Dubai: Workers are paying for medical treatment out of their own pockets because the clinics they are insured with are too far from where they live or work, costing them taxi fare and an unpaid work day.
And those are the lucky ones. Most labourers say their companies do not provide them with medical coverage and they cannot afford the expensive clinics in the cities. Either way they must bear the cost.
Identifying this niche market, a chain of private clinics has mushroomed in labour accommodations across the country to offer low cost treatment to these workers.
The New Sanaiya Group of clinics and pharmacies operate in 10 locations in Ajman, Sharjah, and Dubai to treat labourers who live and work nearby.
Gulf News took an exclusive tour of the clinics with Dr Sanjay Paithankar, the man behind the project.
In the treatment room Ram Prashad, 31, lies hooked to an IV at the clinic in the Jurf Industrial area — 15 km from Ajman city. The nearest clinic is nine km away.
He has no medical insurance and his company does not reimburse his medical bills, he says.
A carpenter at a ship spare parts company, Prashad earns Dh900. In his last visit to a clinic in Rolla, he paid one-third of his salary for a consultation, got a two-day salary cut for sick leave, and he is still sick.
He came to the Jurf clinic, after spending Dh800 since April, with a fever.
"The clinic here is not as expensive as outside. I am getting good treatment," he said of the Jurf clinic which sees about 50 patients daily.
Prashad simply cannot afford to get sick: Suffering from heat exhaustion, he spent most of his salary on medical treatment. He has not sent money home for the past two months, leaving his family penniless. Now he borrows money from friends to survive. "I am not able to save anything," he says.
Mohammad Ghose, 25, an AC technician has had enough. Without medical insurance, he was forced to take a Dh60 taxi ride to a distant clinic in Deira, wasted four work hours, and paid the treatment out of his Dh650 salary. His company did not reimburse him.
"I am going home now after three years and Dh5,000 to come here," he said. "I can't save and I can't afford to live."
Consultation fees outside cost about Dh300. Dr Paithankar charges Dh30.
"They feel that even this cost is high for them. They say they can't afford it," he said.
About ten per cent of his daily practice is free, he added.
Prashad is one of the 77 per cent of low-income workers in Dubai who do not have medical insurance, according to the first comprehensive Household Health survey released last month by the Dubai Health Authority in conjunction with the Dubai Statistics Centre. "Unfortunately nobody cares for these people," Dr Paithankar said.
Mandatory health care has not yet been enforced in Dubai, leaving workers such as Prashad in medical limbo.
Less than five per cent of the clinics' patients come from insurance companies, Dr Paithankar said. "People are too lucky if they get reimbursed by the company."
Yet medical insurance companies fail to realise the business potential of this underserved market of uninsured labourers desperate for medical coverage.
And employers do not understand that cutting costs by slashing workers' medical insurance involves an even bigger cost, said Dr Khalid Maniar, managing partner at Horwath Mak, a business consultancy.
"There is a link between happy, healthy workers and productivity," he said. Healthier labourers are physically more fit and better able to withstand the fierce heat and manual nature of their jobs.
Still, the status quo is a win-win situation for the insurance companies and employers, but while the workers suffer the consequences.
"Insurance companies provide insurance with clinics that are too far for the workers and they don't go because of the distance. Insurance companies are happy because there are no claims, employers are happy because they get a low quotation. But the workers pay with their own cash," Dr Paithankar said.
His clinics have teamed up with Global Net, a third party administrator that has a network of about 200 clinics and pharmacies to administer low-cost insurance policies for insurance companies.
The Dh250 million business began six months ago and has since insured 40,000 persons, Dr Paithankar said. So far, 30 companies in various industries have signed up with insurance companies such as Alliance Insurance, Dubai Insurance, Noor Takaful, Dubai National Insurance, and Union Insurance, according to Global Net Chief Operating Officer Dr Mohammad Afzal Anam.
What workers want
The New Sanaiya clinic in Sonapur, Dubai's biggest labour accomodation, treats 100 workers a day.
The accomodation's name means City of Gold in Hindi — an ironic twist on the reality of the sick and poor lining up here.
Mohammad Ali Mohammad, 41, a carpenter with System Construction, sits in the waiting room with a resigned look on his bandaged face. He paid half of his Dh600 monthly salary at a clinic all the way in Rashidiya for a skin infection although he lives in Sonapur.
Mohammad says he wants medical insurance because he can't afford treatment.
"I asked my company to pay and they refused," he said.
At this clinic he paid Dh130 for treatment, including local anesthesia and wound dressing, which would cost up to Dh600 outside, Dr Paithankar said.
A case in point is Shree Nevas. When asked what medical coverage he wanted from his company, he answered blankly: "What is medical insurance?"
The clinic operates on a word of mouth referral as workers recommend the cheap treatment to their friends.
Up to 60 per cent of the patients are here to see the specialist surgeon for work-related injuries and boils, Dr Paithankar said. Sleeping in overcrowded, small rooms when they arise from double-bunkbeds they injure their heads against the ceiling fans.
In the summer about 70 per cent of the cases are heat-related, he says. "From July to September doctors are crying because all the patients have gone abroad. But we have no time to talk. We're very busy with cases from heat exhaustion and heat cramps," Dr Paithankar says.
Other common ailments are blood pressure, diabetes, skin problems and kidney stones. "The government can't provide health services to everyone," Dr Paithankar says.
His solutions?
A public-private partnership in which the private sector sets up clinics near the labourers' work and accommodation to provide affordable treatment in addition to existing government services.
He is also calling for mandatory health care in Dubai to ensure that low-income groups are not exploited or underserved. Abu Dhabi already has the Daman medical insurance system in place. "They are paying through their noses. If the average salary is Dh800 to Dh1,000 and he is paying one fifth of his salary for health, there is nothing left to send home," Dr Paithankar said.
Companies should also provide workers with a safe work environment, hygienic accommodation, clean drinking water, physical and mental rest, and honour the afternoon breaks from noon to 3pm, he said.
The responsibility also partly rests with the workers. Dr Paithankar noted that prevention is cheaper than the cure. He advises them to drink lots of water, take anti-dehydration tablets, and avoid spicy food which leads to stomach problems. "People think the poor don't get sick, but they do," he said.
Do you think it’s about time the authorities improved labourer’s accommodations? Would you support mandatory healthcare for all?
