From endless shifts to hospital beds: Ride-hailing drivers pay the price for survival

"At first I just drove after my security job to make extra money," the motorbike-taxi driver says. "But the pressure of paying off my mortgage forced me to quit my old job and go full-time." During national holidays he would even extend his working hours to 18 hours to handle the surge in orders. His packed schedule often meant skipping meals, eating a quick banh mi or cold tupperware food. He rarely slept for more than four hours, sometimes catching brief naps on his motorbike between work. When friends warned him, he grinned it away, saying: "As long as I have the energy, I keep running. Money matters more."

But in mid-2024 he began suffering from severe back pain and numbness in his limbs after each exhausting day. Once, while delivering under the rain, he collapsed from dizziness and exhaustion. He went to the Ho Chi Minh University of Medicine and Pharmacy Hospital, where he was diagnosed with a herniated disc, anemia from poor nutrition and physical exhaustion.

Lan, 40, a single mother with two children in Hanoi, also paid a heavy price for working long hours as a ride-hailing driver. After four years she kept to a grueling schedule from 5 a.m. to 10 p.m., sometimes even until midnight. To stay awake, she would drink two or three cups of coffee a day and occasionally energy drinks. Her meals would often be just a quick sandwich or a palm-sized portion of sticky rice, and she would sometimes simply skip lunch due to lack of time.

Ride-hailing driver wait to pick up passengers and drop off goods on Ly Tu Trong Street, Ho Chi Minh City, 2023. Photo by VnExpress/Thanh Tung

Earlier this year, while carrying a passenger, she suddenly felt shortness of breath and her heart racing, and had to pull over. When she saw a doctor, she was diagnosed with stomach ulcers, heart arrhythmia from excessive caffeine and energy drinks and cervical spondylosis from long hours of driving. The doctor warned that if she did not change her lifestyle, her health could deteriorate further.

Drivers like Nam and Lan form an essential part of the economy, but the reality of long working hours in harsh weather conditions and polluted environments poses health risks, especially without proper attention. A 2021 survey done in Hanoi of 549 motorcycle drivers and published in the Journal of Transport and Health found that 22.6% suffered from chronic fatigue and 22% from lower back pain.

Other risk factors like being overweight and alcohol consumption were directly linked to these issues. A 2020 study published in magazine Environmental Research found that drivers in highly polluted cities like Bangkok were at risk of impaired lung function. A 2024 report from news outlet Rest of World uncovered another hidden side: many drivers lack proper breaks and are even denied access to basic facilities like public restrooms.

"The majority of drivers prefer not to take rest, have very short breaks, and get very little sleep," Tobias Kuttler, research associate at Fairwork, a labor project by the Oxford Internet Institute and WZB Berlin Social Science Center, told Rest of World. "[I] have seen drivers with 17-hour average shifts. Those drivers were visibly sleep-deprived and in a bad state if health, taking medications to fight their pain."

Dr. Vo Van Long of the Ho Chi Minh University of Medicine and Pharmacy, Campus 3, confirms that working in extreme weather, rain and dust and time pressure expose drivers to various health risks. The World Health Organization has warned that working over 55 hours a week increases the risk of strokes and heart disease. Interrupted sleep not only causes fatigue and delayed reactions but also leads to chronic illnesses like high blood pressure, diabetes and depression.

Irregular meals and the mental pressure caused by traffic jams, the need to complete deliveries in time and negative customer reviews are silently contributing to stress, burnout and digestive issues and turning these tech drivers into "patients" without their realizing it.

To improve their health, Long recommended that drivers should get six to eight hours of sleep a night, avoid working consecutive night shifts for more than three days and take breaks between gigs. When working under the sun, they should wear light-colored long-sleeve shirts and wide-brimmed hats, use sunscreen with at least SPF 30 and drink 250-300 ml of water every 30-45 minutes, he said. "Avoid excessive caffeine and energy drinks as they can cause dehydration and arrhythmia." He also advised them to carry healthy snacks like fruit or yogurt, drink 2-2.5 liters of water daily and eat at regular hours.

Nam has since reduced his working schedule to eight to 10 hours a day, added nutritional supplements and is undergoing physical therapy as advised by his doctor. While his income has dropped, he now thinks health is his most valuable asset.

"Many of my colleagues still push themselves to the limit because of financial pressure," he said. "But I’ve seen the consequences, and I don’t want to pay a high price. Money can be earned again, but health is much harder to restore."

Lan has also tweaked her work schedule, seeks to rest more and practices some yoga. "I still need to drive to support my children, but now I know how to balance things better. Without health, there is no way to earn a dime."