Home sweet home? Work, life and well-being of

Home sweet home? Work, life and well-being of foreign domestic workers in Singapore (research report)

Home sweet home? Work, life and well-being of foreign domestic workers in Singapore Research report

March 2015

1


Table of contents Acknowledgements ....................................................................................................................... 4 1 Executive summary.................................................................................................................. 6 2

Introduction ........................................................................................................................... 10 2.1

The Humanitarian Organization for Migration Economics (HOME) ...........................................10

2.2

Background and research rationale .......................................................................................................10

2.2.1

Foreign domestic workers in Singapore ......................................................................................10

2.2.2

The relevance of mental health research .....................................................................................12

3

Study objectives and research questions ............................................................................... 14

4

Methodology .......................................................................................................................... 15

5

4.1

Study variables .........................................................................................................................................15

4.2

Questionnaire development ...................................................................................................................18

4.3

Sample .......................................................................................................................................................19

4.4

Recruitment of participants ...................................................................................................................19

4.5

Data collection .........................................................................................................................................20

4.6

Data analysis .............................................................................................................................................21

Results .................................................................................................................................... 22 5.1

FDWs’ individual attributes and behaviors – Individual and sociodemographic characteristics23

5.2

Social circumstances................................................................................................................................27

5.2.1

Employment conditions and working environment .................................................................27

5.2.2

Treatment by the current employer or employer’s family ........................................................31

5.2.3

Social network and support ...........................................................................................................38

5.3

FDWs’ individual attributes and behaviors – View on working and living situation ...................40

5.4

Mental health ............................................................................................................................................44

5.4.1

Prevalence and severity of mental distress ..................................................................................44

5.4.2

Relationships between mental health and FDWs’ individual characteristics and social

circumstances ................................................................................................................................................47 5.4.3 6

FDWs’ opinion of how to benefit their well-being ...................................................................51

Summary and discussion of findings..................................................................................... 53 6.1

Individual attributes and behaviors and social circumstances describing working and living

conditions of foreign domestic workers in Singapore .................................................................................53 6.1.1

FDWs’ individual and sociodemographic characteristics .........................................................53

6.1.2

Employment conditions and working environment .................................................................54 2


6.1.3

Treatment by the current employer or employer’s family ........................................................55

6.1.4

Social network and support ...........................................................................................................57

6.1.5

FDWs’ view on working and living situation .............................................................................58

6.2

Prevalence and severity of mental health problems among working foreign domestic workers in

Singapore ............................................................................................................................................................59 6.3

Relationship between mental well-being, and individual characteristics and social circumstances

of foreign domestic workers in Singapore.....................................................................................................60 7

Recommendations: Legal and policy measures .................................................................... 63 7.1

Recommendations for foreign domestic workers ..............................................................................65

7.2

Recommendations for employers .........................................................................................................66

7.3

Recommendations for the Singapore government ............................................................................67

8

Limitations and challenges of the study................................................................................ 72

9

References .............................................................................................................................. 74

10 Appendices ............................................................................................................................ 80 10.1 Measurement of variables ......................................................................................................................80 10.2 Detailed analysis information and report of relevant statistical information ................................81 10.3 Common statistical abbreviations.........................................................................................................83 10.4 BSI - Single items in descending order ................................................................................................84 10.5 Relationships between individual attributes and behaviors and social circumstances, and mental health (measured by GSI) ................................................................................................................................85 10.6 Multiple regression table ........................................................................................................................86 10.7 Study questionnaire (English version) .................................................................................................87 11 Endnotes ................................................................................................................................ 88

3


Acknowledgements Anja Wessels, research consultant (volunteer) at HOME, was the lead researcher and main author of the report. Oversight of the research process was provided by Bridget Tan (Founder and Chief Executive Officer, HOME) and Jolovan Wham (Executive Director, HOME). Kayoko Ueno, Wesley Tan, Truls Ostbye, Rahul Malhotra, Thein Than Win and Yasmin Lalani provided research, mentoring and guidance in the analysis of the results. An interdisciplinary approach was adopted to increase health care providers’ understanding of the factors which influence foreign domestic workers’ (FDWs) mental health in order to better understand, prevent, detect, mediate (where appropriate), and advocate for FDWs who experience mental health problems. This collaboration of researchers seeks to draw insights from a variety of perspectives and backgrounds and facilitates the critical examination of the results. Anja Wessels Dipl. Psych. is a research scientist with over 10 years of multidisciplinary experience in both quantitative and qualitative research designs, methods and analysis procedures. She has led over 20 laboratory and field studies covering different domains and user groups and has international experience in transforming research outcomes into applicable products, solutions, policies, and implementation processes. As program manager, Anja was responsible for managing diverse virtual teams. Anja is a graduate psychologist with additional degrees in marketing psychology and psychiatry. Thein Than Win, MB, BS, MPAdm., has five years experience in prevention, education and research aspects of HIV/AIDS, STI, maternal and child health, nutrition program, malaria and tuberculosis projects with international NGOs as well as for governmental organizations for marginalized populations. He commissioned and coordinated quantitative and qualitative research projects on HIV and sexual health behaviors of both genders while working for the Health Promotion Board. He is also currently an NGO partner of Saw Swee Hock School of Public Health, NUS in the research project for entertainment based sex workers and interventions for prevention of HIV and STIs. Kayoko Ueno PhD is Professor for Sociology at the University of Tokushima, Japan, with over a decade of research experience related to migrant worker issues. She has also worked with NGOs in Asia and initiated the research division of HOME in Singapore. She has published a single authored book and numerous articles about FDWs in Singapore including the International Journal of Japanese Sociology, Asian and Pacific Migration Journal and SOJOURN: Journal of Social Issues in Southeast Asia. Wesley Tan is a PhD candidate from the Department of Psychology at Macquarie University, Sydney, Australia. His research focuses on the impact of human trafficking, both on the survivors themselves, and the service providers tasked with their rehabilitation and support. Other research interests include psychopathy, memory and embodiment, which are investigated from a psychoanalytic perspective. Additionally, he has extensive statistics experience, having taught both the first and second year undergraduate courses in statistics at Macquarie University, and working as a statistics consultant for honors students completing their thesis research projects. Truls Ostbye MD PhD is Professor in Community and Family Medicine and Global Health at Duke University in North Carolina, Unites States, and Professor in Health Services and Systems Research at Duke-NUS Graduate Medical School in Singapore. He has broad research interests underpinned by epidemiological methods and using a life course perspective. His current research in children is focused on chronic disease, especially prevention of obesity. In adults, it includes occupational and women's health including the health of FDWs and other vulnerable groups of workers. In the elderly, his research is targeting cognitive decline, healthy aging and caregiving. Rahul Malhotra MBBS MD MPH is Assistant Professor in Health Services and Systems Research at Duke-NUS Graduate Medical School in Singapore. His current research in Singapore includes studies of physical, mental and social facets of caregiving for older Singaporeans, health and lifestyles of elderly Singaporeans, social determinants of health, occupational health, including health of FDWs, and evaluation of health promotion programs. His previous research focused on public health issues pertinent in developing country settings such as maternal and child health, reproductive health, communicable diseases and food hygiene. He has authored or coauthored over 65 peer-reviewed papers in the medical and public health literature. 4


Yasmin Lalani Ed PhD is an interdisciplinary qualitative researcher anchored in the field of education and with subfield expertise in gender studies and global health. She has worked with research teams across North and South America and Europe in the areas of mental health, HIV/AIDS, and social inequalities in educational contexts. Yasmin is the volunteer consultant at HOME for qualitative research. Research assistance was provided by Nicole Fraser, Nelly Maria van Amerongen-Broers, Ho Han Yao, Katarina Lindgren Cortes, Brendan Chia, Victoria Haldane, Alice, Sabine Lyko, Yudhy Widhyanto, Chia Irenaeus Paul, Isrizal Mohamed Isa, Juliah Bee, Mel Jarvis, Ray Webber, Yulianti S. Yudo, Sherly Piedragoza and Baby Foo, all of whom contributed as volunteers to the study design, data collection, data entry, questionnaire and data translations, analysis of the results and/or writing this report. HOME staff, especially Sisi Sukiako, Celine Dermine and Jacqui Field, provided further research assistance in recruiting participants, conducting the study and providing legal advice. We are grateful for the support from our partners and stakeholders, namely the Singaporean FDW community, the NGOs Silver Ribbon, HealthServe and Transient Workers Count Too (TWC2), and the Ministry of Manpower. Their valuable feedback and content expertise shared prior to the release of this research have enabled us to derive meaningful recommendations for different parties. A special thanks goes to to all FDWs who volunteer with and/or helped HOME with this research project, specifically HOME Roses, HOME Kartini, Tun Lin Thein, Htwe Htwe Nge, Hnin Thawda Thwin, Barani Maung Maung, Tin Maung Win, Kitty Aye Mar Mar, Khin Lay, Lamin Lwin, Khin Pyone Nwe as well as the women in the HOME shelter, especially Yanti, who dedicated their time helping with recruitment of participants for this study. We would also like to pay homage and dedicate this report to all 670 women who agreed to participate in the study and contribute to HOME’s mission to improve the protection of migrant workers in Singapore.

The study was fully funded by HOME. The funding covered costs for participants’ incentives, printing costs, licenses, and other study-related expenses. No additional funding was required by external sources. 5


1 Executive summary Foreign domestic workers (FDWs) are indispensable to many households in Singapore and make important contributions to the economy and community. However, they encounter strict legal and institutional constraints and are vulnerable to exploitative structures and oppressive working and living conditions. This poses threats to their mental well-being, which is influenced by individual characteristics, socio-economic circumstances and the broader environment. Due to the lack of generalizable research on the mental well-being of FDWs in Singapore, this study sought to address the following research questions: 1. What individual characteristics and social circumstances describe working and living conditions of foreign domestic workers in Singapore? 2. What are the prevalence and severity of mental health problems among working foreign domestic workers in Singapore? 3. What is the relationship between mental well-being, and individual characteristics and social circumstances of foreign domestic workers in Singapore? Apart from identifying and reporting working and living conditions of FDWs as well as their state of well-being, this report also provides recommendations for key stakeholders and the broader community on improving the mental well-being of FDWs. Social and economic benefits of these recommendations are also discussed. Data was collected from 670 employed FDWs, mainly from the three major sending countries, Indonesia, the Philippines and Myanmar, via a cross-sectional quantitative survey. The questionnaire was self-administered in three languages, namely English, Bahasa Indonesia and Burmese. With respect to individual characteristics and social circumstances describing working and living conditions of foreign domestic workers in Singapore, we report the following key results: •

• • • •

•

•

•

•

Participants earned an average monthly salary of SGD515. Independent of the employment time with their current employer, Filipino workers received a higher income than Indonesian and Burmese FDWs respectively. Participants worked an average of 13 hours daily and slept for eight hours each night on average. 40% of the respondents did not have a weekly day off. A majority of employers kept their FDW’s passport (67%) or employment contract (60%). Around one-third of the FDWs (32%) experienced difficulties due to language barriers when communicating with their employer or employer’s family, whereby Burmese workers have more communication problems compared to the other nationalities. 27% of the respondents faced some form of invasion of privacy (most commonly by searching the FDW’s room, checking the FDW’s belongings or phone) at least once by their employer or employer’s family. 73% of the respondents experienced some form of restriction on communication by their employer or employer’s family at least once (mostly by not being allowed to make private phone calls, talk to people outside the employer’s family and/or from the FDW’s home country). 74% of the participants faced some form of restriction on movement by their employer or employer’s family at least once (most frequently by not letting the FDWs leave the house freely, and/or locking her in the house or a room). In terms of nutritional attention, most of the women (83%) always received “enough food”. 18% of the participants were never given “good food” (i.e. left-overs, expired food etc.). 13% of the surveyed women never received food that was appropriate for their religion or culture. Burmese FDWs are more likely to experience overall nutritional neglect compared to the other nationalities. 6


Around half of the respondents (54%) received adequate medical attention and less than half (43%) received adequate dental attention by their employer. • 35% of the participants experienced some form of economic abuse (mostly in form of late salary payments) at least once. 51% of the respondents faced some form of verbal abuse (mainly in form of scolding/nagging, yelling/screaming/ shouting and calling names) at least once. 6% of the respondents had been exposed to some form of physical abuse (most commonly by someone throwing objects at her) at least once. 7% of the respondents experienced some form of moral abuse (in form of insulting comments on their faith or belief(s) at least once. 7% of respondents were victims of sexual abuse (mostly in form of improper sexual comments) at least once by their employer or employer’s family. • 16% of the participants had contact with friends and relatives in Singapore less than once a week and 23% communicated with family and friends in their home country or outside Singapore less than once a week. Burmese FDWs are less likely to have weekly contact with friends and family in Singapore or in their home country compared to the other nationalities. • 81% of the respondents did not visit their home country on a yearly basis, and 12% visited their home country less than once every two years. • The most common contact persons for FDWs faced with emotional problems(s) were friends or family in Singapore (43%), followed by the employer (38%) and family and friends outside Singapore or in the FDWs’ home country (25%). Burmese FDWs more often do not seek external help at all, while Filipino FDWs are more likely to ask for help from others when experiencing emotional problems. • 59% of the participants did not always feel privacy in their current employer’s house. • Approximately half of the respondents (47%) did not always feel integrated into their current employer’s family, i.e. treated as a family member. • 65% of the respondents were not always treated with dignity by their employer or employer’s family. •

• 85% of the participants had some form of concerns and worries about their family (mostly about their children in their home country). • Only one-third of the participants (30%) never suffered from homesickness. Concerning the prevalence and severity of mental health problems among working FDWs in Singapore, the study revealed the following key findings: •

•

•

Overall, the results indicate an elevated level of mental distress among the FDW population in Singapore. More than two out of every 10 participants (24%) could be classified as having poor mental health. Compared to worldwide and Singapore statistics, FDWs in Singapore are doubly at risk to develop mental health problems. When compared to a reference population the relative most severe psychological symptoms concerned “psychoticism” (a mental state of ‘losing contact with reality’, including symptoms such as hallucinations, delusions, grandiosity, paranoia or catatonia), followed by “depression” (which includes persistent low mood, self-esteem, loss of interest and pleasure, and hope), and “interpersonal sensitivity” (that defines feelings of personal inadequacy and inferiority, particularly in comparison with others). The level of mental distress related to “psychotic” symptoms suggests that professional treatment is required. Filipino FDWs experience the highest overall mental distress and suffer more with respect to different mental symptom dimensions compared to the other nationalities. They are also more likely to suffer from poor mental health than Indonesian FDWs. No differences were found between these nationalities and the Burmese FDWs.

7


In terms of the relationship between mental well-being, and individual characteristics and social circumstances describing working and living conditions of foreign domestic workers in Singapore, several factors proved to be significantly related to mental health: •

•

•

For all FDWs, the most important protective factors, which are beneficial for good mental wellbeing are a perceived sense of integration into the employer’s family, a perceived feeling of privacy in the employer’s house, a positive perception of being treated with dignity by and a high level of satisfaction with their current employer or employer’s family and with working in Singapore. Sufficient rest, having one’s own room to sleep in, adequate nutritional and medical attention by the employer and having a stable social network are also crucial for good mental health. Risk factors, which are most detrimental to FDW’s psychological well-being, include languagerelated communication barriers and abusive behaviors (especially verbal and physical) by the employer or employer’s family. Invasions of privacy or restrictions of communication by the employer or employer’s family are also harmful to the FDWs’ mental health. Finally, debt, physical illness, homesickness or worries about their families at home can impair the mental health of FDWs. Overall, more than one-third (36%) of variations in FDW’s mental health problems in Singapore can be explained by the following variables: o High levels of satisfaction with working in Singapore and a perceived treatment as family member by the employer’s family have positive effects on mental health. o Homesickness, the existence of debt, chronic physical illness, language-related communication barriers and sexually abusive behavior by the employer or employer’s family are detrimental to the mental health of FDWs in Singapore. o FDWs from the Philippines have a higher risk than FDWs from Myanmar or Indonesia of developing mental health related problems.

Based on these findings, our recommendations for key stakeholders for better protection of Singapore’s FDW population are: Recommendations for foreign domestic workers: •

•

FDWs should be encouraged to be proactive and approach friends, family and organizations such as HOME for help when experiencing homesickness, distress, family concerns or a mental health problem. FDWs should learn the language of the host family, most typically English and/or Chinese (Mandarin).

Recommendations for employers: •

• •

Employers of FDWs in Singapore should learn some useful phrases of their FDW’s native language, maintain open channels of communication and strive to treat their employees professionally and with respect at all times. Employers of FDWs should ensure a full weekly rest day and limit working hours during the day for their FDWs. FDWs should not be deprived of a phone to maintain contact with friends and family.

Recommendations for the Singapore government: • •

Domestic workers should be covered by the Employment Act and Work Injury Compensation Act. Set limits on FDWs working hours and ensure they are entitled to public holidays and annual leave.

8


• • • • • • • •

• •

•

•

•

•

•

Paid sick leave and adequate and comprehensive medical and dental care should be made compulsory. The right to a weekly rest day should be strictly enforced and it should be 24 hours. Implement regulations, which protect domestic workers’ privacy. Take steps to make verbal abuse a reportable offence and communicate a zero-tolerance stance towards the abuse of FDWs in any form. Enforce the right of domestic workers to hold their passport and identity documents without fear of retaliation from employers and employment agents. Allow domestic workers to switch employers freely without having to seek permission from their sponsoring employer. Provide live-out options for domestic workers. Inspect workplace conditions regularly, especially those of newly arrived FDWs, through visits and private interviews with migrant domestic workers, coordinating with and involving migrant workers groups, and employment agencies. Abolish the SGD5,000 [US2,950] security bond for employers. Regulate the excessive fees employment agencies charge domestic workers by strictly enforcing the two-month salary cap and disallow agencies from imposing ‘loans’ on FDWs to recover costs. Employment agencies in Singapore should create recommended pay scales according to work experience and other relevant qualifications, such as education, and to abolish discriminatory practices that determine entry-level wages according to nationality. The Association of Employment Agencies Singapore and CaseTrust should develop counseling and conflict resolution courses for its members and the attendance of these courses should be a licensing requirement. Bilateral and multilateral cooperation with source countries, such as the Philippines and Indonesia, should be promoted to ensure more effective protection of FDWs from the deceptive, coercive and abusive behaviors of employment agents and employers. Bilateral agreements, which formalize such efforts, should be signed. The Ministry of Social and Family Development should provide resources to Family Service Centres and the newly established Social Service Offices (SSOs) to do outreach, provide counseling and social support for domestic workers. Ratify the International Labour Organisation’s Domestic Workers Convention (C189).

This study is the first of its kind in Singapore and provides detailed insights into the mental health issues faced by FDWs. Overall, results of the study indicate that FDWs in Singapore are especially vulnerable and susceptible to poor mental health and there are clear correlations between FDWs’ mental health issues and exploitative, restrictive and/or abusive working and living conditions.

9


2 Introduction The following section presents a brief overview of HOME’s activities and informs about the working and living conditions of FDWs in Singapore, based on available empirical data, and the relevance of mental health research within this population.

2.1 The Humanitarian Organization for Migration Economics (HOME) The Humanitarian Organization for Migration Economics (HOME), founded in 2004, is a nongovernmental organization and registered charity with Institution of a Public Character (IPC) status, which is dedicated to serving the needs of the migrant worker community in Singapore. The mission objectives of HOME are, first, to develop research and education on the socioeconomic of migration on Singapore and the countries of origin, second, to provide social integration services for emigrants and immigrants, and, third, to provide humanitarian assistance for the effects of 'crisis' migration. HOME has delivered services to thousands of migrant workers in need through its provision of shelters, legal assistance, health education training and rehabilitative services. Roughly 60% of those assisted by HOME are FDWs. Through its day-to-day interaction with the FDW community, HOME has a clear insight into the challenges these women are facing and the support and services, which they require as a result.

2.2 Background and research rationale 2.2.1 Foreign domestic workers in Singapore There are more than 1.3 million documented migrant workers in Singapore, of which are about 1.1 million low-wage workers 1 (as of June 2014). 218,300 of them are documented foreign domestic workers (FDWs)2, forming a sizeable 16% of Singapore’s total foreign workforce3. The majority of FDWs are from Indonesia (estimated number of 120,0004) and the Philippines (estimated number of 70,0005) but numbers show an increase of recruited domestic workers from Myanmar since 2006 (estimated number of 30,0006). In fact, numbers based on estimations by embassies and FDW agents highlight that Burmese domestic workers have increased by 50% over the past two years. In the same period, domestic workers from the Philippines have increased by 30%. There are also FDWs from Sri Lanka, India, Bangladesh and Cambodia, but they represent a notably smaller number of the total work force7. An estimated one in five households employ and are dependent on FDWs for housekeeping and care for the elderly and the young, thus allowing more Singaporeans to (re)enter the workforce. Employment agencies are prevalent in Singapore, with 1,063 licensed employment agencies connecting FDWs with employers8. Employers pay roughly SGD302 million to SGD667 million9 to the central government fund annually for the FDW levy, a pricing mechanism to regulate the number of FDWs in Singapore. Seen as an economic necessity10, Singapore’s national income from FDWs and other foreign labor was estimated to be SGD62 billion in the year 2000 alone11. The growth in the number of FDWs in Singapore seems likely to continue unabated: the government plans to increase the number of FDWs in Singapore to 300,000 by 2030 to provide balance between the number of skilled and less-skilled workers, as well as to provide healthcare and domestic services. The government also contends that foreign workers help businesses thrive when the economy is strong12. 10


Overall, FDWs have held an important position in the lives of Singaporeans since the late 1960’s and are indispensable to Singapore’s economic strength. However, these women encounter strict legal and institutionalized constraints and are vulnerable to oppressive working and living conditions and exploitative structures. This poses threats to their mental well-being. With respect to working conditions, FDWs in Singapore may face “structurally hostile work conditions”13, including long working hours, low wages and unequal access to employment benefits. In an interview study14, conducted in 2005 with 45 Filipino and Indonesian FDWs working in Singapore, respondents reported long working hours (13-19 hours), a lack of rest days inadequate sleeping accommodations (shared with employer or employer’s children), food deprivation, physical and psychological abuse, such as intimidation, belittling, threats of isolation and repatriation. Another questionnaire study15 from 2008 with 302 Filipino FDWs previously being employed in Singapore (10%) and other countries found that FDWs faced problems at work such as poor working conditions, difficulties in getting along with their employer and/or differences in personalities between them and their employer, language barriers, and mistreatments by their employer (e.g. lack of food, denying requests for day-offs and vacation, delayed salaries, heavy workload, and long hours of work). An imbalance of power is particularly heightened given that FDWs live and work in the home of their employer. Thus, they are vulnerable not only to physical abuse but also, and more commonly, to verbal abuse and threats16. FDWs also may face inhumane treatment in the form of employers placing constraints on communications (e.g. the employer does not allow their FDW to have a mobile phone), installment of hidden cameras, inadequate provision or constraints of food or economic abuse (deducting and denial of salary). An analysis of Singaporean court transcripts and press reports17 in 2007 revealed the employer’s home as a site not only of domestic service but also of domestic abuse. The analysis also highlighted a lack of privacy and designated space within the household, which led to physical or other abuse and nutritional neglect of FDWs. Vulnerability to mistreatment and exploitation of FDWs may be exacerbated by the lack of adequate legal protection for FDWs in Singapore. There is an absence of labor laws regulating the conditions of domestic workers (FDWs are excluded from the Employment Act). Singapore’s immigration framework encourages employers to ‘control’ their employees: a security bond of SGD5,000 may be forfeited by employers if their employee engages in certain conduct, and employers determine whether to allow their FDW to transfer to a new employer. Employers also have the unilateral power to end a contract immediately without indicating reasons if they do not longer require the FDW’s service and to send her back to the employment agency or repatriate her. Further, the exchange policies of employment agencies can operate in ways that are exploitative. For instance, employment agencies are able to charge FDWs placement fees equivalent of two-month salary if the employer sends her back to the employment agency and if the agency is to find a new employer for the FDW. These one-sided conditions have the potential to harm FDWs economically and physically and lead to “grossly unequal power relations” 18 between FDWs and their employers, employment agencies and the Singapore government. In relation to social security and medical benefits, FDWs have insufficient medical insurance coverage, especially for serious medical conditions, which require major surgical procedures or longer hospital stays. Discrimination experienced by FDWs is another area of concern. Migrant workers are frequently portrayed negatively in the newspapers and other media, which may lead to a misperception and negative view in the Singaporean public. It is also argued19 that “the displays of employment agencies in shopping centres underscore the notion that domestic workers are goods to be sold, rather than human beings requiring treatment with respect and dignity”. FDWs can be abused, looked down upon and/or disparaged by the Singaporean community as a result of social exclusion Finally, migration stress caused by financial and job-related difficulties, cultural differences and language barriers or discrimination is common. Already isolated by society, FDWs’ relationships to their own families (especially to their children) are likely to be burdened20: Some women are forced to 11


work in Singapore to escape domestic problems (e.g. issues with violence, alcohol abuse and/or gambling in the family home). In addition, their family problems often involve family members at home making incessant requests for money and goods, with the FDW in Singapore often being the only breadwinner in her family.

2.2.2 The relevance of mental health research We acknowledge that there are Singaporeans treat their domestic workers well, but in certain households they are seen as “submissive and docile servants”21. Their exposure to risk factors described above can lead to the exploitation, victimization and marginalization of these women and poses threats to their mental health22. Mental health or psychological well-being makes up an integral part of an individual’s capacity to lead a fulfilling life, including the ability to study, work or pursue leisure interests, and to make day-to-day personal or household decisions about educational, employment, housing or other choices. Good mental health is essential to one’s individual functioning and well-being – these can be measured by reference values such as pleasure, happiness and life satisfaction, family relations, friendships and social interaction and independent thought and action. Overall, mental health and illnesses are believed to be a result of a combination of several different elements rather than just a single factor. Mental well-being is influenced not only by individual attributes (cognition and behavior) but also by a person’s socioeconomic circumstances and their broader environment (i.e. opportunities and rights)23. Table 1: Risk factors and protective factors for mental health.24 Level of determinant

Individual attributes

Social circumstances

Environmental factors

Risk factors

Protective factors

Low self-esteem

Self-esteem, confidence

Emotional immaturity

Ability to manage stress and adversity

Difficulties in communicating

Communication skills

Medical illness, substance abuse

Physical health, fitness

Loneliness, bereavement

Social support of family and friends

Neglect, family conflict

Good parenting/family interaction

Exposure to violence/abuse

Physical security and safety

Low income and poverty

Economic security

Difficulties or failure at school

Scholastic achievement

Work stress, unemployment

Satisfaction and success at work

Poor access to basic services

Equality of access to basic services

Injustice and discrimination

Social justice, tolerance, integration

Exposure to war or disaster

Physical security and safety

12


With respect to individual attributes and behaviors, apart from genetic and biological factors, physical illness, poor nutrition or difficulties in communicating are some of the adverse factors that are relevant to mental health,. Social circumstances that may influence mental health negatively are, for instance, a lack of social support, neglect, family conflicts, exposure to violence or abuse, low income and poverty/debt, work stress, a low educational level or poor housing and living conditions. Environmental factors can include, amongst others, injustice or discrimination or social or gender inequalities (including restrictions in legal or human rights), social exclusion or isolation. Additionally, certain groups in society, such as minority groups, persons exposed to violence or economically or educationally disadvantaged persons (so-called vulnerable populations) may be particularly susceptible to experiencing mental health problems25. Table 1 above provides an overview on different factors that may be beneficial for a good mental well-being or threaten mental health. Mental health problems are serious health concerns that affect 450 million people worldwide26. 10% of the world’s population is suffering from mental illness27. Consequently, mental illnesses are not only a growing public health concern but also a major social and economic issue affecting individuals and families throughout the world28. For instance, the Singapore Mental Health Study29, a nationwide crosssectional interview study, led by the Institute of Mental Health (IMH), indicates that one out of 10 Singaporeans (12%) will be affected by mental illness in their lifetime. Additionally, gender, ethnicity, marital status and chronic physical illnesses proved to be connected to mental disorders in this research. Generally, the prevalence of mental disorders, extent of disability caused by these disorders, and service utilization amongst patients suffering from mental disorders have been extensively studied in developed countries. Nevertheless, only little empirical evidence is available globally about the mental health issues of FDWs, despite the growing number of migrant workers worldwide. The existing research on migrant workers’ mental health conducted in other countries clearly highlights relationships between exploitative and abusive work conditions and mental health problems of female migrant workers30. The relationship between domestic work conditions and the mental health of FDWs is underresearched in the Singaporean context. One qualitative study31 conducted in Singapore in 1993 surveyed 44 Filipino FDWs who had received in-patient treatment for mental illness. Results showed that the most common diagnoses were psychotic schizophrenic disorders. Financial hardships and work-related problems were identified as potential psychosocial and socio-cultural stress factors. The authors concluded that both migration and post-migration stresses influenced most of the respondents’ illness. In an exploratory study led by HOME32 in 2010, work-related stressors as well as forms of abuse faced by participants were assessed and their impact on the health of FDWs in Singapore was identified. 15 focus group discussions with 58 FDWs who were victims of employer or agent abuse during their employment in Singapore were conducted. Key findings suggest that most common forms of workrelated stressors and abuses include being overworked (with an average of 18 hours of daily work), denial of rest days (71%), restrictions on movement (78%) and communication, food deprivation (59%), and emotional (88%) or physical violence (24%), such as punching, pushing, kicking, pulling of ears, slamming head against the wall or beatings. As an assumed result of working under these conditions, physical ailments developed for the majority of the participants with symptoms of mental illness such as anxiety and worry (91%), stress (91%), loneliness (93%), and sadness/ depression (98%). These few studies suggest that mental health problems exist in Singapore’s FDW population. This is also evident in HOME’s everyday experience and contact with approximately 1,000 FDWs yearly who approach HOME for help and assistance. Their problems involve non-payment of salary, illegal deployment and police cases, such as molest, rape or physical abuse. However, available data on FDWs’ mental health in Singapore is based on subjective insular reports, anecdotal evidence or qualitative (not generalizable) research only. As a result, no representative information is available, and thus, there is no possibility to accurately assess and respond to the mental health issues faced by FDWs in Singapore. Generally, FDWs form a significant, yet under-studied segment of the population in Singapore. Due to the lack of quantitative data, the present study sought to focus on FDWs’ mental health. 13


3 Study objectives and research questions The main objective of the study was to conduct a quantitative, comprehensive assessment of the state of mental health and associated factors of working FDWs in Singapore in order to explain and predict potential mental health problems. By doing so, we aim to, first, raise awareness of mental health-related problems among domestic workers in Singapore. Second, we want to inform policy makers, and, third, identify legal and policy gaps in the existing laws to create better protection of FDWs’ overall mental well-being in Singapore. This study adopted an exploratory approach and seeks to provide the first accurate and detailed insights into the mental well-being of FDWs in Singapore. The study addresses the following research questions: 1. What individual attributes and behaviors and social circumstances describe working and living conditions of foreign domestic workers in Singapore? 2. What are prevalence and severity of mental health problems among working foreign domestic workers in Singapore? 3. What is the relationship between mental well-being, and individual chractersitics and social circumstances of foreign domestic workers in Singapore? These three research questions would also allow for comparisons between the major FDW populations in Singapore with respect to their country of origin (i.e. Indonesia, the Philippines and Myanmar).

14


4 Methodology Theoretically, the study was based on the paradigmatic research approach33 of the Diathesis Stress Model34, which proposes a complex bio-psychosocial nature of mental health problems. According to the model, different biological, psychological and environmental factors can all contribute in a dynamic interaction to the development or progression of mental disorders. Mental illnesses are believed to be a result of a combination of several different factors rather than just a single cause, as shown in Figure 1. Figure 1: Factors influencing a person’s mental well-being.

Individual attributes and behaviors

Mental health Social and economic circumstances

Environmental factors

In this study, we focused on FDWs’ individual attributes and behaviors and socioeconomic circumstances. As FDWs in Singapore not only work for but also live with their employer in the same home, the main focus of assessed variables was in relation to the FDWs’ employer or employer’s family, representing the main reference and key contact persons for FDWs in Singapore. No environmental factors capturing social, legal or other circumstances were assessed, as those were defined for all participants by the broader employment conditions and legal policies in Singapore. However, the relevance of environmental factors is discussed in Section 7.

4.1 Study variables We identified relevant variables and constructs based on a survey of existing literature on FDWs’ mental health and general mental health-related empirical data35. Mental health was assessed using the Brief Symptom Inventory (BSI)36. This standardized self-report measure captures mental distress via 53 items using the Global Severity Index (GSI) as global index of mental distress. The GSI provides information on the number(s) of symptoms and the intensity of distress. Furthermore, the measure captures nine psychological symptom dimensions: 15


• •

• • • • • • •

Somatization is the experience and communication of psychological distress in form of somatic symptoms (e.g. pain and/or paralysis). Obsessive-compulsive disorders include intrusive thoughts that produce uneasiness, apprehension, fear or worry (obsessions) and/or repetitive behavior to reduce associated anxiety (compulsions). Interpersonal sensitivity defines feelings of personal inadequacy and inferiority, particularly in comparison with others. Depression includes persistent low mood, self-esteem, loss of interest and pleasure, and hope. Anxiety describes a state of inner turmoil, consisting generalized and unfocused fear, worry, uneasiness and anxiety. Hostility refers to emotionally charged angry and aggressive thoughts, feelings or actions. Phobic anxiety as a type of anxiety captures a persistent yet irrational and disproportionate fear of an object or a situation and leads to avoidance or escape behavior (e.g. agoraphobia) Paranoid ideation describes personal beliefs of being harassed or persecuted or beliefs involving general suspiciousness about others. Psychoticism is a mental state of ‘losing contact with reality’, including symptoms such as hallucinations, delusions, grandiosity, paranoia or catatonia.

Moreover, four additional items (i.e. poor appetite, trouble falling asleep, thoughts of death or dying, and feelings of guilt), which are not univocal to the nine primary dimensions but are of general clinical significance, were measured. The BSI provides reference norms for female non-clinical populations using standardized T Scores (Min = 0, Max = 100) to be able to compare the results of the test for one group with other populations and to assess the severity of mental health related distress by providing a threshold for suggested treatment. Generally, scores above 60 are regarded as high, scores from 55-59 are high average, scores of 45-54 are average, scores of 40-44 are low average, and scores 39 and below are considerably below average. According to the test manual37, a T Score of 63 and above either for the overall indicator for mental distress, GSI, or any one dimension indicates so-called “caseness”, which implies a positive diagnosis that is appropriate to initiate treatment. To further determine cases of distress, available GSI thresholds38 based on the individual scores of the GSI. Individual respondents who had a GSI score greater than .78 were considered to have poor mental health. Reliability, validity, and utility of the BSI instrument have been tested in more than 400 research studies39 using the BSI as measure across a broad range of contexts, including research on migrant worker populations in China40. With respect to potential correlates, i.e. individual attributes and behaviors and current social circumstances describing working and living conditions of FDWs in Singapore, we measured the following variables: a) FDWs’ individual attributes and behaviors: Individual and sociodemographic characteristics -

Country of origin Age Marital status Children (number, age of youngest child) Statement of belief Education (years of schooling after kindergarten) and previous occupation Reasons to work in Singapore 16


-

-

Debt (in Singapore and home country) Use of employment agency Work experience: • Previous work experience as FDW in other countries • Duration of employment in Singapore and total number of employers • Length of employment with current employer Existence of chronic health conditions (including the need for medication)

View on working and living situation -

Perceived feeling of privacy in employer’s house Perceived (level of) integration into the employer’s family, i.e. treatment as family member Perceived treatment with dignity (care, respect, treatment as human being) by employer or employer’s family Family concerns (worry about partner, children, other family members) Homesickness Overall satisfaction41 with... - Current employment agency in Singapore (if applicable) - Current employer or employer’s family - Working in Singapore - Social life

b) Social circumstances: Employment conditions and working environment • • • • • • • •

Monthly income (after salary deduction, if applicable) Daily working and sleeping hours Frequency of rest days Nationality of current employer Number of family members in house Sleeping accommodation Possession of personal documents (passport, employment contract, work permit) Language problems when communicating with employer or employer’s family

Treatment by the employer or employer’s family • • • • • •

Invasion of privacy, including existence of surveillance cameras in employer’s house Restriction on communication Restriction on movement, including possession of key to house Nutritional attention: quality, quantity, adequacy of provided food; number of daily proper meals Medical/dental attention Economic, verbal, physical, moral and sexual42 abuse

Social network and support • • •

Frequency of contact to friends/family in Singapore and in home country Frequency of visits to home country Contact persons (sources of social support) when emotional problems occur

For additional information on scaling and measurement level see Appendix 10.1. Furthermore, selective qualitative data was collected in the form of (voluntary) open-ended questions. Using a qualitative approach via the inclusion of open-ended questions enabled to capture participants’ 17


information based on their own words in their native language and perceived relevance with respect to particular topics of interest. The aim was to give the study a more differentiated perspective by incorporating the participants’ subjective input, thereby enriching the data43. For the purpose of this report, we will incorporate findings related to the following open-ended question: • “What do you think is the best way to help the emotional well-being of domestic workers in Singapore? Please write 1 or 2 ways. You can write in your own language.”

4.2 Questionnaire development We collected the data using a self-administered questionnaire in English, Bahasa Indonesian and Burmese language versions. The final data collection instrument was developed following an iterative, formative evaluative approach: English version. A pretest of the questionnaire in English combined with a focus group session was conducted with 10 FDW participants from the target countries. The discussion was videotaped with the participants’ consent. Main objectives were to test the initial English version of the questionnaire, i.e. questions and instructions, and to discuss and decide if a translation of the survey instrument to the respondents’ native languages was needed and preferred. Based on the participants’ feedback the questionnaire content was further simplified, clarified and shortened due to a long average completion time of 48 minutes. Regarding the language(s) in which the questionnaire should be administered, nine out of 10 participants favored an English version. Thus, the decision was made to administer an English version only. However, this decision was later revised during the data collection (see below). To carry out the entire research project ‘in miniature’ including selecting a sample, pretesting measures, training experimenters, gathering data, assessing sources of bias, and coding and analyzing the data gathered, the revised version of the English questionnaire (based on the pretest and focus group results) was administered to seven participants who fit the selection criteria for the study. This pilot study provided opportunities to further improve the questionnaire and at the same time, facilitated a smooth implementation of the actual survey administration. The pilot session further revealed minor inconsistencies and previously missed language-related problems in the questionnaire. Therefore, we removed or further simplified certain terms or expressions to aid comprehension. Analysis of the data also initially supported the decision to administer the questionnaire in English as all respondents answered the questions. Bahasa Indonesian and Burmese versions. Despite the positive feedback regarding the use of an English version, it became evident during the data collection that the application of the English version would lead to language-related biases and threaten the internal validity of the data collection instrument: The first data analysis showed that mainly Filipino FDWs answered the questionnaire comprehensively and were confident with the administration of the English instrument. Data from other nationalities (i.e. Indonesian and Burmese FDWs’ responses) showed a disproportionate number of missing or inconsistent data. Numerous questions needed to be clarified during the data collection as evident from the experimenter protocols, which indicated that some of the respondents had issues with the English language and comprehension. These problems predominantly concerned the measure for mental health, BSI. For this reason, we decided to revise the data collection process by introducing additional questionnaire versions, including a translation of the BSI, in Bahasa Indonesian and Burmese to include FDWs who may have been hesitant or unable to participate due to language barriers. The data already gathered from these groups using the English questionnaire was used selectively only (see Section 5). We followed a back translation procedure44to achieve Bahasa Indonesian and Burmese language versions of the English instrument that are conceptually equivalent in each of the target countries. Task 18


specifications were defined, and the source text was translated by a native speaker into the respective language and then proofread by another mother tongue editor. Two independent native speaking translators and editors carried out the back-translation respectively. Finally, remaining translation inconsistencies were discussed with additional native speakers.

4.3 Sample Based on statistical considerations (see Section 4.6), we proposed a desired sample size for a confidence level of 99%. Sample size calculations indicated that a sample of 664 participants was needed to achieve these goals. Participants were chosen from the population of currently employed female FDWs in Singapore. To reflect the diversity of the investigated population, the sample was stratified with respect to the nationality of the respondents based on the distribution of the different countries of origin of FDWs. Relevant data was obtained from available census data provided by the Ministry of Manpower45 and by media releases, such as The Straits Times46. Overall, we estimated the distribution of the three major FDW populations to be as follows: around 56% Indonesian FDWs, 32% Filipino FDWs and 13% Burmese FDWs. However, since our last calculations, the Ministry of Manpower 47 released new numbers in June 2014, reporting 218,300 documented FDWs in Singapore.

4.4 Recruitment of participants Although random sampling is generally the sampling method of choice in order to produce generalizable data, this approach was not possible for this study. The Singapore government does not disclose such census data to the public, thus we did not have access to necessary reference census data or statistics. The only data about foreign workforce numbers publicly available is information about issued work permits for FDWs, delivering information about the number of documented, currently employed FDWs for a certain time frame48. FDWs in Singapore do not only represent a vulnerable population but also a population with limited accessibility, resulting in difficulties in collecting relevant data.49 Most of the FDWs have – if at all – only one rest day per week, usually a Sunday. Their rest days may be further limited to less than eight hours (some employers impose a curfew). Further, information communication technologies (ICT) approaches, such as (e)mail or other indirect forms of contact would not have been effective or even possible, as not all FDWs have access to ICT technology and some employers do not allow their FDWs to own or use a mobile phone. In some cases, the employer will also control incoming postal mail and may not forward some information to their FDW. As the study dealt with sensitive topics, such as abuse by the employer, a recruitment strategy that would allow assurance of confidentiality, anonymity and establishment of trust when answering the questionnaire was seen as the preferred method to elicit truthful responses, compared to a random sampling, which would require certain personal information to establish a sampling frame in order to contact potential participants. For these reasons and based on previous research experiences with this population, a direct face-to-face recruitment approach was chosen, as this would increase the possibility of contacting the largest number of participants who may be able to join the study directly. We used the following nonprobability sampling methods to recruit participants for the study:

19


•

•

•

Convenience sampling: Based on the focus group discussion, recruiters used information flyers in English, Bahasa Indonesian and Burmese languages when approaching potential participants at often-frequented locations by FDWs in Singapore on Sundays. These leaflets, also distributed at places, popular with FDWs, delivered all relevant information about the purpose and content of the study. The information flyer also contained a telephone number for interested FDWs to call and learn more about the study. Snowball sampling: We asked every participant at the end of the data collection to tell fellow FDWs about the study and, if possible, hand them a study flyer to participate in the study. This way, FDWs who already joined the study and were familiar with the setting and content of the survey could distribute this information to other potential participants, thus, ‘spreading the word’ and establishing trust about the aims of the survey. Distribution via electronic media: The information given in the study flyer was also distributed electronically on the HOME website and on HOME and FDW related Facebook pages and other social media.

All recruitment was done using a peer-recruitment approach with the help of trained FDWs who were volunteers with HOME and spoke the relevant native languages to talk to fellow FDWs(to further establish trust). The recruiters for the study were trained beforehand by the lead researcher and were regularly briefed with respect to study information and other possible questions potential participants might have. Additionally, all persons who would manage the study hotline at HOME were trained and briefed beforehand on how to address queries and requests from potential participants. Focusing on the three major populations in Singapore, the recruitment involved certain quota in order to capture information from the three major FDW sub-populations, i.e. Indonesian, Filipino and Burmese FDW. This systematic sampling was applied within each stratum (i.e. FDWs’ country of origin).

4.5 Data collection The data collection took place from November 2013 to May 2014 and followed a standardized procedure. Participants were informed about the purpose of the study and gave their written consent to participate, completed the questionnaire and were debriefed and reimbursed after completion. Group administration was implemented when possible. During the data collection, native speaking experimenters were present to address potential questions regarding the survey. Due to the sensitivity of some of the questions pertaining to the respondent’s mental health and given that that the study was conducted on a vulnerable population, respondents were also provided with an information sheet containing potential counseling hotlines to call if/when needed. Participants also were informed that they could decline to answer any question they felt uncomfortable with. Additionally, a trained counselor was present during the data collection to directly help potentially distressed participants. Each participant was reimbursed SGD10 for travel and meal expenses. The data collection took place on four locations across Singapore that FDWs are familiar with and/or visit frequently, i.e. HOME offices in Bugis (Waterloo Street) and Orchard Towers as well as City Plaza and Peninsula Plaza. The data collection locations were accessible to participants on every Sunday, which is the most common FDWs’ day off.

20


4.6 Data analysis Descriptive analyses were performed to describe working and living conditions of the participants (research question 1) and to establish the state of mental health in the sample (research question 2). Statistical differences between working and living conditions and the nationality of participants (research question 2) as well as between mental health and individual attributes and behaviors and social circumstances (research question 3) were tested using non-parametric and parametric techniques. Statistical relationships between mental health and potentially related factors (research question 3) were examined with correlation and regression analyses. Given the limitations of a convenience based sample and self-reported data as well as the nature of this exploratory study, we decided to adopt a conservative analysis approach to reduce the possibility of identifying associations that may not be real. Thus, statistical significance was evaluated using a confidence level of more than 99% (p < .01) using 2-tailed tests. We further report effect sizes with all statistically significant results in order to quantify the magnitude of relationships and differences and to indicate the substantive or practical significance. With respect to the qualitative data gathered via open-ended questions (see Section 5.4.3), the respondents’ responses were analyzed through an open-coding process, which involves identifying different patterns and themes that emerge from the data50. A detailed description of applied statistical methods and an index with common statistical abbreviations can be found in Appendices 10.2 and 10.3.

21


5 Results Valid data was collected from 670 female participants. As outlined in Section 4.2, Bahasa Indonesian and Burmese questionnaires were utilized by participants from Indonesia and Myanmar due to comprehension issues faced by these groups when responding to the questionnaire in English. These problems predominantly affected the standardized measure for mental heath, BSI. For this reason, and after careful examination of all experimenter protocols capturing occurring problems or questions during the data collection, we excluded the following data from the analysis (see Table 2 for detailed sample sizes): Descriptive results. As the examination of the experimenter protocols revealed that none of the respondents had problems answering questions related to the FDWs’ individual and sociodemographic characteristics (Section 5.1) and employment conditions and working environment51 (Section 5.1.2) we used data from all 670 respondents for the analyses (also applicable for qualitative findings as shown in Section 5.4.3). For findings related to the treatment by the employer or employer’s family (Section 5.2.2), social network and support (Section 5.2.3) as well as the FDWS’ view on their working and living situation (Section 5.3) we excluded information from participants from Indonesia, Myanmar, India and Cambodia who filled in the questionnaire in English as we could not disregard the potential issues in comprehension and language with these topics. Data from seven participants with missing information on their country of origin and from three participants who reported to have been contracted to their employer for less than one month were also omitted. The underlying assumption for the latter exclusion was that at least one month of employment would be needed to establish a relationship with the employer’s family to adequately answer questions about certain topics. In total, responses from 564 respondents we used. Mental health findings. For all results related to mental health (measured by BSI) (Section 5.4), we compared data from FDWs from Indonesia, the Philippines and Myanmar only, reflecting the three major FDW populations in Singapore. Previously collected data from Indonesian and Burmese FDWs using an English version of the questionnaire was excluded from the analyses. Further omitted from the analysis were responses from 10 participants (as outlined above) and only respondents with valid scores on the mental health measure BSI were examined. This led to a sample size of 546 participants. Comparisons between FDWs of different countries of origin. For comparisons between participants from different countries we focused on the three major populations of FDWs in Singapore, namely Indonesian, Filipino and Burmese FDWs. Data from six participants from India or Cambodia and seven participants with missing information regarding their country of origin was therefore excluded. In total, 564 respondents’ data sets could be included. Table 2: Sample sizes. Country of origin

Language of questionnaire Total

English Bahasa Burmese

Philippines

Indonesia

Myanmar

India

Cambodia

230 230

87 232 319

4 104 108

5 5

1 1

Missing information 7 7

Total 334 232 104 670

Statistical differences between the countries of origin are reported together with the respective descriptive statistics, i.e. measures of tendency and dispersion. Medium and large effects found are reported in brackets together with the respective statistically significant findings. For the findings of the qualitative analysis quotes from the respondents are used in this report. When participants answered the question in their native language, the translated quote is marked “TL”. 22


5.1 FDWs’ individual attributes and behaviors – Individual and sociodemographic characteristics This section includes information on the participants’ countries of origin, age, marital and motherhood status, statements of belief, education and previous occupation, reason(s) for working in Singapore, debt or financial difficulties, work experience, current usage of an employment agency and existence of chronic health conditions. With respect to the participants’ country of origin52, FDWs from Indonesia represented the largest group (48%), followed by Filipino (35%) and Burmese (16%) FDWs. 1% of the women were from Cambodia or India. Figure 2 provides a breakdown of the FDWs’ nationalities. Figure 2: Countries of origin. 1 16.3 34.7

Philippines Indonesia

%

Myanmar Other 48.1

The reported average age53 of the respondents was 33.31 years (SD = 6.85) and varied between 19 years of age to 60 years old. The age among FDWs from the various countries differed significantly 54. Burmese domestic workers were the youngest group overall with an average age of 28.94 years (SD = 4.83), significantly younger than Indonesian FDWs who were on average 32.63 (SD = 6.03) years old55 and Filipino FDWs with an average age of 36.16 years (SD = 7.38)56(effect of medium magnitude). Indonesian FDWs were also significantly younger than Filipino FDWs57, who were overall the oldest group. Regarding the participants’ marital status58 almost half of the participants (45%) reported to have never been married, as shown in Table 3. Statistically significant relationships were found between the FDWs’ country of origin and marital status59 (effect of medium magnitude): Indonesian FDWs were less likely to report to be single (34%) than Burmese FDWs (83%), while no differences were found between either of these groups and Filipino FDWs (45% singles). Table 3: Marital status. Marital status Single, never married Married Married, but separated from husband Divorced Widowed (husband deceased) Marriage annulled (Philippines)

Answers in % 45.4 29.1 10.7 10.2 4.3 0.2 23


54% of the participants60 reported to be mothers with an average of 1.81 children (SD = 1.02), with the reported average age of the youngest child being 10.88 years old (SD = 5.75)61. A statistically significant relationship between the FDWs’ country of origin and the number of children was observed62 (effect of medium magnitude): Burmese FDWs were less likely to report to be mothers (4%), while no differences were found between Indonesian (54% mothers) and Filipino FDWs (43% mothers) respectively and Burmese FDWs. With respect to their statement of belief63, around half of the participants reported to be Muslim (47%), followed by Christians (43%) and Buddhists (9%). Other identified creeds (1%) included Hindu, Sikh, Freethinker or no affiliation to a religious belief. Table 4 shows the statements of belief by different nationalities. Statistically significant differences64 were observed in statement of beliefs across the different nationalities: Indonesian FDWs were more likely to report a Muslim belief (96%) compared to Filipino (2%) and Burmese (3%) FDWs (effect of large magnitude). Filipino FDWs were more likely to report a Roman Catholic belief (79%) compared to Indonesian and Burmese FDWs (each 2%). Burmese FDWs were more likely to report a Buddhist belief (60%) compared to the other nationalities (each 0%). Burmese FDWs were also more likely to report a Christian belief (35%) than Indonesian FDWs (3%). No statistical differences were found between these groups and Filipino FDWs (19% other Christian belief). Table 4: Statements of belief (%). Statement of belief: Muslim Roman Catholic Christian, other Buddhist Other

Indonesia 95.5 1.6 2.6 0.4

Country of origin Philippines 1.7 78.3 19.1 0.3

Myanmar 2.9 1.9 35 59.2 1

Note. Other beliefs included Freethinkers, believers of the Seventeenth Church of Christ, Baptists, or no religious affiliation.

With respect to FDWs’ educational level, the average number of years of schooling (after kindergarten) among the FDWs65 was 10.8 years (SD = 2.50). Significant differences were found in the FDWs’ education66 (effect of medium magnitude): Both Filipino (M = 11.58, SD = 2.51) and Burmese FDWs67 (M = 11.63, SD = 1.95) reported more years of schooling than Indonesian FDWs (M = 9.99, SD = 2.42). As to the previous occupation of the respondents 68, the majority the women reported to have previously worked in retail (17%), as a homemaker (16%), in the manufacturing sector (13%) or as a domestic worker (12%). Table 5 below shows details regarding the participants’ previous occupations.

24


Table 5: Previous occupation. Sector Retail (cashier, sales lady etc.) Homemaker Manufacturing (factory worker, sewer etc.) Domestic worker Entrepreneur (own business) Agriculture (farming) Hospitality (cook, waitress etc.) Administration (office clerk) Education (teacher) Student Healthcare (nurse, caregiver etc.) Other (marketing, beauty, accountancy, IT, security etc.) Mixed (2 sectors) Unemployed

Answers in % 17.1 16 13.1 11.7 5.8 5 4.3 3.4 2.7 2.7 2.2 5.8 3.9 6.5

In terms of FDWs’ reasons to work in Singapore, the main reasons reported69 were related to economic incentives. The top three reasons stated were “sending money home to their family” (68%), followed by “saving money for the future” (63%) and “being able to send their children to school” (38%). “Other reasons” included the aspiration to build a house in the FDWs’ home country, saving for an own business or retirement or learning the English language. Figure 3 below details the respondents’ motives behind their choice to work in Singapore. Figure 3: Reasons to work in Singapore. 100 90 80 70

68.1

63.3

60

% 50 40

38.4 32.6

30 20

15

13.3

10 0

9.4 3.7

To help my To save To be able to To get new To leave an family / money for the send my experiences unhappy / parents and future abroad difficult children to siblings (send personal life school money home) at home

No jobs I need money Other reasons available in urgently for my home other reasons country

Note. Multiple responses were possible.

25


Burmese FDWs were less likely to report to “save money for the future”70 (10%), while no differences were found between the other groups (Filipino: 36%, Indonesian: 54%). Burmese FDWs were also less likely to report “to be able to send their children to school”71 (5%), while no differences were found between the other nationalities (Filipino: 38%, Indonesian: 56%). Indonesian FDWs were more likely to report their incentive for working in Singapore “to be able to help their family, parents and siblings (send money home)”72 (60)% than Burmese FDWs (18%), while no differences were found between either of those groups and Filipino FDWs (28%). Finally, Indonesian FDWs were more likely to report the reason “to leave an unhappy/difficult personal life at home”73 (21%) than Filipino FDWs (7%), while no differences were found between either of those groups and Burmese FDWs (15%). No statistical differences between the nationalities were found with respect to the work reasons “get new experiences abroad”, “need money urgently for other reasons” or “no jobs available in home country”. 13% of the respondents74 reported being in debt in Singapore, with an average debt of SGD1318 (SD = 1333)75. 12% of the FDWs76 stated being in debt in their home country, where respondents reported to owe SGD2340 (SD = 3451) on average77. Filipino FDWs78 were less likely to report not to have debt (10%) compared the other nationalities, while there were no differences between the Indonesian (28%) or Burmese (27%) FDWs in terms of being in debt. Further, with respect to the total amount of debt for all participants7980, both in Singapore and their home country, Filipino FDWs also reported a higher average debt amount of SGD518 (SD = 1900) than Indonesian FDWs who reported an average debt amount of SGD206 (SD = 890)81. No differences were found between Burmese FDWs (M = 200, SD = 578) and the other nationalities. Among the respondents82, 26% reported to have previously worked as FDW in other countries before coming to Singapore. The three most common countries83 identified were Malaysia (28%), Saudi Arabia (12%) and Hong Kong (11%). These women84 reported to have worked in other countries for 3.26 years (SD = 2.32) on average. Significant relations between the FDWs’ country of origin and previous work experience as FDW in other countries were observed85: Indonesian FDWs were more likely to report having previous experience (34%) than Burmese FDWs (2%), while no differences were found between either of those groups and Filipino FDWs (25%). 68% of the surveyed FDWs86 reported currently being affiliated to an employment agency. No differences were found between the nationalities of FDWs. With regards to the FDWs’ total time working in Singapore87 the average reported number of years among the participants was 6.44 years (SD = 4.96). There were statistical differences between the nationalities88: Burmese FDWs reported a shorter working duration in Singapore with an average of 2.90 years (SD = 2.04) than Filipino FDWs with an average duration of 7.52 years (SD = 6.24)89 and Indonesian90 FDWs with an average duration of 5.93 years (SD = 3.97 (effects of medium magnitude). No differences were found between Filipino and Indonesian participants. In terms of the total number of employers, FDWs91 reported to have worked for 2.42 employers (SD = 1.61) on average during their time in Singapore. No differences were found between the nationalities of FDWs. The reported average employment duration with the FDWs’ current employer92 was 3.49 years (SD = 3.79). With respect to the employment time with their current employer93, Burmese FDWs reported an average 1.66 years (SD = 2.32), a shorter current employment time than Indonesian FDWs94 who reported an average employment duration of 3.74 years (SD = 3.53) and Filipino95 FDWs who stated four years (SD = 4.43) on average (effects of medium magnitude). There were no differences between Indonesian and Filipino FDWs’ employment time with their current employer. 16% of the participants96 reported to have been diagnosed with physical health problems in terms of chronic health condition(s) by a doctor. Most common issue for women with chronic health problems97 was chronic pain (29%), followed by hypertension and high blood pressure or ulcer and chronic inflamed bowel (each 9%) and respiratory disorders (7%). 69% of participants with chronic 26


health issues98 reported taking medication for their condition. Significant relations between the FDWs’ country of origin and the existence of one or more chronic health conditions were observed 99 : Indonesian FDWs were less likely to report physical health problems (9%) than the other nationalities. No differences were found between Filipino (24%) and Burmese FDWs (23%) regarding the report of chronic health problems.

5.2 Social circumstances The following section presents information regarding FDWs social circumstances while working in Singapore. This includes data about their employment conditions and working environment, i.e. information regarding salary, daily working and rest hours, rest days, nationality of their current employer, number of family members in the employer’s house, sleeping accommodation in the house, possession of the worker’s personal documents, and language-related communication barriers. Further, we present findings related to FDWs’ treatment by the employer or employer’s family, including invasions of privacy and restrictions on communication and movement by the employer or employer’s family, as well as abusive behavior by the employer or employer’s family. Invasion of privacy of FDWs as explored in this study includes any offensive or unjustifiable access to one's personal affairs (e.g. intrusion and access to the FDW’s phone, mail and/or personal belongings) without her permission and/or knowledge 100 . Restriction on communication is a form of control of information and interactions between people, such as not allowing the FDW from contacting friends and relatives101. Restriction on movement refers to a private person impeding the free movement of another, including restrictions on leaving the house and/or confinement102. We define abuse103 as any form of violence toward the FDW that potentially harms her physically or emotionally. It includes all forms of physical, sexual and/or emotional ill-treatment, sexual abuse, neglect or negligent treatment or other exploitation that results in actual or potential harm to the a person’s mental and physical health, survival, development or dignity in the context of a relationship of responsibility, trust or power. In this report, we distinguish between six subtypes of abuse – neglect (of nutritional and medical/dental attention), economic, verbal, physical, moral and sexual abuse. Neglect is a passive form of abuse in which a caregiver responsible for providing care for a person fails to provide adequate care for the victim's needs, to the detriment of the victim. Examples of neglect include failing to provide sufficient nourishment, medical care or other needs for which the victim is helpless to provide for themselves. Economic abuse is a form of abuse when one has control over another person's access to economic resources, which diminishes the victim's capacity to support herself and forces her to depend on the perpetrator financially. Verbal abuse is a form of abusive behavior involving the use of language and can occur with or without the use of expletives or threats. Physical abuse is an act of abuse involving physical contact intended to cause feelings of physical pain, injury or other physical suffering or bodily harm. Moral abuse is abuse of one’s character with embarrassing and/or humiliating effects on the victim. It results in the feeling of being offended, disregarded, belittled, denigrated, subordinated or embarrassed by someone else. Sexual abuse refers to the forcing of undesired sexual behavior by one person upon another, when that force falls short of being considered a sexual assault. The section ends with the presentation of results related to FDWs’ social network and support, in terms of the frequency of contact to friends and family in and outside Singapore, the frequency of visits to their home country and sources of social support when emotional problems arise.

5.2.1 Employment conditions and working environment On average, the participants104 reported to earn a monthly salary (after salary deduction, if applicable) of SGD515 (SD = 97.98). With respect to the monthly salary, there are statistical differences between the nationalities of the FDWs105: Independent of the employment time with their current employer106, 27


Filipino FDWs (M = 555, SE = 8.24) reported a higher income than Indonesian (M = 516, SE = 8.04)107 and Burmese (M= 474, SE = 12.40)108 FDWs. There were no differences in salary between Indonesian and Burmese FDWs. Figure 4 shows the differences in income. Figure 4: Monthly salary. 580 555

560 540 SGD

516

515

520 500

474

480 460 440 420 All FDWs

Filipino

Indonesian

Burmese

Regarding the participants’ working hours109, FDWs reported an average of 13.30 hours of work per day (SD = 3.12). In terms of sleeping hours110, results show a reported average of 7.83 hours of sleep per night (SD = 1.30). There were statistical differences between the nationalities of the FDWs With respect to the daily working hours 111: Indonesian FDWs reported working longer per day with an average of 13.85 hours (SD = 2.96) than Filipino FDWs who reported to work on average for 12.72 hours daily (SD = 3.01)112. No differences were found between Burmese FDWs, who stated an average of 12.79 working hours (SD = 3.19), and the other nationalities. Further, no differences were found between nationalities in terms of their daily sleeping hours. Figure 5: Rest days. 100 90 80 70 54.2

60

%

50 40 24

30 20 10

11.5

4.4

3.9

0.8

0.5

0 No day off

Once a month

Twice a month

Three times a month

Weekly

Weekly + public holidays

Weekly + public holidays + special occasions

28


In relation to rest days, around half of the participants113 (54%) reported to have a weekly day-off. 5% of respondents stated to be given a day-off weekly and on public holidays and/or special occasions, (e.g. their birthday). However, 40% of the participants stated having a rest day less than once a week. Detailed responses of the FDWs’ rest days are shown in Figure 5 above. No differences were found between the nationalities of FDWs. Regarding the nationality of their employer, most of the respondents114 reported to work for a local Singaporean employer (68%), with the reported majority of employers being of Chinese descent (80%)115. 10% of the local Singaporeans employer reportedly were of Indian, 7% of Malay and 3% of other descent. As for the foreign employers116, the top three countries of origin reportedly were Australia (11%), the United States (10%) and India, China or the United Kingdom (each 6%). The distribution of employers’ nationalities can be seen in Figure 6 below. Several significant relations between the FDWs’ country of origin and the nationality of their employer117 were observed118: Filipino FDWs were more likely to report to work for a foreign employer (44%%) than Indonesian FDWs (22%%). No differences were found between the other nationalities and Burmese FDWs with respect to working for a foreign employer (25%). Figure 6: Nationality of current employer. 2.9%

29.4%

Local Singaporean Foreigner

% 67.8%

Mixed nationalities

The reported average number of family members in the employer’s house119 was 4.13 (SD = 1.54). No differences were found between the nationalities of FDWs. Figure 7: Sleeping accommodation.

10.2

%

Own room 25.6

Shared room Other accomodation 64.2

29


As to the participants’ sleeping accommodation120, the majority (64%) stated having their own room, while about a quarter (26%) reported sharing a room, mostly with the employer’s children or an elderly female family member, for example the ‘ah ma’ (grandmother). 10% reported sleeping in an “other accommodation”, such as the storage room, living room, kitchen or bomb shelter, as shown in Figure 7 above. No differences were found between the nationalities of FDWs. Regarding the possession of personal documents, FDWs employers reportedly kept the FDW’s personal documents, i.e. her passport121 (67% in possession of employer) or her employment contract122 (60%) in majority of the cases. The work permits of the participants123 were reportedly mainly kept by the workers themselves (75%). Figure 8 below shows the distribution of the possession of personal documents. Several significant relations between the FDWs’ country of origin and the possession of personal documents were observed: As to the possession of their passport124, Filipino FDWs were more likely to report to keep their passport themselves (50%) than Indonesian FDWs (13%) (effect of medium magnitude). No differences were found between these groups and Burmese FDWs (25% in own possession of passport). Regarding the possession of their employment contract125, Filipino FDWs were more likely to report to keep their employment contract themselves (53%), Burmese FDWs (18%) were less likely to report to keep their employment contract themselves. No differences were found between these groups and Indonesian FDWs (35% in own possession of employment contract). With respect to the possession of their work permit126, Indonesian (34%) and Burmese (37%) FDW were more likely to report not to keep their work permit themselves than Filipino FDWs (6%) (effect of medium magnitude). Figure 8: Possession of personal documents. FDW

Employer

Employment agency

100 90 75.3

80

67.1

70

60

60

% 50 40

32.6

32.4 23.3

30 20 10 0 P

E

W

P

E

W

0.3

1.3

0.8

P

E

W

Note: P: Passport, E: employment contract, W: work permit127.

As to language-related communication problems with their employer or employer’s family, approximately one-third of the respondents128 (32%) stated experiencing at least sometimes or more often difficulties because of language barriers when talking to their employer or employer’s family, as shown in Table 6. With respect to language problems when communicating to the employer or employer’s family 129 , Burmese FDWs reported more issues (with 58% having at least sometimes problems) compared to Indonesian (25%)130 and Filipino (38%)131 FDWs who did not differ. 30


Table 6: Language-related communication problems with employer or employer’s family. Answers in % Never Rarely Sometimes Often Always All FDWs 61.1 6.7 27.5 3.4 1.4 Indonesian 65.4 9.3 22.4 2.6 0.3 Filipino 67 5.3 34.2 2.2 1.3 Burmese 38.9 3.7 45.4 7.4 4.6

5.2.2 Treatment by the current employer or employer’s family Overall, 27%132 of the surveyed women reported experiencing some form of invasion of privacy by the employer or employer’s family at least once, most commonly through the employer searching the FDW’s room (17%), followed by the employer checking the FDW’s belongings (16%), checking her phone (8%) and opening her mail (6%). Detailed responses are shown in Table 7 below. Table 7: Invasion of privacy by employer or employer’s family. Does your current employer’s family... ...search your room? All FDWs133 Indonesian Filipino Burmese ...check your things? All FDWs134 Indonesian Filipino Burmese ...check your phone? All FDWs135 Indonesian Filipino Burmese ...open your mail? All FDWs136 Indonesian Filipino Burmese

Answers in % Never

Rarely

Sometimes

Often

Always

I don’t know

72.8 86.1 63.8 61.9

3 4.8 0.9 4.1

9.6 4.3 12.9 14.4

2 1.3 1.3 5.2

2.7 0.4 3.1 7.2

9.8 3 17.9 7.2

75 82.3 71.6 65.7

2.7 2.6 1.8 5.1

9.1 5.6 11.3 12.1

1.3 1.3 0.5 3

2.9 1.7 3.2 5.1

9.1 6.5 11.7 9.1

86.7 92.6 85.2 76.3

1.8 1.3 2.7 1

3.8 2.2 5.4 4.1

1.3 0.4 0.4 5.2

0.9 0.4 0.9 2.1

5.5 3 5.4 11.3

88.4 93 87.8 78

1.1 2.2 0.5 -

2.4 0.4 3.2 5.5

0.6 0.4 2.2

1.5 0.9 0.5 5.5

6.1 3.1 8.1 8.8

As for the overall existence of any form of invasion of privacy by the employer or employer’s family137, Burmese FDWs were more likely (47%) than Indonesian FDWs (18%) to report some form of invasion of privacy. No differences were found between these groups and Filipino FDWs (27%). With respect to the employer or employer’s family searching the FDW’s room138, Indonesian reported this less often (e.g. 86% indicated “never”) than Filipino (64%)139 and Burmese (62%)140 FDWs respectively. Regarding the employer or employer’s family opening the FDW’s mail141, Burmese FDWs reported this more often (e.g. 8% indicated “often” or “always”) than Indonesian 142 and Filipino143 FDWs (each 31


1%). In terms of the employer or employer’s family checking the FDW’s belongings144, Indonesian FDWs reported this less often (e.g. 82% indicated “never”) than Burmese145 (66%) or Filipino146 FDWs (72%) respectively. No differences were found between these groups and Filipino FDWs (72%). Further, no differences were found with respect to the employer or employer’s family checking the FDW’s phone between the three nationalities. 20% of respondents147 reported the existence of surveillance cameras in their employer’s house148 as shown in Figure 9. No differences were found between the nationalities of FDWs. Figure 9: Existence of surveillance cameras in employer’s house. 100 90 80 70

67.2

60

% 50 40 30

19.8

20

13

10 0 Yes

No

I don't know

Overall, 73% of the respondents 149 reported experiencing some form of restriction on communication by their employer or employer’s family at least once. The most common restriction was employers prohibiting FDWs from making private phone calls (25%). Details are shown in Table 8 below. Table 8: Restrictions on communication by employer or employer’s family. Does your current employer’s family... ...allow you to make private phone calls? All FDWs150 Indonesian Filipino Burmese ...let you talk to people outside the family? All FDWs151 Indonesian Filipino Burmese ...let you talk to people from your own country? All FDWs152 Indonesian Filipino Burmese

Answers in % Never Rarely Sometimes Often Always 24.5 37.5 15.6 15.3

6 12.5 1.8 1

21.2 17 23.2 26.5

11.5 10.7 9.4 18.4

36.6 22.3 50 38.8

18.6 22.3 13.1 22.5

8.8 13.8 6.3 2.9

25.7 25.4 27 23.5

12 13.8 7.7 5.7

34.9 24.6 45.9 33.3

11.4 14 4 21.6

8.1 12.3 4.9 5.9

20.4 22.8 19.6 16.7

14.8 16.7 13.4 13.7

45.3 34.2 58 42.2 32


With respect to the overall existence of any form of restriction on communication by the employer or employer’s family153, Filipino FDWs were more likely not to report restrictions on communication (15%) than the other groups. No differences were found between Indonesian (6% not reporting any restrictions on communication) and Burmese FDWs (4% not reporting any restrictions on communication). As to the employer allowing private phone calls154, Indonesian FDWs reported to be less often allowed to make private calls (e.g. 38% reported that they were never allowed to make private calls) than Filipino155 (16%) (effect of medium magnitude) and Burmese156 (15%) FDWs respectively. Further, Indonesian FDWs also reported to be allowed less often to talk to people outside the family157 (e.g. only 22% reported to always be allowed to talk to other people outside the family) than Filipino FDWs (50%)158. Regarding the employer allowing the FDW to talk to people from their own country159, Filipino FDWs reported to be allowed to do so more often (58% reported that they were always allowed) than Indonesian (34%)160 and Burmese161 (42%) FDWs respectively. Generally, 74%162 reported experiencing some form of restriction on movement by their employer or employer’s family at least once. The most common reported restriction imposed on FDWs by the employers’ family was disallowing FDWs from leaving the house freely (25%). Detailed responses are outlined in Table 9 below. Table 9: Restriction on movement by employer or employer’s family. Does your current employer’s family... ...let you leave the house freely? All FDWs163 Indonesian164 Filipino165 Burmese166 ...lock you into the house? All FDWs167 Indonesian168 Filipino169 Burmese170 ...lock you into your/a room? All FDWs171 Indonesian172 Filipino173 Burmese174

Answers in % Never Rarely Sometimes Often Always 25.2 40.8 16.9 8.1

6.9 12.3 4 1

28.4 27.2 24.9 39.4

13.4 11.4 9.8 26.3

26.1 8.3 44.4 25.3

93.3 95.6 95.5 83

1.3 1.3 0.9 2

1.3 0.9 1.4 2

0.4 2

3.8 2.2 2.3 11

98.9 100 98.6 96.9

0.4 2.1

0.2 1

0.4 0.9 -

0.2 0.5 -

In relation to the overall existence of restrictions on movement by the employer or employer’s family175, Indonesian FDWs were more likely (91%) than Filipino FDWs (56%) to report some form of restriction on movement by the employer or employer’s family (56%) (effect of medium magnitude). No differences were found between these groups and Burmese FDWs (75% reported restrictions on movement). With respect the employer allowing her to leave the house freely176, Indonesian FDWs reported they are allowed this less often (e.g. only 8% reported that they were always allowed to freely leave the house) compared to Filipino 177 (44%) and Burmese 178 (25%) FDWs (effects of medium magnitude). Concerning the employer locking the FDW into the house179, Burmese FDWs reported more often they were locked into the house (11% reported to always be locked into the house) than Filipino180 and Indonesian181 FDWs (each 2%). No international differences were found with respect to reports of the employer or employer’s family locking the FDW into a room.

33


Regarding FDWs’ possession of a key to their employer’s house, 75% of respondents182 reported that they had their own key. No differences were found between the three nationalities of FDWs. As to nutritional attention, participants183 reported eating 2.89 proper meals a day (SD = 0.48) on average. Most of the respondents stated always receiving “enough food” (83%). While the majority of the FDWs (66%) reported that they were always provided with “good food”, 18% of the participants reported that they were never given high-quality food by their employer or employer’s family. Additionally, 13% of the surveyed women reported never receiving food that was appropriate for their culture or religion. Detailed responses on FDWs’ nutritional attention are listed in Table 10 below Table 10: Nutritional attention by employer. Does your current employer’s family...

Answers in % Never Rarely Sometimes Often Always

...give you enough food? All FDWs184 2.2 Indonesian185 2.2 186 Filipino 0.9 Burmese187 4.9 ...give you good food (no left-overs, expired food etc.)? All FDWs188 17.8 189 Indonesian 15 Filipino190 12.2 Burmese191 38.5 ...give you your kind of food (rice, halal etc.)? All FDWs192 12.7 Indonesian193 3.9 194 Filipino 2.3 Burmese195 56.7

2.3 2.6 2.2 1.9

6.1 4.3 8.4 4.9

6.3 6.5 8.4 1

83.2 84.3 80 87.4

3 2.7 3.2 3.3

7.2 2.2 12.2 7.7

6.3 7.1 5.4 6.6

65.7 7.3 67.1 44

2.6 0.9 4.1 3.1

10.3 5.3 12.8 16.5

8.8 10.5 9.6 3.1

65.6 79.4 71.2 20.6

As to the number of proper meals per day196, Burmese FDWs reported eating an average of 2.55 proper meals (SD = 0.63) a day, fewer times than Filipino FDWs197 who reported an average of 2.96 meals (SD = 0.47), and Indonesian FDWs with an average of 2.96 meals per day respectively (SD = 0.33)198(effects of medium magnitude). In terms of the quality of food given by the employer199, Burmese FDWs reported that they were given “good food” less often (e.g. 39% reported that they were never given good food) than Filipino (12%) 200 and Indonesian (15%) 201 FDWs (effect of medium magnitude). Concerning the adequacy of food given by the employer202, Burmese FDWs reported they were given culturally and religiously adequate food less often (e.g. 57% reported that they never received “their kind of food”) compared to Filipino (2%)203 and Indonesian (4%)204 FDWs (effects of large magnitude). No differences were found regarding the quantity of food between the nationalities. Regarding the medical and dental attention provided by their employer, the majority of FDWs (60%) that they were always allowed to see a doctor when needed and 82% that their employer always paid for the medical costs. However, zero or rare medical attention was reported by 13% of the respondents (in terms of the employer allowing them to see a doctor). As to dental care, less than half of the respondents (45%) reported that their employer always allowed them to see a dentist while 30% of the participants stated that they were never allowed to see a dentist. Moreover, only 76% of the participants’ employer reportedly always paid for the dental expenses. More details are included in Table 11 below. With respect to the employer allowing the FDW to see a dentist when needed205, Filipino FDWs reported that their employer would allow this more often (e.g. 24% of employers

34


reportedly never allowed it) than Indonesian FDWs (38% of employers reportedly never allowed it)206. No other differences regarding medical and dental attention between the nationalities were found. Table 11: Medical and dental attention by employer. Does your current employer’s family... 207

...let you see a doctor when you need it? Employer pays for doctor?208 ...let you see a dentist when you need it?209 Employer pays for dentist?210

Never 7.0 4.9 29.6 7.9

Rarely 5.8 1.7 5.7 3.6

Answers in % Sometimes Often 18.8 8.2 7.1 4.4 14.7 5 6.9 5.6

Always 60.3 81.8 45 76

When aggregating the questions above to specify adequate (i.e. the employer always allowed to see a doctor or dentist and always paid for medical or dental costs as regulated by law) vs. inadequate medical and dental attention, approximately half of the respondents 211 (54%) reported that they received adequate medical attention and less than half (43%)212 reported to receive adequate dental attention by their employer, as shown in Figure 10 below. Figure 10: Medical and dental attention by employer. Adequate medical attention

%

Adequate dental attention

46%

43% 54%

Yes

57%

No

Yes

No

Overall, 35%213 of the participants reported experiencing some form of economic abuse at least once. Most common reported were late salary payments, which 31% of the respondents indicated that they had experienced. Table 12 below summarizes the respondents’ responses. No differences were found between the nationalities of FDWs. Table 12: Economic abuse by employer or employer’s family. Does your current employer’s family... ...pay your salary at all?214 ...pay your salary late?215 ...deduct salary as punishment?216 ...deny salary as punishment?217

Never 3.1 69.3 95.8 98.1

Answers in % Rarely Sometimes 0.7 1.4 6.7 17.1 0.9 2.2 0.4 0.6

Often 2.3 3.2 0.7 0.2

Always 92.4 3.7 0.4 0.7 35


Generally, 51%218 of the respondents reported experiencing some form of verbal abuse at least once. The most common reported verbally abusive behaviors stated by FDWs were scolding/nagging (43%), yelling/screaming/shouting (28%) and calling names (20%). Most of the respondents reported that their employer had mistreated them on one to two occasions. However, several FDWs stated to be exposed to certain verbal abuses on a weekly or even daily basis. Detailed responses from FDWs regarding verbal abuse by the employer or employer’s family are shown in Table 13. No differences were found between the nationalities of FDWs. Table 13: Verbal abuse by employer or employer’s family. Are there any verbal mistreatments by your current employer’s family? Scold you/nag at you219 Yell/scream/shout at you220 Call you names (e.g. stupid, lazy)221 Threaten to send you back home222 Curse at you223 Threaten to send you back to your employment agency224 Threaten to hurt you225 Threaten to send you to the police226 Threaten to kill you227

Answers in % Never

1-2 times

3-5 times

6 or more times

Weekly

Daily

57.1 72.5 80.3 88.6 89.3 92.2 96.4 97.1 98.9

30.1 16.5 11.2 7.2 5.7 4.2 2.7 2.4 0.9

3.9 2.6 2.2 1.4 0.6 1.3 0.4 0.5 -

2.8 2.9 2.9 0.9 1.1 0.7 0.5 0.2

1.5 1.6 1.8 0.9 1.1 0.5 -

4.8 3.6 1.6 0.9 2.2 0.4 -

6%228 of all participants reported to have been exposed to some form of physical abuse at least once. FDWs mostly reported physical violence as throwing objects or pushing/pulling (each 4%) and shoving/poking/pinching (3%). Moreover, there were also a number of FDWs who reported being mistreated daily with different forms of physical abuse by their employer or employer’s family. Further information on the types of physical abuse is detailed in Table 14 below. No differences were found between the nationalities of FDWs. Table 14: Physical abuse by employer or employer’s family. Are there any physical mistreatments by your current employer’s family? Throw objects at you229 Push/pull you230 Shove/poke/pinch you231 Beat/kick you232 Slap/hit you233 Bite you234 Cut your hair without permission235 Choke you236

Never

1-2 times

95.8 96.4 97.1 98.4 98.4 98.7 99.5 99.6

2.7 2.4 2 0.7 0.9 0.7 0.4 0.2

Answers in % 6 or 3-5 more times times 0.4 0.5 0.7 0.4 0.4 0.4 0.4 0.4 0.2 0.2 0.2 0.2 -

Weekly

Daily

0.2 -

0.5 0.2 0.2 0.4 0.4 0.2 -

Concerning moral abuse, the participants were asked whether their employers had directed any insulting comments towards the FDW’s faith or belief. 7% of the respondents237 stated that they were 36


on the receiving end of insulting comments towards their faith or belief at least once. However, the vast majority of the participants (94%) reported that they were never morally abused. 5% indicated that they were insulted “1-2 times” and insults “3-5 times”, “6 or more times” or “weekly” were each reported by 1% of the respondents. With respect to the employer or employer’s family comments insulting on the FDW’s faith or belief238, Filipino FDWs reported this more often than Indonesian239 and Burmese240 FDWs respectively. 7%241 of the participants reported some form of sexual abuse during their current employment, mostly consisting of experiencing improper sexual comments by their employer or employer’s family (reported by 5%). Detailed responses from the participants are shown in Table 15 below. No differences were found between the nationalities of FDWs. Table 15: Sexual abuse by employer or employer’s family. Are there any sexual mistreatments by your current employer’s family? Make improper sexual comments242 Expose themselves in front of you243 Show you pornographic movies244 Have you touch their private parts245 Molest you/touch your private parts246 Kiss you247 Try to rape you248 Have you been raped by someone from your employer’s family?249

Never

1-2 times

95.1 98.9 99.6 99.6 99.6 99.6 100

3.2 0.9 0.2 0.2 0.4 0.4 -

100

-

Answers in % 6 or 3-5 more times times 0.5 0.9 0.2 0.2 -

Weekly

Daily

-

0.2 0.2 -

-

-

-

The summarized results regarding abusive behavior by the employer or employer’s family are shown in Figure 11 below. Figure 11: Existence of abuse by employer or employer’s family (overview). Economic

35%

% 65%

V erbal

Physical

Moral

6%

Sexual 7%

7%

49% 51%

94%

Yes

93%

93%

No

37


5.2.3 Social network and support Half of the participants250 (51%) reported having daily contact with friends and relatives within Singapore. Mostly respondents251 (52%) stated that they had weekly contact with family members back in their home countries or outside of Singapore. However, 4% and 5% of the FDWs reported having contact less than once a month with friends and family within and outside of Singapore, respectively. Overall, 16%252 of the participants reported to have less than weekly contact to friends and family in Singapore and 23%253 to have less than weekly contact to family and friends in their home country or outside Singapore. Table 16 below provides further information on the frequency of social contacts. As to the frequency of contact with friends and family in Singapore254, Burmese FDWs were more likely to report to have less than weekly contact (32%) compared to the other nationalities. No differences were found between Indonesian (16%) and Filipino (10%) FDWs who reported less than weekly contact with friends and family in Singapore. Burmese participants were also more likely to report to have less than weekly contact with their family and friends in their home country or outside Singapore255 (38%) than Filipino FDWs (15%). No differences were found between these groups and Indonesian FDWs (27% reported less than weekly contact). Table 16: Frequency of social contacts. With friends or relatives in Singapore

With family in home country or outside Singapore

100 90 80 70 60

51.6

51

% 50 40

32.5 25

30 20 10 0

3.6 Less than once a month

8.4

4.8

4.5

Monthly Fortnightly

Weekly

Daily

Less than once a month

11.6

Monthly

7 Fortnightly

Weekly

Daily

While most of the participants256 reported to visit their home country every two years (64%), onetenth of the FDWs (10%) stated that they were never able to visit their families back home during their employment. 8% indicated “other” home visits frequencies, for instance irregular visits depending on their employer’s vacation plans. Some of these respondents also vaguely stated that they would go home once their contract is finished without providing further details. Overall, 81% 257 of the respondents reported visiting their home country less than yearly and 12%258 less than every two years. No differences were found between the nationalities of FDWs. Details are shown in Figure 12 below.

38


Figure 12: Frequency of visits to FDW’s home country.

%

100 90 80 70 60 50 40 30 20 10 0

64

15.6

9.8

Never

Every 2 years

Every 18 months

8.3

1.7

0.6 Every year

Every 6 months

Other

As to sources of social support when faced with an emotional problem259, the most common reported contact persons for all respondents were friends or family in Singapore (43%), followed by the employer (38%) and family and friends outside Singapore or in the FDWs’ home country (25%). However, 14% of participants 260 reported not seeking external help at all when encountering an emotional problem. Detailed responses are shown in Table 17 below. Table 17: Sources of social support when experiencing emotional problems. When you have an emotional problem (for example, when you feel very unhappy, sad or scared) where do you go to get help? I do not go anywhere Friends/family/neighbors in Singapore Employer Family/friends in home country or outside Singapore People in a religious organization (church, mosque, temple etc.) Facebook group H.O.M.E. (hotline, helpdesk) Ministry of Manpower Employment agency Embassy Doctor Police Others (friend, not further specified where; weekly open forum)

Answers in % All FDWs 14.4 42.9 37.7 25.2 9 8.8 7.9 4.7 2.9 2.5 1.6 1.1 1.6

Filipino Indonesian Burmese 6.7 48.5 43.5 39.9 17.5 15.2 12.2 5.4 4.5 3.1 3.6 2.7 2.2

9.9 41.8 41.8 28 2.2 4.7 6.5 5.6 1.7 2.2 0.4 1.3

42 33 15 6 6 4 2 1 2 2 1

Note. Multiple responses were possible, except when having chosen the option “I do not go anywhere”.

Several statistically significant relations between the FDWs’ country of origin and approaching different contact persons when having an emotional problem were observed: Burmese FDWs were more likely to report to “not go anywhere (42%)261, than Filipino FDWs (7%) (effect of medium magnitude). No differences were found between these groups and Indonesian FDWs (10%). Burmese also were less likely to report to go to the employer (15%)262 or to approach family or friends in their home country 39


or outside Singapore 6%)263 when faced with an emotional problem compared to the other nationalities. No differences were found regarding these sources of help between Indonesian and Filipino FDWs (see Table 17 for percentages). Further, Filipino FDWs were more likely to report to search for help via Facebook (15%)264 (no differences were found between the other nationalities) or to approach religious organizations (18%)265 while Indonesian FDWs were less likely to report to seek help from spiritual groups (2%). No differences were found between these nationalities and Burmese workers (6%).

5.3 FDWs’ individual attributes and behaviors – View on working and living situation The section presents the FDWs’ own assessment and perception of their working and living situation in Singapore. This includes their perceived feeling of privacy in the employer’s house, the perceived (level of) integration into the employer’s family, the perceived treatment with dignity by the employer or employer’s family, family concerns, homesickness, and their satisfaction with several life domains. With respect to perceived privacy in the employer’s house266, 41% of the respondents reported that they always felt a sense of privacy in their employer’s house. However, the rest (59%) reported experiencing a general breach of privacy in their current employer’s house and 13% of the participants reported that they never felt a sense of privacy in their employer’s house. Further information is detailed in Figure 13 below. As to the perceived feeling of privacy in the employer’s house267, Filipino FDWs (M = 3.87 (equals answer “mostly”), SD = 1.38) reported higher levels of perceived privacy than Indonesian (M = 3.44 (equals answer “sometimes”), SD = 1.40)268 FDWs. No differences were found between these groups and Burmese FDWs. Figure 13: Perceived privacy in employer’s house. 100 90 80 70 60

% 50

41.4

40 30 20

22.4 13.1

10

16.4

6.8

0 Never

Rarely

Sometimes

Mostly

Always

As to the participants269perceived integration into the employer’s family, i.e. being treated as a family member, around half of the women (53%) reported that they always felt integrated into their current employer’s family but 8% reported that they never perceived to be integrated into the employer’s family, as shown in Figure 14. No differences were found between the three nationalities of respondents.

40


Figure 14: Perceived integration into employer’s family. 100 90 80 70 52.7

60

%

50 40 30

20

20

8.7

10

13.3

5.3

0 Not at all

Rarely

Sometimes

Mostly

Always

As to whether participants feel cared for270, respected271 and treated like a human being272by their employer or employer’s family, 41% of the FDW stated that they always felt cared for while 11% of the respondents reported that they never felt cared for by their current employer or employer’s family. Although around half of the respondents (52%) reported to always feel respected by their employer or employer’s family, 6% stated that they never felt respected. The majority (72%) of the FDWs reported that they always feel treated as a human being by their employer or employer’s family members but 5% reported that they never felt like they were treated as a human being at their daily workplace. Details can be seen in Figure 15. Overall, as to being treated with dignity, 38% of the participants273stated that they were always cared for and felt respected and treated as a human being. However, 65% of the respondents reported the opposite i.e. that they were not always treated with dignity. Regarding the overall perception of being treated with dignity274, Indonesian FDWs were less likely to report that they were always treated with dignity (27%) compared to Filipino (45%) and Burmese FDWs (49%). No differences were found between the latter two groups. Further, regarding the perceived level of respect by the employer or employer’s family275, Indonesian FDWs also reported that they were shown respect less often (e.g. only 44% reported that they always felt respected) than Filipino workers (60%)276. No differences were found between these groups and Burmese FDWs (53% always perceived that they were respected). Figure 15: Perceived treatment with dignity by employer or employer’s family. Do you feel cared for?

Do you feel respected? 5.8

10.7

4.6

6.9

41.3

9.7

20.8

51.9

14.4

9.7 72.3

14

Never

Rarely

3.8

7.5

6.7

%

Do you feel treated like a human being?

Sometimes

Often

Always

41


Overall, 85%277 of the participants reported having some form of family concerns. As to the source of their worries, approximately half of the respondents (48%) reported that they were always worried about their children. At the same time, 53% reported that they never felt worried about their partner. Regarding the FDWs’ worries about other family members, most frequently (34%) women reported to worry sometimes about them. Table 18 shows the respondents’ responses in detail. As to the overall existence of family concerns278, Burmese FDWs were more likely to report no family concerns (38%), compared to Filipino (9% reported no family concerns) and Indonesian FDWs (12% reported no family concerns). No differences were found between the latter two nationalities. Concerns about specific family members also indicate differences between FDWs of different countries of origin: With respect to the FDWs worrying about their partner279, Burmese FDWs reported this less often (i.e. 81% reported to never worry) than Filipino (44%)280(effect of medium magnitude) and Indonesian (50%)281 workers respectively. Regarding the FDWs worrying about their children282, Indonesian FDWs reported their worried more often (i.e. 57% reported to always worry) than Filipino FDWs (40%) 283. No differences were found between these groups and Burmese FDWs. As for the FDWs worrying about other family members284, Burmese reported this less often (e.g. 50% indicated to never worry) than Filipino (14%)285 and Indonesian (24%)286 FDWs. Table 18: Family concerns. Answers in % About your family in your home country or outside Singapore... Never Rarely Sometimes Often Always ... I worry about my husband/boyfriend. All FDWs287 52.5 7.1 27.3 4.4 8.8 Filipino 44 3.7 35.8 4.6 11.9 Indonesian 50 11.8 25 5.6 7.6 Burmese 81.1 13.6 4.5 ... I worry about my children. All FDWs288 9.6 4.6 27.7 10.6 47.5 Filipino 8.8 5.4 39.5 6.1 40.1 Indonesian 7.7 4.2 16.9 14.1 57 Burmese 35.7 14.3 21.4 28.6 ... I worry about other family members. All FDWs289 23.6 7.7 33.5 9.9 25.4 Filipino 14 8.2 45.4 6.3 26.1 Indonesian 24.2 7.8 24.7 13.7 29.7 Burmese 50 5.7 25.7 8.6 10 Note. Excluded were participants from questions “worry about partner” and “worry about children” if they reported not to have a partner or children, respectively.

Regarding homesickness290, only one-third of the participants (30%) reported that they never suffered because they missed their family at home, as indicated in Figure 16 in more detail. No differences were found between the three nationalities of FDWs.

42


Figure 16: Homesickness. 100 90 80 70 60

% 50 40 30

33.7

29.5

17.7

20

9.7

9.5

10 0 Never

Rarely

Sometimes

Often

Always

Regarding the respondents’ satisfaction with their employment agency (if applicable), the majority of the FDWs (60%) reported that they were satisfied or very satisfied. 13% indicated that they were dissatisfied or very dissatisfied. As for the satisfaction with their current employer or employer’s family, more than two-thirds of the women (68%) reported that they were satisfied or very satisfied. Only 7% stated to be dissatisfied or very dissatisfied. With respect to the level of satisfaction with working in Singapore, the majority of FDWs (73%) reported that they were satisfied or very satisfied. Just 3% reported that they were dissatisfied or very dissatisfied. Finally, concerning the satisfaction with their social life, most of the FDWs (65%) reported to be satisfied or very satisfied and 4% stated that they were dissatisfied or very dissatisfied. Table 19 below shows the responses in detail. Table 19: Satisfaction with live domains. Overall, how satisfied are you with... ...your employment agency?291 All FDWs Filipino Indonesian Burmese ...your current employer’s family?292 All FDWs Filipino Indonesian Burmese ...working in Singapore?293 All FDWs Filipino Indonesian Burmese ...your social life?294 All FDWs Filipino Indonesian Burmese

Answers in % Very dissatisfied

Dissatisfied

Neither satisfied nor dissatisfied

Satisfied

Very satisfied

4.7 6.2 3.5 4.3

8.1 7.5 8.3 8.6

27.5 9.6 47.2 24.3

48.1 58.2 34.7 54.3

11.7 18.5 6.3 8.6

2 2.7 0.9 3

4.7 5.4 3.5 6.1

25.8 12.1 38.9 26.3

37.4 40.8 33.2 39.4

30.1 39 23.6 25.3

1.8 3.6 2

1.3 1.3 0.9 2

24.2 12.4 35.8 24.2

46.3 50.2 39.3 53.5

26.4 32.4 24 18.2

1.3 1.8 0.9 1

2.2 2.2 1.8 3

31.7 11.6 50.4 34.3

50.3 64.7 36.3 49.5

14.6 19.6 10.6 12.1 43


With respect to the respondents’ overall satisfaction with their current employment agency295, Filipino FDWs reported higher levels of satisfaction (e.g. 19% reported to be very satisfied) than Indonesian FDWs (6%)296. As to the overall satisfaction with their current employer or employer’s family297, Filipino FDWs also reported to have higher levels of satisfaction (39% reported to be very satisfied) than Indonesian FDWs (24%)298. No differences were found between these two nationalities and Burmese FDWs regarding satisfaction with employment agency or current employer or employer’s family. For the overall satisfaction with their social life299, Filipino FDWs reported to be more satisfied (e.g. 84% reported to be satisfied or very satisfied), than Burmese (62%)300 and Indonesian (47%)301 FDWs (effect of medium magnitude). No differences were found with respect to the levels the satisfaction with working in Singapore between the three nationalities.

5.4 Mental health In the following section, we will outline the prevalence and severity of the participants’ overall mental distress, symptoms or problems. Further, we will establish the relationships between FDWs individual and sociodemographic characteristics, their working and living conditions and their views on these conditions (see Sections 5.1, 5.2, 5.3) on the one hand and their mental well-being on the other hand. The section concludes with predictions of FDWs’ mental health using the data on individual attributes and behaviors and social circumstances.

5.4.1 Prevalence and severity of mental distress With respect to the overall mental distress experienced by FDWs (measured by the Global Severity Index GSI), the participants302 had an average raw score of 0.55 (SD = 0.46, Min = 0, Max = 4). In measuring the differences between the nationalities,303Filipino FDWs reported higher overall mental distress with an average GSI score of 0.69 (SD = 0.49) than Indonesian (M = 0.42, SD = 0.23)304 and Burmese (M = 0.53, SD = 0.50)305 FDWs respectively. Transforming the GSI raw score into a standardized score, which allowed for a comparison with other populations (as indicated in Section 4.1) showed an overall GSI T score of 59 for all participants with a score of 61 for Filipino FDWs, a T score of 56 for Indonesian FDWs and a T score of 58 for Burmese FDWs. By applying the GSI threshold to classify overall mental distress, 24 % of all participants could be classified as having poor mental health, as shown in Figure 17. In terms of statistically significant differences306 between FDWs from different countries of origin307, Filipino FDWs were more likely to be classified as having poor mental health (36%) compared to Indonesian FDWs (11%). No statistical differences were found between these groups and Burmese women (26% were categorized as having poor mental health). As to the nine different psychological symptom dimensions, the three most severe symptoms as indicated by the raw scores for all respondents were associated with the dimensions “interpersonal sensitivity”, followed by the “obsessive-compulsive” and “paranoid ideation” dimensions. However, when considering the standardized T scores, the highest scores are with symptoms related to the dimensions “psychoticism”, followed by “depression” and “interpersonal sensitivity”. As for “psychoticism”, the T Score for all FDWs suggests that the level of mental distress in this dimension does require professional attention and treatment. Table 20 and Figure 18 summarize all scores for each dimension.

44


Figure 17: Participants with good vs. poor mental health. 100

88.6

90 80

76

74

70

63.8

% 60 50 36.2

40 30

26

24

20

11.4

10 0 G

P

All FDWs

G

P Filipino

G

P

Indonesian

G

P Burmese

Note. G = classification as good mental health, P = classification as poor mental health.

Table 20: BSI - Psychological symptom dimensions (raw and T scores). Dimension Somatization ObsessiveCompulsive Interpersonal sensitivity Depression Anxiety Hostility Phobic anxiety Paranoid ideation Psychoticism

FDW’s country of origin All FDWs Philippines Indonesia M SD T N M SD T N M SD T N 0.52 0.57 57 541 0.71 0.64 60 216 .033 0.39 53 228

M 0.58

Myanmar SD T 0.60 58

N 97

0.72

0.63

57

543 0.91

0.69 59

216 0.60

0.56 55

227

0.57

0.55 55

100

0.77

0.66

59

544 0.84

0.68 61

217 0.72

0.62 57

227

0.73

0.72 57

100

0.60 0.53 0.44

0.56 0.60 0.52

59 55 56

544 0.70 543 0.67 543 0.59

0.61 61 0.61 58 0.57 58

216 0.50 217 0.39 215 0.31

0.46 57 0.51 54 0.36 53

228 227 228

0.60 0.54 0.42

0.62 59 0.67 57 0.61 56

100 99 100

0.32

0.43

57

546 0.43

0.49 61

218 0.21

0.34 55

228

0.33

0.43 57

100

0.60

0.59

58

543 0.75

0.61 59

218 0.49

0.55 56

226

0.53

0.58 56

99

0.48

0.54

63

544 0.66

0.56 64

217 0.29

0.40 59

227

0.51

0.62 63

100

Note. T = T Score.

45


Figure 18: BSI - Psychological symptom dimensions (T scores). 100 90 80 70

Caseness

T-Score

60

P

50

I

40

M

30 20 10 0 SOM

O-C

I-S

D

ANX

HOS PHOB

PAR

PSY

GSI

Note. P = Filipino, I = Indonesian, M = Burmese; SOM = somatization, O-C = obsessive compulsive, I-S = interpersonal sensitivity, D = depression, ANX = anxiety, HOS = hostility, PHOB = phobic anxiety, PAR = paranoid ideation, PSY = psychoticism, GSI = Global Severity Index.

There were several statistical differences between severity of symptoms for different psychological dimensions (based on raw scores) and the FDWs country of origin: With respect to the dimension “paranoid ideation” 308 Filipino FDWs had higher scores than Indonesian 309 and Burmese 310 FDWs respectively. Filipino FDWs also had higher scores on the “obsessive-compulsive” dimension 311 compared to Indonesian312 and Burmese313 FDWs. They also scored higher than Indonesian314 and Burmese315 FDWs regarding the dimension “hostility”316. Finally, for “psychoticism”317 Filipino FDWs had higher scores than Burmese318 and Indonesian319 FDWs (effect of medium magnitude). For this dimension, the standardized score for Filipino FDWs (T = 64) indicated “caseness” for this group in terms of required treatment. With all these dimensions, there were no differences between Indonesian and Burmese participants. In measuring “depression” 320 Filipino FDWs had higher scores than Indonesian321 FDWs. They also displayed higher scores in “anxiety”322 than Indonesian FDWs323 as well as in “phobic anxiety”324 compared to Indonesian FDWs325. For these three dimensions no differences were found between these nationalities and Burmese FDWs. Finally, as to “somatization” 326 , Indonesian FDWs had lower scores than Filipino327(effect of medium magnitude) and Burmese328 FDWs. No differences between the nationalities of FDWs were found for “interpersonal sensitivity”. We further identified the following differences between FDWs of different countries of origin regarding the additional items (based on raw scores, see Appendix 10.4 for detailed descriptive statistics): With respect to the additional item “thoughts of death and dying”329 Indonesian FDWs had higher scores than Filipino330 and Burmese participants331 respectively. On the other hand, regarding the additional item “feelings of guilt” 332 Filipino respondents scored higher than Indonesian 333 and Burmese334 FDWs. No differences were found between the nationalities of FDWs concerning the additional items “poor appetite” and “trouble falling asleep”. Lastly, scores from the single items (raw scores, see Appendix 10.4 for detailed descriptive statistics) measuring psychological well-being revealed that the three items for all FDWs with the highest scores were “having to check and double check what you do” (obsessive-compulsive dimension), followed by “your feelings being easily hurt” (interpersonal sensitivity dimension) and “feeling lonely” (depression dimension). 46


5.4.2 Relationships between mental health and FDWs’ individual characteristics and social circumstances In this section, we will present the findings related to the relationship between FDWs’ mental wellbeing and their individual attributes and behaviors and social circumstances that describe their working and living conditions. Based on the statistically relevant relationships between mental health and other assessed variables (see Appendix 10.5), protective and risk factors can be identified not only for all FDWs but also for FDWs across the three nationalities. As indicated in Table 21, the most important protective factor for all FDW’s mental well-being is a perceived (level of) integration into the employer’s family. However, a positive view on the FDWs’ working and living situation in general is also beneficial for their mental health, explicitly concerning the FDWs’ perceived treatment by the employer or employer’s family with dignity and a high level of satisfaction with the current employer or employer’s family specifically and with working in Singapore in general. When it comes to social circumstances, sufficient rest, the provision an adequate sleeping accommodation, adequate nutritional and medical attention by the employer and having a stable social network is crucial for a good mental health. In terms of risk factors, the relationship between the FDW and the employer or employer’s family is crucial. Language-related communication barriers as well as verbal and physical abusive behavior by the employer or employer’s family are the most detrimental for the psychological well-being of FDWs. Further, invasions of privacy, restrictions on communication or any other form of abuse by the employer or employer’s family are harmful to the FDWs mental health. As to individual characteristics, being in debt, the existence of chronic physical health problems or being worried about their families at home and homesickness also contribute negatively to the mental health of FDWs. Table 21: Mental health: Protective and risk factors for all FDWs Protective factors:

FDWs’ individual attributes and behaviors


• Perceived privacy in the employer’s house • A perceived integration into the employer’s family • A perceived treatment with dignity by the employer or employer’s family • Satisfaction with the employer or employer’s family and with working in Singapore • Sufficient daily sleeping hours • An own room as sleeping accommodation • Nutritional attention and provision of sufficient daily proper meals by the employer • Adequate medical and dental attention by the employer • Frequent contact to friends/family outside Singapore or in home country

Risk factors: • • • •

Debt Physical health problems Family concerns Homesickness

• Language-related communication barriers with the employer or employer’s family • Invasions of privacy by the employer or employer’s family • Restrictions on communication by the employer or employer’s family • Verbal, physical, moral and sexual abuse by the employer or employer’s family

Note. Effect sizes: small, medium.

47


For Filipino FDWs, the most important protective factor is a frequent contact to their family in their home country. Language problems when communicating with the employer or employer’s family as well as homesickness are the two dominant risk factors for Filipino FDWs. Detailed information on protective and risk factors for Filipino FDWs’ mental health are outlined in Table 22 below. Table 22: Mental health: Protective and risk factors for Filipino FDWs. Protective factors: FDWs’ individual attributes and behaviors


• Perceived privacy in the employer’s house • A perceived treatment with dignity by the employer or employer’s family • A perceived integration into the employer’s family • Satisfaction with working in Singapore • Sufficient daily sleeping hours • Nutritional attention and provision of sufficient daily proper meals by the employer • Adequate medical and dental attention by the employer • Frequent contact to friends/family in home country

Risk factors: • Debt in home country • Family concerns • Homesickness

• Language-related communication barriers with the employer or employer’s family • Invasions of privacy by the employer or employer’s family • Moral abuse by the employer or employer’s family


Perceptions on being treated with dignity by their employer or employer’s family, a high level of perceived integration into the employer’s family and satisfaction with the employer or employer’s family are the most significant protective factors for Indonesian FDWs. The key risk factors are debt, invasions of privacy and verbally abusive behavior by the employer or employer’s family. Table 23 shows the protective and risk factors for Indonesian FDWs in greater detail. As shown in Table 24, the most important protective factors for Burmese FDWs’ mental health are a positive perception of the working and living conditions with respect to perceived privacy, perceived integration into the employer’s family, being treated with dignity as well as an overall high levels of satisfaction with different live domains. Highest risk factors for Burmese FDWs include a young age of the worker, being in debt, family concerns or homesickness. In terms of social circumstances, languagerelated communication barriers with the employer or employer’s family, restrictions on communications and abusive behavior by the employer or employer’s family are particularly detrimental. Overall, verbal, physical and/or sexual abuses are the greatest risk factors. Generally, the tables above show a number of overlaps in risk and protective factors amongst the different nationalities. Nevertheless, common risk and protective factors for every FDW of each country of origin can be described as follows: A sufficient daily rest is important to maintain a good psychological well-being. Further relevant are the FDW’s perceptions of privacy in the employer’s house and a perceived integration into the employer’s family and treatment with dignity by the employer or employer’s family. Having a high level of satisfaction with working in Singapore is beneficial to the mental health. Detrimental for the psychological well-being are language-related communication barriers. Also harmful is morally abusive behavior by the employer or employer’s family. Finally, homesickness is harmful for mental health for every FDW, regardless of their country of origin. 48


Table 23: Mental health: Protective and risk factors for Indonesian FDWs. Protective factors:



• Perceived privacy in the employer’s house • A perceived integration into the employer’s family • A perceived treatment with dignity by the employer or employer’s family • Satisfaction with the employer or employer’s family and with working in Singapore • Sufficient daily sleeping hours • The own possession of the passport • Adequate medical and dental attention by the employer

Risk factors: • Young age • With mothers: young age of youngest child • Debt • Homesickness

• Language-related communication barriers with the employer or employer’s family • Invasions of privacy by the employer or employer’s family • Restrictions on communication by the employer or employer’s family • Economic, verbal, moral, physical and sexual abuse by the employer or employer’s family


Table 24: Mental health: Protective and risk factors for Burmese FDWs. Protective factors:



• Perceived privacy in the employer’s house • A perceived integration into the employer’s family • A perceived treatment with dignity by the employer or employer’s family • Satisfaction with the employer or employer’s family and with working in Singapore • Sufficient daily sleeping hours

Risk factors: • • • •

Young age Debt Family concerns Homesickness

• Language related communication barriers with the employer or employer’s family • Restrictions on communication by the employer or employer’s family • Verbal, physical, moral and sexual abuse by the employer or employer’s family

Note. Effect sizes: small, medium, large.

49


In order to obtain further detailed statistical information, multiple linear regressions were performed to investigate different individual and socioeconomic factors to predict levels of well-being. For this purpose, a contextual model based on theoretical and empirical relationships between mental health and individual attributes and behaviors and social circumstances was developed. We included variables describing working and living conditions that proved to be significantly related to mental health, as indicated by the overall measure for mental distress (GSI) for all FDWs (see Appendix 10.5) and developed a linear regression model via backwards elimination. For all FDWs, the following variables proved to be statistically significant (see Appendix 10.6) and, thus, were included in the final linear regression to predict levels of mental health problems, measured by GSI: • • • • • • • •

Country of origin: Philippines Homesickness Language problems when communicating with the employer or employer’s family Existence of sexual abuse by the employer or employer’s family A perceived integration into the employer’s family Existence of chronic health condition(s) Satisfaction with working in Singapore Existence of debt in Singapore and/or home country

In the final model these eight predictor variables were statistically significant as shown in Figure 20 and explained 36% of variance in mental health (effect of large magnitude)335. Figure 20: Prediction of mental health for all FDWs. Country of origin: Philippines Homesickness Language problems when communicating with employer or employer’s family Existence of sexual abuse A perceived integration into the employer’s family

.28** .22** .21** .17** -.13*

R2 = 36**

Mental health (GSI)

.12* Existence of chronic health conditions Satisfaction with working in Singapore Existence of debt in Singapore and/or home country

-.12* .11*

Note. Statistical significance: * p< .01; ** p< .001.

50


Overall, more than one-third of variation in mental health problems of FDWs in Singapore can be explained by the following variables: As to FDW’s individual attributes and behaviors, FDWs coming from the Philippines are at relatively higher risk than FDWs from Myanmar or Indonesia. Further, homesickness and the existence of debt or chronic health conditions are detrimental to mental health. High satisfaction with working in Singapore and a perceived integration into the employer’s family have a positive effect on mental health. Regarding social circumstances, language-related communication barriers and sexually abusive behavior by the employer or employer’s family are risk factors for mental health of FDWs in Singapore.

5.4.3 FDWs’ opinion of how to benefit their well-being In the following section, we present the results of the qualitative analysis on the open-ended question “What do you think is the best way to help the emotional well-being of domestic workers in Singapore?”. These qualitative data provide further insights into the participants’ perceived views between mental health and other factors as well as perceptions of their responsibilities and ways to improve their emotional well-being. From the responses, two areas of benefit were identified, namely, individual and external responsibilities. Individual responsibilities. Many of the respondents indicated that the FDW herself is responsible for her own well-being, either through interaction with others or within herself. Many emphasized the importance of a mutual understanding and communication with the employer to reduce stress and worries. For instance, one participant quoted: “To be able to work peacefully, workers need to do their work dutifully and employers need to treat workers well and also need to have a mutual understanding so that no problems arise” (TL). Participants also believed that social support, i.e. turning to friends, family members or fellow FDWs, to share their worries eases the pressure as they counsel each other. For example, one participant wrote “Here, we only have friends, so they are the ones whom we can have heart-to-heart talks with, and who can give us their opinions so that our burden is lessened” (TL). In addition to gatherings in person, there were also other methods identified to alleviate stress and increase the emotional well-being of FDWs. A number of respondents also emphasized the importance of phones to communicate with others. As noted by one of the participants, “Let domestic workers (be) free to use their mobile phone especially when they were homesick”. Another respondent said, “I call my friend, and talk over (the) phone and share my problem(s) and she advise(s) me.” In addition to interaction with others, personal qualities or managing situations by themselves were also highlighted by the respondents as being effective ways to aid the emotional wellbeing of FDWs. Certain personal qualities such as understanding, patience and humility were noted by the respondents as important and helpful qualities in their profession as FDWs in Singapore. Having these qualities could help FDWs maintain control of their mental well-being and perform in their job, as reflected in the response by one of the participants: “I want to encourage FDWs to be very patient and to control your pride. Only then you will have a good relationship with the employer” (TL). Further, one participant remarked, “Take the employer’s scolding as life’s lessons and become the best person in mind” (TL). As to other internal responsibilities, prayers were frequently identified by the participants as a way to cope with an emotionally difficult situation. One of the participants said: “Be patient, work happily. Keep your faith in God” (TL). Respondents further argued that adapting to the Singaporean society, including learning English and its laws, were important in improving the well-being of FDWs. External responsibilities. Other participants stated that the well-being of FDWs in Singapore is the responsibility of other people other than the individual, e.g. their employers, the Singapore government and society. According to the respondents, the employers have certain responsibilities. Being nice and open as well as giving attention, freedom, trust and to have good communication with the employee were identified as healthy factors, which contribute to the well-being of FDWs. Creating a positive environment should be part of the employers’ responsibility, as restricting the FDW or creating too many rules can result in a stressful environment for FDWs as noted by the respondents. . For instance, one respondent wrote: “1. Employers should not have too many rules. 2. Give chances to FDW to explain the problems. 3. Give trust to the FDW” (TL). Furthermore, giving rest days and timely remuneration were also 51


highlighted as specific responsibilities of the employers. One of the respondents said: “It would be better if the Ministry of Manpower and authorities concerned can take serious and necessary actions to address the complaints made by the domestic workers” (TL). Many participants identified certain targets for the Singapore government to support the emotional well-being of FDWs. Their suggestions were to regulate agencies, supervise employers to ensure that proper working hours and rest time are given to FDWs as well as to handle the complaints by the FDWs seriously and professionally. Civil society, including organizations such as HOME as well as other experts (e.g. psychologists) was also identified as having the ability to aid the emotional well-being of FDWs in Singapore, as reflected in one participant’s response: “I think most of us would love to have an expert like a psychologist whom can help us, like from HOME. We know that the volunteers can help us. We can talk through the phone or by seeing them face to face in which will make it easier.” Through providing support, assistance, counseling and information through hotlines, help desks, organized seminars and courses or through other activities, FDWs recognized civil society as playing an important role for their well-being.

52


6 Summary and discussion of findings In the following section, we will summarize and discuss the findings in relation to the study’s research questions (see Section 3).

6.1 Individual attributes and behaviors and social circumstances describing working and living conditions of foreign domestic workers in Singapore 6.1.1 FDWs’ individual and sociodemographic characteristics FDWs from Indonesia represented the largest population, followed by Filipino and Burmese FDWs. One average, respondents were 33 years old and almost half of them were single. Half of the respondents were mothers with two children on average, whereby the average age of the youngest child was 11 years. Around half of the participants identified as Muslim, followed by Christian (one-third) and Buddhist (one-tenth) statement of beliefs. The average number of years of schooling among the FDWs was 11 years. The main reasons to work in Singapore were to be able to send money home to their family, to save money for the future and to be able to send their children to school. Around onetenth of the respondents had debt in Singapore or in their home country, whereby the average owed amount in the home country was roughly double the amount owed in Singapore. Around two-thirds of the FDWs were currently affiliated to an employment agency. Nearby one-third of the women had previously worked as FDWs in other countries on average for three years before coming to Singapore, mainly in Malaysia, Saudi Arabia and Hong Kong. The average total working time in Singapore was six years. Participants worked on average for a total of two employers during their time in Singapore and had been with their current employer for three years on average. 16% of the participants had a chronic health condition, whereby affected women mostly suffered from chronic pain. With respect to differences between FDWs in Singapore coming from Indonesia, the Philippines and Myanmar, findings suggest that Burmese are overall the youngest and Filipino FDWs the oldest group of FDWs in Singapore. There are more Burmese singles compared to Indonesian FDWs. Burmese FDWs are also more often childless. Indonesian FDWs have more often a Muslim belief, Filipino FDWs are more of Roman Catholic belief and Burmese women are mostly Buddhists or Christians. Both, Filipino and Burmese FDWs have more years of schooling than Indonesian workers. Filipino FDWs are more often in debt and owe higher amount than FDWs from other countries of origin. As for reasons to work in Singapore, Burmese FDWs less often work to save money for the future or to be able to send their children to school than the other nationalities. Instead, they are more often motivated by being able to send money home to help their family, parents and siblings. Indonesian FDWs are less often motivated by these reasons and are more often driven to come to work in Singapore to leave an unhappy or difficult personal life at home. Indonesian FDWs also have more previous work experience as FDW in other countries than Burmese FDWs, who have a shorter average working duration in Singapore and a shorter current employment time than Filipino and Indonesian FDWs. Finally, Indonesian FDWs have less often chronic health problems than the other nationalities. The sample of respondents of this study shows a representative distribution (and successful stratification) of FDWs, reflecting the total population of FDWs in Singapore as indicated by published numbers. Participants in this study had a relatively high educational level with an average of 11 years of schooling. Although it is not advisable to directly compare the years of schooling to those educated in Singapore due to differences in the educational systems, it is noted that the mean years of schooling for all Singaporean in general is 10.5 years and 10 years336 for female Singaporeans. 53


6.1.2 Employment conditions and working environment On average, the participants earned a monthly salary of SGD515. FDWs worked on average 13 hours per day and had an average daily sleeping time of eight hours. Around half of the participants had a weekly day-off and 40% had less than once a week off per month. About two-thirds of the respondents worked for a local Singaporean employer and one-third for a foreign employer. One average, there were four family members living in the employer’s house. Although the majority of participants had their own room, about a quarter of them had to share a room and one-tenth slept in another space, such as the storage room, living room, kitchen or bomb shelter. With the majority of the participants, their employer kept their personal documents, i.e. passport or employment contract. The respondents’ work permits were mainly kept by the workers themselves. Approximately one-third of the FDWs experienced language-related communication problems when talking to their employer or employer’s family. With respect to differences between FDWs in Singapore coming from Indonesia, the Philippines and Myanmar, findings suggest, that, independent of the employment time with their current employer, Filipino have a higher income than Indonesian and Burmese FDWs. Indonesian FDWs work longer per day than Filipino FDWs. Filipino women work more often for a foreign employer than Indonesian FDWs. Filipino FDWs keep their personal documents (passport, employment contract, work permit) themselves more often than Indonesian FDWs (effects of medium magnitude). Burmese FDWs are more likely not to keep their work permit themselves (effect of medium magnitude). Burmese workers also have more communication problems when talking to the employer or employer’s family compared to Indonesian and Filipino FDWs. Results indicate long working hours and a relatively low monthly income among the surveyed women. Indonesian and Burmese workers were systematically discriminated with respect to their salary. Overall, (conservatively) assuming that the FDWs have a weekly day off, the hourly rate earned by FDWs is approximately SGD1.50 337, keeping in mind the often wide circle of relatives who depend on the FWD for financial support. As a comparison, current numbers released by the Ministry of Manpower revealed that the average gross monthly income for female Singaporean residents working in the “cleaners, labourers and related workers” sector338 for 2014 was SGD1,197, including employer CPF. Findings also reveal that despite having the legal right to a weekly rest day only half of the women had a weekly day off. However, in these instances the employer is entitled to compensate the worker in-lieu of a rest day. Retrospective analyses with a small subsample (n = 85) show that only 58% of participants were compensated for working on their rest day. Further, every tenth respondent described inadequate sleeping accommodations (e.g. in storage room, living room, kitchen or bomb shelter). Our findings also revealed that the possession of personal documents by the employer was a widespread practice, despite the law placing restrictions at this practice. The existence of language-related communication problems proved to be a predicting factor for mental health-related problems. The relevance of communication skills when being employed as a FDW in Singapore is further underlined when taking the employer’s perspective into account. In a survey among employers in Singapore339 the “ability to communicate with [the employer] or family members”340 was the second most important factor raised by Singaporean employers when selecting their current FDW following the FDW’s actual skills and training. Related research on FDW populations from other countries 341 described similar (or even worse) exploitive employment conditions, including long working hours, the lack of rest days, inadequate living conditions and lack of privacy. For instance, an interview study342 with 70 Sri Lankan FDWs in Lebanon found that the FDWs showed worked an average of 14-17 hours daily, and nine out of 10 interviewees had no rest day. Another interview-based study343 with 28 Cambodian FDWs working in Malaysia revealed that the FDWs worked more than 16 hours a day with little rest. In addition, an interview study 344with 250 FDWs from Sri Lanka, Indonesia, Philippines and Ethiopia working in Jordan documented that employers generally made FDWs work excessive daily hours (16-20 hours) 54


without a rest day. FDWs lacked privacy and slept in inadequate accommodations (e.g. balconies, living room, kitchen, corridor). The study also found that almost all agents and employers confiscated the FDWs’ passports immediately upon arrival. 49 FDWs from Sri Lanka, India, Indonesia, the Philippines, Ethiopia, Nepal and Ghana employed in Kuwait reported in an interview study345 that they had to work unrestricted hours (43% worked 18 hours or more per day at times). Other concerns involved the confiscation of their passport. Further, in a study346 on FDWs in Saudi Arabia, 86 interviewed FDWs from Sri Lanka, Indonesia, the Philippines and Nepal (some previously) working in Saudi Arabia reported average daily working hours of 15-20 hours with no rest or little rest only. None of the interviewees had a rest day. Many workers slept in inadequate accommodations (e.g. storage closets). Employers held the passports of every domestic worker in this study. An interview study347 with 100 Sri Lankan FDWs previously employed in Kuwait, Saudi Arabia, Lebanon and United Arab Emirates, revealed that the women generally worked excessively long working hours (16-18 hours), lacked rest days, had their identity documents confiscated (100%) and were housed in inadequate living quarters (25%). Similarly, an interview-based study348 with 51 Indonesian FDWs employed in Malaysia disclosed particularly long hours of work (typically 16 hours a day) without overtime pay or no rest days. Employers and labor agents routinely held workers’ passports. A retrospective (review of relevant documents) and interview study 349 with 43 FDWs from different countries, including Guatemala, Bangladesh, the Philippines, Sri Lanka, Peru and Senegal, working in the United States, found that FDWs often had their passports confiscated. There was a lack of a proper sleeping space (e.g. FDWs slept in utility rooms, unheated basements etc.) and the FDWs worked 14 hours a day on average. Likewise, an interview study350 with 55 female FDWs from Indonesia, Philippines, Sudan and Sri Lanka working in Syria showed that FDWs’ passports were commonly withheld, and worked 17 hours per day on average with no rest day. a lack of rest days and an average work day of 17 hours. FDWs living with their employers also reported a lack of privacy. In a qualitative study, based on interviews351 with 10 Filipino FDWs in Hong Kong one of the most common issues identified were long work hours.

6.1.3 Treatment by the current employer or employer’s family Around one-third of the respondents faced invasions of privacy by their employer or employer’s family. Additionally, 20% of the FDWs reported the existence of surveillance cameras in their employers’ house. 73% of the respondents experienced restrictions on communication and 74% restrictions on movement by their employer or employer’s family. 75% of the respondents possessed a key to the employer’s house. As to nutritional attention (or neglect thereof), the participants were given three proper meals a day on average. While most of the respondents received adequate nutritional attention with respect to the quantity of food, almost two out of every 10 participants were never given highquality food and 13% of the respondents never received food that was appropriate to their cultural or religion. Only about half of the participants received adequate medical attention and less than half adequate dental attention by their employer. Overall, over one-third of the participants experienced economic abuse at least once and half of the surveyed women had been verbally abused at some time by their employer or employer’s family. 6% of all participants had been exposed to some form of physical abuse and each 7% of the respondents experienced moral or sexual abuse at least once during their current employment. With respect to differences between FDWs in Singapore coming from Indonesia, the Philippines and Myanmar, findings suggest that Burmese FDWs more often and Indonesian FDWs less often experience invasions of privacy by their employer or employer’s family. Filipino FDWs face less often restrictions on communication compared to the other nationalities. Further, Indonesian FDWs are more likely than Filipino FDWs to face restrictions on movement by the employer or employer’s family. Burmese FDWs receive fewer proper meals per day (effect of medium magnitude) and are also more likely to experience nutritional neglect compared to the other nationalities. Filipino women experience moral abuse by their employer or employer’s family more often than Indonesian or Burmese FDWs. 55


The findings revealed that restrictive behavior and mistreatment of FDWs by employers is a common issue in Singapore. Invasions of the FDWs privacy occur not only singularly and restrictions on the communication and movement of FDWs are widespread. Employers also engage in abusive behavior, for instance by neglecting their employees’ need for quality and culturally appropriate food. Burmese FDWs were especially vulnerable to nutritional neglect. Further, despite the law requiring the employer to always provide medical attention352, half of the respondents reported neglect thereof. A striking result was that half of the surveyed women experienced verbal abuse by their employer or employer’s family. A large number of respondents also experienced economic abuse. Although, the number of FDWs who reported being morally, sexually or physically abused by their employer is relatively small, it is evident from the responses that such abuses occur in Singapore. HOME’s current help desk report353 similarly shows that neglectful and abusive employer’s behavior towards their FDWs is an issue in Singapore. Out of overall 405 FDWs who approached HOME, more than half of the women (55%) searched help concerning experienced verbal, physical or sexual abuse and 28% dealt with economic abuse, such as unpaid or withheld wages or illegal deduction to wages. HOME also recently conducted an unpublished survey with 43 FDWs currently residing in the HOME shelter. Results show that only 44% were allowed to help themselves to food in the fridge or cupboard in their last employer’s house. Further, 40% of the women reported to have been always or often hungry while living with their employer. Only less than one out of every tenth participant (9%) were never or rarely hungry. Additionally the vast majority (79%) stated to have lost weight whilst working in Singapore. As supported by other studies on FDWs from other countries, an adverse treatment of FDWs by employers is a genuine and pressing issue354. Economic abuse was found to be prevalent (occurrence in over 50% of the studies), for example in the form of late salary payments, deprivation of food, little or no medical care or restrictions on mobility. Almost all studies reported verbal abuse experienced by FDWs and physical abuse and sexual harassment were also widely reported. An interview study355 with 55 female FDWs from Indonesia, Philippines, Sudan and Sri Lanka employed in Syria showed that many workers worked and lived in “exploitative and slavery-like conditions”356 due to the lack of regulation of the hours and nature of domestic work. Workers were forbidden from leaving the house alone, did not have enough food, no private space and no access to the phone or post. Less than 20% of employers paid for the FDWs’ medical expenses. Another study357 based on interviews with 70 Sri Lankan FDWs in Lebanon described their legal and working conditions as “a contemporary form of slavery”358. The findings revealed that FDWs suffered verbal and physical abuse or violence, nutritional neglect (experienced by one-third of the interviewees), denial of freedom of movement (over 84%) or communication (72%) or confiscation of personal documents (only one-third had their own passport) by their employer. An interview study359 with 28 Cambodian FDWs working in Malaysia revealed that FDWs faced a wide range of labor exploitation and serious abuses, including non-payment of wages, restrictions on movement, and psychological or physical abuse (nearly 50%) and sexual abuse at the hands of their employers. Further, FDWs usually did not receive access to medical care. Interviewbased research360 on 250 FDWs from Sri Lanka, Indonesia, Philippines and Ethiopia working in Jordan documented employers and recruitment agents physically abusing FDWs, almost always confided them to the house, depriving them of food, and denying them medical care. Economic abuse mostly consisted of non-payment of salaries. In an interview study with 49 FDWs from Sri Lanka, India, Indonesia, the Philippines, Ethiopia, Nepal and Ghana employed in Kuwait361 over half (51%) of the women reported economic abuse (late or partial or non-salary payment), 45% reported physical abuse by employer or agent and 14% stated sexual abuse. 16% received inadequate food or were denied food for several days. Other issues were denial of medical treatment and restrictions on freedom of movement. In a study362 on FDWs in Saudi Arabia, 86 interviewed FDWs from Sri Lanka, Indonesia, the Philippines and Nepal (some previously) working in Saudi Arabia reported exploitative work conditions. 74% of the FDWs who returned to their home country of Sri Lanka did not receive their full wages. 37% received inadequate nutritional attention (such as food deprivation or reception of 56


expired food). All FDWs reported some form of psychological abuse. Physical abuse often occurred. 33% reported sexual harassment or assault by the employer or agent. Some employers restricted their employees from making or receiving phone calls, talking to neighbors or restricted their movement. An interview study363 with 100 Sri Lankan FDWs formely employed in Kuwait, Saudi Arabia, Lebanon and United Arab Emirates revealed that the women faced extensive workplace abuses: they were either paid discriminatory low or no full (20%) wages. The FDWs also suffered physical (20%), psychological, and sexual (13%) abuse, food deprivation, forced confinement in the workplace and restrictions on communication with their family. In an interview-based study364 with 51 Indonesian FDWs employed in Malaysia, women often suffered severe restrictions on their freedom of movement and communication by their employer. Interviewees also experienced psychological (35%), physical (18%) or sexual (14%) abuse and one-third was forbidden from practicing their religion. 51% had not received their full salary and 24% received no salary at all. A retrospective study365 based on interviews with 43 FDWs from several countries working in the United States, showed the existence of different abusive behaviors by the employer, such as assault and battery, limited freedom of movement and social isolation. Psychological abuse included verbal abuse and restricting food consumption, denial or restrictions on food and a lack of access to medical care. A qualitative interview study366 with 10 Filipino FDWs in Hong Kong found that many women felt isolated due to the inability to make phone calls or leave the house. Some of the common issues identified were difficult relationships with employers and verbal abuse. A quantitative study367 with 290 Filipino FDWs working in Hong Kong revealed that only 62% visited or had access to a doctor when sick.

6.1.4 Social network and support Half of the participants had daily contact with friends and relatives within Singapore. Approximately half of the respondents had weekly contact with family members back in their home countries or outside of Singapore. 16% of the participants communicated less than weekly with friends and family in Singapore and 23% less than weekly with family and friends in their home country or outside Singapore. 81% of the respondents visited their home country less than yearly and more than one out of every tenth participants less than every two years. The most important contact persons when encountering an emotional problem were friends or family in Singapore, their employer and family and friends outside Singapore or in the FDWs’ home country. However, 14% of participants did not seek external help in this situation. With respect to differences between FDWs in Singapore coming from Indonesia, the Philippines and Myanmar, findings suggest that Burmese FDWs have less contact with friends and family in Singapore as well as to their family and friends in their home country or outside Singapore compared to the other nationalities. Further, Burmese FDWs more often do not seek external help when encountering an emotional problem (effect of medium magnitude) and less often seek help with the employer or family or friends in their home country or outside Singapore when facing an emotional problem. Filipino FDWs more often seek for help via Facebook or approach religious organizations and less often do not seek support from other persons. Indonesian FDWs less often seek support from spiritual groups. A person’s social network through friends and family can be of great importance for migrant workers abroad. However, this study found that more than every tenth participant has not seen her family for over two years. Further, FDWs in Singapore work in a very “unique occupational setting”368, given that they work and live with their employer’s family. The employer becomes their main point of contact, as reflected in the result that the employer is a key contact person if emotional problems occur. A quantitative study369 with 290 Filipino FDWs in Hong Kong similarly showed that important sources of support included family members, friends and the employer.

57


6.1.5 FDWs’ view on working and living situation More than half of the participants experienced some breach of perceived privacy in their current employer’s house and 13% never felt a sense of privacy in their employer’s house. As to the overall treatment with dignity by their current employer or employer’s family, 65% of the participants did not always feel cared for, respected and treated as a human being. Overall, 85% of the participants were worried about their family. Only one-third of the women were never homesick. Though, the majority of FDWs were overall satisfied or very satisfied with their employment agency (if applicable), their current employer or employer’s family, working in Singapore, and/or their social life. With respect to differences between FDWs in Singapore coming from Indonesia, the Philippines and Myanmar, findings suggest that Filipino have a higher perception of privacy in the employer’s house than Indonesian FDWs. Indonesian FDWs are less often treated with dignity compared to the other nationalities. Overall, Burmese FDW have less family concerns compared to Filipino and Indonesian FDWs. In terms of overall satisfaction with the current employment agency (where applicable) and the current employer or employer’s family, Filipino FDWs are more satisfied than Indonesian FDWs. They are also more satisfied with their social life than Burmese and Indonesian FDWs respectively. As shown in the results, despite the broad existence of exploitative work conditions and inadequate treatment by their employer or employer’s family, most of the respondents were satisfied with different live domains. The finding that migrant workers report a high level of satisfaction is common in research with migrant populations370. However, without relating the construct of ‘satisfaction’ to other variables, it becomes meaningless. For instance, in this study satisfaction was related to very basic physiological and safety needs, such as not being abused by the employer, proper nutritional attention and being paid for work to care for their families at home. Regressions to explain average happiness across countries and cultures371 show that subjective well-being (measured as both evaluation and emotion) could be explained by log of GDP per capita, social support, healthy life expectancy at birth, freedom to make life choices, generosity and perceptions of corruption. In Southeast Asia, a decomposition of happiness revealed a descending relevance of the explanations in happiness variations by social support, followed by log of GDP per capita, healthy life expectancy, generosity, the freedom to make life choices and at last perceptions of corruption. Thus, satisfaction needs to be considered in a wider context. Further, social desirable answering behavior due to the party conducting the research and cultural nuances of the investigated population (e.g. not ‘losing face’) need to be taken into account when interpreting results related to the assessment of live domains. For this reason participants’ satisfaction was primarily analyzed in relation to or precipitating mental health in this study. A qualitative study372 involving 10 Filipino FDWs in Hong Kong showed similarly that the majority of women suffered feelings of homesickness and worries about the family being left behind. Other research373 on Vietnamese live in care-workers in Taiwan also discussed the perceived integration into the employer’s family, i.e. the consequences of FDWs being treated as family members, shedding light on the implications the treatment as a family member has over the worker. Findings indicate, that being treated as family members encouraged and made the migrant care workers obliged to do more work tasks than was noted in their work contract. But due to the existing asymmetrical power relation between the employer and the employee as well as the employee’s vulnerability with respect to the laws of employment, the women did not feel they could question their increased workload since they were afraid to lose their jobs.

58


6.2 Prevalence and severity of mental health problems among working foreign domestic workers in Singapore Overall, the participants experienced a ‘high average’ overall mental distress, when compared to a female non-patient reference population. More than two out of every 10 participants (24%) could be classified as having poor mental health. When compared to a reference population, the relatively highest distress was related to psychotic symptoms, i.e. notable changes of a person’s inner world and behavior, including negative (or deficit) symptoms (e.g. social withdrawal, difficulty in expressing emotions, inability to feel pleasure, cognitive symptoms (such as difficulties attending to and processing information, in understanding the environment, and in remembering simple tasks) and affective (or mood) symptoms (often manifested by depression). The level of measured mental distress with to “psychoticism” related symptoms for all FDWs suggests the requirement of professional treatment. The second most severe mental health problems in the sample were related to “depression”, which includes symptoms that reflect a sad and/or irritable mood exceeding normal sadness or grief. More specifically, the sadness of depression is characterized by a greater intensity and duration and by more severe symptoms and functional disabilities than is normal. Depressive signs and symptoms are characterized not only by negative thoughts, moods, and behaviors but also by specific changes in bodily functions (for example, crying spells, body aches, low energy or libido, as well as problems with eating, weight, or sleeping). The third more severe symptom dimension was “interpersonal sensitivity” that defines feelings of personal inadequacy and inferiority, particularly in comparison with others. With respect to differences between FDWs in Singapore coming from Indonesia, the Philippines and Myanmar, findings suggest that Filipino FDWs experience the relative highest overall mental distress and are more likely to have poor mental health compared to Indonesian and Burmese FDWs. Higher levels of mental distress in relation to symptoms of “paranoid ideation”, “obsessive-compulsive”, “hostility” and “psychoticism” are particularly prevalent in Filipino FDWs compared to the other nationalities. Finally, Filipino FDWs experience greater levels of “depression”, “anxiety” and “phobic anxiety” than Indonesian FDWs. Indonesian FDWs suffer less from “somatization” compared to Filipino and Burmese FDWs respectively (effect of medium magnitude). Overall, the surveyed women experienced mental distress, particularly when it comes to psychotic disorder symptoms. It is alarming that nearly a quarter of the respondents could be categorized as having poor mental health. The prevalence of mental health-related problems worldwide is approximately 10%374. For Singapore, 12% of the adult resident population met lifetime criteria for the common affective, anxiety or alcohol use disorders 375 . Compared to these numbers, FDWs in Singapore are doubly at risk to develop mental health problems. Furthermore, findings suggest that Filipino FDWs are especially vulnerable in developing mental health problems. Other research with 196 hospitalized Filipino, Indian, Sri Lanka and other nationalities’ FDWs in Kuwait376 similarly revealed that Filipino FDWs were over-represented among those suffering from “stress-related” disorders. Further, in the Singapore Mental Health Study377 the prevalence of lifetime mental disorders among Indians was significantly higher than among Chinese participants. Indians had higher chances of developing mental disorders compared to participants of Chinese descent. While it is known that certain ethnicities are at greater risk of developing mental health problems, the reasons for why this occurs (whether it could be due to a biological vulnerability or environmental factors) are still under investigated. Hence, we are unable to provide a robust explanation for why Filipino FDWs in our study are at higher risk of developing mental health issues compared to the other nationalities. Further research in this area is needed, including a systematic approach in comparing FDWs in Singapore with women in their country of origin and with Singaporean women working in a similar profession in Singapore. Nevertheless, while Filipino FDWs in Singapore may be particularly vulnerable to emotional distress, there is also the indication that they have more positive social circumstances and views on their situation compared to FDWs from Indonesia and Myanmar, which can result in better coping skills when faced with emotional problems. For instance, the results show that Filipino FDWs reported 59


having the highest sense of privacy in the employer’s house as well as the highest perceived treatment with dignity by the employer or employer’s family, which both proved to be protective factors for the FDWs’ mental well-being. Additionally, Filipino FDWs are less likely to experience some form of restriction on communication, which can be detrimental to their mental health, compared to the other nationalities. Further, they appear to have the most positive view of their working and living conditions, as reflected in their high levels of satisfaction with the current employer or employer’s family and their social life compared to the other nationalities. In general, mental health-related concerns of female FDWs appear to be similar across countries378. In a quantitative study379 with 600 Filipino FDWs in Hong Kong one-tenth of the participants reported anxiety disorder symptoms that indicate psychiatric depression. 197 FDWs from Sri Lanka, India, Indonesia and other countries, previously employed in Kuwait and hospitalized for psychiatric treatment were interviewed380. Stress-related disorders were most common (49%), followed by manic episodes (16%), depression (15%), and acute and psychotic disorders (14%). A retrospective chart review381 of 277 female FDWs from Sri Lanka, India, Bangladesh, Indonesia, Philippines and Pakistan admitted to a psychiatric hospital in Kuwait found that the most common diagnoses among FDWs were neuroses (40%), psychoses (33%), acute situational disturbance (25%), schizophrenia (10%), and conversion hysteria (8%). Similarly, a retrospective chart-review382 of 41 Filipino and Indonesian FDWs admitted in Hong Kong for psychiatric treatment revealed that the most common diagnosis (over 60% of the all women) were psychotic disorders, making FDWs two times more vulnerable to developing this form of mental illness than local women of similar age.

6.3 Relationship between mental well-being, and individual characteristics and social circumstances of foreign domestic workers in Singapore The most important protective factor for all FDW’s mental well-being is a perceived integration into the employer’s family. Having a positive perception of being treated with dignity by the employer or employer’s family and high levels of satisfaction with the current employer’s family and working in Singapore were found to be beneficial to the mental health of FDWs. Sufficient rest, an own room to sleep in, adequate nutritional and medical attention by the employer and a stable social network are crucial in maintaining good mental health in FDWs. Concerning risk factors, language-related communication barriers as well as verbal and physical abuse by the employer or employer’s family were found to be the most detrimental risk factors for the psychological well-being of FDWs. Invasions of privacy, restrictions on communication or any other form of abuse are also harmful to the FDWs mental health. Finally, being in debt, suffering from chronic physical illness or worries about their families at home and homesickness are detrimental to FDWs’ mental well-being. With respect to differences between FDWs in Singapore coming from Indonesia, the Philippines and Myanmar, findings suggest that the most important protective factor for Filipino FDWs is frequent contact with their family in their home country. Language problems when communicating with the employer or employer’s family as well as homesickness are the highest risk factors for Filipino FDWs. As to the most important protective factors for Indonesian FDWs, their perceptions of a treatment with dignity by their employer or employer’s family and a perceived integration into the employer’s family are highly essential as well as a high satisfaction with the employer or employer’s family. The key risk factors are debt and verbal abusive behavior by the employer or employer’s family. Lastly, for Burmese FDWs, the most significant protective factors are a positive perception of the working and living conditions in terms of perceived privacy, integration into the employer’s family and being treated with dignity, and an overall high satisfaction with different live domains. A young age, being in debt, having family concerns or homesickness are high risk factors for Burmese FDWs. As to social factors, 60


language-related communications problems with the employer or employer’s family, restrictions on communications, verbal and/or physical abuse by the employer or employer’s family are particularly detrimental. Verbal, physical and/or sexual abuse were the highest risk factors overall to the mental health of Burmese FDWs. Overall, more than one-third (36%) of variation in mental health problems of employed FDWs in Singapore can be explained by the following factors, whereby this result is of large substantive or practical significance: For FDW’s individual attributes and behaviors, FDWs from the Philippines are relatively more vulnerable than FDWs from Myanmar or Indonesia. Further, homesickness and the existence of debt or chronic health conditions are detrimental to FDWs’ mental health. A positive relationship to mental well-being has a high level of satisfaction with working in Singapore. Regarding social circumstances, language-related communication barriers and sexually abusive behavior by the employer or employer’s family are risk factors for mental health. Lastly, beneficial is a perceived integration into the employer’s family. As to qualitative findings, the perception of structures and responsibilities of individuals, which can benefit the well-being of FDWs in Singapore vary among the participants. Whilst some FDWs feel that they are responsible for their own well-being (e.g. via interacting with others or religious activities) others argue that the obligation lies with other individuals or groups (e.g. the employer, government or civil society). Research from other countries383 with FDWs report similar risk or precipitating factors for mental disorders, which were also confirmed in this study: Regarding the FDWs’ individual attributes and behaviors, ethnicity384 is a contributing factor as Filipino FDWs were found to be especially vulnerable to developing mental health problems. Age is significantly related to mental health385 and results of this study indicate that age is connected to mental health for Indonesian and Burmese FDWs. In this study the age of the FDW’s youngest child was correlated to her mental health. Other studies have argued that having no children is positively related to mental healt 386 . Financial difficulties (debt) 387 , comorbidity or physical illness388 (which was found to be a significant predicting factor for mental health problems in this study), a lack of respect and dignity by the employer389, family concerns, domestic problems and conflicts390 and homesickness391 (which was found to be a contributing risk factor for mental health) are negatively related to mental health. Satisfaction392 with the employer or employer’s family and with working in Singapore (with latter being a predicting factor for mental health in this study) is positively related to mental health. With respect to the FDWs’ social circumstances, generally employment difficulties, job-related problems or stress393 and neglect and carelessness by the employer394 are negative related to mental health. Being overworked (i.e. no time to rest, for example by having insufficient daily sleeping hours) 395 , communication problems due to language barriers 396 , restrictions on communication397, poor nutrition (e.g. food deprivation) or nutritional restrictions398 and the experience of abuse399 (sexual abuse was a significant predicting factor for mental health problems in this study) are negatively related to mental health. The availability of social support400 (i.e. the absence of social or family isolation) is positively related to mental health. Stressors for mental disorders in other FDW research, but were not found in this study, are the following variables: As to the FDWs’ individual attributes and behaviors, their marital status401 is significantly related to mental health (i.e. divorcees or women separated from their partners are at greater risk compared to single women). Religious affiliation402 is a risk factor for mental disorders. A high educational status403 and the extent of work experience404 are positively related to mental health. Work motivation 405 is related to mental health (i.e. migration for non-economic reasons is more beneficial than economic necessity). Concerning FDWs’ social circumstances, a low income406 and the denial of rest days407 are negatively related to mental health. A high frequency of home visits408 is positively related to mental health. Finally, we could identify correlates and contributing factors for mental disorders that were not mentioned in previous research studies. Regarding the FDWs’ individual attributes and behaviors, a 61


perceived sense of privacy in the employer’s house was related to their well-being, and a perceived integration into the employer’s family was identified as significant predictor for mental health. As to the FDWs’ social circumstances, an own room as sleeping accommodation as well as an invasion of privacy by the employer or employer’s family proved to be related to mental health. Further, adequate medical and dental attention as well as their own possession of personal documents (applicable for Indonesian FDWs being in possession of their passport in this study) were identified as protective factors for mental health. The qualitative findings revealed social support as an important beneficial factor for the emotional wellbeing of FDWs in Singapore. Similar results were found in other research with FDWs. In a qualitative study of Filipino FDWs in Hong Kong409 respondents emphasized the importance of meeting fellow FDWs to improve their own well-being. As a result of working overseas (and being separated from their families), the author argues that the family ties of Filipino FDWs are extended to include fellow FDWs. The relationships result in special bonds, a kinship network between the FDWs where one-day gatherings are vital to them as it enhances a sense of “[…] belongingness, security, personal identity and emotional support”410. Further research highlights other methods to enhance emotional well-being in addition to face-to-face gatherings: A quantitative study on migrant workers including Filipino FDWs in Singapore411 revealed how the use of mobile phones provided FDWs with emotional social support through contact with friends and family, resulting in reduced stress and increased emotional and psychological well-being. The use of mobile phones to connect with family members in their home country and with other migrant workers is essential for migrant workers to have a sense of control over their social lives as well as providing a platform for them to maintain autonomy outside of work. When it comes to the FDWs’ social circumstances and their relationship to mental health, overall, the employer and their family play a key-role in the mental well-being of FDWs in Singapore. Whether it concerns the actual treatment by the employer or employer’s family, the employment conditions, the working environment or the perception of the employer or employer’s family’s behavior: It can ‘make or break’ a FDW’s mental health.

62


7 Recommendations: Legal and policy measures This section sets out a list of recommendations for concerned parties that can contribute to improving the mental health of FDWs in Singapore and also outlines some possible benefits for stakeholders. This research has identified several problem areas regarding Singapore’s FDWs’ working and living conditions and has established protective and risk factors for the mental health of FDWs in Singapore. As mentioned in Section 4.1, we focused on individual attributes and behaviors and social circumstances of FDWs in Singapore in its assessment of the factors associated with mental health. However, mental health is also influenced by environmental factors, as discussed in Section 2.2.2 and shown in Figure 21 below. This includes the availability and accessibility of different protections mechanisms for FDWs. A combined effort of employers, employment agencies, the Singapore government as well the labor-sending countries is required to improve the mental health and work conditions for this vulnerable group of women. While employers and employment agencies can provide better protection of mental health by increasing the quality of working and living conditions, authorities can contribute on a broader environmental level. Overall, the study findings on risk and protective factors may assist policy makers in developing and consolidating policies on internal migration so that the lives and rights of the many FDWs in Singapore can be enhanced. This research study was driven by advocacy. From the results we propose a number of customized legal and policy measures that different stakeholders can adopt to improve working and living conditions for FDWs and for a better protection of the well-being of FDWs in Singapore. Figure 21: Systemic network of relationships affecting FDWs’ mental health.

Government Employer Family NGOs

FDW

Friends

Employment agencies

Country of origin governments governments

Individual attributes and behaviors Social and economic circumstances Environmental factors

63


Benefits for stakeholders include412: For the employer, improved mental health among FDWs means enhancing the basic infrastructure towards family life. Improving the quality of life of FDWs means less stress, which will increase their productivity. Additionally, there is the potential to create better trust and relationships between employer and FDW. Finally, if employers have confidence that they have competent assistance at home they will be more willing to expand their families. Employment agencies will have better knowledge of the types of services and programs they can develop to improve the mental well-being of domestic workers. Improved mental health among FDWs will reduce costs through reduced turnover and improve customer satisfaction with both FDWs and clients. Overall, Singapore is a key receiving country for migrant workers and often a role model for countries that wish to establish a migrant workforce. For the Singapore government, an improvement of mental health in FDWs would result in substantial economic advantages as results of, for instance, a reduced turnover rate of FDWs as well as reduced processing administrative and court costs (where applicable). Moreover, an improved mental health of FDWs is beneficial to Singapore’s strategy of increasing the population to 6.9 million by 2030 so as to “enhance work-life measures to help working couples balance work and family commitments”413. Another benefit is that Singapore’s reputation may be enhanced and the country may be seen as an even more desirable workplace for migrant workers and thus attract higher quality of FDWs. Further, better FDWs’ mental health also improves the standing with foreign governments (from FDWs’ home countries) and enhances diplomatic ties. Finally, there could be a significant increase in Singapore’s National Happiness Index (which captures mental health in one major component). Mental illness is the single most important determinant of unhappiness414. Regarding the worldwide ranking of happiness (as of 201-2012), Singapore was ranked on 30th place, Indonesia ranked 76th, the Philippines 92nd, and Myanmar was ranked 121st. Subjective well-being (or happiness) has many beneficial consequences. Empirical evidence 415 shows that emotionally happy people are more likely to be healthy, productive and socially connected. Overall, the study found an elevated level of mental distress among the FDW population in Singapore and clear relationships between FDWs’ mental health problems and exploitative, restrictive and abusive working and living conditions. As a first step, different stakeholders can contribute to raising awareness towards a better protection of FDWs’ mental well-being: Employers could receive information about relevant correlates to the FDW’s well-being as part of the mandatory Employers' Orientation Programme (EOP) before hiring a domestic worker for the first time. Awareness about mental health symptoms for employers could be incorporated during the oneday orientation session for employers conducted by the Ministry of Manpower (MOM) or incorporated in the online course. Non-government organizations concerned with the welfare of migrant workers need to actively engage with the FDW community on mental health issues. In order to achieve this, we collected specific data within the context of this study about how to customize mental health treatment information and preventive education for this population. The next steps for HOME to improve the mental health of FDWs in Singapore include the implementation of information services based on data collected in collaboration with other migrant workers and mental health-related NGOs. For instance, Silver Ribbon (Singapore) has been conducting mental health talks for FDWs at HOME events and is offering complimentary counseling service to FDWs referred by HOME. Further collaborations with NGOs such as Silver Ribbon should be explored, which includes a) the introduction of a training program for FDWs to detect early signs and symptoms of mental disorders among their friends, to provide peer support to fellow workers and to manage their own mental well-being and b) the development of a handbook for employers and FDWs on ways to manage stress and their own emotion and a list of resources. 64


Country of origin governments are in a position to help secure adequate protection for their citizens and ensure that FDWs’ mental health is protected while they are working in Singapore. As FDWs contribute significantly to the economy of sending countries, there is a need to ease the migration process. For instance, language issues are a significant risk factor for mental health. Country of origin governments can address this by mandating that FDWs receive at least minimal skills and language training before being deployed to Singapore. In this study, being in debt proved to be a significant mental health-related problem for FDWs in Singapore. Country of origin governments can manage this issue by requiring Singaporean agencies to be licensed and prohibiting the charging of fees and loans by agents in Singapore and the source country, instead of imposing the cost of employment on FDWs. Pre-departure orientation programs in countries of origin should include information on (mental) health risks and the establishment of contact points for FDWs encountering such risks. Further, the provision of information on access to healthcare prior to migration would be helpful. Foreign governments in FDW source countries could apply a strategy across borders and collaborate with NGOs (regional and in sending countries) and other relevant partners (e.g. the media) to enable the necessary changes in the system on migration. Apart from the need to generally raise awareness, based on the findings, we derived the following key recommendations targeting different levels of factors influencing the mental well-being of FDWs in Singapore.

7.1 Recommendations for foreign domestic workers FDWs should be encouraged to be proactive and approach friends, family and organizations such as HOME for help when experiencing homesickness, distress, family concerns or a mental health problem. Results from this study indicate that FDWs in Singapore have to endure sub-optimal living and working conditions. Additionally, the majority suffered from homesickness or experienced family concerns, which are risk factors for mental health problems. It is important to raise awareness amongst FDWs that they do not have to suffer in silence, especially for the Burmese FDWs, and to try to have frequent social contacts with their families at home (which proved to be beneficial for FDWs’ mental well-being in this study). FDWs should learn the language of the host family, most typically English and/or Chinese (Mandarin). Language-related communication problems were one of the predicting factors for mental health problems, and a common problem, especially for Burmese FDWs. The HOME Academy offers English and Mandarin language courses for migrant workers, which may benefit not only their interaction with their employer or employer’s family but also their psychological well-being.

65


7.2 Recommendations for employers FDWs in Singapore have a very unique employment environment, as they work and live with their employer and employer’s family. Thus, the employer is their main point of contact as reflected in the respondents’ view that their employer is one of their key contact persons when faced with emotional problems. Findings have revealed that restrictive behavior of FDWs by their employers, such as restrictions on communication, invasions of privacy or mistreatment of FDWs in form of nutritional neglect (especially for the Burmese FDWs), inadequate medical attention or (verbal) abuse, are significant problems and are detrimental to FDWs’ mental health. Employers of FDWs in Singapore should learn some useful phrases of their FDW’s native language, maintain open channels of communication and strive to treat their employees professionally and with respect at all times. Overall, the employer and their family play a key role in the mental well-being of an FDW in Singapore. The employer should be pro-active in communicating with the domestic worker to identify problems and difficulties she may be experiencing and working collaboratively to resolve these issues. They should be treated with respect to ensure they are effectively integrated into the family. With respect to food provision for FDWs by the employer, related research416 reveals the importance of direct communication between employer and employee, which often did not occur or was very limited. Explicit inquiries about nutrition, for instance the food perceived as appropriate for the FDW’s culture and faith, could minimize conflict potential and thus increase the quality of the FDWs’ life in their employer’s house dramatically and in a straightforward way. Employers of FDWs should ensure a full weekly rest day and limit working hours during the day for their FDWs. The results have shown that long working hours and lack of rest affect the mental well-being of FDWs. While most employees enjoy their weekends off and have fixed working hours, FDWs in general do not enjoy such benefits. Singapore’s Employment Act stipulates that rest days should be 24 hours in duration and employees should not work more than 72 hours of overtime a month (or no more than 10 hours a day for a six-day work week). We recommend that employers adhere to this standard to ensure the mental well-being of their FDWs. Foreign domestic workers should not be deprived of a phone to maintain contact with friends and family. Homesickness was one of the most important risk factors and a predictor for mental health problems. However, one-fourth of the participants were not allowed to make phone calls. HOME’s experience shows that employers have argued that they do not allow the FDW to use her phone since they can be distracted from their daily work. It is important that the FDWs have access to a phone to be used after the daily work has been done and for the employer to trust the FDW the same way they trust them with taking care of their home and/or children.

66


7.3 Recommendations for the Singapore government There are significant gaps in the content and enforcement of legislation related to FDWs, which can negatively affect their mental health. Thus, targeting these gaps has the potential to positively influence the mental health of FDWs in Singapore. Domestic workers are currently not covered by the Employment Act (EA), which provides basic protection, such as a standard number of working hours and rest days, wage and access to employment benefits. Extending the EA to FDWs and properly enforcing the Act can regulate FDWs’ working and living conditions. FDWs are further excluded from the Work Injury Compensation Act (WICA), which provides injured employees with a low-cost and expeditious alternative to common law to settle compensation claims. This is to ensure FDWs have comprehensive and equal benefits and protection should they be injured at work. Domestic workers should be covered by the Employment Act and Work Injury Compensation Act. Accordingly, we advise that the government review its current legal protections for FDWs, and take all necessary steps to improve their protection including, but not limited to, the steps listed below. Set limits on FDWs working hours and ensure they are entitled to public holidays and annual leave. This study has demonstrated that rest time is important for FDWs’ mental health. Our data demonstrate that FDWs in Singapore work for around 13 hours per day and sleep for less than eight hours. Domestic workers are often responsible for the safety of their employers’ children, the elderly and other family members. In addition to causing poor mental health, fatigue and inadequate sleep increase the risk of workplace accidents as well as decrease workers’ productivity. FDWs deserve to be protected from excessive working hours and to be paid for working overtime and on public holidays. The eight-hour day and 72 hours overtime limit in Section 38 of EA should apply to domestic workers, with overtime pay granted for work done beyond 44 hours a week. Paid sick leave and adequate and comprehensive medical and dental care should be made compulsory. Our data shows the significance of physical health problems as a risk factor for mental health problems as well as the lack of adequate medical and dental attention by the employer, which affected around half of the surveyed women. FDWs need to be adequately and comprehensively protected from having to work when they are unwell. Domestic workers deserve the protection afforded to other workers to receive paid sick leave. This could be subject to the requirements in Section 89, including the minimum length of service and examination by a medical practitioner. Further, employers have an obligation under the work permit terms and conditions to provide medical treatment for FDWs. We recommend that employers’ obligations to provide medical treatment to FDWs are more strictly enforced. We also note that domestic workers continue to be unfairly excluded from the Work Injury Compensation Act (WICA). FDWs, like other workers, incur injuries at work. These injuries often inflict great personal and financial costs on FDWs, as well as contributing to the development of physical health conditions (a risk factor for negative mental health outcomes). Finally, addressing the disparity in medical coverage and to ensure (early) treatment options, doctors, social workers and other healthcare providers could include FDWs in national mental health programs such as the National Mental Health Blueprint (NMHB)417.

67


The right to a weekly rest day should be strictly enforced and it should be 24 hours. Domestic workers are workers as well as individuals with family ties and deserve adequate time off. Risk factors for FDWs’ mental health included insufficient social contacts. Further, our data shows that more than 80% of the FDWs do not see their families yearly, and every tenth woman less than every two years. Homesickness also proved to be a significant predictor for mental health in this study. Only half of the study respondents had a weekly day off and 40% of FDWs had less than one rest day per week in a month. We recommend that the government takes measures to ensure that FDWs are given adequate rest days. Under the current Employment of Foreign Manpower Act (EFMA) framework, the mandatory “rest day” can be replaced with salary in-lieu of a day off. . This provision fails to take into account an FDW’s comparative lack of bargaining power if/when negotiating with employers who are guided by employment agents. The imbalance of power is likely to lead to the FDW choosing financial compensation. In addition, the work permit terms and conditions should be amended to state that the rest day is a continuous period of at least 24 hours. Numerous domestic workers report being asked to prepare meals, clean, and wash in the morning and/or evening of their designated rest day. Domestic workers required to undertake any work during the ‘rest day’ should be entitled to receive overtime pay for the time they work on these days. Implement regulations, which protect domestic workers’ privacy. A noticeable finding of this study was the role of perceived privacy as a risk factor for mental health of FDWs. Additionally, more than half of the respondents perceived lack of privacy in the employer’s house, one-third experienced invasions of privacy by their employer or employer’s family and one-third of the cases in the employer’s household was (possibly) equipped with surveillance cameras. One out of 10 every participants slept in inadequate accommodation, such as bomb shelter, kitchen or living room. The Ministry of Manpower currently advises that employers ensure that sufficient space and privacy are provided for their FDW in order to meet the standard of “acceptable accommodation” as required by the work permit terms and conditions. However, this requirement is vague. We recommend that the government release stronger guidelines, which are enforceable by directing employers to respect workers’ privacy. Ensuring FDWs have their own rooms or ensuring partitions are installed in their sleeping areas are some examples the government should consider. We also recommend that the installation of cameras in worker accommodations should be strictly prohibited to maintain their dignity and privacy. Take steps to make verbal abuse a reportable offence and communicate a zero-tolerance stance towards the abuse of FDWs in any form. With respect to the treatment by the employer or employer’s family, our findings show that half of the respondents reported to be verbally abused at some time. Abusive behavior by the employer or employer’s family, both physical and non-physical, was a significant risk factor for the FDWs’ mental well-being. The Protection from Harassment Act was passed in Singapore in March 2014 and protects against behaviors that harass, alarm, distress or cause a fear of violence in others. A recent online survey418 found that 24% of Singaporeans surveyed had experienced workplace bullying. The Act seeks to protect individuals against such incidences and, empowers victims of harassment or abuse to respond, providing a range of sanctions that they can legally enforce against the perpetrator. It is a broad step towards ensuring protection against abuse for all, whether in a domestic, workplace or public setting.

68


Enforce the right of domestic workers to hold their passport and identity documents without fear of retaliation from employers and employment agents. According to this study, the majority of FDWs surveyed did not hold their own passport and employment contract. These findings highlight the widespread and problematic practice in Singapore of confiscating FDWs’ personal documents. We recommend that the Passports Act and Work Permit regulations be strictly enforced to ensure the workers themselves hold these documents. Allow domestic workers to switch employers freely without having to seek permission from their sponsoring employer. In Singapore, FDWs are generally not allowed to change employers without the consent of their specified employer. The difficulties encountered by FDWs attempting to change employers act as a disincentive for workers to report ill-treatment by their employer. FDWs may endure situations of abuse or mistreatment, which are risk factors for negative mental health outcomes, because of the risk of losing their job and being required to leave Singapore. We advise that the government consider allowing FDWs to work in Singapore without being tied to one employer and to change employers without the threat of repatriation. Such changes have the potential to positively influence FDWs’ mental health, as they will not be forced to endure abuse or mistreatment for fear of losing their jobs and their temporary home in Singapore. Provide live-out options for domestic workers. The Singapore government requires all migrant domestic workers to live with their employers. However, living in the homes of their employers has also meant that live-in domestic workers on average work far more hours than almost any category of workers. This also raises the expectation that they should be available around the clock. Insufficient daily rest is significantly related to mental health. In some cases, living in the employer’s house also isolates the worker, making her more vulnerable to illegal confinement, physical and sexual abuse. Live-out options allow domestic workers to take regular breaks and rest. It also facilitates the enforcement of the Employment Act as it is easier to determine overtime hours and limit working hours. Inspect workplace conditions regularly, especially those of newly arrived FDWs, through visits and private interviews with migrant domestic workers, coordinating with and involving migrant workers groups, and employment agencies. The first year of a FDW’s employment is usually a stressful one as they are adjusting to life with their new employer and his or her family. During this period, they are also paying off their debts to recruiters and are not earning much money. This can cause considerable amounts of stress as they need to provide for their families back home. The Ministry of Manpower should continue its practice of interviewing newly arrived FDWs to check on their well-being. However, it should work proactively with NGOs and other support groups in conducting these interviews, as many FDWs may not feel comfortable talking to government officials only. Abolish the SGD5,000 [US2,950] security bond for employers. The $5000 security bond places an onerous burden on employers to ensure domestic workers are repatriated and do not engage in ‘illegal, immoral and undesirable activities’, as stipulated in the work permit terms and conditions. Employers should not be held liable for the private behavior of their employees. HOME’s contact with employers show that it is also one of the reasons employers restrict the movement of their FDWs and confiscate their passports. If the government is concerned about irregular migration and overstaying, current laws and regulations are sufficient to address these issues.

69


Regulate the excessive fees employment agencies charge domestic workers by strictly enforcing the two-month salary cap and disallow agencies from imposing ‘loans’ on FDWs. Results show a relatively low monthly income of the surveyed women, whereby Indonesian and Burmese workers are paid the least compared to Filipino FDWs. Even when weekly rest days are taken into consideration, our calculations reveal that they earn less than SGD1.50 per hour. Debt was revealed as a significant risk factor for the FDW’s mental health. In Singapore, almost all FDWs who are placed with employers by employment agencies will owe a debt to that agency. For the FDW, this means that she may not receive any salary for a number of months of employment. She is also tied to her employer because of this debt and cannot switch employers without consent. This can make FDWs particularly vulnerable to exploitation. In the event she is allowed to switch employers, she accumulates even more debt as she will be charged a fee for this switch. If she chooses to stay to work off her (imposed) debt, her mental health may be at risk. Legally, employment agencies may charge fees that amount to no more than two months of the FDWs’ salary, as stipulated in the Employment Agencies Act. However, many employment agencies charge much more than that through the imposition of ‘private loans’, which the Singapore government turns a blind eye to. Employment agencies in Singapore should create recommended pay scales according to work experience and other relevant qualifications, such as education, and to abolish discriminatory practices that determine entry-level wages according to nationality. Our study has shown that domestic workers from Myanmar and Indonesia are among the least paid of all the nationalities surveyed. Evidence from our case reports has also shown that domestic workers from South Asia are also poorly remunerated. Singapore often prides itself for being a ‘meritocratic’ society. Therefore, wage discrimination by nationality should be universally condemned and steps taken to prevent it from happening. The Ministry of Manpower should establish a national minimum wage law to address wage discrimination by nationality and their vulnerability to wage exploitation. Employment agencies should work with the National Wages Council, government, trade unions and NGOs to recommend policies that promote equal pay for equal work. The Association of Employment Agencies Singapore and CaseTrust should develop counseling and conflict resolution courses for its members and the attendance of these courses should be a licensing requirement. Results have shown that poor mental health is related to various factors (such as employer mistreatment and poor communication), leading to poor interpersonal communication between employers and workers. Homesickness and stress caused by family problems are also significant contributing factors. Employment agents play a key role in assisting workers to adapt to life in their host family and resolving conflicts with their employers. However, many agents do not have skills in counseling and interpersonal conflict management. The Association of Employment Agencies Singapore (AEAS) and CaseTrust should develop such courses and the Ministry of Manpower should make knowledge of such skills as a licensing requirement.

70


Bilateral and multilateral cooperation with source countries, such as the Philippines and Indonesia, should be promoted to ensure more effective protection of FDWs from the deceptive, coercive and abusive behaviors of employment agents and employers. Bilateral agreements, which formalize such efforts, should be signed. The lack of bilateral agreements has led to the inconsistent application of laws and policies. For instance, countries of origin such as the Philippines have implemented the Philippines Overseas Employment Administration (POEA) contract for all household service workers going abroad to work. However, because destination countries like Singapore do not acknowledge these contracts, it is not illegal to substitute these contracts when the workers arrive. A formal bilateral agreement between Singapore and the Philippines would ensure that measures implemented by one country would be upheld in the next. The Ministry of Social and Family Development should provide resources to Family Service Centres and the newly established Social Service Offices (SSOs) to do outreach, provide counseling and social support for domestic workers. Family Service Centres are often staffed with trained social workers and counselors. They are also conveniently located in residential areas where many FDWs work and live with Singaporean families. These community organizations should be given more resources to reach out to FDWs for social support. Ratify the International Labour Organisation’s Domestic Workers Convention (C189). The Singapore government should send a clear signal that all workers, regardless of occupation should have equal employment rights. Our study has shown that the working and living conditions of domestic workers are clearly related to their mental health. The Convention on Domestic Workers, formally the Convention concerning Decent Work for Domestic Workers, is a convention setting internationally accepted labor standards for domestic workers. The ratification of this Convention will ensure that Singapore laws will provide effective remedy for domestic workers who are vulnerable to labor and human rights violations.

71


8 Limitations and challenges of the study The section will discuss the limitations and challenges encountered in the study. A randomization of the sample was not possible due to a limited availability of and access to reference numbers (census data, statistics). We aimed to decrease the disadvantages of having a convenience sample by successful stratification with respect to the participants’ countries of origin to reflect the diversity of the investigated population and to improve the representativeness of the sample by reducing sampling error. We further endeavored to standardize the administration of the questionnaire and would choose controlled environments to control for disturbing factors. An advantage deriving out of the stratified sampling, i.e. not only involving Filipino domestic workers (as done in most previous research efforts419), but the inclusion of FDWs of different countries of origin as found in the domestic worker population in Singapore, wallowed for novel international and intercultural comparability, which extends related research. We only had access to a preselected group of FDWs, which would lead to a selection bias. For instance, no inclusion of confined or ‘undocumented’ FDWs was given. We also focused only on working FDWs, this means women that are not currently employed (and are e.g. in the HOME shelter) were not included. Given that FDWs in more vulnerable and precious situations were not considered in this study, the assumption may be made that the results could be skewed towards a more positive scenario of FDWs’ mental health and working and living conditions. For example, restrictions on communication or movement would be under-reported in our sample because those who are severely restricted were not available to come to participate in the study in the first place. However, the emphasis on currently employed FDWs as opposed to research that predominantly implied a retrospective focus by investigating formerly employed FDWs that fled their employers and stayed in shelters could be considered as an extension of related research as well. This study utilized self-reported data only. No data from other sources, such as employers or employment agencies, to cross-validate results were collected. Thus, the common limitations for selfreported data apply420. For instance, possible social-desirable answering behavior or extreme response styles (e.g. acquiescence) may have occurred, especially with topics of sensitivity in the questionnaire (e.g. abuse by employer) or culturally specific answering behavior (e.g. positively skewed responses regarding satisfaction). It may be also possible that certain issues may have been underreported, such as sexual abusive behavior by the employer or employer’s family, as participants may have had difficulties discussing this421. In order to address this, we chose a formative evaluative approach to develop the study material and used standardized and sensitive instructions by training experimenters to establish trust and make participants feel at ease during the data collection. With respect to the measurement of mental health, we decided to use the Brief Symptom Inventory (BSI), as it was the ‘best’ standardized instrument available for our purposes. The use of an established, standardized measure to capture mental health allows for the statistical comparison with other data pools and increases the internal validity of the construct. However, since this instrument has not been used in this particular population before, the exact scores and the normalized values have to be interpreted with caution. The magnitude of differences between groups should, if at all, be conservative. Though, the instrument has strong face validity. Further, due to the absence of local norms for the BSI, we adopted the existing criterion cutoffs422. Future studies should develop specific norms for FDWs for the BSI. Finally, the critical question has to be asked as to whether BSI items capturing mental distress symptoms reflect mental illness or actual working conditions of FDWs in Singapore. For instance, the overall level of psychotic mental distress found within this sample suggests the need for professional treatment when compared to a reference group. Psychoticism was measured via statements such as “feeling lonely even when you are with people”, “never feeling close to another person” or “the idea that something wrong is with your mind”. Further, the relatively highest levels of distress were experienced related to the statements “having to check and double check what you do”, 72


“your feelings being easily hurt” or “feeling lonely”. All these items also could reflect social isolation within the FDWs’ living situation or controlling or verbally abusive behavior by the employer (in terms of insults). In any case, the results tell about FDWs’ perception and feelings, which is what matters most. Due to different language versions of the questionnaires, an increased error variance may have occurred. It was not possible to include language as covariate to control its influence as this variable was completely correlated with the country of origin (perfect multicollinearity). Despite choosing a very conservative approach for the translation (back translation procedure, see Section 4.2), we cannot guarantee item and scalar equivalence. We dealt with a vulnerable population, and the contents of the survey may have been potentially sensitive as it asked participants about difficult experiences they may have had during their employment as well as mental health-related problems. Further, one critical objective of the research was to offer policy recommendations at a national level, thus a comprehensive review of all research-related documentation and procedures was vital. Therefore, though not mandatory within NGO research in Singapore, we attempted to gain an external ethics approval to increase our research integrity. For this purpose, we approached several research institutions in and outside Singapore. An external ethics approval through a local academic organization (e.g. the Institute of Mental Health) costs SGD10,000, which HOME could not fund due to a tight study budget and expenses for the welfare of migrant workers. An approval through an external university was not possible, as the researchers have to be officially aligned with the institution. For these reasons, we could not gain an external ethical review but would naturally follow current scientific and ethical standards with our research approach. Further, one of our research members is an expert in ethical research questions and gave, with help of her university supervisor, input for the proposal and approach. This study was the first of its kind in Singapore and is of an exploratory nature. Thus, we may not have captured relevant constructs in enough depth. For instance, the concept of a ‘perceived integration into the employer’s family’, proving to be a significant predictor for mental health, needs to be further specified and investigated. There also is further need to specify certain assessed information, such as ‘restrictions on communication’, related to the statement “not being allowed to make private phone calls” to specify as to whether it applies within or outside working hours. The study result that Filipino FDWs are especially vulnerable to develop mental health problems needs further specification and explanation as not much is known about the reasons why certain ethnicities are more prone to mental health-related issues. Finally, as this research is cross-sectional, no information could be obtained about the mental health status of FDWs over time. More research is needed in this area, for example to find out when those FDWs start having mental health issues, before or during their employment in Singapore. Nevertheless, findings show that FDWs in Singapore are especially vulnerable with respect to their mental well-being and there are clear relationships between their mental health problems and exploitative and abusive working and living conditions. The study sheds light on relevant mental health issues in this population and can serve as baseline measure for future research.

73


9 References Adams, A. E., Sullivan, C. M., Bybee, D. & Greeson, M. R. (2008). Development of the scale of economic abuse. Violence Against Women, 14, 563-588. Anbesse, B., Hanlon, C., Alem, A., Packer, S., & Whitley, R. (2009). Migration and mental health: a study of low-income Ethiopian women working in Middle Eastern countries. International Journal of Social Psychiatry, 55(6), 557-568. Archer, S. (2011). ‘Buying the maid ricoffy’: domestic workers, employers and food. South African Review of Sociology, 42(2), 66-82. Bagley, C., Madrid, S. & Bolitho, F. (1997). Stress factors and mental health adjustment of Filipino domestic workers in Hong Kong. International Social Work, 40, 373-382. Brewster, M. P. (2003). Power and control dynamics in pre-stalking and stalking situations. Journal of Family Violence, 18, 207-217. Bryman, A. (2008). Social research methods. (3rd ed). Oxford: OUP Oxford. Business Dictionary (2015). Invasion of privacy. Retrieved from http://www.businessdictionary.com/definition/invasion-of-privacy.html Carballo, M. (2007). The challenge of migration and mental health. International Centre for Migration and Health (ICMH) feature article. Retrieved from http://www.icmhd.ch/WebPDF/2007/WHA%20DISTRIBUTION%20ARTICLE%2018_05_20 07formatted.pdf Chan, D. (2009). So why ask me? Are self report data really that bad? In C.E. Lance and R. J. Vandenberg (eds.), Statistical and methodological myths and urban legends: Doctrine, verity and fable in the organizational and social sciences (pp. 309-335). New York, NY: Routledge. Chib, A., Wilkin, H. A. & Mei Hua, S. R. (2013). International migrant workers’ use of mobile phones to seek social support in Singapore. Information Technologies & International Development, 9, 19-34. Chong, S. (2007). Mental health in Singapore: a quiet revolution? Annals Academy of Medicine, 36(10), 795-796. Chong, S., Abdin, E., Vaingankar, J., Heng, D., Sherbourne, C, Yap, M., Lim, Y., Wong, H., GhoshDastidar, B., Kwok, K. & Subramaniam, M. (2012). A population-based survey of mental disorders in Singapore. Annals Academy of Medicine, 41(2), 49-66. Chong, S., Vaingankar, J. & Subramaniam, M. (2012b). Policy implications of the Singapore Mental Health Study. Annals Academy of Medicine, 41(6), 49-66. Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155-159. Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Lawrence Erlbaum Associates. Cook, T. D. & Campbell, D. T. (1979). Quasi-experimentation: Design and analysis issues for field settings. Skokie, Il: Rand McNally. de Castro, A., Gee, G. & Takeuchi, D. (2011). Relationship between job dissatisfaction and physical and psychological health among Filipino immigrants. AAOHN Journal, 56(1), 33-40. Department of Statistics Singapore (2014). Mean years of schooling. Retrieved from http://www.singstat.gov.sg/statistics/visualising_data/chart/Mean_Years_Of_Schooling.html Department of Statistics Singapore (2014b). Household income from work. Retrieved from http://www.singstat.gov.sg/statistics/browse_by_theme/income_expenditure.html 74


Derogatis, L. (1993). Brief Symptoms Inventory (BSI): administration, scoring and procedures manual (3rd ed.). Minneapolis, MN: NCS Pearson. Derogatis, L. & Melisaratos, N. (1983). The Brief Symptom Inventory: an introductory report. Psychological Medicine, 13, 595-605. Doucet, S., Letourneau, N. & Stoppard, J. (2010). Contemporary paradigms for research related to women's mental health. Health Care for Women International, 31(4), 296-312. El-Hilu, S. M., Mousa, R., Abdul-Malek, H., Kamel, N., Zohdi, M., Maher A. & Al-Aamatriti, M. (1990). Psychiatric morbidity among foreign housemaids in Kuwait. Transcultural Psychiatry, 27, 209215. Ellis, P. D. (2010). The essential guide to effect sizes: an introduction to statistical power, meta-analysis and the interpretation of research results. United Kingdom: Cambridge University Press. Farlex, the free dictionary (2015). Invasion of privacy. Retrieved from http://legaldictionary.thefreedictionary.com/invasion+of+privacy Goh, N. (2014, February 24). Facing up to bullies at the workplace. The Straits Times. Retrieved from http://www.straitstimes.com/the-big-story/case-you-missed-it/story/facing-bullies-theworkplace-20140227 Guerrero, M. I. (2004). The development of moral harassment (or mobbing) law in Sweden and France as a step towards EU legislation. Boston College International and Comparative Law Review, 27, 477-500. Harkness, J. & Schoua-Glusberg, A. (1998). Questionnaires in translation. In: J. Harkness (ed.). ZUMANachrichten Spezial No. 3. Cross-cultural survey equivalence. Mannheim: Zuma. He, X. & Wong D. (2013). A comparison of female migrant workers' mental health in four cities in China. International Journal of Social Psychiatry, 59(2), 114-122. Helliwell, J., Richard Layard, R. & Sachs, J. (eds.) (2013). World happiness report 2013. Retrieved from http://unsdsn.org/wp-content/uploads/2014/02/WorldHappinessReport2013_online.pdf Holroyd, E., Molassiotis, A. & Taylor-Pilliae, R. (2001). Filipino domestic workers in Hong Kong: health related behaviors, health locus of control and social support. Women & Health, 33(1), 181205. House of Commons (2008, June 30). Protection from Harassment Act 1997. Retrieved from http://www.publications.parliament.uk/pa/cm200708/cmhansrd/cm080630/text/80630w0031.ht m#08070177000028 Huang, S. & Yeoh, B. (2007). Emotional labour and transnational domestic work: the moving geographies of ‘maid abuse’ in Singapore. Mobilities, 2(2), 195-217. Humanitarian Organization for Migration Economics HOME (2014). Help desk report (Q1 & Q2). Retrieved from http://home.org.sg/wp-content/themes/mytheme/assets/2014-help-deskreport.pdf Human Rights Watch (2011). ‘They deceived us at every step’. Abuse of Cambodian domestic workers migrating to Malaysia. Retrieved from http://www.hrw.org/reports/2011/10/31/they-deceived-us-every-step Human Rights Watch (2011b). Domestic plight: how Jordanian law, officials, employers, and recruiters fail abused migrant domestic workers. Retrieved from http://www.hrw.org/reports/2011/09/27/domesticplight-0 Human Rights Watch (2010). Walls at every turn: abuse of migrant domestic workers through Kuwait's sponsorship system. Retrieved from http://www.hrw.org/reports/2010/10/06/walls-every-turn-0

75


Human Rights Watch (2008). ‘As if I am not human’. Abuses against Asian domestic workers in Saudi Arabia. Retrieved from: http://www.hrw.org/reports/2008/07/07/if-i-am-not-human Human Rights Watch (2007). Exported and exposed abuses against Sri Lankan domestic workers in Saudi Arabia, Kuwait, Lebanon, and the United Arab Emirates. Retrieved from http://www.hrw.org/reports/2007/11/13/exported-and-exposed-1 Human Rights Watch. (2005). Maid to order: ending abuses against migrant domestic workers in Singapore. Retrieved from http://www.hrw.org/reports/2005/singapore1205/singapore1205wcover.pdf Human Rights Watch (2004). Help wanted: abuses against female migrant domestic workers in Indonesia and Malaysia. Retrieved from http://www.hrw.org/reports/2004/07/21/help-wanted Human Rights Watch (2001). Hidden in the home: abuse of domestic workers with special visas in the United States. Retrieved from http://www.hrw.org/reports/2001/06/01/hidden-home International Organization for Migration (IOM) (2003). Exploratory study on foreign domestic work in Syria. Retrieved from http://publications.iom.int/bookstore/free/Exploratory_Study_Syria.pdf Institute of Mental Health (IMH) (2011). Latest study sheds light on the state of mental health in Singapore. Media release. Retrieved from http://www.imh.com.sg/uploadedFiles/Newsroom/News_Releases/SMHS%20news%20release. pdf Jureidini, R. & Moukarbel, N. (2004). Female Sri Lankan domestic workers in Lebanon: a case of ‘contract slavery’? Journal of Ethnic and Migration Studies, 30, 581-607. Kelley, K. & Preacher, K. J. (2012). On effect size. Psychological Methods, 17, 137–152. Kong, M. M. (2007). Economic globalization and transnationalising labor: Thai construction workers in Singapore. Labour and management in development, 8, 1-17. Lau, P. W., Cheng, J. G., Chow, D. L., Ungvari, G. S. & Leung, C. M. (2009). Acute psychiatric disorders in foreign domestic workers in Hong Kong: a pilot study. International Journal of Social Psychiatry, 55, 569-576. Lin, S. & Bélanger, D. (2012). Negotiating the social family: migrant live-in elder care-workers in Taiwan. Asian Journal of Social Science, 40, 295-320. Mahendran, R. & Aw, S. (1993). Psychiatric illness in Filipino maids admitted to Woodbridge Hospital. Singapore Medical Journal, 34, 38-40. Malhotra, R., Arambepola, C., Tarun, S., de Silva, V., Kishore, J. & Østbye, T. (2013). Health issues of female foreign domestic workers: a systematic review of the scientific and gray literature. International Journal of Occupational and Environmental Health, 19, 261-277. McDaid, D. (2011). Making the long-term economic case for investing in mental health to contribute to sustainability. Retrieved from http://ec.europa.eu/health/mental_health/docs/long_term_sustainability_en.pdf Mkandawire-Valhmu, L. (2010). ‘Suffering in thought': an analysis of the mental health needs of female domestic workers living with violence in Malawi. Issues in Mental Health Nursing, 31, 112-118. Ministry of Health (Singapore), Institute of Mental Health, Changi General Hospital, KK Women’s and Children’s Hospital, Khoo Teck Puat Hospital, National University Hospital, Singapore General Hospital, Tan Tock Seng Hospital & Health Promotion Board (2010). National Mental Health Blueprint Singapore 2007 – 2012. Health minds, healthy communities. Retrieved from http://www.imh.com.sg/uploadedFiles/Publications/IMH%20National%20Mental%20Health%2 0Blueprint.pdf

76


Ministry of Manpower (MOM) (2015). Hours of work, overtime & rest days. Retrieved from http://www.mom.gov.sg/employment-practices/employment-rights-conditions/hours-of-workand-overtime/Pages/default.aspx Ministry of Manpower (MOM) (2014). Foreign workforce numbers. Retrieved from http://www.mom.gov.sg/statisticspublications/others/statistics/Pages/ForeignWorkforceNumbers.aspx Ministry of Manpower (MOM) (2014b). Employer guidelines. Retrieved from http://www.mom.gov.sg/foreign-manpower/passes-visas/work-permit-fdw/before-youapply/Pages/default.aspx> Ministry of Manpower (MOM) (2014c). Foreign worker survey 2014. Retrieved from http://www.mom.gov.sg/Documents/statisticspublications/Foreign%20Worker%20Survey%202014.pdf Ministry of Manpower (MOM) (2014d). Labour force In Singapore, 2014. Retrieved from http://stats.mom.gov.sg/Pages/Labour-Force-In-Singapore-2014.aspx Ministry of Manpower (MOM) (2014e). Frequently asked question: employer medical obligation for foreign workers. Retrieved from http://www.mom.gov.sg/Documents/servicesforms/passes/Employer_Medical_Obligations_-_FDW.pdf Ministry of Manpower (MOM) (2010). FDW and FDW employer study 2010. Retrieved from http://www.mom.gov.sg/Documents/statisticspublications/Report%20for%20MOM%20FDW%20and%20FDW%20Employer%20Study%202 010.pdf National Population and Talent Division (2013). A sustainable population for a dynamic Singapore. Population white paper. Retrieved from http://202.157.171.46/whitepaper/downloads/population-whitepaper.pdf Nakonz, J. & Wai Yan Shik, A. (2008). And all your problems are gone: religious coping strategies among Philippine migrant workers in Hong Kong. Mental Health, Religion & Culture, 12, 25-38. Organisation for Economic Co-operation and Development (OECD) (2013). Guidelines on measuring subjective well-being. Paris: OECD. Retrieved from http://www.oecd.org/statistics/Guidelines on Measuring Subjective Well-being.pdf Pearson Education Inc. (2015). Brief Symptom Inventory (BSI). Retrieved from http://www.pearsonclinical.com/therapy/products/100000450/brief-symptom-inventorybsi.html#tab-details Peng, C. J. (2009). Sociological theories relating to mental disabilities in racial and ethnic minority populations. Journal of Human Behavior in the Social Environment, 19, 85-98. Reproductive Health Response in Crises (RHRC) Consortium (2003). Gender-based violence tools manual. Assessment tools – IV. Retrieved from http://www.rhrc.org/resources/gbv/gbv_tools/manual_toc.html Respect-me R.U.L.E.S (2014). Emotional abuse is moral abuse. Retrieved from http://respectmerules.blogspot.sg/2005/06/emotional-abuse-is-moral-abuse.html Ritsner, M., Ponizovsky, A., Kurs, R. & Modai, I. (2000). Somatization in an immigrant population in Israel: a community survey of prevalence, risk factors, and help-seeking behavior. American Journal of Psychiatry, 157 (3), 385-392. Rosenthal, R. & Rosnow, R. L. (1983). Essentials of behavioral research: methods and data analysis. New York: McGraw-Hill. 77


Sanders, C. (2004). Organizing for economic empowerment of battered women: Women's savings accounts. Retrieved from http://csd.wustl.edu/Publications/Documents/WP04-15.pdf Sobritchea, C. I. (2008). The sexual and reproductive health status and needs of Filipino female migrant domestic workers. International Conference on Gender, Migration and Development 2008, Manila, Philippines. Subramaniam, M., Vaingankar, J., Heng, D., Kwok, K., Lim, Y., Yap, M. & Chong, S. (2012). The Singapore mental health study: an overview of the methodology. International Journal of Methods in Psychiatric Research, 21(2), 149-57. Sundstrom, E. D. (1986). Work places: the psychology of the physical environment in offices and factories. Cambridge, MA: University Press. Tabachnik, B. G., & Fidell, L. S. (2006). Using multivariate statistics (5th ed). Boston: Massachusetts: Allyn& Bacon, Inc. Tan, A. (2014, March 24). New rules for hiring Myanmar maids cover minimum monthly wage, day off. The Sunday Times. Retrieved from http://www.straitstimes.com/breakingnews/singapore/story/new-rules-hiring-myanmar-maids-cover-minimum-monthly-wage-day20140324 Tan, A. (2013, February 10). Stop hiring Indonesian maids directly. The Straits Times Asia report. Retrieved from http://www.straitstimes.com/the-big-story/asia-report/indonesia/story/stop-hiringindonesian-maids-directly-20130206 Transient Workers Count Too (TWC2) (2013, July 26). Big cut in Filipino maids September 2. Retrieved from http://twc2.org.sg/2013/07/26/big-cut-in-filipina-maids-september-2/ Transient Workers Count Too (TWC2) (2011). Fact sheet: foreign domestic workers in Singapore (basic statistics). Retrieved from http://twc2.org.sg/2011/11/16/fact-sheet-foreign-domestic-workers-insingapore-basic-statistics/ Ueno, K. (2009). Strategies of resistance among Filipino and Indonesian domestic workers in Singapore. Asian and Pacific Migration Journal, 18(4), 497-517. Van der Laan, P. & Verdooren, L. R. (1987). Classical analysis of variance methods and nonparametric counterparts. Biometrical Journal, 29, 635–665. Wikipedia, the free encyclopedia (2015). Freedom of movement. Retrieved from http://en.wikipedia.org/wiki/Freedom_of_movement#Freedom_of_movement_between_private _parties Wikipedia, the free encyclopedia (2014). Abuse. Retrieved from http://en.wikipedia.org/wiki/Abuse Wilkinson, L & APA Task Force on Statistical Inference (1999). Statistical methods in psychology journals: guidelines and explanations. American Psychologist, 54, 594–604. Wong, A. (2010). Identifying work-related stressors and abuses and assessing their impact on the health of migrant domestic workers in Singapore. Practicum report. Retrieved from https://circle.ubc.ca/bitstream/id/163010/Wong_Angela_IAR_Report_2012.pdf Wong, D., He, X., Leung, G., Lau, Y. & Chang, Y. (2008). Mental health of migrant workers in China: prevalence and correlates. Social Psychiatry and Psychiatric Epidemiology, 43, 483-489. Wong, D. & Leung, G. (2008). The functions of social support in the mental health of male and female migrant workers in China. Health & Social Work, 33(4), 275-285. Workplace Safety and Health (WSH) Council (2010). Workplace safety and health guidelines. Fatigue management. Retrieved from https://www.wshc.sg/files/wshc/upload/cms/file/2014/Fatigue_Management.pdf 78


World Health Organization (WHO) (2014). Process of translation and adaptation of instruments. Retrieved from http://www.who.int/substance_abuse/research_tools/translation/en/ World health Organization (WHO) (2013) Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non-partner sexual violence. Retrieved from http://apps.who.int/iris/bitstream/10665/85239/1/9789241564625_eng.pdf?ua=1 World Health Organization (WHO) (2012). Risks to mental health: an overview of vulnerabilities and risk factors. Background paper by WHO secretariat for the development of a comprehensive mental health action plan. Retrieved from http://www.who.int/mental_health/mhgap/risks_to_mental_health_EN_27_08_12.pdf Yu, X. (2009). Influence of intrinsic culture: use of public space by Filipino domestic helpers in Hong Kong. Journal for Cultural Research, 13, 97-114. Yeoh, B. S., Huang, S. & Gonzalez III, J.L. (1999). Migrant female domestic workers: Debating the economic, social and political impacts in Singapore. International Migration Review, 33(1), 115-137. Zahid, M. A., Fido, A. A., Razik, M. A., Mohsen, M. A. & El-Sayed, A. A. (2004). Psychiatric morbidity among housemaids in Kuwait: a. Prevalence of psychiatric disorders in the hospitalized group of housemaids. Medical Principles and Practice, 13, 249-254. Zahid, M. A., Fido, A. A., Alowaish, R., Abd El-Motaal Mohsen, M. & Razik, M. A. (2003). Psychiatric morbidity among housemaids in Kuwait III: vulnerability factors. International Journal of Social Psychiatry, 49, 87-96. Zahid M. A, Fido A. A., Alowaish, R, Mohsen, M. A. & Razik, M. A. (2002). Psychiatric morbidity among housemaids in Kuwait: the precipitating factors. Annals of Saudi Medicine, 22, 384-387. Zubin, J., & Spring, B. (1977). Vulnerability - a new view on schizophrenia. Journal of Abnormal Psychology, 86, 103-26.

79


10 Appendices 10.1 Measurement of variables Variables were measured using the following scales and measurement levels: •

Mental health (interval scale): o Not at all (0) – a little bit (1) – moderately (2) – quite a bit (3) –extremely (4)

•

Response scale type (nominal, ordinal scale): o Yes/no o Marked/not marked

•

Frequencies: o Never/not at all (1) – rarely (2) – sometimes (3) – often/mostly (4) – always (5)

•

Satisfaction: o Very unsatisfied (1) – unsatisfied (2) – neither satisfied nor unsatisfied (3) – satisfied (4) – very satisfied (5)

•

Abuse (verbal, physical, moral, sexual): o Never (1) – 1-2 times (2) – 3-5 times (3) – 6 or more times (4) – weekly (5) – daily (6)

80


10.2 Detailed analysis information and report of relevant statistical information Statistical analyses were carried out using IBM SPSS Statistics 22. For general descriptive statistics and descriptive statistics in parametric tests, mean (M) and standard deviation (SD) are presented. For non-parametric tests, median (Mdn) and range (R) are reported. Percentages (%) are displayed in text with no decimal places and with one decimal place in tables and figures. Parametric procedures with continuous dependent variables included t-tests for two independent samples and univariate variance analyses (ANOVA, ANCOVA) (between-subjects design) to compare more than two independent groups. Post hoc analyses were performed using Tukey’s HSD.T-Tests are reported with the t statistics (rounded to two decimal places) with degrees of freedom (N-k-1) in parentheses, the significance level p and the effect size Cohen’s d. ANOVAs and ANCOVA’s are reported with the F statistics (rounded off to two decimal places) with degrees of freedom (betweengroups dfB, within-groups dfW; separated by a comma) in parentheses, the significance level p and the effect size η². Tukey’s HSD are reported with the significance level p. If the assumptions for parametric testing were violated (normal distribution, homogeneity of variance, as indicated by Leven’s test for equality of variances), non-parametric tests were conducted 423 : Kruskal-Wallis tests were performed instead of one-way ANOVAs to compare more than two independent groups. Reported are the H statistics (rounded to two decimal places) with degrees of freedom and sample size in parentheses (separated by comma) and the significance level p. Post hoc comparisons for significant results, based on the Kruskal-Wallis test, were performed using MannWhitney tests. Mann-Whitney tests were also performed instead on t-tests for independent samples to compare two independent groups. Reported are the U statistics (rounded to two decimal places) sample size in parentheses, the significance level p and the effect size r. Differences for two or more independent groups with categorical variables were performed using Chisquare tests of association, under consideration of sample size requirements. Reported are the Pearson’s χ²statistics (rounded to two decimal places) with degrees of freedom and sample size in parentheses (separated by comma), the significance level p and the effect size Cramer’s V. Post hoc comparisons to examine significant cell differences between observed and expected frequencies were based on standardized residuals corresponding to an alpha of 0.01 (critical value = +/- 2.58). Bivariate correlations were performed using Pearson’s product-moment correlation coefficient, under consideration of the required assumptions of normality, linearity and homoscedasticity. Correlations are reported with the coefficient Pearson’s r (rounded to two decimal places), the sample size N in parentheses and the significance level p. With respect to multiple linear regressions, preliminary analyses were conducted to ensure no violation of the assumptions of normality, linearity, and homoscedasticity for all models. Correlations between the predictor variables indicated that multicollinearity was unlikely to be a problem424. All predictor variables were statistically suitably related (p < 0.01; moderate effects) with the dependent variable for examination through multiple linear regressions to be reliably undertaken. Since no a priori hypotheses had been made to determine the order of entry of the predictor variables, a direct method was used for the multiple linear regression analysis. Reported are the F statistics (rounded off to two decimal places), with degrees of freedom (regression df residual df (separated by a comma) in parentheses, the significance level p. For the predictor variables, the standardized coefficient β and the corresponding significance level p are reported. Statistical significance was evaluated at the < .01 level using 2-tailed tests.

81


Apart from indicating the statistical significance, we also report the effect sizes with all statistically significant results in order to quantify the strength or size of a phenomenon425 (that is, the relation or difference between investigated groups). Obtaining information about the magnitude of an effect facilitates the interpretation of the substantive or practical significance of a research result, as opposed to the statistical significance (which reflects whether the magnitude of the relationship observed could be due to chance) 426 . Following Cohen's 427 conventional criteria, we distinguished between small, medium, or large effects (see Table 25 below). Table 25: Magnitude of effect summary428. Type Correlation Regression Mann-Whitney test Chi-Square test T-test ANOVA, ANCOVA

Effect size Pearson’s r f2 r Cramer’s V d η²

Small .10 .10 .10 .10 .01 .01

Medium .30 .30 .30 .30 .06 .06

Large .50 .50 .50 .50 .14 .14

82


10.3 Common statistical abbreviations N

=

Total number in sample; number of observations

n

=

Number in subsample; number of observations per group

M

=

Mean, measure of central tendency with parametric tests

SD

=

Standard deviation, measure of dispersion with parametric tests

SE

=

Standard error, measure dispersion with parametric tests

Mdn

=

Median, measure of central tendency with non-parametric tests

R

=

Range, measure of dispersion with non-parametric tests

%

=

Percentage

p

=

Probability; significance level

df

=

Degrees of freedom

F

=

Observed F value, F-ratio (percentage of variance explained, used in ANOVA)

dfB/dfW

=

Degrees of freedom (between and within)

η²

=

Effect size for ANOVA

HSD

=

Tukey’s Honesty Significant Difference

t

=

Observed t value

d

=

Cohen’s measure of effect size for t-tests

k

=

Number of predictor variables

H

=

Kruskal-Wallis test value

U

=

Observed U value

R

=

Effect size for Mann-Whitney test

χ²

=

(Observed) chi-square test value

V

=

Cramer’s V; effect size for Chi-square test

Pearson’s r

=

Pearson’s correlation; observed r value

R2

=

amount of variance explained by independent variables in the regression model

f2

=

Effect size for regressions

β

=

Standardized regression coefficient

83


10.4 BSI - Single items in descending order How much were you distressed by (during the last 7 days including today)... Having to check and double-check what you do429 Your feelings being easily hurt430 Feeling lonely431 Trouble falling asleep432 Feeling that most people cannot be trusted433 Feeling blue434 Feeling easily annoyed or irritated435 Difficulty making decisions436 Feeling inferior to others437 Nervousness or shakiness inside438 Feeling weak in parts of your body439 Trouble remembering things440 Feeling that you are watched or talked about by others441 Feeling lonely even when you are with people442 Feeling that people are unfriendly or dislike you443 Faintness or dizziness444 Trouble concentrating445 Feeling tense or keyed up446 Feeling hopeless about the future447 Poor appetite448 Feeling very self-conscious with others449 Nausea or upset stomach450 Feeling no interest in things451 Feeling that people will take advantage of you if you let them452 Feeling blocked in getting things done453 Your mind going blank454 Temper outbursts that you could not control455 Feeling fearful456 Numbness or tingling in parts of your body457 Hot or cold spells458 Others not giving you proper credit for your achievements459 Getting into frequent arguments460 The idea that someone else can control your thoughts461 Feelings of guilt462 Feeling so restless you couldn't sit still463 (anxiety) The idea that you should be punished for your sins464 Never feeling close to another person465 Spells of terror or panic466 Feeling of worthlessness467 Pains in heart or chest468 Feeling uneasy in crowds, such as shopping or at a movie469 Feeling others are to blame for most of your troubles470 The idea that something is wrong with your mind471 Suddenly scared for no reason472 Having to avoid certain things, places or activities because they frighten you473 Feeling nervous when you are left alone474 Thoughts of death or dying475 Feeling afraid in open spaces or on the streets476 Trouble getting your breath477 Feeling afraid to travel on buses, subways, or trains478 Having urges to break or smash things479 Thoughts of ending your life480 Having urges to beat, injure or harm someone481

Dimension

M

SD

Obsessive-compulsive Interpersonal sensitivity Depression Additional item Paranoid ideation Depression Hostility Obsessive-compulsive Interpersonal sensitivity Anxiety Somatization Obsessive-compulsive Paranoid ideation Psychoticism Interpersonal sensitivity Somatization Obsessive-compulsive Anxiety Depression Additional item Interpersonal sensitivity Somatization Depression Paranoid ideation Obsessive-compulsive Obsessive-compulsive Hostility Anxiety Somatization Somatization Paranoid ideation Hostility Psychoticism Additional item Anxiety Psychoticism Psychoticism Anxiety Depression Somatization Phobic anxiety Paranoid ideation Psychoticism Anxiety

1.01 0.99 0.92 0.90 0.89 0.88 0.88 0.86 0.85 0.74 0.73 0.70 0.67 0.67 0.65 0.65 0.65 0.64 0.64 0.61 0.60 0.60 0.57 0.57 0.55 0.54 0.54 0.53 0.52 0.50 0.49 0.48 0.47 0.45 0.45 0.44 0.44 0.43 0.41 0.40 0.40 0.39 0.37 0.37

1.09 1.03 1.06 1.02 1.00 0.98 0.94 0.94 1.02 0.89 0.89 0.84 0.93 0.94 0.86 0.90 0.78 0.86 1.03 0.82 0.82 0.83 0.87 0.82 0.81 0.83 0.85 0.86 0.86 0.80 0.79 0.79 0.83 0.68 0.75 0.80 0.78 0.77 0.78 0.79 0.70 0.80 0.71 0.75

Phobic anxiety

0.35

0.71

Phobic anxiety Additional item Phobic anxiety Somatization Phobic anxiety Hostility Depression Hostility

0.34 0.31 0.30 0.28 0.21 0.19 0.14 0.12

0.64 0.71 0.67 0.64 0.54 0.59 0.55 0.52

84


10.5 Relationships between individual attributes and behaviors and social circumstances, and mental health (measured by GSI) Variable:

A

Relationship to mental health P I

M

FDWs’ individual attributes and behaviors: Individual and sociodemographic characteristics Country of origin482 Age Children: Age of youngest child Debt in Singapore: yes/no Debt in home country: yes/no Debt (SG and/or home): yes/no Existence of chronic health conditions: yes/no View on working and living situation Perceived feeling of privacy in employer’s house Perceived treatment as family member by employer or employer’s family Perceived treatment with dignity (aggregated: care, respect, treatment as human being) by employer or employer’s family Family concerns (aggregated: worry about partner, children or other family members): yes/no Homesickness Overall satisfaction with employer or employer’s family Overall satisfaction with working in Singapore Social circumstances: Employment conditions and working environment Daily sleeping hours Sleeping accommodation: own room (yes) vs. no own room (no) Passport with FDW: yes/no Language problems when talking with employer or employer’s family Treatment by the employer or employer’s family Invasion of privacy (aggregated): yes/no Restriction on communication (aggregated): yes/no Number of daily proper meals Nutritional attention: quality, quantity, adequacy of provided food (aggregated) Adequate medical attention: yes/no Adequate dental attention: yes/no Economic abuse (aggregated): yes/no Verbal abuse (aggregated): yes/no Moral abuse: yes/no Physical abuse (aggregated): yes/no Sexual abuse (aggregated): yes/no Social network and support Frequency of contact to friends/family in home country: at least weekly (yes) vs. less than weekly (no)

P>I **483 P>M *484 y > n *488 y > n **489 y >no **491 y > n **494

- *485 - *487

- *486

y > n *492

y > n *493

y > n *490

- **495

- **496

- *497

- **498

- **499

- **500

- **501

- **502

- **503

- *504

- **505

- **506

y > n *507

y >n *508

+ **509 - **513 - **516

+ **510 - *517

+ **511 - **514 - **518

+ **512 - **515 - **519

- **520

- *521

- *522

- *523

n>y *524 y > n *525 - **526

- **527

- **528

- **529

y> n**530 y > n *533 - **536

y > n **531

y > n **532 y > n *534

y> n**535

- **538

- *539

n > y **540 n > y *542

n > y *541 n > y *543 y > n *544 y > n**546 y > n*550 y > n**553 y > n*556

y > n**547 y > n**551 y > n**554 y > n**557

yes > no **545 y > n**548 y > n**552 y > n**555

-

*537

y > n**549

y>n**558

Note. A = all FDWs, P = Filipino, I = Indonesian, M = Burmese; (bivariate) correlation: += positive, - = negative; differences: > = higher GSI scores than; effect sizes: small, medium, large; statistical significance: * p< .01; ** p< .001.

85


10.6 Multiple regression table R2 β .36**

Model Constant Country of origin: Philippines Homesickness Language problems Existence of sexual abuse Perceived treatment as family member Existence of chronic health condition(s) Satisfaction with working in Singapore Debt in Singapore and/or home country (y/n)

.28 .22 .21 .17 -.13 .12 -.12 .11

B

SE

.46 .26 .07 .09 .31 -.05 .16 -.06 .13

.11 .04 .01 .02 .07 .01 .05 .02 .05

P < .001 < .001 < .001 < .001 < .001 .001 .001 .004 .004

CI 99% (B) .18/.73 .17/.35 .04/.10 .05/.13 .13/.49 -.08/-.01 .04/.29 -.12/-.01 .01/.25

86


10.7 Study questionnaire (English version)

87

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

""""""""ID"

1.&General&questions&about&you&WORKING&IN&SINGAPORE& "

&

1.1&How&long&have&you&been&working&in&Singapore?&&&&&&& (write%down)& & & & & & &

%

Dear%Participant,%%

%

"

Thank"you"for"doing"this"survey"by"HOME."We"want"to"find"out"more"about"your" work,&life&and&well.being&as&a&domestic&worker&in&Singapore.""

"Year(s)"and"%"Months" &

&

%

%

&

1.2&Why&did&you&come&to&work&in&Singapore?"(you%can%choose%more%than%1%answer)" "To"save&money"for"the"future" "To"be"able"to"send&my&children&to&school"

Your"view"is"very"important;"it"will"suggest"ways"to"improve"your"lives"here."

"To"help"my"family"/"parents"and"siblings"(send&money&home)"

"

There&are&3&types&of&questions&in&this&survey:&

""I"need&money&urgently"for"other"reasons" "No&jobs&available"in"my"home"country"

• Questions"to"write&down"an"answer"(for"example,"“What%is%your%age?”)" • Questions"to"choose/circle&1&answer"(for"example,"“Do%you%have%a%day%off?”)% • Questions"where"you"can"choose& more& than& 1& answer"(for"example,"“Why% did%you%come%to%work%in%Singapore?”)" "

"To"leave&an&unhappy&/&difficult&personal&life"at"home" "To"get&new&experiences"abroad" "Other"(write%down):"___________________________________________________________________________________________" "

1.3&What&work&did&you&do&before&you&came&to&Singapore?&_______________________________________________&&&& (write%down)&

How&to&do&the&survey:& • There"are"no"right"or"wrong"answers."

"

• Answer"all"questions"and"try"not"skip"any"questions."

1.4&Have&you&worked&as&a&domestic&worker&in&other&countries&before&coming&to&Singapore?& (choose%1%answer)%

• Please"be"honest."

"No"(go%to%next%question)"

• Answer"the"questions"on"your"own."" • Do"not"talk"to"others"while"doing"the"survey." • If" you" change" your" mind" with" a" question," draw" an" X" through" your" first" answer"and"then"mark"or"write"your"new"answer." • If"you"do"not"understand"something,"please"ask"us."

"Yes"""""!"

In&what&countries?%(write%down)%_____________________________________________________________%

%

For&how&long&in&total?%(write%down)%%

"Number"of"employers"""""""&&&&&&

1.5&How&many&employers&have&you&worked&for&in&Singapore?&&&&&&&& (including&your¤t)?&(write%down)" " " " "

"

Thank"you"very"much!"

"

"%

&

"

1.6&Do&you&have&an&employment&agency&RIGHT&NOW?&(choose%1%answer)&

Sincerely,""


Bridget%Tan%%

"Yes"!"OVERALL,&how&satisfied&are&you&with&your¤t&employment&agency?&(choose%1%answer)%

(Founder%and%CEO%of%HOME)%% %

Very" dissatisfied"

Dissatisfied"

Neither"dissatisfied" nor"satisfied"

Satisfied"

Very"satisfied"

"

"

"

"

"

For%experimenter%only:% Administration%date:%

%

Experimenter%name:%

%

Location:%

%

Data%input%by:%

%

Source%of%recruitment:%% %

%

Other%comments:%

1.7&Do&you&owe&money&in&Singapore&and&in&your&home&country&(to&agent,&money&lender,& others?)&(choose%1%answer%for%each%row)%%

Use%of%“Special%occurrences”%sheet?%(tick%if%yes):%%%%%

" "

"Year(s)"and"%"Months"""%

"

Have%you%missed%any%questions%on%this%page?%Please%check!%

1"

In&Singapore:&

"No"

"Yes""!""How&much?"(write%down)"""""""""""_______________"$"(in"SGD)&

In&home&country:&

"No"

"Yes""!""How&much?"(write%down)"""""""""""_______________"$"(in"SGD)&


2"

2.&Questions&about&your&CURRENT&WORKING&SITUATION&&

2.9&Do&you&have&a&day&off?"(choose%1%answer)%

The%following%questions%are%about%the%employer’s%family%you%are%working%for%right%now.%

"Once"a"week" "Three"times"a"month"

&

"Twice"a"month"

"Year(s)"and"&&"Months""""

2.1&How&long&have&you&been&with&your&&&&&&&&&&&&&&&& current&employer?"(write%down)"""" " "

"

"

"

"

"

"Once"a"month"

"""""""""

"Other"(write%down):"_________________________________________________________________________________"

&

"No"day"off"""""!"

2.2&What&is&the&nationality&of&your¤t&employer&(as"shown"in"employment"contract)?&&&&&&&&&&&&&& (choose%1%answer)%

"I"get"paid"for"no"day"off" "I"do"not"get"paid"for"no"day"off"

&

"Local"Singaporean,&Chinese"

2.10&How&many×&a&day&do&you&eat&a&proper&meal?&(write%down)&&&__________"Times&a"day"

"Local"Singaporean,"Malay"

&

"Local"Singaporean,"Indian"

2.11&Are&you&invited&to&eat&together&with&your&employer’s&family?&(choose%1%answer)&

"Local"Singaporean,&other"(write%down):%__________________________________________________________% "Foreigner"(write%down%nationality):"_______________________________________________________________"

Never"

Rarely"

Sometimes"

Often"

Always"

"

"

"

"

"

"

""

&

"Family"members"""""""""

2.3&How&many&family&members&are&in&your&&&&&&&& employer’s&house?"(write%down%number)

"

"

2.12&Do&you&have&problems&talking&with&your&employer’s&family&because&of&language?" (choose%1%answer)"

""""" "

& 2.4&What&is&your&monthly&salary&from&your&employer?&&

______________"SGD"

(write%down;"in%case%of%salary%deduction%period:%write%down%the%amount%after%salary%deduction)" %

%

%

%

Sometimes"

Often"

Always"

"

"

"

"

2.13&Do&you&have&your&own&key&to&your&employer’s&house?&(choose%1%answer)%

%%%%%%%%%%%%%%%%%

"Yes""

"

"

"No"

"No" """" "Yes"""!""(Estimated)&amount&per&month"(write%down):"""

Rarely"

" &

" 2.5&Do&you&have&additional&sources&of&income?%% (choose%1%answer,%all%information%is%confidential)%

Never"

""

&

______________"SGD"

2.14&Are&there&surveillance&cameras&in&your&employer’s&home?&(choose%1%answer)&

& 2.6&How&many&hours&do&you&usually&work&per&day?"(write%down)"" " " " """"""""""

"Hours""

2.7&How&many&hours&do&you&usually&sleep&per&night?&(write%down)& && " " """"""""""

"Yes""

"

"

"No" "

"

"

"I%don’t%know"

"Hours""

" 2.15&Who&keeps&your&documents?&(choose%1%answer%for%each%row)&

2.8&Where&do&you&sleep&in&your&employer’s&house?&(choose%1%answer)"

&

You&

Employer&

Employment"agency&

"Shared"room"with"(write%down):%__________________________________________________________________"

Passport&

"

&

&

"Other"(kitchen,"living"room,"storage"room,"etc.;"write%down):"___________________________________"

Employment"contract&

&

&

&

Work"permit&

&

&

&

"Own"room"""""!" "I"can"lock"my"room" "I"cannot"lock"my"room" &

& Have%you%missed%any%questions%on%this%page?%Please%check!%

3"


4"

3.&Questions&about&your&WELL.BEING&

How&much&were&you&&&&&&&&&& distressed&by:&

3.1%Below%is%a%list%of%problems%people%sometimes%have.%Read%each%one%carefully%and%mark% the%response%that%best%describes%how%much%that%problem%has%distressed%or%bothered%you% during%the%past%7%days%including%today.%Choose%only%one%answer%for%each%problem.%Do%not% skip% any% items.% If% you% change% your% mind,% draw% an% X% through% your% original% answer% and% then%mark%your%new%answer.%Read%the%example%before%you%begin.%%

(choose%1%answer%for%each%row)" 14."Feeling"lonely"even"when"you" are"with"people"

"

"

"

"

"

If%you%have%any%questions,%please%ask%them%now.%

15."Feeling"blocked"in"getting" things"done"

"

"

"

"

"

16."Feeling"lonely"

"

"

"

"

"

17."Feeling"blue"

"

"

"

"

"

18."Feeling"no"interest"in"things"

"

"

"

"

"

19."Feeling"fearful"

"

"

"

"

"

20."Your"feelings"being"easily"hurt"

"

"

"

"

"

21."Feeling"that"people"are" unfriendly"or"dislike"you"

"

"

"

"

"

22."Feeling"inferior"to"others"

"

"

"

"

"

23."Nausea"or"upset"stomach"

"

"

"

"

"

24."Feeling"that"you"are"watched"or" talked"about"by"others"

"

"

"

"

"

25."Trouble"falling"asleep"

"

"

"

"

"

26."Having"to"check"and"doubleg check"what"you"do"

"

"

"

"

"

27."Difficulty"making"decisions"

"

"

"

"

"

28."Feeling"afraid"to"travel"on" buses,"subways,"or"trains"

"

"

"

"

"

29."Trouble"getting"your"breath"

"

"

"

"

"

% "EXAMPLE:" How&much&were&you&&&&&&&&&& distressed&by:& Body"aches"

" Not"at"all" "

A"little"bit" Moderately" "

"

Extremely"

" "

"

& How&much&were&you&&&&&&&&&& distressed&by:& (choose%1%answer%for%each%row)"

Not"at"all"

A"little"bit" Moderately" Quite"a"bit" Extremely"

Not"at"all"


1."Nervousness"or"shakiness"inside"

"

"

"

"

"

2."Faintness"or"dizziness"

"

"

"

"

"

3."The"idea"that"someone"else"can" control"your"thoughts"

"

"

"

"

"

4."Feeling"others"are"to"blame"for" most"of"your"troubles"

"

"

"

"

"

5."Trouble"remembering"things"

"

"

"

"

"

6."Feeling"easily"annoyed"or" irritated"

"

"

"

"

"

7."Pains"in"heart"or"chest"

"

"

"

"

"

8."Feeling"afraid"in"open"spaces"or" on"the"streets"

"

"

"

"

"

30."Hot"or"cold"spells"

"

"

"

"

"

9."Thoughts"of"ending"your"life"

"

"

"

"

"

10."Feeling"that"most"people"cannot" be"trusted"

"

"

"

"

"

"

"

"

"

"

31."Having"to"avoid"certain"things," places"or"activities"because"they" frighten"you"

11."Poor"appetite"

"

"

"

"

"

32."Your"mind"going"blank"

"

"

"

"

"

12."Suddenly"scared"for"no"reason"

"

"

"

"

"

33."Numbness"or"tingling"in"parts"of" your"body"

"

"

"

"

"

13."Temper"outbursts"that"you" could"not"control"

"

"

"

"

"

34."The"idea"that"you"should"be" punished"for"your"sins"

"

"

"

"

"


5"


6"

3.2&When&you&have&an&emotional&problem&(for&example,&you&feel&very&unhappy,&sad&or& scared),&where&do&you&go&to&get&help?&(you%can%choose%more%than%1%answer)%&

How&much&were&you&&&&&&&&&& distressed&by:& (choose%1%answer%for%each%row)"

Not"at"all"


35."Feeling"hopeless"about"the" future"

"

"

"

"

"

36."Trouble"concentrating"

"

"

"

"

"

37."Feeling"weak"in"parts"of"your" body"

"

"

"

"

"

"I%do%not%go%anywhere"(go%to%next%question)% "Employer"

"Friends"/"family"/"neighbors"in"Singapore"

"Employment"agency"

"Family"/"friends"in"home"country"or"outside"Singapore"

"Embassy"

"Facebook"group"

"Ministry"of"Manpower"

"H.O.M.E."(hotline,"helpdesk)"

"Doctor"

"People"in"a"religious"organization"""""""""""""""""""""""""""""""""""" (church,"mosque,"temple,"etc.)"

"Police"

38."Feeling"tense"or"keyed"up"

"

"

"

"

"

39."Thoughts"of"death"or"dying"

"

"

"

"

"

40."Having"urges"to"beat,"injure"or" harm"someone"

"

"

"

"

"

41."Having"urges"to"break"or"smash" things"

"

"

"

"

"

42."Feeling"very"selfgconscious"with" others"

"

"

"

"

"

43."Feeling"uneasy"in"crowds,"such" as"shopping"or"at"a"movie"

"

"

"

"

"

3.4&If&you&had&an&emotional&problem,&how&would&you&want&to&get&advice&or&help?&&&&&&&&&&&&&&&&&& (you%can%choose%more%than%1%answer)%%

44."Never"feeling"close"to"another" person"

"

"

"

"

"

"Over"the"telephone"

45."Spells"of"terror"or"panic"

"

"

"

"

"

46."Getting"into"frequent"arguments"

"

"

"

"

"

47."Feeling"nervous"when"you"are" left"alone"

"

"

"

"

"

3.5&If&you&had&an&emotional&problem,&whom&would&you&want&to&talk&to?&& & (you%can%choose%more%than%1%answer)&

48."Others"not"giving"you"proper" credit"for"your"achievements"

"

"

"

"

"

"An"expert"(psychologist,"psychiatrist,"etc.)"

49."Feeling"so"restless"you"couldn’t" sit"still"

"

"

"

"

"

50."Feeling"of"worthlessness"

"

"

"

"

"

51."Feeling"that"people"will"take" advantage"of"you"if"you"let"them"

"

"

"

"

"

52."Feelings"of"guilt"

"

"

"

"

"

53."The"idea"that"something"is" wrong"with"your"mind"

"

"

"

"

"

"Other"(write%down):"_________________________________________________________________________________" "

3.3&If&you&can&choose,&how&do&you&want&to&get&information&about&emotional&problems?& (you%can%choose%more%than%1%answer)%% "From"H.O.M.E.’s"website" "From"facegtogface"workshop"or"seminar" "Printed"materials"(leaflets,"flyers,"etc.)" "Other"(write%down):"_________________________________________________________________________________& &

"Via"email" "Facegtogface"counseling"/"consultation""

"Other"(write%down):"_________________________________________________________________________________& &

&&&&&&&&&&&&

"A"fellow"domestic"worker"with"proper"training"

"Other"(write%down):"_________________________________________________________________________________& &


3.6&What&do&you&think&is&the&best&way&to&help&the&emotional&well.being&of&domestic& workers&in&Singapore?&Please&write&1&or&2&ways.&You&can&write&in&your&own&language.& "

" 7"


8"

4.1&Does&your¤t&employer’s&family...."(choose%1%answer%for%each%row)%

4.&Questions&about&the&TREATMENT&BY&YOUR&EMPLOYER&

"

"

The%following%questions%are%about%the%employer’s%family%you%are%working%for%RIGHT%NOW.%% We%will%ask%you%about%how%your%current%employer’s%family%treats%you%SINCE%YOU’VE%BEEN% WITH%THEM.%%

"

"

"

Never" Rarely" Sometimes"

"

"

Often"

Always"

Not%applicable%

Let&you&see&a&doctor"when" you"need"it?""

"

"

"

"

"

"

"

!%Employer%pays%for%it?%

%

"

"

"

"

"

4.1&Does&your¤t&employer’s&family...."(choose%1%answer%for%each%row)%

Let&you&see&a&dentist"when" you"need"it?"

"

"

"

"

"

"

!%Employer%pays%for%it?&

"

"

"

"

"

"

Please%be%honest.%We%keep%all%information%confidential!%

% "

Never"

"

Rarely" Sometimes"

Often"

Always"

Let"you"leave&the&house"freely?""

"

"

"

"

"

Lock"you"into&the&house?"

"

"

"

"

"

Lock"you"into&your&/&a&room?"

"

"

"

"

"

Allow"you"to"make&private&phone&calls?"

"

"

"

"

"

Let"you"talk&to&people&outside"the"family?"

"

"

"

"

Let"you"talk&to"people&from&your&own& country?"

"

"

"

"

"

"

"

Never"

"

Rarely" Sometimes"

Sometimes"

Often"

Always"

I%don’t%know%

Search&your"room?"

"

"

"

"

"

&

"

Open&your&mail?"

"

"

"

"

"

&

"

"

Check"your&phone?"

"

"

"

"

"

&

"

"

Check"your"things?"

"

"

"

"

"

&

Often"

Always"

"

"

"

"

Give"you"good&food"(no"leftgovers,"expired" food,"etc.)?"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

Never"

"

"

Rarely" Sometimes"

"

Rarely"

"

"

4.2&Does&your¤t&employer’s&family...."(choose%1%answer%for%each%row)% Never"

Give"you"enough&food?"

Give"you"your&kind&of&food"(rice,"halal,"etc.)?"

&

&

"

"

Often"

Always"

"

4.3&Are&there&any&verbal&mistreatments&by&your¤t&employer’s&family?&&&&&& & (choose%1%answer%for%each%row) %

&

Never"

1g2" times"

3g5" times"

6"or"more" times"

Weekly"

Daily"

Call"you"names"(e.g."stupid,"lazy)"

"

"

"

"

"

"

Yell"/"scream"/"shout"at"you"

"

"

"

"

"

"

Curse"at"you"

"

"

"

"

"

"

Pay&your"salary&at"all?"

"

"

"

"

"

Scold"you"/"nag"at"you"

"

"

"

"

"

"

Pay"your"salary&late?"

"

"

"

"

"

Threaten"to"send"you"back"home"

"

"

"

"

"

"

Deduct&salary"as"punishment?"

"

"

"

"

"

Deny&salary"as"punishment?"

"

"

"

"

"

Threaten"to"send"you"back"to"your" employment"agency"

"

"

"

"

"

"

Threaten"to"send"you"to"the"police""

"

"

"

"

"

"

Threaten"to"hurt"you"

"

"

"

"

"

"

Threaten"to"kill"you""

"

"

"

"

"

"

" " " " " " "

Other"(write%down):%_____________________________________________________________________________________

& Have%you%missed%any%questions%on%this%page?%Please%check!%

9"


10"

4.4&Are&there&any&physical&mistreatments&by&your¤t&employer’s&family?&& & (choose%1%answer%for%each%row) " " " " " % "

&&&&&&

Never"

1g2" times"

3g5" times"

6"or"more" times"

Weekly"

Daily"

Shove"/"poke"/"pinch"you""

"

"

"

"

"

"

Push"/"pull"you"

"

"

"

"

"

"

Slap"/"hit"you"

"

"

"

"

"

"

Beat"/"kick"you"

"

"

"

"

"

"

Choke"you"

"

"

"

"

"

"

Bite"you"

"

"

"

"

"

"

Throw"objects"at"you"

"

"

"

"

"

"

Cut"your"hair"without"permission"

"

"

"

"

"

"

Other"(write%down):%_____________________________________________________________________________________% & & 4.5&Are&there&any&moral&or&sexual&mistreatments&by&your¤t&employer’s&family?&&&&&&& (choose%1%answer%for%each%row) % "

Never"

1g2" times"

3g5" times"

6"or"more" times"

4.6&If&you&like,&you&can&tell&more&about&how&your¤t&employer’s&family&treats&you&&&&&&&&&&& (Everything&you&write&will&be&confidential!).&You&can&write&in&your&own&language.& "

& &

4.7&OVERALL,&with&your¤t&employer’s&family....&& %(choose%1%answer%for%each%row)"

Never" Rarely" Sometimes"

Often"

Always"

Do&you&feel&cared&for?&&

"

"

"

"

"

Do&you&feel&respected?&&

"

"

"

"

"

Do&you&feel&treated&like&a&human&being?&

"

"

"

"

"

&

4.8&Do&you&have&a&feeling&of&privacy&in&your¤t&employer’s&house?&(choose%1%answer)&

Weekly" Daily"

Not"at"all"

Rarely"

Sometimes"

Mostly"

Always"

"

"

"

"

"

Make"comments"that"insult"your" faith"or"beliefs"

"

"

"

"

"

"

"

Make"improper"sexual"comments"

"

"

"

"

"

"

4.9&Are&you&being&treated&as&a&family&member&in&your¤t&employer’s&family?& (choose%1%answer)&

Expose"themselves"in"front"of"you"

"

"

"

"

"

"

Not"at"all"

Rarely"

Sometimes"

Mostly"

Always"

"

"

"

"

"

Show"you"pornographic"movies"

"

"

"

"

"

"

Have"you"touch"their"private"parts"

"

"

"

"

"

"

Molest"you"/"touch"your"private" parts"

"

"

"

"

"

"

Kiss"you"

"

"

"

"

"

"

Try"to"rape"you"

"

"

"

"

"

"

Have"you"been"raped"by"someone" from"your"employer’s"family?""

"

"

"

"

"

"

Other"(write%down):%_____________________________________________________________________________________% Have%you%missed%any%questions%on%this%page?%Please%check!%

11"

"

4.10&OVERALL,&how&satisfied&are&you&with&your¤t&employer’s&family?&& (choose%1%answer)&

&

&&&&&&&&&&&&

Very"dissatisfied"

Dissatisfied"


Satisfied"

Very"satisfied"

"

"

"

"

"

&

4.11&OVERALL,&how&satisfied&are&you&with&working&in&Singapore?&(choose%1%answer)% Very"dissatisfied"

Dissatisfied"


Satisfied"

Very"satisfied"

"

"

"

"

"


" " 12"

5.5&About&your&family&in&your&home&country&or&outside&Singapore...%% % (choose%1%answer%for%each%row)%

5.&Questions&about&your&FAMILY&AND&FRIENDS&& " 5.1&How&often&do&you&have&contact&with&your&friends&or&relatives&in&Singapore?&& (choose%1%answer)%

&&

"I%do%not%have%family"(go%to%next%question)% Never" Rarely" Sometimes"

%

I%do%not%have%friends%/% relatives%in%Singapore%

Less"than"once" per"month%

Monthly%

Fortnightly"

Weekly%

Daily%

%

%

%

"

%

%

%%%%%%

Often"

Always"

Not% applicable%

I"worry"about"my"husband"/" boyfriend.%

%

%

%

%

%

%

"

I"worry"about"my"children.%

%

%

%

%

%

%

"

I"worry"about"other"family" members."%

%

%

%

%

%

%

I"suffer"because"I"miss"my"family."

%

%

%

%

%

%

5.2&How&often&do&you&have&contact&with&your&family&in&your&home&country&or&outside& Singapore?&(choose%1%answer)% I%do%not%have%family%%

Less"than"once" per"month%

Monthly%

Fortnightly"

Weekly%

Daily%

%

%

%

"

%

%

& & 5.6&OVERALL,&how&satisfied&are&you&with&your&social&life?%(choose%1%answer)%

" " 5.3&What&do&you&use&to&communicate&with&family&and&friends?& (you%can%choose%more%than%1%answer)%

&

&

&&&&&&&&&&&&

Very"dissatisfied"

Dissatisfied"


Satisfied"

Very"satisfied"

"

"

"

"

"

&

"

&

"House"phone" "Mobile"phone" "

"iPhone"/"smartphone"

!"

"

"

!"

"Computer" "

"

!"

"iPad" "

Do&you&use...%(You%can%choose%more%than%1%answer)"""" " "Skype?" " " "Facebook?" "Other?"(write%down)_______________________________"

" "Other"(write%down):"_________________________________________________________________________________" " " 5.4&How&often&do&you&visit&your&family&in&your&home&country?%(choose%1%answer)% "I%do%not%have%family"(go%to%next%question)% "Never" "Every"6"months" "Every"year" "Every"18"months" "Every"2"years" "Other"(write%down):_________________________________________________________________________________" & Have%you%missed%any%questions%on%this%page?%Please%check!%

13"


14"

6.&Questions&about&your&HEALTH&

7.&Questions&about&YOURSELF&

&

"

6.1&Has&a&doctor&ever&told&you&that&you&have&one&of&the&following&chronic&health& problems?&(you%can%choose%more%than%1%answer)&&&

7.1&How&old&are&you&(real&age)?&& & & (write%down,%all%information%is%confidential)"

"I%do%not%have%a%chronic%health%problem"(go%to%next%page%if%you%chose%this%option)% "Respiratory&disorders:""" " " " " " " Asthma,"chronic"lung"disease"(chronic"bronchitis,"emphysema,"etc.)"

"

"

"

"""""

"

"""""""

7.2&What&is&your&country&of&origin?"(choose%1%answer)" "Philippines"

"Hypertension&and&high&blood&pressure"

"Indonesia"

"Chronic&pain:"" " " " " " " " " " " " Arthritis"or"rheumatism,"back"problems"incl."disk"or"spine,"migraine"headaches"

"Myanmar" "Sri"Lanka"

"Cancer"

"India"

"Neurological&disorders:"" " " Epilepsy,"convulsion,"Parkinson’s"disease"

"

"

"

"

"

"

""""

"Ulcer&and&chronic&inflamed&bowel:"" " " " " " Stomach"ulcer,"chronic"inflamed"bowel,"enteritis,"or"colitis"

"

"

"

""Kidney&diseases:"" " " " " " " Acute"or"chronic"kidney"failure,"kidney"stone,"bladder"stone"

"

"

""""""""""

"Other"country"(write%down):"________________________________________________________________________" &

"Cardiovascular&disorders:"" " " " " " " " " Stroke"or"major"paralysis,"heart"attack,"coronary"heart"disease,"angina,"congestive"heart" " failure"or"other"heart"disease"

& 7.3&What&is&your&marital&status?&(choose%1%answer)& "Single,"never"married" "Married" "Married,"but"separated"from"husband"

""Other&(write"down):"________________________________________________________________________________"

"Divorced" "Marriage"annulled"(Philippines)"

"

!"""If&you&have&chronic&health&problems:&Are&you&taking&any&medication&for&it?&& (choose%1%answer)%

"Widowed"(husband"deceased)" &


&

"Yes"""""""!"""Does"your"employer"pay"the"bills"for"your"chronic"medical"condition?" " & & &

"

"

"Diabetes"

&

"Years"

Never"

Rarely"

Sometimes"

Mostly"

Always"

"

"

"

"

"

7.4&Do&you&have&children?&(choose%1%answer)& "No"(go%to%next%question)% "Yes"""""& " "

Number&of&children?&& (write%down)&

&

How&old&is&your&youngest&child?&& (write%down)&

"children" "

"

"

"years""

"

"

"

"""""""""

& &


15"

&


16"

7.5&What&is&your&religion?"(choose%1%answer)" "Roman"catholic" "Christian,"other" "Muslim" "Buddhist" "Hindu" "Sikh" "Other"(write%down):%_________________________________________________________________________________" "None" & & 7.6&How&many&years&did&you&attend&school&(after&kindergarten)?&& (write%down)&

"&years&&

&&&&&&&&&

& & 7.7&If&you&have&any&other&comments&or&remarks&about&this&questionnaire&or&study,& please&share&with&us.&You&can&write&in&your&own&language.& "

&

& Thank&you&very&much&for&participating&in&our&survey!& % Please%check%again%if%you%have%missed%any%question!%


17"


11 Endnotes 1

MOM (2014).

2

Ibid.

3 Based

on a total foreign workforce of 1,337,000, as indicated in MOM (2014).%

4

Tan (2013, February 10).

5

Tan (2014, March 24), TWC2 (2013, July 26).

6

Tan (2014, March 24).

7

TWC2 (2011).

8

Ibid.

Calculations are based on minimum levy paid (SGD120) to maximum levy paid (SGD265) x 12 x number of FDW (209,600), as indicated by MOM (2013).

9

10 Yeoh

(1999).%

11 (Kong,

2007).%

12

National Population and Talent Division (2013).

13

Ueno (2009, p.500).

14

Ibid.

15

Sobritchea (2008).

16

Human Rights Watch (2005), Ueno (2009).

17

Huang, & Yeoh (2007).

18

Ibid.

19

Human Rights Watch (2005).

20

Ueno (2009).

21

Huang&Yeoh (2007, p.199).

22

Wong & Leung (2008).

23

WHO (2012).

24

Figure retrieved from WHO (2012, p.5).

25

Ibid, Peng (2009).

26

Chong (2007).

27

Helliwell et al. (2013).

28

Chong et al. (2012).

29

Chong et al. (2012, 2012b), IMH (2011), Subramaniam et al. (2012).

For example, Anbesse et al. (2009), Bagley et al. (1997), de Castro et al. (2011), He & Wong (2013), Lau et al. (2009), Malhotra et al. (2013), Mkandawire-Valhmu (2010), Wong & Leung (2008), Zahid et al. (2003, 2002).

30

31

Mahendran & Aw (1993).

32

Wong (2010).

33

Doucet et al. (2010).

34

Zubin & Spring (1977).

35

For example, WHO (2012).

36

Derogatis (1993).

88


37

Ibid.

38

Ritsner et al. (2000)%

%Pearson Education Inc. (2015).%

39 40

Wong et al. (2008), Wong & Leung (2008)%

Satisfaction was measured as an evaluation of live domains, as these reflective assessments are more determined by the circumstances of life, such as living and working conditions. Therefore, they are the primary statistic used for measuring and explaining international differences and trends in subjective well-being (Helliwell et al., 2013). We measured subjective wellbeing following the OECD Guidelines on Measuring Subjective Well-being (ibd.) in terms of phrasing and the choice of an odd Likert-scale measurement.

41

42 Physical

and sexual abuse questions and verbal, physical and sexual abuse scaling was adapted from (RHRC) Consortium)

(2003). 43

Bryman (2008).

44

Harkness & Schoua-Glusberg (1998), WHO (2014).

45

MOM (2014).

46

Tan, A. (2014, March 24; 2013, February 10), TWC2 (2013, July 26).

47

MOM (2014).

48

Ibid.

49

Malhotra et al. (2013)

50

Bryman (2008).

An exception was the question regarding language problems when communicating with the employer or employer’s family. We omitted data from three participants who reported being contracted to their employer for less than one month, assuming that at least one month of employment would be needed to adequately answer this question.

51

52

N = 663

53

N = 639

H(2,633) = 82.49, p < .001; Indonesian (Mdn =32.50, R = 36.00), Filipino (Mdn = 35.00, R = 35.00), Burmese (Mdn = 28.00, R = 25.00)

54

55

U(407) = 9741, p