“Because if we talk about health issues first, it is easier to talk about human trafficking”; findings from a mixed methods study on health needs and service provision among migrant and trafficked fishermen in the Mekong

Abstract

BackgroundHuman trafficking in the fishing industry or “sea slavery” in the Greater Mekong Subregion is reported to involve some of the most extreme forms of exploitation and abuse. A largely unregulated sector, commercial fishing boats operate in international waters far from shore and outside of national jurisdiction, where workers are commonly subjected to life-threatening risks. Yet, research on the health needs of trafficked fishermen is sparse. This paper describes abuses, occupational hazards, physical and mental health and post-trafficking well-being among a systematic consecutive sample of 275 trafficked fishermen using post-trafficking services in Thailand and Cambodia. These findings are complemented by qualitative interview data collected with 20 key informants working with fishermen or on issues related to their welfare in Thailand.ResultsMen and boys trafficked for fishing (aged 12–55) were mainly from Cambodia (n = 217) and Myanmar (n = 55). Common physical health problems included dizzy spells (30.2%), exhaustion (29.5%), headaches (28.4%) and memory problems (24.0%). Nearly one-third (29.1%) reported pain in three or more areas of their body and one-quarter (26.9%) reported being in “poor” health. Physical health symptoms were strongly associated with: severe violence; injuries; engagement in long-haul fishing; immigration detention or symptoms of mental health disorders. Survivors were exposed to multiple work hazards and were perceived as disposable when disabled by illness or injuries. Employers struggled to apply internationally recommended Personal Protective Equipment (PPE) practices in Thailand. Non-governmental organizations (NGOs) encountered challenges when trying to obtain healthcare for uninsured fishermen. Challenges included fee payment, service provision in native languages and officials siding with employers in disputes over treatment costs and accident compensation. Survivors’ post-trafficking concerns included: money problems (75.9%); guilt and shame (33.5%); physical health (33.5%) and mental health (15.3%).ConclusionFishermen in this region are exposed to very serious risks to their health and safety, and their illnesses and injuries often go untreated. Men who enter the fishing industry in Thailand, especially migrant workers, require safe working conditions and targeted protections from human trafficking. Survivors of the crime of sea slavery must be provided with the compensation they deserve and the care they need, especially psychological support.Electronic supplementary materialThe online version of this article (10.1186/s12992-018-0361-x) contains supplementary material, which is available to authorized users.

Victims or suspects? Identifying and assisting potentially trafficked fishermen: A qualitative study with stakeholders and first responders in Thailand

“…Prior survey research with Thais conveys an expectation to speak Thai: 74% and 84% believed that unregistered and registered migrants respectively should use Thai to communicate with them ( Sunpuwan and Niyomsilpa, 2014 , p. 27). Language interventions with both crew and captains could enhance communication about working conditions and positively affect fishermen's wellbeing, including for when they seek medical treatment for injuries and illness incurred at work ( Pocock et al., 2018 ).…”

Practitioner Experiences Responding to Suicide Risk for Survivors of Human Trafficking in the Philippines

“…However, as is common globally, the insufficient number of trained mental health professionals, low utilization rates and stigma associated with mental health services, and lack of culturally adapted evidence-based interventions create barriers to ensuring survivors receive needed interventions. As Pocock et al (2018) write, “mental health is essential in packages of care for trafficking survivors; research is urgently needed to identify culturally appropriate mental health interventions … that can be implemented by non-professionals in low-resource settings” (p. 16). Findings from the current study underscore the importance of training anti-human trafficking service providers in suicide prevention.…”

“…In many cases, anti-trafficking service providers in Southeast Asia have not received basic training pertaining to mental health, trauma, or trauma-informed approaches (Surtees, 2013). Further, a general lack of trained mental health providers and accessibility of services poses a key challenge for anti-trafficking organizations aiming to address survivors’ mental health concerns, either through in-house services or referrals (Pocock et al, 2018). Broader issues of mental health stigma (Martinez et al, 2020) and the need for culturally appropriate mental health guidelines and capacity building programs (Colucci et al, 2010) contribute to the significant need for effective, culturally relevant mental health interventions for human trafficking survivors in the Philippines.…”

Providing medical care for suspected human trafficking victims: Perceptions among a cohort of health care providers in Myanmar

“…A considerable percentage of human trafficking victims are known to interface with medical providers during their time being trafficked, and these interactions are considered an opportunity to identify and aid these victims. (3,4,5). Further, victims have specific health needs while being trafficked, and require ongoing specialized care after surviving and escaping.…”

“…Further, victims have specific health needs while being trafficked, and require ongoing specialized care after surviving and escaping. (3,6,7). The ability to identify, approach, and treat current victims and post-trafficking survivors, requires an indepth understanding of these specific needs, including specialized training and access to resources.…”