Labour Exploitation Trafficking and Migrant Health

In construction work, common hazards were: dust inhalation (both from construction-site dust and
dust storms); electric shock; falling from a height or being hit by falling objects; vision loss from
welding or penetrating objects; back injuries and hernias from lifting heavy objects; lacerations
while cutting metal or from being hit with concrete shards during drilling; harms due to extreme
temperatures; and chemical hazards such as asbestos or lead, which can cause mesothelioma, a form
of lung cancer, or brain damage such as leukoencephalopathy.
Few participants in any country studied reported receiving or using any PPE and few believed
employers were responsible for supplying PPE. Training for workers appeared to be most commonly
“on-the-job”, in the form of informal apprenticeships, and primarily via the generosity of other
workers. Workers were often more aware of the hazards that were visible and direct and less likely to
discuss risks associated with longer-term harm (for example, mercury poisoning).
Access to and use of medical services was limited across study contexts, often because of cost, legal
status, and lost wages from missing work. Some interviewees were misinformed about rights to
services. In Peru, access to health care was influenced by the overall weakness of the health system.
In all countries studied, lack of access to health care for those who contracted TB was particularly
worrisome because of the risks of further transmission and poor adherence to TB medication, which
can lead to increased multi-drug resistance. Better information is warranted about occupational and
other health risks and potential options for safety and services. There is also larger role for labour
inspections. Moreover, good mobile health units and wider-reaching occupational health promotion
are needed in locations with high numbers of migrant workers.
Psychological and verbal abuse was more common among interviewees than was physical abuse,
although identified trafficking survivors reported severe physical abuses and confinement. Threats
– and in particular threats to report workers to immigration authorities or police – served to control
both migrant workers and victims of trafficking. Confinement and surveillance were particularly
common among victims of trafficking.
Regardless of work sector, country or gender, both migrant workers and victims of trafficking frequently
reported sources of stress that included long hours, financial worries, poor living conditions and
pressure from colleagues. Compatriots seemed to provide a good source of comfort, formed a useful
network for assistance and were sources of information that helped counter misinformation provided
by exploitative employers. Interviewees indicated that law enforcement and migration officials were
more often a greater source of stress and fear than a potential resource for assistance.
Findings indicate notable similarities and differences between the experiences of migrant workers
and workers who were identified as trafficked. General occupation-related hazards, poor living
conditions and health consequences were similar for workers in the same sector. Use of health
services was similar, though victims of trafficking appeared to have much more restricted movement.
Both migrant workers and victims of trafficking preferred to avoid contact with law enforcement
officials and labour inspectors and both had poor awareness of rights. Critically, for both groups,
efforts to raise awareness of trafficking seemed to have questionable influence.
Among key differences in the experiences of migrant workers and victims of trafficking, identified
victims of trafficking were more likely to be physically abused than migrant workers; work and live in
worse conditions; work more hours per day; and be paid less.
Findings on risk factors for exploitation prior to migration were mixed and sometimes even
contradictory, and generally site- or even case-specific. Kazakhstan findings suggest that risky premigration
arrangements often included receiving some payment or loan. Yet this was not always the
case. Across study countries, engagement with known migrant networks did not necessarily prove to
be protective either. Prior to migration, many workers arranged their jobs through someone known
to them. Some were exploited; some were not. Most Bolivians who were victims of trafficking in the
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Executive Summary