When Malaysia announced everyone should stay at home as part of a nationwide Movement Control Order (MCO) on March 18, Mai Mai, who is originally from Myanmar’s Kachin State, did what she was told.
Crammed into an apartment she shares with eight other refugees in Kuala Lumpur, with no legal status and suddenly out of a job, 23-year-old Mai Mai is one of more than 200,000 refugees and asylum seekers in Malaysia who fear not only the virus, but its effect on their lives.
Nearly 180,000 refugees and asylum seekers are registered with the UN High Commissioner for Refugees (UNHCR) in Malaysia, most of them from Myanmar. Refugee community groups estimate that more than 80,000 have no documentation as they await registration with the UNHCR.
Malaysia currently has the highest reported number of COVID-19 cases in Southeast Asia, and the epidemic has exposed not only the difficulties faced by refugees and asylum seekers in getting medical treatment but also the risk that creates for public health as a whole.
“Refugees too often face needless obstacles in accessing health care,” Dr Susheela Balasundaram, UNHCR associate public health officer, told Al Jazeera. “COVID-19 clearly demonstrates that we are all connected. Barriers to healthcare and discrimination create an environment where the ill are not treated, cases go undetected and the virus spreads.”
Cost of medical care
Malaysia is not a party to the UN Refugee Convention and lacks a legal framework for refugees, who are considered “illegal immigrants” and a policy known as Circular 10/2001 requires healthcare providers to report such people to the police.
Although the law is not always applied, in the past refugees and asylum-seekers – particularly those without papers – have been arrested after going for treatment or giving birth.
Healthcare costs can also be prohibitive. Non-citizens must pay a foreigner rate – often 100 times higher than local rates – in government health facilities, according to the Hospital Kuala Lumpur website. While those with UNHCR status receive a 50 percent discount, the undocumented must pay the full amount.
“The current COVID-19 crisis simply accentuated the harmful public health effects of such policies,” Beatrice Lau, Head of Mission for Doctors Without Borders (Medecins Sans Frontieres, or MSF) in Malaysia told Al Jazeera. “Policies of social exclusion and limited access to healthcare can impact society as a whole, [and] add to the challenge Malaysia now faces in achieving better contact tracing for COVID-19.”
These issues reached a critical point in the last week of February when several hundred Rohingya refugees were among an estimated 16,000 who attended an event at a mosque on the outskirts of Kuala Lumpur to which more than 1,200 COVID-19 cases have been traced.
Amid heightened concern that not all attendees had come forward, Defence Minister Ismail Sabri said last week that the government would not arrest anyone based on their immigration status who sought medical services in relation to COVID-19, while the Ministry of Health announced that COVID-19 treatment would be free for foreigners showing symptoms.
“Inclusive and non-discriminatory policies will only strengthen the response as it is in everyone’s interest that all people, especially the most vulnerable – including refugees, asylum-seekers and the stateless – have access to health services,” said the UNHCR’s Dr Balasundaram, who called the government’s announcement of amnesty “an important step to build trust and confidence helping all who need medical attention to come forward.”