Comment: The price of an expat life in the Maldives

As a Bangladeshi colleague was wheeled into the operating theatre of Indira Gandhi Memorial Hospital for emergency life-saving treatment, I knew where my thoughts should have been.

We seek to assure ourselves that even in a cynical commercial world, you cannot put a price on life. Is such a phrase anything more than sound logic for those in the privileged position to afford the finest Singaporean inpatient treatment, or the insurance to cover hundreds of thousands of dollars of emergency medical evacuation to tax-payer funded Western healthcare?

Life after all is precious. Yet all too often, the true value of precious things is rarely understood until it, or in this case they, are threatened or lost.

The introduction of the complex and troublesome Aasandha universal health insurance program this year by the government of former President Mohamed Nasheed, so far retained by President Dr Mohamed Waheed Hassan, has started a new era in Maldives healthcare.

Maldivians can now obtain treatment and surgery in their own country without relying on the vastness of their own wealth or savings, the kindness of friends, or the mercy of elected politicians and wealthy resort tycoons.

While the execution of such a system should always be open to scrutiny, there is much to be admired in the concept of ensuring every person in the country will be cared for when at their weakest.

But what of the country’s immigrant population? How are an ever-growing group of people in the Maldives – mainly in the form of unskilled workers from Bangladesh trafficked into the country – to be cared for?

For many of the foreign workers who make up a third of the country’s population, and are expected in coming years to equal the number of indigenous employees, the price of life can be counted down to the very last laari.

This is no more apparent when insurance companies can only reimburse treatments for foreign workers that have already been paid for – no matter the level of upfront expense.

What happens when companies or employers, whether out of negligence or limited finances, are unable to bare the initial costs needed for a life saving operation?

Who is there to purchase and provide these patients with the medicines and saline drips from for hospital staff to administer? In the absence of close friends and family, where is the assistance in journeying to a hospital toilet and what alternate options does a low-income expatriate have? In short, who is there to care?

The concern was born – not altogether altruistically – whilst spending Tuesday night sleeping on the floor of a post-operation ward at Indira Gandhi Memorial Hospital (IGMH) in Male’, in case a signature or saline drip was required.

Thankfully, he is well.

Barring “unexpected complications”, he will recover, as will the company’s finances once it is reimbursed from the employee’s insurance policy – only a recent mandatory requirement for obtaining a visa for foreign workers.

As a company representative, the initial costs for vital surgery, though not insignificant, can be reclaimed and more importantly, have to be met.

As an individual and friend, without the financial capabilities and resources of a company, the alternatives would otherwise be unthinkable.

A friend and room-mate of my colleague later explained that over half of his month’s wages were spent Tuesday morning on emergency medicines, scans and x-rays alone – all just to identify the scale of the problem – even before an operation. The price of life, I realise, is appallingly low for the wrong person.

In the wards, visiting hours are 24/7. Family members must maintain constant vigil over their bedridden loved-ones, taking full responsibility for everything from toilet assistance to buying and supplying hospital staff with needed medicines.

It is anyone’s guess how foreign workers – many of them far from home and family and unable to even afford the upfront deposit for treatment – are able to survive the system.

Ultimately my friend appears lucky. As the days pass, colleagues and acquaintances have, in either desperation or adversity, been transformed into an unusual though much appreciated surrogate family of makeshift nursing staff in the ward.

They have become well acquainted with pharmacies and their respective costs, and learned to recognise when saline solutions for drips are urgently in need of replacement. Some have even had to contemplate how best to preserve a friend’s dignity in toilet situations, that are not “always ideal” in maintaining a professional relationship.

Small blessings indeed.

Contemplating such a situation after days spent outside the operating theatres and waiting rooms of IGMH, perhaps there is much to be said for the hospital prayer room.

We are only human after all, but surely there are few times of feeling as completely powerless than when watching another person’s suffering.

Is it right then, that a person – regardless of skills or social standing – should amidst moments of extreme fear and anxiety have to pray for their economic, as well as physical well-being?

Surely some great deeds are not beyond human intervention.


10 thoughts on “Comment: The price of an expat life in the Maldives”

  1. What is the price of a Maldivain life?

    This is supposed to our but all middle management posts or more affluenet in companies are being taken by foreigners. Europeans, Americans Japanese Indians would not allow their country to be control in that manner.

    Ofcourse foreigners should not be blamed. Greed and corruption among the politicians is the cause and the actual victims are Maldivains.

    Go to a supermarket or a sports complex or a high end school. You see relatively more foreigners, while the kids of Maldivians with less income have no other choice but go to run down schools or hospitals.

    Foreigners deserve all the respect but the Maldivian is being crushed today by bad policies.

    Minivannews too is a example of the state of the country. As the most prominenet foreign news site, the opinions on issues are shaped not always by Maldivains, which is a shame.

  2. Its very sad its like this in Maldives.

    But the sad thing even in the rich "developed" countries the price of an expat life is also somewhat like that.

    I remember a case in Australia-NZ where a patient who required daily dialysis was not given treatment (as insurance did not cover this and the patient could not pay) and had to return back to her home country where there is no dialysis available. So she would have died in her home country.

    Also same thing happens with expat workers who get diseases like cancer etc etc who are in rich countries. The insurance would cover for a only very limited time (and usually the person can't pay for the treatment on their own with what they get paid) and the person would have to return back to their country even if that country doesn't have any cancer treatment available.

    Even most of the rich country require the expat workers to pay for their own health issues and usually would not even process a visa without extensive medical insurance payments.
    The free public health care (where tax payers money would also go to) of these countries are also given only to their own people.

    I can provide you with more examples...

  3. Actually its time to do something about expat population here. The govt can start by raising the ratio of locals to expats in tourism to 80% or 90%. The current 50% ratio was coined when tourism was only in Male atoll area. Now tourism has spread across the country and still we are stuck with 50% ratio.

    The reason why locals are marginalized in work area is because employers are simply overwhelmed with pressure from expats. They are also humans who have brothers and friends who need jobs. So they make huge efforts to bring their man to the job. Its not the maldivian kid is lazy or doesn't like work. Dhiraagu which is roughly equal to 3 five star resorts combined, in monetary terms employs 99% local workers and they are still in business. If locals are that averse to work then this would not have been the case.

    Of the countries in this region Maldives has the biggest unemployment ratio and yet this does not seem to be an issue in the country. see link below:

  4. @price? on Mon, 19th Nov 2012 12:17 AM

    "Minivannews too is a example of the state of the country. As the most prominenet foreign news site, the opinions on issues are shaped not always by Maldivains, which is a shame."

    Did you actually care to think about why Minivannews is a "prominent" news site?

    Here's a thought for "Maldivians": sleep less and work harder; you may even surprise yourselves by actually achieving something out of your own efforts.

  5. Locals should be given some kind of a priority, if they were to feel that this is their country.

    Although Maldivians are supposed to be given priority in law, in practice, the story is different.

    According to what I have heard, typically resorts are headed by a white senior manager. The second layer comes from India or Sri Lanka and they form a tight clique. Its next to impossible for Maldivians to survive in the clique.

  6. @price?

    To an extent you may be right in the sense that some foreign owned companies or businesses may be giving priority to foreigners. But having said that this is not always the case and there are also locally owned companies and resorts that give a lot of priority to developing the expertise and skills of Maldivians to fill in these roles. And there are some very capable and good Maldivians who are in top management positions. However more often than not, Maldivians want the easy way out and a quick climb up the hierachy ladder. A lot of the school leavers have too high expectations about jobs and are not willing to adjust to the existing market conditions and too many of us are fixated over the "foreign vs local" employees while not willing to admit that most of the foreigners who come here work hard and are skilled to carry out their job responsibilities properly. We should adopt an attitude where we are willing to learn with an objective of developing the necessary expertise and attitude to serve in top management positions. Such positions can't be automatically given to someone based on their nationality, as that has little to do with ability and qualifications.

  7. @mariyam
    Maldives being a small nation just cannot compete the the mass influx of reagional accountants and other professionals

    How dare u imply maldivians are lazy at the same time over ambitious. Surely this is an issue of lack of senior management leadership. Some kind of an affirmative action policy is needed if the country is to remain intact

  8. Talking about the easy way ouy: you can simply deny the valid arguments and facts rather than facing the true reasons behind the big amount of expats: it's a matter of skills, work attitude and price/quality.

    Unless the well known maldivian friendship policies and corruption are involved, if you're seen as the best person for the job, you'll get the job. Earn it, don't claim it.


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