Migrant workers and international students in Newfoundland and Labrador say they face a constant cycle of unpaid sick leave and a lack of health care, usually while working minimum wage essential jobs.
And more often than not it leaves them struggling to pay the bills and causes immense stress when they're faced with a medical issue, according to some who know the challenges first-hand.
Maria Dussan, originally from Colombia, fainted while working for her employer in the food service industry on campus at Memorial University in St. John's four years ago.
Dussan, who had graduated from MUN by then, said she pleaded with campus security not to call for an ambulance, something she knew would have to pay for because she didn't have health-care coverage.
She was billed $1,800 for the ambulance ride and the visit to the emergency room — while losing income for the time she missed at work. Paid sick days are an important step toward labour fairness, she said.
"The stress that you actually have to pay $1,800, on a minimum wage job, while at the same time you're attempting to pay for your rent and for your food … all of these things together just go to [show] how people who are migrants, who are racialized, it's like a cycle," Dussan said.
To qualify for Newfoundland and Labrador's Medical Care Plan, immigrants are required to have full-time permanent jobs with a contract of at least one year.
Dussan said that requirement leaves a lot of people outside the health-care system, and in many cases they avoid seeking medical attention, fearing insurmountable debt.
"A simple visit to the ER can cost thousands of dollars for people who are already working low-income jobs," she said.
"The way the immigration system is set up is making a lot of migrant workers, international students and people who have just graduated fall through the cracks of the system."
Apoorv Singh, who grew up in India, is in his third year at MUN studying computer science and Spanish.
He said migrant workers, who don't have health-care coverage or paid sick leave, often find themselves in positions where they can be exploited by their employers.
Singh, who has worked multiple jobs during his time in the province, said there was a day he attempted to call in sick at a job in food service, but his manager told him he couldn't. He said he went to work feeling unwell, burned out and fainted during his shift.
"International students and migrant workers are often forced into accepting unsafe work. They're the most vulnerable and easy to exploit people," he said.
Singh said giving everyone paid sick days would make it harder for employers to treat their employees poorly.
A push for change
Both Singh and Dussan are members of the Anti-Racism Coalition Newfoundland and Labrador, and both are working on the group's Healthcare for All campaign, aimed at addressing health-care concerns for immigrants and pushing for policy change.
Dussan said health care for migrant workers should not be left in the hands of their employers.
"Anyone who comes to this province should have access to health care, regardless of their immigration status and regardless of what their employment situations are," she said.
"It's very easy for people to end up in exploitive situations when the things that essential to you to be able to live are in the hands of people who have control of your employment."
Dr. Monika Dutt — a family physician and member of ARC-N.L. — told CBC News change needs to be made at the federal level.
Dutt said people are often required by their employers to get doctor's notes for unnecessary reasons.
"I see patients frequently who do not have paid sick days, and they go to work sick because they don't have paid sick days, or they're coming to see me, sick, when they really don't need to be in a doctor's office," Dutt said.
"They need to be home, but they need a note because they don't actually have paid sick days and need to try to justify why they're off work."
Dutt said the pandemic has made it clear that having paid sick days would help decrease the number of people who might go to work sick, adding they're usually working low-income jobs and who may be Black, racialized, Indigenous, immunocompromised, or have a disability.
There have been workplace outbreaks of COVID-19 across the country, she said, often traced back to someone who was infectious and went to work. Some of the worst outbreaks have happened where people are poorly paid and have little access to paid sick days, she said.
During the election campaign earlier this year, Prime Minister Justin Trudeau promised to introduce 10 days of paid sick leave for federally regulated workers within the first 100 days of re-election and said his government would encourage the provinces to make better sick leave a reality in provincial sectors as well.
Dutt said sick days need to be easy to access.
"It really needs to be legislated, be required for all workers and be there during and after the pandemic," she said.
"Most physicians try to discourage sick notes for short illnesses because it really doesn't make sense for most illnesses for most people to need a sick note. They should be able to say 'I'm sick,' stay at home, get better, come back, and not have to go to a doctor's office [and] have to potentially put other people at risk."