The project is one of the most important programmes supervised by The Executive Board which defined the health requirements needed to be fulfilled by workers coming for work in the region, and set details for laboratory and radiological investigations required to be undergone by those workers in addition to defining the set of diseases that workers should be free from.
In addition, The Executive Board chartered some medical centers in their home countries to conduct the specified medical radiological and laboratory investigations before workers are granted the entry visas to the Gulf States.
The Executive Board also subjects those selected medical centers for regular follow up and evaluation.
The development leap, that the GCC States has undergrone during the last decades, was and is still, undoubtedly, in need of more manpower from other countries to help in the continuous movement of growth, development and construction in the area.
For fear of importing any disease that may be prevalent in some of the countries exporting this manpower, or recruiting workers who are unable to fulfill the tasks assigned to them, something which may cause problems to the importing countries and form a burden to the health services in the member states. This created the need to better choose the candidates to work in the area, taking into account the exactness in the medical test before their arrival.
The immigrants do not affect only the health, but also go beyond to the psychological aspects in addition to their performance; namely the influence of the housemaids and nursemaids upon the children in their early childhood. Regarding those working in the fields like agriculture, commerce, Industry, restaurants, hotels and public services, who leave their impression on the social and attitudinal pursuit and on customs and traditions. All that is also related, directly or indirectly, with the Public Health.
Because of the importance of the medical test of the workers before their arrival to the Council States to be certain that they are free from any infectious disease, and since the Board has remarked that the required conditions of the medical test differ from one to another, and since the medical test centers are dissimilar, the Executive Board sees the necessity to unify the efforts between the GCC States to find common program to test the immigrants.
The 38th conference in Rajab 1415H (January 1995) issued a decision approving that the Executive Board shall maintain the supervision of the expatriates medical test centers. The Board, in this regard, formed commissions to visit the main exporting countries of this manpower to examine and choose the medical centers that are competent enough to make the required medical tests according to the scientific and conventional basics and standards. The Board also determined the health conditions required in the authorized medical center, the required medical aptitudes in the expatriates intending to work in the area in addition to the clinical, laboratory and radiological examinations.
The Board also formed a commission which started work since Muharram 1416H (June 1995) and long up to the year 2003 making visits in the countries of South East Asia, exporting most of the expatriates working in the GCC. States: India, Sri Lanka, Pakistan, Bangladesh, Philippines, Nepal, and Indonesia, Ethopia, Egypt, Sudan, and Syria.
The authorized centers, to now, reached 250 health centers distributed as follows:-
Efforts exerted by the E.B. in this respect resulted in the formulation of the Gulf Technical Committee for Evaluation of Health Centers comprising one member from each of the GCC States. The committee is supposed to visit on list health centers in 11 countries to check the standard of the health centers required by GCC States to conduct pre-departure medical check up of the expatriate workers seeking jobs in the GCC States.
Since it had been established, a lot of achievements were made:
1- Setting the health conditions required in the expatriate workers for work in the GCC States.
2- Setting conditions and requirements (Technical and non technical workers, skilled workers, administrative) in the centers of medical check up.
3- Defining the type of violation (administrative, financial, technical) and setting a list of penalties on the violating centers.
4- Putting an accounting system to collect the fees (inspection and registration of the centers, financial penalties and violations).
5- Expanding the program where it now includes (7) Asian countries (India, Pakistan, Philippines, Sri-Lanka, Bangladesh, Nepal and Indonesia). Each country has been given a computer code; country code, city code, and then each center has its separate code. In the adopted centers of these countries, around 1.5 million workers had been checked. It is worthy to note that the number of centers goes up and down depending on adopting new centers or excluding centers who violated the set rules and regulations of the GCC States.
6- Establishment of GCC Approved Medical Centers’ Association (GAMCA) in those cities that have 3 or more than 3 medical centers that perform expatriate workers pre-departure medical check up, with the objective provision of equal distribution of workers to be examined on the adopted centers. The GAMCA office sets up in an independent unit and computerized place that has the key role to play in equal distribution system and has link amongst the centers as well as with the respective concerned GCC states Embassies / Consular offices in that part of city/country. This office also provides to the EB a statement showing equal distribution to the centers as well as carry out effectively any circular/ orders issued by the EB.
7- Holding the annual meetings for the Gulf Technical Committee to discuss the flow of work in the program administratively, technically and financially and the constrains faced suggesting solutions in coordination with the EB. The workplan for the coming years and recommendations are submitted to the EB. So far, 12 meetings.
8- The Bylaws for the Expatriate Workers Program was established and adopted by the HMC/GCC in its 51st conference in 2001 and it was published in Arabic and English version. It was circulated to the member states, Embassies, Consulate Office and health centers in the countries which supply workers to the GCC states, as well as to GAMCA offices. These bylaws include:
- Health centers’ requirements to be adopted as centers for expatriate workers check up.
- Tests required to be performed in the adopted centers.
- Terms of reference, role and tasks of the E.B., Gulf Technical Committee for Evaluation of the Centers, as well as Embassies and Consulates.
- A list of violations and penalties to be applied on health centers upon finding imperfection in the work.
9- Periodic annual evaluation of the adopted centers by the Gulf Technical Committee (or teams assigned by the Committee) according to a specific form.
10- Installing a computerized electronic connected program of the EB and GAMCA offices, Embassies, and Consulates of the GCC States to secure validity and non counterfeit of medical records. This has been implemented by some of the offices and to be completed in the rest in the near future.
11- Information system of the expatriate workers program has been developed to include quarterly reports about the work done by the centers (Number of workers examined in each of the GCC States, number and percentage of unfit workers, types of unfitness ..etc).
12- A mechanism for electronically accessing any health centers to check any required data at any time about any particular center since its adoption was developed.
13- For new applicants (centers) requesting authorization; the concerned department dealing with the health centers in the E.B. was asked to maintain a register and computerized file with respect to centers requesting inspection for accreditation in each city and country of the (11) above mentioned countries. This is to register the centers and issue specific cards containing diary registration data, sequence of the centers related to the registered ones. This is sent to the centers requesting to be authorized to conform with during the next inspection visit to these new centers if there is a necessity and requirement of the countries to increase the number of approved centers.
14- Circulars are sent periodically to the centers and GAMCA Offices to develop the work of the centers and to improve their performance and keep regular reporting.
15- Continuous collaboration with the member states and its provision with all requested data about the work of the centers.
The Executive body in its extra-ordinary meeting held in Qatar 11-12 Dhu Al-Qa’dah 1424H (3-4 January 2004) discussed a lot of developmental issues for the program and issued recommendation # (1) in this respect. The future plan included the following:
1. Completion of electronic communication amongst the health centers, GAMCA offices, Embassies and Consulates in the GCC States.
2. Completion of formulation of GAMCA office in each city that has more than 2 health centers .
3. The use of the computer program of the adopted medical centers which will enable obtaining full reports about all the centers in addition to reports about unfit cases in the GCC states after recruitment. This will ensure flow of information to the member states through the EB information center.
4. Providing the GCC States with reports about medically unfit cases discovered after recruitment, the EB will immediately take necessary actions without the need to wait for the committee to reach the exporting country to set violations penalties on the non-complying centers. A full report about those cases is to be prepared and circulated to the member states.
5. Expanding the coverage of the program to include other Arab and African countries after availing the required facilities of the program (equipment, personnels, etc.)
6. Giving effect to the proposal made about finding alternatives for financing the program.
The Common Policy Features in examination of the expatriates to GCC States : -
1- The Executive Board follows up the performance of the manpower Medical Centers through all means including sending commissions to, regularly and continuously, evaluate and supervise the Medical Centers in the countries exporting manpower.
2- Commitment of the GCC. States to exchange information about the deported labor for health unfitness and provide the Executive Board with such information to help the Board as a main factor for the evaluation of the centers, where that manpower are examined.
3- The Executive Board shall prepare the list of the authorized centers to examine the manpower in every country according to the approved conditions and specifications.
4- The Executive Board has the responsibility to add new centers to examine the manpower or cancel the authorization of any of these centers.
Fundamentals of Success of the common policy:-
1- The GCC States shall approve the adoption of common policy and strategy regarding the examination of the expatriates.
2- These states shall comply with the decision of the Health Ministers and approve the recommendations taken by the Executive Board to add or cancel the foreign medical test centers.
3- License the medical centers for one year renewable, taking into account the evaluation of the centers in terms of the compliance, seriousness and exactness of the required medical tests.
4- Penalty of the centers issuing incredible certificates.
5- The State members shall exchange information regarding the unfit workers and notify the Executive Board.
6- The State members shall comply to deal with the well equipped centers in the main cities only.
7- Sending, in a continuous and regular way, commissions to follow up the performance of these centers and re-evaluate them.
The Method to follow up and evaluate the manpower examination centers:-
Follow up and evaluation of the manpower in the examination centers in a continuous and regular form, updating the list of the authorized centers by cancellation and addition, every year.
The evaluation of the authorized examination centers shall be as follows:-
a- External Evaluation:
Periodical visits of the technical committee to evaluate the manpower examination centers and reporting the Executive Board including the commission’s recommendations to go on dealing with the center impose material or moral penalties or completely cancel the membership of the center.
b- Internal Evaluation :
1- Done by the periodical reports sent by the concerned authorities in the GCC. States regarding the number of the deported manpower for medical unfitness and the cause of that stating the examination centers issuing the certificate of medical aptitude.
2- Feeding the computer with these information after being gathered from the member states in a periodic way.
3- Data analysis and classification , the result of which to be put forth to the concerned committee in the Executive Board to take the suitable measures according to the size and nature of violations committed by any center.
Method to approve new medical overseas examination centers :
1. The center should be licensed by the local/national health authorities, according to the system followed in the country where the center exists.
2. There should be a real need to endorse new centers in the location, in the city, town, in such a way that the number of centers will match the number of expatriates to be examined annually.
3. A center requiring endorsement to medically examine expatriates will submit a request to any Ministry of Health in the GCC States or to the Executive Board directly along with the documents including the required information, notably:
a. Location and size of the center.
b. Human and physical facilities available in the center.
c. Medical services available in the center.
d. Number of expatriates that can be examined monthly in the center.
e. Pledge to abide by rules and conditions for medical examination of expatriates.
f. Pledge to pay inspection fees, registration and annual membership fees, on time, by a cheque certified to the Executive Board.
g. Enclose a certified cheque paid to the order of the Executive Board, in payment of inspection fees upon the request, for endorsement.
4. The location of the center must be easily accessible to expatriates.
5. The size and facilities of the center must be compatible with the expected number of expatriates to be examined.
6. The center will have the necessary equipment and reagents to carry out required tests in accordance with the latest international criteria and standards of quality control. It will also provide approved certificates of quality control for its laboratories.
7. The medical team in all divisions of the center should be highly qualified up to the efficient standards and training to carry out the medical examinations, in all required specialties. The number of personnel in the medical team should match the magnitude of work required.
8. The administrative staff in the center should be highly organized and efficient in order to ensure that the administration requirements are met to guarantee the issuance and validity of certificates issued by the center.
9. Regular and accurate records should be available about the expatriate examined as well as the results of the laboratory tests carried out.
10.Availability of the necessary personal computers, and various communication means e.g. telephone, fax, etc.
11.The presence of contracts for physicians, technicians and administrative workers in the center.
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