As Covid-19 continues to disrupt the lives of millions of people across the globe, it is clear that this virus has no regard for national boundaries. While vaccine rollouts are bringing back hope through mass inoculation, a large majority of migrant workers around the world are being excluded from national vaccination plans.
Cambodia, Thailand, Laos and Vietnam are now all battling rising Covid-19 outbreaks complicated by porous regional borders and a large population of undocumented migrant workers. Given that reality, Southeast Asian governments must prioritise migrant workers – those who returned home amidst the Covid-19 crisis and those who plan to go back overseas – in their vaccination plans. These governments must be intentional to design vaccination drives with migrant workers, particularly those who are undocumented, in mind.
In a normal year, Cambodia typically sends over a million migrant workers abroad, with approximately 1.8 million Cambodian migrant workers reported to have gone overseas for work in 2018 and 1.2 million in 2019. Since the start of the Covid-19 pandemic, however, we have seen a mass exodus of Cambodian migrant workers coming back from neighbouring countries, especially Thailand. By the end of 2020, more than 122,000 Cambodian migrant workers had returned home from Thailand alone. Among these returnees, some would have chosen to take undocumented routes to avoid detection by the authorities and potential government-mandated quarantine that might follow.
Simultaneously, CENTRAL, a Cambodia-based advocacy group that deals with labour and human rights issues, reported that many Cambodian workers, especially those living close to the border, have been caught attempting irregular crossings back into Thailand as official means have shut. High levels of debt, poverty, and unemployment are considered to be “a lure to return”, forcing workers to risk their safety and sneak across closed borders amid labour shortages in Thailand.
Without proper vaccinations given to these migrant workers in a timely manner, such back and forth border crossings could potentially worsen community outbreaks in both Cambodia and Thailand. Meanwhile, hundreds of thousands of Cambodian migrant workers, especially the undocumented workers, are still stuck in Thailand and in other foreign countries.
Thailand, Malaysia and South Korea, which are the three main destination countries for Cambodian migrant workers, have begun their vaccination rollouts. So far, Thailand and Malaysia have announced that migrant workers will be included in the vaccination plans just like their own nationals.
This should give hope to thousands of Cambodian migrant workers who are still stranded within these two destination countries. That said, no further announcement has been made regarding when these workers will get their vaccinations.
Cambodia’s vaccination plan
Cambodia is one among few other countries to have received free Covid-19 vaccines from China and the COVAX initiative. In early February, the first batch of 600,000 doses of Sinopharm vaccine arrived at Phnom Penh International Airport. Since then, Cambodia has received shipments of the AstraZeneca vaccine and more than 1.5 million doses of Sinovac.
The latest vaccination update released by the Ministry of Health’s official Facebook page as of May 27 showed a total number of more than 2.4 million Cambodians have been vaccinated thus far. This vaccination progress amounts to 24.18% of the initial population of 10 million people over the age of 18 targeted for vaccination.
According to Health Minister Mam Bunheng, the early stages of vaccination rollout are prioritising frontline health workers, those at high risk of Covid-19 exposure or those who are likely to develop serious illness due to Covid-19. Elderly populations and adults with co-morbidities are also among these priority groups.
Other relatively early additions to the list of prioritised groups included garment workers and foreigners who are residing and working in Cambodia. However, returned Cambodian migrant workers and those who attempt to migrate back overseas for work have not been added as a prioritised group yet. This is a mistake.
Migrant workers are among the hardest hit by the pandemic since they have limited access to adequate health care services, employment benefits and sanitary living environments. Existing studies indicate that poor working and living conditions have led to the rapid transmission of Covid-19 among migrant workers.
In Singapore and Malaysia, one study showed how the pandemic has pushed migrant workers to the margins of basic health protection and treatment. A single accommodation can have up to 80 occupants, thus making social distancing almost impossible. Moreover, in Thailand, migrant workers came under fire following the Samut Sakhorn outbreak and therefore became the targets of discrimination, racism and threats from the general public.
Prior to the pandemic, the majority of Cambodian migrant workers were also found to be working and living overseas in cramped and unsanitary accommodation without proper health insurance and access to health care. As the outbreak worsens many have been left out of healthcare plans, while some are potentially scared to seek proper treatment because of their undocumented immigration status. Fear of potential arrest, detention, and deportation have been barriers for many undocumented Cambodian migrant workers in accessing Covid-19 tests, as well as proper medical treatment and of course, vaccination.
In addition, many Cambodian migrant workers also experience difficulty communicating in the language of their host country. High rates of illiteracy coupled with inaccessibility to information may leave them unaware of the precautionary measures they can take, the health risks they may be exposed to, and where they can access proper treatment. An undocumented status may also leave workers vulnerable in the face of working conditions that might put their health at risk.
Without translation efforts at vaccination sites, as well as vaccine information published in various regional languages, undocumented migrants may be unlikely to present themselves for vaccination. This is especially true in the absence of communications and messaging campaigns that promise that immigration status will not be checked at vaccination sites.
These vulnerabilities raise questions as to how effective the inclusion of migrant workers inside national vaccination plans – like in Malaysia and Thailand – will be, both in terms of the commitment from foreign governments to implement migrant vaccination, as well as the determination from migrant workers themselves to get vaccinated. Governments throughout the region must understand and plan around these barriers if they want to build successful vaccination programmes for migrant workers.
Kristin Parco, chief of mission for IOM Cambodia, told the Phnom Penh Post in February that “when it comes to public health, no one is protected unless everyone is protected. It is therefore crucial that governments recognise the public health importance of accounting for all categories of migrants, irrespective of legal status, in Covid-19 national vaccination plans”.
Policies prioritising migrant workers in national vaccination plans regardless of their status are important not only because they reduce discrimination and increase access to healthcare for a marginalised group, but also because it is simple common sense for the wider community in the pandemic era.
Simply put, if we want to fight this pandemic with everything we have, we must take migrants and their health into account.
Thong Sariputta is a Young Research Fellow at Cambodia-based think tank, Future Forum. Her research interests include labour migration, human security, and governance.