What Can P-Noy Do about GAMCA

GAMCA or the Gulf Cooperation Council (GCC) Accredited Medical Clinics Association was reportedly initiated in Bangladesh as a result of the huge number of Bangladeshi workers being sent back home after undergoing medical checkup and found unfit to work in their host countries. Apparently, overseas recruitment and placement agencies in that South Asian country routinely negotiated with clinics to stamp workers “fit-to-work” even if the result of a medical examination is contrary, in exchange for “kickbacks” from the workers.

After the creation of GAMCA in 1999, medical exams were standardized and the number of cases of workers being sent home to Bangladesh due to medical checkup failures, dropped considerably. Hailing the effectiveness of the scheme, GCC countries – Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates – sought to emulate the system in India, the Philippines and other Asian countries.

In 2001, the Executive Board of the Health Ministers’ Council of the GCC established in the Philippines the centralized medical referral decking system, through GAMCA, “to address the proliferation of fake medical certificates, do away with the rebates that affect the integrity of medical testing, and to protect the citizens of GCC countries from being infected with communicable diseases that may be borne by GCC-bound OFWs.” Under this system, Filipinos who are applying for overseas employment in the Gulf States shall undergo medical examinations in GAMCA clinics only.

The GAMCA member clinics in the Philippines are:

1. American Out-Patient Clinic
2. Angelina Apostol Punzalan Medical Clinic
3. Angelus Medical Clinic
4. Arguelles Medical Clinic
5. Christian Cangco Medical Clinic
6. International Diagnostic Clinic
7. L-R Medical Clinic
8. Mabini Medical Clinic
9. Our Lady of Fatima Med Clinic
10. Physicians Diagnostic Clinic
11. Philippine Medical Test System
12. Ruben Bartolome Medical Clinic
13. S.M. Lazo Medical Clinic
14. St. Martin Polyclinic
15. St. Patrick’s Healthcare System
16. St. Peter & Paul Medical Clinic
17. St. Vincent Medical Clinic

There is no denying that GAMCA’s aim is noble. Yet, why is there so much complaints and opposition to its continued existence in the Philippines? Primarily, overseas Filipino workers (OFWs) feel that GAMCA’s standard for a fit and healthy worker is not only very strict, but is somewhat ridiculous. An OFW could be stamped as “unfit” to work in GCC countries if he has any of the following “diseases”:

Infectious category:

• HIV/AIDS reactive
• Hepatitis B surface antifgen, HCV reactive
• Microfilaria positive and malaria blood film positive, known leprosy patients
• Tuberculosis – any type, X-ray showing active PTB, past evidence of PTB or healed pulmonary scar, including minimum fibrosis, calcification (granuloma) pleural thickening, pleural effusion, tuberculosis lymphadenitis
• VDRL/TPHA reactive

Non-infectious category:

• Chronic renal failure
• Chronic hepatitis failure
• Congestive heart failure
• Hypertension
• Diabetes mellitus
• Known case of cancer
• Psychiatric disease and neurological disorders
• Physical disabilities, i.e. color blindness, deafness

A large number of prospective and redeploying OFWs had been denied a chance of working abroad because of this unreasonable GAMCA standard. As emphasized in the list above, a past evidence of PTB or healed pulmonary scar is considered by GAMCA as an infectious disease. OFWs need not be medical specialists to know that a past evidence of PTB or healed pulmonary scar simply means that a person had already been cured of PTB, as evidenced by the healed scar. How could a scar – healed and dry – become a disease, much more an infectious one? This lamentable case is best illustrated by a GMA News.TV story of nurse “Sitti”:

Filipino nurse Sitti thought that she had finally fulfilled her dream of working in Saudi Arabia after passing a hiring firm’s standards, only to be denied that opportunity by a failed medical test administered by an exclusive group of clinics…

… In an e-mail sent to the Center for Migrant Advocacy, Sitti said that a Gamca clinic declared her “unfit” to be deployed because a scar was reportedly found on her lungs.Being a nurse herself, she said that she got a second opinion from the Lung Center of the Philippines and found out from the results that the scar was inactive and was told that this wouldn’t be a hindrance to her work.“Binigyan po ako ng clearance ng Lung Center stating na I am fit to work (I was given a clearance by theLung Center stating that I am fit to work),” she said in the e-mail.After being declared “unfit” by the Gamca clinic, however, she went back to Mindanao, bothered by the thought that if she applied again, she would still be turned down.

Another reason for GAMCA’s notoriety among OFWs and recruitment agencies is the perception that the association is exploiting the OFWs’ inherent vulnerability in seeking medical clearances and is “reportedly operating like a cartel or mafia”.

The “referral decking system” is a centralized medical referral decking system established in 2001 by GCC states — Saudi Arabia, Oman, Qatar, Kuwait, United Arab Emirates, and Bahrain supposedly to stop the proliferation of fake medical certificates and the transfer of communicable diseases from foreign workers to citizens of the GCC-member countries.However, some migrant groups have scored the Gamca for operating like a cartel or “mafia,” saying these clinics connive with each other to reap profit from charging exorbitant medical fees.“The recruitmentagency refers the aspiring OFW to Gamca, and Gamca in turn designates a member-clinic to conduct the medical checkup and formalities on an aspiring OFW only after the job seeker (has paid) hundreds of pesos for the ‘referral’ made by Gamca,” said John Leonard Monterona, Migrante regional coordinator for the Middle East in a recent statement.Monterona previously said that even those who are healthy would be surprised to find that their medical test results indicate that they have a spot on their lungs, or need to clean their teeth, or need to undergo electro-cardiograph (ECG) test.

A 2005 position paper submitted to the Department of Foreign Affairs (DFA) by the Filipino Migrant Workers Group raised the following very convincing points:

… Clinics have started charging PHP2600 to PHP2700 per Worker (Phase 1 & 2). Out of the PHP2600.00, the Clinics give an average of PHP1000 (to as high as PHP1400) to the Agency who refer their workers. This only means that the Clinics are still earning despite giving away almost half of the Medical Fee paid by the workers otherwise it cannot go on for more than a decade (1990-2003). It’s unimaginable that the scheme (actually it’s a SCAM!) went on for 13 long years without the knowledge of the people tasked to look at the welfare of the OFWs resulting into a multi-billion-peso loss that could had been used to improve the lives of the Workers. A Cerebral mind is not needed to have an idea of how this scheme is working to the detriment of the Workers. This year, the amount of Medical fee for OFWs bound for Korea is PHP1,320 pesos only, THE TESTS ARE EXACTLY THE SAME AS THE ONES CONDUCTED TO GCC BOUND OFW’S BY GAMCA MEMBERS. The only difference is that those Clinics are NON-GAMCA members and do not have a DECKING SYSTEM , however, they are accredited by DOH-POEA and most of them are members of AMCOW (Association of Medical Clinics for Overseas Workers)…

As claimed by GAMCA, the Decking System was conceptualized and imposed by the GCC Health Ministers to address the problem they encounter on fake/forged Medical test Certificates. Though there is some compelling reasons for the GCC to guard their interests, it was very clear however, that the DECKING SYSTEM may have been hatched by GAMCA to achieve the following;1.They want to distribute the volume of Workers equally to all members thus assuring everyone an equal share of the booty at any given time.2.With the scheme, the OFWs and the Agencies are now left without a choice as to which Clinic to choose, thus the Clinic can now afford to keep the rebate for themselves.

FACT 1

Those 17 Clinics who now called themselves GAMCA are the same Clinics accredited by the GCC Embassies since the beginning, therefore it is logical to think that they are also the ones responsible for the issuance of the faked/forged Medical Certificates. Some of them were in fact suspended by the Embassies at one time or another and threatened with revocation of their accreditation.

FACT 2

The Medical Decking System was conceptualized and proposed as early as 1999, a series of hearings between the Recruitment Agencies and GAMCA were held at the DOH premises presided by Atty. Lutero without the representation from the Workers. There was resistance from the Recruitment Association aware of the consequences of the scheme, however, it was declared by PASEI & OPAP that they are willing to forego the Rebates for as long as there would be no implementation of the Decking System. Meanwhile, despite the many attempts to implement, GAMCA failed to push through with it. In the 2nd Quarter of 2001 Administrative Order No. 5 was issued approving the implementation of the Decking System, just a few weeks before Secretary Dayrit assumed the office of the Secretary of Health. We can only assume that GAMCA took it as a good timing to have the approval from the Secretary without elaborating the defects of the System. In the pretext of protecting the interest of the receiving countries, GAMCA likewise has managed to get the support of the GCC Ambassadors.

FACT 3

Despite the removal of the rebate and the clamor to lower the cost of medical testing fee, GAMCA has even used the scheme to squeeze the workers dry by imposing a lot of additional tests to benefit other Health Practitioners associated with them. Workers are immediately declared unfit should their BP register at 130 over 90 on their Sphygmomanometer. Should the worker appeal the Tests Results, he will be sent for Cardiac clearance to a designated Clinic of their choice thus spending thousands of pesos unnecessarily. The same goes for simple Dermatological deficiencies, Dental & Optometric Cases. It is now common for Workers to spend over PHP3000. This DECKING SYSTEM has legitimized the abominable act of squeezing more sweat and blood of the hapless OFWs.What makes it worse, even OFW dependents like mothers and children are declared unfit if they are found to be pregnant or found to have Scar in their Lungs. Isn’t this the height of stupidity? These are mothers and children who are going overseas to reunite with their family and not to work.

On September 26, 2008 Department of Health (DOH) Secretary Francisco Duque III signed Memorandum No. 2008-0210 ordering clinics belonging to and identified with GAMCA to “forthwith stop, terminate, withdraw or otherwise end the insidious practice known as the referral decking system.” But up to this time, the order is basically ignored by GAMCA, which continues to implement the system because they have a pending appeal with the Office of the President for the revocation of the DOH Order.

Meanwhile, a large number of OFWs continue to be denied their rightful means of livelihood in GCC countries. Ang hinaing ng mga kabayang Pinoy na napagkaitan ng hanapbuhay dahil sa hindi matuwid na patakaran ng GAMCA ay matatagpuan dito. Pangulong Noynoy, kung tunay ngang ang iyong “boss” ay ang Sambayanang Pilipino, sana ay bigyan mo naman ng pansin ang kanilang hinaing at dalhin mo sa “tuwid na daan” ang GAMCA.

Tags: Featured, GAMCA, Noynoy, OFW, OWWA, POEA