Inclusion essential to containing the pandemic
The government's inclusive approach in dealing with migrant workers during the Covid-19 pandemic is a step in the right direction. But there is room for improvement.
A recent survey conducted by the International Organization for Migration (IOM) on migrant populations found that most respondents felt they had been generally included in the country's coronavirus health response.
It cannot be underestimated how important the commitment of the government to ensure no one is left out of the Covid-19 response has been in containing the impact of the pandemic on economies, businesses and communities across Thailand.
Migrant workers make up an estimated one in every 10 workers in Thailand and generate up to 6.6% of the kingdom's Gross Domestic Product. This is an enormous contribution to the overall economy. Yet, they are also among the most vulnerable when crises hit -- many migrants are frontline workers, at greater risk of exposure to the virus and face significant barriers in accessing healthcare and social protection.
Recognising that excluding anyone from Covid-19 prevention and treatment puts everyone at risk, the government initiated several measures that have helped the country to weather the worst health effects of the pandemic: a Covid-19 Migrant Hotline to support migrant workers, launched jointly by the Department of Disease Control in collaboration with the World Health Organization (WHO) and NGOs; and public health volunteer programmes with over one million volunteers across the country delivering education, medicines and data to public health authorities, led by the Department of Health Service Support.
These are complemented by efforts across society, including government, private sector, civil society and international organisations to reach migrants with information about Covid-19.
Some still missing out
IOM's research shows that migrants have generally been included in the country's Covid-19 health response. In April, IOM found that over 40% of key informants surveyed indicated that most non-Thai nationals in their communities had trouble accessing face masks -- this figure dropped to 15% by October. Migrants are also receiving information to safeguard their health, with 99% of key informants indicating that Information, Education and Communication (IEC) materials are being distributed in migrant communities.
While migrant workers have the same right to access social security, including health care, many are not covered because of language barriers and challenges in enrolling. Some migrant workers report that while their employers deducted social security contributions from their wages, they later discovered their employer had never registered them in the Fund.
Migrants in informal employment are not eligible to enrol in the Social Security Fund. While they can enrol in the Migrant Health Insurance Scheme, the costs -- which are paid by the worker -- deter many from enrolling.
Parents whose children do not have birth certificates issued in Thailand face challenges in enrolling their children in migrant health insurance. An interpreter at a hospital in Chiang Rai province found that some migrant workers are not aware of or did not buy health insurance for their children.
These barriers leave gaps in universal access to health care. During a community outreach activity conducted on Dec 4, IOM staff met a migrant worker who had recently been employed in the informal sector but had broken his leg in a workplace accident. With no health insurance, no savings and no support from his employer, he has not been able to access treatment. In pain and unable to work, he now also faces financial challenges.
Migrant workers face multiple barriers to accessing health care -- these can stem from policy barriers, but also from language gaps, lack of information, stigma and xenophobia and employer malpractices. Irregular migrants, who frequently avoid accessing services for fear of detention, deportation and other punishments, are particularly at risk.
Learning from the pandemic
This public health crisis has brought new challenges to migration management and has revealed that no one is safe until all of us are safe. Thailand's successes in containing the pandemic shows that including migrants in health responses is critical to a healthy and prosperous society for all.
Thailand has been successful in extending universal health coverage to its citizens and has set the stage for itself as an emerging leader in migrant-inclusive health care systems. In 2020, the government committed to make Thailand a champion country for access to healthcare for migrant communities, as part of the implementation of the Global Compact for Safe, Orderly and Regular Migration.
Continuing and increasing efforts to extend health protections to all migrant populations, empower migrants to protect their own health through targeted and translated information and ensuring that migrants are not left behind when the country begins to roll out Covid-19 vaccines can keep Thailand on track to achieve universal health for all people living in the country.
Géraldine Ansart is the Chief of Mission of the International Organization for Migration (IOM) Mission in Thailand. The article is to mark International Migration Day today.