'Doctors' who prey on poverty

Rogue doctors are offering cheap and improper treatment to construction workers in Dubai and distributing medicine that has been imported illegally.

DUBAI // Rogue doctors are routinely offering cheap and improper treatment to construction workers in Dubai and distributing medicine that has been imported illegally. "We are aware that there are fraudulent practices," said Dr Essa Kazim, the head of health regulation at the Dubai Health Authority (DHA). "We have regular inspections, and when we do find them practising against the law of the country, necessary legal action is taken."

In a related matter, Dubai Police said they had charged two men with selling fake health certificates to labourers. In the construction labour camps the rogue doctors are known as "compounders", a colloquial Indian term for an unlicensed medical practitioner. There are also those who masquerade as experts in ayurveda, the Hindu practice of balancing diet, herbal treatment and yoga, according to legitimate Indian doctors with knowledge of the situation in the camps. They claim to bring with them oils and potions from "back home" to cure aches and pains and operate out of makeshift clinics in the industrial areas between Dubai and Sharjah, Karama, Deira and Jebel Ali.

Proceeding on the assumption that labourers are generally more comfortable approaching holistic doctors, as they would in their homelands, the unlicensed practitioners are said to offer a variety of inexpensive services - costing Dh10 (US$2.70) to Dh50 - but which may involve "secret oils" and bandages made from natural products. A fracture, for example, may be treated with massage oils made from a thick paste of mustard oil, barks and leaves, followed by a wrap with a banana leaf or a bamboo mat, or other leaves that cling tightly to the skin.

They may also provide temporary relief to the swelling or oedema through massage. In recommending that the wrap remain in place for about four weeks, they cover the period during which the bones would tend to heal anyway. "These people, the compounders, they will charge you per injection," said M Sriram, a construction worker who lives in Jebel Ali. "Or give you some medicines that don't work. They will always charge per visit that will increase with every visit. You know you are going to a compounder, because the fees are less compared to the real doctors."

A labourer without health insurance would currently pay Dh100 to Dh400 for a consultation with a general practitioner at a private clinic. The cost of any tests and medications would be extra. Some clinics have corporate deals, which might bring the visit fee down to about Dh50, to be covered by the company or the worker. But many companies do not have such deals, or even offer health insurance, so their workers are left to find alternative care.

"These people are exploiting a situation whereby perhaps labourers have limited access time and financial ability to access health care and get medication," Dr Kazim said. "Once the DHA policies fully kick in, in three or four years' time, it will significantly decrease, if not abolish all together, this fraudulent practice." Doctors working with labourers also said they were aware of these fraudulent practitioners and the damage they were causing. But they said many labourers felt they had no choice but to seek a second-rate service.

Mr Sriram said that although his camp in Jebel Ali was visited monthly by a doctor who did regular checkups, there were other camps around him where such facilities were not provided. And while those masquerading as doctors do not enter the camps, they are often available on reference from other labourers who visit them. It is especially difficult for those who work illegally on construction sites, he said.

Workers who do not have the proper paperwork or are working illegally are often forced to use unlicensed medical clinics. The illegal workers will not be treated in government centres, unless it is an emergency. "There are things that can't be helped," Mr Srirham said, "like allergies from working with cement. The dust makes a lot of them sick so they have no choice. It is their weakness and it has to be cured so they visit these doctors. They are under obligation when they visit, so they have to pay. They also go for coughs and cold and sometimes fever. But mostly it is related to allergies."

Dr Khaliq Raza Khan, of the Dr Ismail Medical Centre in Al Quoz, said that for most labourers, who earn minimal salaries, money came first and medical treatment second. As well as those prescribing cheap medications there are also those who perform massages, he said, which can do more harm than good. "If someone massages a fracture it becomes more painful and can be displaced," he said. "This is very bad treatment."