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. 2018 May 9;14(1):45.
doi: 10.1186/s12992-018-0361-x.

"Because if We Talk About Health Issues First, It Is Easier to Talk About Human Trafficking"; Findings From a Mixed Methods Study on Health Needs and Service Provision Among Migrant and Trafficked Fishermen in the Mekong

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"Because if We Talk About Health Issues First, It Is Easier to Talk About Human Trafficking"; Findings From a Mixed Methods Study on Health Needs and Service Provision Among Migrant and Trafficked Fishermen in the Mekong

Nicola S Pocock et al. Global Health. .
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Background: Human trafficking in the fishing industry or "sea slavery" in the Greater Mekong Subregion is reported to involve some of the most extreme forms of exploitation and abuse. A largely unregulated sector, commercial fishing boats operate in international waters far from shore and outside of national jurisdiction, where workers are commonly subjected to life-threatening risks. Yet, research on the health needs of trafficked fishermen is sparse. This paper describes abuses, occupational hazards, physical and mental health and post-trafficking well-being among a systematic consecutive sample of 275 trafficked fishermen using post-trafficking services in Thailand and Cambodia. These findings are complemented by qualitative interview data collected with 20 key informants working with fishermen or on issues related to their welfare in Thailand.

Results: Men and boys trafficked for fishing (aged 12-55) were mainly from Cambodia (n = 217) and Myanmar (n = 55). Common physical health problems included dizzy spells (30.2%), exhaustion (29.5%), headaches (28.4%) and memory problems (24.0%). Nearly one-third (29.1%) reported pain in three or more areas of their body and one-quarter (26.9%) reported being in "poor" health. Physical health symptoms were strongly associated with: severe violence; injuries; engagement in long-haul fishing; immigration detention or symptoms of mental health disorders. Survivors were exposed to multiple work hazards and were perceived as disposable when disabled by illness or injuries. Employers struggled to apply internationally recommended Personal Protective Equipment (PPE) practices in Thailand. Non-governmental organizations (NGOs) encountered challenges when trying to obtain healthcare for uninsured fishermen. Challenges included fee payment, service provision in native languages and officials siding with employers in disputes over treatment costs and accident compensation. Survivors' post-trafficking concerns included: money problems (75.9%); guilt and shame (33.5%); physical health (33.5%) and mental health (15.3%).

Conclusion: Fishermen in this region are exposed to very serious risks to their health and safety, and their illnesses and injuries often go untreated. Men who enter the fishing industry in Thailand, especially migrant workers, require safe working conditions and targeted protections from human trafficking. Survivors of the crime of sea slavery must be provided with the compensation they deserve and the care they need, especially psychological support.

Keywords: Cambodia; Fishing; Forced labour; Human trafficking; Migrant fishermen; Migrant health; Myanmar; Thailand; Trafficked fishermen.

Conflict of interest statement

Ethics approval and consent to participate

As noted in the Methods section, for quantitative data, written informed consent with trafficked fishermen using post-trafficking services in Thailand and Cambodia was obtained prior to interview. A strict ethics protocol based on the World Health Organization Ethical Recommendations for Interviewing Trafficked Women was followed [44]. Ethics approval was obtained from Institutional Review Boards at the Ministry of Social Development and Human Security in Thailand, the National Ethics Committee for Health Research in Cambodia and the London School of Hygiene and Tropical Medicine (LSHTM). The LSHTM IRB number is 5770.

As noted in Methods, the port research site is not named to preserve the anonymity of participants interviewed for the qualitative component. Because of the small number of organizations and individuals working with migrant and trafficked fishermen, participants may be identifiable if the port research site is named. Written informed consent was obtained from each participant. Ethical approval was obtained from the LSHTM’s Observational Ethics Committee (IRB no. 8368) and from the Institute of Population and Social Research’s Institutional Review Board at Mahidol University (IRB No. 2014/1–1-22).

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

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