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LIFE DIFFICULTIES AMONG UNDOCUMENTED FEMALE MIGRANT WORKERS FROM MYANMAR IN SEAFOOD PROCESSING FACTORIES, SAMUT SAKHON, THAILAND SAN SAN HTET A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS (HEALTH SOCIAL SCIENCE) FACULTY OF GRADUATE STUDIES MAHIDOL UNIVERSITY 2016 COPYRIGHT OF MAHIDOL UNIVERSITY iii ACKNOWLEDGEMENTS I would like to express my deepest and sincere gratitude to my major advisor, Lect. Dr. Seung Chun Paek, for his enlightening guidance and inspiring instruction in the development and completion of my study. He stimulated my interest in the field of migration and improved my ability in writing from the starting to the end on my thesis. In the process of meeting and discussion, he not only provided prudent and pointed guidance but also gave me special kind attention, encouragement and warm and sincere support. My heartiest thanks goes to my two co-advisors, Asst. Professor Dr. Penchan Pradubmook-Sherer, and Lect. Dr. Natthani Meemon for their valuable and helpful suggestions and academic guidance. I also wish to express my sincere appreciation to all professors and teachers from the Department of Society and Health for their excellent teaching and supports. And also, I would like to extend my heartfelt thanks to Assoc. Professor. Dr. Kitipat Nontapattamadul for profound and carefully aimed comments and suggestions. I would like to express my special thanks to Registered nurse. Ms. Nahathai Chulkarat, Ms. Kanitha Panraksa, all translators and staff from Samut Sakhon hospital. I would like to offer my great thanks to Vice President Mr. Aung Kyaw, Mr. Sai Sai, Mr. Nay Min and all staffs from Migrant Worker Rights Network for supporting me in the field site and collecting data. Furthermore, I would like to thank all participants in my study for helping to succeed my data collection and to accomplish my thesis. Moreover, thanks also go to all the staffs from Department of Society and Health and all of my friends from Thailand and Myanmar for giving me support and kindness throughout my study. A special gratitude and love goes to my family for their unfailing support. I wish to express my deepest love and thanks to my mother and little brother for their encouragement and financial and psychological supports throughout my study. San San Htet Fac.of Grad. Studies, Mahidol Univ. Thesis / iv LIFE DIFFICULTIES AMONG UNDOCUMENTED FEMALE MIGRANT WORKERS FROM MYANMAR IN SEAFOOD PROCESSING FACTORIES, SAMUT SAKHON, THAILAND SAN SAN HTET 5738264 SHHS / M M.A. (HEALTH SOCIAL SCIENCE) THESIS ADVISORY COMMITTEE: SEUNG CHUN PAEK, Ph.D., PENCHEN PRADUBMOOK-SHERER, Ph.D., NATTHANI MEEMON, Ph.D. ABSTRACT Undocumented female migrant workers from Myanmar are still facing a lot of life difficulties in Thailand. This research focused on the life difficulties of Myanmar undocumented female migrant workers related to health care accessibility, working environment and life as women in seafood processing factories in Samut Sakhon, Thailand. An exploratory qualitative research design, using in-depth interviews and focus group discussion, has been done based on political economy and gender perspectives. The sample was derived from purposive sampling for three health care providers and the snowball technique for twelve Myanmar migrant workers. The finding showed that undocumented female migrant workers reported inaccessible health care, wages lower than that reported by limitedly documented and documented workers were forced to purchase protective equipment for work whereas limitedly documented and documented workers were provided with this equipment by employers. In addition, they were not entitled to any leave (sick, maternity and annual leave) but the rest of migrant workers were allowed to take these kinds of leaves. Another findings described that undocumented migrants worked long hours but they were not paid extra wages. Unlike the undocumented migrant cases, other types of migrant workers worked eight hours per day and they were paid overtime for their extra hours. Additionally, undocumented migrant workers faced more life difficulties regarding not only taking multi roles and responsibilities for their families based on their religious and cultural background but also working for long hours in their place of work. Undocumented workers lacked relaxing time while the rest of migrants had a chance to help with household chores. From the standpoint of political economy, undocumented female migrants were facing more exploitation in the areas of health care access, wages, safety and other benefits compared with migrants. The results recommends that the employers should provide equal benefits and full labor rights to all migrant workers. The relevant officials should support equalizing the necessities in health care access and safe workplaces for undocumented migrants. According to the gender perspective, they should not be discriminated in the division of labor based on gender roles. It shows that both men and women should be balanced their roles and responsibilities in the families. Domestic chores should not be a burden only on women. It should be shared by all members of their families. KEY WORDS: UNDOCUNENTED/ FEMALE MIGRANTS/ DIFFICULTIES/ HEALTH CARE / EXPLOITATION/ UNEQUAL POWER 234 pages v CONTENTS Page ACKNOWLEDGEMENTS iii ABSTRACT iv LIST OF FIGURES viii LIST OF TABLES ix LIST OF ABBREVIATIONS x CHAPTER I INTRODUCTION 1 1.1 Background 3 1.2 Significances of the problem 6 1.2.1 Health care inaccessibility 7 1.2.2 Working environment 8 1.3 Research questions 10 1.3.1 General research question 11 1.3.2 Specific research question 11 CHAPTER II LITERATURE REVIEW 12 2.1 Political economy perspective 13 2.1.1 Capitalist society 16 2.2 Gender perspective 20 2.2.1 Religious and cultural context of Myanmar 21 2.3 A review of the previous literature 24 2.4 Conceptual framework 29 2.4.1 Capitalist society related to health inaccessibility 29 2.4.2 Capitalist exploitation related to working environment 32 2.4.3 Power relationship between men and women: Life as women 34 CHAPTER III RESEARCH METHODOLOGY 37 3.1 Research area 37 3.2 Outlines for sample population 39 vi CONTENTS (cont.) Page 3.3 Sample methods 39 3.4 Proposed recruitment process for informants and key informants 40 3.5 Period of study 43 3.6 Recruitment process 43 3.7 Method of data collection 45 3.8 Research instruments 50 3.9 Data analysis 50 3.10 Validity and reliability of data 51 3.11 Ethical consideration 52 3.12 Proposed research schedule 53 CHAPTER IV RESEARCH FINDINGS 55 4.1 Profile of informant 55 4.1.1 Socio demographic information of informants 56 4.1.2 Background of key informants 65 4.2 Migration status from Myanmar to Thailand 67 4.3 Living conditions of Myanmar migrant workers 69 4.4 Daily lives situations of Myanmar female migrant workers 73 4.5 Social and family relationship 75 4.6 Context of working environment 79 4.7 Background of health care system for migrant workers in Samut Sakhon Province 84 4.7.1 Health examination for migrant workers 86 4.7.2 Health care delivery in study area 86 4.7.3 Pattern of health seeking behavior 88 4.8 Life difficulties of migrant workers 91 4.8.1 Health care inaccessibility 93 4.8.2 Working environment 126 4.8.3 Power relationship between men and women 151 vii CONTENTS (cont.) Page CHAPTER V SUMMARY, DISCUSSION AND RECOMMENDATIONS 163 5.1 Summary findings 163 5.1.1 Health care inaccessibility 164 5.1.2 Working environment 168 5.1.3 Power relationship between men and women 172 5.2 Discussion 174 5.2.1 Social barriers to accessing health care 180 5.2.2 Unequal labor rights in workplaces 182 5.2.3 Double burden works and triple sufferings being women 185 5.3 Recommendations 188 BIBLIOGRAPHY 194 APPENDICES. 203 Appendix A In-depth Interview Guidelines for Informants 204 Appendix B In-depth Interview Guidelines for Key Informants 212 Appendix C Focus Group Discussion Guidelines 214 Appendix D Tables 216 BIOGRAPHY 234 viii LIST OF FIGURES Figure Page 2.1 Conceptual framework 36 3.1 Map of Samut Sakhon province, Thailand 38 3.2 Steps of Informants’ In-depth Interview 49 4.1 Living condition of Myanmar migrant workers 72 4.2 Police card (both sides) 72 4.3 Migrant workers community 78 4.4 Working condition of female migrant workers in small shrimp 84 factory 4.5 Making medical examination and temporary work permit in one 86 stop-service center 4.6 Migrants clinic in Samut Sakhon hospital 88 4.7 Providing mobile health care services to migrant community from 88 Samut Sakhon hospital ix LIST OF TABLES Tables Page 3.1 Proposed recruitment process for informants and key informants 40 3.2 Methods of data collection and sampling 45 3.3 Proposed research schedule 54 4.1 Number of interviewees 56 4.2 Socio demographic information of informants 62 4.3 General living conditions in Thailand 63 4.4 Background of key informants 67 5.1 Number of migrant workers for health insurance accessibility 165 5.2 Reasons of health insurance inaccessibility 165 5.3 Reasons of health care service inaccessibility 167 5.4 Reason of physical safety inequity 169 5.5 Structure: Wage, benefit and working hours 170 5.6 Security: Verbal abuse, physical abuse and social abuse 172 5.7 Power relationship between men and women: Life as women 174 x LIST OF ABBREVIATIONS AIDS Acquired Immune Deficiency Syndrome ARV Antiretroviral BOI Thailand Board of Investment BWU Burmese Women Union CEDAW Committee on the Elimination of Discrimination against Women FAO Food and Agriculture Organization HIV Human Immunodeficiency Virus ILO International Labor Organization INGO International Non-governmental Organization IRIN Integrated Regional Information Networks GNP Gross National Product GDP Gross Domestic Product MAP Migrant Assistance Program MOI Ministry of Interior MOU Memorandum of Understanding NV National Verification OECD Organization for Economic Co-operation and Development OPD Out Patient Department SSS Social Security Scheme UNHCR United Nations High Commissioner for Refugees WHO World Health Organization Fac.

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