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More and more Cambodian workers are coming to Thailand to look for work and many start families here. Those having children often face discrimination and financial challenges when trying to access health care services.

File photo from ILO Asia-Pacific (CC BY-NC-ND 2.0)

Vat Vanne, who has lived and worked in Thailand for more than nine years, is currently five months pregnant.  A month before she got pregnant, she left her job at a factory in Rayong to look for new work because the factory did not offer overtime. When she became pregnant, factories and other places of employment were unwilling to hire her. 

Because she was carrying a baby, she was turned down and now been unemployed for over six months. Her economic situation has deteriorated to the point where she is unable to afford her child's regular medical check-ups.

Many other expectant mothers face the same problem.  It is particularly tough for illegal workers, who don’t make social security payments and can only access health care services by paying for them.

Unexpected pregnancy, unexpected economic problems

According to a Bangkokmedjournal case study published in 2020, with more than 15,000 Cambodians entering Thailand each year, prenatal and paediatric care has become a significant issue. Due to inadequate treatment, ignorance, and the high risks associated with low-income employment, the number of mothers and newborns admitted as inpatients has risen sharply.

After losing her job, Vanne's family has had to rely on her husband's day labourer wages, which are not enough to cover medical checkups and the cost of delivery.

Since becoming pregnant, it has been difficult to earn money. I have an unplanned child. Now it is difficult. Sometimes, when we do not have the money, we do not go to the hospital,” she said. 

After becoming pregnant, she has only had one health check-up, which cost her more than 2,000 baht.

Vanne is concerned about the cost of her upcoming childbirth.  Her visa is soon expire and she needs to renew it in order to avoid becoming an illegal worker without a social security card and health insurance.

Pich Sreyya, 24, works at a machinery factory at Chonburi. Around a month ago, she gave birth to a child, her second born in Thailand.

When she was three months pregnant, she informed her employer. In response, Cambodian workers in the factory were told that if any more employees became pregnant, they would be fired because the machinery in the factory could affect the health of pregnant workers. The factory did not fire her because she had been working there for more than two years. She was told instead to refrain from doing heavy work and working overtime.

As a registered worker, she does not have any issues with paperwork. However, because she did not know how to use the social security card, she did not access her benefits. Instead, she used her own money to pay for medical checkups until giving birth, exceeding her family's budget.

For her first checkup, she had to pay about 3,200 baht. After that, she spent close to 2,000 baht for each prenatal checkup and about 30,000 baht for her delivery.

Sreyya is on a three-months maternity leave and received a 45-day payment from her employer. She has a social security card and believes that she is entitled to a maternity benefit of 25,000 baht from the Social Security Fund. However, a month has passed and she has not received that money.

According to Loem Sopheap, who works for the Raks Thai Foundation, if the worker is a legal worker and has a social security card, she should be able to take maternity leave for 3 months. During that time, she will receive a lump-sum 45-day payment from the Social Security Officer and the employer. Sopheap said that most workers only receive benefits from social security officers, however.

Currently, Sreyya is facing economic difficulties and is also seeking help. Although her husband was earning a living, it was not enough to support the family so he quit his factory job to work on a construction site for higher daily pay.

Sopheap believes that understanding sexual health and life planning is very important for workers. She regularly visits and educates the families of Cambodian workers in Thailand about sexual health issues, advising them on life planning so they can steer clear of family economic crises.

Loeng Sophon, a Thailand-based program officer for Cambodian labor rights group Central, provides funds to Cambodian women workers who are pregnant in Thailand.

Most of the workers who marry and become pregnant in Thailand are between 18 and 19 years old, she said. They often did not know much about family planning and sexual health. Faced with unplanned pregnancies, some even tried to induce abortion through drinking alcohol.

Sopheap added that during 2019, when the number of Cambodian workers who became pregnant was high, doctors at health centres seemed to discriminate against those who went for prenatal check-ups.

When they saw us going for a pregnancy checkup, the doctor asked us how many children we had, and when he heard that it was the third or fourth child, he asked us, Do you come here (Thailand) to work or give birth?” Some workers have even been forced to do tubal ligation,” says Sopheap. 

This includes Chan Hourn, who has spent more than 20 years living and working in Thailand and is currently employed by Raks Thai Foundation.  She was forced to get a tubal ligation when she got surgery to give birth to her third child. 

When we work (at Rak Thai Foundation), some doctors know us, and there is less discrimination. But when we went to the surgery room, the doctor did not recognise us. When they found out we had a third child, they told us to do tubal ligation. If we did not agree, they would not perform a cesarean section for us,” she said. 

Birth registration challenges, employer's lack of interest

In Thailand, parents must be legally employed in order for their newborn children to get support and access public services. 

Sopheap added that, about three to four years ago, even if the parents lacked proper identification, their children's names were still registered to make birth certificates (as non-Thai nationals) at provincial registration centres. It was also possible to register the children of migrant workers in local households. 

Now, however, the authorities demand that employers appear in person to register the births for their workers' children, even when the parents have all the proper documents. A child's birth certificate can only be obtained by employers, who are often unwilling to go through the process. 

According to Sopheap, this has resulted in workers’ children losing their rights to access public services and protections afforded by the Thai government.

She hopes that if employers learn of these difficulties, they will be more understanding and lend their support to help labourers’ children secure their rights.

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