4 All interviews and field-notes were cleaned and validated and entered into the qualitative data analysis software NVivo 10. Data was analysed following the principles of thematic analysis, identifying key themes and patterns, as well as variety within the dataset. Attention was paid to both prevalent and less common themes in terms of understanding the nature and issues faced within family reintegration. Aronson, J., “A Pragmatic View of Thematic Analysis” (1994) 2(1) The Qualitative Report; and Braun, V. and Clarke, V., “Using Thematic Analysis in Psychology” (2006) 3 Qualitative Research in Psychology 82.
5 Surtees, R., “Re/integration of Trafficked Persons – How Can Our Work Be More Effective” (KBF and NEXUS Institute, 2008).
6 The broader community environment is another important layer in facilitating or inhibiting reintegration after trafficking, but is beyond the scope of this chapter. This is the subject of another research study under this project: ‘Moving on: Family and community reintegration amongst Indonesian trafficking victims’.
7 Javanese and Sundanese are the two largest ethnic groups – accounting for 40% and 15% of the population, respectively. Ananta, A. et al., “Changing Ethnic Composition: Indonesia 2000–2010” (International Union for the Scientific Study of Population, 2013), pp. 7–14.
8 In spite of strong similarities between Sundanese and Javanese cultures, Sundanese culture is typically more overtly Islamic and less rigid in terms of its system of social hierarchy, including being more egalitarian, independent, and somewhat individualistic in social outlook. Hefner, R., “Java’s Five Regional Cultures”, in Oey, E. (ed.), Java (Singapore: Periplus Editions, 1997), pp. 58–62.
9 Koentjaraningrat, Tjelapar, “A village in south Central Javaa”, in Koentjaraningrat (Ed.), Villages in Indonesia (Jakarta and KL: Equinox Publishing, 1967), pp. 244–280. See also Robson, S.O. (1987), “The Terminology of Javanese Kinship”, Bijdragen tot de Taal-, Land-en Volkenkunde, Deel 143, 4de Afl., p. 510.
10 Brenner, S., “Why Women Rule the Roost: Rethinking Javanese Ideologies of Gender and Self-Control” in Ong, A. and Peletz, M.G. (eds.), Bewitching Women, Pious Men: Gender and Body Politics in Southeast Asia (Berkeley, CA: University of California Press, 1995), p. 24; and Mulder, N., Inside Indonesian Society: Cultural Change in Java, 2nd edition (Amsterdam and Singapore: Pepin Press, 1996), p. 91.
11 Dube, L., “Kinship and Gender in South and Southeast Asia: Patterns and Contrasts” (9th J.P. Naik Memorial Lecture, 1994) and Minahan, J.B., Ethnic Groups of South Asia and the Pacific (Santa Barbara, CA: ABC-CLIO, 2012), p. 304.
12 Jones, G.W., Asari, Y., and Djuartika, T., “Divorce in West Java” (1994) 25(3) Journal of Comparative Family Studies 395.
13 Zuidberg, L.C.L. (ed.), Family Planning in Rural West Java: The Serpong Project (Amsterdam: Nabrink and Son, 1978), p. 87.
14 Talak (or talaq) is the ending of a marriage with the husband saying specific words to the wife, such as ‘I divorce you’, or by the husband’s actions being considered an end to the marriage (‘activating the talak’, such as through neglect or abuse). Talak is distinguished in law from an official divorce: the 1974 Law on Marriage requires divorce to be executed in court. See Bowen, J.R., Islam, Law, and Equality in Indonesia: An Anthropology of Public Reasoning (Cambridge: Cambridge University Press, 2003), pp. 205–206; and Azra, A., “The Indonesian Marriage Law of 1974”, in Salim, A. and Azra, A. (eds.), Shari’a and Politics in Modern Indonesia (Singapore: Institute of Southeast Asian Studies, 2003), p. 76.
15 The marital status of some women interviewed for this study changed over the course of the research period and from first to subsequent interviews.
16 In Indonesia, not all second marriages indicate the dissolution of the first; approximately 4% of marriages in West Java are polygynous (a husband marrying more than one wife). Jones et al. (n.12) 404. Polygamy is relatively rare in Indonesia, and Javanese people tend to view polygamy negatively. The threat of polygamy can be grounds for divorce. Nurmila, N., Women, Islam and Everyday Life: Renegotiating Polygamy in Indonesia (London: Routledge, 2009), pp. 21–22. Polygamy may be more acceptable amongst Sundanese; it is not uncommon for religious leaders or wealthy men in West Java to have more than one wife. The 1974 Marriage Law made polygamy more difficult, but did not outlaw it. The law states that the foundation of marriage is monogamy, but acknowledges the possibility of practicing polygamy, limiting the maximum number of wives to four and, in accordance with Islamic values, men must treat wives in an equal manner and be able to support them economically. Polygamy requires permission in advance from the Islamic court. Nasution, K., “Polygamy in Indonesian Islamic Family Law” (2008) 16(2) Shariah Journal 208. For trafficked Indonesian women who return to a husband who has more than one wife, there may be additional layers of complexities to the process of family reintegration.
17 Magnis-Suseno, F., Javanese Ethics and World-View: The Javanese Idea of the Good Life (Penerbit PT Gramedia Pustaka utama, 1997), p. 167; Hatley, B., “Theatrical Imagery and Gender Ideology in Java”, in Atkinson, J.M. and Errington, S.(eds.), Power and Difference: Gender in Island Southeast Asia (Stanford: Stanford University Press, 1990), p. 180; and Keeler, W., “Speaking of Gender in Java”, in Atkinson, J.M. and Errington, S. (eds.), Power and Difference: Gender in Island Southeast Asia (Stanford: Stanford University Press, 1990), p. 129.
18 Zevalkink, J.J., Riksen-Walraven, M., and Bradley, R.H., “The Quality of Children’s Home Environment and Attachment Security in Indonesia” (2008) 169(1) The Journal of Genetic Psychology 72.
19 Grijns, M., “Tea-pickers in West Java as Mothers and Workers: Female Work and Women’s Jobs”, in Locher-Scholten, E. and Niehof, A. (eds.), Indonesian Women in Focus (Leiden: KITLV Press, 1992), pp. 111–112.
20 Mulder (n.10) 96.
21 Surtees, R., “Cultural Context”, in Rosenberg, R. (ed.), Trafficking of Women and Children in Indonesia (JKT: ICMC and Solidarity Center, 2003), p. 124.
22 Mulder (n.10) 110.
23 Geertz, H., The Javanese Family; A Study of Kinship and Socialization (Free Press, 1961); and Magnis-Suseno, F., Etika Jawa: Sebuah Analisa Falsafi Tentang Kebijaksanaan Hidup Jawa (New York: PT Gramedia, 1988).
24 Mulder (n.10) 111–112.
25 Berninghausen, J. and Kerstan, B., Forging New Paths: Feminist Social Methodology and Rural Women in Java (London: Zed Books Ltd., 1991), p. 147, 152; Koentjaraningrat (n.9); Magnis-Suseno (n.17) 167–168; and Jay, R.R., Javanese Villagers: Social Relations in Rural Modjokuto (Cambridge, MA: MIT Press, 1969), p. 118; Darroch, R.K., Meyer, P.A., and Singarimbun, M., Two Are Not Enough: The Value of Children to Javanese and Sundanese Parents (Honolulu, HI: East-West Population Institute, 1981), pp. 30–31.
26 Geertz (n.23).
27 Dube (n.11).
28 Dube (n.11).
29 Jay (n.25).
30 Chan, C., “Gendered Morality and Development Narratives: The Case of Female Labor Migration from Indonesia” (2014) 6 Sustainability 6955; and Martyn, E., The Women’s Movement in Post-colonial Indonesia: Gender and Nation in a New Democracy (London: Routledge, 2005), p. 206.
31 Chan (n.30) 6955; and Silvey, R., “Transnational Domestication: State Power and Indonesian Migrant Women in Saudi Arabia” (2004) 23 Political Geography 253.
32 Current estimates are that millions of Indonesian women work in other countries. For example, half a million women migrated from Indonesia in 2007 alone. IOM, Labour Migration From Indonesia (International Organization for Migration, 2010).
33 Geertz (n.23); Mulder, M., Mysticism and Everyday Life in Contemporary Java: Cultural Persistence and Change (Singapore: Singapore University Press, 1978); and Koentjaraningrat (n.9).
34 Mulder (n.33) 39.
35 Mulder (n.33); and Koentjaraningrat (n.9).
36 Amar, S.C.D., Gunem Catur in the Sunda Region of West Java: Indigenous Communication on the MACT Plant Knowledge and Practice Within the Arisan in Lembang, Indonesia (PhD Thesis, Leiden University, 2010), pp. 83–84. Examples inclu
de village/community activities like arisan (a rotating credit fund), pengajian (Quranic group), and pencak silat (a kind of martial arts). Ibid. 94. See also Zevalkink (n.18).
37 The exchange rate from Indonesian Rupiah (IDR) to United States Dollar (USD) is calculated at a rate of 1USD = 11,000IDR. As exchange rates have varied significantly in the past year, calculations have been made using the average exchange rate from 2010–2015.
38 This is consistent with migrants generally, for whom the overwhelming motivation for migration is to improve their economic situations. In Indonesia, predominant items for remittance use include acquisition of land and housing and housing improvements. For example, one survey of 100 overseas contract workers from Java identified the following uses for remittances: 45.8% –housing; 27.1% –land purchase; 24.2% –daily family needs; and 2.7% –business enterprises. Hugo, G., “International Labor Migration and the Family: Some Observations From Indonesia” (1995) 4(2–3) Asian and Pacific Migration Journal 290–292. Another study found remittances were used for schooling costs and day-to-day necessities for family. Mantra, I.B. and Kasnawi and Sukamardi, T.M., Movement of Indonesian Workers to the Middle East (Yogyakarta, Indonesia: Population Studies Center, Gadjah Mada University, 1986), p. 128.
39 In Indonesia, most trafficking victims start out as migrant workers and migrate through both formal and informal agencies and brokers. In both instances, the migrant worker will commonly incur debt to cover various recruitment fees and the cost of training, medical examinations, the visa and passport needed to migrate for work, and the cost of travel to the destination country. Prospective migrant domestic workers typically pay a fee to both the agent and the recruitment agency, and these fees are relatively high, considering that the official poverty line in Indonesia is a monthly per capita income of 312,328 IDR [28USD], and minimum wage (which varies by province) is between 1.2 and 2.7 million IDR [approximately 110–245USD] per month. The women interviewed for this study reported paying fees from 2–3 million IDR [approximately 180–273 USD] to migrate for work. In many cases, the fees to the individual agent were paid up front, while debts to the recruitment agency were deducted directly from the domestic worker’s earnings in the destination country.
40 Brunovskis, A. and Surtees, R., No Place Like Home? Challenges in Family Reintegration After Trafficking (Oslo and Washington, DC: Fafo and NEXUS Institute, 2012), p. 31. See also Brunovskis, A. and Surtees, R., “Coming Home: Challenges in Family Reintegration for Trafficked Women” (2013) 12(4) Qualitative Social Work 454–472; and Bakker, C., Elings-Pels, M., and Reis, M., The Impact of Migration on Children in the Caribbean (New York: UNICEF, 2009), noting that “migrant parents, in many cases, try to compensate for their absence by sending a significant amount of material resources”. Ibid. 9.
41 Common mental disorders are depressive and anxiety disorders that are classified as neurotic, stress-related, and mood disorders. Patel, V. and Kleinman, A., “Poverty and Common Mental Disorders in Developing Countries” (2003) 81(8) Bulletin of the World Health Organization 609.
42 Graham, E., Jordan, L.P., and Yeoh, B.S.A., “Parental Migration and the Mental Health of Those Who Stay Behind to Care for Children in South-East Asia” (2015) 132 Social Science & Medicine 228.
43 An Arabic expression meaning ‘thanks be to God’, which is frequently used by Muslims due to its centrality to the texts of the Qur’an and the words of the Islamic prophet Muhammad. It is an expression commonly used in Indonesia, amongst Muslims.
44 The abuse and exploitation of Indonesian migrant domestic workers has been documented in a number of studies, including research on the trafficking exploitation of Indonesian domestic workers. Please see: Amnesty International, Exploited for Profit, Failed by Governments: Indonesian Migrant Domestic Workers Trafficked to Hong Kong (Amnesty International, 2013); Andrevski, H., “Exploitation and Trafficking: Experiences of Indonesian Migrant Domestic Workers” (no date) Trends & Issues in Crime and Criminal Justice; APWLD, The New Slave in the Kitchen: Debt Bondage and Women Migrant Domestic Workers in Asia (Asia Pacific Forum on Women, Law and Development, 2011); Huling, A., “Domestic Workers in Malaysia: Hidden Victims of Abuse and Forced Labor” (2012) 44 International Law and Politics 629; Human Rights Watch, ‘I Already Bought You’: Abuse and Exploitation of Female Migrant Domestic Workers in the United Arab Emirates (Human Rights Watch, 2014); Human Rights Watch, Hidden Away: Abuses Against Migrant Domestic Workers in the UK (Human Rights Watch, 2014); Human Rights Watch, For a Better Life: Migrant Worker Abuse in Bahrain and the Government Reform Agenda (Human Rights Watch, 2012); Human Rights Watch, “‘As If I Am Not Human’. Abuses Against Asian Domestic Workers in Saudi Arabia” (Human Rights Watch, 2008); Human Rights Watch, “Help Wanted: Abuses Against Female Migrant Domestic Workers in Indonesia and Malaysia” (2004) 16(9B) Human Rights Watch; Killias, O., “‘Illegal’ Migration as Resistance: Legality, Morality and Coercion in Indonesian Domestic Worker Migration to Malaysia” (2010) 38(6) Asian Journal of Social Science 897; Surtees, R., “Female Migration and Trafficking in Women: The Indonesian Context” (2003) 46(3) Development 99.
45 These women may have experienced physical abuse, but did not speak about it in interviews; they may have been uncomfortable to do so.
46 This is likely an underreporting, as we interviewed some women who did not disclose their experiences of rape in the first interview, and we only learned about this in later interviews.
47 Hugo, G., “Effects of International Migration on the Family in Indonesia” (2002) 11(1) Asian and Pacific Migration Journal 34; Graham, E. et al., “Transnational Families and the Family Nexus: Perspectives of Indonesian and Filipino Children Left Behind by Migrant Parent(s)” (2012) 44(4) Environment and Planning 13–14.
48 Wickramage, K. et al., “Risk of Mental Health and Nutritional Problems for Left-behind Children of International Labor Migrants” (2015) 15(39) BMC Psychiatry. Another study of 1,200 households with migrant mothers in Sri Lanka found that 22.1% of children under the age of five showed loss of appetite after the departure of a mother, and 5% in the same age group showed weight loss. Save the Children, Left Behind, Left Out: The Impact on Children and Families of Mothers Migrating for Work Abroad (Save the Children Sri Lanka, 2006).
49 Bakker et al. (n.40) 8.
50 For example, one study of the impact of parental migration in the Philippines and Indonesia found a deficit in children’s subjective well-being when communication with their migrant parents was not maintained. Graham (n.42). See also: Haagsman, K. and Mazzucato, V., “The Quality of Parent-child Relationships in Transnational Families: Angolan and Nigerian Migrant Parents in The Netherlands” (2014) 40(11) Journal of Ethnic and Migration Studies 1677; Fresnoza-Flot, A., “Migration Status and Transnational Mothering: The Case of Filipino Migrants in France” (2009) 9(2) Global Networks 252; Parrenas, R.S., “Long Distance Intimacy: Class, Gender and Intergenerational Relations Between Mothers and Children in Filipino Trans-national Families” (2005) 5(4) Global Networks 317; and Madianou, M. and Miller, D., “Mobile Phone Parenting: Reconfiguring Relationships Between Filipina Migrant Mothers and Their Left-behind Children” (2011) 13(3) New Media & Society 457.
51 Graham et al. (n.42) 229–230.
52 Lu, Y., “Household Migration, Social Support, and Psychosocial Health: The Perspective From Migrant-Sending Areas” (2012) 74 Social Science & Medicine 135.
53 Chan (n.30) 6958.
54 Brunovskis and Surtees (n.40).
55 Hondagneu-Sotelo, P. and Avila, E., “‘I’m Here, But I’m There’, The Meanings of Latina Transnational Motherhood” (October 1997) 11(5) Gender & Society 548–571.
56 Brunovskis and Surtees (n.40).
57 This has been noted in research amongst women trafficked for sexual exploitation in South-Eastern Europe – see Brunovskis and Surtees (n.40); as well as amongst Thai women trafficked for prostitution to Japan – see Caouette, T. and Saito, Y., To Japan and Back: Thai Women Recount Their Experiences (Geneva:
IOM, 1999).
58 Past research in Indonesia found that international migration can lead to marital instability and family breakups. Hugo (n.47) 25.
23
The mental health of trafficked persons
W. F. Scholte, L. Verhaak, A. Lok, and R. Ghafoerkhan
Introduction
This chapter will address mental health problems prevailing in trafficked persons (TPs), particular stressors which may elicit these, and how treatment may help. As most research findings about TPs apply to sexually exploited women, much knowledge displayed here specifically relates to that group. However, the experience of trafficking, in all its forms, is highly stressful and often traumatising, and existing knowledge on psychological trauma and its treatment in general is applicable to a large extent. Yet, more knowledge specifically on TPs is needed; and this chapter will also indicate and discuss existing gaps identified through both desk research and clinical assessment of TPs.
Clinical insight in mental health issues in TPs was gained from the authors’ work for Equator Foundation, a mental health organisation in the Amsterdam region of the Netherlands. The organisation provides a preventive programme, diagnostics, and treatment for TPs. Most TPs are met within the context of an established co-operation with organisations providing social aid and shelter for persons who recently escaped forced labour – the vast majority of whom are sexually exploited women. The Equator approach entails weekly group meetings offering psycho-education and stabilising exercises to TPs staying in the shelter, and a behavioural screening of participants in close co-operation with on the spot counsellors. The latter may lead to a diagnostic assessment. In case of serious mental health problems, individual or group-wise, psychological treatment follows, sometimes combined with pharmacological treatment. Screening takes place in approximately 70 TPs per year; and around 30 new clients per year enter treatment for mental health problems.
Routledge Handbook of Human Trafficking Page 59
