Accompanying a Migrant Worker to the Hospital

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Accompanying a Migrant Worker to the Hospital
By Denise Goh

                  The first thing anyone would notice about Wang Zhi Guo is his rather animated personality and his loud, distinctive voice, which often announces itself in the corridor before you even see him. One of the younger migrant brothers, Zhi Guo is only 38 years old, and he came to Singapore to work so he could support his elderly parents, wife and 15-year-old son. Unfortunately, his plans to send money home were disrupted when he suffered a workplace injury in March 2017. A pipe dropped onto his hand and broke his right thumb, which affected the functionality of his right hand.

                  However, the doctor at his company clinic did not take his condition seriously, only giving him 2 days of MC and 7 days of light duty. Zhi Guo only discovered how short this duration was when he asked his friend to translate the MC letter for him, which had been written in English and had not been explained to him by the doctor. Worried that this medical treatment was insufficient, Zhi Guo went to a hospital by himself, and his suspicions were confirmed. The doctors at the hospital advised surgery for his thumb, but his boss kept delaying his treatment because he did not want to pay for it. Only one month later did Zhi Guo manage to go for his surgery, and a metal plate had to be grafted onto the bone of his right thumb during the operation.

                  I remember Zhi Guo’s eyes watering a little as he showed us his injured thumb, which bore the remnant red angry lines of stitches from the operation. Upset, he told us, “Now I can’t bend my thumb, and I don’t have strength in my right hand – I can’t even do simple things like unlock a door anymore. My hand is disabled, forever useless! And when your hand is useless, you cannot do anything anymore, especially in my line of work. This disability is for a lifetime.” His voice, though indignant, trembled with emotion.

                  Although Zhi Guo had shared with us his frustrations with the medical system, I did not fully grasp the impact of how lost and helpless migrant workers may feel when navigating a foreign system until Joy, another intern, and I accompanied Zhi Guo to his hospital appointment. Although his appointment was scheduled at 11.45 a.m., Zhi Guo had been waiting there since 9 a.m. When we asked him why he came so early, Zhi Guo insisted, “You don’t understand. This medical appointment is very important to me. The medical assessment determines how much compensation I will eventually get – and right now, I have no money left.” Usually boisterous and lively, he was subdued and quiet, his eyes permanently fixed on the screen of flickering cue numbers.

                  When Zhi Guo’s cue number was finally called, Joy and I followed him into the doctor’s room. The doctor called over another doctor to discuss Zhi Guo’s case. However, despite knowing that Zhi Guo could only speak Chinese, they were talking over him in English, without cueing him in to what they were discussing. Zhi Guo was unusually muted, his eyes darting back and forth anxiously to each doctor as they took turns to speak. Yet, despite his confusion and ill-ease, he did not speak up to clarify. It was discomfiting for me to see such a naturally talkative and spirited migrant brother look so deflated and small in his seat.

                  Straight after the doctor had issued Zhi Guo the requisite medical letters, Zhi Guo opened every envelope. “Please translate this for me,” he said urgently, handing us every letter to translate. At first, we found his anxiety strange, but then we realised it was because of his bad experience with his very first doctor – the company doctor who had not been upfront with him about his medical condition and how many MC days he was given – that Zhi Guo was so wary and cautious to begin with. Even as we headed towards the payment counter, we were surprised by other instances of dismissiveness. Whenever Zhi Guo would ask a non-Chinese nurse for directions in Chinese, the nurse would not even wait for him to finish before saying, “I don’t speak Chinese”, with some even walking away. In these cases, Joy and I were glad to have been there to help Zhi Guo translate his requests to English.

                  Through this experience, I got a small taste of what the migrant brothers meant when they felt powerless in such a foreign system. Clearly, neither the doctors or nurses had expressly intended to make Zhi Guo feel disempowered, but they did not realise how alienating and excluding their actions and the language barrier might be for a patient who couldn’t speak English. This is something I myself would not have realised if I did not have the opportunity to see the whole process from Zhi Guo’s point of view. On top of that, migrant workers also face the added difficulty of sometimes being unconsciously dismissed, given that they are not citizens and therefore are seen to occupy a lower priority in our Singaporean society. It was only by following Zhi Guo to his medical appointment that I began to understand just how easy it is to make someone feel so small.

                  What we think of our migrant brothers is conveyed as much through our small, unconscious gestures as they are through our words and actions. While dismissiveness may be met with wariness, this is not the only possible interaction. In fact, goodwill is often reciprocated with goodwill – and with this, we have the hope of building a more inclusive community.

                  At the end of his medical appointment, Wang Zhi Guo turned to Joy and I. “Thank you very much for coming with me to the hospital,” he said, beaming brightly. Some of his old vigour and cheerfulness returned to his voice. “Next time when I see you in the office, let me thank you by treating the both of you to a meal.”

A Second Home

Our migrant brother, K (name changed), is a regular face at HealthServe. One can often catch him bustling around purposefully at our Desker centre – from manning the coupon collection at our Desker Food Project, to joining our migrant brothers in cooking lunch on Wednesdays for everyone else, and even tidying up and cleaning the centre. Although he appears rather gruff and stern, K’s hearty laughter always brightens up his entire demeanor, naturally eliciting smiles from others.

Behind this sturdy dependability and warm laughter, however, hide a quiet pain. For many years, K has worked in the Singaporean construction industry for twelve years without incident, supporting his family back in Tamil Nadu, India. Unfortunately, the year in which he was ready to retire home for good was the very same year a piece of metal from above slipped while he was working, and injured his right arm.

“My arm was bleeding very much,” K recounts gravely. His emotions show through his usually stoic exterior, and his eyes mist over briefly when he remembers what happened. “But my boss no helping me.” His employer was not interested in helping him through his claims process nor paying for his hospital appointments as was expected of him.

Without a steady income, even paying for simple meals became a huge problem for K – let alone larger, more long-term concerns like paying for his two sons’ education. When he called back to tell his family the news, his wife wept bitterly. “Me too,” he confesses, pointing to his eyes. “My eyes, very wet, although I didn’t cry.”

Struggling with these fears, K chanced upon on HealthServe upon a recommendation by a fellow migrant brother. Since then, he has been leaning on the practical help that HealthServe offers, from lunches at our Desker Food Project, to MRT transportation money, and even free haircuts by our volunteer hairdressers. HealthServe also helped him to arrange his hospital appointments, and advised him on what he should do in his claims process. “HealthServe not just help me, but help my family also,” K shares with us. When his income completely dried up and his family was desperately in need of financial support, HealthServe was able to tap into our emergency fund and give him $300 to send home for his family.

More than that, however, HealthServe has become like a second home for him. He enjoys the conversations he has with the HealthServe staff and volunteers, and the different outings and activities. His face brightens up when recalling a recent outing to Gardens by the Bay. He remembers ambling along the beds of delicate flowers in the Flower Dome, snapping pictures and appreciating the view of the bay outside. “I look at the flowers, and I feel changed, I become happier,” he says. “Without HealthServe, I wouldn’t have been able to go to these places.”

Without K, HealthServe would be all the poorer, too. Despite the flexible and malleable structure of HealthServe, one familiar sight that approaches regularity is K appearing at the Desker centre office, cheerfully waving and greeting everyone in the morning before he heads off to the Food Project. After lunch, he would look around to see if there are any needs that the HealthServe office has, and quietly goes over to fill the gap. It is not uncommon to see him voluntarily washing off the bits of leftover rice stuck at the bottom of the gigantic Food Project rice pot, or sweeping the floor and clearing the bin out of his own initiative.

“I’m very happy to meet HealthServe brothers and sisters,” K says, gesturing to the HealthServe staff and interns, as well as the other migrant brothers. “And I want to bring other injured brothers to HealthServe, so that they can get help.” Truly, K embodies the spirit of HealthServe – the spirit of receiving and giving in turn.

Reflections of a Casework Intern

According to a 2015 survey conducted by the Singapore Management University (SMU), over 60% of low-skilled migrant workers in Singapore are “likely to be suffering from serious psychological distress” as they wait for their salary or injury claims to be resolved. Facing great financial stress, some of them may lapse back into behaviours like spitting or smoking, which results in a fine when caught.

One recent case is that of Mr Hossen’s* (not his real name); he was fined $300 for spitting the betel leaf (that he had finished chewing) into a drain. This compounded his current financial troubles brought about by a workplace incident. In January 2016, he was using a power tool at work when a part of it dislodged and hit him above the eye through a gap in his safety goggles. His left eye vision has since deteriorated and become very blurry. He persisted working until November last year when his employer decided that he was unfit for work and wanted to send him home. Hence, he has not been working and receiving any income for about 5 months. Presently, he is still undergoing treatment, and the treatment costs impose a greater financial burden on him. Back at home, his parents, wife and young child are relying on him for financial support and he worries about how he is to provide for them. Like Mr Hossen, many other injured workers face similar financial predicaments. Due to the norms that they are accustomed to back in their homeland, and the enormous pressure they face, some of them may unthinkingly commit an offence like littering or spitting.

As a casework intern with HealthServe, I never thought I’d have to fill up an NEA appeal form for a fine waiver, much less do it for a migrant worker. Prior to this, I wasn’t even aware that one could appeal against a fine! Initially, I was rather sceptical of my ability to assist him, as I was new to writing appeals. I was therefore thrilled to receive an email from NEA a week later, informing me that they had withdrawn the notice to attend court (NTAC) issued for Mr Hossen’s spitting offence and waived the fine. It was really heartening to see the look of elation and relief that crossed Mr Hossen’s face when I told him that his appeal was successful. Witnessing how I could, in my own small way, make a tangible difference to Mr Hossen’s financial circumstances reaffirmed my decision to intern with HealthServe. I am grateful for the opportunities I have had thus far to interact with the migrant workers and be engaged in such important and meaningful work.

Stuck in Limbo

Injured at the worksite, given no MC, employer refuses to pay for medical treatment, beat up by hired gangsters and forcefully repatriated. Unfortunately this is a common story we hear time and time again from migrant workers.

Uddin (name changed) is a 27 year-old Bangladeshi construction worker who has worked in Singapore for 6 years. Last year, Uddin was working at a construction site when he fell backwards and injured his spine, back, and shoulder. Although he had severe back pain, his employer only brought him to a private clinic the next day and, like many injured workers, he wasn’t issued any MC despite his injuries. The doctor suggested that Uddin get an MRI if his pain did not subside but despite his pain persisting his employer refused to pay for an MRI.

Deciding to take matters into his own hands, Uddin went to Tan Tock Seng Hospital, paid for an x-ray out of his own pocket and was given 2 months of MC. Uddin’s employer was unhappy when he found out that Uddin had been given MCs without his knowledge, and as a result cancelled his work permit.

Uddin’s employer hired gangsters to bring him to an office where the supervisor locked him in a room and beat him up. The same day they brought him to the airport and watched him until he went through immigration. For many foreign workers, this is the end of the story. Thankfully for Uddin, he knew his rights and approached an ICA officer, showing him the injuries that he had sustained and explaining that he was being forcefully repatriated. The officer issued Uddin a Special Pass and sent him to MOM to report his injury and file a police report.

Uddin approached HealthServe for assistance with his case and social assistance, as he was paying for his accommodation himself and wasn’t being paid any wages. HealthServe was able to mediate with MOM and Uddin’s employer to set up an emergency meeting between the three parties. Uddin’s employer eventually issued him a Letter of Guarantee (guaranteeing that the employer would pay for an MRI). Yet this story still has no ending. It has been over a year since Uddin’s injury yet there has been no resolution for him. He is owed MC wages, has an outstanding police report, and is waiting for an MRI to assess his medical condition.

Like many injured workers, Uddin is in limbo. He is unable to return to Bangladesh until these items are resolved. In the meantime, he reads books, converses with friends, and walks around.

By Jane Zhang

HealthServe was recently featured in a new book written by Joachim Sim, entitled "Giving Time and Treasure: Celebrating Singapore Volunteerism and Philanthropy."

Synopsis: Amid many paradoxes of today, there are many individuals and organisations that are making it a priority to give their time and treasure through volunteering work and philanthropic contributions to help the less fortunate in our community. This book features some of the recipients of the President's Volunteerism & Philanthropy Awards in 2014 and 2015, and aims to celebrate and inspire giving that is impactful and sustainable. These outstanding givers share a common sense of humanity and a spirit of care for those in need.

By documenting their achievements and propagating the idea of giving, it is hoped that this publication will encourage more Singaporeans to choose to start their giving journeys for a good cause.

Access the e-book here. HealthServe is featured on pages 89-106.