Stöckl et al. Global Health Research and Policy (2017) 2:28 Global Health DOI 10.1186/s41256-017-0049-4 Research and Policy RESEARCH Open Access Trafficking of Vietnamese women and girls for marriage in China Heidi Stöckl1*, Ligia Kiss1, Jobst Koehler2, Dung Thuy Dong2 and Cathy Zimmerman1 Abstract Background: Bride-trafficking has been a growing phenomenon in Southeast Asia, particularly in China, where one-child policies have resulted in demographic imbalances favoring males. Yet, empirical evidence about women and girls sold into marriage in China remains sparse. Methods: This study describes the experiences of 51 Vietnamese women and girls as young as 14 in post-trafficking services who were sold into marriage in China. A consecutive sample of individuals from five services in Vietnam were invited to be interviewed within the first 2 weeks of admission. It is part of a wider dataset for research on the health of men, women, and children in post-trafficking services in Cambodia, Thailand, and Vietnam, the largest study to date on human trafficking and health. We calculated proportions for all variables and conducted bivariate analyses using Fisher Exact Tests for their associations with mental health disorders symptoms. Results: Before leaving home, 31% (n = 15) participants were married. Participants reported high levels of sexual violence (n = 43; 86%) while trafficked and59% (n = 30) spent time in detention before returning to Vietnam. Once in post-trafficking care 52.9% (n = 27) reported probable depression, anxiety or post-traumatic stress disorders (PTSD), two women (4%) attempted suicide in the past month and 38 (75%) remained afraid of their trafficker. Ten (22%) became pregnant while trafficked, and seven (16%) were pregnant at the interview. Conclusions: The cross-border bride trade between Vietnam and China raises complex policy issues, including questions about detention and immigration rights and strategies for supported return processes, including maternal and child health services. As the repercussions of China’s absent female population will persist, Vietnam and China must grapple with the political and social conditions to implement prevention strategies, and resources for women who fall prey to this cross-border bride trade. Keywords: Human trafficking, Vietnam, China, Forced marriage, Mental health and violence against women Background includes trafficking for marriage, there remains little em- Human trafficking is a crime that involves extreme pirical evidence or conceptual clarity about this abusive forms of exploitation, which often leaves survivors with phenomenon [4], which is often only associated with the enduring physical and psychological scars [1, 2]. The “mail order bride” business from low and middle income most commonly accepted definition of human trafficking countries to North America and Europe [5]. is found in the UN Convention Against Transnational The sale of women for marriage has a long history in Organized Crime, which emphasizes that trafficking China. After the Communist Party gained power in involves the coercion and/or deception of individuals for 1949, they instituted policies to redefine social, gender the purposes of exploitation, including for “sexual ex- and family relationships, including abolishing rampant ploitation” and “slavery or practices similar to slavery.” female trafficking and prostitution. As a result, there [3]. While the term ‘slave-like practices’ in the protocol appeared to be no further officially recognized cases of trafficking in women [6, 7] until the introduction of the * Correspondence: [email protected] free market economy and the rapid rise in migration in 1 Gender Violence and Health Centre, Department of Global Health and the late 1970’s [6, 8]. The main underlying factors thought Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SE, UK to influence the trafficking of women for marriage into Full list of author information is available at the end of the article © The Author(s). 2017 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Stöckl et al. Global Health Research and Policy (2017) 2:28 Page 2 of 9 China include patriarchal structures and China’sone- other empirical studies, an ethnographic study and a child policies. Patriarchal structures, such as the wide- quantitative survey of migrants, each with an unidenti- spread expectation for men to marry and produce a fied number of women experiencing forced marriage ex- male offspring for the continuation of the family line plored the trafficking into forced marriage of North hasmetwithadramaticincreaseinbridepricessince Korean women fleeing to China. None of the women in the pre-1978 era. As a result, Chinese men who are these studies planned to marry Chinese men but were pressured by their family to marry, but lack sufficient rather recruited immediately after they crossed the financial or other assets, are often not considered so- border because of their likely vulnerability [10, 15]. A cially desirable partners for women [9, 10]. handful of studies also explore the “Mail order bride” The one child policy, paired with the cultural prefer- business of women from Eastern European, Russian, and ence for sons, has resulted in a skewed sex ratio in rural South East Asian to North America and Europe, how- China and its impoverished regions [11]. The number of ever, most of this work relies on desk-based assessments marriageable women in rural Chinese villages has fur- websites, newspaper reports or legal cases rather than ther declined because a large number of women have empirical work [5, 16]. To our knowledge, only two migrated to more developed coastal areas of eastern quantitative studies have examined the trafficking of China for work or better marriage prospects [11]. The women as wives from Vietnam to China, to date. The numerous men who are unable to find wives and the so- first study included 13 women who were trafficked for cial problem this creates for their families receives con- marriage [17], and the second study used respondent- siderable sympathy from villagers and cadres, who driven sampling of women locally known as having been accept practices that involve the purchasing of a bride trafficked and included 213 women. However, the latter against the bride’s will and therefore would be unlikely research initially included both trafficked women and to report them to police [11]. Additionally, in rural any woman who had migrated to China, married and areas, when a marriage is arranged by parents, a bride- might have been trafficked. Therefore it is difficult to to-be’s consent may not be considered necessary and differentiate between trafficked women and those who many will not see the difference between paying a migrated for marriage or to discern experiences of those ‘bride-price’ versus buying a wife. [8, 12]. who were trafficked [13]. In Vietnam, poverty, unemployment, patriarchal struc- Despite the high visibility of trafficking for marriage tures and a surplus of Vietnamese women in rural areas in newspapers and international reports, empirical evi- in the past due to years of war are tied to a cultural ex- dence is rare. While reports have hypothesized about pectation for single women to marry, which seem to fuel push and pull factors for bride-trafficking within and to the trade in women for marriage to China [11, 13]. China, there remains scant evidence on what women The uneven socioeconomic development between experience during these situations and what hopes and China and Vietnam make cross-border activities and mi- concerns they have after they return in terms of their gration attractive, particularly because crossing the health, well-being and families. This study is one of the border only requires a boarder pass versus a passport first to provide the socio-economic characteristics of [13]. Furthermore, in rural Vietnam, women are ex- women trafficked into forced marriage and in post- pected to marry at a relatively early age, yet because it trafficking services and to describe their experiences can be difficult for Vietnamese women to find attractive before, during and after their trafficking experience. husbands, marriage abroad is viewed as a viable option [13]. There is a history of marriage between Chinese Methods men and Vietnamese or Burmese women, which some- This study is a sub-study of 51 Vietnamese women and times includes bride-kidnapping, a practice often ac- girls as young as 14 in post-trafficking services in cepted by communities, leaving kidnapped brides to Vietnam who were sold into marriage in China. This fend for themselves. [9, 11]. sub-study uses data from a larger observational cross- Despite its high profile in news reporting and inter- sectional study investigating the health of men, women national policies, empirical evidence – both quantitative and children in post-trafficking services in Cambodia, and qualitative - on trafficking