30 October 2024
CO24168 | Health Security of Low-Wage Migrant Workers Post-COVID-19 Pandemic
SYNOPSIS
The COVID-19 pandemic underscored the importance of addressing the welfare of low-wage migrant workers. This includes improving their working and living conditions, better access to healthcare, and more social interactions with local communities.
COMMENTARY
Along with measures taken to treat COVID-19 as an endemic disease, the Singapore government has made efforts to improve the working and living conditions of low-wage migrant workers, including their access to good healthcare.
The 2023 COVID-19 White Paper identified six areas where Singapore could have done better during the pandemic, such as being prepared and having measures to deal with the outbreak of the disease in the migrant worker dormitories. The White Paper also suggested some areas that needed improvement, including earlier ground surveillance and having more data on the health and housing of migrant workers.
As there is a diversity of migrant workers in Singapore, this commentary will focus specifically on low-wage migrant workers, i.e., those on work permits, who work predominantly in the construction and manufacturing sectors.
Health Security Gaps
A 2020 survey on whether low-wage migrant workers in Singapore are receiving adequate healthcare in public healthcare institutions found that 73 per cent reported not having received any insurance information from their employers.
The survey also found that a large percentage of doctors, 73.1 per cent, encountered situations in which healthcare delivery to migrant workers was compromised, mainly because of financial barriers. Some migrant workers cited financial concerns as a reason for not seeking medical attention and the fear of being repatriated if medical costs piled up.
While employers are mandated to cover the cost of medical treatment for migrant workers holding a Work Permit or S Pass, the survey found that, in practice, migrant workers still faced financial barriers due to the lack of a mechanism for outpatient coverage and the possibility of breaching insurance coverage.
The survey also highlighted a gap in knowledge about medical entitlements among migrant and healthcare workers. This should be addressed so that migrant workers are kept informed about their healthcare entitlements and new government initiatives. Communicating healthcare information to migrant workers in their respective languages is also a good practice that should continue.
New Initiatives Post-COVID-19
In 2021, a new primary care plan for migrant workers was introduced to keep healthcare services such as consultations, treatments, examinations, and telemedicine affordable. In terms of improving affordability and access to healthcare, Singapore’s new primary care plan for migrant workers is a positive step.
The plan includes healthcare services such as medical examination, consultation and treatment, medication delivery and health screening. The cost of options range from S$108 to S$145 per worker annually and can be paid in regular instalments by their employers.
To encourage migrant workers to take ownership of their health, they would need to pay a minimal fee for each visit to a medical centre or a telemedicine session. The Ministry of Manpower (MOM) has also introduced medical insurance enhancements for low-wage migrant workers.
Other new measures for low-wage migrant workers include mandatory hourly breaks of at least five minutes for those working outdoors. Employers who do not adhere to the heat stress measures will be penalised.
As for living conditions, MOM will gradually improve around 1,000 migrant worker dormitories to meet higher standards by 2030 and even higher standards by 2040.
Additionally, newly opened recreation centres will offer migrant workers more enrichment programmes and activities organised by NGOs such as “ItsRainingRaincoats” and “Passion To Serve”.
Social Determinants of Health
Beyond focusing on illness prevention and access to affordable healthcare, it is important to consider the social determinants of health for low-wage migrant workers to ensure their holistic well-being.
These include factors that influence health outcomes, such as the conditions in which people work and live. Other aspects of well-being, such as healthy interpersonal relationships, supportive communities, and satisfaction with life, are also important considerations. More pathways for migrant workers to pick up accredited or certified skills that would benefit their career progression and development should be available.
Policymakers should adopt this perspective when formulating social policies, including in the planning for the living spaces of low-wage migrant workers.
Integration and Community
The COVID-19 pandemic has brought migrant worker issues to the fore and arguably fostered a sense of empathy for migrant workers amongst the local population. Moving forward, policymakers and NGOs can work to create more platforms for engagement and inclusion.
Ground-up initiatives and community programmes, such as the migrant workers’ dragon boat team, migrant writers of Singapore (a platform for migrant workers to engage in literature and the arts), and interactive activities and excursions organised by ItsRainingRaincoats, provide a platform for migrant workers to pursue their interests outside of work.
Religious organisations and NGOs have also endeavoured to engage the migrant worker community. During the COVID-19 pandemic, the Alliance of Guest Workers Outreach (AGWO), led by Pastor Samuel Stephen Gift, was one of the charity organisations that served about 7,000 meals daily to workers quarantined in the dormitories. Since then, the organisation, alongside the Migrant I-Care initiative, has rolled out educational programmes, counselling and advocacy work.
Currently, the Migrant Workers’ Centre, an NGO dedicated to championing fair employment practices and the well-being of migrant workers in Singapore, partners with schools and students to create outreach projects for migrant workers under its social acceptance and integration programmes. More should be done to promote the spirit of volunteerism among students and to encourage them to engage with migrant workers.
Conclusion
Migrant workers are a vital part of the Singapore story. The COVID-19 pandemic served as a springboard to address some of the issues they faced in this crisis of a generation. Moving forward, policies to improve the health security of low-wage migrant workers need to consider the social determinants of their health and well-being. Encouraging stronger social relationships and networks between them and the wider population is integral to fostering a more resilient society.
About the Author
Danielle Lynn Goh is an Associate Research Fellow at the Centre for Non-Traditional Security Studies, S. Rajaratnam School of International Studies (RSIS), Nanyang Technological University (NTU), Singapore.
SYNOPSIS
The COVID-19 pandemic underscored the importance of addressing the welfare of low-wage migrant workers. This includes improving their working and living conditions, better access to healthcare, and more social interactions with local communities.
COMMENTARY
Along with measures taken to treat COVID-19 as an endemic disease, the Singapore government has made efforts to improve the working and living conditions of low-wage migrant workers, including their access to good healthcare.
The 2023 COVID-19 White Paper identified six areas where Singapore could have done better during the pandemic, such as being prepared and having measures to deal with the outbreak of the disease in the migrant worker dormitories. The White Paper also suggested some areas that needed improvement, including earlier ground surveillance and having more data on the health and housing of migrant workers.
As there is a diversity of migrant workers in Singapore, this commentary will focus specifically on low-wage migrant workers, i.e., those on work permits, who work predominantly in the construction and manufacturing sectors.
Health Security Gaps
A 2020 survey on whether low-wage migrant workers in Singapore are receiving adequate healthcare in public healthcare institutions found that 73 per cent reported not having received any insurance information from their employers.
The survey also found that a large percentage of doctors, 73.1 per cent, encountered situations in which healthcare delivery to migrant workers was compromised, mainly because of financial barriers. Some migrant workers cited financial concerns as a reason for not seeking medical attention and the fear of being repatriated if medical costs piled up.
While employers are mandated to cover the cost of medical treatment for migrant workers holding a Work Permit or S Pass, the survey found that, in practice, migrant workers still faced financial barriers due to the lack of a mechanism for outpatient coverage and the possibility of breaching insurance coverage.
The survey also highlighted a gap in knowledge about medical entitlements among migrant and healthcare workers. This should be addressed so that migrant workers are kept informed about their healthcare entitlements and new government initiatives. Communicating healthcare information to migrant workers in their respective languages is also a good practice that should continue.
New Initiatives Post-COVID-19
In 2021, a new primary care plan for migrant workers was introduced to keep healthcare services such as consultations, treatments, examinations, and telemedicine affordable. In terms of improving affordability and access to healthcare, Singapore’s new primary care plan for migrant workers is a positive step.
The plan includes healthcare services such as medical examination, consultation and treatment, medication delivery and health screening. The cost of options range from S$108 to S$145 per worker annually and can be paid in regular instalments by their employers.
To encourage migrant workers to take ownership of their health, they would need to pay a minimal fee for each visit to a medical centre or a telemedicine session. The Ministry of Manpower (MOM) has also introduced medical insurance enhancements for low-wage migrant workers.
Other new measures for low-wage migrant workers include mandatory hourly breaks of at least five minutes for those working outdoors. Employers who do not adhere to the heat stress measures will be penalised.
As for living conditions, MOM will gradually improve around 1,000 migrant worker dormitories to meet higher standards by 2030 and even higher standards by 2040.
Additionally, newly opened recreation centres will offer migrant workers more enrichment programmes and activities organised by NGOs such as “ItsRainingRaincoats” and “Passion To Serve”.
Social Determinants of Health
Beyond focusing on illness prevention and access to affordable healthcare, it is important to consider the social determinants of health for low-wage migrant workers to ensure their holistic well-being.
These include factors that influence health outcomes, such as the conditions in which people work and live. Other aspects of well-being, such as healthy interpersonal relationships, supportive communities, and satisfaction with life, are also important considerations. More pathways for migrant workers to pick up accredited or certified skills that would benefit their career progression and development should be available.
Policymakers should adopt this perspective when formulating social policies, including in the planning for the living spaces of low-wage migrant workers.
Integration and Community
The COVID-19 pandemic has brought migrant worker issues to the fore and arguably fostered a sense of empathy for migrant workers amongst the local population. Moving forward, policymakers and NGOs can work to create more platforms for engagement and inclusion.
Ground-up initiatives and community programmes, such as the migrant workers’ dragon boat team, migrant writers of Singapore (a platform for migrant workers to engage in literature and the arts), and interactive activities and excursions organised by ItsRainingRaincoats, provide a platform for migrant workers to pursue their interests outside of work.
Religious organisations and NGOs have also endeavoured to engage the migrant worker community. During the COVID-19 pandemic, the Alliance of Guest Workers Outreach (AGWO), led by Pastor Samuel Stephen Gift, was one of the charity organisations that served about 7,000 meals daily to workers quarantined in the dormitories. Since then, the organisation, alongside the Migrant I-Care initiative, has rolled out educational programmes, counselling and advocacy work.
Currently, the Migrant Workers’ Centre, an NGO dedicated to championing fair employment practices and the well-being of migrant workers in Singapore, partners with schools and students to create outreach projects for migrant workers under its social acceptance and integration programmes. More should be done to promote the spirit of volunteerism among students and to encourage them to engage with migrant workers.
Conclusion
Migrant workers are a vital part of the Singapore story. The COVID-19 pandemic served as a springboard to address some of the issues they faced in this crisis of a generation. Moving forward, policies to improve the health security of low-wage migrant workers need to consider the social determinants of their health and well-being. Encouraging stronger social relationships and networks between them and the wider population is integral to fostering a more resilient society.
About the Author
Danielle Lynn Goh is an Associate Research Fellow at the Centre for Non-Traditional Security Studies, S. Rajaratnam School of International Studies (RSIS), Nanyang Technological University (NTU), Singapore.
