Migrant workers’ mental health can be addressed by ensuring their access to information and medical care, allowing them to communicate their problems or feedback properly, and get assistance where needed.
This was highlighted by Kokila Annamalai, an activist for migrant worker communities, as she addressed the issue of the gaps in communication and medical care among migrant workers who are being quarantined amid the COVID-19 pandemic.
In a Facebook post on Sunday (17 May), Ms Annamalai revealed that migrant workers staying in dormitories and community recovery facilities continue to face difficulty in getting access to medical care for new and chronic issues, as well as emergencies.
“My concern is that the current channels workers have access to for help are highly insufficient,” she wrote. “From my experience/understanding, how it works now is that workers’ main point of contact for information/support/etc remains dorm management/security.”
For instance, migrant workers were told by the dormitory security that they are not allowed to go outside to get medication, while not being provided with alternative avenues to get the medication they require.
Ms Annamalai claimed that one worker had to ask for a blood pressure medication for three weeks at three different facilities where he was moved to, before the activists could contact someone who can provide the worker the assistance he needed.
Moreover, migrant workers have no direct access to the Forward Assurance and Support Teams (FAST). She explained that when the dormitory management or security is being unsupportive, migrant workers will go to activists or non-government organisations (NGOs) to get support. The information will then be forwarded to the Migrant Workers’ Centre (MWC), who will communicate it to the FAST teams for assistance.
Ms Annamalai described it as a “very roundabout way” of getting help, noting that it may not be effective due to its nature of “a game of Chinese whispers”. The parties involved may not possess all the necessary information, and sometimes the worker’s issue tends to be overlooked or regarded as unimportant.
She shared a story of one migrant worker who could not obtain his blood pressure medication on time. The worker needed to get to the hospital immediately as he was sweating profusely. The activists contacted the FAST teams but to no avail, so the worker resorted to an online doctor. Only after some volunteers have rallied and advocated on his behalf, the worker was sent to the hospital.
“He is now in the ICU. If he had had his BP medication in time, would this have happened?” Ms Annamalai asserted.
One of her biggest worries is the difficulty faced by workers who are not connected to any NGO networks, especially when they get ill and are denied care by those responsible. Migrant workers are not only at risk of contracting the COVID-19 virus but also at risk of not getting medication or medical care on time.
“Many workers haven’t heard of a FAST team. Some don’t even know who is managing their dorms at the moment, and they feel helpless when they have a problem,” she noted.
Migrant workers: The lack of information and uncertainty is “demoralising”
Some migrant workers have been moved from room-to-room or level-to-level within their dormitories without knowing the reasons behind these actions.
Although some of them surmised that it was due to the cleaning activities that are conducted level-by-level, Ms Annamalai claimed that the workers did not get any explanations from the dormitory management for the actions. In fact, they are uncertain of when they will be instructed to move again.
What’s more, migrant workers have indicated that the lack of information and uncertainty is “demoralising”, and asked why no one bothers to explain things to them.
There are also accounts of workers being sent to another place to be quarantined or hospitalized without any prior notice. While the rest of the workers were expected to have more space to practice social distancing in the room, other workers – who they do not know and from other companies – were moved in.
The workers speculated that the actions were taken so that some rooms can be turned into isolation areas, but they still hope that someone would explain to them on the whole agenda.
Ms Annamalai remarked, “Living in such precarity is stressful enough without these unpredictable changes happening regularly without explanation.”
Furthermore, migrant workers reported that there are many empty rooms in their dormitory as some workers have been relocated by their employers early on.
But the empty rooms were not being used, which led to the workers questioning why they are not allowed to take advantage of the empty rooms and space out. Ms Annamalai pointed out that migrant workers only seek for an opportunity to understand the reasoning behind these sudden changes, if there are any.
The language barrier between migrant workers and medical teams
Some doctors have shared how it is not practical to use the translation portals that volunteers have set up within the migrant worker dormitories, said Ms Annamalai.
She stated that the translation portals would be more useful in the hospital setting, where the healthcare workers can interact with their patients at all times. But in migrant worker dormitories, the medical teams will only be around for a couple of hours in the morning and evening.
Moreover, the medical teams have to communicate with migrant workers in English when they are in rushed circumstances. Ms Annamalai claimed that medical teams encountered a language barrier where the workers were unable to explain their health conditions and the medical staff cannot reassure or provide guidance to the workers.
“There are no translators in hospitals or dorms, to my knowledge,” she noted.
Migrant workers often not informed why they were moved out of dorms
There are several reports – from doctors and news reports – about migrant workers being panic when they were sent to the hospital as no one explains to them what is happening and why they are sent there.
“When workers are moved out of their dorms, they are frequently not informed why, or where they are going,” Ms Annamalai said.
She further asserted that migrant workers do not know the symptoms or conditions that will qualify them to be taken to the hospital.
For instance, migrant workers who are aged above 50 have been moved out of the dormitories to be monitored by doctors in healthcare settings. But these workers are confused about whether they were tested positive for the virus which explains why they were moved out from the dormitories.
Ms Annamalai explained that some workers who have a high fever think that they will be taken to the hospital, but that is not the protocol. These workers are worried that they have been forgotten or not getting the care that they need given that no one has communicated the protocol to them.
She reiterated that the workers are often not informed of their COVID-19 test results, which is “utterly unacceptable and leads to a lot of anxiety”.
Following that, Ms Annamalai stated that the migrant workers’ mental health can be addressed if they are provided access to information and medical care, being able to voice their problems or feedback properly, while getting the assistance where needed.
“Being asked to pack up and move immediately without knowing why, or being herded into a van without being told where you’re going, or waking up to new roommates, or waiting around after a COVID-19 test only to never hear back – these are sure to make workers feel demoralised, anxious and utterly disempowered,” she said.
It is unconscionable when a migrant worker who is experiencing distressing physical symptoms and requires medication urgently is being turned away, Ms Annamalai remarked.
She added, “It’s hard not to wonder if any of the deaths so far that were not attributed to COVID-19, could have been caused by a delay in a worker getting the medical care he needed for a chronic condition.”