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MOM's Response to a Facebook Post by Ms Kokila Annamalai

In a Facebook post on 17 May, Ms Kokila Annamalai (“Kokila”) claimed that migrant workers were not provided with adequate access to medical care. In the post, she described the experience of an unnamed worker without specifying where he lived. Kokila’s allegations are untrue.

Claim 1: Workers continue to face difficulty in getting access to crucial medication or medical care for new and chronic issues. 

Fact: 

The Inter-agency Task Force (ITF) has put in place a robust medical support plan to ensure that migrant workers across all housing types have access to medical care when needed.
  
As at 31 May 2020, over 53,000 migrant workers had sought medical consultations with the medical teams deployed at all the dormitories. These consultations covered a wide range of conditions, both acute and chronic. Medications were prescribed and couriered to the dormitories where necessary. In most cases, workers received their prescribed medication within two hours of consultation.

The ITF has deployed on-site medical facilities at all 43 purpose-built dormitories and eight sectoral medical posts that serve workers residing in factory-converted dormitories (FCDs). 11 mobile medical and nursing teams systemically screen and provide medical care for workers in FCDs and construction temporary quarters. Dormitories are also matched to nearby Public Health Preparedness Clinics (PHPCs). 

Free shuttle services are provided on an on-call basis for workers to visit the medical posts and PHPCs. In addition, workers continue to have access to medical care during non-office hours through the use of technology. Telemedicine consultations are available to workers using tele-kiosks or their personal mobile phones.

FAST teams deployed to the dormitories and dormitory operators have consistently encouraged and reminded all workers to seek medical help promptly if they feel unwell, even for those with mild symptoms. 

Should the medical teams assess that a worker’s chronic condition cannot be managed on-site, the worker will be referred to hospital. Where necessary, emergency ambulances have been activated for workers.

Claim 2: Case of a worker who could not get hypertension medication in time and experienced a significant lag in getting to a hospital. Worker was admitted to ICU as a result. 

Fact: 

MOM did not receive any alerts or information from Kokila that would have allowed for quick follow-up. Instead, valuable time and manpower resources had to be diverted to trace the incident. Based on the case description and records of interactions with NGOs, we have traced the incident to a case that MOM was alerted to on 14 May 2020. Our investigations reveal a different picture than the dire situation Kokila painted.

The worker lived in a purpose-built dormitory with about 5,000 residents. A medical post has been deployed at the dorm since 7 April 2020. Its operating hours are between 8am to 11am daily, but may end its operations earlier if there are no more workers requiring consultation. However, the dormitory will make a last call to its residents via its PA system and over WhatsApp to alert those who may need medical attention, before the medical post closes for the day. Workers who require medical care after the medical post closes can arrange for a teleconsultation. Alternatively, an ambulance will be activated to convey the worker to a hospital if they wish to consult a doctor in person – an option that is made known to all workers.

The worker’s hypertension medication ran out on 4 May 2020 but he did not visit the medical post. He reported sick on 5 May 2020 for an itch, for which he was prescribed allergy medication. Our records showed that during the consultation, he did not raise to the doctors that he had hypertension nor that he required a top-up of hypertension medication.

On 14 May 2020, the worker wanted to report sick at the medical post at about 9.30am in the morning, but was informed by a security officer that the medical post had ceased operations for the day. Twenty-two workers reported sick that morning and they had all been served by 9.15am. The worker did not indicate that he required urgent medical attention. 
On the same day around 2.30pm, MOM was alerted to this worker’s case by the Migrant Workers’ Centre. The FAST team and dormitory manager went to check on the worker carried out a pulse oximeter test for him and found his readings to be in the normal range. The dormitory manager also advised the worker not to fast if he was unwell and passed him a packed meal for immediate consumption. 

During the visit by the FAST team and dormitory manager, the worker received a call from a doctor who was following up with him on his request for a teleconsultation. The worker told the doctor that he did not feel any pain or tightness in his chest and did not have any problems breathing. The doctor prescribed hypertension medicine for the worker and arranged for it to be delivered to him by that evening. The doctor also advised him not to skip medication even if fasting, and to seek early medical attention if unwell or if his medication ran out in the future. 

Subsequently at 6.39pm, an ambulance was activated and the worker was conveyed to Ng Teng Fong General Hospital where he was hospitalised from 14 to 16 May 2020.  Contrary to Kokila’s claim, he was not admitted to the ICU at any point. Upon discharge, the worker was moved to alternative housing. 

The worker was provided with timely medical attention and treatment. The worker’s dormitory also broadcasted daily announcements and sent WhatsApp messages to group chats with residents to remind them to report sick if they were unwell or had chronic conditions, such as hypertension. 

Claim 3: Migrant worker deaths that were not attributed to COVID-19 could have been caused by delayed medical care for chronic conditions. 

Fact: 

In her FB post, Ms Annamalai alleged that migrant worker deaths could have been caused by delayed medical care for chronic conditions. Her main contention was based largely on her account in Claim 2. But that has been shown to be misleading. 

The Ministry of Health has established criteria for attributing deaths to Covid-19.  Where the criteria is met, they have even done so for patients who have recovered but died subsequently, and those who tested positive only after they had passed on.  

The ITF remains committed to take care of the well-being of our migrant workers. This includes the medical care, availability of food, maintenance of hygiene and remittance needs. We will continue to provide comprehensive support for the migrant worker population to the best of our abilities.  We are grateful to the countless volunteers and NGOs that have highlighted issues of concern for timely follow-up.  Members of the public may also alert us through mom_qops@mom.gov.sg.