Looming peril of migrant labour
Mon is a seven-year-old Cambodian girl recently admitted to Siriraj Hospital with a brain tumour. Her mother, who is separated and has two other children, works legally in Samut Prakan, where the family lives in a makeshift building adjacent to her construction site. Her daily income is about Bt100, so she was unable to pay for the treatment.
This is just one instance of a health issue that's going to become a major national social burden in the near future. Thailand has since 1996 struggled to manage an influx in illegal labourers from Burma, Laos, and Cambodia. It's estimated that there are two million legal and illegal immigrant workers here today, and most of them are of childbearing age. Many bring children with them or have them on Thai soil. There are no accurate figures on migrant children in the country, but in 2002 some 50,000 babies of migrant workers were delivered in state hospitals. All were denied legal status and did not receive birth certificates as Thai citizens. As a consequence, they have no basic rights, such as health insurance or education. Most immigrants also lack proper health certificates and insurance and have had no check-up before entering the country. Most also remain in hiding for fear of deportation. The result of all this is criminal and health problems, including the introduction of contagious diseases. Some under-controlled communicable diseases may be on the rise again, such as tuberculosis, elephantiasis, malaria, syphilis and Aids. In 2003, Mae Sot hospital alone handled 15,982 foreign patients and had to shoulder Bt16 million in treatment costs. Now the situation is worsening across the country. According to Prof Dr Piyasakol Sakolsatayadorn, dean of Siriraj Hospital's Faculty of Medicine, 39 illegal aliens were treated at Siriraj in the last six months at a cost of about Bt5 million, which will never be reimbursed. In purely humanitarian terms, it's our obligation to treat anyone who is suffering, regardless of the cost, but there is grave concern over the scale of these costs nationwide in coming years. As well, some diseases may become too complicated to handle, and some that have been all but eliminated may reappear. Controlling the influx of illegal immigrants is virtually impossible as long as there is disparity between Thai labour income and that of our neighbouring countries. Thailand's gross domestic product covers about 90 per cent of its citizens' healthcare costs, while in Burma, Laos and Cambodia, that figure drops to just 10 per cent. Prof Piyasakol also points out that the Thai economy shifted from 30-per-cent agricultural in 1970 to 10 per cent in 1999, while industry's share has risen from 25 to 43 per cent and the services sector from 44 to 47 per cent. Our neighbours, of course, remain predominantly farm-based. Meanwhile Thailand's shift to an agro-industrial economy and the potential of its exports to compete globally has led to a labour shortage in some sectors. Migrant labour is a major part of the Thai workforce and will remain a key resource for many years. In 2004 Thailand unveiled an Economic Cooperation Strategy to promote economic stability in Cambodia, Laos, and Burma. It's designed to boost incomes and employment there and thus ease poverty. But such programmes will take some time to bear fruit. For now, Thai authorities and international aid agencies must seriously consider the immigrant issue, especially as it affects social and health costs, and impose national guidelines before the situation gets out of control. Assoc Prof Dr Supakorn Rojananin Deputy Dean of Public Relations and Special Affairs Faculty of Medicine, Siriraj Hospital, Mahidol University
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