Malaysia: A commitment to universal health coverage for refugees

23 Apr 2019

Head of Mission in Malaysia, Dick van der Tak, writes: "Internationally, the Malaysian government has expressed a commitment to working towards improving access to health care for all segments of the population. However, for some, “universal access to quality health care” remains a distant prospect. In particular, the more than 160,000 refugees and asylum seekers in Malaysia continue to face steep barriers in accessing health care, despite some of the positive steps that the government has taken to address this issue in the last years. As an international medical humanitarian organisation supporting marginalised communities in Malaysia with primary healthcare, Médecins Sans Frontières has witnessed first-hand the impact that the limited access to health care has on thousands of people. Undocumented refugees who require medical treatment may end up being reported to the immigration authorities and detained, which can deter them from seeking medical care at all.


Jungle sites, shelters for immigrant workers. © Erwin Vantland / MSF

Those who do seek health care may not be able to afford it, as refugees and asylum seekers are subject to unsubsidised foreigner rates for medical fees. For a group that does not have the right to legally work in the country, those fees remain prohibitively high, even after the 50% discount extended by the government to refugees and asylum-seekers in need of treatment at public health facilities. This can force already vulnerable families into making impossible choices, between health care, food or housing. Language barriers and access to information also impede undocumented groups from getting care.

As an Asean country hosting a high number of refugees and asylum seekers, Malaysia could set an example for the region in how to provide health care for the most vulnerable in society. There are a few immediate steps the government could take to improve the health of refugees and asylum-seekers.

First, to ensure refugees are not discouraged from seeking care when they need it most, the authorities could guarantee undocumented refugees protection from arrest and detention at health care facilities. They must ensure that patients’ confidential data, including their documentation status, are not shared with third party stakeholders, such as the Immigration authorities. This could also reduce the burden on Malaysia’s public healthcare system, as more timely treatment helps reduce the costs of using secondary health care later on.

"Malaysia could set an example for the region in how to provide health care for the most vulnerable in society"

The Malaysian government could also provide obligatory, government-funded health insurance to help refugees shoulder high medical bills. It could grant work rights to refugees to lift them out of financial precarity, enabling them to earn a living, pay for healthcare and better contribute to Malaysian society. Additionally, the government could provide interpretation at health care facilities, thereby ensuring refugees fully understand what is said and make informed decisions about their healthcare.

These relatively modest steps would have a transformative effect on the well-being of refugees and asylum seekers in Malaysia, help lift many families out of poverty, and enable them to more meaningfully engage with Malaysian society."