The tooth fairy going around in endless circles

He and a co-worker were on ladders tasked with tightening wire mesh to make a fence around a playground, possibly a future basketball court. The two of them were told by their supervisor to make it really tight, which is understandable because balls will in future be hitting the fence with some force.

On that fateful occasion, as they tightened the clamping wire, it broke. The wrench came flying into Ezzin Mollah’s face, impacting his front tooth.

He was sent to a hospital after the accident and that was where his frustrations began. He tells me that “doctor checking and and say that my teeth split half and need to take out.” The doctor then wrote a note and told Ezzin Mollah to send it to his superiors for follow-up.

I ask Ezzin Mollah why the doctor did not extract his tooth right after the consultation. He replies sheepishly, “I don’t know”. No Medical Certificate was issued to him for him to rest and recover after the shock, and he was immediately sent back into work, while waiting for his supervisors to perform the “follow-up”. He tells me that he was assured by his supervisors (also migrant workers, but from India) that he would receive his treatment, but the tooth has yet to be fixed. It is now October, nine months after the accident.

Ezzin Mollah tells me that he does not mind working because he needs the money to survive, but the pain in his tooth, while not persistent, is unbearable and he wishes for it to be extracted and a crown treatment to be done. His supervisors are well aware of his wish.

What happened in the following months was a frustrating cycle: him asking his supervisors the status of the “follow-up”; company sending him back to the hospital for a “follow-up”; his supervisors putting him on a no-pay leave as he did so; and the doctor telling him that his company had to respond to the note in order to proceed. Ezzin Mollah tells me that all he wants is to just get the crown replacement and earn a living. But he is hesitant in sharing with me more details, probably out of fear that he gets implicated in any publicity and is sent back to Bangladesh.

This case sounds like another example of how migrant workers are trapped by bureaucratic processes surrounding healthcare payment systems involving the hospital, the employer, and the employer’s insurer. In particular, the present practice of hospitals seeking Letters of Guarantee from employers is the most common hurdle. Hospitals won’t go ahead with treatment unless an employer presents such a Letter, and employers often use this opportunity to delay or simply refuse. The result is that the worker is denied treatment, or it is delayed, prolonging his suffering.

The simple fact is that employers of Work Permit holders like Ezzin Mollah have to purchase medical insurance and work injury insurance beforehand. So, why are things so difficult?

TWC2 has long argued that Work Permit holders should be issued with personal insurance cards. Hospitals should only need to verify this card before proceeding with treatment for anyone who needs it, and without delay. Involving the employer and asking for Letters of Guarantee, who, for all sorts of reasons, might not want to make a claim on the insurer, only adds inefficiency to the system.

The one in pain is left by the wayside as the system grinds on.

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In late November, a TWC2 volunteer accompanied Ezzin Mollah for his visit to a dental surgeon. The broken tooth was finally extracted. A bill for $228 was given to him for submission to the employer. We don’t know whether the employer has paid it yet.