Advancing the rights of migrant workers throughout the Middle East

Return to research Posted on Aug 15 2012

GAMCA policies have elicited controversy over the past few years for two primary reasons: the first concerns the facilities’ unfair monopoly over medical testing in labour-receiving countries, and the second regards outdated TB policies that discriminate against perfectly healthy workers. We profiled the latter issues here, here, and here, but this article is primarily devoted to GAMCA’s unfair business practices.

GAMCA stands for G.C.C Approved Medical Centres’ Association. These centres are the only medical facilities the Gulf permits to conduct pre-travel medical tests for prospective migrants. In late July, the Competition Commission of Pakistan (CCP) addressed complaints raised by the Pakistan Overseas Employment Promoters Association (POEPA) on behalf of exploited communities. The CCP fined 20 GAMC facilities and GAMCA administrative offices a total of RS 500 million for “collusive behavior.” The CCP ruled that GAMCA “exploited customers by restricting their choice and imposing unfair terms and conditions.”

Similar accusations against GAMC facilities were launched earlier in the year by Nepalese, Filipino, and Sri Lankan authorities.

The effect of the GAMCA monopoly on migrants is multi-fold: the absence of competition allows GAMCA to impose fees with little consideration to the financial circumstances of workers. Though GAMCA officials in Sri Lanka stated that a recent fee increase of RS 1,500 should not impact workers because foreign sponsors are responsible for such charges, many applicants do pay for their own medical testing, which adds to the exponential cost of pre-migration requirements. One prospective migrant worker explained,

Let us decide where we can undergone medical test with the cheapest but with the best facilities. Because more of this clinics they endorsed are collecting money and they are giving some false test just to repeat again the test with additional fee they collected. I am hoping that the government make priotize this kind of problem [to] remove the graft and corrupt practices not only in government but also in private sectors [Sic]. Source: StopGAMCA.org

The unfair privileges of GAMC facilities also affects the quality of medical service. Many migrants claim that the facilities are subpar and unprofessional. In regards to TB tests in particular, migrant workers complain that GAMC employees do not help them understand the procedures or their results. They are also endure long delays that add to the already stressful nature of pre-travel preparation. According to a resident professional identified as “Maynard,”

The main problem is most GCC nations did not provide GAMCA with any specific guidelines or standards in health screening. If you go to these clinics, you would not see any posters or leaflets showing their guidelines. Any spots or marks on one’s chest x-ray is labeled as TB, including marks and scars not even related to TB, for example, past infections from bronchitis or pneumonia.” Source: StopGAMCA.org

Some also allege that the monopoly on testing begets corruption:

I even asked them if we can bring a result from outside hospital and if the result is negative, are they going to consider or evaluate result for comparison. They said that they will not honor it. …They don’t even think that the people who consulted their clinic do not pick up the money from the streets to finance their medical exams!…I even consulted a rad tech friend who worked as a head radtech in a known hospital, he said that as for his profession “they can do magic with the film to show a false result!”… all we have to do is bribe them and the result will instantly remove all the findings in the film [Sic]. Source: StopGAMCA.org

Migrant Rights spoke with the founder of StopGAMCA.org, Abdul Rahman Asim, earlier this year. Asim explained that the pursuits of labour-sending countries can yield uncertain results:

A collective effort would have much better impact. GCC countries official attitude is very stubborn, if Nepal stops GAMCA centers, they will announce we will hire from Vietnam or some other country, instead of looking into the matter.

Additionally, prohibiting the monopoly of GAMCA facilities would have only limited effects on the most controversial component of GAMCA policy; the discriminatory TB policy itself would not change. But the opportunity to verify test results with a non-GAMCA facility, and the potential for greater patient support from these alternative facilities, would help reduce the stress on workers undergoing TB testing. Additionally, the success of labour-sending countries in influencing one sector of G.C.C migrant policies may establish a precedent to address other GAMCA issues.

Policy Studies & Reports, GCC, Polices & Reform, Racism & Discrimination, Documentation, GCC, News & Events, Research, Workers

36 thoughts on “GAMCA Controversy Update

  1. Maynard says:

    Before going to any GAMCA clinics, please try to read this as GAMCA and even non-GAMCA clinics are making money out of this whole mess. It’s an insanity of misinformation.

    A simple comparison of old and new chest x-ray films can accurately tell whether one has active or cured TB. An AFB smear test is only done when chest x-rays shows abnormal/suspicious results, meaning there might be a new TB infection or there has been notable changes in one’s old vs. new x-ray films (that’s why it’s important to bring old x-ray films when undergoing a new one otherwise physicians will often conclude “suspicious” or “PTB of undetermined activity” findings since they have nothing to compare it with).

    A skin test (PPD or TST) is only used to check whether one has latent TB, it is useless to those who had previously known TB history. Blood tests produces inaccurate results and are banned by WHO. A sputum culture is only done to those who are suspected of having multi-drug resistant TB (MDR-TB).

    So you don’t need to take all these kinds of TB tests, meaning you must refuse to pay for all of these tests. Chest x-rays alone are accurate enough.

  2. rizwan anwar rizwi says:

    Dear sir
    I have problem form GAMCA medical centre.I have done medical form Gamca for Oman in june2012, I was FIT there.
    After six month I want to do medical again, but Gamca is not providing me Gamca slip,
    Since last 3 month I am try for Gamca slip for the medical,
    But they are not providing me
    Saying me to wait
    I am waiting form 3 month,I am in trouble,I am jobless do to this problem
    I can not go abroad due to these problem
    Passport no- J9801636
    Name – Rizwan Anwar Rizwi
    Please help me

    • sir i need yor help .i am going to gamka medcalin desamber month.he is doing unfitt me he is saing after 3 month your next meadcal but nw he is saing after 9 month is my meadcal plz help me I am a job les

  3. mhike says:

    what can i do if your name already submitted to gamca?and your going to apply a new one in other gcc country?

  4. [...] disadvantaged by these policies, many of whom were further agitated by medical centers’ poor or misleading services. Unfortunately, few international organizations were willing to publicly condemn GAMCA’s [...]

  5. Virlyn Corpuz says:

    hi, is GAMCA controversy is still issue nowadays? because i will be undergoing medical test in GAMCA this Feb. I am confuse with this controversy because the clinic may UNFIT me even if i am sure that i dont have any sickness. My Agency told us to prepare atleast 4000 for the medical test.

  6. TOUSIF says:

    I HAVE UNDERGONE HERNIA SURGERY 6 YEARS BACK CAN I PASS GAMCA TEST FOR MECHANICAL TECHNICIAN.

  7. Frederick says:

    I am experiencing the same thing. Before I was hired by a new company, one of their strict requirements is to undergo a pre-employment medical examination. I did the examination in the UAE on December 2012 because I was hired there. Everything is clear and normal as a result of my tests. Then I was instructed by the new employer to hand over my resignation to my previous one and return back to the Philippines at their costs. I had my medical examination to GAMCA here in the Philippines on February 1 and everything is OK except for the result of my x-ray. The clinic said that they found a Minimal Apical Pleural Thickening Bilateral on my x-ray. They suggest another x-ray view and unfortunately they said the result is the same and I am again scheduled to come back for another one. I’m not sure if their findings are accurate or false. I’ve read a lot of threads regarding this matter and all of them talk about the same issue. I just don’t have any idea of what would happen next. I hope this issue ends soon.

    The question: Is Minimal Apical Pleural Thickening would make me “UNFIT” even if it’s not a contagious disease?

  8. Ryan Dela Cruz says:

    Hi,

    I under go testing in one of your accredited clinic “American Out-Patient Clinic” before i been test by American Out-Patient Clinic i’d under go check-up week before and i pass then here’s American Out-Patient Clinic i’d been un-fit so i went to a family friend doctor to check me and i pass now the American Out-Patient Clinic still dont consider my 1st and 2nd check-up because they dont recomend the check-up. they give recomendation to department of health here but to some attorney on the department.

    I’m just concerned on the patients of American Out-Patient Clinic on a month some of the patients here under-go x-ray for five times after that the person will be cleared yet surely that test will get him soon.

    Please let me know what to do next, I just want to work

  9. aamir says:

    can hernia make unfit a prssn to work in UAE

  10. MEREMA MOHAMED says:

    Is seeing or finding scar on x-ray examination conciders as active TB or contgious????am from ETHIOPIA

  11. Ashfaq Hussain Malik says:

    Sir I have got GAMCA no. And medical due to missbehave of doctor medical has beee canceled. Sir I want again medical but how I can take GAMCA slip for medical. Please help me I am blonging to a very poor family.. Thanks

  12. Syed Zahoor ul haque says:

    I have done GAMCA for Oman in Mumbai
    my result is FIT
    But Doctor unnecessarily forcing me to do again blood test
    they showed that my bitrate is 2.6 and it is possible that after six months you ll get Hepatitis
    i said it means i m unfit
    they said no you are fit but do this test again any pay again
    i insist to provide certificate but they are delaying it from last four days

    i saw that they are catching only high profile job ppl to repeat tests and collect money

    there are several case of such ppls specially in Bhatiya hospital Marine line Mumbai

    plz take certain action against them
    they are forcing ppl to undergo test even if they are fir
    and collecting money for each test again

    plz stop this injustice
    thanks Jazak ALLAH

  13. Dinesh says:

    GAMCA (GCC approved medical centers association) is a facilitator for corruption as it forces people to go to a particular medical center. It is unfortunate that in a land of thousands of medical centers only a few are “authorized”. Even then, the candidates should have the right to go the center they choose at least. If they are forced to go according to GAMCA decision, the medical centers will treat the candidates like animals.

    I have been to “Health care diagnostic center” in Trivandrum, Kerala state and the treatment is inhumane, derogatory, insulting and a disgrace to the medical profession, the state and the country. If this is allowed to continue, many will continue to suffer for no fault of theirs.

    Regards,
    Dinesh Mathew
    dinesh_mm@yahoo.com

  14. Jojo says:

    Their policy of automatically tagging applicants with lung scar as UNFIT is inhumane and harsh. Hope we can elevate this WHO to convice the GCC of their outdated policy on PTB scar.

  15. mohd shanu ali says:

    Dear sir

    Last 5 month letter I was done medical hai through by gamca and this month I m agian go in gamca office but they said u come after a year sir I m just asked is that nt posible after 5 month again my medical Because I m totally fit and my visa is perfact pkz reply me

  16. SYED says:

    DEAR SIR
    WANT TO SHARE MY EXPERIENCE WITH MEDICAL CENTER OF GAMCA FOR SAUDI. I M RIGHT NOW AT SAUDI FOR WORK. AS PER RULE I WENT TO GAMCA CENTER AT LUCKNOW,THERE I GOT MY MEDICAL CENTER NAME FROM WHERE I HAVE TO DO MY MEDICAL TEST (ASIAN DIAGNOSTIC CENTER) NEAR HAZRATHGANJ LALBAGH. THEY HAVE MADE ME UNFIT THEY SAID I HAVE FIBROSIS AT LUNG WHICH SHOW IN X RAY. SOME SPOT AT LUNG. I WENT TO ONE HOSPITAL THEIR I DID AGAIN X RAY THEY SAID NO SPOT ALL CLEAR, I TOLD TO ASIAN DIAGNOSTIC CENTER THAT HOSPITAL REPORT IS CLEAR. ASIAN DIAGNOSTIC PEOPLE SAID THEY DO NOT ENTERTAIN OUTSIDE REPORT. SO I ASK ANY OTHER OPTION THEY SAID IF YOU CAN GIVE MONEY WE CAN DO SOMETHING,,SO I HAVE GIVEN MONEY. THEN THEY MADE ME FIT IN MEDICAL CERTIFICATE BUT FROM OTHER MEDICAL CENTER. WHICH IS GAMCA APPROVED.THEY HAVE SOME INTERNAL SETTING,,AFTER COMING TO SAUDI I AGAIN GONE THROUGH MY MEDICAL TEST DONE AS PER SAUDI RULE WHICH INCLUDE X RAY ALSO AND I M FIT BY SAUDI MEDICAL CENTER,, NOW YOU CAN THINK HOW MEDICAL CENTER IN INDIAN IS DOING THINGS FOR MONEY,,IF I HAVEN’T GIVEN THEM THEY WILL PUT ME IN UNFIT AND I WONT BE ABLE TO COME SAUDI,, THIS IS HOW THEY ARE PLAYING WITH PEOPLE LIFE FOR MONEY.

    • Sameer says:

      Can You Please provide me more information about gamca slip re-issue or any option for change of medical center from one city to another city…

  17. MOHAMMED SALIM QURESHI says:

    GAMCA ADDRESS IN LUCKNOW

  18. Ali Faraz says:

    what can i do if your name already submitted to gamca?and your going to apply a new one in other gcc country?

  19. Mohammad says:

    Dear sir,
    I have done medical from one centre in mumbai,Royal diagnostic centre,for job in kuwait and i am declared X-Ray unfit,small patch known as fibrosis,i went to Institute of liver and billiary science,New Delhi,and their X-Ray report showing nothing,i called my consultancy but they are not accepting the report.
    Even that diagnostic center person told me that this is not a disease but this is scar and you are UNFIT.I have 6 years UAE experience and i have never experience such type of problem during medical.
    Which kind of policy is this …when this scar is not harmful for me how it can be harmful for others.
    This kind of discrimination should be stopped.
    I am in support of STOP GAMCA and In Sha Allah policy will be revised very soon.

  20. Noor IMAM says:

    HI ,I have done medical from HEFCO medical center located in Bharatnagr.Delhi,for the job of saudi and I am declared UNFIT due to sugar which is little increased at that time.Now a day sugar is comman problem and can control it.but medical center didn t give a chance to repeat it,There is problem to get another Gamca slip even sugar is controlled .I want to know when I get another GAMCA slip…and gamca rule

  21. ramu says:

    i had also faced the same issue,i had never faced any serious health issue,but when i went for GAMCA check up, they made me unfit by X Ray test for Fibrous calcification scar in my lung.Even the doctor is telling that it is not at all a disease .common for Asian people.

  22. Charanjeet says:

    Discrimination and Harassment on assumption based chest scars.

    My name is Charanjeet Singh, an Indian national.

    March 2013, I received employment in a law firm in D.I.F.C. or Dubai International Financial Centre, when I appeared for medical test at al Muhaisna medical centre which is a part of D.H.A or Dubai Health Authority, suspected that i have old T.B scar. I was deported immediately after scanning, without given me a right to appeal.

    I went to A.I.I.M.S [All India Institute of Medical Sciences] hospital at New Delhi and done all my checkups i.e. Skin test or Mantoux twice, Chest x-ray, Blood test, 3 times Sputum test and a Chest C.T Scan too on special advise by senior doctor to have a close look at the scar.

    Based on my test reports, A.I.I.M.S issued me the Certificate stating that I do not have any active T.B. Senior doctors asked me why did they deported you when there is no sign of T.B in our body?

    3rd December 2013 at Asia’s well known Tuberculosis Hospital in New Delhi that is L R S – T.B Hospital, have checked my all reports and done my chest x-ray and culture test thrice at their hospital. All reports are negative as on date.

    15th January 2014, Latest report from All India Institute of Medical Sciences [AIIMS] hospital, New Delhi has given me fitness certificate stating NO HISTORY OF TUBERCULOSIS IN MY BODY & NO HISTORY OF TUBERCULOSIS IN MY FAMILY.

    20th January 2014 and 22nd January 2014, most recent test reports conducted from two different Pathological labs for the same test on different dates i.e. QUANTIFERON TB GOLD TEST which is specially designed for detecting latent or old tuberculosis, are also Negative.

    Conclusion: – As per written reports and India’s super specialty hospitals, there is no evidence of either Active or Latent Tuberculosis in my body at all.

    Neither I, while working and staying in my home country or Dubai, nor my parents had any kind of T.B infection in their lifetime.

    Loopholes: – This law will only hide patients who have active tuberculosis at present and will never let them come before the government to avoid deportation and get better treatment.

    http://www.thenational.ae/news/uae-news/health/deportation-laws-reform-lies-dormant clearly mentioned by Dr. Mario Raviglione, Director at W.H.O, this is absolute discrimination.

    Feeling of Inequality, Harassment and discrimination comes in the account of those who have suspected scars; in few cases are active tuberculosis patients. Just imagine their pain, they are already sick and on the top of that they are getting permanent deportation.

    Only the wearer knows where the shoe pinches.

    I really felt humiliation from Dubai Health Authority for deporting the patients on the basis of their outdated laws.

    Please sign in to support my online petition for the welfare of future victims.

    http://www.change.org/en-IN/petitions/heights-of-discrimination-against-indians-in-dubai-united-arab-emirates

    I hope necessary action will be taken on this issue on humanitarian grounds.

    Regards

    Charanjeet Singh
    0091 9560728263
    singh.charanjeet@rocketmail.com

  23. Riyaz Shaikh says:

    Please revise GAMCA rules regarding lung scars.

  24. Riyaz Shaikh says:

    If GAMCA-India clears the candidate with lung scar then whehter it will a problem in KSA before pre-employment medical check up ? Will they do further investigation ?

    Do we have to undergo GAMCA test every time we need to renew visa/contract ?

  25. Pradip Dey says:

    Good day Sir,
    I am Pradip Dey. Eight years I have worked in abroad and still I am doing. Recently I am home.I was approved by one company and was said to do medical. The diagnostic centre was under GAMCA. when I finished my test after some while they said that I was medically unfit because of a minimal fibrosis. I went and checked myself on a pathology centre I saw that there was nothing I was absolutely fit. I challenge GAMCA with my report that if they have guts then they should come and give me an answer that why did they do this. they diagnostic centre even said me that I have been black listed from gulf countries if I accept my wrong report I want an answer from GAMCA!

  26. rosalie b. unidad says:

    i have done gamca,the result is unfit..if i apply again in other gamca countries,is it possible or no more chance to wrk in middle east..what countries not under by gamca,,pls help

  27. Ahmed says:

    Dear Sir,

    Can anybody give me the contact details to complain about the facilities and procedures in one of the GAMCA medical centres in Chennai.

    Regards
    Fiaz

  28. amir says:

    hi sir,
    l am amir and I am unfit for GCC countries and on my chest have little scar I discussed with biggest Delhi hospital CMO and he told me I have nothing problem I have done 5 years in gulf countries that they did not make this problem but why now,

    l pray he will die who make this rule insha Alllah.

    Why they can make this kind of stupid rule i want to make harasment case on this gham ka chief medical officer the lot of people making bad pray for him some people say he will die some people say is a bad man some people say he is not human human god please help us we are very in big problem please help those all people as in this problem.

    Allahu akbar allahu akbar allahu akbar allahu akbar allahu akbar allahu akbar asha dual la ilaha illallah asadullah allaha, asha deewana mahammad roseola allaha.

  29. hamid tabrez says:

    GAMCA medical and procedure think that they are either too intelligent or the superior to all medical center, but unfortunately they are the foolest one, I had gone for GAMCA medical and I have minor problem of conginital scoliosis which can hardly be recognised without x-ray, all my medical test was fit but when they had taken my chest x ray, they had notified my minor curve of spine near my shoulder and on this ground they had rejected me and declared me unfit for the official job whereas I had consulted several orthopaedic doctors here in India they said that I am normal person and can do all my day to day job and duties, and they also said me that nothing could be done with this congenital curve of spine which is called as scoliosis, GAMCA authority should check the degree of disability then should take any decision to make a person unfit, Arabian countries are going to wrong direction.

  30. hatimm khan says:

    Sir, Any body Can tell me the Procedure to get the GAMCA slip ???

  31. Dharmendra Kumar Verma says:

    R/Sir,
    My Name Munna Verma before im working at muscat (OMAN) 4 years.
    Now i got offer working at oman.
    Sir my x-ray showing old healed. Im fit or Unfit for oman visa.

    • Dharmendra Kumar Verma says:

      R/Sir,
      Before im working at oman 2007 to 2011. Now i got offer from Oman.
      Sir my x-ray showing old healed. Im not suffering from TB in my life. X-ray report is sulpha group medecine (Bactrim ds) reaction. This healed 23 years old, im FIT or UNFIT for OMAN visa.
      Sir i request to you pl sugesition me, im waiting your answer.

      Thank you sir.
      With regards
      Dharmendra Kumar Verma.

  32. Dharmendra Kumar Verma says:

    R/Sir,
    Before im working at oman 2007 to 2011, some family problem in 2011 so i back india. Now i got offer agen from oman.
    Sir my x-ray showing old healed, im not sufering from any critical deases by biarth to till date. X-ray report is medicine reaction (Bactrim ds ‘sulpha group’). This report for oman visa FIT OR UNFIT pl reply me. Sir in

  33. Jepoy says:

    I also experience the same thing, I have past history of PTB somewhere in 1992 and got my medication for 6 months. When I apply to one agency somewhere in Ermita, Manila. I was selected by the employer supposed to be bound for Qatar, but when my agency told me to do the medical in St. Peter Paul and Mary medical clinic, The result was UNFIT TO WORK becoz of lung scar and pleural thickening, I was very disappointed. After 1 yr I tried again to apply to another agency and I was selected again by the employer, so when the agency again told me to have my medical, I talk to the secretary in the agency and I told her that I have a pending case in GAMCA and show her the past result of my medical, then the secretary call to the doctor in the medical clinic who will conduct my medical, then praise the lord I got FIT TO WORK in my medical report, And when I reach K.S.A. I have to do again my medical for IQAMA, I was clear………….. So my advise to fellow applicant, If you have this problem like mine, try to talk to the manager or to the person who will give the referral for medical and tell your situation. And hopefully you’ll get lucky too like me. So long and God Bless us all…

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Advancing the rights of migrant workers throughout the Middle East