Health burden on illegal immigrants, Who will be responsible for reimbursement?

Health burden on illegal immigrants,

 Who will be responsible for reimbursement?


Supakorn Rojananin

Deputy Dean of Public Relations and Special Affairs

Faculty of Medicine Siriraj Hospital, Mahidol University


Mon was a 7 year-old Cambodian child who was recently admitted to Siriraj hospital for having a brain tumor and being treated accordingly. Her mother of 3 children, separated, had working permit for a labor job in Samutprakarn province and was living in a makeshift building adjacent to the construction site. Her daily income varied around 100 baht depending on employment and was not be able to pay for a remedy. What organization is responsible for such a cost?


The above example is only one incidence on health problems that are going to be a national social burden in a near future.


Thailand has managed the employment of illegal immigrant laborers since 1996 to cope with an influx of illegal workers from neighboring countries, such as Myanmar, Laos, and Cambodia. It is estimated that there were 2 millions legal and illegal immigrant workers in Thailand. These young workers are in the reproductive ages. Many bring their children with them or have their offspring in Thai soil.


There are no accurate estimates of migrant children in the country. However, in 2002, there were about 50,000 babies of migrant workers delivered in State hospitals. These children were denied legal existence. They did not receive birth certificate as a Thai citizen. As a consequence, they had no basic right of all entities, such as health insurance, education and whatsoever.


Most immigrants also did not have proper health certificate or check-up before entering the country nor health insurance coverage. Most also remain in hiding for fear of deportation.  This leads to many criminals and health problems, such as the contagious diseases that they brought in. Some under-controlled communicable diseases may be on the rise again, such as tuberculosis, elephantiasis, malaria, syphilis, AIDS, etc.


In 2003, Mae Sot hospital alone treated 15,982 foreign patients and had to shoulder 16 million baht in treatment cost. But at present, the situation is becoming worse nationwide.


According to Professor, Dr. Piyasakol Sakolsatayadorn, Dean of the Faculty of Medicine Siriraj Hospital, there were 39 cases of illegal aliens treated at Siriraj Hospital during last 6 months period costing about 5 million baht un-reimbursement.


For humanitarian basis, it is our obligation to treat all the suffering people. Even this sum of un-reimbursement does not affect our hospital. However, in the near future, it will cost more if we consider as a whole country. Some diseases may also be more complicated to handle and some may recur from extinction.


To control the influx of illegal immigration is quite difficult or impossible so long as the disparity of the country economy between the neighboring countries is still far high. Among Thailand, Myanmar, Cambodia and Laos, our Thai GDP per caput is about nearly covering 90% and the rest 10% are among the three where as Thai population is about half of all four countries together.


Professor Piyasakol also says that the Thai sectoral structure of GDP has also changed from 30% agriculture in 1970 to 10% in 1999, the industrial and services sections rise from 25% to 43% and 44% to 47% respectively. However, the neighboring countries are still mainly agricultural. The shift towards an agro-industrialized country and the potential of competitiveness of Thai exports in the world economy leads to a shortage of labor in some segments. Migrant labor is by no mean a major part of Thai labor force and it will remain a key resource in the economy for many years.


In 2004, Thailand had launched an Economic Cooperation Strategy project to promote economic stability with Cambodia, Laos, and Myanmar to generate more income and employment across the border and try to ease the poverty of the neighboring countries. However, before these projects becomes fruitful, is it about time for the Thai authority or international welfares to seriously consider the immigrant problems especially on the social and health burden for aliens and amend national guideline enforcement before the situation is far beyond the control?