February 15 – 20: Background Research Portion

Below I’ve attached my background research portion of my academic paper. Initially, I was going to do a masterlist of my findings, but I’ve decided against it because it wouldn’t really be productive (I’d have to condense it into a background research portion eventually anyways). I’m having some troubles with IRB, so moving forward I’ll be only working with medical school directors and academics close to the issue rather than with real human subjects until I can figure out what to do with the IRB. The last thing I want to do is cross any ethical boundaries, which is why I’ve held off on reaching out to actual patients.

There is clearly a huge disparity in the ways in which people are treated medically. Saudi Arabia and the United States both have glaring societal issues in the ways people are treated, both culturally and medically. In the United States, there is a deeply entrenched history of discrimination against marginalized groups— specifically black and Indigenous or First Nation people. In Saudi Arabia, Southeast Asian migrant workers are consistently treated as less-than in favor of ethnically Saudi people. This perpetuated in the kafala system (نظام الكفالة), which is a legal system used to ‘monitor’ these migrant workers in a way that furthers this unfair social hierarchy.

This is not only qualitative analysis of healthcare. There is statistical evidence that backs up the cultural discrimination against these groups. In GCC Countries, 18% of Indian interviewees in the ‘Undocumented Immigrants in Saudi Arabia: COVID-19 and Amnesty Reforms’ study of 2021 reported “in the case of a medical emergency, they had access to medical care through using their documented friend’s legal IDs.” 50% of Bangladeshi migrants interviewed “noted using friends’ legal papers to receive medical care.” One literature review of Nepalese migrant workers found that Nepalese workers had the highest rate of occupational injuries (28%), and that 17.9% were fatal in GCC Countries. In October 2019, 5,200 Indian migrant workers died of fatal heat exposure in Dubai. While these isolated incidents may not have all occurred in Saudi Arabia, there is a trend consistent with migrant workers in GCC Countries.

Furthermore, we see this trend paralleled in the United States with undocumented immigrants. Because undocumented immigrants are ineligible to apply for Medicare/Medicaid, huge amounts of them end up not getting medical care they desperately need in fear of deportation. 46% of undocumented immigrants are uninsured, in comparison to 9% of US citizens. These restrictions curb access to COVID-19 relief, and present multitudinous hardships for immigrants and their wellbeing.


Arab Center DC: Migrant Workers & COVID-19 in GCC Countries

Health Coverage of Immigrants Factsheet

Undocumented Migrants in Saudi Arabia

The Economic and Psychological Impacts of COVID-19 on Indian migrant workers in Saudi Arabia