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Tuesday, March 15, 2016, 09:12

Work injury: Who’s got your back?

By Ming Yeung

There are nearly 6,000 on-the-job injuries every year in HK. Those who suffer the most may face years of waiting for rehabilitation. Ming Yeung  reports.

Work injury: Who’s got your back?

Hong Kong’s unenviable record for workplace safety is long overdue for a complete overhaul. On the job fatalities in Hong Kong (5.2 deaths per 10,000 workers) are triple those of Australia (1.7/10,000 workers) and double those of Singapore (2.1/10,000 workers) on an annual basis. Of equal concern is Hong Kong’s lack of facilities to treat the more than 55,000-60,000 work-related injuries occurring every year.

Local studies reveal that the Hong Kong public healthcare system doesn’t even focus on work rehabilitation as part of its treatment approach. With 10 percent of work related injuries requiring at least three months of rehabilitation, the five-to-six thousand workers needing help are forced to wait in long queues, until the golden period for rehabilitation (within six months of the injury) has passed, by the time they receive attention. Since there’s no workers compensation fund, employees sidelined by injury face the additional hardship of having no income.

K.K. Law had no idea what he was in for, after he was hurt in December 2014. It was his fifth day working on a new job at a local hotel. He and three fellow workers were moving some shelves. Law tumbled down some stairs and sprained his back.

He was ready to shake it off until a sharp pain in his back warning him, this was serious. He couldn’t walk.

The Employees’ Compensation Ordinance requires that employers pay any injured employee four-fifths of his monthly earnings at the time of the injury. Law had five days on the job.  Not much there. He got HK$3,000. He couldn’t go and see a private doctor with that and getting an MRI (Magnetic Resonance Imaging) scan in private hospitals was way out of reach.

Doctors told him he had a slipped disc and put him in the queue for therapy — a queue, stretching out for 150 weeks. Waiting time of two years to see an orthopaedic specialist for non-urgent cases are common in Hong Kong.

“The pain is perpetual but there is no way out,” he sighs. “The first few months I could barely walk. Every 10 steps I had to stop for a break. My finances ran out and I was in despair,” the 39-year-old recalls.

Work injury: Who’s got your back?
The MORE program promises early diagnosis, prompt case management, and timely rehabilitation for injured workers. (Edmond tang / China Daily)

A glimmer of hope

The first ray of hope shone, when Law was invited to join the Multidisciplinary Orthopedics Rehabilitation Empowerment (MORE) program, under Dr Law Sheung-wai of the Department of Orthopaedics and Traumatology at the Chinese University of Hong Kong.

The MORE program, inaugurated in 2011, promises early diagnosis, prompt case management, and timely rehabilitation for injured workers, functional restoration and early return-to-work.

In other advanced economies, Dr Law acknowledges, patients suffering from work injuries are given specialized treatments to speed up recovery and get them back to work.

Not only do workers in Hong Kong have to repeatedly visit hospitals to get medical certification, Dr Law notes, those stuck in endless queues, are likely to develop secondary disabilities.

They get a little stir crazy from their disability and inactivity. They get depressed, start losing self-respect and may commit suicide, says Professor Paul Yip Siu-fai of the Department of Social Work and Social Administration at the University of Hong Kong.

Yip’s department worked with the Employees’ Compensation Insurance Residual Scheme Bureau on a survey to try to figure out why the local system for helping injured workers is so lamentably bad.

Labour Department statistics show that in 2013, for every 1,000 workers, there were 14.2 claims related to on-the-job injuries. That puts us, about in the middle when compared to other countries and regions based on International Labour Organization statistics.

Yip’s research shows that after preliminary diagnoses, workers are left to deal with pretty serious pain with passive treatment, like taking rests and getting physiotherapy.

Dr Law adds his own perspective, noting lack of coordination and communication among referring doctors and other healthcare professionals all the way up the chain. In most cases, there are no case managers to care for injured workers and watch them progress toward returning to work. Dr Law argues these are failing that extend the recovery process substantially, and cause unnecessary misunderstanding between workers and their employers.

Chan Kwok-cheong suffered two work injuries over a two year period from 2010 to 2012. He’s a maintenance worker for an electric company. During a routine check on a rainy night, Chan slipped and fell down some stairs and hurt his back. He reported the injury to his employers. Within a few days, the company’s insurer assigned a case manager to handle all necessary procedures.

Chan joined the MORE program after having recurring back pain from his second injury. He recovered within three months. The first time he was hurt, it required more than a year going through the same routine channels that bedevil most injured workers.

“The biggest barrier is that Hong Kong contributes a lot to science and theories of work rehabilitation, but there is no comprehensive system to deliver on the theories,” Dr Law points out.

The MORE program aims to fill that void, with orthopedics specialists at its core, liaising with specialists from other disciplines, including physiotherapists and occupational therapists. In their joint consultations, rehabilitation plans are devised for each patient.

Dr Law and his team have helped more than 300 injured workers since the program started nearly five years ago.  The results have been positive. Among the 183 MORE patients who have been discharged, 64 percent have returned to work. That’s more than double the success rate (31 percent) of those who receive only standard care.

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