On labour exploitation, academic advocacy and embracing complexity with Nicola Pocock

This article is part of the Public Health People series where I meet with different public health professionals from all around the globe. Join me in exploring the greatest insights from their fields, their passion projects and their principles for both work and life.

Who is Nicola Pocock, and why did I want to meet with her?

I first got to know Nicola through Twitter. She was the first person to respond to the article I wrote about Nikki K. Here was her response:

Her comment on my first article ever had spread warmth down to my toes. I immediately looked her up and what I found just floored me.

Currently an Assistant Professor at the London School of Hygiene and Tropical Medicine (LSHTM), Nicola has worked with Aidha, The Asia Foundation, China Medical Board and the International Labour Organization (ILO).

And her research interests? They lie at the intriguing intersection between migration, labour exploitation and health. This intersection is a strategic one: Nicola believes that adopting a global health-based approach is an effective way to get issues like child labour and human trafficking on the policy agenda. But her task is far from easy. Working closely with some of the most vulnerable groups in the world puts her in touch with a great deal of suffering.

Right now, Nicola is at the most exciting point in her career. She and a small team have been tasked to revise one of the most important tools used to measure child labour estimates around the world: the Statistical Information and Monitoring Programme on Child Labour (SIMPOC).

I had an entire list of questions for her. When I reached out to her, she received me with the same warmth and empathy that distinguished her academic pursuits. In this article, we cover the following:

• How did she end up working in the fields of migration and labour exploitation?
• What is it like doing research fieldwork with trafficked persons?
• What is the role of academics in fighting for social justice in global health?
• How might we do impactful research that uplift the communities we study?
• What are her philosophies for work and life?

This article took me a long time to write because I wanted to do her justice. I hope you'll enjoy this conversation as much as I did. If you're interested in pursuing a meaningful graduate career, this article ends with Nicola’s curated list of helpful resources to point you in the right direction.

How did she end up working in the fields of migration and labour exploitation?

Nicola’s PhD was in human trafficking in Southeast Asia- a topic that brings to mind heavy themes such as violence, exploitation and trauma. It’s already difficult enough to discuss, let alone study for it for years. How did Nicola decide to pursue her PhD in this area?

Like many wide-eyed fresh graduates before her, Nicola aspired to change the world.

After completing her undergraduate education at the University of Warwick, she had jumped on a plane to Eritrea to become a volunteer English teacher. But she would be in for a rude awakening. "It was a repressive military dictatorship,” she says. “When I got there, it was just so much more difficult than I imagined." Realising that she might be better suited for a role elsewhere, she left Eritrea and joined her mother in Malaysia, where she could still experience life outside the UK. Then, she found a volunteering opportunity that would later inspire her to study one of the most complex issues in the world.

Aidha is a non-profit in Singapore that teaches financial literacy and confidence skills to foreign domestic workers and lower-income Singaporean women. It had been less than an hour's bus ride away across the Malaysian border in Singapore- which had been perfect for Nicola.

There, she met Dr Sarah Mavrinac, the founder of Aidha. In Dr. Mavrinac, Nicola saw the kind of person she could become. “Sarah had a PhD in accounting from Harvard Business School and had been a professor in Singapore,” Nicola says. “But when she noticed a gap in financial literacy among marginalised groups of women, she decided to quit her professorship to start Aidha."

Nicola loved Aidha. "The hope and optimism there was just infectious. It was a community built on lifting one another up," she says, wearing a smile so wide I couldn't help but grin in return. Since she was working closely with female domestic workers in Singapore, it was at Aidha where she first learned about migration in ASEAN- in particular, just how many low-wage migrants there were in the region. “I even came back to Singapore to work, just to continue volunteering at Aidha,” she says. From 2009 to 2012, Nicola upgraded her intellectual prowess during her time as a researcher at the National University of Singapore and honed her craft while knee-deep evaluating real-life programmes doing her soul’s work at the non-profit.

Thoroughly inspired by Dr. Mavrinac’s impact, Nicola aspired to start a non-profit that will inspire the same hope and optimism Aidha did. Since Aidha was the culmination of Dr Mavrinac’s profound intellect and passion, the path ahead was clear: she was going to get a PhD too.

When the time came for Nicola to apply for her PhD, she was keen to do her thesis on financial literacy among migrant workers- informed by her time at Aidha. However, she came across a project that immediately piqued her interest. “It was a project investigating the experiences of human trafficking survivors in Cambodia, Thailand and Vietnam,” she says. "It looked so interesting,” Her desire to do work related to migration and exploitation made the project a perfect fit. And this initial interest soon blossomed into years of generating evidence for advocacy for some of the world’s most vulnerable persons.

What does fieldwork in human trafficking research look like?

Research in this field is very much about uncovering the reality of people’s lived experiences. And for an issue shrouded in crime and danger like human trafficking, social realities the truth need to be triangulated with as many stakeholders as possible.

Nicola had been ready to fly to Thailand to conduct her PhD fieldwork in Thailand’s fishing sector in 2014 when the US Trafficking in Persons (TIP) report had just been released. According to the report, Thailand’s efforts to combat human trafficking had just been downgraded. It was now categorised as a ‘Tier 3’ nation, the lowest ranking tier, joining 22 other countries including Iran, North Korea and Saudi Arabia.

“I was anxious throughout my plane ride,” she says. “I was scheduled for interviews with government stakeholders in the fishing sector. And they were getting slammed for severe human rights violations.” As global backlash against Thailand unfolded, Nicola had anticipated great resistance during her interviews, “I was so sure that it’d be hard to get them to share.”

But the situation had been the complete opposite. “Everyone wanted to talk to me about it.” She counted off her fingers the people whose stories she collected: social workers, frontline NGO staff, policymakers and policemen. The global reports had missed one important thing: the stakeholders in Thailand already knew there was a trafficking problem. And they were actively trying to address the problem. “They needed someone to tell their side of the story- the stories that don’t make it out there because no one wants to listen,” Nicola says.

Whose stories needed telling? For one, those of the policemen. “I love interviewing the police because people in law enforcement reveal the most fascinating insights,” she says. As a trafficked person, your fate lies not only in the hands of your employer but also in those from law enforcement. Further, the police are often painted as the bad guys. They’re either seen to collude with exploitative employers or slammed for not doing enough to help trafficked persons.

But the reality isn’t so simple. Nicola recalls one of her interviews with a labour inspector, “in a province of hundreds of thousands, there were only two labour inspectors who could inspect fishing boats.” Her interviewees had cried out at the impossibility of their tasks: “How are two people going to root out all the trafficking the government has demanded?” In that situation, there were no corrupt nor lazy officials. Rather, the problem was having insufficient resources and suboptimal government policies.

And here’s a surprising insight: manpower shortage in government agencies turned out to be a persistent issue in Thailand. According to one labour official, “out of 85 staff members, only 5 are permanent staff members who own the legal permit to conduct legal inspections on the fishing boats.” This means that those 5 members are constantly overworked. That’s not all. The police are just not incentivised to find trafficked cases. “If you find any forced labour cases, your workload increases for a week,” Nicola says. “And you’ve already got enough to do.”

Like Nicola, I find myself empathising with them. And perhaps the most important discovery was that human trafficking persists in Thailand not simply because of corruption, or outright ill intent. Rather, the problem had been rooted in systemic failures and government policy restrictions.

What is the role of academics in fighting for social justice in global health?

Startup founders build and distribute.

Artists create and share.

What about academics?

What makes global health research distinct from other domains of research? Unlike several fields where research can remain purely theoretical, global health deals with immediate matters of life and death. Hence, global health research should transcend the mere publishing of papers and attending conferences- into creating tangible impact.

Should academics then publish and advocate? According to Nicola, an academic should shoulder the dual responsibility of both inquiry and advocacy. Unfortunately, many stop at inquiry.

Even Nicola, whose work is fundamentally impact-driven, confesses that she herself is slow to disseminate her work on a larger scale. "You get no brownie points for engaging with policymakers and going out of your way to share your work more widely,” Nicola says. And because academics are not incentivised to translate their hard work into tangible impact, “the equally, if not, more important work of getting the right people to pay attention gets neglected.”

"The very least you could do is to share your work with others, and set closed-door government and partner meetings." All of this she learned from Cathy Zimmerman, her PhD supervisor and colleague- also the second woman (after Dr. Marvinac) to have a profound impact on her life.

Given workload constraints, Nicola believes that academics should, at the minimum, publish and get their material into the hands of folks who can advocate.

How might academics fulfil this role more fully?

Put yourself in Nicola’s shoes.

After months of interviews and analysis, you find out that trafficked fishermen in Thailand suffer from violent abuse and mental health trauma. What would you do?

After learning that due to language and cultural differences, migrant workers in Malaysia have their mental health issues dismissed and cannot receive proper diagnosis and treatment when they are ill- what actions might you take?

Would you publish your papers and be done with them? If you were to imagine yourself as part of the communities there were studied, what would you want academics to do?

This is where intentional dissemination and advocacy of work comes in. “We make sure we arrange a meeting with the relevant stakeholders to discuss the results of our work,” Nicola says. Emails don't cut it. Share your work with government agencies in person.

She recounts one of her meetings with the social welfare department in Thailand overseeing shelters for trafficked persons. “We found problematic levels of PTSD among our study population,” she says. “During this meeting, we were able to have a productive discussion on how the department can address the trauma the migrants were facing.”

The results were straightforward: the community needed counselling services- immediately. Without that meeting, it might have taken months, even years for the social welfare department to even chance upon the results of the study. How many more months might the community need to wait for the department to then provide the psychosocial care that they need?

In short, intentionally disseminate and advocate for the work you’ve spent months to years crafting.

How might we do impactful research that uplift the communities we study?

First, maintain academic neutrality. Much of Nicola’s research involves fieldwork: sitting down with stakeholders and conducting in-depth, often highly personal interviews. When studying the populations she does, it can be easy for the academic to want to be seen as the righteous advocate- and forget that the interviewee simply wants to be seen. Since research is all about uncovering lived experiences and social realities, how can we then honour their worldviews and experiences?

It boils down to the kind of questions you ask. Questions should be (1) neutral and (2) open-ended. That way, the persons you are speaking to are encouraged to express their opinions freely. Ultimately, you want to create a reassuring space where the other party feels safe. “You want to make people feel comfortable to share,” Nicola says. And to do that, “you need to be careful. Ask neutral questions and avoid making any value judgments.”

Second, embrace complexity. “Being in this space, you realise that there is just no straightforward, black-and-white answer to any social problem,” Nicola says. Problems are instead, highly complex and multi-faceted. What does she mean by that? Let’s take an example: since the COVID-19 pandemic, the world has seen skyrocketing numbers of child labour. “Schools are closed. Parents are losing their jobs,” she says. “To put food on the table, kids are being sent out to work.”

Protecting children isn’t as easy as outlawing child labour, or re-opening schools to get them back in. “Once kids are out of school,” Nicola closes her eyes, “it’s very difficult to get them back in.” Given the current economic and public health crisis, we need to realise that sending their children to work is a necessary reality for many families.

The important question here is no longer: How are we going to get children out of their dangerous jobs and into school? Rather, the question we should ask is: How might we protect kids from getting injured or permanently disabled when they’re working, so that they can continue finding better jobs in the future?

To Nicola, embracing complexities means adopting a systems perspective. This means acknowledging that processes overlap, systems feed into each other and solutions often require structural change that can take decades to undo.

It helps that Nicola is fascinated with her subject matter. To her, complex social issues such as human trafficking or child labour are “the juicy stuff”. But she also acknowledges that, to someone else, they could be really difficult. Take her field for example. Working in human trafficking often means navigating difficult government structures, not to mention getting up close and personal with criminal activities. Impacting change can too, be slow and discouraging.

But she stays rooted in her stance. The difficulty is not a suitable excuse. Imploring academics not to be afraid, Nicola urges academics to ask, “What’s needed? What are the complex issues hiding in plain sight that are waiting to be addressed? What is it that the world needs academics to do?”

Her philosophies for work and life

Be honest to both yourself and to others. “It’s so important to put your cards on the table,” she says. “Don’t hold back on what it is that you’re really interested in or curious to find out about.” Her advice? Admit what you know and what you don’t know. And be respectful.

To create meaningful impact, show up for your partners. Actively nurture your relationships with your partners, regardless of whether they are your students, non-profits or policy-makers. This is because relationships need to be tended to with care. “Add value. Connect them with people that can fill their needs. Offer resources and expertise,” she says. At the end of the day, strong partnerships open doors to real, sustainable change. “These valuable relationships don’t come by often. You’ve got to leverage on them the best you can.”

Grow alongside your students. If there’s one thing Nicola loves, it’s learning from her students. “Our students do amazing things,” she says, throwing me a winning smile. “Their enthusiasm is infectious and just so inspiring.” Unfortunately, academics aren’t always encouraged to spend time with their students. Still, Nicola urges fellow colleagues to actively lift students up, either through active mentoring or connecting them to relevant resources. The result is usually a win-win-win: the professor gets to learn, the student gets to contribute, and partners benefit.

Concluding with hope and optimism

Nicola hadn’t mentioned the one defining trait that led her to do great work: her ability to inspire hope and optimism. It had radiated off her throughout our Zoom conversation and subsequently over our email correspondence. After writing this piece, I realised that it must have been the same spirit she carried with her to Eritrea and the same spirit that nurtured her loyalty to Aidha.

When it comes to combating tough problems in migration and labour exploitation, the world needs someone who is patient enough, curious enough, has a strong sense of justice and willing to go the extra mile.

And Nicola checks all boxes.

Her favourite books in recent years (Nicola’s notes are italicised)

1. Hope in the Dark by Rebecca Solnit - restorative if you are trying to do anything related to social justice.
2. Mountains beyond Mountains by Tracy Kidder - an inspiring story of Dr Paul Farmer setting up Partners in Health.
3. Love Warrior by Glennon Doyle - for lessons in vulnerability and remaining true to yourself.

Nicola’s published works

Here are some of Nicola’s published works, all of which are great references if you would like further reading on migration, labour exploitation and health.

• Health of men, women, and children in post-trafficking services in Cambodia, Thailand, and Vietnam: an observational cross-sectional study
• Labour Trafficking among Men and Boys in the Greater Mekong Subregion: Exploitation, Violence, Occupational Health Risks and Injuries
• Universal health coverage in 'One ASEAN': Are migrants included?
• Moving towards culturally competent health systems for migrants? Applying systems thinking in a qualitative study in Malaysia and Thailand

Nicola’s list of recommended resources

If you’re interested in finding out more about using research skills for impact, or career resources for those with advanced degrees,  here are some of Nicola’s recommended material:

• Roostervane - career resources mainly aimed at PhDs transitioning out of academia, but useful advice for masters graduates too. Their youtube interviews on transitioning PhDs are also great.
• Heterodox Academy - a group of academics and educators promoting viewpoint diversity and critical thinking as part of research and teaching. They have a podcast too.
• Effective Altruism - a movement promoting the use of reason and evidence to do the most good in the world, including evidence-backed philanthropic giving.
• The Michelle Obama’s Podcast - I’ve really enjoyed her insights on building your career, managing family life and work.
• Conversations with Tyler - To learn about development economics in a friendly conversational way from Tyler Cowen himself. He has a fun and  piercing interview style.

A note from Nicola on 6th Jan 2021, who will be taking on a new position at the Lumos Foundation. while remaining an honorary academic at LSHTM.

“Since this conversation (12th Oct 2020), I’ll be moving into a new role as Head of Data & Research at the Lumos Foundation. Believing that “Children belong in families, not orphanages,” The Lumos Foundation is a non-profit aiming to end the institutionalization of children and promote shifts towards family and community-based care globally.

I am excited to join Lumos and look forward to leading efforts in documenting their systems change model. That aside, I can’t wait to learn from partners and colleagues about the important issues around family-based care and early childhood development among others. Looking back on my journey, I’m now coming back full circle to the NGO world- which is heartening and will no doubt be enlightening.”

Thank you so much for reading.