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Southeast Asian Government Officials Discuss Treaty to Provide Better Protection for Women Migrant Workers

In Bangkok senior government officials from Southeast Asia will discuss ways to help give better protection for women migrant workers in Asia through the establishment of an international treaty.

Every year, thousands of Burmese migrant workers come to Thailand looking for a better life. They cross the border through a combination of push factors (deteriorating economy, lack of employment, and human rights violations such as forced relocation, forced labour, high taxes) and pull factors (proximity, demand for cheap labour). Approximately 1.1 million Burmese workers are registered with the Thai authorities, but the actual number of migrants is likely to be double that.

One of the most pressing needs for Burmese migrants in Thailand is access to health care. For the last two years Medecins Sans Frontieres has been running health programmes to provide assistance to migrant workers in Phang-nga province. Since the beginning of last year the number of migrants increased in the province due to the increased workforce demands for post-Tsunami reconstruction. The rebuilding of the tourism infrastructure is an effort led largely by the migrant workforce. Currently, there are estimated to be around 50,000 migrant workers in Phang-nga, of which around 17,000 are registered.

For women, lack of access to reproductive health services are contributing to avoidable illness and death. With little or no access to family planning services, unwanted pregnancies are common and with them the risk of unsafe abortions, which can result in haemorrhage and serious infection. Giving birth in a safe hospital environment is virtually impossible for the uninsured, who are charged between 5,000 and 20,000 baht for a hospital delivery. Once born, children are placed at high risk of disease due to lack of vaccination (a survey done last year among rubber plantation and construction site workers found that 80% of children were not adequately vaccinated).

To be eligible for health insurance, migrants workers first have to be registered. This is often not possible for a number of reasons. First, the conditions of registration change almost every year, creating a climate of constant confusion.

A second issue is the cost. In order to obtain a health insurance card migrant workers must first obtain a temporary work permit and a temporary ID card. The total cost for all three cards is around 4,000 baht -- around a month's wages which, on top of debts incurred to travel to Thailand, is unaffordable for most.

Third, some important conditions are excluded from the health scheme for migrants. For example, anti-retroviral therapy is not provided even though the vulnerability of female migrant workers places them at high risk of contracting HIV.

Finally, newcomers and their followers are currently unable to register because the registration process has been closed since March 2006. We know of several migrant women who arrived in the last six months and are currently pregnant. They are unable to register but are also unable to pay the hospital fees when it comes time to give birth. Newly arrived migrants who fall ill today are supposed to wait months before their eligibility for registration access to health care will be considered, according to a system which remains unclear.

There are many issues that need to be addressed to improve protection and reduce vulnerability among migrants. There is a simple way for the Thai government to demonstrate its serious commitment to this important issue: simplify the registration process, open it up for all migrants, and reduce the cost. This will do much to improve the health of migrant women, and men, who are contributing so much to Thailand's economy and society.

Paul Cawthorne is the country director and David Wilson is the medical co-ordinator for Medecins Sans Frontieres.

Adapted from: ‘A chance for Thailand to show leadership.’ Bangkok Post. 7 November 2006.