country after experiencing physical, psychological and other kinds of assaults in the first three months of this year.
The number would be higher if the male returnees were included. A study by IOM revealed that 38% respondents faced discrimation in the hospitals due to their returnee migrants status.
Disparities towards returnee migrants in hospitals is a reflection of the pervading exclusionary nature of Bangladesh's health system. The prevalence of corruption, mismanagement and administrative subjugation, especially in government hospitals, outweigh the benefits of providing affordable health service to the underprivileged population.
Sometimes, critical cases are declined to minimise the risks and complexities. Ms Shilpi's frequent request for an immediate surgery, for instance, had been frequently rejected as the initial incision was made abroad with sophisticated instruments. Moreover, the shortage of residential beds and slow-running procedures add to the misery of patients. In contrast, private hospitals offer instant surgery, but at a high cost.
Ensuring a hazard-free health service for returnee migrants is sidelined in the reintegration framework of Bangladesh.
Globally, some countries have taken the initiative to repatriate patients from host countries to ensure treatment in their homelands. Offering health insurance schemes is another way of ensuring better health. Overseas Filipino workers pay for health insurance, which allows them to access healthcare upon return to the country.
In Bangladesh, in addition to the minimal services provided by the government, some non-governmental organisations (NGOs) have taken initiatives to provide medical assistance. The scarcity of funds and the restrictive eligibility criteria of the respective programs, which sometimes exclude potential victims, are major barriers in this process.
Therefore, the government should take more bold and broad initiatives, as well as, coordinate with stakeholders to ensure smooth health service for sick migrant workers. Integrating the health insurance system in the migration process and scaling up the prevailing health supports to ill migrants can be regarded as primary interventions.
Overall, there must be a strategy for identifying ailing migrants at the airport and categorising them based on their fatalities. Then, ensure emergency support in accordance with their needs. Finally, providing special cards and establishing a dedicated desk for them in the government hospitals would be a momentous tribute to our remittance fighters!
Ataur Rahman Maruph, sector specialist at BRAC migration program
Disclaimer: The views and opinions expressed in this article are those of the author and do not necessarily reflect the opinions and views of The Business Standard.