Measures to Contain
In the current context of the global economy, migrant workers are playing a significant role in strengthening the country’s economy. Bangladesh has a of note contribution to the global Labour market. The remittances sent by around one and a half crore migrant workers in more than 174 countries of the world are enriching the country’s foreign exchange reserves and contributing directly to the GDP growth of 12 per cent. In 2021 alone, migrant workers sent remittances of Tk 189 thousand 367 crores. Saudi Arabia, the United States, Kuwait and the United Arab Emirates are the top four countries in terms of remittances respectively.
Bangladeshi migrant workers in the Middle East are principally employed in hospitals, garment industries, factories, construction works, offices, agricultural farms, markets, restaurants, domestic activities etc. There are multifaceted healthrisks in Gulf countries including adverse weather and high temperatures, consumption of high fat and processed foods, lack of opportunities for physical exercise and sports, sandstorms, various allergies and variations in humidity levels, differences in working environment and attitude of authorities and being away from family for a long time etc.In a research amongst the migrant workers in Kuwait, following ten diseases have been revealed more common among others. These are peptic ulcer disease (PUD), inflammation/infection of the lungs and airways, muscle, bone and joint pain, hypertension, diabetes, dental diseases, skin problems, kidney disease, road traffic accident and heart diseases.
In the Middle East, summer season is longer that stays more or less for 7 months. During summer, the rate of heat stroke and heat exhaustion problems is high. A research article published in Kuwait’s “The Times” reveals that the death rate from heart disease is 4 times higher than other seasons. This period is dangerous for kidney patients.
A 6-year study amongst the expatriates in Middle East countries found high levels of fat, high blood pressure, smoking, diabetes and stress, physical inactivity, obesity and smoking to be responsible for the risk of heart disease among them. Migrant workers are also engaged in various types of unsanitary, dirty and dangerous work. As they have to work in hot, humid and unhygienic environment of households, restaurants, factories; there are reports of many people suffering from diarrhoea, tuberculosis, skin diseases, jaundice and other infectious diseases.
Animal farm workers suffer from tuberculosis, various eye diseases and chronic pain and inflammation in muscles and joints. Workers in mines and other factories are found suffering from diseases such as reduced lung function, high blood pressure, diabetes, cancer etc. Restaurant and food preparation workers suffer from infectious diseases in various organs including esophagus, digestive system and liver.
The Middle East accounts for the majority of the 2,000 million tons of dust thrown into the air each year. According to the World Meteorological Organisation, desert storms are one of the leading causes of health loss for workers, the young and the elderly in these regions. Asthma, pneumonia, bronchitis, emphysema, allergy, silicosis, COPD etc. are caused by infection in the respiratory system. Ischemic heart disease (IHD), brain hemorrhage and high blood pressure can also cause these dusts.
Besides, it plays a role in the infection of various diseases of meningitis, eyes and skin. According to 39 different studies conducted under the World Health Organisation, the number of patients and deaths due to heart disease and cerebrovascular disease increases significantly during and after dust storms. During this time, the number of patients with cardiovascular diseases in the hospital increased by 67 per cent, IHD patients by 35 per cent, cerebrovascular diseases by 20 per cent and the number of respiratory system patients by COPD by 20 per cent. Mortality from respiratory tract infections and meningitis increases manifold during desert storms.
Migrant workers suffer from various social inconsistencies, discrimination and unfamiliar environment leading to increased physical and mental illness.Most are found sick with excessive physical hardships; still, they need to withstand these hidingall kind of ailments. Most of the labourers have to stay in uncomfortable conditions in unsecured and unhealthy corridors, store rooms or shacks.
Many suffer mental breakdowns due to various forms of mental disorders including depression and schizophrenia. Even cases of suicide are recorded to occur. Prolonged separation from family, deprivation of social and family affection, loneliness, work related matters, health related problems, conjugal life problems, parenting problems, financial constraints, limited recreational facilities, excessive use of social media, use of dangerous equipment, loss of close relatives are among the more common causes of their mental ailments.
Workers despite illness due to various policies or lack of access to medical facilities or insurance are deprived of medical facilities in many instances. In many cases, even if they can go to the hospital, they do not get the proper treatment because of language problems or incompetence.
Many a times the expats are found to hide physical illness for fear of financial deprivation; which later turns into a worse situation. Traveling illegally or holding illegal visa, passports or having no legal work permits, residency etc.are more pronounced. They also face bitter experiences in medical examination for fitness while traveling abroad; many times, medical test results are falsified, fit cases are revealed as unfit and vice versa and bribe is a routine issue in these regards.
The death toll of Bangladeshi workers working abroad due to various diseases, injuries, lack of proper treatment is huge. According to the expatriate welfare desk of Hazrat Shahjalal International Airport and various media sources, from January to December 2018, 1008 bodies arrived from Saudi Arabia. A significant number of women workers also admitted to torture during this period. Apart from this, 201 from Kuwait, 228 from United Arab Emirates, 87 from Bahrain, 276 from Oman, 26 from Jordan, 110 from Qatar, 40 from Lebanon have returned home. In addition, 2315 people in 2009, 2299 in 2010, 2225 in 2011, 2383 people in 2012, 2542 in 2013, 2872 in, 2831 in 2015, 2985 in 2016 and 2919 bodies returned to the country in 2017.
According to Bangladesh Institute of Labour Studies (BILS) research on expatriate women workers, 38 per cent of women suffered physical abuse after going abroad, 52 per cent of women workers were forced to work overtime, 61 per cent scarcity of food and water, a significant number of victims of sexual abuse and rape have been reported. Research has revealed that 87 per cent of women workers do not receive proper medical care during expatriation. About 85 per cent of women who have lost their jobs or returned home are depressed, 61 per cent are burdened with debt, 55 per cent suffer from physical and 29 per cent mental illness. Even after returning to the country after being humiliated abroad, women workers are being disrespected by the society and family. As many as 38 per cent of women are considered to be characterless, 33 per cent have been divorced. Expats are not fully informed about health and services before traveling abroad and in many cases, there is no relevant information about their medical care abroad.
The United Nations, World Health Organisation, International Labour Organisation and other concerned Organisations have urged all appertain to come forward to protect the health and dignity of migrant workers. The World Health Organisation has emphasised the importance of ensuring the health care of migrant workers. The International Labour Organisation (ILO) is working to ensure health care for migrant workers in all countries. The International Convention on the Rights of Migrant Workers protects the health of all migrant workers; it has even focused on ensuring basic healthcare for illegal workers. Allhost countries of migrant workers need to come forward to ensure proper Labour health laws. Companies employing workers should increase monitoring of the activities of those involved in the fulfillment of healthcare contracts. It is the responsibility of the owner to provide first aid and healthcare to migrant workers. Employment contracts should specify health insurance, medical benefits, workplace safety, injury and death compensation.
Bangladesh has formulated specific policies and management guidelines in the 7th five-year plan in light of the recommendations of the World Health Organisation to reduce the health risks of migrant workers. With the help of the ILO, a three-year National Strategy has been formulated and implemented to ensure the healthcare of migrant workers. The Migrant Act 2013 and the Migrant Welfare and Employment Act 2016 provide for compensation for injury and death and ensuring safe and dignified work and health care for expats.
The Ministry of Health and Family Welfare is working to ensure proper health check-up of migrants, health insurance, social and health security and maintaining data profiles of returning migrant workers on health issues. It should ensure the implementation of all migrant Labour laws with priority to the health protection of migrants. Autonomous health departments may be established to provide health care to migrant workers at different stages of their migration.Concerned NGOs, electronic, print and social media should come forward to play an effective role in implementing the issues and making all concerned aware. The society and family of migrant workers must play a role in their physical and mental well-being. Provisioning them the due dignity, respect and reverence is the esteemed responsibility of the family and society. Migrant workers are playing a valiant role in bringing the social and family well-being and making state’s economy strong.
Bangladesh has judiciously formed a separate ministry long ago and taking various initiatives in this regard. All stakeholders those concerned with ensuring the healthcare of migrant workers should come forward to fulfill their respective responsibilities properly. Also, as part of the family and society, we should always stand by their side.