Women and Migration The Mental Health Nexus PDF

Women and Migration:
THE MENTAL HEALTH NEXUS

A Research on Individual and Structural Determinants of Stress and
Mental Health Problems of Filipino Women Migrant Domestic Workers
Action for Health Initiatives (ACHIEVE), Inc.

Vrije Universiteit Medical Center Metamedica / Health Care and Culture (VUMC-MHCC)
Women and Migration: The Mental Health Nexus
A Research on Individual and Structural Determinants
of Stress and Mental Health Problems of Filipino Women Migrant Domestic Workers
Published by Action for Health Initiatives (ACHIEVE), Inc. and Vrije Universiteit Medical Center Metamedica/
Health Care and Culture (VUMC-MHCC) with funding from the European Union through the EC-UN
Joint Migration and Development Initiative.
Principal writer: Prof. Maria Theresa Ujano-Batangan

Additional write-up: Prof. Ivan Wolffers, Lia van der Ham, Raquel Ignacio
Content Editor: Maria Lourdes S. Marin
Statistical Analysts: Michelle Ong and Alvin Mejorada
Editor: Dino A.E. Subingsubing
Layout & Design: Chriss J. Capili and Joy Q. Mauricio
All rights reserved. Copyright 2011

ISBN: 978 971 0466 09 2
Project Title: Developing Interventions to Address Stress and Mental Health Problems
among Women Migrant Workers

162-A Scout Fuentebella Ext., Kamuning, Quezon City 1103 Philippines
Tel (+63 2) 414 6130 Telefax (+63 2) 426 6147
E-mail: achieve_caram@yahoo.com
Website: www.achieve.org.ph
This publication has been produced with the assistance of the European Union through the EC-UN Joint
Migration and Development Initiative. The contents of this publication can in no way be taken to reflect the
views of the European Union, IOM or the United Nations, including UNDP, UNFPA, UNHCR and ILO, or those
of their member states.
Website: www.migration4development.org.
Table of Contents
4 Acknowledgments
5 Foreword: Action for Health Initiatives (ACHIEVE)
6 Foreword: Vrije Universiteit Medical Center Metamedica/

Health Care and Culture (VUMC / MHCC)
7 Message: International Organization for Migration (IOM)
8 Abbreviations and Acronyms
10 Executive Summary
21 Introduction
23 Section 1: Review of Related Literature
45 Section 2: Research Methodology
49 Section 3: Research Results and Discussion
98 Conclusions and Recommendations
103 References
106 Annexes
Acknowledgments
Action for Health Initiatives (ACHIEVE), Inc. andVrije Universiteit Medical Center / Health Care and
Culture (VUMC-MHCC) would like to recognize and convey gratitude to the people and agencies for
their generosity and willingness to share their time, experiences and expertise, which enriched this
research project. Their valuable support has made this endeavor fruitful and has resulted in possibilities
for partnerships and collaboration in promoting and protecting the rights of women migrant domestic
workers. We would like to extend our gratitude to the following:
Ms. Jennifer Manalili, the former Administrator of the Philippine Overseas Employment Administration
(POEA), including the staff of Central Office, and its regional offices: Regional Office for Northern Luzon
led by Chief Nonette Legaspi-Villanueva, Regional Office for Visayas led by Chief Evelia M. Durato and
Regional Office for Mindanao led by Chief Carolina B. Agdamag;
Ms. Marvi Ador of the Overseas Workers Welfare Administration (OWWA) and OWWA Regional Welfare
Offices (RWO): OWWA RWO I led by Chief Esperanza Cobarrubias, RWO XI led by Chief Zenobia L.
Caro and RWO VII led by Chief Mae Codilla;
Undersecretary Florita Villar of the Department of Social Welfare and Development (DSWD) Central
Office and its field offices: DSWD FOI led by Director Leonardo Reynoso, DSWD FO XI led by Director
Ester Versoza and DSWD VII led by Director Evelyn B. Macapobre;
Atty. Enrico Fos of the Office of the Undersecretary for Migrant Workers’ Affairs (OUMWA) of the
Department of Foreign Affairs (DFA); Dr. Eduardo Janairo of the National Center for Disease Prevention
and Control (NCDPC) of the Department of Health (DOH); Dr. Venus Arain of the National Center for
Mental Health (NCMH);
Ms. Rose Bayan of Kanlungan La Union; Members and officers of Bannuar Ti La Union and Timpuyog
Ti Agkabsat; Ms. Jean Goulbourn of the Natasha Goulbourn Foundation;
ACHIEVE’s Administrative staff, Rafael Alberto, Anafe Luna, and Elena Bejar, for their support;
And most especially, to all the women migrant domestic workers, who were involved in every stage of
the research and have been very generous in sharing their experiences, stories and time with us.
Foreword
In recent years, various international as well as regional development and human rights organizations
have voiced their concern about the increase in documented cases of work-related mental health
problems. They have noted the many negative impacts of these issues on the social-cultural life and
economic productivity especially of vulnerable groups like women migrant domestic workers, indigenous
peoples and poor farmers in developing countries. The World Health Organization in its Mental Health
Policy and Service Guidance Package (2005) for workplace related policies and programmes notes
that mental health problems are the result of a “complex interplay between biology, psychological,
social and environmental factors”. Although work-related stress is not usually classified as a mental
disorder, it can precipitate or eventually lead to depression, chronic anxiety, poor concentration and
other psychosocial and emotional as well as physical health problems. Among the key factors cited by
WHO that contribute to work-related stress are excessive workload and poor working conditions,
conflicting demands of work and family / household life as well as the lack of participation and control
over income and work policies.
Over the years, the Action for Health Initiatives (ACHIEVE) has produced numerous policy action studies
that aimed to contribute to a better understanding of the labor conditions of overseas migrant workers,
including the factors that make them most vulnerable to physical health problems. These studies have
amply documented how the human rights of migrant workers have often been compromised, if not
violated, due to the inability of state parties and service providers, both in sending and receiving countries,
to provide acceptable, affordable and appropriate measures to protect them from abuse and harm.
Problems of overseas and mobile workers are also rooted in their lack of awareness of the causes of
health risks and vulnerabilities as well as their lack of access to enabling information and services.
This study is a pioneering effort to further enrich our knowledge of the psycho-social dimensions of
overseas domestic work. Through use of quantitative and qualitative research techniques, the study
team looked into the stressors of women migrant domestic workers, the manifestations of stress and
its impacts on their personal, interpersonal, family and economic life. The recommendations generated
by this study can hopefully be used to strengthen current policies, programs and services to promote
the emotional and physical health of our women migrant domestic workers and their families. Again, as
previous literature argues, the right to health – its protection, promotion and fulfillment – can only be
fully realized through the concerted effort of all stakeholders. The recommendations put forward by the
research team call for measures to strengthen current policy and program initiatives to address
employment and related sources of stress of migrant workers, while simultaneously creating an enabling
environment for them to develop life skills and culturally sensitive self-empowerment strategies to promote
personal health and well-being.
Carolyn I. Sobritchea, Ph.D.

ACHIEVE, Inc.
5
WOMEN & MIGRATION: THE MENTAL HEALTH NEXUS
Mental Health Problems of Fili pino Women Migrant Domestic Workers
Foreword
We lack sufficient knowledge about the health of migrants. In the past, international health-care focused
on the containment of infectious disease transmission. From their perspective, employers have been
interested in migrants´ health as an aspect of the quality of labor the migrant will be able to provide.
Emphasis was on testing the health of migrants. Of late, politicians in rich countries began discussing
control of migration and have brought up the issue of the cost of migration through more use of the
social system. The general health and well-being of migrants itself however, was not the focus of
attention.
Receiving countries have not been investing in proper monitoring of health, let alone mental health of
migrants. Some countries have even used their access to health care as a means to control migration.
Sending countries can only organize information sessions for leaving migrants and services for returning
migrants with health problems. What is needed, however, is solid knowledge about whether migrants
are really more vulnerable, as many health advocates claim; which factors of migration impact on their
health and well-being; and, the relationship between these health threats and the conditions that made
them leave their countries.
It is the role of health research to make the lived realities of people visible and provide insight into the
interrelations among factors that impact health. With regard to migrants´ health there is a lot of catching
up to do. Mental health of migrants suffers even more from underexposure.
In the framework of the Joint Migration and Development Initiatives (JMDI) and supported by the European
Commission-United Nations (EC-UN), the Action for Health Initiatives (ACHIEVE), Inc., in partnership
with the Vrije Universiteit Medical Center Metamedica / Health Care and Culture (VUMC-MHCC)
carried out this participatory research to shed light on the mental health of women migrant domestic
workers. The data produced is rich and gives good insight on the realities of their lives. But it is not
enough. A lot more has to be done. This research provides us with a solid background for testing
potentially successful interventions. If we are content with what we made visible now, we fail in the very
core of the need of this kind of research. This is just a beginning.
Professor Ivan Wolffers, Ph.D.

Vrije Universiteit Medical Center Metamedica /
Health Care and Culture (VUMC-MHCC)
6
Message
This study, Women and Migration: The Mental Health Nexus addresses the critical gap in migration
research as it looks at the mental health of Filipino women migrant domestic workers. In 2009 alone,
the Philippines deployed 69,669 female domestic workers (new hires) roughly about 39 percent of all
the new hires deployed (POEA 2009). By the nature of their work and workplace, and the factors that
drive them to work in this occupation, domestic workers have come to be among the most vulnerable
among our migrant workers. Often however, only the physical abuses that occur are documented and
responded to, isolated from the fact that mental anguish and stress can often be a daily struggle for
many, if not for most migrant domestic workers.
Through the European Commission funded Joint Migration and Development Initiative (JMDI), the joint
UN Country Team paid particular interest to this project among many good proposals, in view of its
compelling perspective in contributing to the knowledge base needed in accounting for an often neglected
issue relative to the welfare of vulnerable women domestic workers. Concern for mental health is not
just about prevention of its worst traumatic outcomes. The recent turmoil in the Middle East and North
Africa (MENA) region resulted in a wave of employment displacement which has affected many OFWs,
notably domestic workers, health workers and other migrant laborers. One may only have to place
themselves in the positions of these migrants in order to understand how they must drop the thought of
employment when it poses a clear threat to their lives and safety.
As action oriented research, the Action for Health Initiatives (ACHIEVE) and the Vrije Universiteit-
Metamedica / Health Care and Culture (VU-MHCC) have utilized the research findings and a participatory
process of validation to design rights-based, gender responsive interventions for frontline service providers
at all stages of migration (pre-departure, during and post-migration). This study is timely as the community
of nations, in particular labour origin countries, has come to raise concern as to who comes quickly to
the rescue of domestic workers trapped in conflicts. The Philippines government, certainly, can benefit
from this research contribution in its efforts to champion the cause of domestic workers in a number of
regional and international fora, notably the Colombo Process and the deliberations on the breakthrough
draft ILO Convention on Domestic Work. While countries of origin must be prepared to further support
the physical and mental health of returnees, there is the larger challenge of how such goal can be
shared by receiving country authorities. Research like this provides critical insights and information to
form a deeper understanding of issues like migrant mental health, which can consequently guide the
design and implementation of key programmes.
The IOM congratulates ACHIEVE and UV-MHCC for consistently focusing on a field of concern specifically
migration and health, which has relatively lagged behind to capture due level of attention of stakeholders
and interest groups.
International Organization for Migration (IOM)

Manila
7
Abbreviations & Acronyms

ACHIEVE Action for Health Initiatives, Inc.
AE United Arab Emirates
AIDS Acquired Immune Deficiency Syndrome
BH Bahrain
BN Brunei Darussalam
CARAM Coordination of Action Research on AIDS and Mobility
CEDAW Convention on the Elimination of All Forms of Discrimination Against Women
CY Cyprus
DFA Department of Foreign Affairs
DILG Department of the Interior and Local Government
DOH Department of Health
DOLE Department of Labor and Employment
DSWD Department of Social Welfare and Development
EENT Eye, ear, nose, throat
ES Spain
FADS Filipino Anxiety and Depression Scale
FGD Focus group discussion
HIV Human Immunodeficiency Virus
HK Hong Kong
IL Israel
ILO International Labor Organization
IOM International Organization for Migration
IT Italy
JO Jordan
KD Kuwaiti dinar
KII Key informant interview
KW Kuwait
LB Lebanon
LGU Local government unit
MO Macau
8
NCR National Capital Region
NGO Non-government organization
NRCO National Reintegration Center for OFWs
OFW Overseas Filipino Workers
OM Oman
OUMWA Office of the Undersecretary for Migrant Workers’ Affairs
OWWA Overseas Workers’ Welfare Administration
PDOS Pre-Departure Orientation Seminar
PEME Pre-employment medical examination
POEA Philippine Overseas Employment Administration
QA Qatar
SA Saudi Arabia
SG Singapore
STI Sexually transmitted infection
SRRS Social Readjustment Rating Scale
SSS Social Security System
TB Tuberculosis
TW Taiwan, Republic of China
VUMC-MHCC Vrije Universiteit Medical Center Metamedica/Health Care and Culture
9
Executive Summary
Background of the Research
In 2010, an estimated 214 million or 3.1 percent of the world’s population are currently living, permanently
or temporarily, outside their country of birth or citizenship. More than one third of migrants are hosted in
Europe (32.6 percent), while others are hosted in Asia (28.7 percent), North America (23.4 percent),
Africa (nine percent), Latin America and the Carribean (3.5 percent), and Oceania (2.8 percent).
In the last ten years, there was an increase in number of women migrants; women currently represent
about 48 percent of the 214 million worldwide migrants. The increasing proportion of women migrants is
most evident in Asia, where hundreds of thousands of women – both low-skilled and skilled – emigrate
each year. Recent statistics show that the main origin countries are Indonesia, the Philippines, Sri
Lanka and Thailand and the main destination countries and regions are Hong Kong (China), Malaysia,
the Middle East and Singapore.
Given the significant numbers of women migrating as domestic workers, there is concern regarding
their health and general well-being. The new transnational face of domestic workers generates important
questions about the even greater vulnerability of this invisible community. Their daily interaction with the
state, the host society, and their employers can be marked by discrimination on the intersecting basis
of their ethnicity, nationality, class and gender. How do developments concerning global migrant flows
influence the health and well-being of these domestic workers?
Studies have shown that stressful experiences increase one’s vulnerability to diseases and mental
health problems. This is because sustained stress has a negative impact on a person’s immune system,
generates passivity and hopeless resignation. Individual factors such as age and gender influence the
experience of imbalance. Stress may also have positive effects (that of transformation) and stress and
crisis may also trigger growth.
Coping styles of Filipinos, nested in collectivist culture, may not always work in other settings. Specifically,
the emergence of the pseudo- family comprised of compatriots may also impede adjustments necessary
in cultures that are task oriented and impersonal. Prayer is also one of the tools used to cope. This is
attributed to the Filipinos’ strong and positive sense of spirituality, which is considered to be a source
of strength in the individual. The latter has been considered as a major coping mechanism in times of
crises among Filipino women migrant domestic workers.
10
Given the aforementioned, the following analytical framework was proposed for this research, which
takes into account the different stages of migration (i.e. pre- migration, on site and upon return/
reintegration) and socio – demographic characteristics of migrant domestic workers (i.e. age, civil
status, educational background, place of origin and type of work) as contexts in identifying mental
health needs of female migrant domestic workers. Due consideration should be directed to socio-
cultural contexts in the countries of origin and destination, existing laws and mandates for the development
of mental health programs for the identified population, and important standards of ethics and care in
the development of mental health services and programs. Recommendations in addressing mental
health needs of women migrant domestic workers will be drawn from the outcome of the research.
Research Management and Methodology
There were two major phases in the conduct of the action research. The first entailed the conduct of
preparatory activities, while the second included the data gathering, collation and analysis processes.
The preparation phase involved the following sub-steps: (1) review of related literature, scoping of existing
mental health services and conduct of focus group discussions (FGD); (2) finalization of the study
design; (3) planning for data organization and management; (4) formation and training of the data-
gathering teams; (5) field manual development; and, (6) translation, pre-testing and finalization of data-
gathering tools.
The data gathering, collation and analysis phase included: (1) social preparation for data gathering; (2)
data gathering in the study sites; (3) data editing, encoding, and collation; (4) data reduction and
presentation; (5) finalization of the case studies; (6) data analysis; and, (7) writing of the research
report.
Three research methods were utilized in the conduct of this action research: (1) survey research; (2)
key informant interviews; and, (3) case studies.
Four research sites were identified for the study: La Union and National Capital Region (NCR) in Luzon,
Davao City in Mindanao and Cebu City in the Visayas. These were selected to represent differing
populations from the three main island groups of the Philippines (i.e. Luzon, Visayas and Mindanao).
11
With regard to the respondents, inclusion criteria were: adult female individuals (18 to 60 years old) who
have finished at least one contract as an overseas domestic worker. The participants came from different
life stages (i.e. young adulthood and middle adulthood), different types of domestic work (e.g. child
minder, cook, “all around”, etc.) and places of destinations (e.g. Asia, Europe, Middle East). A total of
500 respondents were interviewed.
To conduct the research, research teams were organized thus: The national coordinating team, which
was composed of the following: (a) project coordinator; (b) principal investigator; and, (c) project assistant.
The local coordinating team in the different study sites included: (a) team leader; and, (b) field researchers/
interviewers.
Research Results
Among the key research findings were:
Participant / respondent socio-demographic characteristics
• Most participants identified trade as the primary source of income of their barangay (36 percent),
led by retail sales (34 percent), and followed by wholesale trading (5.1 percent). Agriculture as
a main income source came second, followed by manufacturing. For the primarily agricultural
communities, farming of crops to be sold was the top means of livelihood (17.9 percent), followed
by livestock raising for sale (5.6 percent), farming for personal needs (4.1 percent), and raising
livestock for personal needs (one percent).
• The mean age of those surveyed from the four research sites is 35.09 years, with a range of 18
to 60 years.
• Most survey participants are married (51.2 percent), some are single (32 percent) while others
are separated (nine percent), widowed (four percent) and cohabiting (four percent). Most of
those who are single came from the young adult group (20.20 percent). Majority of the
respondents have reached high school or college (with 35.2 percent having completed high
school, another 32.4 percent reached college and 18.8 percent completed college), particularly
for those in the young and middle adult categories. In terms of religious affiliation, majority are
Roman Catholics (76.6 percent), with a smaller number being Born Again Christian (6.6 percent)
and Muslim (6.4 percent).
12
• Majority of survey participants are currently unemployed (67.4 percent), while a few work for
their own income (20.8 percent) and a number receive regular pay from work (7.4 percent). For
those who are working, most are primarily involved in trade (28 percent), particularly in retail
selling (49 percent). Some provide private services (13 percent), like doing laundry and sewing
clothes (as a dressmaker or tailor). Some are employed (four percent). For those who have
current sources of income, the mean income per month is PhP5,421 (US$120.46).
• Most study participants had completed one to two contracts as overseas domestic workers
(67 percent). Some finished three to four contracts (18 percent) and five to six contracts (5.4
percent). A smaller percentage had completed seven to eight contracts (1.2 percent), nine to
10 contracts (1.2 percent) and more than 10 contracts (4 percent).
• The top five reasons for working abroad were: (1) to save for the future; (2) to be able to send
children to school (3) poverty; (4) no jobs available in the Philippines; and, (5) to help parents
and siblings.
Pre-migration status and requirements
• A large number of survey participants reported that they left as domestic workers (86 percent)
while one in ten left as tourists (10 percent). Some of those who left as tourists were able to
get work permits on site. Others left as caretakers, factory workers, nursing aides, or
dressmakers. While majority of the participants said their job title is consistent with their
contract (92 percent); some noticed different job titles stated in their contracts (e.g. babysitter,
caregiver, tutor, tailor / dressmaker or factory worker). Significantly, eight percent (8.1 percent)
did not read their contract and another three percent did not have any contract when they left
to work abroad.
The top five most frequent pre-employment medical examinations (PEME) that the survey
participants had undergone were: x-rays (84.2 percent); urinalysis (82.8 percent); blood workups
(82.4 percent); stool examination or fecalysis (79.4 percent) and general physical examinations
(79.4 percent). Half (57.4 percent) reported they went through a psychometric test while (39.4
percent) underwent neurological test. Ninety-two per cent said their informed consent was
secured but only 86 percent were informed of the result of their medical examinations.
13
• Majority of the respondents (78.6 percent) said they attended the Pre-Departure Orientation
Seminar or PDOS. The PDOS providers included: recruitment agencies (39.7 percent); the
Philippine Overseas Employment Administration or POEA (25.7 percent); the Overseas Workers’
Welfare Administration or OWWA (24.2 percent) and non-government organizations (4.3 percent).
The survey participants recalled these top five topics from the PDOS: (1) travel rules and
procedures (17.6 percent); (2) information on culture and laws of the host country (14 percent);
(3) how to adapt to a different culture (14 percent); (4) information on how to remit money (14
percent); and, (5) how to adapt to a different language (12 percent).
Working conditions abroad
• Living arrangements: Majority of the survey participants lived with their employers (94.8
percent). In terms of the amount of time spent working and living arrangements, majority (58
percent) of those who live out work nine to 12 hours; almost a quarter (23 percent) worked 13
to 16 hours; and, one out of ten respondents (11.6 percent) worked 17 to 20 hours. Of those
who lived with their employers, 27 percent work from 17 to 20 hours, almost a fourth (23
percent) worked for 20 to 24 hours. A fifth (22 percent) worked for 9 to 12 hours; and another
fifth (20 percent) work for 13 to 16 hours.
• Working hours: A quarter of the participants work for 13-16 hours (26 percent) while almost
another quarter work from five to eight hours (23.8 percent), 17 to 20 hours (22.2 percent) and
nine to 12 hours (20.2 percent). Others also noted working for an unlimited number of hours or
for as long as they have work (7.2 percent).
• Survey participants identified the following tasks they performed in their employers’ household:
cleaning house (87.6 percent); cooking meals (77.4 percent); doing laundry (74.4 percent);
taking care of employers’ child/children (62.2 percent); and washing the car (25.4 percent).
Though considered illegal and a violation of contract, some reported cleaning the house of their
employer’s relative(s) / friend(s) and taking care of their employer’s friend’s child.
• Half (58.6 percent) of the participants said that they are entitled to regular days off. Of these,
70.5 percent avail of the benefit. The frequency of their regular days off varies, however, with
most having them once a week (48 percent), followed by once (17 percent) or twice a month (8
14
percent). An even smaller portion (7.5 percent) have a day off only during Christmas Day (when
the employer goes out), or twice a week, or once every three months, to cite some examples.
The five most cited activities they engage in during their day off are: (a) go out, take a stroll,
shop, and eat out (31.4 percent); (b) meet / spend time with friends (24.6 percent); (c) attend
church / hear mass / attend Bible study sessions (24.6 percent); (d) do part-time work (10.2
percent); and, (e) stay at home (9.6 percent).
• Individual income and expenditures: The mean income for all respondents is PhP17,027.80
(US$378.39) per month. A minority (2.8 percent) working in developed countries – such as the
United States, Canada, Spain, Italy,and other European countries – earned salaries ranging
from US$1,000 to US$3,000 or higher. Sixty percent of respondents earned below US$400;
about 20 percent received US$400 to US$500 a month. The lowest salary stated per month
was PhP 5,500 (US$122.22). Sixty-eight percent of respondents, their reported salary is
consistent with their contract. Majority of survey participants (98.4 percent) said they send
remittances to their family. The percentage of their income which they send home varies. Most
of them send a big chunk of their earnings to the Philippines: 41 to 50 percent of their income
(18.3 percent); 71 to 80 percent of their income (16. 8 percent); and 91 to100 percent of their
income (15.2 percent).
• Social protection and safety nets: More than a third (35 percent) reported they do not have
any form of insurance while they were in the Philippines. Some have social security (31.8
percent), national health insurance (29.8 percent) or government social security insurance (.8
percent). Most of those who were insured noted that their coverage included health insurance
(37 percent); life insurance (16.8 percent) and coverage for illness, sickness, or injury (15.3
percent). While working overseas, 54 percent had insurance coverage which included health
insurance (48 percent), illness / sickness / injury (19.4 percent) and life / death insurance (17.5
percent). Majority of those who reported having insurance while working abroad worked in Hong
Kong, the UAE, and Singapore. Most of those working in Saudi Arabia and Kuwait were not
provided with insurance.
15
Migration – related health concerns and issues (health conditions, stressors, coping with
stress, sexual and reproductive health, health services availed of)
• Most respondents (56.50 percent) of the study did not experience any illness while working
abroad. Those who fell ill (43.5 percent), reported experiencing the following most frequently
cited symptoms: fever (33 percent); cough (28 percent); colds (12 percent); flu-like symptoms
(12 percent); and, headache (nine percent). Very few respondents sustained injuries while
working overseas (17.8 percent). Majority of these experienced cuts and abrasions and were
from Hong Kong and the UAE. Amputation or loss of body part was reported by two respondents
from Saudi Arabia. Most of those who reported dislocation, fractures and sprains worked in
Saudi Arabia and the UAE. Most of those who sustained burns, contusions, bruises and
hematoma were from Saudi Arabia. Some other conditions where injuries were sustained
included being bitten by a dog; falling while handling persons because of the weight of the
elderly person she was taking care of; and, slipping and falling.
• One of the sources of stress of migrant workers based on the FGDs is the difficulty in balancing
the demands of work abroad and family life back home. Results of the survey shows that such
condition is considered to be “somewhat difficult” by 38 percent of respondents; “very difficult”
by 27.7 percent; “not very difficult” by 27 percent; and “not at all difficult” by a minority (7
percent). Furthermore, the greatest source of stress while abroad is stress at work (43 percent),
while others identified stress from both work and home (26 percent); and stress at home (25
percent). Only 5.6 percent stated that neither is considered to be stressful.
• A little more than half (55 percent) of respondents experienced stressful life events while
employed overseas such the death of a close family member (19 percent); diagnosis of a
serious illness of a close family member (12.4 percent); break up of a long term relationship
(9.6 percent); respondent diagnosed with a serious medical problem (6.12 percent); loss of
employment for more than two months (3.06 percent); and transfer from former home (3.06
percent).
• The most frequently identified physical manifestations of stress while overseas were: fatigue
(64.6 percent); headache (60.4 percent); muscular tension (49.8 percent); upset stomach /
indigestion (36.4 percent); feeling faint or dizzy (36.2 percent); and, inability to sleep (36
percent). On the other hand, while in the Philippines, they experienced: headache (48 percent);
16
oversleeping (2.2 percent); upset stomach / indigestion (23.8 percent); fatigue (19.8 percent);
inability to sleep (18.2 percent); and, muscular tension (17.4 percent).
• Significantly, the number of psycho-emotional symptoms reported by the participants decreased

while in the Philippines compared to when they were abroad. The same trend was observed
among the reported psychological manifestations of stress. While overseas, the following
were experienced: loneliness (68.2 percent); desire to cry (66 percent); sadness (66 percent);
feeling nervous (36.8 percent); and irritability (32.4 percent). While in the Philippines, they
reported irritability (24.4 percent) anger (23.6 percent); sadness (22.8 percent); desire to cry
(19.6 percent) and loneliness (15.8 percent).
• Food is one of the sources of stress identified by FGD participants. This may be due to the
absence, inadequacy, and unpalatability of food provided by their employers. Missed meals
further add to this. Majority of the participants (74.6 percent) reported that they never missed
a meal in a week’s time, but some missed meal/s in a week, specifically: one meal (7.2
percent), two to three meals (nine percent), four to seven meals (2.6 percent) and eight or more
meals (4.2 percent). This trend is seen among respondents coming from both the young and
middle adulthood stages.
• When asked about their sources of joy and happiness while abroad, the categories of their
responses included: talking to / sending text messages to one’s family (14.8 percent); receiving
one’s salary (seven percent); having a good and generous employer (6.6 percent); thinking of
one’s family (five percent); playing with / taking care of her employer’s child/child(ren) (4.8
percent); sending money to one’s family in the Philippines (3.8 percent); receiving gifts from
employer (3.6 percent); strolling / going to the mall / shopping (3.2 percent); helping one’s
family (three percent); having a high salary (2.8 percent); seeing other Filipinas (2.6 percent);
chatting with friends (2.4 percent); saving money (2.4 percent); and, being inspired by one’s
family (two percent)
• In terms of the necessity of engaging in a romantic relationship while working abroad, only 11.7
percent answered positively. Majority of these had a male partner (91.4 percent), while some
had a female partner (seven percent). Less than half (41.6 percent) reported that they had sex
with their partners. A small number (3.6 percent) had sex with someone not their spouse. Their
sexual partners include male friends (39.1 percent); boyfriends (21.7 percent), and casual
17
acquaintances (17.4 percent). Other partners included co-worker, female friend, commercial
sex worker, employer or customer or client (for those engaged in paid sex). It is important to
note that some women migrant domestic workers need contraceptive counseling and services,
as well as prenatal care, as some of them get pregnant while working overseas.
• When asked if the respondents ever consulted a counselor or a mental health professional,
three percent answered in the affirmative. Of this number, 43 percent reported that they sought
the services of a pastoral counselor. Others reported seeing a psychiatrist (21.4 percent),
counselor (14.3 percent) and a psychologist (14.3 percent). With regard to their family members,
two percent have family members consulted mental health professionals, specifically psychiatrists
and substance abuse counselors
• The leading sources of support of migrant domestic workers are: Filipino friend (26.2 percent);
female employer (11.2 percent); mother (5.5 percent); relative (5.2 percent) and co-worker (4.9
percent). It is important to note that a fifth (20.3 percent) of the respondents reported that they
do not have any source of support. A few of the respondents experienced seeking assistance
from the Philippine Consulate in the country where they are working (8.6 percent). The services
they availed of from the agency included the following: renewal of worker’s documents (e.g.
passport, contract) [23.3 percent]; advice regarding refund of placement fee, dealing with conflicts
with employer, and the deportation process (23.3 percent); provision of temporary shelter (20.9
percent); and, facilitated return to the Philippines / deportation (18.6 percent). Others identified
being assisted in filing complaints, counseling, financial and legal assistance (9.3 percent)
while 4.6 percent of those who went to the embassy reported that they did not avail of any
service.
Recommendations
Recommendations are drawn along three areas-policy, research and program development and
intervention. Specifically, these are:
18
On policy development and implementation
• Enforce policies protecting the rights and welfare of women migrant domestic workers [such
as, for example, the Migrant Workers Act (RA 8504) and the Amended Migrant Workers Act
(RA 10022), POEA guidelines and other most strategic policies]
• Review current policies in relation to health and migration, specifically the Philippine Mental
Health Policy Framework, and support the call for the enactment of a National Mental Health
Act that would incorporate the issues and concerns of migrant workers
On research
• Conduct cross-cultural research on migration and mental health (i.e., on-site research that
will look at the relationship of culture / context / condition in the host countries and mental
health of migrant workers)
• Conduct research on the mental health status and needs of children (family) of women migrant
domestic workers
On programme development
Pre-departure
• Integrate mental health in programming of relevant government agencies such as the Department
of Education (Dep Ed) and Department of Social Welfare and Development (DSWD), among
others
• Incorporate mental health topics in the module of the Pre-Departure Orientation Seminar
(PDOS)
• Training of PDOS providers on mental health topics and concerns
• Integration of counseling / psychosocial intervention in the training of foreign service personnel
• Participation of family members in PDOS and other training such as financial literacy
19
• Assessment of mechanisms being used to identify mental health needs of OFWs and how
they are being responded to (in relation to the conduct of psychiatric tests that if an applicant
fails the test, s/he will not be able to work abroad because of being “unfit to work”)
On site
• Setting up of referral mechanisms that will respond to the mental health needs of women
migrant domestic workers
• Making services available for women migrant domestic workers
• Mapping of services
• Provision of continuing support to families of women migrant domestic workers through
organizing, training, counseling, among others
Upon return
• Provision of services to women migrant domestic workers and their families (livelihood,
counseling, among others)
20
Introduction
The Commission on Filipinos Overseas (CFO)1 reports that the estimated number of Filipinos outside
the country reached 8,579,378 in December 2009. Of this figure, 3,864,068 (45 percent) are contract
workers; and 658,370 (7.67 percent) are irregularly documented migrants.2 In 2009, the total number of
new contracts (both new hires and rehires) processed for landbased Overseas Filipino Workers (OFWs)
reached 1,092,162. A total of 175,298 women migrated to work as newly-hired workers in 2009; 40
percent of these were household service workers.3 Such figures do not represent the total stock of
female migrants abroad, as these exclude rehires, those who still have ongoing work contracts, and
those who are undocumented.
Women migrant domestic workers experience various forms of discrimination due to their gender, race
and class. Many are isolated and subjected to exploitation, physical abuse, sexual violence, maltreatment
and labor rights violations, such as contract substitution and non-payment of wages.4 Because domestic
work is not recognized as work in most destination countries, women working in this sector often do
not have access to social and legal protection. They also have the least access to health services and
information, including sexual, reproductive and mental health.
Mental health has been defined by the World Health Organization (WHO) as the “state of well-being in
which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work
productively and fruitfully, and is able to make a contribution to his or her community.” Mental health
also encompasses a person’s emotional stability to handle pressures and other stressors.5 In the case
of women migrant domestic workers, they are clearly placed in situations where there are additional
stressors brought about by their working and living conditions and also by the distance and separation
from their families and social networks.
While there are existing data and interventions concerning labor rights violations, and physical and
sexual abuses of women migrant workers, there are very few researches and services addressing
health, specifically their mental health concerns. Such absence or gap is likely to be a function of the
absence of collated, updated and relevant data. Likewise, there is often no linkage being made in
various reports on abuses, violence and problems faced by women migrant workers to their state of
mental health. This research will endeavor to establish the links between the living and working conditions
of women migrant workers and their mental health. Apart from looking at living conditions of women
migrant workers, the research will also look at the impact of separation and distance from their families
and social networks, as this also impacts on their mental health and well-being. A research that was
1
A government commission mandated to uphold and promote the interests and well-being of overseas Filipinos
2
Commission on Filipinos Overseas Stock Estimate of overseas Filipinos as of December 2009. http://cfo.gov.ph/pdf/statistics/
stock%202009.pdf
3
Philippine Overseas Employment Administration, 2009
4
Quesada, A and M. Marin. 2009 Unveiling HIV Vulnerabilities. Filipino Women Migrant Workers in the Arab States. ACHIEVE, Inc.
5
Mayor, R. 2008. Untangling the Mental Haywire. Health Alert Asia Pacific edition
21
done in Japan among Filipino migrant workers showed that migrants more frequently experience family-
based life strains compared with life strains resulting from working and living conditions.6
In 1990, the Philippine Embassy in Singapore reported that within a six-month period, there were six (6)
deaths due to suicide among Filipina domestic workers.7 A research in Kuwait back in the early ‘80s
also showed that the rate of first admission in psychiatric hospitals were five times higher among
female migrant workers than among the local Kuwaiti women.8 Ten years later, another study in Kuwait
found that the most common psychiatric diagnoses among foreign domestic workers were ‘acute stress
reaction’, ‘acute adjustment disorder’, ‘manic episode’, ‘depressive episode’, and ‘acute and transient
psychotic episode’.9 Media reports in the last few years regularly feature stories and accounts of
returning OFWs in situations of distress such that in 2008, the Office of the Undersecretary for Migrant
Workers Affairs (OUMWA) of the Department of Foreign Affairs (DFA) proposed the conduct of mandatory
psychiatric screening of all outgoing migrant domestic workers. While this call was promptly rejected
by various organizations and even the recruitment agencies, it gave evidence to the urgency of addressing
mental health issues among migrant workers, albeit it meant addressing more the structural factors
and conditions that lead to mental health problems among women migrant domestic workers.
Existing pre-departure programs for female migrant domestic workers do not include services related to
mental health. Neither does it provide realistic and comprehensive information on working and living
conditions in the country of employment. While services of the Philippine Embassies and Consulates
in the destination countries include counseling, domestic workers are mostly isolated or have only one
day off a week, thus, this service is not very accessible to them. Returning migrant workers, especially
those who underwent distress and abuse, are often brought back to their families and communities,
without adequate and sustained psycho-social support. Government agencies and CSO service providers
also speak of their inadequate capacity to address mental health issues.
This research is envisaged to provide evidence in the formulation of appropriate rights-based and gender-
responsive policies and programs addressing mental health issues of women migrants. In addition to
generating information, the project entails development of a package of interventions and conduct of a
pilot training course on psychosocial assistance for women migrant workers, specifically targeting
frontline personnel from service provider institutions from both government and CSOs. It is hoped that
the findings of this research can further inform the advocacy agenda on women migrants’ rights and
health, in national, regional and international spaces.
6
Ohara-Hirano, Y. Cognitive life strains and family relationships of Filipino migrant workers in Japan
7
CARAM Asia citing Gulati, L. 2005. Domestic Workers and Health.
8
Ibid, citing el-Hilu, et. al. (1990).
9
Ibid citing Zahid, et. al. (2003).
22
Section 1: Review of Related Literature
This review is a modest attempt to present a comprehensive view of the international and local literature
concerning health issues of migrant domestic workers, with particular focus on their mental health. In
the review, both primary and secondary data were utilized, which led to a vast body of data of different
classes – both epidemiological studies and small-scale qualitative studies, and of different levels of
evidence – from findings based on well-designed research projects to anecdotal knowledge. Relevant
literature is presented with examples from different countries, if available. By analysing these issues,
this review attempts to establish an understanding of the vulnerability and risk factors affecting migrant
domestic workers.
In 2010, an estimated 214 million or 3.1 percent of the world’s population are currently living, permanently
or temporarily, outside their country of birth or citizenship10. More than one third of migrants are hosted
in Europe (32.6 percent), while others are hosted in Asia (28.7 percent), North America (23.4 percent),
Africa (nine percent), Latin America and the Carribean (3.5 percent), and Oceania (2.8 percent)11.
There are multiple ´pull´ and ´push´ factors contributing to global migration. Poverty is commonly cited
as the predominant reason why people migrate. Other factors include increasing differences between
countries, decent work and human security in certain parts of the world, the growing demand for high
and low-skilled workers in destination countries and the geographical proximity and historical linkages
between origin and destination countries12.
Migration is a process of social change, whereby an individual moves from one cultural setting to
another for the purposes of settling down either permanently or for a prolonged period13. Migration for
overseas employment involves three stages: pre-departure; post-arrival and onsite; and return /
reintegration. Pre-departure begins when a person has made a decision to apply for overseas employment.
This period covers the actual application process, medical testing, contract signing and compliance
with the legal pre-departure requirements. Onsite or post-arrival covers the period of arrival of the migrant
worker in the country of destination and the entire duration of his or her employment. Reintegration
involves the period of return of the migrant worker to his or her country of origin and the corresponding
adjustment and assimilation period. When conditions permit, such as the absence of legal prohibitions,
a migrant worker may decide to settle permanently in the destination country. The process of migration
is oftentimes characterized by circularity – that is the movement back and forth from the country of
origin and the country of destination.
10
Human Development Report 2009. Overcoming barriers: Human mobility and development; UNDP; 2009 p. 21
11
International labour migration: a rights-based approach. International Labour Organization, 2010, p.17
12
Martin P / Widgren J, International Migration: Facing the Challenge, Population Reference Bureau 2002.
13
Bhugra and Jones, 2001, p. 216
23
Migrant work has always been part of the process of migration. Regionally, 15 million Asians work in
countries other than their own14. In the Philippines, an estimated number of 8,579,378 Filipinos are
overseas, 4,056,940 are immigrants, 3,864,068 are are contract workers while 658,370 are irregularly
documented migrants.15 Two patterns govern migrant work, specifically regular (i.e. legal entry to the
country of destination) and irregular (i.e. migration without proper documentation from sending country)
migratory patterns (CARAM Asia, 2002). These patterns are not mutually exclusive, there are cases
when regular migrants become irregular due to changes in their legal status, as a result of various
reasons such as non- possession of travel documents, escape from abuse or exploitation, failing
mandatory testing, or being undocumented free lancers. These two patterns lead to harm or no- harm
situations16 at different stages of the migration process.
A Women and Migration
In the last ten years, there was an increase in number of women migrants; women currently represent
about 48 percent of the 214 million worldwide migrants17. The increasing proportion of women migrants
is most evident in Asia, where hundreds of thousands of women, both low-skilled and skilled, emigrate
each year. Recent statistics show that the main origin countries are Indonesia, the Philippines, Sri
Lanka and Thailand and the main destination countries and regions are Hong Kong (China), Malaysia,
the Middle East and Singapore18.
Women are believed to be pulled to migration due to the preference and demand for them in gender-
stereotyped work such as domestic work, care-giving and entertainment. Such work are outside the
coverage of social and labor laws, thereby putting women at risk of abuse , violence, exploitation by
recruiters, employers and state functionaries19.
In the Philippines, women account for around 50 percent of legal migrant workers (United Nations,
2008). In 2009, the total number of new contracts (both new hires and rehires) processed for landbased
Overseas Filipino Workers (OFWs) reached 1,092,162. A total of 175,298 women migrated to work as
newly-hired workers in 2009; 40 percent of these were household service workers.
According to Hanochi (2007), migration of women in the Philippines is primarily driven by poverty thus
the need to explore other sources of livelihood. Working abroad has been the solution to address a
14
8th Regional Conference on Migration, 2002
15
Commission on Filipinos Overseas Stock Estimate of overseas Filipinos as of December 2009. http://cfo.gov.ph/pdf/statistics/
stock%202009.pdf
16
IOM, cited in CARAM Asia, 2002
17
Human Development Report 2009. Overcoming barriers: Human mobility and development; UNDP
18
ILO 2010: International Labor Organization: A Rights-based Approach , p 28
19 th
8 Regional Conference on Migration, 2002
24
variety of economic woes. It is therefore not surprising when in 2005, the POEA recorded that among
migrant domestic workers alone remittances were pegged at US$255,689,000. Almost half of the women
migrant domestic workers are college graduates (43 percent) and half have at least a high school
education20. Majority of these women (52.5 percent) have taken loans from relatives and less than a
fourth (15 percent) from money lenders, to be able to pay for the costs of applying for domestic work
abroad.
1. Women and Domestic Work
Women domestic workers constitute a unique working population. They are predominantly females,
and ethnically different from their employers. The live-in nature of their work isolates them and makes
them especially vulnerable to abusive working conditions20. Migrant domestic workers are adult women
who voluntary migrate from one country to another to find work in the domestic service sector.
The International Labor Organization (ILO) defines domestic work as “a wage- earner working in a
(private) household, under whatever method and period of remuneration, who may be employed by one
or more several employers who receive no pecuniary gain from their work”21 Based on the definition, the
following characteristics of domestic work were derived: .
Box 1: Characteristics of domestic work 22
• The work site is a private home.

• The work performed is of a domestic nature: cleaning, cooking,
laundry, childcare and personal care and may include other
home-based tasks such as gardening, driving or patrolling.
• The work is carried out under the authority, direction and supervision
of the householder.
• The worker is remunerated in cash and/or in kind.
• The employer derives no pecuniary gain from the work performed.
20
The Women’s Foundation, 2006, p.63
21
ILO 2009, Moving towards Decent Work for Domestic Workers: An Overview of the ILO’s work, p.9
22
ILO 2009
25
In many countries of destination, domestic work is not considered part of formal work (CARAM Asia,
2002). In a study of national laws conducted by ILO in 2004, only 19 out of 65 countries have specific
laws or regulations dealing with domestic work23. This perspective ties in closely with the view that this
type of work is “women’s work”, which consequently leads to the discourse on the division of the
“productive” and “reproductive” domains. Domestic work is often considered as unproductive work and
as economically invisible...it assumes that domestic work does not create value because the immediate
products are used for direct consumption within the same unit of production, i.e. the household.24
The work conditions of migrant domestic workers are replete with problems, specifically wage differentials,
contract violations, poor working relations, physical and sexual violence (The Women Foundation,
2006). The absence of legal protection further exacerbates the condition of migrant domestic workers.
The following statistics drawn from the study conducted by the European Union in five European cities
reflects the situation of live-in domestic workers (cited in CARAM Asia, 2002):
• Average daily working hours: 17.2

• Average monthly wage: 162.75 euro
• Psychological abuse (threats, shouting, insults) : 88%
• Physical abuse (striking, kicking): 38%
• Sexual abuse and rape: 11%
• Irregular access to food (leftovers, deprivation) : 61%
• No room of one’s own (forced to sleep in hall, kitchen, etc.): 51%
• Confinement (forbidden to leave household unaccompanied) : 34%
• Confiscation of passport by employer: 63%
• Irregular payment: 55%
• Pay lower than agreed: 58%
• Free time not respected: 91%
These realities impact on the physical, social and health conditions of migrant workers. Gender differences
were also identified in the conditions faced by female and male migrant workers that further disadvantage
women migrant domestic workers. In Hong Kong for example, women migrant domestic workers are
paid an average monthly income of HK$3,619 which is less than the HK$4,758 that men receive for the
same type of employment. The nature of work varies too, as men are assigned to driving and gardening
jobs, while women are tasked with childcare, cooking and cleaning. In terms of days off, women are
23
Ramirez-Mechado J, Domestic Work, Conditions of Work and Employment: A Legal Perspective, ILO, 2003
24
CARAM Asia, 2002, p. 98
26
given an average of 3.5 rest days per month compared to males (3.9 days per month). Despite contract
rights, 50 percent of domestic workers do not claim sick leave or consult a doctor for illness and 85
percent pay for their own medical expenses. The study also cited a research (AMC, cited in The
Women Foundation, 2006) that 26 percent of female respondents experience at least one form of
physical abuse. Verbal abuse was noted to be prevalent. Five percent reported that they experienced
various types of sexual abuse (such as obscene language, exposure to pornographic material, and
rape). Filipino women migrant domestic workers reported that they have been kissed, touched and were
the subject of sexual advances by their male employers.
Gender intersects with ethnicity, as seen from a review of research on women migrant domestic workers.
Globally, Asian migrant domestic workers are preferred not only because they are cheap but also
because they are considered to be hardworking and malleable (CARAM Asia, 2002). Within Asia,
Indonesian women domestic workers are paid less than Filipinos and Thais in Hong Kong (The Women’s
Foundation, 2006).
Gender also intersects with existing social hierarchies in destination countries with migrant workers
being considered to be at the lower rungs of the occupational hierarchy. Religion also serves as a factor
in the migration pattern of female domestic workers. For example, Middle East countries prefer workers
with similar religious backgrounds (CARAM Asia, 2002). This explains the migration pattern of women
migrant domestic workers from Mindanao. Due to these interrelated factors, women’s work is further
undervalued, resulting in limited access to resources and services, social exclusion, discrimination and
violence in host countries (8th Conference on Migration, 2002).
B Migration and Well-being
Given the significant numbers of women migrating as domestic workers, there is concern regarding
their health and general well-being. The new transnational face of domestic workers generates important
questions about the even greater vulnerability of this invisible community. Their daily interaction with the
state, the host society, and their employers can be marked by discrimination on the intersecting basis
of their ethnicity, nationality, class and gender. How do developments concerning global migrant flows
influence the health and well-being of these domestic workers?
Among women migrant workers, specifically Asian migrant workers, studies have shown high incidence
of mental illness and job-related accidents due to employers’ failure to comply with safety standards
resulting in workers’ disability and death (8th Regional Conference on Migration, 2002). Unsafe work
conditions, long hours of work and strenuous activities, have also resulted in lifelong disabilities such
as Steven’s Johnson syndrome, enlargement of the heart, and hypertension. Their vulnerability to
27
contracting sexually-transmitted infections, including HIV, is also present (ACHIEVE, 2009). Violence
against female domestic workers has also been reported (The Women’s Foundation, 2006).
There is no existing literature that specifically targets migrant domestic workers and their health on a
global level. Whenever we read about health problems in relation to domestic workers, usually the
excesses are depicted by the media: cases of abuse, rape and torture. However, focusing only on
excesses has at least two drawbacks. First of all, the media can give the implicit message that migration
in itself is the root of all problems. Indeed, in May 1995 Philippine president Fidel Ramos called for
initiatives to keep migrant mothers at home (Parreñas, 2001). Secondly, the attention is directed away
from less obvious and more hidden health problems faced by domestic workers: work-related accidents,
clandestine abortions, low access to health care, as well as loneliness and depression, to only mention
a few.
1. Migration and health
Migration health (Migration Health Annual Report, 2005, p.2) is defined as the complete physical,
mental and social well-being of migrants and mobile populations and not merely the absence of disease
and infirmity. Determinants of migrant health could be divided into environmental, behavioral, socio-
economic and genetic-biological factors. Some determinants of migrant health along the different stages
of migration have been identified (Annual Report Migration Health, 2005; CARAM Asia, 2002; Bhugra
and Jones, 2001) and are shown in table 1.
Table 1. Determinants of migrant health
Pre-migration/ Migration process/ Post migration

Pre-departure Post-arrival
Health determinants of migrant’s Access to health in host country Access to health in country
country of origin
Travel related conditions Conditions in the process of Economic, social, cultural and
migration political reintegration
Process of migration Acceptance of host country Issues pertaining to return and

visitation
Migration policies Vulnerabilities of migrant Social costs of migration
Disparities in the health Accessibility of health care

determinants in host country and services
Accessibility, availability, and Support systems

affordability of health and social
services
Economic costs
28
According to Carballo (2007), some emerging health concerns among the migrant population are chronic
stress, poor dietary adaptation, rapidly changing lifestyles, Type 2 diabetes and cardiovascular problems
such as hypertension and stroke.
The risk of sexual abuse and exploitation is a reality for women migrant domestic workers. Difficulties
in managing these conditions were observed as migrant individuals have to shoulder socio-economic
burdens, are oftentimes alone and unable to access and use local health and social services.
2. Migration and mental health
Mental health has been defined by the World health Organization (WHO) as the state of well-being in
which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work
productively and fruitfully, and is able to make contribution to his or her community. Given this definition,
one can surmise that mental health is not just the absence of mental illness.
Positive mental health involves a sense of psychological well- being which goes hand in hand with a
healthy sense of self25. Some of the factors that affect well-being include emotionality and life satisfaction.
Emotionality pertains to both positive and negative emotions and the capacity to regulate these feelings.
Among adults, well-being is associated with a decrease in negative emotions such as anger, fear and
anxiety; and an increase in cheerfulness. The latter has been correlated positively with education and
marital status. Life satisfaction on the other hand, entails an assessment of one’s subjective well-
being. This includes good coping skills and capacity to adapt. Important contributors to this are social
support and spirituality. It has been said that counting one’s blessings increases life satisfaction.
Generally well-being has been associated with physical health, capacity of enjoying life, positive feelings
about self and serenity in looking at life events26.
Ryff and colleagues27 further developed a model of well-being, which is comprised of six dimensions,
specifically, self-acceptance, positive relations with others, autonomy, environmental mastery, purpose
in life and personal growth. These are collectively associated with social well-being, defined as the
quality of a person’s self reported relationship with other people, the neighborhood and the community28
- an essential aspect of wellness and are a relatively unexplored area of mental health. Keyes and
Shapiro (cited in Papalia, Olds and Feldman, 2007, p. 601) identified five dimensions of this construct:
social actualization, social coherence, social integration, social acceptance and social contribution.
25
Keyes and Shapiro, 2004 cited in Papalia, Olds and Feldman, 2007, p. 598
26
Papalia, Olds and Feldman, 2007, p. 599
27
Cited in Papalia, Olds and Feldman, 2007, p. 600
28
Papalia, Olds and Feldman, 2007, p.601
29
Migration, whether forced or voluntary, creates a strain on individuals and families. The process is
typically associated with uprooting, leaving some family members behind and breaking with social
customs and values that have provided a sense of continuity29. Undoubtedly the process of migration
puts a lot of strain on individuals and the people they leave behind and may contribute to migrant health
issues (Bhugra and Jones, 2001). Specifically in the realm of mental health, the responses of migrants
to the demands of the new environment, have been characterized as a mix of culture shock, language
problems, homesickness, difficulties staying in touch with families left behind, anxiety about work
insecurity, and in case of clandestine migrants...the constant fear of deportation (Carballo, 2007).
Bhugra and Jones (2001) purported that the different stages of migration may create vulnerabilities and
stresses that accompany the process of assimilation, acculturation and deculturation which are necessary
in adapting to a new socio-cultural environment. The same study forwarded that the high rates of
psychological problems and disorders are related to migration. For example, it has been observed that
the incidence of schizophrenia is related to stresses produced by migration. In the same vein, Lerner,
Kanevsky and Witztum (2008, p. 291) posited that immigration is acknowledged to be a major stress
which may increase the emotional distress of an immigrant and in some cases may lead to pathological
reactions. Most commonly recorded mental psychiatric disorders due to migration are: anxiety disorders,
depression, dysthemia and adjustment disorders. These are primarily due to acculturation problems,
immigration stresses and social isolation, exacerbated by low health seeking behaviour, as immigrants
do not seek medical attention until their mental health status compels them to be hospitalized. A study
done among Filipinos migrating to the United States show that migrants use less mental health care
than other groups, regardless of age, gender and geographic locations; drop out of treatment prematurely;
tend to use services only in crises; have somatic expressions of mental issues; and refuse treatment
because of severe stigma associated with mental illness30.
Murakami (2009) further enthused that cultural changes affect mental health. Working in a different
culture creates conflicts due to differences in language, lifestyle, and values; as well as the feeling of
isolation from one’s network. The changes in global movements in more recent years, with females
moving as much as if not more than males, draws attention to the differential characteristics and
experiences of female migrants (Carballo, 2007). Oftentimes, women are moving alone as a consequence
of which they find themselves with minimal social support. Research has shown this is true among
female domestic workers, as they are excluded from mainstream society (The Women’s Foundation,
2007). They also experience violation of contracts and are subjected to subservient and dependent
positions. Their relationship with their employers is ambivalent, as they are considered as helpers and
29
Carballo, 2007, p.1
30
Sanchez and Gaw, 2007
30
competitors to their children. Women workers who left their families behind have to provide economically
for them and may experience problems in maintaining their relationships with family members because
of the distance and time away from them. A reality faced by migrant female workers is informalization of
labor. This may be due to disasters or untimely termination of contracts (Hirochi, 2007). When this
happens, informal communities are formed at the fringes of society making them vulnerable.
3. Migration and stress
health problems (Meyer, 2002). This is because sustained stress has a negative impact on a person’s
immune system, generates passivity and hopeless resignation. Individual factors such as age and
gender influence the experience of imbalance. Stress may also have positive effects (that of transformation)
and stress and crisis may also trigger growth (Bee and Bjorklund, 2004).
Stress is defined as a physical or mental response to demands from the environment (Bee and Bjorklund,
2004). One type of response is physiological, where the body reacts to the condition of stress. The
second response to stress is psychological, which include cognitive defence and behavioural responses
(Marks et al, 2004). This recognizes the perspective that psychological stress as a particular relationship
between the person and the environment that is appraised by the person as taxing or exceeding his or
her resources and endangering his or her well-being31.
In understanding stress further, it is also imperative to look into the different triggers of stress which are
collectively known as stressors. According to Pearlin, stress (Meyer, 2003) is a condition where the
individual becomes active in the process of adaptation. Thomas Holmes and Richard Rahe developed
the Social Readjustment Rating Scale (SRRS) which consist of 43 life-change events which require
adaptation. The top ten sources of stress in the scale are (Bee and Bjorklund, 2004): (1) death of a
spouse; (2) divorce; (3) marital separation from mate; (4) detention in jail and other institution; (5) death
of a close family member; (6) major personal injury or illness; (7) marriage; (8) being fired from work; (9)
marital reconciliation with mate; and, (10) retirement from work.
The abovementioned scale was further improved by succeeding researches along such lines. One such
development was that of Pearlin (Meyer, 2003), who made a distinction between scheduled life changes
and unscheduled life changes, the latter being more stressful than the former. The value of the individual’s
appraisal of the life event is also worth considering in the process, as stressors vary depending on the
individual’s assessment of the phenomenon.
31
Marks et al, 2004, p. 263
31
Another type of stress identified in the literature is minority stress, which concerns individuals belonging
to minority groups. This is said to be a result of the stigmatized social category the person is a part of32.
The foundations of minority stress are structures and institutions in society, including societal processes
which challenge the capacity of the individual to control (Szymaski, 2009). It goes beyond what one
individually feels and experiences. According to Meyer (2003), societies can trigger stress because
they stimulate the values that lead to conflicts in structures, mirrored by differing values of dominant
cultures and minority groups. Meyer further established the assumptions of minority stress, which
those who are not members of minority groups do not experience: (1) it is an additional source of stress
among stigmatized individuals; (2) it is chronic; and, (3) it is socially-based.
Alcid (2007) noted Theodore Esman’s perspective of migrant groups as minority groups. These groups
never get assimilated into the whole society and develop a diasporic consciousness maintaining
sentimental and material links to the land of origin either because of social exclusion or internal cohesion.
This creates a destabilizing effect on transition and movement of the individual’s cultural characteristics
and the changes that takes place in all social contexts.
Racial discrimination is considered a chronic stressor that can elevate blood pressure and increase the
risk of stroke33. There are also researches pointing out to stress resulting from gender discrimination.
Haslette and Lipman in 199734 observed that even small gender inequities on the job were a significant
source of stress among women. Sexism also directly impacts women’s health. In domestic work,
another source of stress is the worker’s ambivalent identity as a family member and an outsider (The
Women’s Foundation, 2006).
Migrant domestic workers attribute the discrimination they experience in their host country to the
nature of their work (60 percent), their foreign status (22 percent), gender (five percent) and age (four
percent)35. Discrimination comes in different forms, including very subtle ones, specifically in stereotypical
perceptions of migrant workers. The experiences of Filipino domestic workers in Hong Kong attest to
this:
“In particular, it has been observed that the sexuality of Filipino domestic workers in Hong Kong are
subject to social commentary and control... media representations of Filipino domestic workers in
Hong Kong… recognise a stereotypical image of promiscuity...such an image may be rooted in
historical links between domestic service and sexual services (p.67).”
32
Rotosky et al, 2007
33
Guyll, Matthews and Bromberger, 2001, cited in Bee and Bjorklund, 2004
34
Cited in Bee and Bjrorlund, 2004
35
AMC, cited in The Women’s Foundation, 2006
32
Stress factors identified by Murakami (2009, p.60) among migrant workers include:
• Adapting to an unfamiliar culture and lifestyle which may deprive them of the ability to cope
• Heavy workload
• Communication problems
• Values and way of thinking
• Less social support
• Conflicts between sending country and host country
• Lack of understanding of local situation
Married women domestic workers also have to contend with changes in their family structure and
dynamics while they are abroad and after their return36. The new role of the wife as a breadwinner
creates transitions in gender roles and expectations in the family which sometimes strains relationships.
Studies show an increase in behavioral and social problems among children of overseas workers and
drunkenness and infidelity among male spouses left behind. More often than not, female migrant domestic
workers carry the brunt of blame and guilt of such consequences. The following table illustrates the
connection of problems experienced by the migrant workers and the consequences for their well-
being37.
Table 2. Problems experienced by migrant workers
Problems Consequences
Poor working conditions including long Industrial accidents, work related illnesses
working hours, no safety measures
Low wages limited to minimum living cost Ill balanced nutrition/ malnutrition
No access to health information No proper treatment
Difficulties in communication at medical Cannot explain health state

institutions or disease
No maternity protection Bad health conditions of women and children
Mandatory medical testing for pregnancy, Forcible deportation

HIV, among others
No health insurance for undocumented Self medication, development of diseases

migrantsHigh medical cost
Sexual, mental and physical abuse Emotional and psychological trauma
Different social status, exploitation, Loss of dignity, self respect

working in 3D jobs
(Source: Choi, cited in the 8th Regional Conference on Migration, 2002)
36
CARAM Asia, 2002; Pingol, 2002
37
Choi, cited in the 8th Conference on Migration, 2002
33
health problems (Meyer, 2002). This is because sustained stress has a negative impact on a person’s
immune system, generates passivity and hopeless resignation. Individual factors such as age and
gender influence the experience of imbalance. Stress may also have positive effects (that of transformation)
and stress and crisis may also trigger growth38.
Stress is defined as a physical or mental response to demands from the environment39. One type of
response is physiological, where the body reacts to the condition of stress. The second response to
stress is psychological, which include cognitive defence and behavioural responses40. This recognizes
the perspective that psychological stress as a particular relationship between the person and the
environment that is appraised by the person as taxing or exceeding his or her resources and endangering
his or her well-being41.
C Coping with Stress
1. Coping: definitions and concepts
An important buffer from stress is the sense of personal control, evident in the ability to cope. Coping is
characterized by awareness of one’s feelings, cognitions, behaviors and physiology42. Lazarus43 identified
the following types of coping:
• Confrontative coping: I expressed my anger to the person who caused the problem.
• Distancing: I made light of the situation; I refused to get too serious about it.
• Self-control: I tried to keep my feelings to myself.
• Seeking social support: I talked to someone to find out more about the situation.
• Accepting responsibility: I realized that I brought the problem on myself.
• Escape / Avoidance. I hoped a miracle would happen.
• Deliberate problem solving: I made a plan of action and I followed it.
• Positive reappraisal: I came out of the experience better than when I went in.
Not all responses to stressors could be classified as coping (Miller, 2001). Responses to stress can be
categorized as voluntary and involuntary – only voluntary responses are considered to be coping responses
(Compas et al, 2001). According to Carver et al (1989), there are three major categories of coping
strategies: (a) problem focused (focused on what needed to be changed); (b) emotion-focused (addressing
38
Bee and Bjorklund, 2004
39
40
Marks et al, 2004
41
Marks et al, 2004, p. 263
42
Compas et al, 2001; Lazarus and Folkman, 1984
43
1993, cited in Bee and Bjorklund, 2004, p.350
34
emotional disturbance); and, (c) dysfunctional (avoidance of the problem). According to Gutierrez et al
(2007), a more appropriate way of differentiating types of coping would be discriminating between
engagement coping and disengagement coping. Problem-focused and emotion- focused strategies
belong to the first while dysfunctional coping belong to the second category.
Miller (2001) purported that engagement coping entails changing the situation and is characterized by
control of one’s self and one’s condition, associated with problem focused and problem-solving strategies44.
Involvement in a political struggle is also classified under this. Disengagement, on the other hand, is a
strategy in which the attention and action of the individual entails avoidance of the stressor. Under this
are mental disengagement, denial and behavioral disengagement. Part of mental disengagement is
behavior that does not directly relate to the stressor, such as sleeping (Carver, Scheier and Weintraub,
1989). A person may be aware of the stress but decides to divert her attention to something else. Denial
entails distortion of reality and changing the meaning of reality. Behavioral disengagement includes
helplessness, surrender and avoidance of objectives that may necessitate confronting the source of
stress. Help-seeking implies directing one’s attention, thoughts and behaviours to society and engaging
society and individuals in the process of responding to the source of stress. Social support plays a
critical role in the process.
2. Coping among migrant workers
Among migrant workers, coping with difficulties may include tobacco and alcohol abuse (Carballo,
2007). Some address issues by challenging subservient roles at a discursive level of individual or
collective engagement45. Filipino domestic workers are observed to come together to be part of group
activities such as playing cards, eating Filipino food, dancing and attending mass. Apart from these,
they are also active in directing their reactions and outrage to negative images created of them, such
was the case when the “helper doll” was issued in 1986. This doll embodied the image of Filipino
domestic workers as docile and hardworking. Activism of Filipino women migrant domestic workers is
observable in Hong Kong, despite limitations, this contributed to strengthening protection of domestic
workers’ rights (The Women’s Foundation, 2006).
Coping styles of Filipinos, nested in collectivist culture, may not always work in other settings. Specifically,
the emergence of the pseudo- family comprised of compatriots may also impede adjustments necessary
in cultures that are task oriented and impersonal46. Prayer is also one of the tools used to cope. This is
attributed to the Filipinos’ strong and positive sense of spirituality, which is considered to be a source
44
Gutierez et al 2007; Fuster, 2002
45
Lowe, cited in The Women’s Foundation, 2006, p. 67
46
35
of strength in the individual47. The latter has been considered as a major coping mechanism in times of
crises among Filipino migrant domestic workers.
3. Social support as a coping strategy
Through time, researchers proposed that well-being requires the fulfillment of various support needs
that are provided through relationships with intimate others48. These needs include attachment, social
integration, reassurance of worth, guidance, reliable alliance and the opportunity to provide nurturing49.
Support is more effective when it comes from those who are similar in values and characteristics, and
who are facing or have faced similar stressors somewhat more successfully. Spouses, children, relatives
and peers are likely sources of social support. Empirical studies on social support substantiate the
contention that support provided by a spouse and family members may take precedence over other
sources of support (Meyer, 2002). Gender factors also play a role here, women who contribute more to
household work and supportive nurturing might draw more positive emotion from the presence of
companionship. Studies50 showed that women are generally more family-oriented, child-centered and
relationship-oriented than men. These characteristics make them experience being away from home
doubly stressful.
Social support, according to MacArthur and MacArthur (1998), is considered assisting someone in
terms of emotional and instrumental help. Respectively, these are acts that show affection and encourage
a person’s self worth, as well as the provision of tangible or material aid. In general, these behaviours
have been found to have positive influence on the health and well-being of recipients of support51. From
the social cognitive perspective, social support influences health by influencing self-esteem and self-
regulation. Since the experience of self is closely related to how one is viewed by others, social support
operates by influencing evaluations of self and others. Consequently, perceived social support indirectly
leads to well-being, by promoting self esteem first before enhancing one’s sense of wellness.
Gilbert (2000) and Uchino et al (1996) surmised in their researches that social support brings forth the
capacity of directly addressing problems and stressors, which also lead to physical health. Meyer
(2002, p. 587) claimed that those who enjoy close relationships eat better, exercise more, and smoke
and drink less. He related the demonstration of such healthy behaviours to self-esteem, which is
related to having close relationships that allow an individual to evaluate and address the source of
stress. Confiding painful feelings to someone is also correlated with lesser health problems. Negative
effects of stress on health and happiness decrease when one has adequate social support compared to
47
Conde, 2004, p. 160
48
Meyer, 2002; Weis, 1974
49
Dehle and Landers, 2005
50
Cited in Jiang and Winfree, 2006, p.36
51
Cohen, 2001; Helbrun, 2008; Lazarus and Folkman, 1984
36
those with weak social support (Bee and Bjroklund, 2004). Women, who portray multiple social roles
as wife, parent, caregiver and worker, suffer from stress when they do not have adequate social support.
People are generally happier when surrounded by family and friends. Cultural factors also impact on
this, as shown in researches documenting the differences on the impact of support in collectivist and
individualistic cultures52. Sanchez and Gaw (2007) highlighted the collectivist characteristic of the Filipino
culture, which is associated with family, regional affiliation and peer group in the achievement of mental
health. Reciprocity and mutual caring, which characterize these relationships, have been noted to
impact on health seeking behaviours, as assistance from family members and friends are sought before
mental health professionals. Treatment is oftentimes in consultation with family members.
Despite the proven buffering effect of social support, there are also negative effects of social support.
When interactions are characterised by anger, dislike, criticism or undermining, these relationships will
have substantial effect on an individual’s sense of well- being and mental health53.
D Addressing the Healthcare Needs of Women Migrant Workers
1. Access to health care
Carballo (2007) confirms that even in host countries providing universal healthcare coverage, migrants
still fail to benefit from the services available. This is due to how migrants perceive their illness and what
they can do about it. Language barriers and poor communication between migrants and health personnel
contributes to the problem, as well as misperceptions of migrants on the local health care systems.
Migrant workers are also tied to their work and may not be able to take time off to avail of health
services. The status of the migrant further complicates the issue, as illegal migrants tend to fall outside
the parameters of organized health care and end up resorting to emergency services when they are
unable to address their illness.
In order to deal with these access barriers to health care, migrant women may indeed prefer to go to the
doctor when in their home countries, on their rare holidays. In the study by Holroyd et al. (2003), this
definitely seems to be a frequent practice; 44 percent of the women reported a general practitioner in
the Philippines to be a regular source of medical care, as compared to only 26 percent who reported a
general practitioner in Hong Kong. The migrant domestic worker’s low health care utilization reflects
shortages of time, a lack of economic resources and/or different prioritisation, cultural, communicational
and discriminatory problems in addition to a lack of freedom to seek health care if she needs medical
care.
52
Bettencourt and Dorr, 1997, cited in Meyer, 2002
53
37
2. Concerted Global Efforts
Participants in the 7th Regional Conference on Migration (2001) proposed an advocacy framework in
combating problems experienced by migrant workers and to protect their rights, nested in international
labor and human rights standards such as the UN Migrants Convention, CEDAW and ILO migration
conventions. They recognized that the problem with advocacy in migration is the reality of the need to
engage different countries and stakeholders, which involve confronting issues on race, gender and class
discrimination as well as changes in roles, jobs and contexts of individuals. Other basic migrants’ rights
included in the discussion were rights to social services and social security, health and safety, including
medical and retirement benefits.
The process of addressing migrant workers’ health needs to be a concerted effort by origin and destination
countries. The process of addressing migrants’ health necessitates the process of bridging national
health systems and international systems. There is a need to look into the social determinants of health
at all phases of migration. Multidisciplinary approach and cross- country perspectives needed to be
employed in the process54. Services for migrant workers therefore should not only include services for
communicable diseases and acute health care, but also the provision of appropriate preventive measures,
as well as health services for chronic conditions, care for older migrants, and special needs of women. All
these should be integrated in the existing systems available to migrant workers. Migration research
points out to the need to determine migrant needs and access to health services, evaluation of public
health interventions and the development of culturally sensitive, acceptable and affordable services55.
In 2008, the 61st World Health Assesmbly convened by the World Health Organization passed a resolution
on the Health of Migrants. The resolution called on the member states to address the issue of health of
migrants by adopting policies and programmes that enable migrants to have better access to health
information and services. This resolution led to the development of an Operational Framework on Migrants’
Health, which was presented in the 63rd World Health Assembly in 2010. The operational framework
addressed four key areas, namely: monitoring migrants’ health; policy and legal frameworks; migrant
sensitive health systems; partnerships, networks and multi-country frameworks.
3. Addressing health needs of Filipino migrants
Among Filipinos migrants, there is an identified need for culturally and linguistically competent providers56.
The following guidelines for culturally sensitive approach to treatment of Filipino migrants in the United
States were drawn from the research of Sanchez and Gaw (2007, p. 814): (a) Pay attention to immigration
54
Migration Health Annual Report, 2005
55
Migrant Health Annual Report, 2005
56
38
history and regional orientations; (b) Determine the underlying reason for treatment; (c) Ensure adequate
understanding of the diagnosis and treatment plan, bearing in mind that social inhibitions and nonverbal
cues can mislead; (d) Use visual cues and communicate in a collaborative manner; (e) Facilitate
dialogue, inquiring about physical, as well as mental health complaints; (f) Utilize the family and identify
the patient’s power hierarchy; (g) Allow the patient time to process any information given; (h) Respect
personal space; (i) Note mannerisms without making assumptions about their meanings; (j) Do not be
misled by the presenting affect; (k) Maintain judicious use of medication; and, (l) Engage patient by
actively focusing in the individual symptoms.
Deducing from the above, a comprehensive cross cultural assessment needs to be done in the
development of psychosocial interventions, taking into account the following: (a) Immigration history;
(b) Socio-economic beginnings; (C) Regional orientation; (d) Tracing the chronology of events prior to
the visit; (e) Considering the family’s conceptualization of the condition and course of treatment; (f)
Ascertaining health practices and fears for implications of treatment; (g) Identifying the people of
influence; and, (i) Motivations and actions that contribute to family welfare.
4. Protection of migrant workers
The 1990 International Convention on the Protection of the Rights of all Migrant workers and Members
of their Families provide a broad range of protection for migrant workers and their families. Some of the
important provisions of the Convention include the protection of human rights of migrant workers and
their families; freedom from slavery or servitude; protection from violence, physical injury, threats and
intimidation; provision of services/assistance e.g. health, education, housing, among others57.
ILO’s Decent Work Agenda, on the other hand, focuses on creating opportunities for all men and
women of working age, including migrant workers, to obtain decent work in conditions of freedom,
equity, security and human dignity.58
In 1995, the Migrant Workers and Overseas Filipino Act was enacted that puts together the national
policies on overseas employment and establishes a higher standard of protection and promotion of the
welfare of migrant workers, their families and distressed Filipinos overseas. The law was amended in
2009 and is currently known as Republic Act (RA) 10022. The law’s guiding principles include upholding
the dignity of citizens whether in the country or overseas; full protection to labor; full employment and
equality of employment opportunities; adequate and timely social, economic and legal services;
57
ILO, International Labor Migration: A Rights-based Approach, 2010, p133
58
ILO, International Labor Migration: A Rights-based Approach, 2010, p 71
39
fundamental equality before the law of women and men; the significant role of women in nation building
(gender sensitivity is a necessary component of programs); and the right to participation in democratic
decision-making processes of migrant workers and overseas Filipinos59.
Concretely, the law defines the roles of different agencies such as the Department of Foreign Affairs
(DFA) to issue travel advisory /information dissemination; the Labor Department (DOLE) and its attached
agencies to attend to all travel and work deployment needs of overseas workers, such as accreditation
and regulation of recruitment agencies, among others. The OWWA’s National Reintegration Center for
OFWs (NRCO) has been tasked to develop reintegration programs for returning Filipino migrant workers.
Another important provision of the law is the establishment of Migrant Workers and Other Overseas
Filipinos Resource Centers in countries where there is a large concentration of OFWs. The center is
expected to provide services such as medical care, social counseling, community outreach, temporary
shelter, welfare benefits and airport assistance when needed.
5. Promoting mental health among migrant workers
Murakami (2009) noted that based on their evaluation of Japanese working overseas, the presence of
the following are crucial in promoting mental health of migrant workers: self-care; industrial physician;
care by higher ranking members of organization; and, care by outside resources such as medical
clinics, counseling facilities and other public services. She added that it is the role of the employers to
support prevention of problems at an early stage, introducing program treatments and promoting smooth
re-adaptation and adaptation to the workplace.
One study purported that mental health adjustment among Filipino domestic workers needed to be
addressed and one method to deal with such concern is through Sunday gatherings60. These gatherings
serve as group counseling sessions where domestic workers find a venue to seek comfort and release
emotional tension.
In the Philippines, the Department of Health (DOH) implements the National Program for Mental Health.
Premised on the policy shift from mental hospital–based psychiatric treatment to community-based
mental health care, the program entails integration of mental health care in general health services61. It
aims to promote mental health in the general population, to reduce the risks and prevalence of mental
disorders, and to improve the quality of life of those who are affected. Currently, six priority areas of
concern have been identified, specifically, (1) mental disorders; (2) substance abuse; (3) disaster and
59
Sobritchea C. et al 2010, Health of our Heroes: Access to Sexual and Reproductive Health Services and Information of Women Migrant
Domestic Workers. p.22
60
The Women’s Foundation, 2006
61
Conde, 2004
40
crisis management; women, children and other vulnerable groups; epilepsy and overseas workers62.
Mental health programs for OFWs mentioned in the program are those run by OWWA, such as the pre-
departure policy to have overseas contract workers undergo neuropsychiatric screening. A pre-departure
seminar is compulsory, where lectures should include the culture of the country of destination, expected
stresses and coping strategies. Assessments of the PDOS conducted by various entities point out to
the inadequacy of a one-day seminar to fully prepare migrant workers for overseas work.
In 2002, a joint initiative by the DOH, DOLE and DSWD was rolled out involving social welfare officers
and medical officers in Philippine consulates who can provide counseling and social welfare assistance.
While this was implemented during the first two years of the effectivity of the MOA, there are concerns
about the sustainability and continuity of the programme. Physicians in consulates have been reported
to have been trained by DOH to identify mental disorders.
Another attempt to address mental health concerns of migrant domestic workers, albeit replete with
controversies, was the suggestion of the Office of the Undersecretary for Migrant Workers Affairs
(OUMWA) of the Department of Foreign Affairs, to require psychiatric screening of all outgoing migrant
domestic workers. Opposition to this recommendation has been raised by various sectors – migrant
workers, recruitment agencies, and overseas workers’ organizations. The DFA justified the proposal
requiring departing Filipino household service workers to take psychiatric tests by saying that seven of
every ten domestics in death row have a history of insanity63.
Undersecretary for Migrant Workers Affairs Esteban Conejos further reported that “ In these [death
conviction] cases, the only defense that we’ve had was insanity…I’m not a medical expert, but I have
talked to them and they say they have done what they’ve done because it was a message from God, or
they’re still getting a message from the ground.’
E Mental Health and Well-being In Filipino Culture
1. Filipino concepts of mental health and well-being
Among Filipinos, health and happiness are considered to be intertwined and should be balanced to
achieve wellness64. Positive characteristics such as tiyaga (hard work), patience and endurance; and
lakas ng loob (inner strength) and hardiness are related to capacity of individuals to be happy. The
experience of wellness is also related to an individual’s mental health.
62
Conde, 2004
63
http://globalnation.inquirer.net/news/breakingnews/view/20080821-156020/DFA-defends-psychiatric-tests-for-departing-domestics
64
41
In the Philippines, the sense of wellness, well-being and positive mental health, is tied in to the
achievement of ginhawa (comfort). According to Salazar (1982), ginhawa is an aspect of one’s personhood
(pagkatao) that is related to the individual’s state of physical, mental and social health. It is considered
to be a condition or state which is, though related to the external realm (labas), significantly rooted in
the inner core (loob) of one’s being. The experience of ginhawa is related to kaluluwa (soul) which is the
core of an individual’s being that is immortal and is the foundation of morality. Kaluluwa is not associated
with a person’s religiosity but to one’s spirituality which characterizes an individual (tao) as essentially
mabuti or good. This is the wellspring of buhay (life) and sigla (roughly translated to a combination of
flow and positive affect), which allows one to attain ginhawa. The latter is typically described using the
following phrases: gaan ng buhay, aliwan ng buhay, kaibsan ng hirap, mabuting pamumuhay, paggaling
sa sakit, and pahinga. Attaining this state therefore entails experiencing total health or wellness in all
realms – physical, psychological and social. The non-achievement of ginhawa may be due to and may
lead to the experience of siphayo or pains of the soul (rough translation), which is associated with
incidence of illness, including mental health problems.
2. Social support and coping in Filipino culture
The system of social support among Filipino migrants depicts the relationships in their country of origin
characterized by kapwa (shared identity) and the distinction between the ibang tao ang hindi ibang
tao65. Enriquez (1989) forwarded the assertion that social relationships and interactions among Filipinos
are categorised into ibang tao (outsider category) and hindi ibang tao (one of us category). The local
language provides a conceptual distinction in several levels and types of interaction between the two66:
• Ibang tao or Outsider category - Pakikitungo (level of amenities / civility); Pakikisalamuha

(level of “mixing”); Pakikilahok (level of joining / participating); Pakikibagay (level of conforming);
and, Pakikisama (level of adjusting)
• Hindi ibang to or One of us category - Pakikipagpalagayang loob (level of mutual trust / rapport);
Pakikisangkot (level of getting involved); and, Pakikiisa (level of fusion, oneness and full trust)
These levels of interaction define the nature of relationships individuals have and constitute the core
interpersonal behavior of pakikipag-kapwa, which comprise the super- ordinate concept of kapwa.
According to Maggay (2002), these levels are correlated to the level of disclosure in an interaction – the
higher the level of pakikipagkapwa, the higher the level of disclosure. The quality of perceived social
support may also be related to this, there is greater likelihood to perceive social support in the context
65
66
Enriquez, 1989, p. 31; Santiago and Enriquez, 1976
42
of relationships that are characterized as hindi ibang tao. Traditionally, people who are considered to be
one of us are family members and friends. This may be the reason why the family serves as a critical
source of support, and when this is absent, an informal definition of ‘family’ which may constitute
friends, neighbors and other members of the community are established67. This is seen among female
migrant domestic workers, when they form groups and create spaces for these groups as a way of
addressing and coping with the demands of overseas work68.
3. Views on mental illness among migrant Filipinos
According to Tsai et al69, there are commonalities in migrant Filipino views of mental illness, which are
identified and summarized in Table 2. Sanchez and Gaw (2007) further noted that among Filipino
migrants, there is a prevalence of depression, but low suicide rate. They also coined the term “smiling
depression” which characterized the behaviour of Filipinos with depression. Clinical depression for said
population is most often due to separation from family and financial difficulties. The low suicide rate is
attributed to the presence of extended family and social support. Barriers to treatment include dealing
with family hierarchy and regulation; fatalistic attitude and religious fanaticism; lack of belief in the
capacity to changes; communication barriers, externalization of complaints and lack of culturally
competent services.
Table 3. Similarities in migrant Filipino views of mental illness
Topics Viewpoint
Nature of mental illness Perceived ridicule encourages hesitance in
accepting having mental illness and
avoidance of services
Alternative coping measures Family and peer groups, indigenous healers

and dependence on religion, reduce
perceived need of services
Cost Prioritization of economic and environmental

needs over mental health services
Knowledge of mental health services Limited awareness of services limits

access
Operating hours Adult family members work making it difficult

to use services during usual hours
Belief systems Mental illness reflect weak spirit, adverse

reckoning and consequences to personal
and ancestral transgression
Limitation of services Lack of culturally appropriate relevant

services; language barriers
(Source: Tsai, in Sanchez and Gaw, 2007, p. 811)
67
Conde, 2004; Medina, 2001
68
The Women’s Foundation, 2006; CARAM- Asia, 2002
69
Cited in Sanchez and Gaw, 2007, p. 811
43
F Analytical Framework
Given the aforementioned results of studies in the area, the following analytical framework is proposed
for this research, which takes into account the different stages of migration (i.e. pre- migration, migration
process and post migration) and socio – demographic characteristics of migrant domestic workers (i.e.
age, civil status, educational background, place of origin and type of work) as contexts in identifying
mental health needs of female migrant domestic workers. Due consideration will also be directed to
socio- cultural contexts in the countries of origin and destination, existing laws and mandates for the
development of mental health programs for the identified population, and important standards of ethics
and care in the development of mental health services and programs. Recommendations in addressing
mental health needs of female migrant domestic workers and development of the training design for
service providers will be drawn from the outcome of the research.
Diagram 1. Analytical Framework
Stages and Mental Health Needs Enabling Laws/ Recommendations:

Contexts of According to Policies
Migration Socio-Demographic • Policy development/
Characteristics of • International reforms
Pre-migration Women Migrant mandates, laws • Training and
Examples Domestic Workers and policies capacity building for
• Economic service providers
• Hiring/placement • Age/life stage • Local mandates, • Improvement of
conditions laws and policies services
• Preparations • Civil status • Research and
• National laws documentation
Migration Process • Place of origin • Other prevention
Examples (urban/rural) and intervention
• Economic measures
• Cultural context • Educational Existing Programs
• Social support background & Services
• Experience of (Local and on-site)
abuse • Type of work
• Psychological
Post-migration (Individual Training Program
Examples e.g. debriefing,
• Return medical care, • Framework
counseling, • Design
education) • Policy mandates
• Referrals
• Psychosocial • Case management
(Relational protocols
e.g. family • Care for service
counseling, couple providers
interventions, • Others
training)
• Societal
(Community e.g.
Standards
law enforcement,
community • Ethics
theatre) • Practice
44
Section 2: Research Methodology
A. Overview of Research Activities
The action research consisted of two phases. The first consisted of preparatory activities, while the
second included the data gathering, collation and analysis processes.
1. Phase 1 - Preparatory Activities
This phase involved the following sub-steps: (a) review of related literature, scoping of existing mental
health services, and conduct of focus group discussions (FGDs); (b) finalization of the study design; (c)
crafting of the data organization and management plan; (d) formation and training of the data-gathering
teams; (e) translation, pre-testing and finalization of the data-gathering tools; and, (f) development of
the field manual.
2. Phase 2 - Data Gathering, Collation and Analysis
This stage covered: (a) social preparation for data gathering, which included an orientation on the study
for local government leaders, host institutions, gatekeepers and stakeholders in the research sites,
identification of potential research respondents and participants, and logistical preparations for the
research team; (b) data gathering in the study sites using the survey forms and key informant interview
schedule, as well as conduct of the case studies; (c) data coding, encoding and collation, including
data quality checks and transcription of the results of the FGDs and key informant interviews (KII); (d)
data reduction and presentation in tables, graphs, and other forms of data presentation; (e) finalization
of the case studies; (f) data analysis; (g) validation of the results; and, (h) writing up the research report.
B. Research Methods
Three research methods were used in the conduct of this action research: (1) survey research; (2) key
informant interviews; and, (3) case studies. The survey was used to determine the mental health needs
of Filipino women migrant domestic workers. For this particular study, the survey involved structured
interviews to determine the mental health attitudes, beliefs, practices and perceptions of Filipino women
migrant domestic workers. Pre-testing was done with participants coming from the same population
where the study participants would be drawn (i.e. women migrant domestic workers).
The key informant interview (KII) entailed the conduct of a semi-structured interview focusing on key
aspects of the research problem. Programme implementers were interviewed to determine their
perceptions and practices in promoting the well-being of women migrant domestic workers. Also
interviewed were informants from regional and national agencies and migrant support organizations
45
involved in various capacities in the development, implementation, monitoring and evaluation of policies
and programs geared toward addressing the mental health needs of women migrant domestic workers.
The KII guide covered these areas of inquiry: description of current policies / programmes / projects;
assessment of gaps and gains in the implementation of policies / programs / projects; assessment of
existing referral mechanisms; identification of challenges and lessons learned; and, suggested ways /
mechanisms of addressing the challenges identified.
The case studies documented the lives of selected women migrant domestic workers and included an
analysis of their experiences.
The research process was characterized by the following values and perspectives:
• Observance of ethical standards in the research process. Observance of ethical principles

governing the research cycle was given utmost importance in the data gathering and analysis
process. Informed consent was secured from the research participants before the data gathering
process. Furthermore, the participants were made aware of their rights as respondents, especially
of the right not to disclose any information they are not comfortable disclosing and their right to
withdraw at any point of the research process.
• The ethics of confidentiality and respect for privacy were strictly enforced in the research process,
which meant that no personal information which can lead to the identification of the research
participants was included in the research documents and report. All data generated in the
study were coded based on the variables considered in the process of research. In addition to
this, no information on the participants were released without the consent of the individuals
involved.
• Context-based and process-oriented research process. The whole research process was context-
and process-based; that is, the process of data gathering and analysis took into consideration
the socio-cultural realities of the participants. The data gathering tools and procedures were
also subjected to the evaluation of the research participants. The research tools were pre-
tested, translated and back-translated from English to Filipino, and back to English.
• Culturally sensitive and gender sensitive research process. The various methods employed
and the process of data gathering and analysis were based on the cultural variations that
characterized the population studied. The process of data gathering and interpretation took into
consideration the values, practices, relations, needs, beliefs, preferences, resources, and other
aspects of subcultures defined by gender.
46
• Rigor in the research process. The development of the research framework, data gathering
tools, and procedures were guided by the review of literature, established methods of data
generation, consultation and pre-testing of instruments to ensure the reliability and validity of
the research findings.
• Participatory process. Former migrant domestic workers were involved in the project, from the
development and implementation of the survey (as field interviewers) and in the validation phase.
C. Sampling Design
1. Study sites
Four research sites have been identified for the study: La Union and the National Capital Region in
Luzon, Davao in Mindanao and Cebu in the Visayas. These were selected to represent differing
populations from the three main island groups of the Philippines (i.e. Luzon, Visayas and Mindanao).
The survey was conducted in the barangay where women migrant domestic workers live and in agencies
such as POEA, recruitment agencies where they process their application.
Selection of research participants
Since there are no harmonized national and local statistics on the number of female individuals working
overseas as domestic workers, non-probability sampling was used in the survey.
The identification of respondents at the barangay (village) level was done purposively, based on the
information provided by gatekeepers in the research sites. Snowball sampling was employed in the
process.
The inclusion criteria for the sample are: adult female individuals (18 years old and above) who have
finished at least one contract as a migrant domestic worker. The participants came from different life
stages (i.e. young adulthood and middle adulthood), different types of domestic work (e.g. child minder,
cook, “all around” ) and countries of destinations (e.g. Asia, Europe, Middle East). A total of 500
respondents were interviewed (200 from NCR, 100 from Davao, 100 from Cebu and 100 from La Union).
47
The participants in the key informant interview were also identified purposively. The selection criteria
are:
• Involvement in programs geared toward addressing the mental health needs of women migrant
domestic workers at different levels of intervention (i.e. international, national, regional, provincial
and municipal) and foci of intervention (e.g. individual, family, peer group, community).
• At least two years of hands-on experience in the implementation of such programs.
The identification and selection of individuals who will take part in the case study was based on the
result of the survey. The sampling of participants entailed maximum variation to capture differing
experiences and perspectives. Five case studies (two from the Philippines and three from Holland) were
included in this study.
48
Section 3: Research Results & Discussion
This section of the report discusses the main findings of the survey conducted among 500 women
migrant domestic workers who participated in the study. Though the outcome of the survey is the focal
point of the write-up, the case studies of selected women migrant domestic workers, results of focus
group discussions and post survey consultations among women migrant domestic workers, and the
data from interviews conducted with key informants from governmental and nongovernmental organizations
were also included to provide context and additional information to better understand and analyze the
main findings generated by the survey.
A. Socio- demographic profile of participants’ barangay (village)
The following tables show the socio-demographic profile of the barangays where the participants surveyed
came from.
Most participants identified trade as the primary source of income of their barangay (36 percent), led by
retail sales (34 percent), and followed by wholesale trading (5.15 percent). Agriculture as a main income
source came second, followed by manufacturing. For the primarily agricultural communities, farming of
crops to be sold was the top form of livelihood (17.9 percent), followed by livestock raising for sale (5.6
percent), farming for personal needs (4.1 percent), and raising livestock for personal needs (one percent).
Table 1. Primary source of livelihood in the barangay (village)
Trade Agriculture Manufacturing

36% 23.2% 16.2%
Retail business (33.8%) Farming crops to be sold VariedWood /

(17.9%) furniture(4.1%)
Whole sale business Raising livestock to be Food

(5.1%) sold (5.6%) manufacturing(2.5%)
Farming for personal Leather (2.1%)

needs (4.1%)
Raising livestock for Mat weaving(1.4%)

personal needs
(1%) Factory worker (1.2%)
49
Manufacturing activities in the barangay include woodworking / furniture making, food manufacturing,
leather tanning, mat weaving, and factory work. Secondary income sources include: transport, private
services, and trade.
In terms of accessibility of their village to the nearest town center, the respondents noted that if they
walk to the town center from their village hall, it will take those about 51 minutes to arrive. Using local
transport, the travel time is nearly halved to 22 minutes. A combination of walking and taking transportation
takes them about 33 minutes. From these, it could be said the participants’ communities are generally
accessible.
The respondents also described their communities as “being peaceful” (10 percent), “progressive” (eight
percent), and “clean and well-kept” (six percent).
Post survey consultation workshops conducted in NCR and La Union show a trend of unemployment
among returning women migrant domestic workers. The workshop participants said they had difficulty
getting jobs or finding sources of income when they come back in the Philippines. This is the reason
why most of them would like to save money to start their own business so they could stay in the
country for good. Some participants told of success stories of women migrant domestic workers who
were able to set up their own business. However, they had also heard of negative experiences among
fellow women mirgrant domestic workers, some of who came home only to find out that their families
had not invested their hard earned money wisely or had not saved enough for their future. According to
the workshop participants, running out of resources is one of the reasons why most women migrant
domestic workers decide to leave the country and their families again.
B. Socio- demographic profile of participants
The mean age of those surveyed from the four research sites is 35.09 years, with a range of 18 to 60
years. Mean age of the young adults (18 to 30 years old) is 27.86 years, while those in middle adulthood
(31 to 60 years old) is 39.88 years. The average age of those who are having their papers processed is
34.34 years and those on vacation is 35.87 years.
50
1. Civil status, educational background and religious affiliation
51
Most survey participants are married (51.2 percent), some are single (32.2 percent) while others are
separated (nine percent), widowed (four percent) and cohabiting (four percent). Most of those who are
single came from the young adult group (20.2 percent). Majority of the respondents have reached high
school or college (with 35.2 percent having completed high school, another 32.4 percent reached
college and 18.8 percent completed college), particularly for those in the young and middle adult
categories. In terms of religious affiliation, majority are Roman Catholics (76.6 percent), with a smaller
number being Born Again Christian (6.6 percent) and Muslim (6.4 percent).
In terms of membership in and size of their nuclear family, 27 percent of respondents said they had four
members, 20 percent had five members, 19 percent had three members, 13.4 percent had six members
and 8.6 percent had two members. The mean number of individuals in families is 4.5, while the number
of family members ranged from 2 to 13 individuals.
Number of participants with children. The mean number of living children (among those who have children)
is 2.43, with a range from one to seven. The mean number of male children is 1.52, with a range of one
to five, while the mean number of female children is 1.58, with a range of one to four.
52
2. Current work status
Majority of survey participants are currently unemployed (67.4 percent), while a few work for their own
income (20.8 percent), and a number receive regular pay from work (7.4 percent). For those who are
working, most are primarily involved in trade (28 percent), particularly in retail selling (49 percent).
Some provide private services (13 percent), like doing laundry and sewing clothes (as a dressmaker or
tailor). Some are employed (four percent).
For those who have current sources of income, the mean income per month is PhP5,421 (US$120.46).
The approximate income distribution of the participants is as follows:
53
3. Overseas work experience of participants
a Contract
Most study participants had completed one to two contracts as migrant domestic workers (67 percent).
Some finished three to four contracts (18 percent), five to six contracts (5.4 percent), and seven to eight
contracts (1.2 percent). A smaller percentage had completed nine to 10 contracts (1.2 percent) and
more than 10 contracts (.4 percent). The usual length of contract is two years, but this may vary based
on the country of destination, legal status of the worker and living arrangement.
For those with unfinished contracts (189), 96.8 percent were not able to finish one to two contracts.
Most of these individuals came from those who are currently on vacation. FGD participants cited reasons
why contracts are terminated, which include: incidences of abuse; early termination of contract; breach
of contract by the employer; differences with employers; and, domestic workers’ desire to go home
because of illness or homesickness.
The contract signed in the Philippines may change once the worker arrives at the country of destination,
according to post survey workshop participants. Some experienced signing a different contract upon
entry in the destination country. Breach of contract stipulations also occur, as seen in the following
comments: “...sa akin two years gagawin ang household chores, cleaning, cooking, washing, linis ng
kotse. Nakalagay may sariling banyo, kwarto, gaano kalawak ang bahay, ilang kwarto ang lilinisin,
ilang tao ang aalagaan...yung lang ang nakalagay sa kontrata pero hindi sinunod, marami pang ibang
pinapagawa...” [“…in my contract, (it is stated) that within two years, tasks would include household
chores, cleaning, cooking, washing, washing the car, and that I would have my own bathroom, room. (It
is also stated) how large the house is, how many rooms have to be cleaned, how many persons to look
after…These are all in the contract, but these are not followed; there are other tasks actually performed.”
(post survey consultation workshop)
54
The story of Myra from Cebu (refer to Annex: Consolidated Case Studies) provides an example of how
a documented migrant domestic worker dealt with changes in her status from being a documented
migrant worker in Lebanon, to an undocumented one. This situation was brought about by the end of
her contract and a change in employers. Since she wasn’t ready to go back home because of financial
obligations, Myra had to content herself with a tourist visa (renewed three times) provided by another
employer in Romania. The absence of legitimate status as a MDW subjected her to psychological
distress as well as physical abuse.
Marita (refer to Annex: Consolidated Case Studies), a domestic worker in Holland left her first employer
after finishing her one-year contract because of individual differences with her employer. She was
subsequently hired without a contract by another employer for some time, until she again changed
employers.
The case of Naty on the other hand entailed a breach of contract. Before leaving the Philippines, she
signed a contract stating that she will be working in Kuwait for two years and will be receiving a salary
of US$300 (approximately PhP13,000) a month. These conditions were not implemented, as she was
only given 45KD (Kuwaiti Dinar, or PhP8,100) and she went on to work with four employers under
varying conditions.
In the case of Gen, she experienced not having a contract while working as a cleaning lady for different
households. She went abroad using a tourist visa and lived with a relative for a while. This subjected her
to constant fear of being deported and difficulties in accessing services – such as bank transactions
and medical and dental services.
These cases show that changes in contracts and absence of contracts make women migrant domestic
workers vulnerable, as they are unable to protect themselves from exploitation and abuse, aside from
being unable to access needed services.
55
b Reasons for working overseas
Majority of respondents (53 percent) said it was solely their decision to work abroad, while some were
influenced by friends (12 percent), relatives (11 percent) or siblings (eight percent).
Variations were noted regarding the reasons behind the decision to work overseas as domestic workers
among participants. Most of the reasons given by the participants are economic in nature e.g. to save
for the future, to be able to send children to school, poverty, no jobs available in the Philippines, to help
parents and siblings, etc. However, it is also important to note that there are also participants who left
to avoid conflict with family members and to escape an abusive relationship, as time away from the
country provided them space to be away from abusive situation. In Marita’s case, she saw leaving the
country as a way to make a fresh start, after two incidents of attempted sexual abuse in the past. (“It
is one of the reasons that I want to go somewhere, because it happened in the province of my father
and the other in the province of my mother, so where should I go?”).
56
c Destination countries and reasons for choosing particular countries
Table 8 shows the countries of destinations of women migrant domestic workers during their most
recent contracts. The top five countries of destinations are Hong Kong (19.6 percent), Saudi Arabia
(13.2 percent), United Arab Emirates (12.2 percent), Singapore (11.2 percent), and Kuwait (nine percent).
57
Table 9 shows the reasons of survey participants for choosing to work in destination countries.
72
Country codes: BN – Brunei; BH – Bahrain; CY – Cyprus; HK - Hong Kong; IL – Israel; IT – Italy; JO – Jordan; KW – Kuwait; LB – Lebanon;
MO – Macau; OM – Oman; QA – Qatar; SA – Saudi Arabia; SG – Singapore; ES – Spain; TW – Taiwan, Republic of China; AE – United Arab
Emirates (Source: World Intellectual Property Organization, WIPO Standard ST.3)
58
Looking solely at the top five destination countries, it can be seen that the most frequently cited reason
is economic, specifically poverty, the lack of jobs in the Philippines, and high salaries abroad, among
others. Those who go to Hong Kong and Singapore said that they were influenced / persuaded /
sponsored by their family members, relatives or friends who currently work there. Those who choose
Saudi Arabia and Kuwait say these countries hire / accept women migrant domestic workers where
there are job orders and available work visas. The United Arab Emirates is selected usually as a result
of the recruitment agencies’ decision.
The latter is reflected in the case of Naty. She heard over the radio that a recruitment agency was
looking for domestic workers for Kuwait and they were not charging placement fees. Naty grabbed the
opportunity and applied with the agency. In the case of Sandra, it was her siblings who did all the
processing for her travel to Holland to work as an au pair. She only found out about this when she was
called to get her passport and other travel documents.
59
Regarding the length of stay working as migrant domestic workers during the last contract, majority of
the respondents stayed abroad for two years (53.8 percent) while 35.4 percent stayed for less than two
years.
Pre-migration status and requirements
A large number of survey participants reported that they left as domestic workers (86 percent) while one
in ten left as tourists (10 percent). Some of those who left as tourists were able to get work permits on
site. Others left as caretakers, factory workers, nursing aides, or dressmakers.
While majority of the participants said their job title is consistent with their contract (92 percent); some
noticed different job titles stated in their contracts (e.g. babysitter, caregiver, tutor, tailor / dressmaker
or factory worker). Significantly, eight percent (8.1 percent) did not read their contract.
60
As part of the pre-departure medical examination (PEME) of applicants, survey participants said the
five most frequent medical examinations they had undergone were: X-rays (84.2 percent); urinalysis
(82.8 percent); blood workups (82.4 percent); stool examination or fecalysis (79.4 percent) and general
physical examinations (79.4 percent). Half (57.4 percent) reported they went through a psychometric
test while two out of five (39.4 percent) reported that they went through neurological testing. Nine out of
ten (92 percent) said that their informed consent was secured prior to going through the medical tests.
However, only 86 percent were informed of the results of their examinations.
Majority of the respondents (78.6 percent) said they attended the Pre-Departure Orientation Seminar or
PDOS. The seminar providers included: recruitment agencies (39.7 percent); the Philippine Overseas
Employment Administration or POEA (25.7 percent); the Overseas Workers’ Welfare Administration or
OWWA (24.2 percent) and non-government organizations (4.3 percent).
The survey participants recalled these top five topics from the PDOS: (1) travel rules and procedures
(17.6 percent); (2) information on culture and laws of the host country (14 percent); (3) how to adapt to
a different culture (14 percent); (4) information on how to remit money (14 percent); and, (5) how to
adapt to a different language (12 percent).
4. Living arrangements
Majority of the survey participants lived with their employers (94.8 percent). In terms of the amount of
time spent working and living arrangements, majority (58 percent ) of those who live out work nine to 12
hours; almost a quarter (23 percent) worked 13 to 16 hours; and, one in ten (11.6 percent) worked 17 to
20 hours.
Of those who lived with their employers, 27 percent work from 17 to 20 hours, almost a fourth (23
percent) worked for 20 to 24 hours. A fifth (22 percent) worked for 9 to 12 hours; and another fifth (20
percent) work for 13 to 16 hours.
61
Workshop participants from NCR observed the same trend when it comes to the conditions of work.
They said there is a greater likelihood for live-in domestic workers to be exploited by their employers
since they are always available and accessible to them. Some of them even have experiences of
working non stop until the wee hours of the morning and waking up early the next day. In the case of
one of the workshop participants: “Ako halos isang oras lang ang tulog dahil sa dami ng trabaho,
kailangang tapusin kundi matatambak ang trabaho. Kaya pumupunta ako sa CR, doon na ako natutulog.
Sobrang istrikto ng amo ko, sinusunod ko lang. (I only sleep for one hour because of my workload. I
need to finish my work, if not, my work will pile up. I usually go to the comfort room to sleep. My
employer is very strict; I need to comply with her).
5. Work conditions
a Working hours
The average working hours of the participants vary as could be seen from the table below. A quarter of
the participants work for 13-16 hours (26 percent) while almost another quarter work from five to eight
hours (23.8 percent), 17 to 20 hours (22.2 percent) and nine to 12 hours (20.2 percent). Others also
noted working for an unlimited number of hours or for as long as they have work to do (7.2 percent).
Long hours of work could be attributed to the bulk of work delegated to the domestic worker and
requirements of employer. As shared by one of the workshop participants, “madami talaga akong
gawain, 12 ang inaasikasong bata, ako lang mag-isa. Sa umaga, magluluto ng pagkain nila, tapos
gigisingin isa-isa. Tapos ihahanda ang uniform, 12 piraso. May isa akong alaga, 17 years old na,
nagpamedyas pa sa akin. Dun talaga ako naluha, malaking babae eh. Kasi utos ng isa, hindi ka pa
tapos, tawag na naman ang isa. Tapos pag nasa school sila, maglilinis ng bathroom, ng mga kwarto
nila. Pagdating nila, nagkakagulo na naman ang bahay, kakalinis mo lang, gugulo na naman. Wala
kang katulong eh, mag isa lang ako.” (I take care of 12 children. In the morning, I’ll prepare breakfast for
them, then I’ll wake them up. I will prepare their school uniform; 12 sets of uniform. One time, one of my
wards, a 17 year old girl, asked me to put her socks on. I cried on that instance. They are demanding.
One will request for something and I’m not yet done with the first request, another one will call me for
62
something. While the kids are at school, I’ll clean the bathroom and their rooms. When they come
home from school, they will scatter their things; the house will become a mess again. I have no one to
help me, I’m alone.)
A look into the destination countries shows the variability in the number of hours required from female
domestic workers in meeting the demands of their work. Most of those from Brunei, Jordan and Kuwait
work from nine to 12 and 13 to 6 hours a day respectively; while those from Bahrain work from nine to
12 hours. Most of those employed in Singapore, Israel and the UAE work from 13 to 16 hours. In
Taiwan, most would work from five to eight and 13 to 16 hours. Those who reported working for 17 to 20
hours work in Oman, Qatar and Saudi Arabia. In Hongkong, some would work for five to eight hours
while others work for 13 to 16 hours. Half of those in Cyprus work for five to eight hours while others work
from 13 to 16 and 17 to 20 hours. Majority of the participants working in Italy, Macau and Spain reported
working for five to eight hours a day. One respondent each from Bahrain, Kuwait and Saudi Arabia
reported that they work more than 24 hours, depending on the time required finishing their tasks.
Oftentimes, such long working hours are not compensated fairly. A response from one of the post
survey consultation workshop reflects this: “...four hours lang talagang oras ng pahinga, gigising ng 5
63
a.m. Tutulog madaling araw na...20 hours ang trabaho talaga. Merong overtime pay sa iba, sa akin
wala.” (I only sleep for four hours; I need to wake up at 5:00 a.m. I go to bed around dawn. I work for 20
hours. Others get overtime pay, but I don’t)
b Scope of household work
Survey participants identified the following tasks they performed in their employers’ household: cleaning
house (87.6 percent); cooking meals (77.4 percent); doing laundry (74.4 percent); taking care of employers’
child(ren) (62.2 percent); and washing the car (25.4 percent). Though considered unacceptable and a
breach of contract, some reported cleaning the house of their employer’s relative(s) / friend(s) and
taking care of their employer’s friend’s child. Other tasks performed are shown in Table 15 above.
The case studies of Myra, Naty, Marita and Gen also show the varieties of tasks they need to fulfill in
the households where they work. Differences in the length of time spent on working in their employers’
home and the number of households they work in, also vary significantly. In Myra’s case, a 21-hour
workday was normal in her employment in Lebanon and 22 hours in Romania; with, Natty, she was on
call 24 hours, taking care of her Kuwaiti employer’s child.
c Days off benefit and availment of days off

Half (58.6 percent) of the participants said that they are entitled to regular days off. Of these, 70.5
percent avail of the benefit. The frequency of their regular days off varies, however, with most having
them once a week (48 percent), followed by once (17 percent) or twice a month (eight percent). An even
64
smaller portion (7.5 percent) have a day off only during Christmas Day (when the employer goes out), or
twice a week, or once every three months, to cite some examples. Table 16 shows the number of
participants in the study who have reported enjoying a day off. In Table 16 though the sample is small,
there are some countries where all the respondents stated that they have days off (such as Israel, Italy,
Macau, and Spain).
FGD participants said some employers who hire them for multiple contracts, would not provide regular
days off because the latter consider their domestic worker’s end of contract vacation in the Philippines
as accumulated days off. Though the respondents find this unacceptable, they said they had no other
choice but to abide by the decision of their employers.
The five most cited activities they engage in during their day off are: (a) go out, take a stroll, shop, and
eat out (31.4 percent); (b) meet / spend time with friends (24.6 percent); (c) attend church / hear mass
/ attend Bible study sessions (24.6 percent); (d) do part-time work (10.2 percent); and, (e) stay at
home (9.6 percent).
65
The respondents also answered they are able to do the following during their free time or leisure time:
(a) pray (95 percent); (b) talk to or text / SMS family (82.2 percent); (c) play music or listen to music
(72.2 percent); (d) read (69 percent); (e) watch television (65.4 percent); (f) drink alcohol (58 percent);
(g) take a nap (51 percent); (h) exercise of walk for more than 30 minutes (50 percent); (i) socialize with
friends (47.4 percent); and, (j) go to church / attend religious services (44.8 percent)
6. Individual income and expenditures
Their mean income is PhP17,027.80 (US$378.39) per month. A minority (2.8 percent) working in developed
countries – such as the United States, Canada, Spain, Italy,and other European countries – earned
salaries ranging from US$1,000 to US$3,000 or higher. Sixty percent of respondents earned below
US$400; about 20 percent received US$400 to US$500 a month. The lowest salary stated per month
was PhP 5,500 (US$122.22).
Sixty-eight pecent of respondents reported that their salary is consistent with their contract. Majority of
survey participants (98.4 percent) said they send remittances to their family. The percentage of their
income which they send home varies. Most of them send a big chunk of their earnings to the Philippines:
41 to 50 percent of their income (18.3 percent); 71 to 80 percent of their income (16. 7 percent); and 91
to100 percent of their income (15.2 percent).
66
When asked about other sources of income, about one in ten (11.8 percent) answered that they had.
More respondents from the middle adulthood category said they had other sources of income than
those from the young adulthood category. Other sources of income mentioned were: doing part time
jobs (84.7 percent), which includes cleaning houses (51.4 percent); baby sitting (8.3 percent); serving
as caregiver (4.2 percent) and ironing clothes (4.2 percent). A smaller percentage (5.6 percent) sold cell
phone loads. These responses show that even the part time work of migrant domestic workers focuses
on household work associated with fulfilment of the ascribed caring and nurturing role of females. This
despite the presence of laws that specifically states that migrant domestic workers are not allowed to
take on part time work. FGD participants attributed this to the meager income some of them get from
their full time jobs.
As shown in Graph 1 (below), survey participants reported spending every month on the following:
remittance to family (91.8 percent); communication (62.4 percent); food (60.8 percent); personal effects
(48 percent) and toiletries (39 percent). Details of remittances to families show that majority of young
adults would send 41 percent to 50 percent of their salaries to family members in the Philippines, while
majority of those in middle adulthood (most of whom are married) would send from 71 percent to 80
percent and 91 percent to 100 percent.
Majority of survey participants (98.4 percent) said they send remittances to their family. The percentage
of their income which they send home varies. Most of them send a big chunk of their earnings to the
Philippines: 41%-50% of their income (18.3 percent); 71%-80% of their income (16. 7 percent); and
91%-100% of their income (15.2 percent).
Significantly, women migrant domestic workers coming from Metro Manila seem to receive a higher
mean income, compared to participants from other sites. The lowest mean income per month was
observed among those coming from Davao in Mindanao.
67
Graph 1: Respondents’ expenditures
Only 10.6 percent of respondents said there are instances in their stay overseas where they did not
have any income. In these situations, they relied on other sources of financial support, such as borrowing
money from others (26 percent); using their own savings (24 percent); and borrowing money from a
family member (10 percent). A minority (six percent) also said they received help from the Philippine
embassy, while some (four percent) pawned personal items such as jewelry, and cell phones. Others
(28 percent) resorted to not sending money home, asking help from their employer, getting a part time
job, or even engaging in paid sex.
7. Family income and expenditures
A significant number of the respondents (70 percent) said other family members are helping them to
earn a living. These include their spouse (57.4 percent); parent/s (26.3 percent); siblings (19.1 percent)
and children (2.6 percent).
68
Graph 2: Family expenditures
Families left in the home country spend monthly on the following: food (96 percent); electricity (77.4
percent); school expenses (73.2 percent); water (45 percent) and communication (34.8 percent).
Households of young adults have the following reported monthly expenses: food, electricity, school
expenses, water and payment of loans.
8. Social protection
More than a third (35 percent) reported they do not have any form of insurance while they were in the
Philippines. Some have Social Security or SSS (31.8 percent), national health insurance or PhilHealth
(29.8 percent) or government social security insurance or GSIS (0.8 percent). Most of those who were
insured noted that their coverage included health insurance (37 percent); life insurance (16.8 percent)
and coverage for illness, sickness, or injury (15.3 percent). While working overseas, 54 percent had
insurance coverage which included health insurance (48 percent), illness / sickness / injury (19.4
percent) and life / death insurance (17.5 percent).
Majority of those who reported having insurance while working abroad worked in Hong Kong, the UAE,
and Singapore. Most of those working in Saudi Arabia and Kuwait were not provided with insurance.
69
Those who did not have any insurance gave the following reasons for not availing of this type of social
protection: (a) insurance coverage benefits were not included in the contract (16.1 percent); (b) lack of
knowledge about insurance (8.8 percent); and, (3) inability to afford insurance premium or contribution
(seven percent). Participants who answered “other reasons” (28 percent), cited specifics as: having a
thrifty employer; illegal / undocumented status; lack of need for insurance (because respondent just
stayed home), among others.
C. Migration- related health concerns and issues
1. Illnesses and injuries
Most respondents (56.5 percent) of the study did not experience any illness while working abroad.
Those who fell ill (43.5 percent), reported experiencing the following most frequently cited symptoms:
fever (33 percent); cough (28 percent); colds (12 percent); flu-like symptoms (12 percent); and, headache
(nine percent).
Very few respondents sustained injuries while working overseas (17.8 percent). Majority of those who
experienced cuts and abrasions were from Hong Kong and the UAE. Amputation or loss of body part
was reported by two respondents from Saudi Arabia. Most of those who reported dislocation, fractures
and sprains worked in Saudi Arabia and the UAE. Those who sustained burns, contusions, bruises and
hematoma were mostly from Saudi Arabia. Some other conditions where injuries were sustained included
being bitten by a dog; falling while handling persons because of the weight of the elderly person she was
taking care of; and, slipping and falling.
70
2. Stress
a Stressful life events experienced

One of the sources of stress of migrant workers based on the FGDs is the difficulty in balancing the
demands of work abroad and family life back home. Results of the survey shows that such condition is
considered to be “somewhat difficult” by 38 percent of respondents; “very difficult” by 27.7 percent; “not
very difficult” by 27 percent; and “not at all difficult” by a minority (seven percent). Furthermore, the
greatest source of stress while abroad is stress at work (43 percent), while others identified stress from
both work and home (26 percent); and stress at home (25 percent). Only 5.6 percent stated that neither
is considered to be stressful.
Other stress – related health problems and conditions experienced abroad are depression (7.1 percent),
hypertension (5.6 percent) and ulcer (5.6 percent). Majority (79.4 percent) did not report any stress
induced physiological reactions.
A little more than half (55 percent) of respondents experienced stressful life events while employed
overseas such the death of a close family member (19 percent); diagnosis of a serious illness of a close
family member (12.4 percent); break up of a long term relationship (9.6 percent); respondent diagnosed
with a serious medical problem (6.1 percent); loss of employment for more than two months (3.1
percent); and tra percent nsfer from former home (3.1 ).
Comparing the experience of those from the young and middle adulthood groups, there were more
stressful life events experienced by respondents from the latter than those in the former. This is plausible
considering that most of those in middle adulthood are already married and have children (Table 21).
71
b Manifestations and sources of stress
72
The most frequently identified physical manifestations of stress while overseas were: fatigue (64.6
percent); headache (60.4 percent); muscular tension (49.8 percent); upset stomach / indigestion (36.4
percent); feeling faint or dizzy (36.2 percent); and, inability to sleep (36 percent). On the other hand,
while in the Philippines, they experienced: headache (48 percent); oversleeping (2.2 percent); upset
stomach / indigestion (23.8 percent); fatigue (19.8 percent); inability to sleep (18.2 percent); and,
muscular tension (17.4 percent).
Significantly, the number of psycho-emotional symptoms reported by the participants decreased while
in the Philippines, compared to when they were abroad. The same trend was observed among the
reported psychological manifestations of stress. While overseas, the following were experienced:
loneliness (68.2 percent); desire to cry (66 percent); sadness (66 percent); feeling nervous (36.8 percent);
and irritability (32.4 percent). While in the Philippines, they reported irritability (24.4 percent) anger
(23.6 percent); sadness (22.8 percent); desire to cry (19.6 percent) and loneliness (15.8 percent).
Some of the effects of stress were verbalized by the post survey consultation workshops participants
thus:
“Ang epekto ng stress, nakakalimot ako. Nalilimutan ko magpainom ng gamot ng

alaga. Nanlagas din ang buhok ko, pumayat ako, lumabas ang mga ugat ko. Pinauwi
na ako, hindi na talaga kaya. Hindi ko natapos ang kontrata.” (The effect of stress to
me was I became forgetful. I forgot to give the child his medicine. I had hair fall, I lost
weight, I had swollen varicose veins. They sent me home because I cannot carry on. I
did not finish my contract.)
“Pumayat talaga ako noon, mukhang matanda. Tuyot na ang utak pati pa ang katawan,
nalalagas ang buhok ko…Sa pagkain, isang minute lang. Naghahang na talaga ang
isip ko. Pagkatapos ng kontrata ko, hina-hire pa ako, hindi ko na tinanggap. Nung
nakalabas na ako ng bahay nila, papunta na ako ng airport, para akong ibon na
lumilipad. Nakalaya na ako. Pagkauwi ko dito parang nagkaano din ang isip ko,
parang mild na naapektuhan. Tulala ako, hindi ako nakakausap. Wala na din akong
lakas ng loob.” (I lost weight then, I looked old. My mind and body got drained, I had
hair fall… After my contract, they wanted to rehire me but I declined. When I was on
the way to the airport, I felt like a bird on flight. I was free. When I arrived home, it
seemed like my brain was slightly affected. I stared blankly and they couldn’t talk to
me. I lost my inner strength.)
73
c Sources and levels of stress

The significance of particular stressors as perceived by the respondents abroad and in the Philippines
is summarized in Table 22. This also shows the manifestations and sources of stress of participants
while abroad and while in the Philippines.
According to the post-survey consultation workshop participants, other contributing factors to the
experience of stress were the lack of control and fear experienced by domestic workers in the context
of their relationship with their employer. In the table, these can be inferred from such items as money
(insofar as it related to the pay they actually received), personal safety, and the nature and scope of the
work they did (including work hours).
One participant said, “Isa pa, kailangan lahat ng gagawin mo ipapalam mo sa amo mo. Matatakot kang
magpahinga, matatakot kang magsabi sa amo mo kasi baka pauwiin ka nang bansa. Sabihin nandito
ka para magtrabaho.” (“In addition to that, all the things that you do, need the permission of your
employer. You cannot rest, and you will hesitate to ask for your employer’s permission, for fear that she
/ he might send you home. You are always told that you are here to work.)
Food is one of the sources of stress identified by workshop participants. This may be due to the
absence, inadequacy, and unpalatability of food provided by their employers. Missed meals further add
to this. Majority of the participants (74.6 percent) reported that they never missed a meal in a week’s
time, but some missed meal/s in a week, specifically: one meal (7.2 percent), two to three meals (nine
percent), four to seven meals (2.6 percent) and eight or more meals (4.2 percent). This trend is seen
among respondents coming from both the young and middle adulthood stages.
74
A workshop participant said her source of stress when she was working abroad was food. She got sick
and was temporarily crippled, which according to her, was due to heavy workload and lack of food. “Ang
stress ko talaga sa gutom. Walang almusal, kape lang o kaya tubig kasi hindi naman daw nila sagutin
ang magbigay ng pagkain… Nagreklamo ako sa agency na kulang ang pagkain. Ang sagot daw ng
employer ko, okay naman daw ang binibigay nila. Pero sa akin, hindi okay, kasi hindi rice e, noodles
lang na tira-tira nila.”(The source of my stress then was hunger [lack of food].There was no breakfast; I
only had coffee or water. [My employer said that] it’s not their obligation to provide me with food. I went
to my agency and complained that my employer does not give me enough food. According to the
agency, my employer told them that they give me enough food. But for me, the food is not okay. There
is no rice, it’s just leftover noodles. )
Majority of the participants said they are concerned with the level of stress in their everyday life, with
two out of five being “very concerned” (46.1 percent) and a third being “somewhat concerned” (30.6
percent). Only eight percent said they are not at all concerned.
In terms of their rating of stress experienced during the different phases of migrant work (on a scale of
1-5, 1 being the lowest and 5 being the highest), the mean ratings were: pre-migration, 2.97; migration,
3.47; and post migration, 2.62. The mean highest was when the respondents were on-site or abroad.
Although few experienced injuries while working abroad, majority of those who did, reported experiencing
high levels of stress (a 5 rating).
75
The level of stress experienced may be related to the number of unfinished contracts, with those not
being able to finish one to two contracts experiencing high levels of stress. With this association, the
trend shows that those who finished a lot of contracts seem to have less stress. This may be related to
their greater ability to cope with the demands of work and being away from their families, which increases
through time. It was also observed that participants who stayed less than two years have higher stress
than those who stayed longer. Such trends however, needed to be verified further in future researches.
76
d Manifestations of stress
77
Table 25 shows the different manifestations of stress in different countries of destination. There are
variations of the most often cited manifestations in the top five destination countries. In Hong Kong, it is
“feeling as though you want to cry”; in Saudi Arabia, “fatigue”; in the UAE and Singapore, “loneliness,”
and in Kuwait, fatigue, loneliness and feeling sad respectively.
It is also important to highlight the fact that there are participants who had ideations of suicide (“thought
of ending one’s life), even if the number is quite small (6.6 percent). The participants who reported this
were employed in Saudi Arabia, the UAE, Singapore, Kuwait, Brunei, Hong Kong, Taiwan, Israel, Jordan,
and Qatar.
Table 26 below summarizes the levels of stress reported by the respondents in the different countries of
destination. Seven of these countries (i.e. Bahrain, Hong Kong, Jordan, Kuwait, Macau, Qatar, and
UAE) had the highest number of respondents stating a stress level of 3. Six of these (i.e. Cyprus, Israel,
Lebanon, Oman, Saudi Arabia, and Singapore) have more respondents reporting a stress level of 5.
Those working in Brunei have an equal number of respondents selecting stress levels of 1 and 5; from
Italy, levels 1 and 2; Qatar, levels 2 and 3; and Taiwan, levels 3 and 4.
78
e Factors affecting manifestations of stress (living arrangements, work hours, and days off)
Relating the participants’ selected stress levels onsite to their living arrangements, most of the participants
in stay-in arrangements rated their stress as 3 (27.6 percent); 4 (17.4 percent) and 5 (23.4 percent).
Most of those in live out arrangements selected ratings of 1 to 3 (1: 1.2 percent, 2: 1 percent, 3: 1.2
percent). This indicates that the increase in stress ratings may be associated with conditions related to
living arrangements and living conditions.
There are also differences in manifestations of stress between those in stay-in and live-out arrangements.
For those in the former, the five most frequently identified manifestations of stress are: “loneliness”,
“feeling as though you would cry”, “feeling sad”, “fatigue” and “headache”. Among those in live-out
arrangements the manifestations are almost the same with the addition of “change in appetite”. Due to
the small number of sample for the latter group, these results need to be further studied.
79
The stress level on site may also be related to the number of work hours a day, as shown in Table 28
which shows a general trend of having a high rating of stress with working less than or higher than five
to eight hours a day.
If the presence and absence of days off are charted vis- a-vis manifestations of stress one could
surmise from Table 29 that individuals with days off have fewer manifestations of stress than those
without.
80
Another source of stress identified in the post survey consultation workshops is the legal status of the
domestic worker. Being undocumented or undergoing a change in the nature of work overseas could
add to the problems of migrant domestic workers, as verbalized thus:
“...ako kasi dapat waitress, hindi domestic. Kaya pagdating ng Abu Dhabi, mahabang proseso pa.
Nakadagdag talaga sa alalahanin.”(“I was supposed to work as a waitress, not as domestic [worker].
When I arrived in Abu Dhabi, it was still a long process. It’s an additional worry.
“Ako natagalan sa Singapore kasi tourist kami eh. Wala namang hinanap, gusto lang sabay- sabay
kaming lalabas. Kinakabahan kami, nagutom na din sa tagal. Tapos kinakabahan ka sa papel mo,
baka ma-hold. Baka mahuli ka at baka ma-A to A (airport to airport) ka.” (We waited a long time at
Singapore airport because we’re tourists. They [immigration officials] are not looking for anything; they
just want us to leave together as a group. We were nervous. We were hungry because of the long wait.
We were nervous because of our [insufficient / fake] documents; we anticipated that they will hold us
[in the immigration]. We were thinking what if we get caught; what if we will be A-to-A (airport-to-
airport)”.
The workshop results also pointed to possible differences in the experience of stress among younger
and older domestic workers. The participants believe that mid-adults could handle stress better because
of their experiences and their social networks: “May diperensya. Kasi yung mga older doon, may mga
experience na. Yung younger, wala ka pang masyadong experience abroad. Mas takot pa, hindi pa
nagjojoin sa ibang recreational activities...pag bata ka hindi ka pa sigurado sa decision. Pag matanda
ka na, base sa experience mo, mas kalmado ka...” (“Yes, there is a difference. The older [domestic
workers] have more experience. The younger [domestic workers] don’t have enough experience [of
working] abroad. They are more cautious and they do not join recreational activities... if you are still
young you are still not sure about your decision. If you are older, because of your experience, you’re
more calm.”)
D. Wellness and well- being
1. Positive and enjoyable experiences
Survey respondents cited positive experiences that helped cushion experiences of psychological stress
while working abroad. These are shown in Table 30.
81
When asked what activities they enjoyed most while they are working abroad, the survey participants
identified the following activities: continue working/doing household chores such as cooking, cleaning,
etc., having day off and holidays, doing activities with employer; shopping/strolling/going out, doing
activities with their employer’s child/children, etc.,. It is important to note that 8.78% of the survey
participants said that they do not remember any activity they enjoyed doing while working abroad.
82
When asked about their sources of joy and happiness while abroad, the categories of their responses
included: talking to / sending text messages to family (14.8 percent); receiving one’s salary (seven
percent); having a good and generous employer (6.6 percent); thinking of one’s family (five percent);
playing with / taking care of her employer’s child(ren) (4.8 percent); sending money to one’s family in
the Philippines (3.8 percent); receiving gifts from employer (3.6 percent); strolling / going to the mall /
shopping (3.2 percent); helping one’s family (three percent); having a high salary (2.8 percent); seeing
other Filipinas (2.6 percent); chatting with friends (2.4 percent); saving money (2.4 percent); and, being
inspired by one’s family (two percent).
The aforementioned sources of joy and happiness centered more on positive relationships with family
members, employers, employer’s children, friends and fellow domestic workers. Though financial factors
were considered important, these seem secondary to maintaining smooth relationships with other
individuals in their lives. The FGD results affirm this finding, so even such an activity as shopping, is
done to purchase things that they send home more than things that they need for themselves. The act
of sending a Balikbayan Box to their loved ones back home is a source of joy and an affirmation of their
ability to provide for the needs of their families, more than affirming solely their economic capacity.
However, 3.5 percent of the respondents answered “none” when asked about their sources of joy and
happiness.
Apart from the aforementioned, the survey, narrative and post survey consultation workshop participants
also identified some of their strengths, which allowed them to survive the demands of their work and
being away from their families. One of their major sources of strength is their spirituality and religiosity
which is exhibited by praying, going to church and maintaining “a relationship with God”. Another is
their families. They reported that thinking of their families, communicating with them and receiving
emotional support from them saw them through hard times. For those who had children, thinking about
their welfare and their education motivated them further into working hard. The presence of supportive
friends, romantic partners and other social networks served as links and connections while overseas.
The participants also recognized individual characteristics that they possess which allowed them to
cope, which include industry, fortitude, “fighting spirit” and determination, knowing how to save money,
keeping oneself healthy, and patience.
2. Coping with stress
Table 32 shows the mechanisms used by the participants to cope with problems and issues faced.
Generally, the most frequently used strategies are: turning to religion (prayed/read the bible, went to
83
church, etc.); focusing on and venting emotions (cried); behavioral disengagement; mental
disengagement; and, seeking social support.
In the case of Naty, who suffered physical, sexual and psychological abuse at the hands of her employers
and was even jailed for leaving them, spirituality tided her through the difficult times. She would sing
religious songs softly to calm her mind and lighten her feelings because she felt that “God listened to
her songs”. Her experience of “fear and helplessness” made Naty “cling to her faith firmly”. Later, her
faith and the thought of her family, gave her the strength to plan her escape.
3. Importance of social support
The presence of social support is also associated with the stress ratings as seen from Table 33, which
shows that the presence of support is related to lower ratings of stress. Most of those who reported
that they do not have any sources of support rated their stress level from 3 to 5. This was confirmed by
post survey consultation workshops results where the participants shared experiences when they felt
the ameliorating effects of the presence of their families, friends and co-workers, when faced with
stressful life events and problems. This is evident in the narratives of Marita and Gen.
84
In Marita’s case, her sources of support are her current host family which encourages her to enjoy her
weekend and days off; and her Filipina friends, to whom she confides her problems and struggles. In
Gen’s case, her support network consists of Filipina friends who she regularly sees in church or in
social gatherings; an organization to which she belongs (Trusted Migrants) and another to which she
volunteers to help fellow Filipinos (Stichting Bayanihan); her family in the Philippines, with whom she
regularly communicates through online chat rooms; and, her boyfriend who she says is very supportive
of her.
Other responses generated from the questionnaire and post survey consultation workshops point to
positive thinking; assuring oneself that one can do it; and fighting back when the employer becomes
unreasonable or abusive. Some just do not think about their problems by keeping themselves busy and
concentrating on the work. In one of the workshops, a participant said it is important to assume that
going overseas to work is stressful and one needs to accept this as a reality to be coped with. With this
85
in mind, the overseas domestic worker will be better prepared to meet the challenges of working abroad,
as evidenced by this sentiment:
“Ako naman, natural lang na ma-stress ka. Dapat handa ka at alam mo ang dapat gawin doon, alam
mo ang gagawin sa iyo ng amo mo, makikisama ka sa kanila. Iisipin mo talaga sa una dahil iba ang
ibang bansa, iba ang Pilipinas. Pero nag-decide kang lumabas, kung anong mangayari sa iyo, tanggapin
mo na lang. Bahagi ng decision na lumabas ng bansa ang stress. Coping mechanism yan, positive ang
maidududlot at nakakatulong na isipin na bahagi talaga ito ng pag-aabroad.” (“My take on that, it’s only
natural that you’ll be stressed out. You need to be ready and you should know what to do once you’re
there. You know what your employer could do so you better get along with them. The very first thing you
need to think about is that [life] abroad is different compared to [life] in the Philippines. But because you
decided to go abroad, whatever happens to you there, just accept it. Stress is part of working abroad.
[Accepting that] is in itself, a coping mechanism. It could bring positive results to think that stress is
part and parcel of going abroad.)
E. Sexual and reproductive health
In terms of the necessity of engaging in a romantic relationship while working abroad, only 11.7 percent
answered positively. Majority of these had a male partner (91.4 percent), while some had a female
partner (seven percent). Less than half (41.6 percent) reported that they had sex with their partners. A
small number (3.6 percent) had sex with someone who was not their spouse. Their sexual partners
include male friends (39.1 percent); boyfriends (21.7 percent), and casual acquaintances (17.4 percent).
Other partners included co-worker, female friend, commercial sex worker, employer or customer or
client. The latter applied to those who engaged in paid sex.
The survey participants also cited other reproductive health concerns experienced by their fellow domestic
workers. These are unwanted pregnancy, abortion, sexually transmitted infections, including HIV, myoma
and cyst. It is important to note that majority of Filipino women migrant domestic workers belong to the
reproductive ages thus, sexual and reproductive health services such as access to contraceptive
counseling and services, pre-natal care, etc. should be available at various stages of migration.
86
1. Restrictions and abuse
Table 34 summarizes the nature of restrictions and abuse experienced by the research participants,
while Table 35 includes the types of restrictions and abuse experienced by other female domestic
workers, as reported by the research participants.
87
The range of restrictions and abuses vary from the behavioral, psychological to the sexual. While some
of the abuses are more serious, such as getting raped, slapped, cursed and being shouted at; some
are very subtle, e.g., being prohibited from talking to neighbors, prohibited from leaving the employer’s
house or being asked to wear only specific types of clothing. These types of abuses were also identified
by post-survey consultation workshop participants and mirrored in the narratives of selected migrant
domestic workers included in this report, as sampled below:
Myra tells a story of how she was treated by her male employer in Romania at the time her tourist visa
was about to end. It started when she accidentally damaged the glass frame in the living room. She
admitted her mistake and told the male employer that she was willing to pay for the damages. But
88
without saying a word, he grabbed her hair forcefully and hit her strongly in the face with his fist, drawing
blood as a result.
“Sinuntok ako, dumugo ang aking mukha, hinila niya ang buhok ko pataas hanggang sa fourth floor.
Ang dahilan ng pananakit niya ay dahil nung naglilinis ako sa sala, natamaan ko yung frame, natanggal
yung salamin. Sinabi ko sa kanya, ‘sir, natanggal yung salamin, babayaran ko ito, magkano ba ang
ipapabayad mo?’ Hindi siya umimik at yun na, hinila niya na yung buhok ko at sinuntok niya ang mukha
ko. Dumugo ito at nung kinaumagahan, namaga. (“I was punched till my face bled. Then he dragged me
by the hair to the fourth floor. This was triggered when I accidentally dislodged a mirror from its frame
while cleaning the living room. I had approached him and reported the incident, and asked how much
was I liable for the mirror’s breakage. Without a word, he pulled my hair and punched me in the face.
The following day, my face was swollen.”)
Naty tells of how she was locked up in the ceiling of the toilet. Her first eight months were spent where
the heater and airconditioning exhaust were located. She described it as being like in an airplane day
and night from the noise. The flooring was sand so that she was like a dog covered with sand everytime
she woke up. The room was very dark and she saw no light while inside. The space was only enough for
her to sit up or lie down. She had no beddings and had to urinate where she was sitting.
Naty also tells of an incident when her employer tried to sexually molest her. The employer would ask
her to massage him while he wore only a face towel. If she refused to massage him, he threatened that
he will rape her. When her employer became insistent, they would chase around the house. At times,
she would slip on the stairs from running away. She would also grab the sleeping child and use him as
her shield or she would cry then her employer would back away. “When the Filipina cries, they take pity.
He would then draw away,” according to Naty.
Sandra experienced how she was told at the beginning of her employment that her main task was to
take care of the children and help a bit in the household chores. However, later on she had to do
everything in the house, which included occasionally helping her host-mother71 in her catering business.
Some of the respondents in the study also experienced forced sex or rape (2.6 percent), where the
perpetrators include the male employer (68.7 percent) and co worker (12.5 percent). Other perpetrators
include male friend, boyfriend, and the employer’s son. Box 1 shows the participants’ myriad responses
who were raped.
71
Host-mother refers to female employer in the Netherlands
89
Box 1. Responses to being raped (One respondent per answer)
• Called mother for advice; kept silent
• Fought back; reminded her male employer that she is just a domestic worker
• Fought back; threatened rapist that she will kill him
• Fought back; told her female employer about the incident but she did not believe her
• Fought back; told her female employer of the incident. Male employer said sorry.
She did not push through in filing complaint
• Begged him to stopReported the incident to authorities

• Got scared
• Shouted “Lord help me!”; rapist ran away
The cases above of Sandra, Myra, Marita, and Naty are clear evidence of the extent of restrictions
and abuses that women migrant domestic work may entail. Women migrant domestic workers have
minimal social support, are away from their home countries, and when they live in the homes of their
employers, their work may not be recognized as work, making them vulnerable to such treatment.
The experiences of abuse have far reaching effects, according to workshop and case study participants.
Some still feel the emotional and psychological pain even after returning home, as seen from stories of
flashbacks, numbness, sleeplessness, anxiety, and stigma. Some of these are mirrored in the following
response:
“...nung nandon ako, hindi ako ninenerbiyos. Ngayon naiiba, nagugulat na lang ako na may nararamdaman
na akong ganito. Naging nerbiyoso ako simula nung nung bumalik ako ...Hindi ako nakatulog sa gabi.
Sa tingin ko may nagbago sa akin mula nang nanggaling ako sa abroad” (“Before, while I was working
abroad, I didn’t use to feel anxious. Now it’s different. I easily get nervous ever since I’m back. I can’t
sleep at night. I think something in me has changed since I came back from abroad.)
It is not surprising therefore that key informant interviewees and survey participants have tales of other
migrant domestic workers who just break free from reality or lose their mind (nababaliw) after being sent
home from abroad.
90
F. Health services
When asked if the respondents ever consulted a mental health professional or counselor, three percent
answered in the affirmative. Of this number, 43 percent reported that they sought the services of a
pastoral counselor. Others reported seeing a psychiatrist (21.4 percent), lay counselor (14.3 percent)
and a psychologist (14.3 percent). With regard to their family members, two percent have family members
who consulted a mental health professional, specifically a psychiatrist (80 percent) and a substance
abuse counselor (20 percent). These were consulted for various reasons, as could be gleaned from the
following box.
Reason/s for consulting a mental health professional
(1 respondent per answer, in alphabetical order)
• Asked advice on how to fix relationship with her father
• Depressed and couldn’t eat because she was swindled by the recruitment agency
• Depression
• Extreme homesickness
• Fear that she will not be allowed to go home she told them what happened
(experience of abuse)
• Marriage counseling
• Spiritual guidance
• Did not know how to cope

• Felt like she would go crazy thinking about her family in the Philippines
• Thought of committing suicide because of too much work and anxiety
• Sister learned that she was abused
• To be relieved from physical and emotional problem
• To fix her relationship with husband
When it comes to sexual and reproductive health services availed, Graph 4 provides a summary of
what the respondents have accessed. Majority (62.4 percent) however, never availed of these health
services while working abroad.
91
Sources of care and support
When asked about the respondents’ sources of care and support when they are sick, most of them
stated they rely on no one (52.3 percent). On the other hand, respondents identified their employer
(31.94 percent), co-worker (8.8 percent) and friend (4.63 percent) as the people who took care of them
while they were sick.
The leading sources of support are: Filipino friend (26.2 percent); female employer (11.2 percent);
mother (5.5 percent); relative (5.2 percent) and co-worker (4.9 percent). It is important to note that 20.3
percent of the respondents reported that they do not have any source of support.
A few of the respondents experienced seeking assistance from the Philippine Consulate in the country
where they are working (8.6 percent). The services they availed of included the following: renewal of
worker’s documents (e.g. passport, contract) [23.3 percent]; advice regarding refund of placement fee,
dealing with conflicts with employer, and the deportation process (23.3 percent); provision of temporary
shelter (20.9 percent); and, facilitated return to the Philippines / deportation (18.6 percent). Others
identified being assisted in filing complaints, counselling, financial and legal assistance (9.3 percent)
while 4.6 percent of those who went to the embassy reported that they did not avail of any service.
The cases of Myra and Naty show contrasting experiences of ‘assistance’ from two Philippine embassies.
While Myra was discouraged from pursuing her case and was not given sufficient assistance; Naty
claimed she was provided the necessary support from the time she escaped from her employers to the
time she was incarcerated and the time she went home. Different types of services were provided to
her, specifically, legal, medical, and psychological. Yet, she also recognized the limitations of government
agencies in responding to the needs of overseas workers with the same plight.
G. Benefits of working abroad
The female participants in the study identified a variety of perceived benefits of working abroad, foremost
would be their capacity to send their children to school and meet their families’ needs. Securing one’s
92
future by saving and establishing their own business, as well as having their own home, were also
mentioned. It is not surprising therefore, that despite the issues and stress they went through while
working abroad; they still hope to leave again in the future.
All the narratives attest to the importance of being able to earn for and help their families, as a major
advantage of working overseas. Some of them also recognize other benefits such as being able to travel
to other places and learning more about other cultures. But apart from these, they also stayed on (or
are planning to go back) because they feel that they have to prepare for their own future. They do not
see their home country as having sufficient economic opportunities for them to be able to fulfill their
dreams – for their families and for themselves (even to the point of risking their well- being).
Attitude toward overseas work
The outcome of the post survey workshops and narratives conducted with the female domestic workers
included in the study highlight the difficulties they encounter from the time they decided to work abroad,
migrated for work and came back home.
Generally, most of the groups of women migrant domestic workers who participated in the workshops
still had plans of working overseas. Despite negative experiences (from restrictive to abusive conditions)
they experienced in the past, they believe that they will have a better fate the next time they go abroad
and that they just need to ensure that they do not go back to the countries they have been to before.
The case studies show the resilience of women migrant domestic workers in the face of adversity. Yet
one needs to recognize that such may also subject an individual to further exploitation. Unless the
option of staying for good becomes attractive to them, it is likely that they will continue to perceive that
overseas work is their sole practical choice to address their families’ and their own needs.
93
H. Program needs
1. Membership in Organizations
Majority of the survey respondents expressed that they are not members of any organization while
overseas (82.9 percent). Only 16.6 percent said they belong to one or more of the following groups:
religious (50.6 percent); sectoral (overseas domestic workers, 25.3 percent); sectoral (women, 12.7
percent); cultural (3.8 percent); ethno-linguistic group (3.8 percent); volunteer group (2.5 percent); and,
sexual identity (1.3 percent).
The finding shows that religious organizations serve as the primary organization that many migrant
workers identify with. This is due to a variety of reasons. Post-survey consultation workshops show that
these groups are active in recruiting members; they are conveniently situated in the churches where
migrant workers hear mass or pray; they provide emotional and social support; and they are nurturing
especially to new comers in the country. It is usually in these contexts where some of the migrant
domestic workers’ friendships are also formed and nested.
The countries of destination where respondents reported that they are members of organizations come
from Hong Kong, Singapore, Taiwan, Cyprus, Italy, Saudi Arabia, UAE, Israel, and Qatar.
The five most frequently identified reasons why most survey participants never joined organizations
based were: “no time” (24.3 percent); “not allowed to go out” (10.4 percent); “no day off” (9.2 percent);
“not interested” (6.2 percent); and, “does not know anything about organizations” (3.8 percent). Such
results were affirmed in the post-survey consultation workshops, with the additional reason of physical
distance between their place of work and the church or parks where fellow Filipinos meet during their
days off or on weekends. Some workshop participants also confessed to avoiding members of organized
OFWs because of fear that they may just bring problems (e.g. being contacted when one flees her
employer; being at the center of gossip, being asked for financial assistance, among other things).
The respondents identified the following assistance that members of organized groups are provided
with: spiritual/moral/emotional support (25.9 percent), financial assistance (11.1 percent), counseling /
advice (8.6 percent) and information about labor migration (7.4 percent).
In Sandra’s case, the presence of the Bayanihan support group helped her through trying times with
her host-mother. A personal friend who was also a member of the organization linked her to possible
employers when she was jobless and was looking for sources of income. Friends from the organization
also helped her by providing shelter after she left her host-family. Meanwhile, Gen, who goes to church
94
and joins bible sharing sessions, shared that these activities strengthens her. Informal groups of women
migrant domestic workers housed in embassies abroad also provide additional support to female victims
of abuse, as in the case of Naty.
2. Issues, Concerns and Needs
The respondents were asked to identify their problems and concerns, coping behaviors and resources
needed in each of the three stages of migration. The most frequently reported ones along the different
areas are shown in the succeeding tables.
95
The table above shows the problems encountered by the participants at different stages of migration.
These table shows that though it would be financial concerns that would cut across the different stages
of migration, there will be differences in terms of ranking vis-à-vis other factors, such as psychosocial
ones. Psychological (i.e. homesickness / loneliness / stress) and relational issues (i.e. dealing with
employer) have been dominantly identified in the migration phase, while financial need leads the concerns
in the pre-migration and post-migration stage.
These financial concerns vary depending on the stage of migration. In the pre-migration phase the
concerns include not having financial resources to support the application process, while in the post
migration, it is more an issue of their ability to support their needs due to the absence of employment
and not having earned or saved enough money while working overseas.
Issues pertaining to relationships with one’s family are also salient at different phases. In the pre-
migration stage, this involved apprehensions about the possible effects of being away from the family. In
the migration phase, this evolved into homesickness and involved a lot of thinking about children and
family members left in the Philippines. In the post-migration stage, this is characterized by positive
emotions of being reunited with one’s family, as well as the negative thought (or reality) of finding out
that one’s husband had extra marital affairs.
The case studies also show the extent of stress; exploitation and abuse female migrant workers go
through. Being in another country (especially if one is undocumented) limits one’s access to social
services. Being a minority makes one vulnerable to exploitation. Being a woman subjects one to
discrimination and gender-based violence. The inability to understand the destination countries’ language
and culture; absence of social networks and support; financial obligations back home; poor employer-
employee interactions; insufficient assistance from the foreign posts exacerbate existing problems
and issues. Extreme cases of being imprisoned and inhumane treatment of “erring” women migrant
domestic workers further impinge on the already volatile mental health of female overseas workers.
The issues identified in the survey and the narratives are nested in other problems besetting the general
Philippine society. This was highlighted in the workshops:
“Agree ako na may kakulangan talaga ang gobyerno na mabigyan ng trabaho ang mga Pilipino. Kasi
base dito lumabas man tayo ng bansa o bumalik, pera talaga ang problema natin. .. kasi sa Hongkong
narinig naming may programa si Gloria, pero parang hindi lahat nakakauha nun. Tapos yung mga
organisasyon, hindi kilala sa ibang bansa. Hindi mo alam kung saan ka hihingi ng tulong.” (“I agree
with the [finding that says] that there are gaps and weaknesses in the government’s ability to provide
jobs for Filipinos. Because of this, whether we work abroad or here, [the lack] of money remains a
96
problem. There should be an organization that will help OFWs. While I was in Hong Kong, we heard that
[President] Gloria [Arroyo] had a program, but it seems that not everybody benefited from it. The
organizations are not known in the country of destination. You don’t know where to ask for help.”)
3. Services and Policies Needed
The various services and policies recommended by the survey participants to address their identified
needs and concerns along the different stages of migration are summarized in the succeeding tables.
These were affirmed and validated by the inidviduals who partiicpated in the FGDs, narratives and key
informant interviews.
The five most frequently identified services and policies that should be in place to address the needs of
migrants in the pre-migration stage are: (a) provision of financial assistance or support to applying
women migrant domestic workers; (b) provision of information and orientation on migration realities, the
host country, among other things; (c) enforcement of policies to protect the rights of women migrant
domestic workers; (d) reduction or abolition of placement fees; and, (e) provision of services for women
migrant domestic workers and their families.
The need to review current policies in relation to health and migration, specifically the Philippine Mental
Health Policy Framework, and support the call for the enactment of a National Mental Health Act that
would incorporate the issues and concerns of migrant workers was also raised.
On-site, the following are needed: (a) setting up of help / grievance / information desks for women
migrant domestic workers; (b) provision of services on site; (c) ensuring that contracts are followed; (d)
monitoring of women migrant domestic workers’ situation and provision of information; and, (e) skills
training.
Lastly, upon arrival in the Philippines, the following must be put in place : (a) provision of economic
opportunities for returning women migrant domestic workers; (b) provision of skills training; (c) provision
of services for women migrant domestic workers and their families; (d) conduct of reintegration seminars
for women migrant domestic workers and their families; and, (e) assistance to women migrant domestic
workers in their re-application process.
97
Conclusions & Recommendations

Women constitute a significant number of individuals leaving the country for better economic opportunities.
Their experience is influenced significantly by their gender identity, as they try to straddle the ascribed
family role they left behind and their new role as female domestic workers in other countries. In the
process, they not only confront economic and cultural problems, but also psychosocial issues, including
mental health and well-being concerns. This reality therefore should serve as the basis of any research
in understanding the positive and negative effects of migrant work. It should also be the assumption in
any intervention work aimed at mitigating the costs of migration.
In understanding the mental health status, needs and issues of migrant domestic workers, one needs
to look into factors that may contribute to their well-being. One such factor is the stage of migration
they are in and the issues and demands associated with each phase. The most frequently identified
issue and resource needed during pre-migration center on finances needed in the application process,
screening procedures, travel documents and others. During migration (being on site) the concerns shift
to homesickness / loneliness, adjustments, work environment and workload. While majority stated that
they did not encounter any issue during the post migration phase (upon returning home to the Philippines);
some still identified financial issues, as well as strained relationships with family members, as prevalent
problems.
The aforementioned differences in the identified mental health needs and issues along the different
stages of migration are also reflected in the variations in the manifestations of stress reactions when
the participants are abroad and when they are in the Philippines.
It is important to note that though some of the identified reactions were the same, the ranking of these
physical manifestations changed. Additionally, the number of symptoms reported by the participants
decrease while in the Philippines compared to when they are abroad.
The same trend is also observed among the reported psychological manifestations of stress. One
conclusion is that differences in the expressions of stress – physical or psychological - may be related
to the shifts in the primary context (work or home) of the migrant worker. These must be considered in
the development of interventions for the mitigation of stress among members of the said population.
The need to address competing demands of their work abroad and their families in the Philippines is
another salient factor in understanding the mental health status of female migrant domestic workers.
The participants reported that they find it difficult to balance these two aspects of their lives. This may
be associated with the double burden faced by female domestic workers – where despite their ability to
contribute to the coffers of the family, they are still expected to fulfill their care-giving roles in their
families even if they are overseas. Relating these two demands to the experience of stress, more
98
respondents reported that their greatest source of stress while abroad is still stress at work , while
others identified stress from both work and home.
The women migrant domestic workers’ living and work condition(s) may significantly influence their
state of well-being. Very seldom does one focus on one single task; most of them are involved in
multiple tasks. Though majority of the participants said that they work solely in their employers’ home,
there are those who do work outside the household (such as for the employer’s parents or friends),
performing the same tasks without additional compensation. Such tasks, associated with nurturing and
sustaining families, are traditionally constructed as female roles. Thus the same roles that these women
left in their homes in the Philippines, are replicated in their work abroad. Even among the very few
respondents who reported that they have other sources of income abroad, most are engaged in part
time work consistent with these female roles.
Comparing the participants’ level of stress to their living arrangements with their employers, most of
those in stay-in arrangements rated their stress level from 3 to 5 (on a scale where 1 is low and 5 is
high). Though there were a small number of participants in live-out arrangements, it is interesting to
note the trend of their ratings, which were from 1 to 3. This shows that it is possible that the increase in
stress ratings may be associated with their living conditions. The stress level onsite may also be
related to the number of work hours a day which shows a general trend of having a high rating of stress
with working for longer periods a day.
Though women migrant domestic workers may have the legal right to avail of days off, some still do not
enjoy such a work benefit. There are also several ways of taking a day off – once a week, once a month,
once a year or accumulated days off used as vacation leave, among others. The latter shows how
devalued domestic work is, as it is not considered as productive work, time off from work is not something
that is considered to be essential in domestic work. Study participants’ responses show that having a
day off allows them to enjoy activities individually or with friends which facilitate their adaptation to the
demands of being away from home.
Perceived personal capacities in terms of physical health, ability to cope with stress and state of well-
being are factors that positively influence one’s ability to address stress. Most of the participants in the
study gave themselves high ratings which denote perceived positive state of health. Such could be
considered as a critical buffer to daily hassles and critical life events. Positive experiences also cushion
the negative impact of stress while working abroad. Among the participants, their stated sources of joy
and happiness centered more on positive relationships with family members, employers, employer’s
children, friends and fellow domestic workers. Though financial factors are also important, these seem
secondary to maintaining smooth interpersonal relationships with other individuals in different spheres
of their lives.
99
Mitigating the effects of stressors are the perceived benefits of working abroad. The female participants
in the study identified various advantages, foremost of which would be their capacity to send their
children to school and meet their families’ needs. Securing one’s future by saving and establishing their
own business, as well as having their own home was also mentioned. It is not surprising therefore that
despite the problems and stress encountered while working abroad, they still hope to leave again in the
future.
Another person-specific factor that affects the respondents’ experience of mental health issues and
concerns is the type of coping strategies to deal with stress. The most frequently used strategies
employed by the respondents in this research were: turning to religion, focusing and venting of emotions;
behavioral disengagement; mental disengagement; and seeking social support. Other responses also
include positive thinking, assuring oneself that one can do it, and fighting back when the employer
becomes unreasonable or abusive. Some avoid thinking about their problems by keeping themselves
busy and concentrating on work. Though the latter may not be an effective way of dealing with stressful
situations, it may provide the individual with short-term respite from emotionally challenging situations.
The appropriateness of the strategy employed depends on its impact in promoting positive mental
health.
If positive experiences mitigate the negative effects of stress on well-being, some negative experiences
aggravate threats to wellness. One such threat includes restrictions and abuse. The range of restrictions
and abuses reported by the participants vary from the behavioral and psychological to sexual. Some of
these restrictions and abuses are overt while others are not. The experiences of abuse have far reaching
effects according to the participants. Some respondents say they are still experiencing the resurgence
of the emotional and psychological pain brought about by the abuse even after coming back to the
Philippines.
The presence of social support networks while working abroad must be considered as well. It was
observed in the study that such networks were apparently related to lower ratings of stress. Most of
those who reported that they do not have any source of support rated their stress level from 3 to 5.
Participants noted the mitigating effects of the presence of their families, friends and co- workers, when
they are faced with stressful life events and problemsLastly, access to healthcare and health seeking
behavior are critical factors to consider. Many of the respondents reported that they have health insurance,
yet most of those who experience getting sick did not avail of health services. Most rely on themselves,
while some depended on friends and co- employees. Self- medication seems to be an acceptable
practice in dealing with health problems. These health seeking behaviors may be due to cultural barriers,
lack of information on health services, restrictions posed by employers in accessing services and
participants’ own fear of getting terminated if they are found out to be ill or unwell.
100
One interesting observation in the study is the possibility that certain factors may affect or co-vary with
female migrant workers’ experiences of stress and positive mental health. These include life stage,
current work status, specific work conditions (such as days off and work duration) and country of
destination. It would be important to pursue these in succeeding studies to determine the extent of their
influence and impact in promoting positive mental health and well-being.
Given these findings, recommendations are drawn along three areas: policy, research and program
development and intervention. Specifically, these are: (see how they are aligned with the POI
On policy development and implementation
• Enforce policies protecting the rights and welfare of women migrant domestic workers (such as
the Migrant Workers Act of 1995 (RA 8042); the Amended Migrant Workers Act (RA 10022);
POEA guidelines and other strategic policies)
• Review current policies in relation to health and migration, specifically the Philippine Mental
Health Policy Framework, and support the call for the enactment of a National Mental Health
Act that would incorporate the issues and concerns of migrant workers.
• On research
• Conduct of cross-cultural research on migration and mental health (i.e., on site research that
will look at the relationship of culture / context / condition in the host countries and mental
health of migrant workers)
• Conduct of research on the mental health status and needs of children (family) of women
On programme development
Pre-departure
• Integration of mental health on programming of relevant government agencies such as the

Department of Education (Dep Ed) and Department of Social Welfare and Development (DSWD),
among others
• Incorporation of mental health topics in the modules of the Pre-Departure Orientation Seminar
(PDOS)
• Training of PDOS providers on mental health topics and concerns
• Integration of counseling / psychosocial intervention in the training of foreign service personnel
• Participation of family members in the PDOS and other trainings such as financial literacy
101
• Assessment of mechanisms being used to identify mental health needs of OFWs and how
they are being responded to (in relation to the conduct of psychiatric tests that if an applicant
fails the test, s/he will not be able to work abroad because of being “unfit to work”)
On site
• Setting up of referral mechanisms that will respond to the mental health needs of women
• Making services available for women migrant domestic workers
• Mapping of services
• Provision of continuing support to families of women migrant domestic workers through
organizing, training, counseling, among others
Upon return
• Provision of services to women migrant domestic workers and their families (livelihood,
counseling, among others)
102
References
Alcid, M. (2007). Diaspora: Moving beyond minority status. Women in Action. No. 3, 2007. Isis
International
Bee, H.L. / Bjorklund, B.R (2004). The Journey of Adulthood, 5th edition. Upper Saddle River, NJ: Pearson
Prentice Hall.
Bhugra, D. and Jones, P. (2001) Migration and Mental Health. Advances in Psychiatric Treatment.
CARAM Asia.(2002) Regional Summit on Foreign Migrant Workers: Report. Kuala Lumpur, Malaysia.
CARAM Asia (2005). Domestic Workers and Health. Kuala Lumpur, Malaysia
Carballo, M. (2007). The challenge of migration and health. International Centre for Migration and
Health (ICMH).
Carver, C.S. Scheier, M.F. and Weintraub, J.K. (1989). Assessing coping strategies: A theroretically
based approach. Journal of Personality and Social Psychology, 56, 267-282.
Commission on Filipinos Overseas. Stock Estimate of Overseas Filipinos (as of December 2009). http:/
/cfo.gov.ph/pdf/statistics/stock%202009.pdf.
Conde, B. (2004). Philippines mental health country profile. International Review of Psychiatry, 16 (1-
2), 159-166.
Constable, N. (1997). Sexuality and discipline among Filipina domestic workers in Hong Kong. American
Ethnologist 24 (3): 539- 58.
Constable, N. (1999). At Home but Not at Home: Filipina Narratives of Ambivalent Returns. Cultural
Anthropology 14 (2): 203- 28.
Constable, N. (2002). Filipina Workers in Hong Kong Homes: Household Rules and Relations. In:
Ehrenreich, B. & A.R. Hochschild (eds) (2002). Global Woman: Nannies, Maids, and Sex Workers in
the New Economy. Granta Books, London.
Dehle , C.; Larsen, D. and Landers J. (2001) Social Support in Marriage. The American Journal of
Family Therapy, 29, 307-309.
103
D’Souza, A (2010). Moving Towards Decent Work for Domestic Workers: An Overview of the ILO’s Work
. International Labor Organization. Geneva
Enriquez, V. (1989). Indigenous Psychology and National Consciousness. Institute for the Study of
Languages and Cultures of Asia and Africa (Tokyo).
Fuster, JM (2002). Frontal lobe and cognitive development. J. Neurocytol. 31, 373-385
Gutierrez, F.; Peri, J.M.; Torres, X.; Carseras, X. and Valdes, M (2007). Three dimensions of coping and
a look at theories of evolutionary origin. Journal of Research in Personality, 41, 1032-1053.
Hanochi, S. (2007). Globalization and the hidden insecurity of women migrants. Women in Action, 3,
26-34.
International Labor Organization (2010). International Labor Migration: A Rights-Based Approach. Geneva.
International Organization on Migration (2005). Migration Health Report. Geneva
Jiang, S. and Winfree, LT. (2006). Social support, gender and inmate adjustment to prison life: Insights
from a national sample. The Prison Journal, 86 (1), 32-55.
Lazarus, RS and Folkman, S. (1984). Stress, Appraisal and Coping. New York: Springer.
Mayor, Ross. (2008) Untangling the Mental Haywire. Health Alert Asia Pacific edition (Manila: Health
Action Information Network
Murakami, Y. (2009) Cross – cultural factors in workers’ mental health from the experiences of EAP
services. World Cultural Psychiatry Review. January, 60-64.
Ohara – Hirano, Y (2000). Cognitive life strains and family relationships of Filipino migrant workers in
Japan. Kyushu University.
Papalia, D. / Olds, S / and Feldman, R. (2007) Human Development, McGraw-Hill Companies.
Ramirez – Mechado, J. (2003) Domestic Work, Conditions of Work and Employment: A Legal Perspective.
International Labor Organization. Geneva.
104
Sanchez F. and Gaw A. (2007) Mental Health Care of Filipino – Americans. Psychiatric Services. Vol.
58:810-815.
Santiago, C.E. and Enriquez, V.E. (1976). Tungo sa MakaPilipinong Pananaliksik. Sikolohiyang Pilipino:
Mga Piling Papel, 1 (4).
Sobritchea, C. et al. (2010) Health of our Heroes: Qualitative Study on Access to Sexual and Reproductive
Health Services and Information of Women Migrant Domestic Workers. Action for Health Initiatives Inc.
(ACHIEVE). Manila.
The Women’s Foundation (2006). The Status of Women and Girls in Hong Kong 2006. Hong Kong: The
Women’s Foundation
United Nations (2008). International Migrant Stock: The 2008 Revision. Accessed 19 November 2010
from: http://esa.un.org/migration
United Nations Development Programme (UNDP 2009). Overcoming Barriers: Human Mobility and
Development. Human Development Report.
Wolffers, I. and T.M. Painter (2002). Programs for Mobile Populations and their Partners. In: P.R.
Lamptey and H. Gayle (eds). HIV/AIDS prevention and care in resource-constrained settings: A handbook
for the design and management of programs. Family Health International, Washington. 229-257.
Zahid, M. Fido, A. Alowaish R. Abd El-Motaal Mohsen M. Abdul Razik M. (2003). Psychiatric morbidity
among housemaids in Kuwait. III: Vulnerability factors. International Journal of Social Psychiatry 49 (2):
87-96.
Conferences
8th Regional Conference on Migration (2002). Migration and Migrant Workers’ Health and Well- being.
October 8 – 11, 2002. Dhaka, Bangladesh.
7th Regional Conference on Migration (2001) Devloping National and Regional Advocacy Agendas on
Migrants’ Human Rights. June 13-16, 2001. Jakarta, Indonesia.
On-line materials
www.un.org/esa/population/publications/ittmig2002/WEB_migration_wallchart.xls Accessed Dec 2003
105
Annexes: Case Studies

Myra’s Story (Cebu)
Myra (not her real name), is 28 years old, a Roman Catholic, and a high school graduate. She
lives with her parents in Cebu City and is the youngest of six siblings. Myra’s parents are not
engaged in any income-generating activity, while her unmarried siblings (a sister and a brother)
have irregular incomes.
Although unmarried, Myra has two children with a common-law husband. Myra got pregnant at
age 19, prompting her and her boyfriend to live together, but the relationship lasted for only
three years. He was unemployed and spent most of his time drinking with friends. The separation
did not come easy for Myra because they have children, and the man was not supporting the
family. This lack of support was one of the reasons why she decided to work abroad. She felt
bad about what had happened, but the desire to move on for the sake of her children and family
was greater.
At the time of the interview, Myra worked as a contractual worker in a local company. She was
earning PhP150 (about 2.50 euro) per day, amounting to roughly PhP3,000 (49 euro) a month.
Despite the insufficient income, she claims it is a job that does not require college education.
Her contract is renewed every six months, contingent upon the recommendation of her immediate
supervisor. Myra has been working there for almost a year now.
Seven years back, a female friend informed her of a notice posted by a recruitment agency
recruiting domestic workers in Lebanon at the barangay hall, (“Nangita ko’g trabaho pero wa
koy masudlan, usa kaadlaw, ang among silinga’ng amiga nakakita nga naay gi post sa barangay
hall ang agency nga nangita og domestic helper para Lebanon). Interested, she went to the
agency, was interviewed and was accepted. However, when it came to procuring the required
documents and going through the procedures (such as passport, birth certificate, and medical
examination), her money was not enough to defray the related expenses.
Myra approached her parents and suggested that they borrow money (PhP6,000 /US$133.33)
from a relatively well-off neighbour, with their house as collateral. For fear that Myra might not
be able to repay the loan or redeem the house, her parents did not agree. Eventually, and after
she made a promise that she will work hard abroad to settle the obligation, her parents approved.
Myra recalls having undergone various medical examinations, such as tests for pregnancy,
sexually transmitted infections (STI), HIV, hepatitis B and C, dental, eye / ear / nose / throat,
urine, stool, blood, drugs, and was also subjected to X-ray and general physical examinations,
and psychological evaluation. The results were made known to her by the agency. [Even during
the migration stage, Myra recalls again undergoing pregnancy and urine tests.]
106
Upon completion of the requirements, Myra was given a two-year working visa as a domestic
worker. Together with other applicants, she participated in a series of lectures reportedly initiated
by the agency. These covered the following topics: health information, remittance of money,
how to save money / earnings, the culture and laws of the host country, travel rules and
procedure, cultural adaptation, language and coping mechanisms. She also claims having
participated in the Pre-Departure Orientation and Seminar (PDOS), but could not say whether
she underwent training with the Technical Education and Skills Development Authority, (TESDA).
She stayed in Manila for three months, waiting for the agency to inform her that they have
found an employer for her. Due to the high cost of living in the city, Myra asked her mother to
borrow money (PhP2,000 / US$44.44) again from the same neighbor, bringing their debt to a
total of PhP8,000 (US$177).
Finally, the agency found her an employer in Lebanon, and Myra was scheduled to leave soon
for Lebanon.
It was stipulated in her first contract that she would be receiving a monthly salary of US$300
(roughly PhP13,000), and one day off from work. She knew however, that she would only be
receiving US$150 / month (PhP6,900) because the agency informed her that the $300 was
only on paper, to comply with immigration and POEA requirements, and not her actual salary.
Myra accepted the arrangement because she was anxious to leave and work in another country.
Myra recounts the sources of stress in the pre-migration stage: separation and lack of financial
support from her partner; lack of resources to support parents’ and siblings’ needs; and, expenses
for the working-permit requirements. Myra repeatedly cited her concern for the welfare of her
two children and her love for her parents and siblings as the primary factors which gave her the
courage to go through life despite the many emotional and financial difficulties).
To cope, she listens to the radio and talks with her children. She also says the love and
support obtained from her parents siblings, especially her sisters and friends have contributed
to her well-being.
Her family, she says, is the main reason why she decided to work abroad. In her words, “I know
how difficult it is to live in another country, but I have no choice because we are in need; what
will we eat if we insist on the work we want?” From 2005 to 2007, Myra, then aged 23, worked
as a documented domestic worker in Lebanon earning a monthly income of US$150 (about
PhP7,000). Her duties included washing and ironing clothes, cooking/preparing food, cleaning
house, and taking care of the sick (the sister of her male employer).
107
When she first met her employers, she expressed gratitude for being chosen among all
applicants. Myra said she appreciates how her female employer treated her. There were times
when she would ask Myra about her life back in the Philippines, and they would laugh together.
During the first few days of her stay in Lebanon, Myra was apprehensive, because of the on-
going war in the country. She said she was so scared; her body was always shaking from too
much nervousness
Her male employer’s sister, she claims, was also good to her, and advised Myra to drink a
glass of water with sugar to ease the nervousness
Apart from nervousness, Myra had to work 21 hours a day, leaving room for only three hours of
sleep. Her employers did not go to bed, which also kept her up, for fear that she might be
reprimanded. Although she claims she had never been sick in Lebanon, she admits she was
always feeling very tired.
Limited food and constant hunger was another concern in Lebanon, but she was able to find a
way to address this. Oftentimes, she would secretly sneak in bread and a glass of milk inside
the toilet..
In Lebanon, she was not given a day off from work, contrary to what was stipulated in the
contract. However, she did not mind it since she was also afraid to go out
When asked about source(s) of her strengths and why she was able to handle the difficult
situations, Myra points to her children, family, and her obligation to repay her debts in the
Philippines. Instead of thinking about the difficulties faced, she would listen to music (what she
usually does in the Philippines) to ease fatigue or, just stay in bed to relax. To cope with
loneliness, she would call and talk to her children and parents.
This is what she had to say when asked why she did not complain, “I needed the job. It was my
decision to work abroad. Problems have solutions and “I did not mind the heavy workload
because the pay was good”.
Aside from her family’s moral support, she says her lady employer and male employer’s sister
were supportive of her financial needs.
Myra concludes this part of her story by saying that in Lebanon (and even Romania) what
made her forget about her loneliness was when she had sent money to the Philippines
108
Despite completing the two-year contract in Lebanon, Myra’s employer did not want her to
leave the country thinking that she might not be able to come back. They had Myra extend her
stay for four months and assured her that they will find a way to get her a tourist visa.
When her employer’s brother from Romania came to visit them, he offered to get Myra a two-
month tourist visa so she could go to Romania temporarily to work for them as a domestic
worker. The brother offered Myra higher pay (US$300 / PhP13,800). This was the primary
reason she did not have second thoughts about accepting the offer. Her new employers were
able to secure three consecutive two-month tourist visas, resulting in Myra’s six-month stay in
Romania, Lebanon and again in Romania.
She was grateful for the work because she needed the money, she was not ready to return
home given the many financial obligations, and because she was assured that her employer
would handle the needed papers. She admits that she also enjoyed the travel and the opportunity
to see other places, including the experience of riding on a plane. A domestic worker with an
expired visa is not easy, she continues. They are sent to another country, as a tourist, to avoid
apprehension or deportation. They do not have any legal protection if they fall into the hands of
a bad or abusive employer
If an undocumented domestic worker experiences physical abuse, she would not find it easy
to report the matter to the Philippine embassy. This is one reason why some women return
home to the Philippines with physical injuries, or why they run away.
Myra tells a story of how she was treated by her male employer in Romania at the time her
tourist visa was about to end. It started when she accidentally damaged the glass frame in the
living room. She admitted her mistake and told the male employer that she was willing to pay
for the damages. But without saying a word, he grabbed her hair forcefully and hit her strongly
in the face with his fist, drawing blood as a result.
She says that, at that time, she was a willing victim because he obtained her a tourist visa and
she was receiving a higher monthly salary The higher salary encouraged her to stay despite
her being undocumented and maltreated. She did nothing because, at the back of her mind,
she needed the work so she could save money
Sometime in 2007, her employer in Romania decided to get Myra a two-year working permit.
Again, it was the higher pay (US$300 / PhP13,800) that made her accept the offer.
109
Document requirements were processed by the employer without Myra having to pay for
expenses incurred. Her work covered house cleaning, fetching water, baby sitting a female
child, cooking, washing, and ironing.
Similar to her situation in Lebanon, Myra had to work 22 hours a day, something which she
claims she already got used to. Caring for a child – which included, bottle-feeding and changing
diapers – contributed to her lack of sleep. Food was strictly limited to bread, unlike in Lebanon
where she had the chance to eat other kinds, albeit inadequate. To deal with this, Myra would,
like before, secretly eat bread and milk in the toilet whenever she felt hungry.
According to her, work in Romania as very tiring not only because she had to make sure that
the needs of the employer’s child were properly attended to, but because she had to fetch
water from the 2nd floor of the building (where the source of water is located) and bring it up to
the 4th floor (where they live). The difficulties, however, did not prevent Myra from fulfilling her
obligations. When loneliness crept up, listening to music and talking to her parents and children
on the cellphone made her feel better.
Morale boosting and other support in this case came from one of Myra’s married sisters.
Whenever she is delayed in sending money, she would ask that sister to take care of her
children’s needs. There were also times when she had asked money from her lady employer
whom she describes as a good person (“Ako, og magkaproblema ko’g kuwarta, makig-estorya
gyud ko sa akong amo nga babaye sa Romania, dili gyud ko molimod niya og estorya kay
maayo ra man siya nako, akong ingnong nga gusto ko magpadala og kuwarta sa Pilipinas kay
nagkinahanglan sila, pero og dili sila mosugot, dili man sad ko mamugos”).
Aside from other Filipino female domestic workers she met at the playground, Myra claims
she enjoyed the company of the child she was babysitting, which really made her happy.
She also had the opportunity to meet other Filipino women when her employer’s family went to
the beach. There they exchanged stories, including experiences as domestic workers.
Looking back, Myra says that the worrying about how her family was doing created more
anxiety than the difficulties she faced abroad (“Pero di gyud nako malikayan nga mas kapoy
huna-hunaon ang pamilya kaysa trabaho, mas bug-at ang problema sa pamilya”).
Eventually, Myra finished the second contract, but her employer extended her stay for another
four months. Within this period, her male employer hit her again in the face, again causing
bleeding. This time, she ran off and reported the incident to the Philippine Embassy (“Iya
110
nasad ko’ng gisumbag sa nawong nagkadugo lang gihapon ko, nilayas ko, niadto ko sa
Philippine Embassy, ni reklamo ko sa akong nawong nga nahubag”).
To her dismay, she was discouraged from filing a case, and was told that processing of her
departure documents will take a much longer time (“Pero giingnan ko sa Philippine embassy
nga kong mo file ko og kaso dugay pa ang pag process sa mga papeles.”). Convinced that the
Philippine Embassy could not do anything to help her, Myra decided to go home.
Finally in 2009, Myra returned to the Philippines with only US$300 (Php13,000) in her pocket.
She was frustrated to know that her parents were not able to save the monthly allowance she
sent them. Her siblings were unemployed, and she was had no choice but pay the debts After
all the years abroad, Myra said she lost weight as a result of lack of sleep and rest, both in
Lebanon and Romania.
The money she had was not enough to pay the debts, forcing Myra to pawn all the jewelry she
bought in Lebanon and Romania
To avoid dwelling too much on her negative experiences, Myra would just go for leisurely walks.
“Now that I am here, I have no master” Her family is still her source of emotional support,
including her married sister who has become the go-to-person whenever she needs money.
When asked whether she has any plans of working abroad again, she replies “not in Lebanon
or Romania, maybe in some other place when given another opportunity. She complains about
her inadequate income at the company which is not sufficient to make both ends meet. She
does not however intend to reapply soon saying that she still wants to have more time with her
children
111
Naty’s Story (Davao)
A. “I will have my own restaurant in the City.”
Naty (not her real name) is 42 years old, with four children from her first marriage. She now lives
in a city in Mindanao with her partner, his daughter, and her daughter. Before going abroad, she
lived and tilled a farm owned by her parents in North Cotabato. Aside from farming, she also
worked in a rubber plantation, tapping rubber trees. As far as she could recall, she had been
farming and tapping rubber trees with her family. It was a hard and back-breaking work, especially
when the rains came and they had to rush to collect the rubber tree “milk”, lest the rain would
wash it all away.
One day, she learned that working abroad paid big. Thus, she vowed, “I will go abroad and put
up a restaurant in the City,”. Not long after that, she heard on the radio an opportunity to fulfill
her dreams. Greenfield Recruitment Agency (not its real name) announced that that they were
looking for overseas contract workers to work in Kuwait and that no placement fees will be paid.
For Naty, that would mean two hundred dollars a month - sufficient to start a new restaurant.
She immediately went to the agency. It was March 14, 2005.
Naty passed the interview and submitted the necessary documents (birth certificate, passport,
NBI clearance, among others). On March 30, the agency asked her to go to Manila to undergo
the Pre-departure Orientation Seminar (PDOS) and medical examination. She did not go through
Overseas Workers’ Welfare Administration (OWWA) because, according to her, it was not
required at that time. She left the country spending only a total amount of PhP6,000 (US$133.33)
for the processing of the documents and air fare to Manila.
Naty left the country on June 19, 2005 and arrived in Kuwait, received by an agency there. The
contract she signed in the Philippines was for two years, entitling her to receive US$200 (about
PhP10,000) a month.
The agency in Kuwait, however, did not disclose the full terms of the contract. Instead, she had
four employers and received a monthly salary of 45 Kuwaiti Dinar (KD) or PhP8,100 only. Her
first employer paid the IQAMA (work permit), worth 350KD to the agency in Kuwait. The IQAMA
was only good for six months. Her second employer took out IQAMA for one year and paid the
amount of 400KD. The third employer did not pay for the IQAMA and she stayed for four (4)
days before she was returned to the agency without any salary.
112
The fourth employer was her most horrid experience. In her entire stay of 14 months, her salary
was never paid and she was beaten and locked up by her female employer.
During the interview, Naty smiled during some phases of her story. Toward the end of her
narration, she broke down and said, “When I retell this story, it feels like it was happening
again. I could feel the pain I felt then.”
This was how her story started.
When she arrived in Kuwait, her first employer chose her from among the domestic workers in
the agency. They paid the IQAMA of 350KD for six months of work. The family that Naty worked
for was Kuwaiti and occupied the third floor of the house of the male employer’s mother. Her
main task was to care for their two-year old son 24 hours a day; her other tasks were to wash
and iron clothes and clean the three floors of the house. She did not need to cook as the
household took their lunch in the unit of the employer’s mother. They ate a full meal during
lunch only and had bread for breakfast and for dinner. Since there was only one full meal a day,
Naty ate as much as she could during lunch so she had enough energy to do her tasks.
Most of the time, she was left alone with her male employer because the wife was still studying.
It was during these moments when her employer tried to sexually molest her. The employer
would ask her to massage him while he wore only a face towel. If she refused to massage him,
he threatened that he will rape her. When her employer became insistent, they would chase
around the house. At times, she would slip on the stair in her efforts not to be cornered. She
would also grab the sleeping child and use him as her shield or she would cry, and then her
employer would back away. “When the Filipina cries, they take pity. He would then draw away,”
according to Naty.
These incidents started during her second month at work. She begged her employer to return
her to her agency. But she was asked to pay the 350KD that they paid for her permit so she
endured her situation because she could not pay the amount. She shared her situation with
another Filipina domestic worker employed by the mother of her employer. She learned that no
domestic worker stayed for a long time with her employer because of his behavior. She tried to
tell the wife also but she said that she sided with her husband and did nothing about the
situation.
One good thing with her first employer, Naty says, was that she regularly got her salary for five
months. The employer did not pay her first month’s salary - an agreement between her employer
and the agency. She remitted all her salaries, except the last month, to her family in the
Philippines.
113
Since she was not allowed to go outside the house, her employer sent the money himself and
paid the transfer fee of 2KD, but Naty was asked to keep this information from his wife or she
would get angry. Her employer offered to make her his second wife because he really wanted to
marry a Filipina. He wanted a Filipina wife because Filipinas are attentive and his wife was only
23 years old and was always out. At the end of her 6-month IQAMA, she was returned to her
agency.
Upon her return, her money, cell phone, and other belongings were taken by the agency. To be
employed, she underwent the same process as with the first employer. Naty said, “We were
like piglets that they will select from. We sit (in a corner)…then they will ask us to walk.” When
the employer has made a selection, they will then pay the IQAMA. This time, her second
employer paid the IQAMA of 400KD and for one year. Each new IQAMA, her employer paid
100KD higher.
Her situation was no different. The male employer also molested her. When asked if she was
raped, she evaded the question. The male employer, also a Kuwaiti, worked for the boat industry
and would be home for two weeks each month, while her female employer went to work everyday.
Even though she had a separate sleeping quarter, and was able to lock it when she slept, her
employer used a duplicate key and did whatever he wanted. At times, she would wake up with
him touching her. Since the employers’ two-year old daughter slept with her, she would tightly
embrace the child to stop her employer from what he was doing. Sometimes, her employer
would also open the bathroom while she was taking her bath. At this point, Naty expressed
what she thought of her employer, “He is a pervert! During winter season, from November to
March, he becomes more perverted.” she added.
On her ninth month, she begged her employer to return her to the agency. They did not want to
let her go because nobody would take care of their daughter. She was also asked to pay the
whole amount of the IQAMA before they released her. She again had to wait out the term of her
work permit, when she was freely released.
Meanwhile, to cope and to save her, “I ran and ran. I ran and ran. Then I would grab her
daughter whenever his perversion attacked again. Whenever I slept, I had three layers of
clothing so he cannot easily touch me.” One time, she hid under the TV shelf and he grabbed
her feet. She kicked him and begged him saying, “I came here to work only because I have to
feed my children.” He would usually withdraw and apologize, especially whenever she mentioned
her family and children. Her employer was also afraid of his wife so he could not fully molest her
whenever the wife was around.
114
At the end of the IQAMA with her second employer, she was returned to the agency. They
allowed their daughter to hug her and they stayed for an hour in the agency so the child could
fully bid her goodbye.
Back at the agency, she stayed for another three days before the third employer came. However,
it was not full-term employment. No contract was signed, and after three days she was returned
to the agency. She was just made to clean the stock room without pay. This was apparently a
common practice because Naty said, “That was how it was. (They) will get you in the agency
and observe you for five to nine days. If they don’t like you, (they can return you). Some abuse
this privilege (in order to get services for free).” Naty complained this practice to the OWWA in
Kuwait.
Naty’s fourth employer was an Egyptian and his third wife. “Very horrible sadists,” was how
Naty described them. The husband lived on the first floor with the first wife and on the second
floor lived the second wife. Her employer had four children, aged 15, 12, eight and five years old
respectively.
From the time her employer took her from the agency, Naty was locked up in the ceiling of the
toilet. Her first eight months were spent near the heater and exhaust airconditioning exhaust.
She described it as being like in an airplane day and night from the noise. The flooring was
sand so that she was like a dog covered with sand everytime she woke up. The room was very
dark and she saw no light while inside. The space was only enough for her to sit up or lie down.
She had no beddings and had to urinate where she was sitting.
To get above the toilet, Naty had to use a table and when she was going up her employer poked
her backside with a broom. For another six months, she was moved down and slept beside the
toilet bowl without a mat and blanket.
She was only allowed to go out for three hours whether the work was finished or not. Without
any word she would do laundry, iron clothes, clean the house, and wash dishes. While she did
her work, her employer sat by the door to guard her.
While locked up, she talked to no one and was not seen by anyone. She did not even see the
sun nor know the time and day. She would only learn the date when the children change into
their uniforms in the bathroom.
She was locked up to prevent her from escaping and to prevent her male employer to see signs
of her maltreatment. Her employer feared her escape because they could not afford to give her
115
salary. They relied only on the monthly government subsidy for each of their children and the
free food commodities they received.
Not only was she locked up, her employer also severely maltreated her. According to Naty:
“I was physically maltreated. I was locked up...Scratched, slashed with a knife. My arms were
pricked with a ballpen or fork. Pushed around. She would make me (clean the floor) and throw
a strong powder soap and a gallon of acidic cleaning agent...I wrung the (rug). Then my face
was pressed on the floor. I would be thrown grounded red chili, 1 jar, or ground pepper...my
head and face felt hot. Thus, I cried and cried because it was very hot. I was like a child who
was begging. I was like a two-year old.
“I was very thin because she did not let me eat. Then I was all bruised. Both arms were like an
eggplant, very black. My head was burnt from the chlorox (acidic reagent). The chlorox trickled
down my head. I just closed my eyes.
“She was happy when she saw me suffering with pain. She then sang. I was dipped (in the toilet
[bowl]) then she pulled my hair and flushed it in the toilet. I got bald at that time. Then she
would laugh, dance, and rejoice.
“My whole body ached. Painful, especially when she kicked my ribs when I was carrying seven
carpets. I was very thin and bruised all over. I had no slippers. I did not change the uniform I
wore for 14 months. It was threadbare.”
During that period, Naty’s meal would usually consist of only a piece of bread, which was
slipped in the hole where she was locked up. No potable water was given and she drank the
salty water from the faucet. She drank as much as she could that sometimes her stomach
trembled when she hung the laundry. Then her employer would eat her meals in front of Naty,
just for spite. There was a time when she did not eat anything for seven days.
She became terrified of her employer that everytime she heard her voice she panicked and
prayed for God’s help. She felt as if she was going crazy.
Throughout all that she experienced, Naty said, “But with God’s mercy, I did not get sick even
a little...I just prayed to God. I was like a child. I prayed that He remove me from this house,
this hell. I prayed all the time.” She felt she was protected by God that she suffered no major
injuries, even when her employer pushed her on the stairs. Her employer was also wary of her
because no matter how Naty was hurt she would stand up. One time, her employer tried to
stab her eye with a pen thinking she had the power of the Evil Eye.
116
Besides praying, Naty would sing religious songs softly. This calmed her mind and lightened
her feeling because she felt that God listened to her songs. This is also her way to entertain
herself. In the process, she would fall asleep and dream of delicious food and of places or of
going home to the Philippines. When she woke up, her flesh felt like being electrocuted due to
hunger.
Finally, Naty had a chance to escape. Her employer was in deep sleep. She knew that the key
to the door was tucked in the sleeper’s waist. Naty took a knife and was about to stab her
sleeping employer. But the knife fell and her hands trembled. She realized she could not kill a
person even if it meant freedom for her.
Another opportunity came and, this time, she grabbed it without hesitation. It was two in the
afternoon and the family was having lunch in the living room. Her employer ordered Naty to
come outside and do the laundry. She went out to the living room and saw that the door in the
first floor was open. She ran as fast as she could and flew down seven flights of stairs, out of the
open door. She shouted to the husband that she could not take it anymore and would die in
their house. They were shocked and were not able to move or say anything, especially when
they saw her bloodied, bruised, and swollen flesh. Once outside the house, she immediately
flagged a taxi and went straight to the Philippine Embassy.
Once Naty saw the Philippine flag and stepped into the Embassy premises she felt as if she
was already back in the Philippines. She felt relieved and joyful when she saw Filipino faces.
She was very nervous when she arrived, and this lasted for a week. Although she had reached
third year high school, she even forgot how to spell ‘month’ while making her sworn statement
at the Embassy. After the legal business was taken care of, the Embassy staff turned her over
to the OWWA center, where she was dressed, fed, given first aid, and finally allowed to sleep.
Rested, Naty afterward recounted her story with a staff who counselled her. Her medical
examination was postponed while her more serious injuries – head fracture, burns and intense
fear – were attended to.
During the months she stayed with her last employer, her family in the Philippines sought the
assistance of OWWA and POEA in Davao to find her. Flyers and TV missing person
announcements were broadcast. When she arrived in OWWA-Kuwait she had to call home to
assure them that she was still alive and safe.
In her stay in OWWA-Kuwait, Naty found somebody whom she felt like a mother to everyone
there. This person made them laugh, talked to them, gave them counsel, and provided physical
therapy. She felt more comfortable because of this motherly figure.
117
After a month’s of stay in OWWA, she received a subpoena. Her employer filed a case of
absconding against her. She was imprisoned for one month and transferred to about five different
prisons, but she can only remember two (Sulay Biya and Talha). She stayed for two weeks in
Sulay Biya. The last prison where she stayed most of her one month was Talha, which she
compared to the National Penitentiary in the Philippines. When they arrived in each prison,
they were led nude to three different sheds for thourough inspections.
In jail, she cried and prayed a lot and preferred to be by herself because she did not want to join
her inmates whose topic of conversations were mostly about their boyfriends. She did not feel
any danger inside as long as she behaved formally. Otherwise, the prison guards would sexually
abuse an inmate, which she knew happened to many of her inmates. Food was sufficient, with
ample rice, chicken and a piece of fruit the usual meal. However, hygiene was a problem
because all inmates in one cell shared one toothbrush and one underwear.
About six Embassy and OWWA staff visited the Filipino inmates twice a month to bring them
food, medicine, and toiletries. These provisions were shared by the Filipino inmates with those
of other nationalities, especially Indonesians and Indians, who apparently were not visited by
their embassies.
During jail visitations, OWWA staff would ask them whether they wanted to continue working
abroad or go home. Naty, for her part, asked what would happen if she decided to stay and file
a case against her agency and her last employer. She was advised that she may stay longer in
jail if she decided to take these actions. Given the situation and possibilities, Naty decided to
go home.
Fortuitously, a Filipino reporter in one of the major media networks in the Philippines came
across her story and interviewed her while she was still in OWWA-Kuwait. The reporter gave
her plane ticket back to the Philippines.
Once she was released in prison, her belongings and passport were given to her. On the way to
the airport, they were escorted by policemen. This was how Naty recalled that day, “We were
like pigs that were transported in a vehicle with barbed wire. What we went through was too
much.”
Naty also saw a lot of OFWs who had been staying at the OWWA center for a long time, still
waiting to be returned to the Philippines. Some had given birth and were raising their children in
the shelter. OWWA provided milk and vitamins to the children and supported mothers with a
livelihood program on rug making and selling blankets.
118
Naty arrived in the Philippines wearing the same uniform she wore for 14 months. She stayed
at the OWWA center for a month until her wounds healed and was ready to go back to her
family. This time, she did not call her family because she could not get herself to talk. Instead,
she would constantly cry.
Part of the healing process at the center was a daily check-up by a nurse every morning.
During meal times, a staff would also sit with her and talk to her informally. All they had to do
was to sleep and eat. The facilities were clean, so Naty was able to rest properly. She felt
happy because now she could talk and was surrounded by fellow Filipinos instead of seeing
only Arabs.
But she eventually got bored because she was used to working instead of doing nothing and
was glad to go home. Before finally going home to Mindanao, OWWA gave her a referral letter,
endorsing her for assistance to its Mindanao branch.
She went to the POEA and OWWA to avail of benefits due to OFWs. But, she could not get a
PhP50,000 (810.92 euro) loan because she had no collateral. This did not diminish her
determination.
Naty went to the National Labor Relations Commission (NLRC) and asked advice on filing a
case of unpaid salary against the local recruitment agency. NLRC told her that she needed to
get her own lawyer to fight the case. She went to the Mayor’s Office, and presented her case.
The Mayor sent her to the public attorney’s office where she was provided legal counsel. In the
process, Naty learned that it will be the agency in the Philippines who will have to pay for her.
She can no longer file a case against her agency in Kuwait.
At the time of the interview, Naty already won the case and the agency was asked to pay her
P130,000 (2,108.39 euro). However, the agency closed down, for reasons not specified, and
could no longer pay her.
In the whole process of gaining what she lost, Naty spent her nights in Rizal Park and walked
from office to office to save cost. During this time that Naty met her second husband who gave
her support. She decided not to go back to her family and lived with her second husband.
She missed her children and went to ask her only daughter to live with her in Davao City and to
continue her studies even if only through the Department of Education’s Alternative Learning
System.
119
To help support her daughter and her new family, Naty worksed at a canteen, where she earned
PhP120 (98 euro) a day working for nine hours, six days a week. Her daughter also worked in
another canteen and went to class every Saturday.
However, her daughter found the alternative learning system not enough to educate her and
wanted to attend regular high school. With this, a new vision was planted in Naty. She now
wants to work abroad again as a domestic worker but not anymore in the Middle East.
120
The Story of Gen
Gen (not her real name) grew up in Bacolod city, where she worked and studied at the same
time. It was hard for her to combine the two, so she dropped out of college after the first two
years.
Seeking to improve her life, Gen decided to go to Manila in July 1993. She was 22 years old.
Gen had little money left from her savings, but she did not want to inconvenience her parents.
An aunt in Manila who had a small business helped her out. It was hard for her to find a job in
Manila since she had no degree and spoke a local dialect. She knew few people and had little
money. She had to ask her aunt for money which made her uncomfortable, and kept in contact
with her parents through letters. Gen always told them that she was doing fine. For three
months she stayed in different places, alternating with her aunt and with friends from the province.
Gen eventually found a job in the kitchen of a fast-food restaurant through an agency. Everything
there was new for her, because she did not have any experience with cooking and was unfamiliar
with kitchen equipment and utensils.
Her six-month contract ended, and the restaurant hired her as a regular employee, doing the
kitchen inventory. She was later promoted to an office position, eventually becoming manager of
one of the chain stores.
Gen liked her job and learned a lot. She was very proud to have gotten where she was, despite
the lack of a college degree. However she had difficulty dealing with her colleagues who sometimes
complained about her, something she would cry over. However, she had a good relationship with
her boss who supported and encouraged her, sometimes with financial incentives for ‘doing a
good job’.
According to Gen, one thing that could make her sad was if she did not accomplish her work for
that day. She said she had the tendency to always say “yes” to orders from clients, even when
they were too big to handle. This stressed her out.
Gen sent some of the money she earned to her sister in Bacolod City to pay for the latter’s
education.
As time passed, hard times affected the restaurant she was working in, causing her to consider
leaving to work abroad. Before she left, her boss asked her to assign someone to replace her.
121
This was a dilemma for Gen, because she found it hard to choose among her colleagues. As a
result, her co-workers started to distrust her and tried to influence her decision. They also held
her responsible for the replacement of five colleagues. Some would even threaten her.
Looking back, however, Gen considers her time in Manila a good experience. She stayed in
Manila for 10 years for the same employer and she had a satisfying social life.
When Gen decided to leave the company, she wanted to go to Canada or the Netherlands,
where she had an aunt who had been living there for 14 years but regularly visited the Philippines.
She wrote her aunt about her situation and asked whether her aunt and uncle could invite her to
come to Holland. They agreed and sent her an invitation, so she could apply for a visa. She
fulfilled all the requirements for the tourist visa and after it was approved she left for Holland.
This was in 2003.
When Gen arrived in Holland, she stayed with her aunt, who still spoke the same dialect
(Ilongo), which made the culture transition easy for her to deal with.
However, she says she did not feel like herself at that time, and experienced difficulty thinking
straight, feeling like her brain was empty.
Gen began to plan her next steps, since tourist visa was only valid for three months and staying
with her aunt’s family began to cause relationship strains. She was not comfortable being
around her uncle, who she said was always telling her what to do and watched her every move.
He sometimes talked to her in an angry way and used harsh words in Dutch, which she could
infer from the intonation. Her aunt apparently did not side with her and kept quiet when this
happened.
One of her coping behaviors was to go out of the house a lot. She met other Filipinas through
her aunt. She would go to a Filipino church and attend social gatherings.
She tried to stay positive and thought it was better to socialize and make friends. During that
time her uncle wanted to know whether she would stay in Holland or go back to the Philippines.
She decided to stay, because did not want to go home with no savings or earnings.
People told her it would be easier for her to stay if she had a boyfriend to support her. Her uncle
and other Filipinas suggested logging on to Internet chat rooms or putting out newspaper
advertisements to form relationships. Although hesitant, she decided to go along with their
advice.
122
Gen was convinced that in the end she would still be the one to decide if she liked somebody
or not. After that there were a lot of calls for her from several men. She was not sure about what
to do, because many Filipinas married men to get citizenship and residency documents. It was
a difficult decision for her, because she was concerned about her future. After asking her
mother for advice, she decided not to be with somebody she did not love. She would rather be
independent and support herself.
Gen decided to try and find a job. Because she did not have the necessary papers, the only job
she could get was cleaning houses. She asked help from her friends and found a job with a
family, which she liked a lot. They also referred her to their friends and colleagues, for whom
she could work for as well. As a result, she was employed by eight families.
Many of her employers are Americans temporarily working in the Netherlands for the same
company. Eventually, her contacts expanded to include four other families, all of whom Gen
described as “nice families”. Meanwhile she decided to live by herself.
Gen has been in the Netherlands for the past seven years. In the beginning, the work was
difficult for her, because it was heavy work, to which she was not accustomed.
However, she wanted to be a good cleaning lady and tried her best. On reflection, Gen says
accepting and loving your work makes the job easier. Other Filipinas come to her for help to find
a job. For her this is difficult, because she does not have papers. Sometimes she asks a friend
to help her with cleaning, so they can earn some extra money. She wonders why so many
Filipinas have papers but do not have a job and do nothing.
Not having papers creates many difficulties for Gen. For example, it is hard to access a bank.
She carries an ATM card in the name of her aunt, but she cannot put a lot of money in the bank
because her aunt has an ‘uitkering’ (disbursement). She also has to watch out for the police
and prays everyday that they don’t come to her. It is not easy to go to the doctor or the dentist
without papers; she always needs another person to organize this for her and set up an
appointment. Because she has gum and dental problems, the dentist asks her to come back
regularly, even if she does not have papers. She has a doctor and a dentist. Luckily she has a
friend who offered to help her out in these cases.
To have a working permit is one of Gen’s dreams. She is a member of the organization ‘Trusted
Migrants’, involved in such advocacy. She sometimes worries about other Filipinas who do not
have or make the time to take part in this or who prefer to stay out of sight. She thinks that if
you do not struggle for it (work permit) you will never get it. She is a member of the FNV as well
and pays her membership fee of 100 Euros. Aside from that, she does volunteer work at
123
Stichting Bayanihan to help fellow Filipinos. Gen also cares for her aunt, who is a cancer
patient.
Gen sends part of the money she has earned to her family in the Philippines, which she
considers part of Filipino culture. She does not worry a lot over them, but she explains that she
has to work for this money. She says they can manage themselves and her mother knows how
to spend it wisely.
However, if a family gets sick, this causes problems and they ask money from her. If somebody
is in the hospital, Gen feels that she can’t refuse this, because it may be a life or death matter.
In these cases she sends a small amount of money as a gift. She could not afford to give a big
amount, because people would not be able to pay it back. She does not want people to say she
did not help them in their hour of need.
Gen explains that if you have a lot of money in the Philippines, a lot of people will approach you
to ask for money. As a result, she never says yes immediately. She first asks borrowers what
they will do with the money and then thinks about it for some time. In some instances, she even
asks her sister for proof of where the money was spent, such as photographs or receipts. She
says she does this because she wants to be able to trust them with her money. Sometimes
she tries to find out discreetly who among them she can trust more with the money. Gen says
that even if they are her brother and sisters she needs to know this; she is far away, and has not
seen them for a long time. Even her father is not exempt. She sometimes asks what he did with
the money she sent over.
Gen divides her income between the Philippines and the Netherlands. She explains to people
in the Philippines that in the Netherlands, everything costs a lot and she needs to spend for
herself too. She also saves money for future needs.
When she first arrived in the Netherlands, one cause of stress for Gen was the lack of a job.
Another stressor was the lack of insurance. Because of this, she had to pay a lot of money out
of her own pocket everytime she went to the doctor, who she paid in cash.
These visits were frequent, since she has had a skin problem, even while in the Philippines. The
condition improved with the help of one of the Dutch doctors’ treatment. Apart from this, Gen did
not have many problems with her health since she came to Holland. A third stressor was her
aunt’s cancer. Her aunt had been a widow for the past three years and her relationship with her
daughter is not good. The aunt has also kept things from Gen and from her own daughter.
124
Gen tries to accept her aunt the way she is. She considers it her role to take care of a cancer
patient, even if her aunt had been dishonest with her. She often prays to God for advice and
consults other, more experienced, people. Gen tries to love her aunt, even though it is difficult.
She often calls her aunt to ask how she is doing; she takes her to the hospital and takes care
of her at home.
It is hard for her that her aunt has a negative attitude and never shows appreciation for Gen,
which makes it harder for her to accept her aunt. Her work takes her away from all the stress
at her aunt’s house. Sometimes, she feels guilty because her aunt is left alone. The worries
over her aunt are a big burden for her. However, she tries to stay positive by telling herself that
she should consider herself lucky because she is happy and has enough money; there are
many people in worse situations.
One thing that makes Gen happy is regular communication with her family. She lives alone in
her apartment and occasionally feels lonely and misses her family. She keeps in contact with
them through online chats.
Gen is busy all days of the week, which makes her happy. But, if she is tired, she listens to her
body and takes a rest. She feels lucky to have her own apartment, where she could relax.
Sometimes Gen prays for more strength if she is tired and wants to do something that is
important to her. Faith and prayer are very important to her. Gen goes to church once a month,
but attends bible-sharing sessions every week. She says she learns a lot from older Filipinas.
Gen also reads a lot, which helps her deal with stress. She also likes to be inspired by the
books she reads. Another de-stressor is talking with other people and “doing good things for
others”, which make her very happy.
In the winter Gen does not go out a lot, because of the cold. Temperature permitting, she
sometimes goes to a fund-raising dance. She also likes to do karaoke (sing-along) during the
weekend; she likes to sing, dance, laugh and go home with a smile.
Another thing that makes her happy is when her boyfriend visits her when he has time. He is
also a busy person and they each have their own lives. They see each other one or two times
a week. She often goes to Amsterdam, but sometimes he comes to Rotterdam to meet Gen’s
aunt. He often helps her out if they need to go somewhere by car. Her boyfriend is important to
her, because he supports her and she feels he is someone she can lean on. Financially she
does not need his support, because she has her own money. She met him three years ago
through a Christian website chat room.
125
Gen leads a very busy life, but tries to make time for everything and stay positive. She says it
helps her to accept the situation as it is, and that a person’s character and positive thinking are
what matter. Her mobile phone is open 24 hours a day. She does not go home until she has
accomplished her scheduled tasks for that day.
At the moment, Gen does not plan to go back to the Philippines, because she is taking care of
her aunt. She thinks it is God’s plan that she is in the Netherlands now. She plans to return to
the Philippines and together with her boyfriend, arrange for her visa to come back to Holland.
She also saved money for her visa expenses. She does not want rely on her boyfriend financially,
she reiterates. Gen also plans to study, in the Netherlands or in the Philippines. Eventually,
she wants to have her own property in Bacolod City.
Gen thinks it is very important for Filipinas who go abroad to be able to connect with an
organization or church. In these places, they can find a lot of other Filipinas who can help them.
For Gen it was good that she knew someone who introduced her to these organizations and
encouraged her to join them.
She also thinks what is decisive are the person’s will and ability to do something: if people
don’t take action themselves, nothing will happen. This is why she tries to encourage other
Filipinas to go out and explore their life, go to Information Days events, and socialize.
Gen used to be very sociable in the Philippines. This trait has never left her, which is why she
finds it important to meet other people, compatriots or of other nationalities. She also thinks it
is important for people that they don’t stay alone in their house, because it contributes to their
stress.
126
The Story of M
M is a 23 year old female from Davao in the Southern Philippines. Her parents are separated.
M’s father does not live with them and her mother is living in with her boyfriend. Because of that,
M lived with her four brothers, who she looked after for about six months at some point. She
also has one sister living in Manila.
M had just finished a two-year computer course but had trouble finding a job, when a cousin of
her told her about being an au-pair. M read about it on the Internet and decided that it was what
she wanted to do. Because there was an agency in Manila looking for au-pairs, M left Davao to
stay with her sister in Manila. She felt excited to have the chance to go abroad. M felt she did
not have a real home in the Philippines and it would be easy for her to go away. At the same
time she realized that it might not be easy, reinforced by what her friends had told her as well.
Mostly, she worried about her brothers because they were living alone. She was afraid they
would not have a happy childhood and get into trouble.
M always wanted to go to Europe, which in her mind, was both a modern but still traditional
place, which was to her liking. She did not want to stay in the Philippines as a result of past
experiences.
While still a child, her uncle tried to sexually abuse her. She had a similar experience with a
distant relative when she was in her second year of high school. The first occurred in her
father’s province, the second in her mother’s. As a result, M felt she had nowhere to go.
She wants to support her family, but also make something with her life. She has no friends
working abroad. Her family had no idea of what she was planning on doing, but nevertheless
supported her decision.
M initially thought she would be staying in Manila for a short while, but because of problems
with the agency she ended up living in the city for a year. After registration with the agency, M
did not hear from them for six months. When she phoned to find out what happened, it turned
out that they lost her documents when they moved their office. She had to go to the agency a
second time to follow up the documents.
M suspected the agency was not registered. She also felt she paid them too much money. She
had to pay about PhP 35,000 (570 euros) for one month of training. The training included
swimming lessons, but at the end, she still did not know how to swim. Two of her ten fellow
127
participants could already swim and ride a bike, but had to pay for the training anyway. For
herself, bicycling was a useful part of the training. M was however annoyed with the agency
because they told her the training was compulsory and they would not send her abroad if she
did not undergo it.
Airfare was not included in the money she paid the agency. This was to be paid by the host
family. M had to follow up all the papers and pay all expenses for her visa by herself. She
thought the agency would assist her, but they only instructed her to transact everything with
the embassy. Even the host family in the Netherlands was concerned why the agency did
nothing. Paying expenses out of her own pocket landed M in debt, which she had to pay back
out of her salary for the first four months in the Netherlands.
While waiting for her papers to be finally processed, M did not have a job for six months.
Eventually, she was employed as an inventory clerk at a bakery. However, because she had to
take part in the agency’s “training”, she had to quit her bakery job, which made her employer
angry. For M, however, it was no great loss, since she had to work a 12-hour day, waking up at
six in the morning and getting home at six in the evening.
When M arrived in the Netherlands, no one was at the airport to pick her up. Her cousin helped
her get in contact with her host. M was happy that she had a friend with her, who was in the
same situation. Despite this, she could not contain her excitement.
Her first host family – a relatively well-off family – lived in Huizen, which M describes as a “place
of solitude with big houses”. The host mother was Russian, who was pregnant at the time, and
her husband Dutch. Her charges were two boys, aged four and two years old. After two months
the host-mother gave birth, which added an infant to the children she would look after.
For the first two months M had a lot of free time. Her tasks changed when the baby came.
When there were only two children to look after, she earned 400 euros (about PhP25,000),
which is more than what au-pairs normally get, because she worked more hours.
She thinks that maybe this is illegal, because the contract stated that au-pairs should not work
beyond what was stated. However, M says she knows that many people work more than is
stated in the contract. M’s host mother noticed that she was cleaning very well –she used to
take care of her four brothers- and asked her to do more cleaning. M grabbed the opportunity to
earn more money.
After the baby came she was cleaning the whole house and got 700 euros (about PhP43,000)
for this. At that time the host mother was often at home surfing the internet. M started to think
128
that the situation was unfair and she was working too much. She realized that she was not
happy. She already worked half days on Saturday and Sunday, but the family often asked her
to work even more. In the beginning she always said yes, but later she started to dislike this.
She started to feel lonely, because she was in the remote area of Huizen and could only meet
her friends on Sundays. She also wasn’t able to go shopping. Her host mother was a very silent
person who did not like to talk. They would often have lunch and keep silent. M felt very
uncomfortable with the situation and, after a while, stopped eating at the same time as her host
mother.
This experience had a negative influence on M and she started to be hesitant in speaking to
others; it became hard for her to socialize. Because of the whole situation M decided that she
did not want to stay with the host family after the one-year contract ended. She booked a flight
back to the Philippines and started buying gifts for her family. On the day she was scheduled
to leave, she did not make it in time for her flight and decided to stay in Holland. Although
unintentional, M started to consider staying in the Netherlands the evening before her flight, as
she was talking to friends at a party. M never had regrets about the decision she took.
Through a female acquaintance, M was introduced to her second family in Den Haag. She
describes them as socialites (“people who only go to parties”). According to M, they were a
more “bossy” than the first host family. They had a child who was severely allergic to pollen.
This was especially bad in the summer, so the child had to stay in the house all the time. M
had to take care of and entertain him. She did not mind doing this, but missed the social
interaction with other children and friends.
M remembers one time she had a fight with the host mother. She would always wake up the
host parents as she prepared the boy for school. However, one time the host parents had fallen
asleep again after M woke them up. After dressing up the boy, she began to do her chores.
However, she did not notice that the parents returned to sleep and that he boy was late for
school. Seeing this, M went to her host mother to ask why he was not at school. The host
mother blamed M for not waking her up. She also told the boy that it was M’s fault and called
M an idiot in Dutch. M understood enough Dutch to know the meaning of the word and got very
upset. She packed her bags straight away and left.
She said she did not want to be treated like that and that it was easy to do this, because she
did not have a contract. She knew the family would not report her, because they would get in
trouble as well.
M met her third and current host family through a friend. The family lives in Amstelveen and has
three children (aged eight, six and four years old respectively) in the household. She describes
129
them as a very messy family with free spirits. In a way, M said she likes that because they do
not tell her what to do and she is not afraid to make mistakes. They are very supportive of
anything she wants to do.
M describes the three children as “very energetic”. The eldest – a daughter – has attention
deficit disorder (ADD) and is always running around and screaming. M said she often says bad
things to her. She is also not toilet-trained, so M has to clean it up after her. While she says
she needs a lot of patience with this child, M could accept the situation because she knows
there is something “wrong” with the child.
M is very happy with the family and she has lasted with them for a year.
Recently the family got a new dog, which created more stress for M but she says she does not
mind it. However, she has less free time now.
She used to take on extra cleaning jobs with the neighbors, but she had to give it up because
she no longer had the time to do it. In compensation, she got a raise from her host family. M
now has Saturdays and Sundays off. The family always encourages her to enjoy her weekend.
In her free time M likes to read books.
M is supporting her family financially from the Netherlands, specifically two brothers – one is in
high school preparing for college and the other is in college. M’s concern at the moment is for
one of these brothers to pass his examinations, because she is providing the money for his
education.
M says she is concerned about what happens with the money she sends. However, she does
not send a lot and she never sends extra. She always sends money for specific purposes, like
payment for bills and tuition fees. M is apprehensive that if she sends a lot of money, her family
would just spend it all impulsively.
In her first year in the Netherlands, M saved very little money, and consequently sent little to
her family. She found it hard to save money and had to pay back a debt to the agency. Now she
says she is more used to handling money and is able to send more to her family.
M has some friends, part of the same batch that had undergone training in the employment
agency. M has two good friends at the moment. Her best friends stay next door with the
neighbors. She says this contributes to the fact that she likes her work right now and helps to
relieve stress. M often uses Skype, even to talk to her friend next door.
130
She also likes to go out for bowling or dates with her boyfriend of six months. However she
does not want her cousin to know about this, because she is afraid of such relationships and is
very protective of M, partly because of her own past experiences.
M’s boyfriend had wanted to settle down, but M was not ready for this. Even though M liked the
boy, she decided to break off with him; she preferred to be independent.
M finally told her cousin about this, with the expected negative reaction. M attributed this to
Filipino culture, which is “narrow-minded and dictating”. M said this is one of the things she
dislikes about the Philippines and thinks attitudes are better in the Netherlands. She also likes
the fact that she can be independent in her host country and that everybody can work and
study.
M feels she has become more assertive since she came to the Netherlands. Her mother is
surprised that now she always says what she wants. What she does not like about the host
country, on the other hand, is that the kids often get too much freedom and lose respect for
their parents. She also sees this in her host family, when the children (especially the oldest)
curse at their mother.
M is still an undocumented worker at present and she always has to be careful not to be
caught. She tries to avoid getting in trouble and always has to do “the right thing”. She has no
problem with this: she does not go out at night and does not get into trouble. At the moment it
is not a problem for her that she does not have papers. However, she thinks it is better to go
back to the Philippines because it might cause problems in the future.
Even though M does not have papers she can still travel. In fact, she has been to France. At the
start of her stay in the Netherlands, when she still had papers, she went to Morocco with her
host family. However, that is not a vacation for her, because she had to take care of the
children. She also goes on holidays with her current host family and, this time, it really feels
like a vacation for her.
M says she has not had major health problems. But if she does, she can get help from her host
mother who is a doctor. Some time ago M had a bout of influenza and stayed in bed for four
days. Her host mother helped her then. The host mother also helps her with contraceptives. M
has a bad case of acne and very heavy menstrual periods. A pill dispensed by her host mother
relieved her condition. In the Philippines, M says, people discourage the use of contraceptives,
because “people think that you have sex if you use that and that is considered bad”. M does
not agree with this; she thinks it is better to promote safe sex. M does not tell her Filipino
friends that she is using the pill.
131
M also has insurance, managed by a private agency.
M says she misses her family, especially her brothers, but she maintains regular contact with
her family through Skype. The host family gave M an old laptop when they purchased a new
one. She is also in contact with her sister. She does not know where her father is, so she has
no contact with him. Her family is one of the biggest stressors for M at the moment. Before,
with her first family, it was the loneliness. Now she is no longer lonely, because she is able to
meet a lot of other Filipinas.
M plans to return to the Philippines by December 2011. By that time she would have stayed in
the Netherlands for four years. She will be 24 years old then and she plans to study psychology.
Her sister, however, advised her to study something that could be applied everywhere.
When she goes back, M said she would first work to fund her studies. She managed to save
some money in the Netherlands. She is also taking swimming lessons. She says new skills
might help her find a job in the future. Her host family supports M in these.
M rates her overall well-being when she was in the Philippines (on a scale from 1 to 10) as a 5.
At the moment – if she does not think about the fact that she does not have official papers - her
well-being is an 8. She hopes that after she will go back to the Philippines it will be a 10.
M says she knows many Filipinas who have had a much tougher time than she has. For
example, a Filipina from her batch was sexually abused by the host father. The girl is back in
the Philippines, but the employment agency did not help her. Another friend is very homesick,
usually a primary cause of stress. M also knows girls who complain about not having enough
free time in their job. A friend complains about her host who accuses her of being “only here for
the money” and tells her that if she will not do her job, she will not get the money. According to
M, this is not the idea of an au-pair, “who is here also to experience the culture”. Another friend
says the financial demands of her family in the Philippines is her primary cause of stress, since
they call her anytime they need money and they want her to send money, even for something
as small as a calculator.
M thinks it is important for Filipinas to have the right information before they leave. She mentions
her negative experience with the placement agency. Agencies should be transparent about
work contracts and “be honest about what the women can expect”.
M’s agency told her she had to get along with her host and that if any problems would come up,
the au-pair should be the one to solve it. M thinks this is not fair, because a mismatch of an au-
pair and a host can always occur. Besides, many women from the Philippines would be afraid
132
to speak up to their host. M knows that many of her friends are afraid to say something they
don’t like to their host for fear that the host will be angry with them. Because of this, M also
thinks it is important for the women to have someone they can run to if they have a problem.
They should know that they have a lot of options if there is a problem. They should be informed
before they leave, but also when they are abroad.
M says it is important to have someone to talk far from home. This is also to prevent forming
dependent and abusive relationships, where women have boyfriends because they do not want
to be alone and then become dependent on the male partner, who sometimes turn out to be
abusive.
M says it is important for au-pairs to have a network of au-pair friends. If abuse or maltreatment
occurs, everybody will know it. It will be easy to get the message out. In addition, M thinks it
would be good to follow up on the women; to have someone who is informed and concerned.
She would have liked to have someone follow her up, because she feels that nobody knows
where she is or what she is doing.
After coming back to the Philippines, M says that she will just “do her thing”. However, she
would like to stay in contact with a support group in the host country, so she would be able to
contact them if there are problems. With the Internet it has become easier to stay in touch,
though many au-pairs do not have a computer. According to M, these women are more isolated
and feel lonely.
133
The Story of Susan

Susan is a 22 year old female from Southern Luzon. The youngest of 10 children, Susan’s
parents are farmers. Susan grew up mostly with her brothers, because her sisters were already
married and lived with their husbands. Susan says that she grew up in a happy family.
Before she came to Holland, Susan worked for two years in a small appliance store after
finishing high school when she was 17 years old. She did not go to college. Susan liked
working there as she could only do simple tasks.
When she was 19, her sister and brother arranged for her to go to Holland to be an au-pair. They
processed the papers for her visa without informing her. Through her sister’s husband they had
found a host family for her, with a Filipina married to a Dutch man. Susan only found out about
this when they told her to get her passport and prepare for the trip to Holland. She was very
surprised and thought it a bit strange that they had not told her.
However, she was excited to go, because she wanted to travel and experience life abroad. She
also got a positive impression of the family and she looked forward to learning about Dutch
culture. She also thought it would be good for her future. In the Philippines, she would not be
able to earn enough money to continue her studies. She originally planned to apply for work in
Dubai or Canada, with her preference for the latter.
She was grateful that the preparations had already been done by her sister. When her visa was
ready, Susan had to go to the Netherlands embassy for an interview and payment of the
needed fees. She says the process was almost the same as when one is hired as an au-pair
through an agency. The difference with an agency is that she did not get any training. She did
not have any idea what Holland would be like. She was told that her host family would explain
everything when she got there.
When Susan arrived in Holland, she met her host family for the first time. The family had three
children (aged 17, seven and five years old, respectively). Her main responsibility would be to
take care of the two youngest children: a boy and a girl.
At first, Susan relates, the children were quite wild (“they were crying and shouting a lot”).
Susan thinks this was because they did not get enough attention. During the first few months,
it was hard to take care of them because of this behavior. Later on, under Susan’s care, they
started to behave better. Initially, it was difficult for Susan to communicate with the children,
because they spoke little English. Later on, they spoke more English and Susan learned some
134
Dutch. This helped her bond with them. Susan liked to take care of the children, because she
loves children and always took care of her nieces and nephews.
In the beginning, Susan was told that her main task was to take care of the children and help
a bit in the household chores. However, later on she had to do everything in the house, which
included occasionally helping her host-mother in her catering business.
During the first few months Susan was happy with this setup. She liked the children and had a
good relationship with the host-parents. As she performed more household chores, Susan had
misunderstandings with her host-mother, who she says sometimes treated her badly. It was
hard for her to take a day off from work and that she did not have freedom with her host-family.
She was not allowed to meet with friends.
She felt alone and liked to meet with other Filipinas. She had a friend who worked with a family
nearby, but her host-mother did not want Susan to get involved with that family and told her it
was better to stay at home. So, in the beginning she often stayed at home on her days off and
ended up taking care of the children. She would usually wake up at seven in the morning and
worked until eight in the evening, when the children were going to bed.
After three months, when she became lonelier, Susan struck up friendships. With her new-
found friends, Susan went out to the city centre and spent her evenings there. This strained her
communication with her host-mother more, as the latter did not want her to have friends and go
out. The host-mother told Susan that other people would “manipulate” or “brainwash” her. Susan
tried to convince her otherwise, but that did not help.
Behind her back, the host-mother started complaining about Susan to her family in the
Philippines. She told them Susan did not listen to her and was behaving badly. Susan started
to have a bad time with the family and often cried at night and confided to her friends about the
problems with her host mother. She did not want to work for them anymore, but also did not
want to go back to the Philippines.
During that time, Susan found a new host-family in Norway and she began processing her
papers to transfer there. She found the family through the Internet (at the site Au-Pair World)
where she put up her profile. Susan then informed her host-mother about her plan to go to
Norway, but the latter did not want her to go.
Also during this time there was more misunderstanding between Susan and her host-mother,
but Susan tried to stay focused on her work. After six months, when she was preparing the
papers for her visa to Norway, the situation escalated. The host-mother wanted to go to Den
135
Haag and secure the necessary paper work for her. However, Susan wanted to do it herself,
because she wanted to be independent. She says she tried to explain to her host-mother in a
friendly way, but the latter got mad. Susan’s temper also flared, because she planned to go
with a friend that her host-mother did not approve of.
On the day of Susan’s interview in the embassy in Den Haag, she left in the morning with her
friend to do their business in Den Haag. They also went to the Dutch Immigration and
Naturalization Service (IND) to get information about regulations on au-pair employment in
Norway. She got back late at night and her host-mother was already asleep. The next day
Susan told her about her visit to Den Haag. However, the host mother got mad at her because
she thought Susan went to the IND to report her host-family’s treatment. She did not belief that
Susan went there to collect information. According to the host mother, Susan had been
“brainwashed” by her friend into doing this.
The host-mother told Susan perhaps it was better if she stayed with her friend and ceased to be
part of the host family. When Susan called her friend share what happened, the host mother got
even madder, very aggressive and drove her out of the house. For fear of what her host-mother
could do to her, especially at night, Susan did not want to come back to the house.
Susan did not have problems with the host-father, who had earlier informed her that her host
mother had been hospitalized in the past for mental illness and was taking medication for it.
Sometimes, Susan says, she “loses her mind” and thinks she is Mary and her son is Jesus.
In total, Susan stayed with this family for eight months.
Upon leaving the house, Susan decided it was best to stay with friends until her visa was
approved. She stayed with different friends. In the meantime, Susan says her host-mother still
spread bad stories about her, to her friends and her family in the Philippines – that Susan had
left the house because she was a lesbian and had a girlfriend.
For one month after the fight with her host-mother, Susan did not have any contact with her
family, because she did not have any money. The host-family had been sending all the money
she earned directly to the Philippines. Her host mother had told her that it was better to do it
that way. Because of that, Susan could not buy things for herself. Sometimes, her friends
would buy things for her; at other times she got extra work for a few hours a week to earn some
money. However, at the time the host mother sent her out she did not have anything.
After a month she was able to contact her family again and explain the situation to them.
Susan stayed with friends from Bayanihan for two months. They supported her and did not ask
136
her for any money. That was hard for Susan to accept, but her friends were very understanding
of the situation and helped her to find a new job.
Looking back, Susan says she never expected this to happen when she left the Philippines,
especially because she had a good impression of the family.
After two months, Susan found her current host-family with the help of the friend from Bayanihan.
Housekeeping is Susan’s main responsibility with her new host-family. The family has two
mature sons (aged 17 and 23 years old, respectively). She says this host family is “very nice”
and she feels a part of the family. She feels safe and also has her freedom. The family follows
to the regulations for au-pairs, even if Susan does not have papers to stay in Holland. She likes
the work because they teach her how to do the cooking and cleaning; she is learning a lot.
Because she is the youngest in her family in the Philippines, Susan did not know how to do
these things before.
At present, Susan feels much better and is learning through her new experiences. The longer
she is in the Netherlands, the more she likes it. She hopes she can get the papers to stay in
the country legally. Her undocumented status is difficult for her, because she always has to be
careful and alert.
Susan gets a monthly allowance from her host family, half of which she keeps for herself, the
rest sent to her family in the Philippines. This time she sends the money herself. She is the
only one of her brothers and sisters who is working abroad and supporting her family financially.
Most of the amount sent to her family is spent on medicine, because both of her parents
require medication. Her mother also goes to the doctor for monthly check-ups, which is very
expensive. Aside from that, her parents spend for food and other living expenses.
Susan never worries about how her family spends the money, because she knows that her
mother is very smart at that. She is still not able to buy many things for herself, save for the
basics.
Susan is also saving up to continue her studies. Her parents are old and she does not want
them to pay for her education. She wishes they would stop working, because they have worked
hard their whole life and they are now both ill.
Susan likes to spend her free time with friends. They would go to bars, restaurants, cinemas,
and shops. This, despite Susan’s continuing apprehension about going out of the house.
137
At the moment, her former host mother is still looking for Susan, because she wants to send
her back to the Philippines. This is why she does not go to the city very often. She would
rather go to other cities where she also has friends. Susan does not have a lot of Filipina
friends. Her only Filipina friends live near her old host family.
Her best friend in Holland is a Cape Verdean girl living in Rotterdam. She prefers that this
friend is not Filipina, because meeting compatriots reminds her of the bad experience with her
Filipina host mother.
Susan connected with Bayanihan through a friend who worked for the organization. She likes
the organization, but at the moment she is not involved in their activities. Many people there
know her host family and Susan is afraid that her host mother will hear of her presence there.
She stays in contact with the organization, but not publicly. She knows that if she needed
help to return to the Philippines, Bayanihan would help her with the documents.
Susan had a boyfriend in the Philippines before she left, but she broke up with him, because
he wanted her to come back and marry him. She thought it was too early to get married. She
explains it’s more important to think about the future before settling down. Other people tell
Susan that it’s time to get married, but she first wants to earn money for her future children
and save up for their education. Her own experience taught her lessons about being poor and
she does not want this for her own children. The break-up was a bit sad for her, but since she
did not see him for a long time it was easier to handle it. At the moment she is happy to be
single.
Susan has not had any health problems since coming to Holland. However, she mentions
experiencing a lot of stress due to the situation with her host mother. She suffered from
headaches and loss of appetite. She felt helpless and did not know what to do about the
situation. She did confide to her friend about the problem, who encouraged her to talk more
about her problems and feelings, so she would feel better. As a result Susan says her “mind
is better’. She also feels better after talking to her mother, who she really misses. At that time
she would have liked to go back to the Philippines, but her host mother held her ticket and
refunded it.
At the moment, Susan sometimes misses her family and life in the Philippines. She stays in
contact with her family mostly through the telephone. She can’t use the computer, because
her family does not have a computer in the province. When she is lonely, her new host mother
tries to cheer her up. The new host mother is almost like a second mother to her.
138
Susan feels she has almost adapted to Dutch culture. She recognizes this in the way she
talks; she is confident about what she wants. In addition, she likes the people and the food.
The weather is a bit cold for her, but this is no problem.
Susan thinks that she will not be able to go to Norway anymore since her former host mother
had bad-mouthed her to the prospective host-family there. She told them that Susan was only
working as an au-pair to find a husband. A problem with her visa also arose. Susan thinks that
the family in Norway will stop the processing of the papers.
For now, Susan plans to stay in Holland for a while to earn money. After three years, she
hopes to go back to the Philippines to continue her studies. Susan plans to study accountancy,
because it is easy to find a job with this background. She hopes to stay with the host family
that she works with now.
Susan rates her overall well-being in the Philippines (on a scale from 1 [lowest] to 10 [highest])
as a 9. She rates her time with the first host family as ‘maybe a 4’, because it was a really
bad experience for her. At the moment, she rates her situation much better; i.e., an 8 or a 9.
Susan is interested to work for an organization like Bayanihan. She likes the support provided
by such a group and if she works there, she can help others as well. She says she wants to
be active in the organization when she gets the proper documents to stay in Holland. Susan
thinks that many other people like her would benefit from an organization like Bayanihan.
Susan thinks that training before working abroad would help people to prepare better. She
does not have experience with this herself, but she is willing to undergo such a process to
learn things about the way of life, work and the culture in the country of destination. Susan
thinks it is very important to cooperate and adapt to the culture in another country. In her
case, it was important for her to learn how to ride a bicycle.
139
Project Team
Overall Project Coordinator Maria Lourdes S. Marin
Project Coordinator (The Netherlands) Prof. Ivan Wolffers

Project Coordinator (Philippines) Raquel Ignacio
Project Assistant (The Netherlands) Lia Van der Ham
Research Team
Principal Investigator Prof. Maria Theresa Ujano-Batangan
Statisticians Michelle Ong, Alvin Mejorada
Field Researchers
National Capitol Region (NCR) Cebu
Luidia Plasencia Prof. Maria Fiscalina Nolasco (Field Coordinator)
Jasmin Necesito Alicia Mariblanca

Nelia Quintanar Hermenia Caballero
Marites Reyes Jocelyn Pacana
Sonia Tongco
La Union Davao
Edna Valdez Ms. Bernadette Guillermo (Field Coordinator)

Elizabeth Alegre Ana Urbano
Marietta B. Simborio
Lovely Mae Calig-onan
140
Focus Group Discussion (FGD) Participants
Luidia Plasencia Evelina Diego

Zenaida Barbado Erlinda Tosculas
Joelyn Baldoza Melinda Tabio
Nenita Gonzales Amelia Dominio

Rowena Austria Dina Esperanza
Participants: Post – Survey Consultation Workshop with Women Migrant Domestic Workers
Aurarita Virey Florencia G. Balcita
Aida Duplas Elizabeth M. Duculan
Maria Cielito Unasco Girlie R. Carino

Amelia Dominio Minda P. Galase
Ma. Rowena Tonedo Vilma C. Flores
Emily Argomido Evelyn M. Dulay

Zenaida Guinte Lilibeth D. La Torre
Jovelyn Burca Felma Edna M. Joson
Erlinda A. Dumpit
Corazon A. Dapig
Margie B. Vinoya
Arlene S. Belesario
141
Key Informant Interviews

National Capitol Region
Atty. Rico Fos

Executive Director
OUMWA – DFA
Ms. Marvi Ador

Planning and Programming Development Division OWWA
Dr. Venus Arain

National Center for Mental Health
Ms. Carol Jimenez

SWOIII Social Technology Bureau, DSWD
Ms. Fe Nicodemus
President
KAKAMMPI
Ms. Liberty Casco

Director
Philippine Overseas Employment Administration
Region I
Ms. Esperanza Cobarrubias

Chief
OWWA RWO I
Ms. Nonette Legaspi-Villanueva

Chief
POEA Regional Office for Norther Luzon
Ms. Rose Bayan

Coordinator
Kanlungan La Union
142
Mr. Dominador Laruco
President
Timpuyog ti Agkabsat
Region VII
Ms. Evelia M. Durato

Officer-in-Charge
POEA Regional Center for Visayas
Ms. Mae D. Codilla

Officer-in-Charge
OWWA RWO VII
Region XI
Erlinda B. Albay,
Officer In-Charge
Consegundo Fernandez
Administrative Officer
Regional Consular Office – Davao, Office of theConsular Affairs, DFA
Ms. Rosemarie Luntao

Officer-in-Charge
Program and Services Division OWWA RWO XI
Lorna Mandin
OIC
Integrated Gender and Development Division Davao Local Government Unit
Sr. Diane Cabasagan

Director
Center for Overseas Workers-Davao
143
www.achieve.org.ph
Action for Health Initiatives (ACHIEVE), Inc. is a non-stock, non-profit organization based in Quezon
City, Philippines. ACHIEVE is engaged in the development and implementation of programmes and projects
addressing HIV/AIDS, gender, sexuality, health and migration issues. It is currently engaged in reviewing
HIV-related policies and legislation to address issues of stigma and discrimination and access to justice of
people living with HIV and other key affected populations.
Guided by its pioneering action researches, ACHIEVE has implemented framework-setting programme
responses on migration, gender, sexuality and HIV and AIDS issues in the Philippines. Through the years,
it has successfully implemented projects in partnership with government agencies, international institutions,
local NGOs and CBOs and communities. It has also undertaken numerous capacity building activities and
consultancies, locally, nationally and internationally.
ACHIEVE is a member of the Coordination of Action Research on AIDS and Mobility in Asia (CARAM-
Asia), a regional network of organizations working on migration, health, human rights and HIV and AIDS
issues in the Asian region.
For more information about ACHIEVE, Inc, please contact:

162-A Scout Fuentebella Extension, Barangay Sacred Heart,
Kamuning, Quezon City, Philippines
Tel : (+63 2) 414 6130
Telefax : (+63 2) 426 6147
E-mail : achieve_caram@yahoo.com
Website : www.achieve.org.ph

Women and Migration The Mental Health Nexus PDF

Caricato da

Informazioni sul documento

Titolo originale

Copyright

Formati disponibili

Condividi questo documento

Condividi o incorpora il documento

Opzioni di condivisione

Hai trovato utile questo documento?

Questo contenuto è inappropriato?

Copyright:

Formati disponibili

Women and Migration The Mental Health Nexus PDF

Caricato da

Copyright:

Formati disponibili

Women and Migration:

THE MENTAL HEALTH NEXUS

Action for Health Initiatives (ACHIEVE), Inc.

Principal writer: Prof. Maria Theresa Ujano-Batangan

All rights reserved. Copyright 2011

Action for Health Initiatives (ACHIEVE), Inc.

5 Foreword: Action for Health Initiatives (ACHIEVE)

6 Foreword: Vrije Universiteit Medical Center Metamedica/

7 Message: International Organization for Migration (IOM)

8 Abbreviations and Acronyms

23 Section 1: Review of Related Literature

45 Section 2: Research Methodology

49 Section 3: Research Results and Discussion

98 Conclusions and Recommendations

Carolyn I. Sobritchea, Ph.D.

Professor Ivan Wolffers, Ph.D.

International Organization for Migration (IOM)

Abbreviations & Acronyms

Research Management and Methodology

Among the key research findings were:

Participant / respondent socio-demographic characteristics

Pre-migration status and requirements

Working conditions abroad

• Significantly, the number of psycho-emotional symptoms reported by the participants decreased

A Women and Migration

1. Women and Domestic Work

Box 1: Characteristics of domestic work 22

• The work site is a private home.

• Average daily working hours: 17.2

B Migration and Well-being

1. Migration and health

Table 1. Determinants of migrant health

Pre-migration/ Migration process/ Post migration

Process of migration Acceptance of host country Issues pertaining to return and

Migration policies Vulnerabilities of migrant Social costs of migration

Disparities in the health Accessibility of health care

Accessibility, availability, and Support systems

2. Migration and mental health

3. Migration and stress

No access to health information No proper treatment

Difficulties in communication at medical Cannot explain health state

No maternity protection Bad health conditions of women and children

Mandatory medical testing for pregnancy, Forcible deportation

No health insurance for undocumented Self medication, development of diseases

Sexual, mental and physical abuse Emotional and psychological trauma

Different social status, exploitation, Loss of dignity, self respect

(Source: Choi, cited in the 8th Regional Conference on Migration, 2002)

C Coping with Stress

1. Coping: definitions and concepts

2. Coping among migrant workers

3. Social support as a coping strategy

D Addressing the Healthcare Needs of Women Migrant Workers

1. Access to health care

2. Concerted Global Efforts

3. Addressing health needs of Filipino migrants

4. Protection of migrant workers

5. Promoting mental health among migrant workers

E Mental Health and Well-being In Filipino Culture

1. Filipino concepts of mental health and well-being

2. Social support and coping in Filipino culture

• Ibang tao or Outsider category - Pakikitungo (level of amenities / civility); Pakikisalamuha

3. Views on mental illness among migrant Filipinos

Alternative coping measures Family and peer groups, indigenous healers