Health optimization of immigrant labourers: Clinical Pharmacist Supplementation Augustine Xavier

Health optimization of immigrant labourers: Clinical Pharmacist Supplementation

Augustine Xavier

5^th year Pharm D,Dept  of Pharmacy practice,ACP

    Labour migration is not something that we Keralites are alien to since a fair share of our population had migrated to the Gulf countries to make a living in the past. But in the past decade or so, we have seen a new trend where labours migrate from other states of India to Kerala and they have become a major contributor to our total non-skilled workforce. They have also become part of our state population which cannot be overlooked.

   Majority of these workers are from states like Tamil Nadu, Karnataka, Andhra Pradesh, Orissa, West Bengal, Assam, Gujarat and Bihar. It would be a fair expectation that more workers would be from Tamil Nadu since it is geographically closer to Kerala. But the scenario that we have is paradoxical with more people coming from Orissa, West Bengal and Bihar. They generally come in the form of a flock of labourers or along with their families and stay in rented homes. Attractive wages, suitable living conditions, lower living costs, good social and travel facilities and the co-operation from the natives might be few of the several mentionable factors contributing positively towards this migration rate. It is a thing of pride that we Keralites are still upholding our cultural phrase of  “AdhitiDevoBhava” through our deeds. But still there are few loose ends which need to be scrutinized.

   Our cultural values and health care sector has always been a guiding beacon for other states of India. But the effectiveness of these practices on preserving the health of non-native unskilled labourers need careful introspection.  

It becomes the responsibility of the hiring companies or labour contractors, to provide a healthy living condition and working environment to such labourers especially in places where the works involved are of high risk nature. Although there are rules and regulations laid down by the government to ensure the safety of these labourers, the contractors/companies tend to overlook these rules. The lack of authentic ID proofs or equivalent documents about the labourers, lack of records for maintain the address or number of workers employed and inadequacy of health policy insurances has been acting as loopholes for the contractors to leap away from such responsibilities. Monetary aspects are the driving factor behind such practices which even pulls them back from getting adequate medical care even at the times of utmost necessities.

   Except during emergencies or accidents, these labourers are heavily dependent on the government hospitals with very few of them being dependent on the traditional medicines as well. Traditional medicines are used in cases of sprains, fractures, jaundice, piles, envenomation etc. by these workers. Another arena of health sector to which these people are dependent are the community pharmacies. They tend to use the services of retail pharmacies to alleviate the diseases they contracted from their work sites or dwelling areas. They tend to depend on the pharmacies for drugs to use in cases of cough, fever, allergies, joint pains, gastric upsets and even dermatological conditions. They rely on these outlets generally for conditions like anorexia, fatigue and stomach pain, and also utilize the services by these sources to obtain cosmetics such as face wash, hair gel, body lotions, sunscreen etc.

  The medications that they obtain from these community pharmacies are of over the counter (OTC) nature about which they might have acquainted through various medias. They tend to prefer the low cost brands of the drugs about which they might have heard from somewhere. But the linguistic problems have been a major drawback for these people from getting optimum benefits from such pharmacies. They are primarily unable to convey the exact reasons in an understandable manner to the pharmacists and neither are they able to provide adequate counselling to these labourers due to the language barrier. A few recommendations which have to be practiced in such cases have been enumerated below.

RECOMMENDATIONS:

·         Pharmacists must give special attention to the non-Keralite customers.

·         Use the most suitable means of communication with such people. If necessary either written enquiries or translational attempts can be made.

·         In cases where the linguistic barrier is too difficult to combat, the help of a bilingual third party or equivalent arrangements can be utilized.

·         The utilization of the drug samples or placebos can be used to give them a demonstration on the optimal utilization of the medications provided.

·         Studies have shown that use of pictograms to increase the understanding of the consumers can enhance their compliance. All the essential points for the proper use of drug such as the dose, duration, frequency and method of use can represented pictorially without exceeding a page.

·         At the time of patient counselling, pharmacists should give these people ample time to make notes of the counselling points in their own native language. Resources such as paper or diagrams should be provided by the pharmacists to note down the same.

·         Help desks have to be established under the authority of government hospitals at district or taluk level for safeguarding the health of the non-native labourers. The inclusion of voluntary agencies and pharmacist can be pivotal in enhancing the effectiveness of such help desk initiatives.

·         A multi-linguistic telephone counselling system has to be implemented through which people of any language. (Similar to the multi-lingual options that we have on customer care services of various telecom operators).

·         New health insurance schemes to give coverage to the workers for diseases/accidents contracted during the working conditions have to be initiated and they have to be incorporated into the proposed National Health Insurance schemes.

·         Programmes for non-native labourers have to be organised whereby they are given free of cost blood testing and awareness sessions on diseases, rational drug use, harms of smoking alcohol etc.

·         Drug information centres or toll free numbers which gives free drug information and functions round the clock has to be established and attempts must be made to familiarise these workers with such systems.

Mr Augustine Xavier ,5^th pharmD counseling the  laborer about the medicines.

   These workers, even though would like to know details about the proper use of drugs are handicapped due to our non-cooperation and carelessness. By following at least few of the above mentioned recommendations, we can certainly alleviate the helpless condition of such people who are working to earn a living in these foreign lands. Their health is our responsibility and turning away our faces from their problems is inhuman and shameful thing for us, the people of Kerala who take pride in our own traditions and cultural richness. In a state that is trying to promote itself into a health tourism hub to foreigners; isn’t this step motherly behaviour to our own nation’s citizens a thing of great shame.

Let our culture and traditions be a guiding beacon to everyone else and may our deeds to others help us to always stand steady with our faces held high with pride.!!