57% returnee migrants burdened with loans for medical care denied abroad: Study

Highlights:

• Study conducted on 1,096 returnees from seven migrant-heavy districts
• 76% of returnee migrants managed migration cost from loans 
• 55% of returnee migrants engaged in domestic work
• Respondents migrated spending an average Tk4.60 lakh

Around 57% of returnee Bangladeshi migrants have taken loans averaging Tk90,000 for medical care that was denied to them while working abroad, a recent study by the Ovibashi Karmi Unnayan Program (Okup) has found.

These unexpected costs add to the already significant Tk4-6 lakh migration expense, a financial burden previously unaccounted for in migration cost analyses, as per the study titled "The Hidden Cost of Migration".

The study, unveiled today at a city hotel, highlighted the significant yet overlooked costs of medical treatment for returnee migrants.

According to the findings, only 30% of migrant workers managed to access medical treatment for various health issues in their host countries. The remaining 70%, often dealing with hazardous work environments, poor accommodations, and lack of healthcare access, were forced to return home due to physical and mental health complications.

Of the returnees, 57% resorted to borrowing an average of Tk90,000 for domestic medical treatments as they had no alternatives.

Unseen struggles of migrant workers

While the study was being conducted, a 33-year-old returnee migrant, who worked in Saudi Arabia in 2019, shared his ordeal with the researchers.

He said, "I was given cleaning work at a restaurant where I worked for 12-13 hours daily with no leave at all. I was allocated a small room to share with six others and the food they gave me was unhygienic.

"After passing around 15 months, I started feeling pain in my anal area. As the pain became unbearable, I told my employer to take me to a doctor, but he didn't care."

When his condition deteriorated, forcing him to stop work, he visited a doctor at his own cost who suggested a surgery. He then requested his employer, but he refused to pay. 

"Later, I spent Tk80,000 from my pocket for treatment. Though I felt cured for several months, I was not. I had to return in July 2023 with that complication. Soon, I was diagnosed with colon cancer," he told the researchers.

According to the study, hazardous and poor working conditions, including excessive heat exposure, poor accommodations, unhygienic food, abuse and exploitation, forced labour against will, and lack of mechanisms to file and address complaints, are some of the reasons behind severe mental and physical complications among workers.

Among these returnees, physical health problems afflicted 48%, while the rest struggled with mental health issues.

During the event, Dr Mohammad Mainul Islam, professor of population science at Dhaka University, said, "From my independent research, I have found that undocumented migrant workers are unable to claim healthcare services. Additionally, many are unable to access healthcare due to language and cultural barriers."

He emphasised the importance of providing workers with prior training on the language and culture of their destination countries.

The study surveyed 1,096 returnees from seven migrant-heavy districts – Cumilla, Dhaka, Faridpur, Narsingdi, Narayanganj, Manikganj, and Munshiganj –  between 2021 and 2023, all of whom received health and mental support from Okup during this period. 

Among the respondents, 39% were male and 61% female.

According to the study, 76% of migrants covered their migration costs through loans, while 15% relied on savings, 7% from selling land, and 3% from other sources. The study further revealed that 55% of the workers were engaged in domestic work, followed by 25% in construction, 8% as cleaners, 4% in agriculture, and 2% in other sectors.

The most common ailments included back pain, tumours, cardiac and injury-related complications, and other severe conditions such as cancer, kidney, and uterine infections, as per the study.

Employers cut salary for treatment abroad

Among those who managed to get treatment abroad, 90% received employer support, while 10% paid from their own pockets, often relying on loans, as per the study.

However, 27% of workers who received support claimed that the employers deducted the medical expenses from their salaries. 

The 10% who received treatment abroad using their own money, mostly arranged the fund from home by taking loans, the study stated.

Shakirul Islam, chairperson of OKUP, said, "A significant amount of money is remitted out of the country through illegal channels to cover the treatment costs of migrant workers and to pay for the return tickets of those with health complications."

"There is no track and no calculation of this money," he added. 

"Due to the early return of workers with health complications and the deduction of treatment costs from their salaries, Bangladesh loses a substantial amount of remittances every year," Shakirul said, adding, "Loans taken for treatment plunge migrant workers into a debt cycle, creating huge socio-economic burdens for them."

According to the study, the majority (55%) of the returnees were from Saudi Arabia, followed by Oman (10%), Jordan (7%), the UAE (5%), Qatar (4%), and various other countries (19%).

The study also highlighted that Gulf Cooperation Council (GCC) labour laws mandate employers in all states (except Oman) to cover the medical expenses of workers who sustain work-related injuries or illnesses.

The expenses include hospitalisation, medical examinations and tests, radiology, prosthetic devices, and transportation to the treatment centres.

However, the primary challenge lies in the lack of proper monitoring and the absence of mechanisms to hold employers accountable for implementing the law, the study noted.