On the day before his departure, Mohammed Dulal Harunur Rashid brought a little self-made poster to Transient Workers Count Too’s office. It said “I and my family never forget TWC.TOO . . .  Long live TWC.TOO. Every social worker and associate.” It was one of those touching moments when everything we did seemed worthwhile.

It had not been easy. The issues presented by Dulal’s case were unusual, and even now at the time of writing, the final resolution is not entirely clear.

Having completed a two-year working stint in Singapore, Dulal, 27, arrived in Singapore September 2011 for a second contract with a company named Green Ocean. In February 2012, he hurt his back and was placed on sick leave. This injury did not turn out to be too serious and he eventually recovered. Nonetheless, treatment, review and assessment took several months, during which he was placed on a Special Pass, to permit him to stay on in Singapore.

However, within a week or so after the injury, he complained of pain in his loins. Alexandra Hospital did a blood test after which he was referred to National University Hospital (NUH). The diagnosis came back: Chronic hepatitis C.

TWC2 volunteer Christine Hart took a special interest in his case. She went back and forth between the hospital, the patient and TWC2, to get the facts and assess the need.

Dr. Low How Cheng from NUH wrote: “It will benefit this patient to receive treatment for hepatitis C as this will retard the progression of hepatitis C (liver fibrosis which will lead to liver cirrhosis and increased risk of decompensated and liver cancer).” He advised that treatment with pegylated interferon and robavirin (the standard treatment) should commence immediately.

The problem was the cost. Another letter from Dr. Bhavesh Kishor Doshi from NUH stated: “This patient will need 6 months of therapy (as a minimum) for his hep C. The estimated cost is $15,000.”

So here was a worker who was required to stay on in Singapore for treatment of a work-related injury, now finding himself with hepatitis that needed expensive treatment. And it had to start immediately. Who was responsible for the cost? The question was posed to the Ministry of Manpower (MOM) but they needed more information. However, they said that if the employer didn’t provide the required treatment, TWC2 could “highlight the case to us [MOM] for our assessment.”

The doctors’ advice being that delay would substantially jeopardise Dulal’s chances,  TWC2 decided to step in to get the treatment started while this question was sorted out. We were able to do so through our Care Fund, for which the largest donor is Kwan Im Thong Hood Cho Temple. TWC2 expects to be reimbursed this amount by Dulal’s employer, Green Ocean, in due course.

 

Weekly injections

Dulal went for his first of 24 weekly injections starting 24 May 2012. He was told that it was very important not to miss a week. Each injection cost over $500.

By August, the file on the back injury was closed. He was assessed not to have suffered any permanent incapacity. By mid-September, MOM notified him that he was to be repatriated within a few days; they would not further extend his Special Pass. From MOM’s perspective, they saw no reason for him to remain in Singapore.

But what about his hepatitis treatment? Doctors had clearly said it should not be disrupted.

Appeals to MOM were fruitless. They would not be moved, but they said they would put in a good word with the Immigration and Customs Authority to help him get an ICA Special Pass. This resulted in a further two weeks’ extension, but the ICA too said no further extension was possible.

Those were two hectic weeks. TWC2, through contacts in Bangladesh, managed to ascertain that the same treatment was available at a top-notch hospital in Dhaka, and also got an estimate of the cost there. Then our social worker Raymond Ang, had to make several visits to Dulal’s NUH doctor to get all his documentation together so that the needed information about his medical history and treatment to date could be comprehensively relayed to Dhaka. TWC2 gave Dulal $3,000 so that he could afford the treatment there as well as find some place to stay in Dhaka — which is not where his family is — while completing the treatment.

Dulal flew home on the evening of 12 October 2012 with three more injections to go.

A week later, Dulal called Raymond from Dhaka to report that he had successfully gotten his first of the remaining jabs. The transfer of the medical files had gone smoothly. He also called Debbie Fordyce, the head of TWC2’s Direct Services Subcommittee and asked her to relay his thanks to Christine Hart. He sounded happy.

Now all we have to do is to get Green Ocean to pay up.