FEATURE/For unregistered children of migrant workers in Taiwan, health care rights dicey

By Sean Lin, CNA Staff reporter

[Editor's Note: This is part one of a two-part series examining the health and work challenges facing both legal and undocumented migrant workers in Taiwan who are pregnant or raising children, as well as the health issues affecting their children.]

Taiwan has long lauded its protection of human rights and even enshrined the United Nations Convention on the Rights of the Child into law in 2014, but that has been of little help to unaccounted-for migrant workers and their children if they need to see a doctor.

Around 92,000 unaccounted-for migrant workers and 850 children of such workers estimated to be in Taiwan as of March do not have safe or permanent access to health care services.

Many of those workers left exploitative employers, and without a path to have their contracts with those employers revoked and transfer legally to another employer, they resort to opportunities in the informal sector, leaving them in a precarious no man's land.

At the heart of the issue is the fear of getting caught and being deported, which would gravely jeopardize their livelihood and that of their families back home.

Under Taiwanese law, migrant workers who leave their employers are permanently barred from working in the country again.

Living on the edge

Such fears are real for parents like Neri, an absconded migrant worker being sheltered by the Harmony Home Taiwan, a nonprofit organization looking after unregistered migrant babies in Taiwan.

According to Neri, as soon as she checked into a Taichung hospital to give birth to her son, she was reported to the National Immigration Agency (NIA).

"The NIA came to the hospital to pick me and my son up," Neri recalled.

"However, as I had just given birth to a baby, they left me alone for three months, but I didn't want to go back to them [the NIA], so I ran again," she said.

Neri said she never underwent any prenatal tests due to the fear of being reported to and caught by the NIA.

"Medical institutions are not required by law to report unaccounted-for migrant workers and their children," said Wang Guan-ting (王冠婷), a director at Harmony Home Taiwan.

"But in practice, most of them still do, whether out of concern that it would otherwise make it difficult to track their babies' growth or encourage unregistered migrant workers seeking medical help to flock to a certain hospital through word of mouth," Wang said.

Speaking with CNA on May 14, Wang Yu-ling (王幼玲), deputy chairperson of Taiwan's National Human Rights Commission, called on hospitals to prioritize humanitarian care and refrain from reporting unaccounted-for migrant workers requiring medical assistance to deter such patients.

"In a war, if a warrior from an enemy country comes to a hospital to seek medical assistance, you should treat him too," Wang Yu-ling said.

"If all hospitals reported unaccounted-for migrants, they would be forced to buy over-the-counter drugs or seek the help of unlicensed doctors or non-doctors, which would only make matters worse," she said.

Universal rights?

When asked about the Ministry of Health and Welfare's position on unaccounted-for migrant workers seeking medical assistance, Deputy Health Minister Lue Jen-der (呂建德) told CNA that the ministry believes "health rights are universal human rights and do not care whether a patient is a [unaccounted-for] migrant worker."

"We must do our best to treat any ill person to help them recover," Lue said.

The health ministry has initiated talks with the NIA to identify a measure that could balance human rights and the need to crack down on illegal migrant workers, such as not conducting inspections at hospitals, because that would "infringe upon health rights," Lue said.

Asked whether the health ministry had given hospitals guidance on reporting unaccounted-for migrants seeking medical assistance, Lue said only: "That is not our main concern."

In response to CNA's request for comments, the NIA denied having conducted inspections at hospitals in its pursuit of migrant workers who left their employers or asking hospitals to report such workers or their children.

"However, if hospitals need to verify the personal information of foreign patients for triage and request the help of NIA personnel, the NIA must, by law, take action against patients identified as unaccounted-for migrant workers or other types of foreigners who have overstayed their visa," the NIA said.

A race against time

Due to the fear of possible deportation, most migrant workers ask NGOs such as Harmony Home Taiwan to take them or their children to hospitals the NGOs are familiar with so they are not reported, Wang Guan-ting said.

However, doing so could delay treatment and put children in a dire situation, she said.

Yuli, another unaccounted-for migrant worker sheltered by Harmony Home Taiwan, said that when her eight-year-old daughter, Mozha, became seriously ill in November 2021, she had to travel seven hours on a bus from Lishan in Taichung to Taipei to seek assistance from Harmony Home Taiwan.

The trip from Lishan to any train station or the Taiwan High Speed Rail (THSR) Taichung Station would be at least a three-hour drive, not to mention that for her, the price of a THSR ticket to Taipei was simply prohibitive.

So, she took an intercity bus to Yilan County and hopped on another bus to Taipei, Yuli said.

The long trip was inevitable because even with the help of a Taiwanese acquaintance, none of the hospitals would attend to Mozha, even though her daughter's situation had worsened to the point where she "could not open her eyes or move," Yuli said.

After arriving in Taipei, Mozha was diagnosed with brain cancer in both her cerebrum and cerebellum, and what ensued were four surgeries, a combined six-month hospitalization, including nine weeks in an intensive care unit, and a lengthy chemotherapy process lasting until August 2023, according to Yuli.

Costly health care

Because undocumented migrant workers and their children are not covered by Taiwan's National Health Insurance (NHI) program, medical fees can sometimes be extreme.

In Mozha's case, her medical bills totaled NT$2.26 million (US$74,900), most of which was later waived or refunded by the National Health Insurance Administration after it certified that Mozha had a "major illness or injury," said Kuo Li-kai (郭立凱), a senior supervisor at Harmony Home Taiwan.

Kuo said that because of the critical condition Mozha was in, his organization was able to persuade the NIA to issue her residency permit through an ad hoc program, which afforded her NHI coverage.

For other unregistered migrant children, however, paying medical bills can be a daunting task for their caregivers.

Wang Guan-ting recalled an example of a preterm baby helped by Harmony Home Taiwan having to be hospitalized for more than a month, during which the baby underwent treatment.

That resulted in Wang's organization owing the hospital more than NT$2 million in medical fees, which it has yet to pay off despite having held a fundraiser, she said.

Given that unregistered migrant children could generate large medical bills, Kuo suggested that the government include them in the NHI program by establishing a fund supported by monthly premiums paid by the children's parents and public donations.

Noting that Taiwan has adopted the United Nations Convention on the Rights of the Child as its domestic law, Kuo argued that having parents who are unaccounted-for migrant workers is no excuse for denying children their health rights.

"These are two separate issues," Kuo said.

"Since they were born in Taiwan, they should enjoy the same rights as Taiwanese children while they are in Taiwan, even though they might return to their country or be adopted one day," Kuo said.

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