‘Unethical and inappropriate’: revealing corpses’ records of the gaps that led to migrant worker deaths

Ambulances sent to the wrong address. Workers refuse health care for fear they will have to pay for it. Employers – rather than health workers – who monitor COVID-19 symptoms on high-risk farms in Ontario.

This is one of the ‘profound’ obstacles faced by nine migrant workers who died across the province during the first waves of the pandemic – which jeopardizes critical care when workers face life-and-death health emergencies a new study of coroners’ records.

The research, conducted by a team of medical doctors, nurses and academics with decades of experience in migrant worker health, found a myriad of failures that contributed to the deaths, including poor testing protocol and conflicting quarantine conditions with “limited supervision.”

Chief Researcher and Assistant Professor of Nursing at the University of the West, Susana Caxaj, called the evidence a “terrible reminder that the province and the health care system are still ignoring the challenges” facing a vulnerable group of workers.

“We have normalized substandard care and protection of these men and women.”

Several of the study’s authors participated in a review conducted last year by the Ontario deputy coroner following the deaths of temporary foreign workers during the pandemic, including Bonifacio Eugenio Romero, Rogelio Munoz Santos and Juan Lopez Chaparro.

Tuesday’s report was carried out with the support of the Migrant Worker Health Expert Working Group and uses a survey of corpses for a total of nine deceased workers, none of whom are mentioned in the study.

The report found several migrant workers died just days after receiving positive test results.

“These workers would have benefited from more intensive health monitoring after testing positive for COVID-19 so that their deterioration could be identified and addressed,” said Maxwell Tran, a co-investigator and resident public health and preventive physician. medicine at the University of Toronto.

But in some cases, access to even the most critical support has been delayed due to miscommunication, language barriers and vulnerable workers’ limited familiarity with the healthcare system. In one case, an ambulance was delayed because it was sent to the wrong address; in another one, a worker initially refused emergency hospital treatment because they feared they would have to pay for it.

While the virus swept the province, symptom monitoring was also sometimes delegated to employers, the study found – a practice it calls “both unethical and inappropriate”. The report said it was sometimes “unclear” to what extent workers received health assessments at all, and whether it was done personally by a health worker.

With greater access to testing, infections may have been detected earlier and “allowed for better monitoring and treatment,” the study adds.

Some migrant workers died while isolating themselves. Although some health units provided written information or regular phone calls to workers who were isolating, there was no standard protocol, the report found. Quarantine conditions were similarly patchy, the researchers found, and required clearer guidelines and strong oversight to be effective.

The study points out that “several migrant workers in agriculture have already died in the early weeks of the 2022 season in Ontario,” pointing to the need for urgent action.

Meanwhile, none of the nine deceased workers’ files had any contact tracing information, indicating “a lack of information sharing in this regard on the part of public health units.”

“Understanding likely sources of infection can help identify effective public health interventions and areas for improvement,” the study said.

“Many migrant agricultural workers have died over the years, even before the COVID pandemic, but a judicial inquest into their deaths has never been held,” added Janet McLaughlin, professor of community health at Wilfrid Laurier University, who told the research has worked.

While most of the deaths studied were related to COVID-19, at least one migrant worker died after being hit by a vehicle while traveling at night.

“Living in rural and small towns with limited access to transportation, completely removed from walkable neighborhoods, creates increased risks for migrant agricultural workers,” Caxaj said.

“With limited control over their schedule, and even their activities during their downtime, they may be at greater risk of becoming victims of car accidents.”

The study’s recommendations include improving rural infrastructure to address those issues – as well as ensuring that local healthcare providers have the training needed to ensure “awareness and trust are built before a health emergency.”

Other recommendations include stronger travel protocols for workers to ensure access to KN95 or N95 masks and access to safe transportation from airport to farm when arriving in Canada. Regular and accessible tests and culturally sensitive health assessments “conducted by health professionals at regular intervals” with interpreters are also crucial, according to the report.

The study also calls for a national housing standard for migrant workers and robust health and safety enforcement, including third-party recruiters placing workers on farms. Workers need a “clear path to residence,” the report said, in order to “maintain the health and human rights standards to which they are entitled.”

“We owe it to the men and women who grow our food to ensure that no stone is left unturned to understand the contributing factors to their untimely death,” McLaughlin said.

“And to do everything possible to prevent future tragedies.”

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