Surveillance in Occupational Health: The Case of Taiwan's Medical Examination System for Migrant Workers

Occupational health inspection is an important component of the worker's health protection system. In the case of migrant workers, health examination appears to play rather a role of epidemic control than that of health protection. This paper aims to investigate the case of Taiwan, which started to introduce migrant workers in 1989. In-depth interviews and secondary data analysis were used in this study.

A migrant worker in Taiwan is requested to have four times of medical examination during their contract period. The government and the employers may adopt the methods of reject entering or deportation to sustain a healthy labor market, which conforms to both epidemic control and economic development. Judging the result of medical examination highly relies on biomedical knowledge. In the process of medical examination, migrant workers in Taiwan suffered not only from the power disparity caused by medical knowledge between the doctor and themselves but also their disadvantages of language and culture. Medicine, therefore, has actual social power that transcends the essence of science.

The medical examination is a process of medical gaze, during which the body and the action of a migrant worker become the objects which the mechanism of social surveillance displays. The hospital becomes the state's proxy organization, and the doctor becomes the entrusted actor that executes surveillance. Medicine, law and the state's policy form a stringent net of social surveillance. From the viewpoint of occupational health, the outcome of this inspection system has departed far from the core of occupational health inspection.