"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.

BACKGROUND: Human 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. RESULTS: Men 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%). CONCLUSION: Fishermen 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

Victims or Suspects? Identifying and Assisting Potentially Trafficked Fishermen: A Qualitative Study with Stakeholders and First Responders in Thailand

Prompted by reports of ‘sea slavery’ in the fishing industry and threats of sanctions, Thailand has faced pressure to eradicate human trafficking the fishing sector. Although the Thai government has responded with anti-trafficking policies, there remains little understanding about their implementation. Specifically, little is known about how government agencies, NGOs or industry perceive “trafficking”, and no research examines how trafficked fishermen are identified and assisted. This study aimed to: 1) explore how stakeholders described trafficking in the fishing sector and their perceptions of trafficking indicators; and 2) identify challenges encountered by frontline responders to identify and assist trafficked fishermen. We conducted interviews with 33 key informants, which were analysed thematically. Findings indicate that authorities and industry representatives believed migrant brokers caused employers to “inadvertently” traffic men. Trafficking was perceived to take place primarily outside of Thai waters, beyond the government's jurisdiction. Most stakeholders considered violence and being confined as key indicators of trafficking. Officials expressed confusion about whether debt bondage and document confiscation “counted” as indicators. Ambiguity and confusion about trafficking indicators in screening forms, combined with perceived “deservingness” of official victim status, underpinned frontline responders’ decisions about who was a victim of trafficking (VoT). Practical and structural constraints included interpreter shortages, and expanded civil servant remits without commensurate staff increases, which hindered officials’ responses to trafficking. This study addresses a critical knowledge gap on the implementation of anti-trafficking policies and offers findings to assist policymakers to address the challenges faced by frontline responders to improve victim identification and assistance

Occupational risks, health needs and victim identification of trafficked fishermen in the Greater Mekong Subregion – Interview transcripts

Transcripts from semi-structured interviews performed with 33 key informants during August - October 2014. Interviews explored factors influencing health of migrant and trafficked fishermen in Thailand during the pre-trafficking, trafficking and post-trafficking stages, and factors influencing how potentially trafficked fishermen were identified and assisted. Informants were comprised of Labour, health or welfare officials [9], Law enforcement officers [6], NGO service providers [12], INGO representatives [3] and Industry representatives [3]

Additional file 1: of “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

Conceptual Framework A. Factors influencing physical health of trafficked fishermen. Conceptual Framework B. Factors influencing healthcare responses for migrant or trafficked fishermen in Thailand. (PDF 606 kb