Need paracetamol? Call an ambulance, pay $150

Photo courtesy of Kirsten Han

By TWC2 volunteer Ada C and others, based on telephone interviews in April 2020

Sungei Tengah Lodge , a mega-sized foreign worker dormitory, is located in the west of our island. According to its website, it is “the largest purpose-built dormitory in Singapore”, boasting a density of “25,000 workers all under one roof”. With the Covid-19 “circuit breaker” measures in full swing, places like Sungei Tengah Lodge have become tightly controlled, escape-proof internment camps.

As Ghisao (an alias), a Bangladeshi worker resident in the megadorm, found, it became nearly impossible to even obtain paracetamol.

Ghisao wasn’t ill with Covid-19, but he had sustained a hip injury at his workplace in the middle of March, before the pandemic struck our island in full force and lockdowns instituted. At that point, he was given two days of medical leave and painkillers, but no treatment beyond that. He is unable to lie on his injured side, and the pain is severe enough to keep him awake at night. Yet, with the nation’s focus being directed towards isolating dormitories and suppressing Covid-19 outbreaks amongst Work Pass holders, Ghisao’s hip injury has shrunk in relative urgency to near-invisibility.

Medical attention has been diverted to the virus, while other health-related needs, even essential ones, have been marginalised.

Over in a Tuas dormitory, Parthi (also an alias) has had his eye surgery postponed indefinitely in the circumstances. He had been prescribed anti-bacterial and anti-fungal medication but had no way to seek advice as to whether to continue with the medication, nor could he procure prescription refills.

Then there is Beybul (not his real name) who, having endured many days of stomach upset, found himself unable to get medication to relieve his symptoms.

Where’s the doctor?

Through the first weekend after the “circuit-breaker” measures were imposed (7 April 2020) — effectively a lockdown not only of dorms, but city-wide — there was great confusion as to how to get medical attention for essential, but non-Covid-related needs. Doctors’ appearances in dormitories were, by that point, random and rumour-based. Residents confined in their rooms could only hope to glean patchy information from security guards and sources over the phone. There was no official rota or schedule for makeshift clinic openings.

Faced with a lack of medical personnel on site, the only alternative was to visit a clinic outside of their dormitory. Yet, to do so was equally challenging. In normal circumstances, workers in dormitories were generally advised to call their employers to make arrangements for a trip to a clinic or, if employers did not extend aid, they were to reach out to the dormitory staff for help.  But these were not normal times. Sungei Tengah Lodge and S11 were under quarantine. No one was supposed to sashay out of these dorms.

In Ghisao’s case, his pleas for help in getting paracetamol to ease his hip pain was met with the suggestion from the Sungei Tengah Lodge security guards that they could call an ambulance.  He would have to pay $150 for the ambulance, about a hundred times the cost of an over-the-counter box of paracetamol.

Ghisao reiterated that he just needed medicine for the pain, but the security guards said they didn’t have any medicine and could not arrange any medicine for him.

Day One

He then reached out to another service organisation, an MOM-related one. Through its helpline, Ghisao reached a Bengali speaker and repeated his simple request, only to be told he should “contact your employer” — which Ghisao knew was in no position to help, or wouldn’t be in any mind to help.

Ghisao finally called TWC2 and our volunteers swung into action.

First trying to figure out whether there was any on-site clinic at Sungei Tengah Lodge, TWC2 spoke with three men staying there. Two of the three were not aware of any; the third said he had heard vaguely of a medical facility on the ground floor, but wasn’t sure.

We then called that MOM-related service organisation — the same one Ghisao had called earlier. We reached the same helpline and explained Ghisao’s situation but were told that the worker himself had to call the helpline (even though he already did and didn’t get help). Eventually, the person on the helpline then said maybe they could assist by contacting the dorm.

With this glimmer of hope, Ghisao attempted to call the helpline again, several times through the evening because not all calls were answered. Meanwhile, pain was returning to his hip in the absence of medication. When, in his persistence, he did manage to get through, he was again told that if he felt really unwell he should ask for ambulance and go to the clinic — the same absurd advice he had gotten from the security guard earlier in the day.

Later that night, someone called him — Ghisao wasn’t sure where that call was from, but possibly the MOM-related service organisation — informing him that doctors would be coming to his dorm the next day. He could have a consultation then.

Day Two

Through the morning and early afternoon of the following day, TWC2 kept in touch with Ghisao. As each hour passed, the news was the same: no sign of any doctor or clinic.

TWC2 tried to see if another NGO, Healthserve, could help. We’ve long known that Healthserve has volunteer doctors and they even ran clinics in selected dormitories; so they’re experienced in delivering medical help to dorms. But we were informed that Healthserve has been stunted in their capabilities since the pandemic began. Healthcare professionals have been told to restrict their movement across healthcare premises to avoid cross-contamination, meaning that many were no longer able to volunteer with Healthserve.

By late afternoon of the second day, TWC2 felt that we (or Ghisao) could no longer rely on others. The only way would be if we bought some paracetamol and delivered the boxes to Sungei Tengah Lodge ourselves.

But would we be allowed to do so? A debate broke out amongst our volunteers. We had read that requests from individuals wanting to donate things to workers in dormitories had been turned down;  even employers wanting to send food to their employees were barred. The reason for that might be that it would be a nightmare to set up the logistics of receiving something at the gate and delivering it to the right individuals inside.

Let’s check with the dorm itself, we decided. We called. No answer. We had no assurance that such aid we were going to deliver would be allowed in and passed on.

Parthi received help from TWC2 through a similarly circuitous manner. Attempts to clarify his eye condition with Ng Teng Fong Hospital over the phone had failed due to the huge call volume they were facing in this period. In the end, a photo of his injured eye was sent to a personal contact of a volunteer, an ophthalmologist based in India. That specialist then replied giving a diagnosis and advised that while Parthi did not require continued use of anti-bacterial and anti-fungal drops, he would require clean saline wash and an eye shield to protect the injured eye. We got our supplies through to him in a similar fashion as Ghisao’s painkillers.

Simultaneuously, another TWC2 volunteer contacted Healthserve, a medical NGO, who then traced Parthi’s records and liaised with his employer. The employer then sent a box of “lubricating and rewetting eyedrops” to him the next day.

Beybul was the only one of three cases in this story who finally managed to see a doctor. He was diagnosed with gastritis and given suitable medication.

Questions remain

With the Ministry of Health reportedly deploying eight medical teams to the dormitories this week, the situation looks likely to improve — though it should be borne in mind that there are 43 purpose-built dorms and hundreds of factory-converted dorms, all in either gazetted lock-downs or with equally stringent movement controls. One suspects that the main focus of the medical teams would be to conduct Covid-19 swabs, which leaves the question of whether they are able to meet the basic healthcare needs of the hundreds of thousands of workers confined in these places unanswered.

In Ghisao’s own words, the Ministry of Manpower (MOM) had taken care of “big problems”, but non-Covid-19 problems like his have been lost in the process.