Arab News Daily
 
JEDDAH, Feb 23: Local media reported recently the case of a foreign woman in her 50s who fell ill while shopping with her daughter in a Makkah mall. They went to the nearest hospital, which was privately owned. The hospital refused to admit the woman because she didn’t have enough money to afford treatment. She died before the Saudi Red Crescent could get her to a public hospital.

“If it’s proved (that the private hospital refused to treat an emergency case due to insufficient funds), the hospital will be punished for lack of cooperation,” Talib Al-Hujaili, assistant director of Health Affairs in Makkah, told the daily Al-Madinah this past week.

The media and officials have not mentioned the nationality of the woman, but they said the case illustrates the problem of expatriates unable to get health care.

Even though a law went into effect last year requiring all foreign workers to have health coverage before their residency permits will be renewed or acquired, many expatriates are still not covered. The number of such workers may decline by next year as all visas, which are good for two years, become renewed. But only time will tell if the law has any effect on insuring the currently uninsured. Without health insurance, expatriates have no access to health care unless their sponsors decide to pay out-of-pocket, which is not a requirement.

Free treatment at public hospitals is off-limits to non-Saudis and private care is costly. If they go to a public hospital, they are expected to pay for the treatment.

Wages of the lowest paid foreign laborers can be as little as SR400 a month. For them private treatment is out of the question. And even workers who are paid closer to the average, private care can be a bite.

“I went to the cheapest dentist and spent SR800,” said Mohi Al-Dein, a Bangladeshi driver. “My salary is less than SR1,200 (monthly).” Al-Dein’s family back home is used to receiving SR1,000 of this salary every month to survive. Thanks to the out-ofpocket dental visit, Al-Dein’s family will not receive the usual remittance.

Al-Dein is just one among many who face cutting wives, parents and children off in the event that need to seek medical treatment.

Usually the jobs with the lowest wages and skills lack health insurance. But these workers are just as likely — if not more likely — to fall ill at one point during their tenure in the Kingdom. “We get very ill, but we fear going to the doctor to avoid paying the expensive bills. Though my employer is generous I cannot ask for a lot. We all have families back home who need the money more so I want to be in good health to be able to support my family,” said Hawwa, an Ethiopian housemaid.

Though housemaids were delighted with the news that their salaries had increased from SR750 to SR1,500 at the beginning of this year, the raises were not applied to all nationalities because it was specific Asian government that instituted the requirements rather than the Saudi Labor Ministry.

The problem of health care seems to take on a class distinction, says Imran A., an Indian mechanical engineer who has a health plan through his employer but is also paid less than his Western colleagues.

“They get paid more, so they can afford the bills,” he said. “I get paid less and my medical insurance is minimal. With my asthma I often need check-ups.” Some workers have suggested that public hospitals provide the same free coverage to anyone living legally in the Kingdom.

“The social benefits go to the Saudis though we work here and sometimes we work even more than the Saudis. We deserve this benefit,” said Aktar, a Pakistani driver and a gardener. Meanwhile, the conflicts between the poor and uninsured and the hospitals that treat (or refuse to treat) them continues. Stories of hospitals refusing to release patients, or even newborns to their parents, appear in the press from time to time.

Most recently, in December a Pakistani man and his Indian wife were not allowed to claim their newborn from Al-Salama until finally a generous donor came forward and settled the bill. Because of the act of charity, the hospital didn’t receive any punitive measures from the authorities for holding a newborn hostage.

The Health Ministry has been clear that this practice is illegal. Nevertheless it often takes the intervention of a charity group, or generous private citizens, to resolve these cases by paying the bills.

Another issue is how illegal residents obtain medical treatment. In December 2005 a high-profile case raised the specter of what to do with illegal residents who face health crises. In that case a pregnant African beggar being turned away from a hospital even though she was dilated with the baby’s head partly breached.

This newspaper contacted the official spokesman at the Ministry of Health Khaled Al-Mirghalani but he did not respond.