Migrant workers in the UAE face an unprecedented dengue outbreak due to government negligence

Migrant workers in the UAE are facing an outbreak of dengue due to a lack of clean-up efforts after the heavy flooding in April, according to a report released by FairSquare.

On 16 April 2024, record flooding in the UAE claimed the lives of at least five people. The health toll is still rising as  stagnant bodies of water across the country have created breeding grounds for mosquitoes and led to a wave of dengue cases.

James Lynch, co-director of the human rights group FairSquare, said:

“April’s devastating floods took a severe toll on people in all parts of the UAE, the impact made worse by climate change. The aftermath has been no different. As cases of dengue have rampaged through the community, the toll on migrant workers, who live in marginalised neighbourhoods and struggle to access quality healthcare, has been particularly harsh.”

FairSquare’s investigation, based on anonymous interviews with three healthcare professionals, a government official, and migrants, found a troubling disparity in flood clean-up efforts. While urban and central areas were prioritized, low-income migrant worker neighbourhoods were left neglected for over three months. This neglect created stagnant water, ideal breeding grounds for mosquitoes that transmit dengue. Furthermore, the investigation revealed significant barriers to healthcare access for migrant workers who may have contracted the virus.

I know two people who went to get tested for dengue and were positive — they needed the test to take sick leave — but there are more who have not tested and were just at bedrest… God knows what diseases are out there.

The UAE has not released data on the number of dengue cases, however, according to the Khaleej Times, hospitals have reported a significant increase in cases of viral fever, cold, and cough. Fairsquare’s interviews with medical professionals in Dubai and Sharjah also confirmed a surge in dengue and waterborne diseases. A nurse in Sharjah also reported dealing with upwards of 30 cases of dengue every 4–5 days.

In May, the Minister of Health said that the government had deployed nine specialist teams to eliminate 409 mosquito breeding sites, whilst acknowledging that the “situation is still spreading at a fast rate.”

A government official who wished to be anonymous told FairSquare that they were proud of the clean-up efforts but also acknowledged that ‘more industrial’ areas (where many migrant workers in company accommodation live) were overlooked.

“The big [breeding grounds] were dealt with right away. But there were so many that were not identified but have clearly been impacting people. We have been working on getting them removed and also enforcing truck spraying to ensure these areas are okay again. These have been in areas that are more industrial, generally.”

A migrant worker living in one of Dubai’s free zones told researchers that their area was only cleaned up once their employer complained to authorities about workers getting sick. A resident of Ras Al Khaimah, reported mosquitoes and stagnant water near his neighbourhood for over a month following the floods.

“They have not gone… I know many people who got sick. I know two people who went to get tested for dengue and were positive — they needed the test to take sick leave — but there are more who have not tested and were just at bedrest… God knows what diseases are out there.”

A migrant worker who lives in Sonapur, a Dubai neighbourhood home to 200,000 migrant workers, mostly men living in labour accommodation, said:

“Where I live, water had been accumulating for weeks after the rain. The big roads got cleared urgently but areas like this have had stagnant water for a very long time and, now, there are mosquitoes and all sorts of insects everywhere. And you will see a queue outside any clinic in areas like this.”

One healthcare worker said that areas where migrant workers lived and worked were “absolutely” worse off than other areas, with stagnant water remaining on the ground until June. However, they felt nervous to offer any further detail for fear of getting into trouble with the authorities.

With healthcare only accessible via private, employer-tied insurance, and with mandatory health insurance only enacted in the emirates of Dubai and Abu Dhabi, workers report a number of obstacles in accessing treatment and information about dengue. One doctor who treats many low-income workers in a private clinic in an industrial area in Sharjah said that alongside physical health concerns, the dengue risk was causing a “mental health crisis” among workers:

“Workers are just very worried. They think of the pandemic and the precarity that followed and they just don’t want that happening again…. Their whole lives are at the mercy of their manager and suddenly they are – many of them all at once – getting sick in a way they have not experienced before.”

The workers’ concerns are not unfounded. MR’s previous reporting during the pandemic revealed that low-income workers face an increased risk of illness due to their overcrowded living and working conditions.

The government official who spoke with FairSquare’s researchers said, “I think a big issue has been that workers have been getting sick and their managers are not helping them access the right information or healthcare help.”

Under the Kafala system, migrant workers, especially those living in company-provided housing, are at the mercy of their employers. Authorities wipe their hands of responsibility, only acting on the issue if employers issue a complaint.

The 2022 Vital Signs Report published by FairSquare detailed the discrimination that migrant workers face accessing healthcare in the Gulf States due to affordability and lack of documentation. With many workers resorting to self-medicating via painkillers or non-prescriptions sourced from their origin country.

Image credit: Enrique Dans @Flickr