Tamil Nadu’s public healthcare steps in as workplace injuries expose insurance gap among migrant workers

Published 24 July 2026 · health

Akash Kumar lay quietly on a hospital bed, his world turned upside down by a workplace accident involving a steel-cutting machine that had left him

Akash Kumar lay quietly on a hospital bed, his world turned upside down by a workplace accident involving a steel-cutting machine that had left him with a severe limb-threatening injury behind his left knee. With no family by his side, the 19-year-old from Bihar struggled to understand the flurry of conversations around him, held back by a language barrier in an unfamiliar place. Beyond the severity of his injury, his situation has brought into focus a less visible challenge faced by many migrant workers - the lack of adequate financial protection. For many migrant workers like him, Tamil Nadu’s public healthcare system has often become their only hope. At the Department of Vascular Surgery, Government Stanley Medical College Hospital (SMCH), at least four to five migrant workers involved in industrial and workplace accidents are treated for major vascular trauma every month. These include injuries sustained from fall from heights, machinery-related incidents in glass and tile manufacturing units, and accidents involving agricultural equipment, especially harvesting machines.

“In the case of Akash, the injury completely cut through the main blood artery behind the knee, nearby vein and nerves, making it a life and limb threatening injury. Losing a limb at 19 years will devastate his life and livelihood. We performed a by-pass procedure for major blood vessels in his left leg, saving his limb and life. He is recovering from severe haemorrhagic shock. Rehabilitation will take a longer period,” K. Elancheralathan, professor and head, Department of Vascular Surgery, SMCH, said. Similar stories The beds next to Akash told similar stories. Two other migrant workers - Babu Sheik, 24, from West Bengal and Ragunath, 31, from Bihar - are being treated for severe vascular injuries sustained at their workplaces. While Sheik suffered an injury to the left mid arm caused by a wood cutting machine, Ragunath fell down from a ladder while holding a cutting machine resulting in an upper arm brachial artery injury.

All three of them underwent surgeries in the last two weeks. The workers said they earn between ₹20,000 and ₹25,000 a month. One common thread that runs through their stories is the lack of insurance coverage and financial security faced by many workers in the unorganised sector. Elancheralathan said that most cases of industrial accidents and workplace injuries referred to the department arrive in severe haemorrhagic shock due to uncontrolled bleeding. “For many, the journey to definitive repair is a race against time. To survive, they must withstand hours of a complex bypass procedure, simultaneous orthopaedic bone stabilisation and aggressive resuscitation by the emergency anesthesia team. Managing these complex injuries often requires six to eight hours of operating theatre time. It requires an immediate minimum of four units of blood, transfused without delay, regardless of whether the patient has donor attenders available. These patients often have no insurance, no proper attendants, language barriers, and unexpected complications.