There is nothing more heartbreaking than learning that one has contracted the HIV virus and that seeking medication would mean losing one's only means of survival.
This tragic plight is faced by many migrant workers, some of whom reveal their ordeal to The Nation's Thanapat Kitjakosol.
Even though Thai law requires that all employers provide their workers with social-welfare benefits, only a third of the estimated one million migrant workers in the country are entitled to this privilege because many company owners prefer not to pay the required fees.
And what makes matters even worse is that some hospitals leak the names of workers found to be HIV-positive, and more often than not, these workers are sacked. Of the 261,040 registered migrant workers in Samut Sakhon, only 22,000 were found to have social security, which grants them access to anti-retroviral drugs, while 138,636 only hold health insurance cards that do not cover HIV treatment.
Ye (not her real name), a 42-year-old Myanmar worker, contracted the virus a decade ago from her husband, who died seven years ago. The couple had been sneaking in and out of Thailand looking for jobs since Ye was 17, when agents only charged Bt900 for a job, which now costs Bt15,000.
Luckily, her two sons work in Samut Sakhon's Mahachai district and they are helping her cover the Bt1,500 per month needed to cover her medication.
"Without the medication, I would have been dead a long time ago due to complications such as diarrhoea, tuberculosis and bad stomach pain," she said.
Being jobless, Ye has neither health insurance nor social security, but luckily the Rak Thai Foundation got to know about her case and sent her to Samut Sakhon Hospital for treatment.
Panita Thaweelua, from the Anti-retroviral Programme for Alien Workers, said the foundation has enough in donations to provide medical support to 2,000 workers nationwide. However, it can only cover 100 workers in Samut Sakhon, where more than 200 alien workers have tested HIV-positive.
"The problem is that factory owners employing 50 to 100 workers choose not to pay the 5-per-cent fee for social welfare, while those employing 3,000 to 5,000 workers allow less than a third of their workers to join social security in order to mislead officials," she said.
Of the 300,000 legal and illegal foreign workers in Samut Sakhon, at least 80 per cent do not have any health insurance or access to social welfare. In most cases, they are forced to borrow huge sums of money to buy drugs or end up having to beg for treatment at hospitals. Many promise to pay their bills in instalments, but very few are able to keep this promise, which leaves hospitals mired in unpaid bills worth millions of baht.
Sirikorn Lertchayothit, coordinator of the Rak Thai Foundation in Samut Sakhon, said that though the law requires that all alien workers be registered with the social security scheme, many are not because the law is not effectively enforced.
"Those who have other illnesses may be treated in hospitals, but it is almost impossible for those with HIV to get any treatment. They have to buy what is available over the counter and eventually die from complications," she said.
Also, many state agencies prefer not to provide anti-retroviral drugs to migrant workers because they believe it would be a waste, especially since many return home, relocate or change their phone number for fear that others, especially their boss, would find out about their infection.
"Some employers are tipped off by hospitals about their workers being HIV-positive, and often the employers terminate their employment," she said.
As per 2011 statistics revealed by the foundation, Samut Sakhon had 223 migrant workers and 3,853 Thai workers found to be HIV-positive, and 910 died from complications.
Adisorn Kerdmongkol, an NGO official, said foreign workers are made to pay Bt1,900 per year in fees for social security, but only one third of them are entitled to the system. About 70 per cent of them have the health insurance card, which costs them an annual fee of Bt600.
"Especially foreigners working in the fishing industry don't have access to HIV treatment. Without effective law enforcement, they will never be able to exercise their right to healthcare under the social security system," he said.