Written by Hang-Tang Chen; translated by Yu-Chen Chuang.
Image credit: Listener.
At the end of 2023, The Reporter, a non-profit online media in Taiwan, published a special issue titled “Ten Years After the Te Hung Hsing Murder: Comprehensive Repair from Migrant Labor Condition to Mental Health.” This report was prompted by an incident in July 2013 on the distant-water fishing vessel Te Hung Hsing 368, where six Indonesian fishermen, unable to bear the violent treatment from their Taiwanese captain, accidentally killed the captain and the chief engineer. Going back another ten years, in February 2003, a Taiwanese author, Liu Hsia, died after a physical altercation with her Indonesian caregiver, Vinarsih, who was experiencing mental exhaustion and delusions of an earthquake. Taiwan has been recruiting migrant workers for over 30 years. Looking ahead, Taiwan’s migrant worker policy must evolve to effectively address the physical and mental healthcare needs of these workers.
I’m part of the organisation “Listener,” a legal and public health platform launched in 2020. We aim to connect Taiwan’s legal, mental health, and medical professionals with migrant workers through interpreters. Over three years, we have facilitated access to mental health consultations for migrant workers, coordinating with interpreters with counselling ethics training. We also work with pharmacists and family doctors to develop multilingual cards in languages like Indonesian, Filipino, Thai, and Vietnamese for medical consultations. Drawing on my experience in advocating for migrant workers’ health rights, this article explores the necessity of comprehensive policies. It emphasises the importance of recognising migrant workers beyond their contributions as labourers, ensuring their well-being and dignity are fully recognised and supported.
Disrupted Relationships: Self-Care and the Hidden Burdens
The issues migrant workers face in Taiwan are not limited to labour relations with their employers. Being separated from their families and experiencing changes in relationships leads to physical and mental imbalances. For instance, in 2022, a migrant worker, Ah Tuan, who had been working in Taiwan for five years, began to speak less, appeared distracted, and suddenly burst into tears. We later discovered that he was going through a difficult personal situation, leading him to entrust his child to his parents and fall into a state of self-blame. Eventually, with the companionship of friends and advice to speak with a counsellor, Ah Tuan slowly began to find a new focus in his daily life, especially through nightly video calls with his son.
Workplace relationships can also be a source of mental and emotional stress. This was evident in 2022 when a Vietnamese student, Lin, contacted me for help after a fellow migrant worker attempted suicide. The worker, Ah Ping, employed at a nursing facility, was experiencing verbal bullying and physical violence by her colleague. When taken to the hospital by her employer, the employer communicated with the doctor in the absence of Ah Ping. The diagnosis was subsequently simplified to headache and high blood pressure, concealing the fact of physical violence. Despite Ah Ping’s efforts to seek help from various channels, including her employer, the agent, and the government-provided labour consultation telephone line, the employer only brought her colleague to apologise, attempting to resolve the issue without further action.
Seeing Ah Ping’s ongoing mental distress, Lin could not stand by and do nothing. She supported Ah Ping in getting psychiatric help by arranging a video consultation. Nonetheless, the employer dismissed the psychiatric diagnosis and pressured Ah Ping to decide between returning home or resuming work. Confronted with overwhelming pressure and a mental health crisis, Ah Ping considered taking her own life. In response, I connected with social workers and searched for multilingual suicide prevention resources, offering Ah Ping reassurance about the availability of emergency refuge to help soothe her emotional distress. However, Ah Ping’s mental and physical health had already deteriorated amid the back-and-forth of seeking help and navigating administrative procedures. Eventually, she decided to terminate her employment and return home.
Identifying Policy Shortcomings
The Declaration of Alma-Ata, established at the 1978 International Conference on Primary Health Care, states in its first clause that “health is not merely the absence of disease or infirmity but a state of complete physical, mental, and social well-being, and is a fundamental human right.” However, the implementation of this principle is typically shaped by sovereign states’ policies designed to protect their own citizens, which may exclude migrant workers’ health rights. For instance, host countries often refuse to provide protective measures requested by the migrant workers’ home countries. On the one hand, healthcare is linked to each country’s socio-economic development status, level, and social welfare system design, leading to significant differences and gaps between countries. On the other hand, in the global capital competition, low- and semi-skilled migrant workers are often unrecognised in labour policies, considered easily replaceable and not in need of the welfare benefits given to high-skilled migrants. Meanwhile, immigrant policies are closely tied to national sovereignty, leaving migrants under the constant threat of actions like deportation.
In January 2024, several NGOs and think tanks, with the support of the European Economic and Trade Office, organised the EU-Taiwan Exchange Forum titled “Overcoming Isolation and Vulnerability,” aiming to take action to safeguard the human rights of migrant domestic workers and fishers. On the forum’s first day, discussions focused on migrant domestic labour. Officials from Taiwan’s Ministry of Labor and the Ministry of Health and Welfare attended to share insights and respond to inquiries. During the discussions, I seized the opportunity to raise a question about the health support available to migrant workers. Drawing on December 2023 statistics revealing that there are over 750,000 legal migrant workers in Taiwan, including more than 230,000 migrant care workers, I questioned whether the government departments had any plans to implement medical and psychological interpreter training programs. This question is based on a critical realisation: the mental and physical well-being of these migrant workers cannot solely rely on personal support networks.
Responding to my inquiry, representatives from the Ministry of Health and Welfare and the Ministry of Labor shared their current initiatives. First, the Ministry of Health and Welfare introduced its digital learning platform for long-term care, allowing migrant workers to learn caregiving skills online. However, it’s important to note that this tool is designed for skill acquisition, which doesn’t address the workers’ mental and physical healthcare needs. On the other hand, a Ministry of Labor representative highlighted the 1955 service line, which was equipped with bilingual translators ready to assist migrant workers in various situations and connect them with local government support. Yet, despite the broad scope of the 1995 service line, its service primarily focuses on labour and employment issues, not specialised mental health care. In reality, both these resources fall short of meeting the comprehensive mental and physical healthcare needs of migrant workers. The process often involves navigating through layers of referrals and bureaucracy, which can erode their dignity and well-being.
Shaping Inclusive Policies
In 2022, the Ministry of Labor launched the “Foreign Intermediate Skilled Workforce Program” and, in 2023, planned to sign a memorandum of understanding MOU with India on recruiting Indian workers. In 2024, the Ministry of Health and Welfare started a residential long-term care institution and an international program in cooperation with academia, recruiting students from Southeast Asian countries. These initiatives were designed to fill the gaps in Taiwan’s labour market, yet they barely address the intricate realities faced by migrants.
As post-industrial countries worldwide face similar challenges of ageing societies and declining birth rates, Taiwan’s migrant worker policy must consider what conditions can attract people to stay. These migrant workers are not just labourers; they are individuals with their own abundant life stories. They arrive in Taiwan and contribute to the labour shortage challenges, yet they often encounter issues that go well beyond their job descriptions. Take Ah Tuan, for instance, who found himself unable to meet his family’s needs back home due to his work commitments abroad. Or consider Ah Ping, who suffered workplace violence from a colleague, only to find her employer prioritised maintaining harmony over resolving the root of the conflict. These stories underscore the need for policies that recognise the full humanity of migrant workers beyond their economic contributions. Our migrant worker policy necessitates investing more resources and effort to foster a diverse and flourishing community.
Hang-Tang Chen (陳翰堂) is a Ph. D. in international politics at National Chung Hsing University. His research interests are transnational migration and Southeast Asian migrant worker policies in Taiwan. He also works at Listener: Migrants’ Legal and Community Health Platform, focusing on human rights education and promoting multicultural understandings.
This article was published as part of a special issue on “2023 to 2024: Looking Back, Thinking Ahead.”
