Research reveals major health care, communication challenges for migrant domestic workers in Hong Kong

Migrant domestic workers support many Hong Kong working families in childcare and household duties but their own personal needs seldom receive significant attention.

The Department of English and Communication at The Hong Kong Polytechnic University (PolyU) has conducted research into the health and other structural issues faced by migrant domestic workers in Hong Kong, especially during the COVID-19 pandemic. Findings reveal that health literacy and access to information and facilities are crucial to their well-being.

The researchers have interviewed more than 700 Filipino and Indonesian migrant domestic workers and surveyed more than 400 to investigate their life stories and well-being in Hong Kong, covering topics from narratives about their (traumatic) experiences, health literacy and health care needs to their communication networks.

In view of the increasing number of workers driven by growing demand for domestic elderly care in Hong Kong, these studies aimed to highlight the significance of cultivating favorable conditions for workers.

Prof. Hans Ladegaard, Professor of the Department of English and Communication at PolyU, said, "Our research shows that Indonesian workers, in particular, face marginalization and isolation due to language and communication problems and a lack of awareness of their rights. Many took only a three-week Cantonese course before arrival, which clearly does not guarantee their Cantonese proficiency, while most of them are also unable to speak English.

"Many workers even do not know it is illegal to be paid under the minimum wage or that they are entitled to have 24 hours off once a week. Therefore, it is crucial to prioritize efforts to provide language learning support and to educate these workers about their rights."

Inadequate access to health facilities and information is one major challenge facing these workers. According to Prof. Ladegaard's research, when the COVID-19 pandemic-induced loneliness, isolation and homesickness put them at higher risk of experiencing depression and anxiety, they only had limited access to support.

To address the issue, the team advised that health campaigns be conducted in a language that the workers can understand and that accessible channels such as social media are mobilized for promotion. The research also indicated utilizing cartoons and storytelling to be more effective in communicating with migrant populations.

Another research study, led by Dr. Jeffry Oktavianus, Assistant Professor of the Department of English and Communication, found that community storytelling networks, including interpersonal relationships, community organizations and media outlets, played an essential role in supporting the migrant domestic workers in coping during the pandemic.

His research was published in the journal Health Communication in 2021.

The study revealed that many workers could not obtain knowledge about effective preventive measures during the pandemic, due to the absence of reliable and accurate information in their native language. Interaction with workers' communities on social media thus became their major source of informational and emotional support.

However, workers were also exposed to fake news through interpersonal networks, which led to adverse effects, such as having a negative psychological impact. Dr. Oktavianus remarked, "These networks provide crucial support, but also spread misinformation, creating both opportunities and challenges for empowering marginalized communities."

The research further highlighted the potential of community organizations in debunking hoaxes by disseminating credible news, thereby eliminating uncertainty, refuting misinformation and aiding in understanding the chaotic situation.

In this regard, health campaigns are encouraged to utilize community-based storytellers, such as Indonesian organizations or ethnic media, to communicate public health information. Meanwhile, improving digital literacy is also important for helping foreign workers distinguish fake news from real.

While the Philippines now has one of the highest breast cancer diagnosis rates in Asia, there is also an increasing number of Filipino workers diagnosed with breast cancer in Hong Kong. Dr. Margo Turnbull, Assistant Professor of the Department of English and Communication, led a research team focusing on the health literacy needs of migrant domestic workers.

Published in the journal Qualitative Health Research, the study provides a critical examination of how breast cancer and migration impact the lives of these workers.

This study again emphasized the importance of health campaigns in workers' native language and of their access to health facilities, particularly on Sundays, enabling them to receive timely diagnoses and assistance. Dr. Turnbull added, "Improving language and communication skills can also increase workers' effective utilization of medical resources, alleviate the psychological impacts of having cancer and enhance their confidence in advocating for their health care needs."

Currently, Dr. Turnbull is working with a cancer support group to co-develop multilingual communication resources that can be used by migrant domestic workers to share information about their diagnosis and care needs with their employers, families and doctors.

In light of the structural issues uncovered by the studies, a symposium, "Migrant Worker Lives Matter", organized by the Department of English and Communication in collaboration with two local migrant worker NGOs, PathFinders and Mission for Migrant Workers, will be held at the PolyU campus on 24 May.

The event aims to address the challenges faced by migrant domestic workers and explore ways for Hong Kong to become a more inclusive society.