The [him] moderator wonders why the military governments of either country could be expected to show leadership on this issue.

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A chance for Thailand to show leadership
Paul Cawthorne and David Wilson
Bangkok Post

This week in Bangkok senior government officials from Southeast Asia will discuss ways to help give better protection for women migrant workers in Asia through the establishment of an international treaty.

Every year, thousands of Burmese migrant workers come to Thailand looking for a better life. They cross the border through a combination of push factors (deteriorating economy, lack of employment, and human rights violations such as forced relocation, forced labour, high taxes) and pull factors (proximity, demand for cheap labour). Approximately 1.1 million Burmese workers are registered with the Thai authorities, but the actual number of migrants is likely to be double that.

One of the most pressing needs for Burmese migrants in Thailand is access to health care. For the last two years Medecins Sans Frontieres has been running health programmes to provide assistance to migrant workers in Phang-nga province. Since the beginning of last year the number of migrants increased in the province due to the increased workforce demands for post-Tsunami reconstruction. The rebuilding of the tourism infrastructure is an effort led largely by the migrant workforce. Currently, there are estimated to be around 50,000 migrant workers in Phang-nga, of which around 17,000 are registered.

Access to health care is frustrated by a number of obstacles. The most common is lack of registration, which prevents access to the Thai health insurance system. Around half of all migrants we see are unregistered and have no health insurance. Without health insurance, treatment costs are prohibitively expensive. We have seen a case of a migrant worker who was admitted to hospital for a stab wound, treated as an emergency case, and charged 50,000 baht. He was subsequently arrested because he could not pay the bill. (The average daily wage of a construction worker is 150 baht.)

For women, lack of access to reproductive health services are contributing to avoidable illness and death. With little or no access to family planning services, unwanted pregnancies are common and with them the risk of unsafe abortions, which can result in haemorrhage and serious infection. Giving birth in a safe hospital environment is virtually impossible for the uninsured, who are charged between 5,000 and 20,000 baht for a hospital delivery. Once born, children are placed at high risk of disease due to lack of vaccination (a survey done last year among rubber plantation and construction site workers found that 80% of children were not adequately vaccinated).

To be eligible for health insurance, migrants workers first have to be registered. This is often not possible for a number of reasons. The employer may be unwilling to support their registration in order to keep within their quota of migrant workers; migrants may leave their initial place of work, willingly or unwillingly _ working conditions are often severe _ and be left without a sponsor; or fear of authority may keep them from making themselves known. But the one of the most important factor keeping migrants from registering is the bureaucracy of the registration process.

First, the conditions of registration change almost every year, creating a climate of constant confusion; the current plan under discussion is to issue migrants with special passports, but this would require them to return to their border country of origin, which many Burmese migrants are unwilling to do.

A second issue is the cost. In order to obtain a health insurance card migrant workers must first obtain a temporary work permit and a temporary ID card. The total cost for all three cards is around 4,000 baht _ around a month's wages which, on top of debts incurred to travel to Thailand, is unaffordable for most. (For those who argue that migrant workers are a drain on the health system, it should be noted that in 2004, health insurance payments contributed 1.06 billion baht to the health system.)

Third, some important conditions are excluded from the health scheme for migrants. For example, anti-retroviral therapy is not provided even though the vulnerability of female migrant workers places them at high risk of contracting HIV.

Finally, newcomers and their followers are currently unable to register because the registration process has been closed since March. We know of several migrant women who arrived in the last six months and are currently pregnant. They are unable to register but are also unable to pay the hospital fees when it comes time to give birth. Newly arrived migrants who fall ill today are supposed to wait months before their eligibility for registration access to health care will be considered, according to a system which remains unclear.

There are many issues that need to be addressed to improve protection and reduce vulnerability among migrants. There is a simple way for the Thai government to demonstrate its serious commitment to this important issue: simplify the registration process, open it up for all migrants, and reduce the cost. This will do much to improve the health of migrant women, and men, who are contributing so much to Thailand's economy and society.

Paul Cawthorne is the country director and David Wilson is the medical co-ordinator for Medecins Sans Frontieres.

http://www.bangkokpost.com/071106_News/07Nov2006_news26.php

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Myanmar opens passport offices in Thai border towns
Agence France Presse
7 November 2006

Yangon: Myanmar's military government has opened three temporary
passport-issuing offices on the Thai-Myanmar border aimed at people hoping
to work in Thailand, state-run media reported Tuesday.

"Temporary passports will be issued in a day for Myanmar citizens who wish
to work in Thailand only," the New Light of Myanmar newspaper said.

The three temporary passport offices were opened simultaneously Monday in
the border towns of Myawady, Kawthoug and Tachilek, the paper reported.

It said up to 30,000 people could apply for the temporary passports, which
would be available for people planning to work in Thailand, and for
Myanmar citizens already in the neighbouring country.

Some 8,961 illegal Myanmar workers based in Bangkok had already sent their
applications for passports to Myanmar's foreign affairs ministry at the
request of the ministry of labour in Thailand, the paper said.

In August this year, Thailand and Myanmar announced they planned to grant
special passports for 10,000 workers in an effort to prevent illegal
migrants flooding into Thailand.

At the time, they said Myanmar workers would need the passports in order
to apply for a visa to work in Thai-land.

Between 500,000 and 600,000 Myanmar workers are registered in Thailand,
while about one million illegal migrants -- 80 percent of them from
Myanmar --  are thought to be in the kingdom.