There are no mattresses, only bare beds and people. It’s early in the afternoon and I’m standing in a place people from the outside world are almost never allowed to enter. How did I get here, and will the moment come I am yanked away? It is so muggy. The moisture in the air is thick and heavy. I can already feel the sweat running down my forehead, making me blink. A single pedestal fan whirs on the opposite side of a bleak and dark room, desperately failing to keep the room cool. Bunk beds line the grey concrete floor, stained with dirt and footprints. The only colour comes from the buckets of dirty clothes and suitcases at the end of each bed. Sun shines through the terrace door, shedding light onto patchy white walls as well as the brown faces of the some of the men responsible for Singapore’s world-class skyline. This is a migrant worker dormitory.

According to Singapore’s Ministry of Manpower, there are more than 1.3 million foreign migrant workers in Singapore, making up almost one quarter of the nation’s entire population. Many of these foreign workers venture from Bangladesh, South India, Myanmar and Thailand, seeking to financially support families back home. Men in particular come to work in the construction industry, where they can be paid as little as $18 per day for 12–14 hour shifts.

Most of these men reside in one of 53 such dormitories. Some house more than 10,000 people spread across several buildings.

During the peak of the COVID-19 pandemic, some of the worst outbreaks occurred inside migrant worker dorms. This resulted in strict lockdowns for as long as 17 months. According to The Straits Times, by December 2021 more than 175,000 out of 323,000 residents had contracted the virus. Major COVID-19 testing measures were put into place, sometimes involving taking RAT tests twice daily. National University of Singapore medical professor Truls Østbye says the pandemic had a horrible impact on those in dormitories, and for the first time it exposed Singaporeans to how migrant workers are living.

“There were some serious outbreaks in those dormitories. There was a lot of attention brought to conditions. Even Singaporeans were a little shocked to see the living conditions they were in,” he says, shaking his head.

As a result, late last year the MOM announced a primary healthcare system for migrant workers and updated standards for new dorm constructions. However, workers are still relying heavily on public donations to NGOs to fund their medical treatment and for financial support. On top of this, according to a report in The Straits Times, there have been little to no changes to the standards of the existing dormitories.

Standard GP consultations in Singapore cost anywhere between $20-25, making it highly unaffordable for migrants who are earning less than this on a daily basis. Migrant worker Tasrif Ahmed has been in Singapore for six years and advocates for improving the lives of those who travel to the country for work. He works six days per week fixing air conditioners and air ventilation systems. Ahmed also lives in a dorm with 10 others.

“The living conditions were totally unexpected. We thought we’d have good living conditions once we moved to Singapore. But then once we came here we are kind of forced to stay here in this situation,” he says while the bustling sounds of a busy street surround us. “All the migrant workers’ daily wages are always low. It’s very hard for them to go to the hospital, to see a good consultant, a good doctor, get tested, go through all the processes and come back. It’s very expensive which we couldn’t bear.”

Instead, workers who suffer from illness or injuries often attend NGOs such as Healthserve for medical treatment. Every Saturday, workers with flu, back ache, muscle aches or even fungal infections attend for support. Healthcare professional and former Healthserve volunteer Erika* says the organisation offers migrant workers a much more affordable option for receiving medical help.

“The only difference between migrant workers going to Healthserve or a GP is Healthserve is much cheaper. At its heart, it is like a GP clinic. There are doctors, nurses, pharmacists, physiotherapists, dental surgeons and they are all volunteers who are actually working as health professionals outside of Healthserve,” she says quickly while her hands fidget.

Using these services can cost migrant workers as little as $5 for treatment, and in case a worker requires more serious attention, Erika says they may see a more specialist doctor for free: “We [also] have dental specialists, eye specialists, orthopaedic specialists who are also willing to then see our migrant worker brothers in their specialist clinic, and to waive the consultation charges,” she says.  

According to the Asia Pacific Foundation of Canada, 27 migrant workers have died at their workplace in Singapore this year. Advocate for migrant workers GJ* says due to the sheer numbers, safety can become less of a priority. “Injuries do happen, and they should not be happening. This is also a lot to do with company’s safety protocols. When you’re dealing with a lot of workers, there’s time constraints for projects. So sometimes they overlook safety precautions, and that leads to workplace injuries,” he says as he slowly sets his pint of beer down on the table.

Although there are insurance policies in place to cover migrant worker injuries, most are not comprehensive enough. In many cases, employers are charged with covering the cost of serious treatment and often they cannot afford, or don’t want, to pay unsubsidised medical bills for their employees. GJ says employers come under fire in the media for workplace injuries and NGOs become tasked with covering the cost of hospital treatment: “Whenever these kinds of injuries pop up in the news and you see horrific images of migrant workers in casts in hospital beds, often there’s crowd funding which accompanies that … Not all of it but part of it [is being raised].” If funds cannot be raised, workers risk having their work permits cancelled, being sent home without receiving medical attention and are easily replaced by their employers.

Those injured or ill migrant workers who have been left in the dark by their employers often reach out to the TWC2 organisation for financial support. As the fan buzzes in her office in Little India, cars whistle by in the street below. Fordyce says workers are generally unsure of how to go about seeking help for serious injuries so volunteers provide them with the guidance they need: “We have to make sure that they’ve filed a claim or that their employer has also filed a claim so that the Ministry is aware. We make sure that they’re going to the hospital, making sure that they get the treatment they need, as well as the diagnostic treatment which sometimes can be expensive and sometimes can be delayed,” she says in a soft tone. “They don’t receive subsidies for their medical care. So their medical care is several times more than what a Singaporean will pay. A Singaporean would pay much less, whatever it is.

“Migrant workers do the dirty, demeaning and dangerous jobs.”

After the COVID-19 pandemic, the MOM recognised the lack of support provided to migrant workers and the systemic healthcare gap which exists between them and Singaporean citizens. This resulted in the implementation of a new healthcare system which involves dividing the nation into six geographical sectors, each containing a medical service provider known as an anchor operator. Each of these AOs will be charged with delivering primary healthcare services as well as a 24/7 telemedicine service to migrant workers. Visitors will pay $5 per trip to the medical centre and $2 for each telemedicine session. On top of this, a Primary Care Plan to ensure these services can operate was also recently implemented, costing employers $108-138 per worker per year.

Alongside the PCP, new housing standards for migrant workers have also been announced in order to try and improve migrant worker living conditions, and more effectively reduce illness and virus transmission. These standards are set to include better ventilation, cleanliness, minimum space requirements for residents and maximum room occupancy numbers. Some of these changes such as room occupancy mean they are now capped to 12 or less residents. Beds must also be placed at least 1 metre apart and adequate fans must be provided in rooms as well as air filters in bathrooms. Currently, these new standards only apply to newly built dormitories with more 1000 beds but as of April 1 next year will apply to those with as little as seven.

Despite all these efforts to improve migrant worker wellbeing, little progress has been made to implement the new system. The new PCP will also not cover the costs of hospitalisation or surgeries for injured migrants meaning they will continue to depend on organisations such as TWC2 to receive important treatment. Worker advocates are asking whether alterations will be made to the living conditions of the existing large and small dormitories.

Some people believe both these changes will ensure the health of migrant workers into the future, but others are not convinced and are wondering when they will see a real difference. GJ believes the new healthcare system is a step in the right direction.

“Essentially everyone will have the same point of contact, so they can actually build a relationship,” he says with a glint of of hope in his voice. In terms of the number of workplace deaths for migrant workers, GJ says the new system may reduce this number, but it will have to cater for the massive number of workers: “Healthcare coverage can improve that [number]; I think that’s a good start. The problem with anything that’s been done for migrant workers in Singapore is that it’s always the demand versus supply, there are so many workers. The scale is just too high, that no matter all the initiatives they still kind of benefit only a small section, ” he says.

Migrant workers such as Ahmed are still waiting for the new healthcare system to come into place, although he is confident it will work in the favour of the community post-COVID.  

But when it comes to Ahmed’s living conditions, the 26-year-old still struggles and is wondering when the improvements will be made. “We are hearing the news that it is going to be changed. They are planning for new standards for dormitory systems in Singapore, but nobody knows how long it takes to implement it,” he says. When Ahmed first arrived, he was anxious and frightened to see where he would be living. He expected his life in a dorm to improve: “I was always expecting a new day to come, and things would be improved but six years have gone by and nothing’s happened,” he says as though his hope for change has run out.

For employers of migrant workers, the situation looks a little different.

Back at the dorm, construction firm manager Andrew Tyron walks me through the dormitory where 100 of his migrant worker staff live. I was shocked at his offer. Almost no-one is presented with the chance of such a tour. Tyron is frustrated the new standards have not come into place at the already existing dorms and says improving the lives of migrant workers at home will further improve their productivity while at work.  

“Those standards are only for the new dorms. They are not taking care of the bigger [already existing], larger dorms with more than 10,000 people,” he says, throwing his hands up in the air.

“I have workers who tell me that dorms are really in an unsanitary condition, especially in the sense that you have 16 big men using the same toilet. Sometimes it can get very messy, especially when people don’t take responsibility for their own mess and everything.  It gets worse for the shared toilets. With the shared toilets you have about 20 rooms on the one floor, so men sharing four toilets that can get really disgusting,” he says, his face dropping.

“I think dorms can be improved. They need more transparency about employers being able to check them. But then they also need employers that have the heart to go and check.”

Tyron also doesn’t believe the new PCP will adequately provide support to those in need of serious medical help.

“We are being charged roughly about $5-$10 per worker per month which is roughly $150 per year for one worker. This worker goes to a clinic, he pays $5. The clinic can only take care of fever, flu and a cough. Anything else: hospital,” he says frustratingly. “Occasionally we have falls and cuts and bruises, but we take care of them. PCP forces us to subscribe to a medical plan that doesn’t take care of these injuries.

“I think all that matters is that the Singapore construction industry really needs to start looking at migrant workers as human beings. Another soul out there which is also trying to earn a living for their families. They have kids back in their own countries which they don’t see for years.”

More action is planned for next year, for both the new healthcare system as well as upgrades to the already existing dorms. For now, people like Ahmed and Tyron will continue to wait for changes to be made.

“We are working in a good environment; your workplace is really good. You give your full to your work. But then at the end of the day you come home, and you have this unacceptable and uncomfortable environment. There’s no privacy at all. The living conditions should be improved as soon as possible.”

– Tasrif Ahmed

Slowly, I walk down the dark grey stairs, leading me back to the sunlit entrance of the concrete dormitory. The sound of the road drowns the cheery goodbye from the old woman in her security guard uniform. The boom gate falls, and that world is closed once more.

*Real names withheld by request

The 2022 Curtin Journalism Singapore Study Tour was funded under the federal government’s New Colombo Plan scheme.