However, the 37-year-old was quickly hit with the harsh realities of being a refugee, particularly the exorbitant healthcare costs.

For 13 years, Niang was forced to pay unsubsidised “foreigner” rates at government hospitals, as she was not in possession of a UNHCR card which allows her access to essential services.

The financial strain became unbearable when Niang and her husband decided to start a family in 2020.

“My pregnancy happened at the height of the Covid-19 pandemic. I faced a lot of financial issues because government hospitals denied me treatment as I did not have a UNHCR card,” she told FMT.

“I had to go to a private hospital, which cost me a bomb. I had gestational thrombocytopenia at the time too, which meant that I sometimes had to go for consultations more than once a month,” she told FMT.

Gestational thrombocytopenia is a condition that occurs when the platelet count in a pregnant woman’s blood drops to a lower-than-normal level.

The cost of Niang’s consultations often exceeded RM120, and with e-hailing charges reaching up to RM40 each way, she frequently spent more than RM200 per visit.

“We prepared financially for our babies, but we still faced monetary issues because my husband is a general worker and he doesn’t earn much,” she said.

It was only after a three-year wait that she finally received her UNHCR card this year. Her new status will see medical charges incurred at a government hospital for her second pregnancy subsidised by 50%.

“The healthcare system in Malaysia is good for Malaysians but challenging for refugees like me due to high foreigner rates.

“However, I’m thankful the Malaysian government offers a 50% discount for refugees with UNHCR cards,” she said.

Barriers to healthcare

Dr Charmaine Ch’ng, of Autrui Clinic, which provides subsidised healthcare to underserved communities, said many refugee mothers experience similar struggles, often incurring bills running into thousands of ringgit for deliveries alone.

In government hospitals, foreign women must pay RM2,593 for a normal delivery, while Malaysian women only pay RM10, RM150, or RM300, depending on the type of room chosen.

“Many refugees live day-to-day and have very minimal earnings. For them, a difference of RM100 is significant. It could cover their entire day’s food and rent,” she told FMT.

But in addition to the high cost, Ch’ng said refugee mothers also face barriers to healthcare, including difficulties navigating the system and lack of legal identification.

She also said language barriers further discourage refugees from seeking medical treatment, as they often cannot understand healthcare professionals, leaving them feeling helpless.

Ch’ng believes healthcare professionals have a duty to advocate for the refugee community to ensure policymakers and local communities understand their struggles.

“As healthcare professionals, we must be the voice for these underserved communities who do not have a voice,” she said.

“My hope is for doctors and healthcare services from both public and private sectors to collaborate better, improving our capacity to accommodate more underserved communities seeking healthcare.”