Tuesday, June 23, 2009
CARAM Asia notes that many in the public and governmental sphere have started to raise questions about the link between foreign workers and the rise of certain diseases. As a regional network that works directly on the issue of health and mobility we would like to clarify our own perspective on these matters based on our own research and to argue why policies such as mandatory testing of migrant workers as a screening mechanism for employment and work permits, does more harm than good in the interest of public health. Furthermore, we would like to remind both the government and the public that unlike nationals, migrant workers are continually denied access to affordable healthcare services and are already subject to increasingly discriminatory measures that exclude them from the workplace.
There are currently around 2.5 million documented migrant workers and a further million undocumented in Malaysia, and despite the fact that many migrants work in dangerous, difficult and demeaning modes of employment, the vast majority continue to be denied access to even the most basic health care services.
At the outset, migrant workers are forced to undergo medical screening before issued with a work permit within the country, and this is often excused in the public sphere as a precondition to fight HIV and other diseases. At the outset, the imposed determination of whether a migrant is HIV positive and using that status to exclude the individual from entry or continued stay may have the perverse effect of creating incentives for those migrants to avoid legal routes of entry and encourage illegal entry or falsification of supporting documents. Furthermore, groups such as the World Health Organisation (WHO) have continually shown that these methods have little success in fighting the spread of the virus, and this reduces the argument to one which signifies HIV as that of a foreign problem.
Despite the fact that the National Strategic Plan on HIV and AIDS (NSP 2006-2010) identified migrant workers as one of the key vulnerable groups who are at risk of infection, CARAM Asia notes with grave concern that there still remains no targeted national programmes and services for HIV prevention for migrant workers within Malaysia.
A person’s HIV status should not be used as an indication of fitness to work and although HIV is a communicable disease, it is only transmitted through specific behaviours. Therefore, education on the prevention of the virus remains the best public health approach in protecting both the public and the migrant, not discrimination and exclusion. Moreover, as a result of the country deporting migrants due to their status, many migrants who fear that they have become infected while in the country, do not access medical channels for fear of deportation, thus having a detrimental effect on both their individual lives and the overall fight against the virus.
The mandatory testing policy used in Malaysia is in direct contradiction to the International Labour Organisation’s Code of Practice on Prevention and Management of HIV/AIDS at the Workplace which states that HIV positive workers have the right to continue working and access to treatment and care as they are able to work.
If the government is concerned over the rise of diseases amongst foreign workers, then it is crucial that they immediately address the health of migrants at all levels of the process including conditions within detention camps. Over the past six years there have been approximately 1,300 custodial deaths of undocumented migrants in Malaysian detention camps, many of which could have been prevented had these people been given access to adequate health services. The recent case of two Burmese who died in Juru detention camp due to Leptospirosis, usually caused by animal waste contaminating water or food, underlines the urgent need to provide health, cleanliness and healthcare to prevent such needless deaths.
Furthermore, in order to prevent the spread of diseases in overcrowded detention centres, there is an urgent need for the government to provide greater oversight mechanisms that would seek to provide accountability of the governing authorities including the immediate disbandment of Ikatan Relawan Rakyat (RELA).
It is in light of all these aforementioned factors that CARAM Asia recommends the following to the government of Malaysia;
Ensure migrant workers have full access to workers medical reports. The withholding of this information is a breach of privacy rights.
Sign and ratify the International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families
The mandatory testing policy is in contradiction to the Code of Practice on Prevention and Management of HIV/AIDS at the Workplace which states that HIV positive workers have the right to continue working and access to treatment and care as they are able to work. The Code of Practice – 2001 is initiated by the Human Resources Ministry.
Harmonise all laws and policies on health testing to ensure that any testing that migrants must undergo adheres to internationally accepted standards that include: informed consent, confidentiality, pre and post-test counselling, and proper referral to treatment, care and support services.
Provide health care information and affordable health care services for unskilled migrant workers to promote good health among this group of low wage workers. The government must ensure that pre and post counselling and prevention information is given in a way that migrants can understand.
Provide oversight mechanisms of accountability that would mean officers and persons responsible for the acts or omissions that resulted in death and suffering should be charged and prosecuted for these crimes.
The Director General of Immigration must remain committed to the departmental pledge that cleanliness and hygiene should be readdressed in detention centres with new measures taken and this must be continually reviewed with its findings made public.
Immediate disbandment of Ikatan Relawan Rakyat (RELA).
