Migration, Health, and Inequalities: Critical Activist Research across Ecuadorean Borders 9781529207132

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Migration, Health, and Inequalities: Critical Activist Research across Ecuadorean Borders
 9781529207132

Table of contents :
Front Cover
Series
Migration, Health, and Inequalities: Critical Activist Research across Ecuadorean Borders
Copyright information
Table of contents
List of Figures and Tables
Acknowledgments
Series Preface
1 Introduction
2 Migration-related Health Processes
Reflective mourning
Active and passive migrant trauma
Migratory stress
Migrant crises triggers
Return shock
Unrecognized migratory resilience
3 Coping with the Challenges of Migration
Disillusion adjustment
Paralyzing and motivating nostalgia
Denied migrant health and normalization of malaise
Pain encapsulation
Well-being ideal and transgenerational goals
Strategic return
Settling readjustment
Involuntary return rebound
4 Post-migration Family Relationships
Family de/re-construction
Simultaneous migration of nuclear family with children
Migration of parents without their children
Fathers migrating alone
Mothers migrating alone
Migration of older siblings alone
Childless couples
Communication distortion
Subordination to concealment and deception
Unspoken pacts
Resentment and detachment
Sensible comprehension
5 Transformative Border Politics
Geopolitical boundaries
Gender/sexual regimes
Ethnoracial hierarchies
Socioeconomic borders
6 Conclusion
Notes
References
Index
Back Cover

Citation preview

R o b e r ta V i l l a l ó n

Migration, Health and Inequalities critical Activist Research Across Ecuadorean Borders

G l o b a l m i g r at i o n a n d s o c i a l c h a n g e

Global Migration and Social Change series Series Editor: Nando Sigona,   University of Birmingham, UK   The Global Migration and Social Change series showcases original research that looks at the nexus between migration, citizenship and social change.

Forthcoming in the series: Mediated Emotions of Migration Sukhmani Khorana

Out now in the series: Postcoloniality and Forced Migration Mobility, Control, Agency Edited by Martin Lemberg-Pedersen, Sharla M. Fett, Lucy Mayblin, Nina Sahraoui and Eva Magdalena Stambøl Navigating the European Migration Regime Male Migrants, Interrupted Journeys and Precarious Lives Anna Wyss Visiting Immigration Detention Care and Cruelty in Australia’s Asylum Seeker Prisons Michelle Peterie Temporality in Mobile Lives Contemporary Asia–Australia Migration and Everyday Time Shanthi Robertson

Find out more at bristoluniversitypress.co.uk/global-migration-and-social-change

Global Migration and Social Change series Series Editor: Nando Sigona, University of Birmingham, UK

International advisory board: Alan Gamlen, Monash University, Australia Leah Bassel, University of Roehampton, UK Avtar Brah, Birkbeck, University of London, UK Sergio Carrera, CEPS, Belgium Elaine Chase, University College London, UK Alessio D’Angelo, Middlesex University, UK Andrew Geddes, European University Institute, Italy Roberto G. Gonzales, Harvard University, US Elżbieta Goździak, Georgetown University, US Jonathan Xavier Inda, University of Illinois, US David Ingleby, University of Amsterdam, Netherlands Anna Lindley, SOAS University of London, UK Cecilia Menjívar, University of California, US Peter Nyers, McMaster University, Canada Jenny Phillimore, University of Birmingham, UK Ben Rogaly, University of Sussex, UK Paul Spoonley, Massey University, New Zealand Susanne Wessendorf, London School of Economics, UK Amanda Wise, Macquarie University, Australia Elisabetta Zontini, University of Nottingham, UK

Find out more at bristoluniversitypress.co.uk/global-migration-and-social-change

MIGRATION, HEALTH, AND INEQUALITIES Critical Activist Research across Ecuadorean Borders Roberta Villalón

First published in Great Britain in 2022 by Bristol University Press University of Bristol 1–​9 Old Park Hill Bristol BS2 8BB UK t: +​44 (0)117 374 6645 e: bup-​[email protected] Details of international sales and distribution partners are available at bristoluniversitypress.co.uk © Bristol University Press 2022 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library ISBN 978-1-5292-0710-1 hardcover ISBN 978-1-5292-0714-9 ePub ISBN 978-1-5292-0713-2 ePdf The right of Roberta Villalón to be identified as author of this work has been asserted by her in accordance with the Copyright, Designs and Patents Act 1988. All rights reserved: no part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise without the prior permission of Bristol University Press. Every reasonable effort has been made to obtain permission to reproduce copyrighted material. If, however, anyone knows of an oversight, please contact the publisher. The statements and opinions contained within this publication are solely those of the author and not of the University of Bristol or Bristol University Press. The University of Bristol and Bristol University Press disclaim responsibility for any injury to persons or property resulting from any material published in this publication. Bristol University Press works to counter discrimination on grounds of gender, race, disability, age and sexuality. Cover design: Andrew Corbett Front cover image: Abraham G. Salazar Bristol University Press uses environmentally responsible print partners. Printed in the UK by CPI Group (UK) Ltd, Croydon, CR0 4YY

Contents List of Figures and Tables Acknowledgments Series Preface

vi viii x

1 Introduction 2 Migration-​related Health Processes 3 Coping with the Challenges of Migration 4 Post-​migration Family Relationships 5 Transformative Border Politics 6 Conclusion

1 21 76 123 171 231

Notes References Index

242 243 251

v

List of Figures and Tables Figures 1.1 1.2 2.1 2.2 2.3 2.4 2.5 2.6 2.7 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 3.10 3.11 3.12 4.1 4.2 4.3 4.4 4.5 4.6 5.1

Conceptual map Website’s logo Illustration of reflective mourning Illustration of active migrant trauma Illustration of passive migrant trauma Illustration of migratory stress Illustration of migrant crises triggers Illustration of return shock Illustration of unrecognized migratory resilience Illustration of disillusion adjustment Illustration of paralyzing nostalgia Illustration of motivating nostalgia Illustration of denied migrant health Survey data on ‘What did you do when you felt poorly, weak, or sick?’ Illustration of normalization of malaise Illustration of pain encapsulation Illustration of well-​being ideal Illustration of transgenerational goals Illustration of strategic return Illustration of settling readjustment Illustration of involuntary return rebound Illustration of family de/​re-​construction Illustration of communication distortion Illustration of subordination to concealment and deception Illustration of unspoken pacts Illustration of resentment and detachment Illustration of sensible comprehension Illustration of transformative border politics

vi

15 17 24 27 28 41 51 56 62 77 80 81 83 86 89 95 100 101 106 110 116 125 153 157 161 164 168 173

List of Figures and Tables

Tables 1.1 1.2 3.1

Glossary of migration-​related health processes 11 Glossary of migration-​related psycho-​sociocultural mechanisms 12 Typical health conditions of normalized malaise 90

vii

Acknowledgments This project would not have been possible without the participation of the many migrants and migrants’ relatives from Ecuador and other Latin American countries, who were willing to share their own experiences and knowledge of migration to the United States, Spain, and back for the development of our collective understanding on health and migration. Similarly, the contributions of health and migrant services providers and advocates were fundamental, particularly because of their genuine interest in improving their praxis to better assist migrants. To respect confidentiality, I cannot name each one of you. Therefore, please take this general message as a sincere recognition and expression of gratitude for your collaboration. I owe a special acknowledgment to Riccardo Colasanti, a pioneer in the field of migrant health, who was the original promoter of my engagement in this project; and to Johanna Montalvo, Xavier Astudillo, and Yadira Gavilanes, who followed his lead at the Institute for Health and Migration in Loja of the Hospital of the Universidad Técnica Particular de Loja, Ecuador and got involved wholeheartedly. Moreover, I would like to thank Margalida Font Roig at the Pontificia Universidad Católica del Ecuador (PUCE)-​Sede Santo Domingo de los Tsáchilas; María Fannery Suárez Berrío at PUCE-​ Sede Ibarra; Mar Alvarez Segura, Montserrat Lafuente, Laura Amado Luz, Marina Fernandez Andujar, and Marta Oporto Alonso, and their students at Universitat Abat Oliba CEU, and Myriam García Blázquez at Sant Joan de Déu Hospital, in Barcelona, Spain; and Erika Márquez at Universidad ICESI in Cali, Colombia, Tania Vásquez Luque at Instituto de Estudios Peruanos in Lima, Peru, and Alina Camacho-​Gingerich at the Center for Latin American and Caribbean Studies at St. John’s University for their contributions toward the completion of this project in its various phases. In addition, I would like to highlight the invaluable support provided by research assistants Marcelo Rodrigo in Loja, and Damayra Figueroa, Sarah Kraft and Crismari Edua, graduate students in the Department of Sociology and Anthropology at my institution. Likewise, the involvement of undergraduate students from the design and photography classes of Aaris Sherin and Alex Morel also at St. John’s cannot go unnoticed. They offered a refreshing perspective on how the knowledge amassed in this project could be shared publicly in various viii

Acknowledgments

ways; particularly, the works by Kayana Ternize, Nikola Venglarovam, Aliyah Campbell, and Arecis Tiburcio Zane. Furthermore, I wish to voice my deep appreciation for the creative engagement of Abraham G. Salazar, who made this research visually rich and accessible for multiple audiences. I would also like to convey my humbleness for having been awarded financial support to develop fieldwork for this project by the Rielo Institute for Integral Development (2015), the Fulbright Foreign Scholarship Grant to Ecuador—​Council for International Exchange of Scholars (2016 and 2017), the Catholic Relief Services Global Grant (2017 and 2018), and the Social Action Award from Sociologists for Women in Society (2018). Finally, I wish to recognize the psychological support provided by Vanina, who gave me respite and clarity to navigate many challenging moments. And, last but not least, I would like to foreground my deepest gratitude to Isabella, mi hija, Beatriz and Roberto, mis padres, and Abraham, mi compañero. Without their love, trust, and understanding, I would not have made it. I am forever grateful. Gracias, siempre.

ix

Series Preface Roberta Villalón’s book is a great fit for the Global Migration and Social Change series and brings to it an original perspective on health and inequalities in migration that, to date, had only appeared at the margins in some of the previous volumes we published. Migration, Health, and Inequalities: Critical Activist Research across Ecuadorean Borders brings to our series more than the focus on health. It offers an in-depth analysis of the experiences of Ecuadorean migrants; it considers their mobility towards different destinations, namely Spain and the United States; it looks at the impact of migration on Ecuadorean migrants beyond the initial onward migration so dominant in current migration research often obsessed with chasing the latest “crisis,” taking instead a transnational approach that captures the circularity and/or multi-directionality of migratory trajectories; it includes in the analysis migrants, their non-migrating relatives, and the communities they inhabit or leave behind; and, finally, as an activist scholar who has done extensive work with Latin American survivors of gender violence and worked across established disciplinary boundaries, Villalón does so with the ultimate goal of contributing to reducing health inequalities among migrants and non-migrant populations, and, as a result, promoting the collective health of communities. Informed by a range of critical theoretical perspectives, the book draws on four years of transnational and multi-sited research on migration-related health inequalities among migrants and their non-migrating relatives, exploring their experiences as well as the coping mechanisms they deploy to manage, mitigate, and transform the status quo. It also brings into the conversation the perspectives of health and support workers that engage with these communities. Through its transnational perspective, the book shows how migration regimes at origin, transit, and destination interact—and, together, contribute—to the system that produces health inequalities. The analysis goes one step further: it doesn’t stop at showing the interlocking structures of oppression that contribute to producing health inequalities, and how they shape the spaces for individual and collective mobilisation and agency; it also offers a critical space for transformative intervention, informed throughout by the belief that critical and activist scholarship, despite difficulties, can play x

newgenprepdf

Series Preface

a role in disassembling such pervasive exclusionary systems and practices. We are delighted to give a platform to this book and to encourage a broader critical debate on the drivers and consequences of health inequalities among migrants and their communities and the ways to challenge them. Nando Sigona Cairo 19 May 2022

xi

1

Introduction Migration always tests and often disturbs the well-​being of migrants and their relatives. Healthy migrants may become ill because of the stressful conditions of migration, migrants may return to their places of origin with poor mental and physical health, and relatives of migrants who stay behind may develop psychological and physical problems. All these unhealthy processes have consequences at not only the personal and family level, but also the community level, generating a public health impact on sending, transit and receiving communities. Moreover, the worsening living conditions surrounding migrants and their relatives in their places of origin, the increasingly precarious and dangerous quality of migration journeys, and the growing hostility towards immigrants in transit and receiving countries have further deteriorated health outcomes in general. The health challenges of migrant populations are unquestionably on the rise (International Organization for Migration, 2018; World Health Organization, 2019). Nevertheless, the effects that migration has on individual, family, and collective health are rarely included in health professionals’ education or made public knowledge among migrant populations. Likewise, they are rarely considered in migration policies, or used to coordinate health and migration policies nationally and transnationally in a systematic or efficient manner. This dilemma has attracted the attention of health providers and migrants’ advocates who have been invested in reducing health disparities among migrant and non-​migrant populations for several decades. Organizations around the world, including the pioneering work of the Italian Society for Migration Medicine (SIMM), the Platform for International Cooperation on Undocumented Migrants (PICUM), Migrant Clinicians Network, National Association of Community Health Centers, Iniciativa de Salud de las Américas, Doctors Without Borders, and Physicians for Human Rights, to name a few, have been developing research, providing and advocating for migrant-​oriented health services and trying to influence inclusive national and international policy agendas from the ground up from a human rights perspective. Triggered by refugee crises affecting Europe in the last 1

MIGRATION, HEALTH, AND INEQUALITIES

decade, the International Organization for Migration and the World Health Organization began to articulate research and set common goals emphasizing equal access to health for all migrants regardless of their background or legal status and calling for culturally and linguistically appropriate health services (International Organization for Migration, 2013). Moreover, in 2016, the European Office of the World Health Organization formed the Knowledge Hub on Health and Migration, offering a bibliographic and formative platform to develop health programs in line with the needs of migrant communities. Despite these efforts to turn around the fact that “the health of migrants has remained a neglected theme” (International Organization for Migration, 2018, 16), the breach that exists between international and national laws that establish the right to health as a human right, and their actual implementation and enforcement is tremendously extensive. Advocates concur that much is yet to be accomplished, and they are convinced that both research and activism are strategic to the advancement of migrants’ well-​ being, rights, and collective health (Iniciativa de Salud de las Américas, 2017). In 2015, I was invited to join one of the organizations that focused on this matter: the Institute for Health and Migration of the Hospital of the Technical Particular University of Loja, Ecuador. Migration processes in this country had been at the center of public and academic interest, particularly after the stark rise in emigration to Spain, the United States, and Italy after Ecuador’s economic crisis of 1999. Ecuador had indeed played all three migratory roles: origin, destination, and transit, while displaying high rates of internal migration from rural to urban areas and between cities, as well as a significant number of return migrants given the implementation of universal citizenship, open migration, and repatriation policies (Herrera, 2008; Ramírez, 2013; Falconí Trávez, 2014; Jokisch, 2014). At the Institute for Health and Migration, I joined a team of health professionals to design a project with the ultimate goal of preventing, treating, and reducing the negative health impacts of migration, and consequently help in reducing health inequalities among migrant and non-​migrant populations, and promoting collective health.1 They called me in because of my experience as an activist scholar who had worked with Latin American immigrant survivors of gender violence and studied social inequalities and migration processes transnationally (Villalón, 2010a, 2010b, 2011, 2014, 2015).2 They were certain that in order to reach a better understanding of the issue and improve health services and policies, an interdisciplinary approach was necessary. These doctors were aware of the impact on the welfare of migrants who face the challenges of cultural disparities, unwelcoming political contexts, precarious migration travels, and worsening labor conditions. They were also familiar with the literature that had identified certain health processes affecting migrants, including the so-​called ‘healthy migrant effect’ or ‘Latino paradox’—​the fact that Latin American immigrant groups present less 2

INTRODUCTION

prevalence of chronic health problems than the native population in the United States (Rubalcava et al 2008; Ullman et al 2011; Cabieses, 2014). They knew of the hypothesis of the ‘healthy but vulnerable migrant’ given that the typically stressful conditions of migrant life sooner or later challenge this population’s health (Lara et al 2005; Miranda et al 2005; Caplan, 2007; La Parra Casado et al 2007; Ríos-​Marín and Hernández-​Londoño, 2014), and of the ‘syndrome of chronic and multiple stress’ or ‘Ulysses syndrome,’ found in transcontinental immigrants (Achotegui, 2004; Cuestas, 2011). They had also witnessed the ‘salmon bias’ in migrants who had returned home after their health began to decline (Abraído-​Lanza et al 1999; Turra and Elo, 2008), and the psychological and physical problems experienced by the relatives of migrants who stayed behind (Ron Encalada, 2010; Lu, 2011; Castillo Sanchez and Londono Gaoña, 2013). Given their intercultural practice, they were sensitive to the ‘Salgari’s syndrome’ (Geraci, 2006), which described the negative effects that mismatching expectations between migrant patients originally from “less developed” areas and doctors working in “more developed” locations had on the patient-​doctor relationship. Nonetheless, despite their extensive knowledge of the subject, these doctors remained troubled by the limited information available on the Ecuadorean case in its entirety and complexity, and were particularly puzzled by the gap between theories, public health and migration policies, and health providers’ training and practices. After careful examination of the literature, most of which had been produced by a medical, psychological, epidemiological, or public health field, we collaborated as a team and developed a critical, interdisciplinary, and applied research project. Its main objective was to complete an in-​depth study of how migration processes affected the health and well-​being of Ecuadorean migrants and their families to improve services and ultimately enhance the individual, familiar, and collective health of these communities. Four years of transnational, multi-​sited research resulted in the identification and conceptualization of health processes experienced by migrants and non-​migrating relatives as well as the psycho-​sociocultural mechanisms they employed to cope with the challenges that migration from Ecuador to Spain, the United States, and back generated. These findings were contextualized with the experiences of other Latin American migrants and analyzed in line with the body of knowledge on health, migration, and inequalities from a distinct theoretical and methodological framework that offered a unique way to unearth typically overseen processes and practices. The perspective of this research combined the benefits of the extension of sociology itself (encompassing various demographic, social, cultural, political, economic, and legal factors, among others, for the study of migration and health in this case) with the assets of four other critical schools of thought. First, the radicalism of the intersectional prism of Black, postcolonial and decolonial 3

MIGRATION, HEALTH, AND INEQUALITIES

feminisms (Hill Collins, 1986, 2019; Crenshaw et al 1995; Roberts, 2002; Segato, 2003, 2016; Acker, 2006; Cho et al 2013; Martínez-​Andrade, 2019), including the writings of academic activism (Naples, 2003; Jaggar, 2008; Shayne, 2014), and those that apply intersectionality to the study of health (Navarro and Shi, 2001; Nazroo, 2003; Williams, 2003; Hankivsky and Christoffersen, 2008; Raphael, 2009). Second, the insight from critical race, ethnic, and migration studies (Haney-​Lopez, 1996; Ong, 1999; Glenn, 2000; Hing, 2004; Mooney, 2005; Meñaca, 2006; Johnson, 2007; Sayad, 2007; Romero, 2008; Castles, 2009; Navarro, 2009; Sanchez and Romero, 2010; Ticktin, 2011; Villalón, 2015). Third, the angle provided by Latin American critical epidemiology (Breilh, 1977, 2003, 2010a, 2010b, 2013; Donnangelo, 1979; Laurell, 1982; Almeida-​Filho, 1989, 2000; Samaja, 1992; Waitzkin et al 2001; Krieger, 2012). Fourth, the unique contributions of critical medical anthropology (Farmer, 2001; Freund et al 2002; Iriart et al 2002; Castro and Singer, 2004; Biehl and Petryna, 2013; Renzaho, 2016; Brown et al 2017; Farmer et al 2017; Illingworth and Parmet, 2017; Singer and Baer, 2017). Specifically, based on Latin American critical epidemiology’s theory of the ‘social determination of health’ of the 1970s—​built on the assertion that health is not molded exclusively at the individual level, but instead is the result of a socially determined complex process (Donnangelo, 1979), the study focused on how migratory processes overlapped with race, ethnicity, nationality, socioeconomic status, gender, sexuality, legal systems, and policies among other relevant social factors transnationally, and affected migrants and non-migrating relatives’ health and well-​being (Donnangelo, 1979; Laurell, 1982; Williams, 2003; Hankivsky and Christoffersen, 2008; Navarro, 2009; Raphael, 2009; Breilh, 2010b, 2013). Given that all of these conditions were socially constructed, culturally relative, and historically grounded, a​nd therefore, influenced but did not predestine human life (Berger and Luckmann, 1967; Foucault, 1980; Spivak, 1988; Crenshaw, 1995; Hill Collins, 1998; Mani, 1998; Menon and Bhasin, 1998; Mahmood, 2001; Ortner, 2006; Agustín, 2007; Villalón, 2010b; Romero, 2011), the research also considered how migrants and non-​migrating relatives navigated through these intersecting structural forces and analyzed how their thoughts, actions, and practices sustained, reinforced, or challenged the very elements of the social matrix in which they lived and experienced migration-​related health challenges. Thus, the project provided a critique to the way in which the World Health Organization had adapted the model of ‘Social Determinants of Health’ in a way that even if concepts such as culture, ethnicity, gender, and class were considered, they were entered into the analysis as if they were disembodied, external stressors (Commission on the Social Determinants of Health, 2008; Breilh, 2010b; Malmusi et al 2010; Passos Nogueira, 2010; Cabieses, 2014). By including more complex 4

INTRODUCTION

theoretical debates about the dialectic social construction of overlapping structures and practices of inequality, this research conveyed a textured analysis of health, migration, and inequality that instead emphasized the tangibility and malleability of the social determinants of health as they were embodied by migrants, non-​migrating relatives, and providers of health and migration services. Moreover, this project’s connection of feminist theories with literature on critical race, ethnic and migration studies, and critical medical anthropology allowed for the analysis of how the dominant biomedical discourse on migration and health, marked by the study of syndromes like the Latino paradox, the salmon bias, or the focus on tropical infectious diseases, was problematic. Building on Achotegui’s critique (2004), this study interrogated the common practice of pathologizing and banalizing migrants’ health, which produces a countereffect in the very populations seeking assistance by labeling and marginalizing migrants as well as overlooking or minimizing important aspects of their well-​being. Furthermore, the research examined the national and transnational political economy of nationhood and citizenship, which has systematically prioritized certain groups over others as shown by critical race, ethnic and migration studies. Accordingly, this research took into consideration how dominant research as well as policies on health and migration reflected these hierarchies by creating layers of marginalization even between migrant populations like refugees, asylum-​ seekers, internally displaced persons, stateless persons, irregular immigrants, economic and voluntary migrants. Some forced migrants were legitimated by international law, provided with rights and services (regardless of how poorly), and carefully studied to offer them the most adequate mental and physical treatments to help them recover from the trauma caused by extreme violent situations. On the contrary, other type of migrants, particularly those with an irregular status, were sidelined as undeserving or even ostracized as possible agents of infectious diseases. Consequently, the study paid close attention to Ecuadoreans who had migrated regularly and irregularly, maintained or achieved a regular status abroad or not, and could have been considered economic refugees (even if there is no such official category, and therefore were simply treated as authorized or unauthorized immigrants in their countries of destination and received services accordingly) to learn about their experiences comparatively. Moreover, it included return migrants and non-​migrating migrants’ relatives, two groups which have been neglected in both the literature and policymaking. By taking a critical look at these inconsistencies, the project contributed to the dismantling of harming hegemonic discourses and practices, and paired with action, furthered efforts to promote health equality and collective health (Breilh, 2013). This interdisciplinary, critical theoretical approach to migrant health acknowledged how various interlocking structural systems of oppression 5

MIGRATION, HEALTH, AND INEQUALITIES

molded the range of individual and collective agency and identified the embeddedness of such divisive schemes in people’s thoughts, practices, interactions, and material and symbolic creations. In addition, it emphasized the relevance of critical thinking, social movements, and social change: in recognizing the complexities of structural oppression rested a heightened potential to challenge those systems through conscious individual and collective efforts. In other words, this perspective turned critiques into action, as it believed that despite difficulties, such pervasive exclusionary systems and practices can be disassembled. In this line, an activist research methodology was applied to develop the project. Activist research is a practice “with a very specific aim—​the creation of social change” in collaboration with the population involved in the study (Esterberg, 2002, 136). Activist researchers are led by fundamental principles, their goal: to produce an analysis that retains the integrity of political processes, specific events, diverse actors, and social context while revealing the broader processes at work that may not have been visible to the individual participants or even to the researcher at the time they were engaged in the struggle or when they conducted the research. (Naples, 2003, 31) The four main principles are (1) to be alert and receptive to the power relations that are generated throughout the research process; (2) to engender and maintain an “open and democratic” relationship between researchers and participants (Esterberg, 2002, 136); (3) to create a collaborative way in which knowledge is produced by researchers in dialogue with the traditionally called “research subjects,” which indeed are “knowledgeable, empowered participants” (Hale, 2008, 4) with and about whom the research is being developed; and (4) to be attentive to the political implications and applications of the research project with the aim of breeding social change to dismantle whatever oppressive circumstances are affecting the group of people involved in the study (Villalón, 2014, 2019a). Accordingly, this study’s theoretical framework and methodological instruments were designed together with the health professionals and migrants’ advocates involved in the project, all of whom were invested in bettering migrants’ well-​being, the advancement of the universal respect of the human right to health, and the promotion of collective health. Survey and interview questionnaires were devised with an interdisciplinary team that included family doctors, psychologists, expert physicians on migration medicine, anthropologists, and sociologists. Moreover, the process of recruitment of participants was conducted to ensure their input would be considered to adapt the project to their needs. All data collected were made available to participants, and their feedback was also included as part of the 6

INTRODUCTION

analysis. Migrants and migrant relatives’ accounts of migration and their health experiences as well as health providers’ views were at the core of the study and included in the text substantially for readers to learn directly from them (Menon and Bhasin, 1998; Garfield, 2005; Chabram-​Dernersesian and de la Torre, 2008). Furthermore, action programs (including community workshops and trainings) were co-​designed with various research participants and developed after the analysis of preliminary data, including feedback from migrant focus groups with the aim of ensuring that the knowledge shared was accurate and helpful for migrants, advocates, and providers (Dubet, 2012). Last, the diffusion of research findings was done in multiple ways and languages in order to reach diverse audiences, from radio and TV presentations in local Ecuadorean media, to co-​produced informative posters, graphic and visual materials to be made widely and freely accessible through a website devoted to the project,3 co-​authored reports and presentations in academic and professional settings internationally, a journal article in Spanish (Villalón, 2019b), a contribution to an edited volume in English (Villalón and Kraft, 2022), and now, this book. The application of activist research methodology had the power to disrupt hegemonic discourses and practices (Connell, 2007; Jaggar, 2008; Zuberi and Bonilla-​Silva, 2008) that re-​victimized migrant populations, and supported collective efforts to advance health and social justice. Altogether, the theoretical and methodological framework of this project created a unique lens to focus on typically overlooked (and thus marginalized) populations as well as dis/​uncover health processes and coping mechanisms from the ground up and identify their link to broader structures and practices of inequality, and therefore, the possibilities for destabilizing social and political borders and boundaries transnationally. From 2015 to 2019, the project was developed in the cities of Loja and Santo Domingo (two internal locations with high numbers of migrants to date understudied) as well as in Guayaquil in Ecuador, New York and New Jersey in the United States, and Barcelona in Spain (three main destinations of Ecuadorean migrants).4 Through nonprobability (convenience) and purposeful (theoretical and snowball) sampling techniques, quantitative and qualitative data was collected about Ecuadorean migrants to locations in the Global North (mostly the United States and Spain and also other European countries like Italy, France, and Germany) as well as in the Global South (mostly neighboring Latin American countries like Colombia and Peru), return migrants in Ecuador, and non-​migrating relatives who had remained in this country. Also, data was gathered about other Latin American migrants and their families to contextualize health and migratory experiences and infer if the results of the study were unique to Ecuadoreans or commonly found in migrants from other countries with similar destinations. A total of 351 surveys (222 completed by Ecuadoreans, and the remaining 129 by other Latin American 7

MIGRATION, HEALTH, AND INEQUALITIES

migrants) were gathered; 40 individual and seven group semi-​structured interviews with Ecuadorean migrants and migrants’ relatives, including return migrants and migrants’ community organizers, were conducted. Survey and interview participants had to have migrated or had a close family member who migrated, and they had to be 18 or older. Their gender, socioeconomic status, racial/​ethnic background, or migratory statuses were not predetermined, which allowed us to explore how important these factors were for their health and migration processes. Similarly, the length of stay was not restricted with the aim of discerning how the years they spent abroad affected their experiences. There were two versions of the survey, one for migrants and another for non-​migrating relatives of migrants, and both were available in Spanish. Surveys were administered in person in Ecuador and the United States in various locations where migrants and relatives could be found, like health centers, hospitals, migrant services’ organizations, and universities; and they were also distributed online in Spain and the United States. The surveys started with an informed consent section and agreeing respondents were asked to initial the forms only, in order to preserve confidentiality. The first set of questions was designed to gather general demographic information. Then, the surveys concentrated on migration data including origin, destination, length of stay, reasons for migrating, and difficulties pre- ​and post-​migration. Next, the surveys focused on health aspects like health status before migrating, health changes after migration and upon return both of migrants and non-​migrating relatives, migratory stress symptoms, and healthcare. The surveys also contained questions about people’s awareness of migrants’ rights and health rights and the relationship between migration and health as well the advantages and disadvantages of migration. The surveys included multiple choice questions and short open questions. The quantitative and qualitative data of these surveys were complemented by personal and group interviews, which were conducted in Spanish or English depending on the interviewees’ preference. As well as demographic and general migration questions, personal interviews discussed the reasons for the participant’s or their relative’s migration, and return if applicable; thoughts, memories, and feelings about the migratory experience and how it might have affected family relationships and the health of migrants and non-​migrating relatives; experiences with healthcare provision if any; and last, their recommendations for other people who may be considering migrating. Group interviews also began with questions about destination, length of stay, and similar background information, and then progressed to conversation starters like the ones included in personal interviews. Given the diverse group dynamics, these conversations took different routes, and we followed the participants’ lead, which focused to various degrees on economic hardships pre-​and post-​migration, strained family ties, jeopardized physical, mental, and emotional well-​being of migrants and non-​migrating 8

INTRODUCTION

relatives, and/​or balancing the positive and negative aspects of migration in hindsight. Moreover, data was amassed through participant observation, informal conversations and unstructured interviews in community workshops, professional trainings and research presentations on health and migration. A total of 11 community workshops were held, five in Ecuador and six in the United States. The workshops in Ecuador, run by the interdisciplinary research team in Loja and the vicinities of Cuenca, invited migrants and relatives to learn about how migration may affect their health and well-being, and what could be done to prevent and deal with these challenges. Those in the United States took place in New York and New Jersey, sometimes led only by me, and other times co-​led by Abraham G. Salazar, this project’s contributing artist, who concentrated on hands-​on activities. The focus of the workshops ranged from the general topic of health and migration to the more specific of gender, health, and migration; migration and violence; migratory stress; and migratory resilience. Workshop participants included migrants from Latin America, among which there were migrant services and healthcare providers. The latter were specifically targeted in the three professional trainings and accompanying academic presentations on health and migration in Ecuador. The trainings involved learning from the literature on the topic, which at the time was mainly only available in English so its instruction in Spanish was particularly important, as well as teaching research methods specifically to develop pertinent studies to expand our limited knowledge on the Ecuadorean case while thinking about how to develop best practices to assist people affected by migratory processes. Trainings’ goals were set in conjunction with the team of doctors at the Institute for Health and Migration, who had recognized the need to raise awareness and provide formal education on this issue. The trainings were complemented with two congresses on health and migration organized by Colasanti, Montalvo, Astudillo, and Gavilanes, and four smaller-​scale seminars in Loja. Due to confidentiality and security reasons, pseudonyms were used, and dates and locations of the interviews were indicated broadly as year and city. Ethically, this research was guided by the three main principles of following due scientific methods and procedures, respecting the rights of research participants, and being a transparent and honest researcher throughout all phases of the study.5 Specifically, the sociological code of ethics was strengthened by the feminist and activist research ethics, which provided additional consideration to matters of power relationships between researchers and participants as well as structural risks of vulnerable populations (Naples, 2003; Jaggar, 2008). In line with these notions, besides being particularly careful with regard to participants’ privacy and safety, I was conscious of how my positionality as a relatively young, female, invited, and funded foreign academic, who was originally from Argentina 9

MIGRATION, HEALTH, AND INEQUALITIES

but was coming from an institution in the United States, influenced my relationships with colleagues and participants. Accordingly, field notes included reflections on the intersection of these political, economic and sociocultural dynamics, and my analysis acknowledged how these matters were part and parcel of the study presented here (Sjoberg and Nett, 1997). Last, but not least, the ethics practiced was the principal reason for this research resulting in the conceptualization of health processes and coping mechanisms from the ground up, as they emerged from the first-​hand knowledge of migratory processes shared by the very migrants and relatives themselves and were developed in conversation with them and migrant services and healthcare providers in safe and constructive spaces. In line with this ethical perspective and based on the aim of studying both outward and return migration flows as well as the relatives of migrants who stayed in their place of origin, the term migrant over immigrant and emigrant was intentionally selected to include emigration, immigration, and return migration, as well as membership in a family with migrant relatives. Migration was understood as a process that modifies the experiences (but does not define the essence or identity) of people, families, groups, and communities in diverse, complex, and paradoxical manners, traversing between “incomplete forms of absence and presence that eventually, sooner or later, will become complete” (Sayad, 2007, 125). Thus, the first conceptual contribution of this project was to define emigrants, immigrants, and return migrants as active migrants, and the relatives of active migrants who stayed in their country of origin as passive migrants. Throughout the book, active and passive migrants’ accounts were included to analyze how health processes and psycho-​sociocultural mechanisms were experienced and utilized by them all accordingly. The next set of conceptual contributions of this project were the re-​ definitions and definitions of the health processes and psycho-​sociocultural mechanisms that were uncovered through the research. While these concepts are thoroughly explained in the following chapters, a synthetic glossary is provided to guide the readers, displayed in two tables, one for health processes (Table 1.1) and one for mechanisms (Table 1.2). Three of the seven health processes conceptualized (reflective mourning, migratory stress, and return shock) built on the well-​known definitions of migratory mourning and Ulysses syndrome elaborated by Achotegui (2004, 2009). Unrecognized migratory resilience was based on the general writings about resilience (Southwick et al 2014; Bourbeau, 2015) but applied and adapted specifically to migration. The other three health processes (active migrant trauma, passive migrant trauma, and migrant crises triggers) emerged directly from the study of active and passive migrants’ experiences. In the case of migratory stress, quantitative data was collected about symptoms for both active and passive migrants, providing a statistical complement to 10

INTRODUCTION

Table 1.1: Glossary of migration-​related health processes Health Processes Definition Reflective mourning

A process that active and passive migrants go through after leaving their country of origin that includes grieving for what was lost or left behind, and the hardships that may have arisen during transit and upon arrival, as well as re-​evaluating the reasons that led to migration and the opportunities that a new phase in their lives may bring.

Active migrant trauma

The lesion that the migratory process generated on the active migrant.

Passive migrant trauma

The lesion that the migratory process generated on the passive migrant.

Migratory stress

The stress that active and passive migrants experience due to the inherent difficulties of migratory processes, including traumatizing pre-​departures and journeys, the challenges of transculturation and family reorganization, and the coming to terms with new living conditions.

Migrant crises triggers

Life events that generate a crisis in active and/​or passive migrants that makes them question their life conditions and future plans.

Return shock

The stress and trauma resulting from familiar, sociocultural, political, and economic re-​adaptation that occurs when active migrants move back to their place of origin.

Unrecognized migratory resilience

The unnoticed strengthening that active and passive migrants experience due to successfully overcoming hardships or traumatic experiences related to migration processes.

Source: author’s own elaboration.

the narratives gathered through in-​depth personal and group interviews, and community workshops. The 17 psycho-​sociocultural coping mechanisms conceptualized were grouped in three categories: (1) processing the effects of migration; (2) active/​ passive migrant relationships; and (3) return migration. Table 1.2 provides the definitions of all of these. Only one of the psycho-​sociocultural coping mechanisms was a response to an existing concept in the literature on health and migration: strategic return, which countered the salmon bias hypothesis (Abraído-​Lanza et al 1999; Turra and Elo, 2008). All the other mechanisms conceptualized surfaced from the in-​depth, activist transnational study of migrants’ experiences that was developed for this project. In general, the concepts introduced to describe migration-​related health processes and coping mechanisms provided a textured take on active and passive migrants, respecting their complexity as human beings, acknowledging their intelligence and emotions, and highlighting their agency, in line with feminist 11

MIGRATION, HEALTH, AND INEQUALITIES

Table 1.2: Glossary of migration-​related psycho-​sociocultural mechanisms Mechanisms by category

Definition

Processing the effects of migration Disillusion adjustment

Process of adaptation to the reality of living as an active migrant, which frequently does not match pre-​departure expectations and projections.

Paralyzing nostalgia

Overwhelming feelings of longing and sorrow for having left family members and/​or their communities behind, which prevent active migrants from acclimatizing to their new life in their destination and moving forward.

Motivating nostalgia

Feelings of longing for relatives and/or communities of origin that encourage active migrants to make all possible efforts to be successful in achieving their migratory objectives with the end goal of returning.

Denied migrant health

Overlooked health changes related to migratory processes resulting in a lack or delay of treatment by active and passive migrants.

Normalization of malaise

Active and passive migrants’ understanding of health problems as intrinsic to the migratory condition resulting in the minimization, and thus, mistreatment thereof.

Pain encapsulation

The containment of the dreadful feelings caused by migratory processes that active and passive migrants undergo to carry on with their lives.

Well-​being ideal

A belief that a state of holistic welfare will be eventually achieved, which helps active and passive migrants to persevere through all the hardships related to the migratory process.

Transgenerational goals

Migrants’ life purposes set multi-​generationally, with a historical, future-​oriented, and collective drive that surpasses individualistic interests and day-​to-​day occurrences.

Active/​passive migrant relationships Family de/​ re-​construction

The disarticulation and alterations of migrants’ family units with the departure and/​or return of its members based on the new dynamics generated by the migratory process.

Communication distortion

Inaccurate and misleading dialogues between active and passive migrants to avoid worries and diminish guilt.

Subordination to concealment and deception

Active and passive migrants’ systematic acceptance of partial and hidden information, and deceit as an unavoidable aspect of living as a migrant family.

Unspoken pacts

Tacit agreements between active and passive migrants that are to be respected to keep the family functioning. (continued)

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INTRODUCTION

Table 1.2: Glossary of migration-​related psycho-​sociocultural mechanisms (Continued) Mechanisms by category

Definition

Resentment and detachment

Bitterness and indifference felt by relatives who did not participate in the family’s decision-​making process regarding migration or did not agree with the idea of migration and/​or family separation due to migration.

Sensible comprehension

An understanding of otherwise objectionable behavior based on a realistic assessment of the challenges and complexities of living as a migrant family.

Return migration Strategic return

Return migration resulting from a reflective and instrumental decision-​making process based on transgenerational goals, well-​ being ideal, and current circumstances in destination and place of origin.

Settling readjustment

Overcoming the impact that return migration caused in active and passive migrants by being at peace with the efforts and consequences of the migratory process, including its effects on the family, and the current reality of their homeland.

Involuntary return rebound

Overcoming the negative consequences of an imposed return to the migrant’s homeland.

Source: author’s own elaboration.

and critical race, ethnic and migration studies that stress the “protagonism implied in the decision to migrate” (Agustín, 2006, 73). Another concept introduced in the book to note is that of transformative border politics.6 To define it, a distinction must first be made between formal and informal border politics—​the former referring to the formal mechanisms that establish geographical, political, and social boundaries from the top-​down, and the latter referring to the informal processes and practices that sustain, reproduce, and challenge these from the bottom-​up. With this contrast in mind, this research showed how active and passive migrants interacted with formal border politics, including geographical boundaries between countries, national and international politics regarding migration, residency, and citizenship, and racial/​ethnic, gender/​sexual, class, and other intersecting social structures and practices of inequality in places of origin, transit, and destination. Active and passive migrants learned how to navigate formal border politics and were able to maintain, recreate, contest, and alter them. In doing so, they enacted their own informal border politics. When these informal border politics resulted in challenging and dismantling formal border politics, a transformative border politics was unearthed. Hence, active and passive migrants were able to traverse, rework, and transcend 13

MIGRATION, HEALTH, AND INEQUALITIES

geographical as well as political, economic, social, and cultural boundaries that had pushed them to the margins. Transformative border politics was transnational in nature and had a radical potential to curb inequality and generate social change. The concept of transformative border politics is grounded in theories of intersectionality that point to people’s location within and action throughout and beyond social matrixes embedded in policies, reflecting hegemonic ideologies, and shaping power relations. Migration allowed for traveling across the social matrixes found in different societies, and these journeys uncovered the variability of individual and familiar location in these social matrixes. Migratory processes also represented opportunities to shift people’s perception of where they stood, devise strategies to move through, and transform the matrixes themselves. Four examples from this research illustrate the potential of transformative border politics. First, migrations occurred because of and despite migratory policies (geographical borders were crossed regularly and irregularly, and residency and citizenship policies were respected, disregarded, and altered). Second, migratory experiences challenged taken-​for-​g ranted gender/​sexual dynamics that prioritized men, masculinity, and heterosexuality (both active and passive migrants questioned heteropatriarchal dynamics because of migration). Third, they demonstrated the degree of equality of different ethnoracial cultures (both active and passive migrants became aware of the level of discrimination of migrants and people of color in the Global North and at the same time, reassessed their own country’s ethnoracial politics). Fourth, they allowed for transnational social mobility (both active and passive migrants endured hardships at home and abroad but succeeded in leaving behind poverty or impoverishment and ensuring higher educational levels for younger generations). Altogether, transformative border politics manifested migrants’ power to move through and change social systems of inequality transnationally. A comprehensive conceptual map is presented in Figure 1.1 showing the links between the various health processes, psycho-​sociocultural coping mechanisms, and the resulting transformative border politics triggered by migratory processes. Starting from left to right with the family pre-migration, followed by the initial migratory processes and the rise of the family post-migration, with its possible consequent migrations, including returning to the country of origin, and the partial or total reunification of the family. The pair of psycho-​sociocultural mechanisms that family members sustain before, throughout, and after migration are located at the top of the figure: well-​being ideal and transgenerational goals. Resulting from migration, the group of health processes and mechanisms that active and passive migrants may endure and employ are listed. On the right-​hand side of the figure, the health 14

newgenrtpdf

Figure 1.1: Conceptual map Well-being Ideal & Transgenerational Goals

Reflective mourning

15

Own dynamics, members’ ties, conflicts, and history

MIGRATION Usually triggered by critical factors

Migrant crises triggers

Disillusion adjustment

Paralyzing & motivating nostalgia

Denied migrant health

Normalization Pain of malaise encapsulation

Return shock

Family post-migration

Strategic return

Settling readjustment

Involuntary return rebound

RETURN MIGRATION

Comprised of active and passive migrants, and sometimes new family members

May include partial or total reunification

May include subsequent, layered migration of family members (partial or total reunification)

May be followed by new rounds of migration

Family de/re-construction New dynamics, members’ ties, conflicts, and continued history

Communication distortion

Subordination to concealment & deception

Unspoken pacts

Resentment & detachment

Unrecognized migratory resilience & transformative border politics

Sensible comprehension

INTRODUCTION

Family premigration

Active & passive Migratory stress migrant trauma

MIGRATION, HEALTH, AND INEQUALITIES

processes and mechanisms triggered by return migration are presented. Focusing on active and passive migrant family relations post-​migration, the central mechanism of family de/​re-​construction with its five other complementary mechanisms are indicated. Last, the two overarching consequences of migratory processes are included at the bottom of the figure: the health process of unrecognized migratory resilience, and the practice of transformative border politics. In the following chapters, each one of these concepts is explored in depth by weaving empirical data from surveys, interviews, and workshops. Chapter 2 focuses on the seven migration-​related health processes. Chapter 3 looks into the psycho-​sociocultural mechanisms employed by active and passive migrants to cope with the effects of outward and return migration. Chapter 4 concentrates on family de/​re-​construction and the complementary mechanisms utilized to tackle the changes that migration causes in the relationships between active and passive migrants. Chapter 5 explores transformative border politics and its manifestation in the geopolitical, gender/​sexual, ethnoracial, and socioeconomic realms. Last, the Conclusion highlights the study’s main contributions to the literature on health and migration and includes theoretical and practical recommendations to improve migrants’ welfare and further collective health. Moreover, throughout the book, the explanation of the concepts is accompanied by illustrations that were created exclusively for this study with the objective of facilitating the spread of this knowledge and improving accessibility beyond academic circles. These images, which were first used in community workshops to gather migrants’ feedback and then refined to be included in the project’s open website (see Figure 1.2), were designed by Abraham G. Salazar, a Cuban active migrant in the United States, who became engaged in this undertaking because: When I was first exposed to this research, I saw my story reflected and it helped me personally mostly because I realized that what had happened to me was not a rarity. Then, as an artist I wanted to collaborate in disseminating how our relatives’ and our health is affected by migration so we can be better prepared to deal with all the challenges that come up, understand what might have happened to us, and heal. The drawings are a means to connect us with our inner difficulties, which we are not always able to verbalize. They are an expression of our frustrations or vicissitudes as migrants. Also, the illustrations help in portraying migrants’ voices; voices that are usually silenced or hidden. They can work as mirrors where we may be able to see ourselves reflected, and then, they can help us engage in a healing process.

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INTRODUCTION

An important part of this activist research project, Abraham’s participation enriched the way in which we could make dense academic materials visually compelling and accessible to a wide range of people, from young children to the elderly, with lower or higher levels of formal education, and more or less time to devote to learning about health and migration. His contribution also included his participation in workshops in New York and New Jersey where he led activities like drawing and cartooning for migrants to express their experiences and feelings in relation to the topics discussed. These opportunities allowed him to “grasp how other migrants were understanding the content presented and come up with better ideas on how to represent it visually in a more efficient manner” (Abraham G. Salazar, Personal Interview, New York, 2017). But before moving on, the specific characteristics of the people who took part in this research project must be foregrounded. To start, almost every active migrant had left Ecuador because of economic reasons. In general, poverty, impoverishment, and a clear lack of any future upward mobility were determining factors. The financial crisis of 1999 made that poverty unbearable for many and pushed a significant number of middle-​class workers and professionals to see international migration as their only way not to (further) lose their socioeconomic status. In very few cases, active

Figure 1.2: Website’s logo

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MIGRATION, HEALTH, AND INEQUALITIES

migrants had left simply because they wanted to experience living in other countries and learning from other cultures. Also, an overwhelming majority emigrated alone, leaving significant family members behind. In some cases, parts or all of the family reunited after several years, either abroad or back in Ecuador. All active migrants had transgenerational family goals in mind: their migration was geared towards finding better living conditions for the entire group, with a clear intention of achieving upward socioeconomic mobility mostly marked by improving their housing situations (by securing ownership of their own homes, as well as improving housing for their parents and providing dwellings for their children, while ensuring that these homes met basic needs and services at a minimum) as well as procuring education up to college for the younger generations. Passive migrants were aware of the family effort involved in migratory decisions, and while respectful and understanding, regretted their relatives’ departure. Indeed, both active and passive migrants evaluated migration as an extremely taxing process in which the achievement of significant benefits and desired goals did not compensate for the emotional costs suffered by everyone involved. Indeed, 84 per cent of all Ecuadorean active migrants and 76 per cent of passive migrants reported that they were cognizant that migration could affect the physical and mental health of both migrants and non-​migrating relatives. Moreover, a great number of active and passive migrants were particularly sensitive to the toll that migration had taken on their physical health and psychological well-​being given that more than 99 per cent of active migrants and 96 per cent of passive migrants reported having excellent or good health before their own or their relatives’ migration, and 60 per cent of active migrants and 22 per cent of passive migrants reported experiencing health alterations post-​migration. Next, the United States and Spain were the two main destinations, but Spain had become particularly appealing after the crisis because while the United States was becoming increasingly restrictive, Spain maintained its welcoming policy (Jokisch and Pribilsky, 2002; Bertoli et al 2010). Since 1963, a bilateral agreement between Spain and Ecuador had facilitated mobility by allowing travel without a visa to Spain for up to 90 days, with the option to renew the visa, apply for residency, and eventually obtain dual citizenship. This required Ecuadoreans to gather a significant sum of money (approximately $2,500) both to cover their flights and as proof of sufficient financial support but in comparison, this was not as expensive or daunting as traveling irregularly to the United States. Spain was also a friendlier destination than the United States because of language and cultural affinity, as well as Spain’s inclusive public health, education, and welfare policies towards immigrants. Still, many continued to travel to the United States, due to its economic and political strength and pull as a world power, and a

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INTRODUCTION

long history of Ecuadorean emigration there which had resulted in a strong network of relatives and compatriots with job connections. Participants’ experiences in these two destinations (the number of active and passive migrants who had migrated to or had relatives in Spain was double that of the United States) allowed for inferences regarding how more or less inclusive and prosperous contexts shaped active and passive migrants’ welfare and the occurrence of health processes and use of psycho-​sociocultural coping mechanisms. Regarding the final composition of the active and passive Ecuadorean migrants who participated in the research, about 95 per cent self-​identified as mestizo (a person of mixed ethnoracial ancestry), there was about an even split of male and female participants, about 90 per cent of the passive migrants were between 18 and 32 years old, while in terms of active migrants, only 50 per cent fell into that age group and the rest were mostly in their thirties and forties. Approximately three quarters of active migrants had completed a tertiary or technical education, while 54 per cent of passive migrants had completed high school, and 40 per cent were progressing towards or had completed a higher education degree. Regarding their economic solvency, half of active migrants and 41 per cent of passive migrants reported that their monthly income was enough to cover living costs; 27 per cent of active migrants and 16 per cent of passive migrants reported they could save money; 6 per cent of active migrants could send money back home; and 23 per cent of active migrants and 44 per cent of passive migrants could not afford a living. As far as the origin of other Latin American participants, our study comprised an important number of active migrants from Colombia, Argentina, Mexico, and Peru who had also migrated to Spain and the United States. Last, the migrant services and health providers who participated in this research included adults of different ages and years of experience, were originally from Ecuador and other Latin American countries as well as the United States, Italy, and Spain, and had various ethnoracial and gender/​ sexual identities and socioeconomic status. All, however, were truly devoted to their professions and occupations and expressed a genuine interest in learning more about health and migration in order to improve their services to advance migrants’ well-​being. Given the nature and sampling of the study, it could not be claimed that its results were generalizable or representative of all Ecuadoreans and Latin American active and passive migrants, or migrant services and health providers. However, the triangulation of various methodologies allowed for analytical insight that in the context of the literature on this topic could contribute to a better understanding of migration, health, and inequality generally. The theoretical and methodological perspective adopted also allowed for the exploration of broader theoretical questions that went

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beyond the purely descriptive or were restricted to corroborate or reject pre-​existing hypotheses. Based on the premise that (1) health is not only biologically and genetically, but also socially determined; (2) migration is a social determinant of health; and (3) migrants and non-​migrating relatives’ experiences are located within intersectional and transnational social matrixes that affect their opportunities and power, this research explored how migrants and relatives’ agency in dealing with migration-​related health challenges sometimes reproduced, but at other times challenged and dismantled, unequal social structures and practices transnationally. Through these migration and health experiences, social and geographical borders were not only traversed but also transcended in a radical manner from the ground up.

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2

Migration-​related Health Processes This chapter focuses on the seven health processes triggered by migration that were identified and conceptualized in our study of the Ecuadorean case in the context of other similar Latin American migratory processes. Reflective mourning, active migrant trauma, passive migrant trauma, migratory stress, migrant crises triggers, return shock, and unrecognized migratory resilience are explained through excerpts from stories of health and migration shared by active and passive migrants in individual and group interviews and community workshops as well as quantitative and qualitative data collected through surveys.

Reflective mourning One of the main concepts in the literature about health and migration is the one of migratory mourning, developed by Achotegui (1999), which explains that international migrants go through a process of grief due to leaving behind family, relatives, and friends as well as their language, culture, and land; modifying their social status, including their socioeconomic and ethnoracial standing; and last but not least, facing risks to their personal integrity due to precarious journeys, and the possibility of being deported, or discriminated and exploited as foreigners. In many ways, migratory mourning is different from the grief one experiences when a loved one passes away given that what it is left behind when one migrates does not cease to exist. Then, migratory mourning is a process that is partial, and therefore, recurrent because the possibility of furthering direct or indirect contact with the land of origin and people in/​from there prevails. Psychologically speaking, migratory mourning is a regressive process as it is tied to very early memories of being and self-​formation as a child that are difficult to elaborate and may lead to a return to infantile behavior due to feeling overpowered and insecure (Achotegui, 2009). Mourning can affect the personality and identity of immigrants, as well as the state of the relatives who are left behind and people who receive them abroad. Moreover, migratory mourning is 21

MIGRATION, HEALTH, AND INEQUALITIES

transgenerational given that the children of migrants are also involved in dealing with their parents’ migration and their history as a migrant family, including when return migration occurs because moving back is experienced as a new migratory process and implies another mourning phase. Building on psychological theories of stress and grief, Achotegui (2009) suggests that the process of elaboration of migratory mourning involves four stages: denial, resistance, acceptance, and restitution. Typically, immigrants initially deny that migration had any effect on them, then, they start to complain about the hardships of getting used to their new lives and feel that they have to return home to feel better again; after, they reach a point when they believe their new situation abroad is adequate; and finally, they come to terms with the good and the bad, both back home and away and find themselves at peace where they are. As a result, immigrants surpass their ambivalent feelings towards their places of origin and destination and achieve a more balanced assessment of their past, present, and future. However, if immigrants are not able to overcome this mourning process, they can develop what Achotegui (2004, 2009) theorized as the Ulysses syndrome, or multiple chronic stress disorder which includes more severe health alterations. His analysis points out that immigrants who develop this disorder have usually experienced extremely difficult situations prior to departure, during their travels, and upon arrival, which place them in a “permanent state of crisis” (Achotegui, 2009, 167). Migratory mourning and the Ulysses syndrome were a grounding point of reference for this research project. Survey questions included symptoms of the latter, and individual and group interviews and community workshops explored at length how active and passive migrants experienced the former. Findings reflected Achotegui’s theses to a certain degree, but they also brought additional layers and complexities to the ways in which active and passive migrants underwent mourning and stress both in situations of outward and return migration. Based on the analysis of these experiences, I reconceptualized the process of migratory mourning as reflective mourning, then distinguished the trauma that active and passive migrants traversed (active migrant trauma and passive migrant trauma), defined migratory stress, identified migrant crises triggers, and developed the notions of return shock and unrecognized migratory resilience. Reflective mourning is a process that active and passive migrants go through after leaving their country of origin. It includes grieving what was lost or left behind and the hardships that may have arisen during transit and upon arrival, as well as re-​evaluating the reasons that led to migration and the opportunities that a new phase in their lives may bring. The purpose of reconceptualizing Achotegui’s migratory mourning is to emphasize the contemplative process that active and passive migrants engage with regarding the complexities of pre-​, transit, and post-​migration as well as 22

MIGRATION-RELATED HEALTH PROCESSES

the strength that forward-​thinking gives them to transcend the challenges. Reflective mourning broadens the focus from the heaviness of loss to the potential for personal and family growth that migration entails, as well as the constructive process of reassessing what was left behind and why (which on many occasions can include extremely negative situations that may have generated trauma and/​or require grieving). The contemplation involved in mourning acknowledges the difficulties of the migratory process and at the same time, emphasizes its positive aspects. Thus, reflective mourning is a learning process that balances past, present, and future, and pros and cons, and includes but also transcends emotions (see Figure 2.1). Claudia, an active migrant in Spain expressed it clearly: “I always explained migration like a death and a re-​birth because in many ways, many things die, but new things emerge. The process was very hard, but when you overcome it, it is satisfactory, and one becomes stronger” (Claudia, Personal Interview, Barcelona, 2018). Similarly, Pedro, an active migrant in the United States shared: “At the beginning, one goes through a mourning process. Loneliness is felt strongly. It is a personal process of grief because of what was left behind. If one goes far away from where one has always lived, is like something dies inside. Something new is born too” (Pedro, Personal Interview, New York, 2017). Also, Gerardo, a return migrant from various European countries to Ecuador, claimed, “Among the good and the bad that migrating entailed, we also were able to learn and take something good from it” (Gerardo, Group Interview # 1, Loja, 2017). Mourning, and learning from it, could be of value to others too. As Marcela, a return migrant from Spain in Ecuador, shared: For me it has been very difficult. But there are nice things too. Not everything is bad. You also learn very much. Suffering teaches you to be humble and to share. While some people think that because they suffered, others must suffer as well; I think the opposite: because I suffered, I can teach it, share with others what I experienced and learned so they do not suffer. (Marcela, Group Interview # 5, Loja, 2017) Paula had a similar attitude towards sharing information about what migrating entails. She had gone to Spain for two years and returned to Ecuador, and had emigrated to the United States, many years later, and returned once again. She reflected: I would have liked to know how it was there for real before leaving. Because one thing is what they tell you, and another thing is when you get there. When I left, I was young and had plans to finish my university studies in Spain. But I could not do it because it was 23

MIGRATION, HEALTH, AND INEQUALITIES

economically impossible. My cousin had told me a rosy version of how it was to live there because of her illusion to be together with me, but I know that if I had known the truth, I would have been more prepared, and it would not have affected me that much. It was very hard, very hard. When I returned, I talked to my brother about everything realistically. I did not want to lie to him. … It was very hard for me to be away, also when I went to the US years later. … But at the same time, migrating was very useful. It helped me very much because I returned to Ecuador with a different mentality. (Paula, Personal Interview, Loja, 2016) Figure 2.1: Illustration of reflective mourning

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The deliberation about the hardships experienced before making the decision to migrate was a significant aspect of the grieving process. Research participants had left in grave socioeconomic circumstances which had been accentuated by the financial crisis in Ecuador. This added a bittersweet element to their mourning: while they missed their relatives, land, culture, language, and so on (if active migrants) or the person/​s who had left (if passive migrants), they did not miss the dire conditions or the political and economic circumstances that had forced them to make the decision to migrate. Instead, their predicament pre-​departure had been so detrimental to their well-​being (sometimes to the point of being traumatic) that it was essential to heal those wounds, and migrating was part of the solution. This ambivalence complicated the process of mourning and prompted a logical and pragmatic outlook. Etelvina, a passive migrant with her husband in the United States, explains: He left 12 years ago. The idea was that he would return after a few months to keep his regular status, but the economy here got even worse, so he overstayed his visa and then, it was useless to come back. We had been scammed by a notary and lost almost everything. As soon as he arrived in the US, he started working. It was very tough. But he knew that economically it was not reasonable for him to return. He had to endure all kinds of things, but he stayed there so he could help saving the family. Despite hardships, he could always send remittances and we slowly came out of the hole we had fallen into. … Our daughters were able to study. So, even if we all had a heavy soul pain, it was clear that him staying abroad was for the best even if he hated being there and we dreaded being apart. … We are proud of our daughters’ growth and that we have been able to provide for them despite how hard we were hit by the crisis and how difficult it has been to be far all of these years. (Etelvina and Clara, Personal Interview of mother and daughter, Loja, 2016) Another example of mourning when considering the difficulties of migration was articulated by Manuel, a return migrant from the United States to Ecuador. He had traveled through Honduras and Guatemala, into Mexico, across the border in a journey led by a series of coyotes (smugglers) that took several weeks. His experiences in transit included hunger, exposure to extreme cold and hot temperatures, overcrowding, claustrophobia, as well as witnessing sexual violence, drug overconsumption, and death. In his words: I WAS [his emphasis] able to make it. I crossed. At the beginning, I had a lot of stress. Now I know it was stress. I had nightmares of being chased, or I simply started to remember when I had been chased at the 25

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border. I could not sleep. I didn’t eat well. I lost weight, I looked like a skull! But after the first year, things got better. … I worked, studied, and was able to get ahead. … What I went through when I crossed marked me. Affected me. No doubt. But I was able to persevere. I ended up staying in the US for 30 years. I did well. I would like to emigrate again, this time to Europe, maybe Holland. (Manuel, Group Interview # 3, Loja, 2017) As these experiences showed, active and passive migrants traversed a process of grieving that was on the one hand, painful and difficult, and on the other hand, liberating and constructive. Migrants assessed the positive and the negative aspects of their migratory process, including the reasons for their decision to leave and the hardships of travel and work conditions, balancing the remaining benefits and lessons learned with a forward-​looking disposition. Reflective mourning allowed active and passive migrants to move on and reassert a sense of self influenced but not defined by their migratory experience. This capacity to be thoughtful helped in handling migration-​related trauma.

Active and passive migrant trauma By paying attention to the personal, sociopolitical, economic, and historical contexts, this project explored how migration could put active and passive migrants’ health at risk and become traumatic experiences. For active migrants, the trauma resulted from the hardships experienced before migration, in transit, and after arrival. The more severe the living conditions and incidents, the more challenging to the well-​being of the migrant. Also, trauma was dealt with more or less ability depending on the original strength of the migrant; naturally, the weaker the psychological and physical state, the more difficult it was to process and overcome it. Thus, exogeneous and endogenous factors affected how active migrants experienced trauma (see Figure 2.2). In the case of passive migrant trauma, similar factors applied: critical conditions prior to departure also affected passive migrants, but mostly, it was the emotional shock generated by family separation that weighed the heaviest, especially if the active migrants were close relatives. Children of active migrants were the most disturbed, even if left to the care of loving kin (including their own mother or father) back home. For couples, the non-​ migrant partner managed better with the trauma of a de facto separation if (1) it was consensually agreed on; (2) there was a certainty of the length of the migration; (3) remittances started to arrive, easing the financial situation; (4) the family migratory project as a whole started to work; and (5) the migrant partner continued to be in communication with and faithful to the 26

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Figure 2.2: Illustration of active migrant trauma

non-​migrating partner and family. Likewise, children of couples separated due to migration who were cognizant of the family’s collective effort processed trauma better if their plan was respected by all and successful. Passive migrant children who eventually reunited with their active migrant parent/​s traversed reflective mourning and trauma, in many cases due to the difficulties of recreating a face-​to-​face family dynamic especially when several years had passed and family changes had occurred (for example, separation, new relationships and siblings). Last, parents of migrating adults found the departure of their offspring traumatizing, especially when their 27

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Figure 2.3: Illustration of passive migrant trauma

communication ceased, visits occurred sporadically or not at all, and they were aware that their adult sons and daughters were facing difficulties abroad (see Figure 2.3). The ways in which active and passive migrants coped with the changing dynamics of their relationships and the challenges of migration will be discussed in detail in Chapter 4. Now, we focus on the experiences that were shared in individual and group interviews to better understand the nuances of migrant trauma. Manuel, mentioned earlier, suffered significant strain during both his trip to the United States and the first year of life there. He claimed: Crossing was traumatizing. What I witnessed is hard to believe that can happen for real in this world. I saw it all, men raping women and girls, men raping men and boys, one-​on-​one or in groups, and people turning their backs in panic to be the next one, feeling impotent. I saw people dying right next to me. People urinating and defecating on themselves while trapped in the back of the truck that was taking us across Mexico. I experienced hunger as I had never had. And thirst. We would desperately drink dirty water when we found muddy ponds because we thought we were going to pass out. … I had to stay quiet and obey the despicable men who were taking us through. Men who were so high that they were not able to respond 28

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to their own actions. Violence. Extreme, inexplicable violence. So, yes, we, migrants were traumatized by all of that. The nightmares and the memories sometimes won’t let you sleep or do what you must do. … Sometimes I think that I am a bit crazy. Because it affects you to have gone through all of that—​it really does. And one thing is to hear it, and another thing is to live it … running as if the Devil were the one chasing you and jumping into a hole who knows how deep, so you don’t get caught. … It was very hard. I don’t know exactly how, but I was able to get over it and keep on the struggle to make it. I was young and strong. … The first few months were tough, in that little town in the outskirts of New York. … For me, the language was the largest obstacle. Fear not to understand or be understood. And racism was hard too, working and not getting paid for it, even having trouble with other Ecuadoreans who were not supportive at all. … The first year there was like the first year in military training. But once you survive it, you are OK. (Manuel, Group Interview # 3, Loja, 2017) The combination of pre-​departure, transit, and after arrival trauma was a very common experience for most of the migrants who had crossed the border without authorization. In the words of Emily: We were affected by the economic crisis, the devaluation and change of currency. My father told me that from dusk to dawn all our savings became nothing. They were not able to afford anything, so in one day, he made the decision to leave for the United States with an uncle of mine and no papers. I don’t know exactly how they did it. But I know that they flew to Mexico and from there, they crossed the desert. Most of my relatives who left in that period did the same, they migrated irregularly. Some were able to get their residency because they got married. I have relatives who were born there already, so they are citizens. My father left when I was five years old. He returned after five years. My parents did not end up divorced, but for me it was very difficult because I spent many years of my childhood without him. For him, migrating was a tremendous change, a psychological crisis because he lived with fear. Crossing from Mexico to the United States was very tough; they crossed at night, hiding. Many of the people who were with him died in the process. Only few were able to make it. And once there, they did not know how to talk, who to trust, where to work. … Until they could get used to being there … they lived exploited by the gringos. (Emily, Group Interview # 5, Loja, 2017) 29

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Active migrants to the United States or Spain who had the required paperwork to travel and enter as tourists did not experience this kind of transit-​related trauma. Nevertheless, the majority had still endured critical times pre-​departure due to economic scarcity usually accentuated or caused by the Ecuadorean economic crisis, or in some cases, due to their own personal troubles. For example, Luis went to Spain because he could not make ends meet: The situation was unbearable. My income was not enough. I dropped out of my studies. My wife and daughters did not have enough to survive. We would buy food and it would not be enough to feed us for the entire month. We were having a deadly time. If we bought shoes for our daughter, we did not have enough to eat. We sacrificed the most we could and tried to subsist month by month. The possibility of migrating to work abroad seemed the only way out. (Luis and Camila, Personal Interview of father and daughter, Loja, 2016) The precarity in which they were living was part of the trauma carried by Luis, the active migrant, as well as his wife and daughters, the passive migrants, who could endure the emotional costs of the separation given their pressing need to live to tell the tale. Likewise, dire conditions pushed Alma, Hernán’s wife, to go to Spain, as Hernán explains: We were in a calamitous situation. I had been working well at an electricity plant, had been able to build two houses, but my wife decided to help her brothers to study and didn’t tell me anything. She had resorted to loan sharks and when the crisis erupted, they raised the monthly interest rate to 60 per cent. It became an impossible debt. I sold everything, the houses, the car; I lost everything. So, my wife decided to migrate so she could recoup what was lost. I didn’t want Alma to leave, but she insisted. Slowly we were able to pay the debt, but I didn’t care about the money. The sad part was that our home had broken apart. (Hernán, Personal Interview, Loja, 2016) Leonardo’s family was hit hard by the financial crisis too, so his mother took him to New Jersey. They entered with tourist visas while his father and brother stayed in Ecuador. Apart, they were all working to recover economically, but the plan to return after the authorized three months shifted because “they realized that it would be more beneficial to stay to secure a better future. My father joined us two years later” (Leonardo, Personal Interview, New Jersey, 2019). Changing return dates was common and traumatizing for active and passive migrants who repeatedly expressed that even if they had originally planned to be away for a few months, or a 30

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couple of years at the most, and reunite with their family, they were forced to extend their stay abroad and separation due to the inability of ameliorating their family’s economic conditions back home given the accumulated debt they had incurred in order to migrate, the difficulty of amassing savings due to the high cost of living abroad, and the slow recovery of the Ecuadorean economy. In Camila’s words: When my father told us that he was coming back the last time, we did not believe him. He had told us so many times that he was returning, that he was going to be back home for the next Father’s Day … or that he would stay with us next time he visited … but it had never happened. So, we stopped believing. And every time he returned to Spain, we all felt so, so sad. Because migrating affects not only the one who travels, but those who stay. Especially when three months become 12 years. (Luis and Camila, Personal Interview of father and daughter, Loja, 2016) On several occasions, pre-​migration personal/​family troubles had formed part of passive and active migrant trauma. For example, Jorge’s family migration to the United States was decided owing to medical reasons: We came here because my brother needed surgery. They had found a tumor under his left shoulder blade that had to be removed before it touched his lungs. My mother had gone through a bad experience with the medical system before, because I was born with a problem in my eye: I could not open my eyelid and had three unsuccessful interventions in Ecuador. My parents were afraid that my brother’s treatment would also go wrong, but in his case, the problem was not cosmetic but severe. (Jorge, Personal Interview, New Jersey, 2019) In the case of Paula, her move to Madrid was intended: to avoid trouble with my father, because I got pregnant and was not married or had a steady boyfriend, and he was very strict. I already had plans to study abroad so when I found out I was pregnant, I decided to leave and join my cousin who had moved there a few years before. Hence, she was traumatized by the underlying conflict that she had with her father and the secrecy surrounding her condition; in her words: “It was very hard. I was very depressed, every day I cried … I cried a lot in that country, not because people treated me wrong rather because of my situation: besides the pregnancy and my father, I could not afford to study as planned” (Paula, Personal Interview, Loja, 2016). Independently from 31

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their transit and pre-​departure experiences, migrants were impacted by traumatizing conditions and occurrences at their places of destination. In this regard, having a regular or irregular migration status made a difference. In general, but not always, irregular migration meant greater exposure to trauma, and regular migration, slighter. Both active and passive migrants were affected by the regular or irregular character of the migration. On the one hand, irregular migration tended to generate more trauma given the higher chances of being mistreated or deported, and the uncertainty of reunification plans (be they abroad or back in Ecuador). On the other hand, regular migration did not always result in the accomplishment of migratory plans (usually due to economic strains or changes in family dynamics) and therefore, led to traumatic failure and frustration. All these conditions tested the ability of active and passive migrants to deal with potential challenges and plan for future endeavors. The case of Etelvina, Clara, and Armando illustrates irregular migration active and passive trauma. Etelvina’s husband, as mentioned earlier, had migrated to the United States with a tourist visa, began to work without an employment authorization and later, decided to stay abroad irregularly due to his continuously pressing family’s economic needs. Etelvina stated: Armando was able to work right away, as soon as he arrived, he began to work. But it was hard, very hard. He was paid very, very little and had to work very long hours. They never made it easy for him. He always said that there they were very racist. He has always worked in something related to electricity that demanded plenty of physical strength. That has been bad for his spine. The job also required for him to be very dexterous and extremely careful with how he handled things manually to avoid accidents. His job is not an easy one. It is risky. All these pressures made him sick. It made me sick too. I started to have high blood pressure and thyroid problems. I was ill. I had all kinds of illnesses. I even had to have surgery because I developed a condition in my uterus … I mean, everything fell on me. And my husband Armando was depressed; he would say, ‘Oh God, if it were for me, I would rather go to a church and die, so they would bring my body back to Ecuador.’ He had a horrible depression. He also had back problems to the point that he had to start walking with a cane, and at his job, they would tell him, ‘You are illegal—​if you don’t come to work, you lose. Here it is forbidden to get sick.’ So even if he was ailing, he had to go to work to be able to eat. … And my daughters, well, they also felt it, they would get sick often, and were terribly saddened with their father away, especially knowing that he was having such a hard time. (Etelvina and Clara, Personal Interview of mother and daughter, Loja, 2016) 32

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The racism and exploitation that Armando endured, together with the threat of losing his job and the risk of deportation, as well as his exposure to hazardous circumstances in the workplace, were all traumatizing to him and his family. Etelvina, Clara, and Sofía, the other daughter, felt powerless as they could not do much to help Armando. They were also frustrated with the unexpected but necessary length of his extended stay abroad, and continued to feel uncertain, 12 years later. In Clara’s words: When we speak with him, he always says, ‘I am tired of this.’ But there is nothing here to give him the strength to pick up and leave, to come back to Ecuador. He is waiting … I don’t know … for the right moment to come back … and I don’t really know when that will be. (Etelvina and Clara, Personal Interview of mother and daughter, Loja, 2016) Carmen’s case of irregular migration to Madrid also comprised trauma. She left on her own and stayed there for nine years before moving back to Ecuador. She was a single mother and had left her five-​year-​old son with her parents. She expressed: When one starts to remember, it is very sad. In order to pay the debt that I had incurred to travel to Spain, and send back some extra for my family, I worked as a live-​in domestic worker for three years. But that job drives you insane. To be locked in a house every single day, working non-​stop. I didn’t have the residency, so I could not work in my profession, as a nurse—​How can I say? I was a bit depressed at the beginning. I would feel like doing nothing. Just nothing. But I was a fighter, and one way or another, I always found the strength to work. One always has to work. Her son suffered passive migrant trauma due to the departure of his mother: He did not get sick, but now, I realize that he was emotionally wounded. He grew up with my parents who took good care of him. But he reproaches me that I left him alone. He resents me. And really, the most hurtful for me was not to be with my son. I still suffer about that today. Leaving my son, and my family … it affected our health, our emotional well-​being. And the suffering adds up; it has a great emotional cost. It is very sad. (Carmen, Personal Interview, Loja, 2016) Regular migration also led to active and passive trauma. As suggested earlier, the exposure to trauma was usually less intense because the fear of lacking the proper documentation was not a factor. However, trauma was still 33

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present. To illustrate this, I share two distinct cases, that of Matías, based on more favorable conditions and assured prospects, and the other of Lesly, who came from and arrived on precarious grounds. Matías had decided to move together with his wife and son for professional and family reasons to the United States. In his case, they were coming from a prosperous socioeconomic situation in Ecuador and arrived in New York to manage their relatives’ thriving businesses with granted migratory authorization. They were looking forward to the opportunities that lay ahead. However, Matías and his family still experienced difficulties: Our process of adaptation was hard, like it is for every migrant. We had some advantages because we had our regular status, were not struggling economically, were professionals, and knew the language—​or at least we thought we knew it, because one thing is to take classes, and another is to be in a world in English and communicate every day fluently! For our son it was very difficult though. He was only four and he was just getting a hold on Spanish, so it was shocking for him to enter an English-​only school where he didn’t understand anything at all. It was a hard decision that we made, but in retrospect, we think that it was the best one. But, yes, at the beginning it was very hard, it was extremely hard for me too, to see him so unprotected and disoriented. … The other aspect that made it a rough transition for me was to adapt to such a different rhythm of work, especially in the Hispanic market, where there is no balance between work and personal well-​being. Here people live to work. Their jobs are their lives, and their lives are structured around their jobs. So, I started to work 90, 80, 100 hours per week, six or seven days of the week. Our quality of life as a family was terribly impacted … we also gained a lot of weight—​35 extra pounds for me—​because we didn’t have time to eat well or exercise, or rest. My wife too, we both had the same workhours. Matías’ family suffered the traumatic excess of exigency attached to their jobs, and both their marriage and son were negatively affected: We were like zombies. Our son was complaining to us that we would not go out anymore, and if we went out, we were drained, and in a bad mood. My wife and I would fight. It was very tough to see that our son was feeling lonely. He would stay in daycare until 7 or 8 at night, and at the weekend, we would bring him with us to the office, where he would spend all day on his own, reading … and he would tell us that he was feeling very bored, that he was tired. I would also notice the level of stress that my wife was enduring. She was not respected at work because even if she was the most prepared one, with the highest 34

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degree, they discriminated against her because she was a woman and boycotted her work because she was ‘the favorite niece’ of the owners. We were under so much pressure that we would argue all the time. I thought we were going to end up divorced. Their family migration also generated passive migrant trauma, mostly for Olga, Matías’ mother-​in-​law, who had stayed behind, but also, to a lesser degree, for his brother. Olga agonized over the departure of her daughter: who was practically the only person she had been relying on because she was divorced, and her other daughter had moved to Spain many years ago. Also, Olga had become very attached to our son, so she entered a depression after we came here. For my brother it was emotionally costly too because we were very close. (Matías, Personal Interview, New York, 2019) Lesly’s experience of migration also involved trauma. Having secured the appropriate authorization, she migrated to New York with her younger brother to join their older brother and their father with the aim of finding a “better future.” Lesly’s family was very poor. Their father had gone to the United States when she was four years old, and her mother stayed behind to raise four children: We had worked since we were very young to be able to subsist. The older we got, the more things we needed because we all went to school. My older brother took my father’s role to provide for the family, and when he realized that he could not make ends meet any longer, he migrated to the United States. My mother had to work all the time to feed us and pay back the debt we had because of my brother’s migration (he traveled without papers, so it was very expensive). My brother had suffered the abandonment of my father very much and when our brother also migrated, he was very troubled. He started to hang out with bad friends and consume drugs. He was still docile, though, so my mother and older brother thought that he could fare better if we went away. My father had been able to request the residency for us, so we left, except our sister, who had a daughter and didn’t want to leave her behind. My mother, in her modest way, thought that we would be better off abroad, that we would not have the needs we had in Ecuador. But, in my experience, I can assure you that for a 13-​and 16-​year-​old, being far away from everything they knew was not exactly a better life. Lesly and her brother experienced several trying situations after arrival. The first shock was that upon the promise of reuniting with their father, it 35

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became clear that he was not going to take care of or help them in any way. Their brother did, as much as he was able to. Lesly shared: While we sort of knew that my father had gotten married, we had been told it had been to regularize his migratory status. So, finding out that indeed my father was in a real relationship with this woman, and that we had a half-​brother, and a stepbrother was a blow. But even worse was that we didn’t know where we were going to go or live because we were not welcomed at our father’s home. Our older brother ended up taking us in. He lived in a room, a small, tiny room in Brooklyn. We had a cot to share. Practically, our brother was the one who finished raising us up, he helped us economically, and was always available. He did the best he could. He worked all the time to be able to provide for all of us here in the US and back home. Despite the older brother’s disposition, Lesly and her sibling endured several more traumatic experiences, including not being allowed to return to Ecuador for two years because their father thought that if they left, they would not want to return to the United States given that: At the beginning, we would be crying all the time, we were practically locked 24 hours in that tiny room, not knowing anybody. We suffered very much. We missed our country very much, the language, our family, and mostly, our mother. We spent all day alone. In Ecuador we lived in a house, we could go out to the park without fear, we could play with our neighbors, we could live like children, like free children. We could not call my mom either because it was very expensive—​sometimes we could call her once a week, but for a short time (it was not as easy as it is now). My brother felt that he had been abandoned again, now by my mother. And he didn’t fare well. As soon as he joined the GED program that he had been assigned to in the Bronx, he found a new set of bad friends and started drinking alcohol and smoking marihuana all the time. … I went to high school and graduated, but still had a long-​lasting sorrow. I didn’t know what was point of being in this country or this culture: it was so different here, I missed Ecuador very much and all I wanted was to go back. I had the sensation of having been deserted by my mother as well. I resented her because back then it was very difficult for me to understand that she had done the best she could. Now, as an adult, I understand, but it created great trauma in me. Lesly and her brother’s migration to the United States also comprised passive migrant trauma. Their mother, despite her agreement to send them abroad: 36

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suffered when she let go of her two younger children, who were still minors. It was very painful to her. She had suffered from nervousness, and our departure made it even worse. She was nervous not to be with her children, not to know if we had eaten or not, if this or that. … She was always worried and anxious. (Lesly, Personal Interview, New York, 2019) In line with Lesly’s history, several migrants underwent a traumatic experience when they reunited with their relatives abroad. In some cases, the second wave of migration occurred when the family had amassed enough resources to pay for travel, regularly or irregularly. In other cases, it happened when the active migrant abroad had been able to regularize their migratory status and could arrange for passive migrants to join them because they were settled enough (had a steady job and a place to live). Like Lesly and her brother, many passive migrants would reunite only to be surprised by the new family configuration of their parent/​s and harmed by the lack of space for them in it. Natalia shared what happened to her nieces: My husband’s brother also emigrated. First, he left alone. Then, his wife emigrated and left their two daughters with the grandmother. After a few years, they brought their daughters to Spain, because she thought ‘they were not going to love them anymore.’ Then, the daughters on one of their trips back to Ecuador told their grandmother that they wanted to stay with her, that they had a very bad time in Spain. They felt strange with their parents, especially with their father who they didn’t really know because they had grown up without him. They also were being mistreated in Spain by their new sister, who would tell them to return to Ecuador because those were her parents, not theirs. The sister would hit them and treat them very bad. The two girls would sit in a corner and cry and say that they wanted to go back to Ecuador. But they could not. They were minors. (Natalia, Personal Interview, Loja, 2016) Group and individual interviews revealed that older children of active migrants also had traumatic experiences when reuniting abroad. For example, Carina had missed her parents very much and dreamed of being back together with them, but: everything was different in Spain. My parents were working all day long to provide for the family, and I had to manage by myself. I remember one of the first days I went to school alone, I had to take the train and the bus, and I got lost. I took the wrong bus and ended up in a place far away, at the other end of town. I broke down and asked some 37

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women who were walking around to help, but they could not help me because really, I was all the way out there. Nobody helped me and I was crying in the street. Finally, I managed to call my father and he came to pick me up. But what I experienced in general was fear. Fear of the unknown. (Carina, Group Interview # 4, Loja, 2017) Furthermore, couples’ reunification could be complicated. Magdalena, who was very attached to her parents and siblings, and had dropped out of medical school to join her husband in Spain, shared: It was very hard. Despite that I went to Spain to rejoin and live together with my partner, I felt a loneliness that was inexplicable; an inexplicable emptiness. Like a toothache that is there, but it doesn’t have a cure. Despite being together with my love, and later expecting a baby, my sadness would not leave me. When I felt so much sadness, I didn’t even want to call my family in Ecuador to avoid feeling how much I missed them. My sadness, the depression, affected my pregnancy—​I almost had a natural termination. I had to quit my job and that made it even worse because I had to stay all the time in the house, as if I were locked down, and that made me even more blue and nostalgic. Magdalena’s son was born healthy, but soon, she had to deal with her husband leaving them to start another family: He had spent three years in Spain before I came, and when I arrived, I learned that he had a hectic social life that didn’t stop once I arrived. He didn’t include me either. He left us, and I had to take care of my son on my own. I had to quit my studies again—​I was taking some nursing courses there—​and started to work Sunday to Sunday as a cashier at the supermarket to be able to subsist. My son and I lived in a rented room, and we barely made it. I fell into a depression again. I felt very lonely. I didn’t have any friends or a social life. I only worked and cared for my son and feared not to be able to pay the rent. I started drinking. I had stomach problems and stress. (Magdalena, Personal Interview, Barcelona, 2017) While the separation of a couple is usually a traumatic experience that requires emotional and psychological healing, even when consensual, separation due to migration was particularly traumatizing on two instances: when the longed-​for reunification ended badly, like in the case of Magdalena; and when the partner abroad became engaged in a new romantic relationship while still keeping their relationship intact back in Ecuador. If the latter occured, passive migrant partners would find out about it sooner or later, 38

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usually through gossip or rumors. Then, they would put up with the situation by either confronting their active migrant partner and ending their marriage or union, or if children were involved, ignoring it and continue to demand their partner’s financial responsibility towards their family. Hernán recalled: When Alma returned to Ecuador to visit, I realized that she had changed, that something was going on. She was like far away. Once she went back to Spain, I started to hear rumors that she was with someone else. Later, it was confirmed. She got engaged with an older man there and told me that she didn’t want anything to do with me anymore. That she had made her life over. After a few years, my children migrated to Spain to be with their mother. My life then became a disgrace. … I started drinking heavily and wanted to kill myself. (Hernán, Personal Interview, Loja, 2016) As mentioned in the case of Lesly, passive migrant trauma was usually present in the case of parents whose children migrated. For instance, Carol’s parents suffered terribly. She shared: My father suffered from what the doctor called ‘emotional diabetes,’ and my mother suffered very much, but because my father got sick, she was forced to put her own suffering aside to care for him. In any case, she still had an inner suffering that did not let her be in peace. (Carol, Personal Interview, Loja, 2016) Similarly, Rita talked about the effect the migration of her older son had on her: He left to sustain the entire household because I was a widow. Emotionally, it affected us very much. Because of his departure, I developed rheumatoid arthritis. And that was related to my being depressed. It affected me very much and continues to affect me to this day, 14 years later. It is something terrible. (Rita, Group Interview # 2, Loja, 2017) Children whose parents left also demonstrated passive migrant trauma, like in the case of Luciano, who was interviewed when he was 20 years old and recollected his experience of his parents departing when he was about eight years old: When I stayed here while my parents were gone, I began to get sick because I didn’t have my parents. My relatives tell me that I was very sad and wasn’t doing very well. For example, I had … I don’t know, 39

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I don’t know how to explain it … for a while I was suffering from severe bone aches … I don’t know … I would feel weak … I don’t know why … I even became … how do you say it? … paraplegic or something like that … because I could not move this one leg … this leg was stiff. (Luciano, Personal Interview, Santo Domingo, 2017) Frida, crying, shared that after her parents’ departure to Spain because of financial difficulties, her brother and her were also separated because their grandparents were arguing over who would take care of the children. Then, “One of my brothers went with the paternal grandparents, and my other brother and I stayed with our maternal grandparents. It was very hard” (Frida, Group Interview # 4, Loja, 2017). The separation of siblings only increased the trauma experienced given that they had already had to adapt to life without their parents due to their migration, like in the case of Lara, Milly, and Nelly who shared that when only two of the sisters moved to Spain, “it was devastating, very depressing for the three of us” and for Lara, who had stayed, “it was like getting used to being left behind once again” (Lara, Group Interview # 4, Loja, 2017). On the whole, passive and active migrants experienced trauma as a result of migratory processes. The trauma, like reflective mourning, was better fared if the active and passive migrants were stronger to begin with. However, and logically, the more traumatizing the situations they encountered pre-​, during, and post-​migration, the more difficult it was to overcome them and the more scars they left. The next health process to be analyzed, related to reflective mourning and active and passive migrant trauma, is migratory stress.

Migratory stress Migratory stress is defined as the stress that active and passive migrants experience due to the inherent difficulties of migratory processes, including traumatizing pre-​departures and journeys, the challenges of transculturation and family reorganization, and the coming to terms with the new living conditions. My conceptualization is based on the literature that analyzes the psychological and physical disorders associated with migration, particularly Achotegui’s concept of the Ulysses syndrome experienced by migrants in severe cases. However, it proposes a version that applies to the common experiences of both migrants and relatives in less extreme circumstances, while emphasizing that the stress can be a result of not yet overcoming traumatic events that could have occurred pre-​, during, post-​and return migration (see Figure 2.4). Migratory stress includes symptoms in the depressive (sadness, crying, suicidal thoughts), anxious (tension, insomnia, nightmares, recurrent and intrusive thoughts, irritability and nervousness), cognitive (confusion, distraction), and somatic areas (fatigue, body pains 40

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Figure 2.4: Illustration of migratory stress

and aches, migraine, change in appetite and weight) similar to the ones observed with the Ulysses syndrome (Achotegui, 2004, 2009; Lara et al 2005; Miranda et al 2005; Caplan, 2007; La Parra Casado et al 2007; Ríos-​ Marín and Hernández-​Londoño, 2014). While none of these symptoms on their own would suffice to diagnose a passive or active migrant with Ulysses syndrome or migratory stress, together they constitute common health conditions that passive and active migrants experience. Stress is important to notice because when a person is exposed to stress in a manner that is “unusually intense, chronic, uncontrollable, and overwhelming, it can give rise to—​or exacerbate—​burnout, depression, anxiety, and numerous physical conditions, such as inflammatory, cardiovascular, or other medical illnesses” (Southwick et al 2014, 2). The personal and group interviews as well as the surveys performed in this research project clearly revealed that migratory stress and its symptoms were ubiquitous. In most cases the symptoms and stress levels were moderate and controllable, but of course, there were a few severe cases like the ones described by Achotegui’s Ulysses syndrome. Leonardo and his family’s experiences (irregular migrants to the United States) illustrate the range of migratory stress degrees. For Leonardo, it was hard to leave his father, his big brother, who practically raised him, and his other relatives, friends, and community in Ecuador behind: I was sad. I dreamed that I was still in Ecuador for the first four years of my life here in the US. Literally for four years, every single night, 41

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I dreamt I was in Ecuador. And when I woke up, I felt a heavy sorrow, and wished I could return, but we could not. Leonardo’s mother, with whom he originally migrated, also felt sad: because she missed my father and had to adjust to work cleaning houses even though she was an English teacher back home. It was also conflictive for her to hear me complain or wish that we returned because I was old enough to understand that economically, it was better to stay here due to how hard the financial crisis had hit our family in Ecuador. Leonardo’s mother had had thyroid problems before arriving in the United States, but according to Leonardo: they got worse because of the stress of migrating and living undocumented, plus the frustration and the sadness she felt when she started to take care of my dad, who after a few years of being here in the United States with us developed ALS [amyotrophic lateral sclerosis]—​Lou Gehrig’s disease—​because of the ever-​present fear he had of being deported to Ecuador and his hurt ego. My dad had completed college and occupied high positions in business and marketing, and he had been working well in Guayaquil before the crisis. But then, when he came to New Jersey, he started to work cleaning houses with my mother. Leonardo was convinced that the fear of the risk of deportation took a heavy toll on their family’s physical and mental health and described how “even now, that I’ve had my green card for a while, I see the word ICE [Immigration and Customs Enforcement] and I panic” (Leonardo, Personal Interview, New Jersey, 2019). While it is not possible for me to assess if Leonardo’s father’s disease was a severe somatization related to migratory stress, what is relevant to observe here is that Leonardo believed that indeed it was. Migratory stress was also experienced by authorized migrants in Spain, like in the case of Marta: We lived in a rural area, my husband and I were like the housekeepers of a rich couple. I cooked and cleaned, and he took care of maintaining the house and grounds. We were earning well and were able to provide for our daughter who started school close by to where we were living and working. But from being like locked down out there, working all the time, I had terrible, unbearable headaches every single day. I suffered so much. I would cry because we were alone there, the three 42

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of us, isolated, without family or friends. I thought my headaches were because I was nervous. I would take acetaminophen or ibuprofen daily. I was very unstable, sometimes I felt fine, but then, I would get very nervous and start crying. And I didn’t understand why. Suddenly, I would have dreadful body aches. I had also gained a lot, but really, A LOT [her emphasis] of weight, even if I wasn’t eating much at all because I didn’t feel like it! But I know it was all mental: my head was like exploding because I worked and lived in Spain, but my mind was really in Ecuador, and I only wished we could go back. (Marta, Group Interview # 2, Loja, 2017) Practically all the active and passive migrants that were interviewed individually or in a group setting confirmed that they had repeatedly experienced migratory stress symptoms, the most common being sadness, crying, insomnia, body aches and pains (including headaches, migraines, and stomach problems), weight changes, and anxiety. Pablo’s experience mirrored that of other migrants: I got really chubby, I mean, fat, even if I didn’t eat because during the day, I wasn’t even able to take a break to eat, and at night, once the workday ended and I returned home, I was so sad and lonely that I skipped dinner altogether not to be reminded that I was not sharing the table with my family. (Pablo, Personal Interview, Loja, 2016) Mario described his father’s migratory stress symptoms: One is tired, nervous, stressed. For example, when my father left for the United States, he was plump. And the dream he had back then was to send money back to buy a house of our own because we lived in my grandmother’s house. He worked two jobs every day, from Monday to Saturday, and he rested on Sunday. Each job had an eight-​hour-​long shift, so he only had eight hours for himself. He left plump, but returned without his belly, practically gaunt. He also had been diagnosed with gastritis because of the bad quality of life he had over there. (Mario, Group Interview # 4, Loja, 2017) Ester talked about her brother’s stress, common to other stories shared by and about passive migrants: My brother, when my father had been in the United States for about three years, began to suffer from headaches. I don’t know as a scientific fact that it was because of my father’s migration, but my mother would say that to us. My brother was starting school and he started to have 43

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these severe headaches, and he would faint. My mother had to have him treated for it. After that, he developed gastritis, maybe because of all the medicines he had to take. He was the most affected one health-​wise in our family. He suffered from continuous illnesses. And that lasted for several years even after my father had migrated back to Ecuador. My brother had nightmares, he would cry, he was nervous. I remember that he would sleep with my mother (he took my post because I was the youngest one! [laughs]). I went to my sister’s room, and my mother took care of him. My mother took two of my brothers out of school because they would not feel at ease. Once my father returned from the US, they restarted school. (Ester, Group Interview # 5, Loja, 2017) Daniela shared her sister’s experience: When our father left, my sister got very thin. They started to give her vitamins, but she wouldn’t gain weight. It was an excess of thinness [laughs]. Later, because she missed my parents, she stayed like small, like she didn’t grow enough physically, and then, she started with the headaches. Even if she was taken to the best doctors, she would not get any better. After my parents returned, her headaches went away, they became slight and rare. Before, she had a migraine and would vomit from the pain, she would cry, faint, she would get all red, violet, every color. We would have to call the doctor in an emergency because we could not stabilize her. But since my parents returned, she got better. If she has it, it’s once a year, but before it was weekly. When she went to school, she couldn’t really do it, she had dreadful pain. (Daniela, Group Interview # 6, Santo Domingo, 2017) In general, stress symptoms were considered a normal occurrence resulting from the hardships of migration, and unless the symptoms were severe (like in the case of Ester’s brother or Daniela’s sister), active and passive migrants seldom sought medical or psychological treatment, regardless of their ability to access healthcare (which in the United States was limited, especially for irregular migrants, but in Spain and Ecuador was not). On the rare occasions when active and passive migrants sought assistance, doctors, mental health counselors, or migrant service providers infrequently identified that the symptoms were related to migratory processes, even if the patients and their relatives were convinced they were. Based on these common attitudes, I conceptualized two connected psycho-​sociocultural coping mechanisms, denied migrant health and normalization of malaise, which I explain in detail in Chapter 3. These mechanisms refer to how active and passive migrants deal with the effects of migration and how migrants interact with providers of 44

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health and migrant services. This study confirmed Achotegui’s observations that migrants are often misdiagnosed or not diagnosed at all (2009), mostly due to the combination of a banalization or disdain of symptoms (not only by service providers but also by migrants themselves) as well as a low level of awareness both in the medical and psychological professions and the public of the particularities of migrants’ health. The surveys that active and passive migrants took complemented the observations gathered through individual and group interviews. Our surveys included specific questions about migratory stress symptoms, as well as health status pre-​and post-​migration, and several other questions that I will raise in relation to corresponding health process and coping mechanisms later in the book. In what follows, I share descriptive statistical data collected on migratory stress symptoms that Ecuadorean research participants reported, pointing to variations depending on them being active (n=​97) or passive migrants (n=​125), and their destination.1 As a point of reference, I also present their reported health status pre-​migration and perceived health changes post-​migration. Overall, the statistics show that a very small minority of active migrants (1 per cent) and passive migrants (3.3 per cent) had poor health pre-​migration, confirming the well-​known healthy migrant effect, which highlighted the fact that an overwhelming majority of migrants decide to move away from their countries when they (and the relatives they leave behind) are in excellent or good health (Rubalcava et al 2008; Ullman et al 2011; Cabieses, 2014). This study’s dataset also shows that a majority of active migrants (59 per cent) perceived health changes post-​migration, in line with the hypothesis of the healthy but vulnerable migrant that underscored the link between the hardships associated with migrant life and the deterioration of their health (Lara et al 2005; Miranda et al 2005; Caplan, 2007; La Parra Casado et al 2007; Ríos-​Marín and Hernández-​Londoño, 2014). When focusing on the symptoms specifically, one can clearly see that in general terms, an average of 70 per cent of active migrant respondents reported having experienced crying, tension, insomnia, repetitive/​intrusive thoughts, irritability/​nervousness, fatigue, and body aches and pains frequently or sometimes as opposed to never; 50 per cent reported changes in appetite; and about 42 per cent reported the occurrence of nightmares and confusion/​ distraction frequently or sometimes as opposed to never. The four symptoms with the highest reporting of having been experienced frequently were insomnia, sadness, tension, and fatigue. The symptom with the highest combined positive reporting was sadness (82.5 per cent frequently or sometimes), and the only one with a particularly low reporting was suicidal thoughts (89.5 per cent never). Regarding passive migrants, the percentage of participants who reported health changes was much lower (22 per cent), which in this case could 45

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be explained by the young age of the respondents as well as the fact that only 38 per cent had a direct family member (parents, siblings, children, or spouse) abroad, and 54 per cent had relatives who had migrated 10–​20 years ago and 18 per cent more than 20 years ago. Despite the low percentage of health changes reported, three quarters of relatives experienced the symptom of sadness, and around half reported crying, tension, insomnia, fatigue, and confusion/​distraction frequently or sometimes. One third reported having nightmares, repetitive/​intrusive thoughts, and body aches and pains frequently or sometimes. About three quarters never experienced changes in appetite, and, like active migrants, a vast majority (89.2 per cent) never had suicidal thoughts. The symptom with the highest reporting of having been experienced frequently was sadness, followed by irritability and nervousness, tension, and repetitive and intrusive thoughts. Here it is important to keep in mind that all the personal and group interviews with relatives revealed critical psychological health changes that emerged due to their family members’ departure, which concurs with studies on this matter such as Ron Encalada (2010), Lu (2011), and Castillo Sanchez and Londono Gaoña (2013), to name a few. Crosstabulation of survey data with destination showed that where active migrants relocated influenced the way in which migration impacted their health and well-​being. For example, while the rates of excellent and good health status were extremely high for active migrants who went to the United States (95.3 per cent), Europe (100 per cent), and Latin America (100 per cent), destinations changed the proportion of migrants who reported health changes post-​migration. Migrants in the United States found the highest health impact at 81 per cent, followed by Latin America at 54.4 per cent, and then, Europe at 52.9 per cent. The individual and group interviews confirmed the additional hurdles attached to migration to the United States due to the restrictive migration policies (which resulted in more irregularities and laborers working without documentation in precarious and exploitative conditions), the discriminatory ethnic and racial social context, the high cost of living, the low levels of social protections and benefits, unaffordable healthcare, and the additional language and cultural barriers. All combined, these presented more arduous obstacles which usually prevented migrants from returning to visit or reuniting in the short or medium term; a fact that negatively impacted both active and passive migrants. Like Ramón expressed in a group interview when sharing his story: United States is hard. You are on your own. Even if you have relatives, everyone is busy, trying to make ends meet, and they don’t have time to help you. You end up working all the time, and it is never enough. Plus, the racism you end up finding everywhere, even from other Latin 46

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American migrants who ‘made it’ and think they are better than you. (Ramón, Group Interview # 6, Santo Domingo, 2017) The migratory experience in Europe (which for Ecuadoreans was mostly Spain, where language was usually not a barrier—​unless for children who attended school in places like Catalunya—​followed by Italy and a combination of a few countries in the continent) was also hard, but generally speaking, less strenuous in comparison to the United States given that migration involved a path to regularization, and social protections and benefits, including free access to healthcare, were available to migrants despite their status. These conditions eventually eased travel and family reunification, which positively impacted both active and passive migrants albeit only moderately because separation and migrant life were still difficult to sustain. In the words of Luis, a father who migrated for 12 years and visited his family back in Ecuador every three years, and his daughter, Camila: Father:

In my case, it was like a depression that hit me every time I visited, and I had to leave again. I had to take medication to be able to sleep. And at the weekend, I had to drink [alcohol] to fall asleep. When I was working, I was fine, but when I returned home, everything crumbled. Sometimes I ate. Sometimes I didn’t eat. I would feel hunger, but after two bites, my stomach closed and that was it, I couldn’t eat any more. In the mornings, I would wake up, make my lunch to take to work, but then, I wouldn’t even open it up. I would sleep. I would lose weight. I would get flu after flu. Sometimes I would feel so sleepy that I could not bear staying up during the day, at work. But then at night, I couldn’t fall asleep even if I was very tired. I would stay up, watching the time pass by 1, 2, 3, 4, 5, 5:30—​time to get up again. Every time I returned to Spain it would take me about two months to be able to have a good night’s sleep and feel fine.

Daughter:

When my father would leave and go back to Spain it was a total debacle. The goodbyes were very difficult. I would try to sustain my sister, who was more sensitive. She would get sick. My mother would also get sick. I always tried to be the strongest. Even my grandmother would be affected; she would not feel like eating anything. She would say to us, ‘If he comes, he should just stay. If not, 47

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he should leave forever.’ And I, who was already sad because of my dad’s departure, would feel even worse because I saw everyone around me feeling bad. … It was very hard. (Luis and Camila, Personal Interview of father and daughter, Loja, 2016) In the case of Latin America, the situation was mixed because the expected positive effects of cultural and language proximity, and availability of public services were counterbalanced with unstable economic and political environments (that led to uncertain migratory and reunification plans) as well as long-​standing nationalistic cultures that usually resulted in discriminatory behavior towards migrants. Raúl, an Ecuadorean active migrant to Colombia, stated this clearly: In the end, you leave your country to go next door, thinking it will be easier and better than going far away. You think it will be similar, you speak the same language, you share a history. But no. It is still very difficult. There is discrimination, and similar problems with corrupt governments and bad economies. (Raúl, Personal Interview, Cali, 2017) An important point of reference to contextualize the experiences collected specifically about Ecuadorean migrants is that both quantitative and qualitative data gathered about other Latin American migrants confirmed the observations presented here. Survey respondents also included active migrants in the United States and Spain from Colombia, Peru, Argentina, and in less quantity from Cuba, Venezuela, Bolivia, Chile, Brazil, and Uruguay—​referred here as ‘Other Latin American Countries’ (OLAC) (n=​129). Community workshop participants in New York and New Jersey included migrants from Dominican Republic, Cuba, Puerto Rico, Mexico, Guatemala, Honduras, El Salvador, Nicaragua, Venezuela, Colombia, Peru, Chile, Brazil, Paraguay, Argentina, besides Ecuador. Quantitative data about migratory stress symptoms generally showed similar statistical trends although there were also some differences to note. For example, all Latin American active migrants reported experiencing frequently or sometimes—​as opposed to never—​sadness (at least 90 per cent), crying (at least 68 per cent), tension (at least 73 per cent), and fatigue (at least 64 per cent). All respondents except Argentineans reported similar trends of insomnia to Ecuadoreans, with more than 60 per cent experiencing it frequently or sometimes (Argentineans were at the half point, with 50 per cent never). Nightmares were experienced frequently or sometimes at a higher rate by all other Latin American participants (averaging in the 60 per cent mark as opposed to Ecuadoreans’ 42 per cent). Regarding repetitive and intrusive thoughts, at least 60 per cent 48

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reported it frequently or sometimes in all cases except OLAC. A similar situation was found regarding the symptom of irritability and nervousness, with all at 70 per cent or higher frequently or sometimes, with the exception of OLAC (with 55 per cent). Regarding body aches and pains, at least 67 per cent of Ecuadorean, Peruvian, and Colombian participants reported them frequently or sometimes, as opposed to Argentinean and OLAC that presented 57 per cent and 46 per cent respectively. The exception to reporting confusion at higher rates frequently or sometimes was Colombian (68 per cent) while the rest of the countries had lower rates at an average of 42 per cent. Suicidal rates presented more relevant differences: Ecuadorean, Colombian, and Argentinean respondents had a similar proportion with about 90 per cent reporting never having suicidal thoughts, but Peruvian and OLAC had 72 per cent reporting never. The last symptom, changes in appetite, also showed some variation, with Peruvians reporting instability at 70 per cent, Colombians at 57 per cent, and Ecuadoreans at 51 per cent while on the contrary, 54 per cent of OLAC and 62 per cent of Argentineans reported stability. Community workshops including participatory activities addressing active and passive migrants’ health processes and psycho-​sociocultural coping mechanisms mirrored the Ecuadorean case. Gregorio, a Venezuelan active migrant made a comment that resonated with other workshop partakers: Of course, migration is stressful! And I’m not surprised that it didn’t matter so much if you went to Europe or the United States. In the end, the hardest part is to leave one’s country. The trauma to leave your past behind. Your family, your loved ones. Your language, your culture. It doesn’t matter how easy you may have it abroad, the pain that you feel from leaving is the same. I have relatives that went everywhere, and they all faced emotional, material, and health difficulties. (Gregorio, Community Workshop # 9, New York, 2019) Valentina, a Colombian migrant spoke about the hardships that her daughter suffered after she had migrated to the United States, and what occurred once they were reunited: My daughter and I were separated for three years. I came to New York, and she stayed with my mother and sister. My daughter would tell me that even if everything was all right, she missed me terribly and could not bear be away from me. It was very hard to be away from her for me as well. I was stressed and overtired from working all the time. I was about to sacrifice it all, and instead of waiting for our documents to migrate, I was ready to pay a coyote so we could be reunited sooner. Thank God I received the papers before I paid the coyotes. Then, 49

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I was able to travel and pick up my daughter to bring her with me to New York. However, despite that we were happy because we were finally back together, we were very sad because we missed our family and our country. Here, it is never the same as being home. (Valentina, Community Workshop # 11, New Jersey, 2019) Similarly, Pilar, a Peruvian workshop participant, shared: It was very difficult to leave my family behind in Peru. But I always pretend to be strong not to sadden my daughter and granddaughters. I don’t want that my husband sees me sad either. I had a very tough experience crossing the border. I witnessed death. I was raped. Other women in the group were raped as well. But we had to keep quiet to move on and had to do everything we could to make it across. After I was here in the US, I lived as if I were a prisoner. After looking for jobs and doing all kinds of random work, always minimally paid, I was able to start working as a live-​in nanny. I worked from 7 am to 11 pm. Non-​stop. I took care of two infants, cooked, cleaned, did the laundry, took the children for walks, played with them, changed their diapers, fed them, put them to nap and sleep at night. I didn’t have time to eat myself and had few hours to sleep because if the children woke up, I had to take care of them too. They paid me less than minimum wage even if that was illegal, and they never paid me overtime. I was exhausted and angry. I was doing my work right, and with love for the children, but still, I was mistreated by the parents. Even if I was very tired, I could not fall asleep at night. I felt like nothing made sense. I missed my family. I was irritated, sad, frustrated. I wanted everything to disappear. Me too. But I kept going for my children back in Peru. I sent every cent I could to them so they would have a better life. (Pilar, Community Workshop # 10, New York, 2019) As a whole, quantitative and qualitative data revealed the pervasiveness of migratory stress both in active and passive migrants, with variations but still constant in cases of regular and irregular migration, origin and destination, gender, age, and experiences pre-​, during, and post-​migration. The next health process to focus on is migrant crises triggers, which identifies what circumstances cause health difficulties in active and passive migrants, including those who seemed to have overcome reflective mourning, trauma and stress.

Migrant crises triggers Migrant crises triggers were conceptualized as life events that generate a crisis in active and/​or passive migrants that made them question their life 50

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conditions and future plans. These crises can occur at any point in time and can affect all migrants and relatives including those who seemed to have already overcome their reflective mourning process as well as their active or passive migrant trauma and migratory stress (see Figure 2.5). The events generating migrant crises can be endogenous and/​or exogenous to the family. Endogenous life events include school and college graduations, marriages and weddings, pregnancies, births, accidents, violent episodes, illnesses, and death of relatives. Exogenous incidents typically involve economic or political crises and policy changes affecting living conditions in either or both places of origin and destination such as social turmoil, violence and insecurity, unemployment, inflation, devaluations, and migration policies affecting residential, citizenship, repatriation, and deportation prospects. These events can trigger individual and relational Figure 2.5: Illustration of migrant crises triggers

51

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crises involving the emergence or re-​emergence of migratory stress symptoms in the depressive, anxious, cognitive, and somatic areas, which in some cases can lead to serious conditions if the crises are unresolved or untreated. Besides these health effects, the crises experienced by active and passive migrants typically involved existential questioning, weakening of self-​worth (usually due to overwhelming feelings of regret, remorse, and guilt), family conflict and separation, and the reassessment of life projects and change of plans (like deciding to reunite the family by either active migrants returning to the home country or passive migrants moving abroad). Research participants shared their experiences in individual and group interviews. For example, Ariel, an active migrant in the United States, expressed: Everything had been perfectly fine. I was doing great. Leaving everything behind had been difficult, but I found work and was able to help my family. It was a lot of effort, but I was satisfied. But then, many years later, my mother passed away and I could not travel in time for the funeral. I was devastated. I had not seen her in years. Nothing made sense any more. I fell into a severe depression. (Ariel, Community Workshop # 4, New York, 2017) Penelope, a passive migrant, stated: I don’t even remember if I felt bad or not when they left because I was too young. They tell me I was sad. I know that after, later, I was fine, I grew up loving my grandmother the most. But I also loved my parents even if they had left me back in Ecuador. But when I found out that my mother was pregnant and they decided to stay in Barcelona, I collapsed. I felt horrible. I didn’t want to go to school or eat. I was very, very angry. (Penelope, Personal Interview, Santo Domingo, 2017) The illness and passing of grandparents were also highly disturbing for active migrants, especially when they were not given an honest account of the situation and consequently, they found out too late and could not say their goodbyes in time. For example, Roque’s father did not tell him about his grandmother’s death, and Roque only learned of it by chance later via a cousin. Roque “was very upset” and ceased communication with his father for a while because he was “angry and hurt” (Roque, Group Interview # 4, Loja, 2017). Accidents were another common occurrence that triggered migrant crises. Natalia shared the experience of her husband Horacio, and how it affected the family: 52

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My husband wanted to return to Ecuador after he suffered a work accident. His arm was compromised. They had to give him 60 points. A piece of steel fell on him, and the machine crushed his hand. They could not operate on him in the small town where we lived so he had to be sent to Madrid. The firm where he worked at told him that if he had severed his arm, they could have compensated him for damages. Like I was saying, then, he fell into a depression. He had a lawyer from Spain, but he was being compelled to sign an agreement for him to quit without reparations. The doctors explained to him that his arm was going to stay like that, and that he was not going to be able to work doing the same type of job again because it required a strength that he was not going to recover. And besides that, he developed a hearing problem; he was like deaf. We had to talk to him very loudly! Things got even more complicated because a brother of his passed away. So, from desperation, he didn’t want to have anything else to do with Spain. He wanted to return. I insisted that he stay and fight in court because he could have won the trial and he could have obtained disability, but he didn’t want to deal with it anymore, and he signed his resignation and an official voluntary return to come back to Ecuador. (Natalia, Personal Interview, Loja, 2016) In the case of Fabián’s family, who had been able to successfully settle in Spain after serious hardships, their crisis was triggered by a sudden medical matter: My case was special because we were here in Ecuador to visit family when my wife had an ictus. Then, we extended our stay, but I had to return to Spain to continue working after two months. Once there, it wasn’t long until the [2008] crisis hit Spain. Anyway, I had to bring my wife to Spain because in Ecuador medical attention was very bad. I had my wife there for two, three years—​and she recovered very much. But she didn’t want anything else but to return to Ecuador. Then, I practically felt obligated to return. Our children had stayed in Ecuador after she had the incident. They did not want to be in Ecuador, and only wished they could be in Spain (they had moved with us to Spain when they were three and five years old, so they practically grew up there). It took them more than five years to get used to living in Ecuador, they felt it was deadly. (Fabián, Group Interview # 1, Loja, 2017) Other common experiences that triggered individual and family crises included the graduation of the children who had stayed behind, their marriage, and the birth of grandchildren. Nuria stated: 53

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My life didn’t make any more sense. My daughter graduated from college, got married, and was going to give birth to her first child, my only grandson. And me? Away? Missing out. I was depressed. And anxious. I had to rethink it all. I decided to migrate to be with my daughter and grandson. (Nuria, Personal Interview, New York, 2016) Exogenous life events also triggered migrant crises, the classic case as far as Ecuadorean migrants was concerned, as mentioned earlier in the case of Fabián, was the 2008 global financial crisis that hit Spain hard and left many unemployed. In the United States, the financial crisis was also severe, but in addition to economic repercussions, it gravely impacted on migratory policies—​similar to what occurred in the aftermath of 9/​11, and the election of Donald Trump as president in 2017—which led to not only a heightened anti-​migrant, xenophobic environment, but also an increase in deportation operations and various migration limitations against entry and family reunification, involving changes in local, state, and border policies of surveillance, detention, and punishment. For example, Jorge shared: After September 11, I recall the changes in migration policies and how it affected us. My father could not renew his driver’s license, and that affected the family the most because where we lived, we had to drive; it was not possible to live without a license. Before, tourists with a passport could get a license if they passed the driving test in New York. My parents then had been able to get their license legally and they still had it valid, but when it expired, and the law had changed they had to continue to drive with an expired license. Thank God that they had a car that they had bought before that law change and the insurance could be extended on the car if they paid because the company never asked for their renewed license. But, still, they were fearful to be driving with an expired license. They had to be always vigilant of the police and be very careful not to do a driving infraction. When I turned 16, I could not learn how to drive or apply for a license because we didn’t have the residence. But for work, my father really needed to drive because he worked in construction. First, when he had just arrived, he would go to the sidewalk in Main Street, where they would pick up workers for the day, but once he started to build a reputation because he was good at his job, he started to be hired independently, and he was being sought after. My mother worked taking care of children. They both paid taxes, but they never had to show an employment authorization. Still, they were always worried and scared that they would get in trouble, and we would be deported. The changes with 9/​11 brought a new source of stress to the family because even if we were doing 54

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fine at school, we had a new sister born in the US, my father was working well, and we were happy as a family, we were stressed that other new policy changes would be announced and that we would have to return or do something different to be able to stay here. (Jorge, Personal Interview, New Jersey, 2019) The world economic crisis of 2008 affected most countries although at different rates and times. Many Ecuadoreans who were in Spain or Italy, especially those who had already been there for several years and had achieved certain economic mobility, decided that it was a good time to return to Ecuador because by then, their country’s economy had grown and still seemed strong. In addition, there were appealing repatriation policies put in place with tax incentives, retirement plans, and social services. However, these policies were not implemented fully or smoothly, and soon after, Ecuador’s economy and political project started to crumble. Return migrants found themselves in worse situations than they had anticipated, including their own navigating of the return shock (which I will discuss later). The case of Yolanda’s parents illustrates this common experience: My parents had left because of the crisis here in Ecuador. They struggled in Spain but were able to persevere and stabilize economically. They were able to help us continue our education and go to college, they sent remittances and built a house here. Years later, they had to face another crisis, but in Spain, and they lost their jobs there. They could have tried to get unemployment benefits because they were residents. But instead, they thought it was like an opportunity to return. They had met their goals and had been missing us very much. Plus, back then, Correa [the President of Ecuador] here had programs to make return migration easier (they were promised tax and retirement benefits and other things). But when they returned, things were not exactly as promising and easy. They could not find jobs, and the services that were supposed to be available for return migrants didn’t really work. Also, here the economy started to get worse. My parents, and us, started to gain weight because we were all worried that we were doing bad economically, and that my father had not been able to make ends meet and overcome the problems, so he was losing everything that he had been able to amass. Instead of growing, the castle he had built up was falling. He was not doing or feeling well, and all these worries made him gain weight. (Yolanda, Group Interview # 4, Loja, 2017) In summary, active and passive migrants experienced crises that were caused by endogenous and/​or exogenous life events. The crises occurred at different points in their lives, on many occasions after they had overcome 55

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their processes of reflective mourning, migratory trauma, and migratory stress. Their economic and migratory status influenced their ability to act, especially if their way of dealing with the crises was to embark on return migration. However, they were not the main determinants of their capacity to overcome the crises, which instead was primarily based on their psychological and emotional individual and relational strength as well as their social and cultural capital and their skills to take advantage of it. All of these factors are connected to active and passive migrants’ resilience, which will be analyzed after the next section on return shock.

Return shock Defined as the stress and trauma resulting from familiar, sociocultural, political, and economic re-​adaptation that occurs when active migrants move back to their place of origin, return shock was a health process experienced by both returnees and the passive migrants with whom they reunified (see Figure 2.6). This health process could emerge in migrant families who deliberatively and consensually decided their return as well as in families who found themselves forced to return due to endogenous or exogenous crises, including health problems, unemployment, change in migratory or labor laws, and deportation. When the return was imposed, return shock was usually more taxing. However, many migrants whose return was voluntary traversed severe return shocks. The following cases illustrated how this health process was experienced by active and passive migrants. Figure 2.6: Illustration of return shock

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Graciela talked about the return of her husband, who had been away for 13 years trying to support his family financially: He had two accidents at work. He came back after the second one. And since he’s here, he has been depressed. He passes his time locked up, crying. He also had gotten sick—​his tonsils and kidneys. He feels migrating was a failure. My daughter suffered from his departure very much—​we had to find professional help for her. And my husband’s mother also suffered; she was very sad and started to get sick often. The family broke up, and he thinks it was all his fault. (Graciela, Personal Interview, Loja, 2016) Jazmín, who had migrated to Spain with her parents, and returned to Ecuador alone, to go to college, shared her story: Three years ago, I came back to Loja to study architecture because in Spain it is very expensive to get that degree, my sister was here (she had never migrated), and my parents were already thinking about returning. But they stayed working in Spain because we still don’t have much economic stability. And now I have the feeling that I think my sister must have had when she stayed here alone. Because I live alone and must cook, I have to do everything in the house, and architecture is a tough career, so … I don’t ever sleep, and to say the truth, sometimes, I don’t even eat. My sister tells my parents to return already. They ended up staying abroad 18 years! She tells them that we can make ends meet here, in a way or another … We want them to return because it is very difficult not to be able to share what’s happening to you with nobody, especially, your parents (Jazmín, Group Interview # 3, Loja, 2017). Rocío returned to Ecuador when she was 26 years old; she had migrated to Spain with her family when she was 13 years old because of a family debt due to the economic crisis which had led Ecuador to the dollarization policy, and returned because of economic reasons too: Spain was in crisis, my father lost his job, and I lost my job. We were forced to return because the money we had was not enough to make ends meet. My older brother stayed in Spain because he was married and had a son. Returning was hard. We had a house, which was good, but we had to fix it up, clean it, paint it, fix broken things. The first three months here I would plead with my father to go back to Spain. We had to sleep on the floor, we didn’t have any privacy because the rooms were filled with things. Our house was a mess, and I started 57

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to go out with a guy, but we fought, we had a bad relationship, it was deadly. I also was having problems because here they would not recognize my degree as nurse assistant, and I had to fight for them to validate it. I could not see the light at the end of the tunnel, so I would tell my father, ‘I am going back to Spain, here there is no future,’ I could not see any future. It was a real shock to come back. And for my younger brother it was even worse. He came here at 18 years old, and he was hoping he would be able to begin to study at the university. Also, he had left Ecuador when he was only four years old, so he was raised with another rhythm, a completely different lifestyle. It was a very heavy shock for him to come to live at this village. He tells me, ‘I will not live in a village. I need to live in a city, where you have more … where people are not watching every little thing that you do.’ For me it was difficult to adapt to the reserved culture that they have here. How can I explain myself? In the university, for example, I have a way of speaking that is very direct, straightforward, and here I had to eat my words and die of anger on my own because I cannot express myself openly. Also, here, my classmates are like children, I see them as children, very immature. I really ought to control myself. They are closed-​minded and dependent on their parents, even if they are old enough to be independent. For instance, there was a young woman who would not go on a trip nearby because her dad would not allow her to travel. The parents are very possessive, and the children don’t dare to confront them even if they are already adults. It is like they have not woken up. At the university, it was also shocking to find professors that have antiquated teaching methods, they are extremely strict and use severe punishment methods. The other problem is that men are very macho and in general, backward-​thinking. They think that by now I should be married, with children, and that has been quite depressing. Rocío also talked about how her father experienced the return shock: When we left for Spain, my father had a business here, a pharmacy. And like everyone else, he left a family member in charge of the business, because you trust them. He left my grandparents in charge. My grandfather always has been a womanizer, and he likes to pretend he has more than what he had, but with someone else’s money. Because of the crisis, the pharmacy was in debt, that’s why we went to Spain, to be able to save the business. But my grandfather was irresponsible with the finances of the pharmacy and made the problem even worse. So, when we returned, my dad was enthusiastic; 58

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he thought he could solve the conflict with his father, that he would become responsible and pay him back. But not, my grandfather rejected my father’s request. He said, ‘What you lent, is lent, I do not have any debts with you.’ Then, my father sued his parents, hoping this would bring his father to pay back the debt. But no, it didn’t work. He didn’t pay. He didn’t do anything. And now, everyone is mad at my father because he denounced them. And of course, my grandfather would not distinguish between my father and us, so he is mad with all of us. One time I called him to check in on them and see how they were doing because my grandmother was sick, and he told me that we were all dead for them. Later, my uncles and aunts also cut relationships with us because they had trouble with my brother. … So now, we have reached a point where we don’t care any more. Our doors are open, but we are not going to let ourselves be maltreated. Later in the interview Rocío described how after her return she felt sad, cried, didn’t feel like doing anything, didn’t feel she had the strength to go on, felt nervous or anxious, closed up and didn’t share her feelings to avoid exploding, had repetitive thoughts about the economy, and often wondered, “What would have been of my life if I had stayed or returned to Spain?” (Rocío, Personal Interview, Santo Domingo, 2016). Jackelyn commented that her family’s return to Ecuador was also shocking because: My father had difficulties—​he could not find a job at the beginning. He also had thought that here, with all that they were saying about the country doing great and the programs for returnees, he was going to be able to have a business or something. He came back full of expectations, believing that he was going to have plenty of opportunities. And now we have enough to be well, but for a while, it was a big slump. We had to change our lifestyle completely. In Spain we had gotten used to having more possibilities. For my parents, the return was like starting from zero, all over again. They didn’t know what to do or how to do it. That phase lasted a long time, and it was like, you come back with an idea and then, you had to change it all. And with no help. We are still struggling. Jackelyn also expressed that for her mother and herself it was also very shocking because they had gotten used to being in Spain, and all their friends were there: “We were sad to leave, and here we cried often, especially when we communicated with our friends there and started remembering. … My mother got depressed and had to take antidepressants” 59

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(Jackelyn, Personal Interview, Santo Domingo, 2016). Jackelyn, like Rocío, also found it very difficult adapting to the teaching style in Ecuador, coming from Barcelona. The experiences gathered through personal and group interviews about the shock that return migration produced in both active and passive migrants resonated with surveyed Ecuadorean migrants who reported on their relatives’ and their own health after coming back. On the one hand, 39 per cent of surveyed returnees reported undergoing health changes. On the other hand, 34.4 per cent of passive migrants reported that they observed that their returned relatives’ physical and mental health changed after coming back, and 29.4 per cent of passive migrants reported their own physical and mental health changing after their relatives returned. These descriptive statistics only point to the health aspect of return migration, which is only one portion of the conceptualized return shock. The qualitative personal and group interviews and community workshops provided additional texture to how return migration is experienced. The shock involves stress and trauma, but the symptoms are not always deciphered or experienced as health issues. The conversations with active and passive migrants, including return migrants, highlighted this very clearly: unless participants had endured concrete, frequent, or severe health problems, they would speak about the shock of their or their relatives’ return as anecdotal or worrisome, but not as a medical or psychological condition, especially when the obstacles that were identified as the cause of the tension were exogenous (economic hardship being the main example). Also, there was a tendency to underestimate the consequences of experiencing return shock, which was usually coded as part of the process of getting used to being back and reuniting with family and friends after several years of living abroad. This minimization was reflected in the way surveyed active and passive migrants responded to the questions about seeking professional assistance when their or their relatives’ health worsened post-​return. Of the return migrants whose health deteriorated, only 33 per cent sought medical or psychological attention, while in the case of the passive migrants whose own health worsened after their relatives’ return, it was even lower (6 per cent). The highest proportion was found in the case of return migrants who reunited with their families, with 83 per cent reporting to have looked for professional attention—​a situation one can deduce was due to the family’s pressure to see their relatives’ health taken care of. Other reasons why both active and passive migrants tended to play down return shock can be attributed to the fact that they had all endured reflective mourning, migratory stress, active or passive trauma, and migrant crises, so return shock was perceived as a familiar process. Moreover, by the time they had reached the point of return migration, both active and passive migrants had become more resilient than before 60

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to traverse the difficulties that may arise with this new phase in their lives, as will be explained next.

Unrecognized migratory resilience The last health process to be discussed in this chapter was related to the strength that migrants and relatives amassed as they went through the other very taxing health processes mentioned earlier, as well as the additional challenges related to economic, sociocultural, and psychological pressures associated with migrant life. Instead of simply signaling this as resilience (Turner and Simmons, 2006; Southwick et al 2014; Bourbeau, 2015), I conceptualized it as unrecognized migratory resilience because on the one hand, it has characteristics proper to the experience of being an active or passive migrant, and on the other hand, even if both active and passive migrants were clearly resilient, there was an overwhelming tendency for them not to perceive, own, or celebrate it. Thus, I defined it as the unnoticed strengthening that active and passive migrants experience due to having successfully overcome hardships or traumatic experiences related to migration processes (see Figure 2.7). The research showed that active and passive migrants in general were tenacious when faced with the challenges caused by migratory processes. They overcame difficult situations in their daily lives and strived to progress. In most cases, they achieved their goals, and frequently, they surpassed their own expectations. In the end, they became stronger after experiencing arduous or traumatic events related to migration. Psychologically speaking, they were resilient, they had “the ability to bend but not break, bounce back, and perhaps even grow in the event of adverse life experiences” and had made “a conscious effort to move forward in an insightful integrated positive manner as a result of lessons learned from an adverse experience” (Southwick et al 2014, 2, 3). However, both active and passive migrants did not necessarily view themselves as resilient. In some cases, they recognized that they had been able to resist and persevere but did not feel emboldened or took pride on it. In general, there was a feeling of an unbalanced sacrifice for what had been gained by the process, and a heightened sense of vulnerability and/​or instability. Like Jorge, who had endured and successfully overcome many taxing situations with his migrant family who had an irregular status in the United States for several years, expressed: If you asked which words described me, I do not think of strong or resilient … hmmm, instead I think of perseverant and creative, because I think that in order to be able to keep on going, one has to be creative in the way one … like, sometimes everyone is telling you, ‘No,’ so one has to find the way to keep on moving forward. Strong? Well, 61

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I guess … yes, but, no, I don’t really think of myself in that way. I think that it is very difficult to describe oneself as strong because one still has the feeling that everything can go right or not. … We live in such a delicate, vulnerable situation, that it is difficult for me to say, ‘Oh! I’m strong because I’m going to continue to keep up the struggle,’ because something can happen, something can go wrong, and so, no, I don’t feel that I am a strong person. Hopefully in the future I will. (Jorge, Personal Interview, New Jersey, 2019) The contradictory dynamic of being resilient but not acknowledging it was found in active and passive migrants independently from the degree of success they had achieved. That is, migratory resilience was overlooked and not considered as an asset by a continuum of migrants from those who were still struggling to make ends meet to those who had already Figure 2.7: Illustration of unrecognized migratory resilience

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secured economic stability and growth and reached or surpassed their goals of personal and familiar well-​being. The combination of systemic volatility (or the threat of such) both in the countries of origin and destination with the scars left by migration tamed active and passive migrants’ ability to cherish their resilience. Despite the fact that resilience was disregarded, migrants demonstrated an awareness of how they had managed to overcome the various challenges they had encountered along the way and persevere in their personal and family pursuit of improving their well-​being as active or passive migrants, or in other words, how they had traversed the “process to harness resources in order to sustain well-​being” and “a sense of hope that life does indeed make sense, despite chaos, brutality, stress, worry or despair” that is, how they had been resilient (Southwick et al 2014, 5, 6). Personal and group interviews and workshops revealed their resilience process; Leonardo, an active migrant who also had an irregular status for several years in the United States, for example, provided a detailed response: For me it was very important not to be pulled by urban legends: that is, when you are being told that you CANNOT, you should trust that actually, you CAN. That ‘Yes! There is a way to make it happen. If you are told NO, you must insist, insist, and insist because YES, there is possibility.’ Migrants cannot be led by the NO, because there is always a way to do it [his emphases]. We also must be positive and stay positive. … It’s important for us to look for support groups for practical things like health, rights, education, etc., as well as for personal and emotional issues. We should give value to ourselves. We must value ourselves to be able to do better emotionally, because if not, one lets oneself go down the pipe. One example of this is how much we are paid, because that is one of the things that depresses us. So, when we are told that we are worth nothing, we must be the ones telling them what we are really worth, and how much we should be paid for our labor! Also, when it comes to health: we should not wait until we are sick. We should prevent illnesses and be proactively caring about our health. We need to be open to receive help, especially psychological support. Personally, I was able to move forward because I had good friendships and good relatives (but, not all are supportive, so if they are not, don’t get close to them!) One must look for and select well one’s emotional and moral pillars because if not. … Until today I get people telling me, ‘No, you cannot do it now, you already missed out on this or that opportunity.’  But I have been always able to find the right person to tell me, ‘You are not like that, don’t give up, go on and ask around!’ And those people are the friends that one should count on. And even if you 63

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don’t have to fully avoid negative people, you should try not to see them too frequently—​I mean, don’t go out of your way to be with negative people! Not getting in touch frequently with negativity is key. And to be optimist is not the same as being naïve. One should learn from experiences; besides, one has to be forgiving and constructive instead of attaching to grudges. It is important to learn from disagreements and conflict. I have always tried to learn how to better explain myself and avoid getting offended or fixated in a particular way or attitude. Another thing has been not to look at things like a failure. Instead, look at the opportunity to change, to set goals, and think about how you will achieve them. I also have always relied on role models: my father was one, my mother another. Pillars, strong pillars of mine. They were not perfect, but that is to be a role model: despite not being perfect, having several things that inspire. It was also very beneficial to get involved in the community, do volunteer work. For example, I always worked cleaning houses, and with that, I was able to afford college. But, in the meantime, I volunteered and found new opportunities, met new people, networked. And the most important: know who you are, how you identify yourself. That way, they cannot frame you from outside. You need to know who you are and say it out loud, with your own history, you own stories, to back it up, to be able to express why you have that personality. (Leonardo, Personal Interview, New Jersey, 2019) Other migrants revealed resilience processes that were grounded solidly but in fewer aspects, many of which coincided with Leonardo’s, like reliance on key family members, establishing fruitful relationships with mentors in school or at work, and developing one’s autonomy and initiative while recreating and reaffirming one’s sense of self as well as the personal and/​or family life purpose. Cecilia was first a passive migrant after the departure of her father to the United States, her mother to another city in Ecuador, and later, her grandmother, who had raised her, to the United States as well; and then, at 13 she became a regular active migrant after her father obtained custody after the death of her mother. Cecilia reflected on her resilience process mirroring the experiences of many other young active migrants: I had learned since I was very little that if I behaved well, I had a house to live at, but if I misbehaved, I would not. This happened after I started to live with my mother again: because I had grown up with my grandmother since I was a baby, and I had always thought SHE was my mother [her emphasis]. Then, even if I knew that my mother was my real mother, I also knew that I had to earn her love; that I had to earn the love of those who were taking care of me. So, when I came 64

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to the United States, I was certain that I had to earn the affection of the people who were with me like to show them that I was worthy of staying with them—​maybe I had that in my mind because of the many times I had been through family changes. Then, at the beginning when I came to New York with my father, who I didn’t really know much, it was a shock to meet my stepmother (who I didn’t even know existed!) But I did my best to get along and be loving. When my stepmother got sick—​she had cancer—​I was practically the one who took care of her; I took her to all her appointments, to radiation, etc. because my father had to travel. And I did it because internally I had always known that I had to behave well. The experience drew us closer, and eventually, she became one of my main pillars here. But what really helped me get through the impact of moving out of Ecuador—​like, the first year was horrible: every day I would go to bed crying, uncontrollably, until 1, 2, 3 in the morning, until I felt asleep, and in like six months, I lost like 30 pounds; I missed my grandmother terribly and only wanted to be back in Ecuador; I felt … empty—​was school. The school was very, very bad, but there, I could take my mind off my problems. Also, a year later, I met a teacher who eventually became like a mother to me, she was my first mentor, and thanks to her I was able to move forward, finish school, and go to college. At 14 I also started to work, so I kept myself busy: I would be at school and stay until late doing extra-​curricular activities, and then, I would go to work so I would spend the least amount of time possible in my house. I also worked on the weekends. I liked distracting myself with things that were not my problems—​it was like not to put too much mind to my own issues … because how can I put it? In my head, I felt like there was a very dark side that I wanted to avoid, so to do that, I always felt that I had to focus on something else, in work or school. … Later, I did the same when I entered college, I would basically spend all day until late at night and the weekends studying or working out of the house. But, in any case, it was the help of mentors that helped me the most. My high school teacher was the one who made me realize that I was capable, that I was going to make it, that I could go to the university instead of a community college … that I could apply for a fellowship. She was the one who taught me that mentors are like tools in one’s toolbox. And I learned that if I was in a different environment, I had to look for someone who would help me become the best I could in that place. But I also learned that the relationship is mutual—​that is, is not just networking or name-​dropping—​it is building a relationship where I could really feel 100 per cent comfortable to ask for help. 65

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I also looked to build intimate relationships that would help me move forward. For example, my first boyfriend was the best student in my high school, so he helped me a lot. And in the university, I also had a boyfriend who was very dedicated; and now, my current boyfriend, who I met in law school, is also very hard-​working and helped me very much—​so, yes, I always saw my boyfriends in a good light, and that helped me move forward. I think it has been very important for me to study, that is, to immerse myself in what I love to do. And that is the key to move forward for us, migrants: to devote ourselves in the positive things that we like, whatever those are, studies, books, religion—​because I had many friends who got into things that were not positive and they cannot get out. My strategy was that, to focus 100 per cent in something positive. (Cecilia, Personal Interview, New York, 2018) Concentrating on studying was a common theme in the resilience process of young active migrants. Diana, whose parents migrated to the United States, where she was born, but later returned to Ecuador, and after a few years, decided to migrate again to the US, also focused on studying and utilized the strategy of spending time out of the house to avoid bad feelings: When we came back to the US, we moved to New Jersey, and there, in the school I went to, nobody spoke in Spanish and all instruction was in English. And I was scared because I was not used to having bad grades (in Ecuador, I was a top student!) So, having bad grades because of the language hurt me. I thought I was stupid! Before I was smart, and then, stupid! I wondered what had gone wrong with me! They even wanted to put me in a lower grade! And I would be like: ‘No, no, no—​if you put me back in 7th grade, I’ll move away!’ So, I insisted so much that they assigned me to an 8th grade class. Later, we moved to the Bronx and there, I went to a high school where I really felt very bad. There were other students who would make fun of me because I didn’t know English. I was bullied constantly. So, I refused to keep going to that high school—​I was very stubborn! If it’s no, is no! I found out that a friend of mine had gone to a high school that they were just opening that was called Bronx International High School and she loved it because it was only for migrant students who had been in the US for less than a yearlong, so they taught English while teaching every other subject. So, I switched to that high school and started to learn the language and do better at school because they didn’t punish us from not speaking well in English. Little by 66

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little I improved. Also, because we were migrants from all parts of the world, we spoke English among ourselves and helped one another too. Besides the school, what helped me a lot was to read. I had always loved reading! I used to go to the library and read the books for babies and toddlers to learn the language, and besides, I enjoyed reading them! Interviewer:

Did someone recommended you do that as a good learning strategy?

No! I figured it out on my own because I really loved reading. Another thing that helped me was that my little cousin would watch cartoons and there was one that he loved very much so he would see it again, again, and again. I learned all the songs by heart. I was also determined that I wanted to be able to be on my own, to be independent. … Then, I focused on school. A lot. Too much. I didn’t like to be at home so, I would be at school from the morning until the afternoon, then, go to after-​school programs and return around 9 or 10 pm and go straight to bed. I tried to be the least possible in the house. I didn’t like to be there. In one of the after-​school programs, I did a robotics course at Columbia University. … And I decided I wanted to be an engineer. I graduated high school as a valedictorian and went to college out of state. I went to Pennsylvania; I had a fellowship. And there, I started to study engineering from the very beginning. But it was a mistake! [laughs] The first years were very hard because there all other students came from private high schools or top suburban schools where they had taken AP [college level] calculus, physics, and chemistry, but I had not; I felt so stupid! After a year and a half of studying hard, I would not improve, so I decided to take some time off to restart. I went to community college classes in the interim spring and summer semesters to strengthen my foundations, and spent all my savings! I worked at a restaurant in the weekends. Then I returned to college to continue with my engineer degree, but I shifted focus because I had entered with the idea of doing electrical or mechanical engineering and decided to move on with civil engineering because since I had started the university, I had been part of a group called ‘Engineers Without Borders.’ We had gone to Honduras a few times to install a system for potable water. I worked translating at the beginning, but later, I helped design the system and became interested in civil projects because they had an impact in the community. … I earned a degree in Engineering Studies, and in my last semester, I started to work as an intern in Turner Construction, that is one of the largest 67

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construction companies in New York. (Diana, Personal Interview, New York, 2019) Active migrants who were passed their schooling years talked about focusing on work to not only meet their financial needs and goals, but also to find solace and distraction. Hugo, for example, stated: I worked all day and at night. I worked two jobs, and, I had a weekend gig. I needed the money, of course, to afford to live in New York, and I wanted to earn enough to pay the debt I had and help my family. But I also worked all the time because that was how I could keep myself busy and feel less the loneliness and sadness. Working that much helped me persevere, and get ahead economically and emotionally. (Hugo, Personal Interview, New York, 2019) Matías also shared his observations about overworking from his experiences as a business manager: There were people in the family business that were working about 80 or 90 hours per week. They were zombies. Really, you would look at them and you would see zombies. So, I decided to make a change because I had learned that the better quality of life the workers have, the higher their productivity. It was not healthy for them or the business. But, when I implemented the policy of less hours for the same pay, I found resistance. They were upset even if it was clear that they were not losing any money. I had workers calling me during their days off or the weekend and tell me: ‘I don’t know what to do, I never had a free day, I don’t know what to do with myself, I’m going crazy.’ And this was worse with workers who didn’t have a family. These were the ones who knew the less what to do with free time, because all their lives were focused on working. Their jobs were jobs and hobbies. Working was all for them, so when they had free time, they didn’t know what to do, and not having anything to do made them feel depressed. That’s when they started to be nostalgic, when they started to realize what was happening to them. And the workers who had families here, were also lost about their free time, it was like it was too late to reconnect with their children, who had been left alone systematically because they had been working, and working, and working. So, my proposal to reduce the number of work hours to improve their quality of life and ultimately, the business’ productivity was met with disapproval, resistance, and negativity. I realized that migrants build self-​employment, not business. That is, if they try creating their own 68

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business, they do it because they want to be self-​employed forever, not at someone else’s mercy. But they don’t realize that they can slow down and still be sound financially. Working is their way to feel useful. Working is the response to everything. And eventually, when they realize that they had spent so much time working that they don’t have any other way of living, it is sometimes too late. (Matías, Personal Interview, New York, 2019) Diana and Hugo’s experiences also point to another aspect of resilience processes that was usually mentioned, and led to the conceptualization of transgenerational goals, which I discuss extensively in the next chapter. Active migrants articulated clearly that one of their main motivations to strive to move forward was the “sacrifice” that their families had made for their “well-​being” (Jorge, Personal Interview, New Jersey, 2019); “the desire of returning to be with my family and enjoy life and the well-being we had created” (Luis and Camila, Personal Interview with father and daughter, 2016, Loja). Passive migrants, like Olivia, similarly stated: For us to put up with the challenges of being separated from our parents, we had to understand the sacrifice that they were making for all of us. Then it was important to give our parents the happiness that we were doing well, that we were growing up well, to be good people, good professionals, that we were going to build a home with values and principles. To strive for all of this, to accomplish this, helped us overcome the difficulties, forget the hardships of the past, and build a new life with better perspectives for the future. (Olivia, Group Interview # 4, Loja, 2017) Likewise, Lara, another passive migrant, expressed: First, we separated from our parents when we were 11 years old here in Ecuador, so we could study and go to school, and some years later, they migrated to Spain. It was very difficult, because we had to take care of everything on our own without our parents’ help. Phone calls were seldom—​it was not like they were calling us all the time—​and it was not the same than having them present, even if it were to help you to do your homework, go to the parent teacher conferences, or to care for you when you were sick. For us, when one of us got sick, we had to become the mom and take care of one another. But, like someone else said, those difficulties are ultimately surpassed. We had to adjust to that way of life because it was the only way we could move forward, because our parents could not leave their jobs either. And I think that in some way, also depending on the personality of each person, one 69

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becomes stronger, more responsible, and learns to value and make good decisions. … We were able to adapt to what happened by understanding that they were processes that would help us move forward, and now, we are who we are because we were able to face those circumstances. Now, that we can be with our parents again, we are simply making up for lost time. (Lara, Group Interview # 4, Loja, 2017) Brenda, a return migrant from Spain, elaborated on how they had been able to overcome the challenges they experienced as active migrants: I think what helped us all was that we had a fixed goal, so … we didn’t really have an alternative either because we had left and we were in debt, and no matter what, we had to work and move forward. So, I would observe, one is doing jobs that one does not like, that one never dreamt about, and says, ‘Well, then, this is it, and I have to do it, because I can, and I am worthy.’ And one must have the sense of being respectful of others and oneself. For me that was very important, doing the jobs I had to do respectfully, which helped others trust me, which in turn strengthen me because I would see that I was starting to be valued, and later, they started to recommend me as a good worker. So, we showed them that we were good people, responsible, good workers, that we were valuable people. That we were honest and trustworthy. These opened doors for us everywhere. (Brenda, Group Interview # 3, Loja, 2017) In line with Brenda, Gastón, who had also migrated to Spain and returned, said: “We learned very much. The good and the bad. But we had enough wisdom to make the right choices. And be respectful, and besides, do things well” (Gastón, Group Interview # 2, Loja, 2017), and Marco, who spent several years working all over Spain and had recently come back to Ecuador, emphasized, “One learns not to pretend to be someone who you are not. To be humble yet determined. To be honest and straightforward” (Marco, Group Interview # 6, Santo Domingo, 2017). Active and return migrants agreed that to move forward they had become aware of both their own cultural norms and habits (how these were perceived by others and how they matched or not with the dominant culture in the place of destination), and the ones from the place where they had migrated to. Some found this process of cultural learning and unlearning to be more conflictive and difficult than others, but all were conscious of the important role that it had in their own efforts to overcome the challenges of outward and return migration and advance their personal and family goals. For example, Simón who went to Spain and after several years returned to Ecuador, commented: 70

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We bring our culture with us, and sometimes, it is not appropriate. Here people think for instance that if they have a university degree, they are better than others, and they don’t bother to say hello to those they think are beneath them—​which is not what I encountered when I was in Spain, where I dealt with very rich and important people who were humble and simple. Or, for example, here in Ecuador the culture is very machista. But it is not the same in Spain, where feminism is stronger. And one has to learn from these differences to be better, to be respectful and respected, and to move forward, even if it is hard. (Simón, Group Interview # 2, Loja, 2017) Antonia, also a return migrant from Spain, agreed, stressing: “When we return, we come back with new ideas, with other fundamentals, and we clash with what we used to find acceptable, and people here are also shocked at our new habits and demands, so it is difficult to agree or be satisfied” (Antonia, Group Interview # 2, Loja, 2017). Several returnees were particularly dissatisfied with public officials who they found “disrespectful and dismissive of one’s needs” (Pamela, Group Interview # 1, Loja, 2017), and if they had children who returned to school, they expressed disappointment at how they had been mistreated by teachers: When we came back, it was a new challenge to get used to what was accepted as appropriate in school here. I had teachers here telling me that they didn’t want my children in their classes because they were too informal with them and questioned them. And I had to explain that their way of treating them was not a sign of disrespect but simply of habit—​that the way they were behaving was like it was in Spain—​and I assured them that my children were well educated and had good manners; that they were good students. I insisted that in the end, it’s the parents who teach the children to be good people, and that I guaranteed that they had been taught right. Some teachers understood, but others did not, and we were lucky that the worse teacher retired. I think teachers who have return migrant students have to be more sensitive to how hard it is for them to have migrated twice, forth and back! My children, despite the changes and the obstacles, persevered and did well in the end, but it was a big challenge. (Nancy, Group Interview # 2, Loja, 2017) Rocío, who was an active migrant in Spain where she went to high school, and had recently returned to Ecuador, shared: It is important to have space and time because it’s like you need it, you need it because every culture has its customs, and some way or another, 71

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even if one is Ecuadorean, one took the habits from there and it’s not the same. Here, I had to readapt to talk in a more respectful way, to regain sensibility towards people, not to be so straightforward. Because I am very direct, and I had gotten used to the customs from Spain, because I had spent all my youth there, and had gotten very used to the fact that there, you go ahead and say what you think, and you say it in a direct manner, I mean, you don’t go around the bushes. And of course, here, here, people get offended and upset, they take things the wrong way. So, yes, something that is very important to do is to take time for oneself to first, adapt to the place, and then, adapt when interacting with other people. In my case, first, I stayed home for a while, and got used to being in Ecuador with people who were closer to me, and later, I went out of the house. Because if you don’t do it that way, it’s impossible. I experienced exactly the opposite when I went to Spain. When I arrived, I started school right away, I moved in with my uncle and aunt who had a completely different lifestyle to ours because they had been living in Spain for a very long time. At school, I was like, ‘Where am I? What time zone am I in?’ I had a very bad time. I had it rough. (Rocío, Personal Interview, Santo Domingo, 2016) Ryan, who experienced return shock after spending several years in Spain, talked about how he overcame it: My family, uncles, and friends helped me integrate back. But it was difficult, especially in the beginning. I didn’t feel like doing anything; I was sad. But I would say to myself: ‘Come on! Enjoy! Be positive!’ At first, it didn’t work, but slowly it got better. I always considered myself as a strong person: like, I can be down or cry, but, right away, I tell myself: ‘Enough! Let’s see … I must get out of this. This should pass; I must move forward. Be positive.’ So, I look for something to do. I get distracted with something, somehow. I try not to think about what’s making me feel bad. And now, I’m super adapted. … Returning also helped me to realize that I needed to be more ambitious and less conformist. … In the end, from the hardships I took something positive. (Ryan, Personal Interview, Santo Domingo, 2016) Friendships were also relevant and commonly present in resilience processes of young active migrants. For example, Lesly told me: School helped me, and there, I met a friend. And I was with her like all the time. I would go to school, and then, I would go to her house, and there was her mother, and I would feel like she was like my mother, and I would see my friend as my sister. So, all of that made me feel 72

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better. And they also helped me stay in school; they encouraged me. That friendship helped me get out of the sadness I would feel when I was in my house. They were from Ecuador as well, from the same area, and they felt affection for me, the mother too, so I would feel good while I was with them. … I was also motivated to finish high school because that had been an ambition in my family, and even if my father was denigrating toward us, and his family never believed in my brothers and me, I would not fall down. Instead, I would get stronger to demonstrate to them that they were mistaken. My push was to show them that I was going to be able to persevere, do something good with my life or be somebody in this country. … I also looked for support outside my family, like with boyfriends, although that didn’t work well always. … Another outlet that helped me move forward was to get involved in church because there were people there who cared for me, even if they were not close, they still had an interest in my well-​being and that was helpful. (Lesly, Personal Interview, New York, 2019) And Luciano, a return migrant from Spain, said that: I was able to deal with the return primarily by making new friends. At first, I would stay inside my house, thinking (and missing) all my friends from Madrid. And if I had not managed to get out and meet new friends, I would have not been able to make it. So, I think it is very important to get out and explore, explore, explore. That’s why I chose to study Hospitality and Tourism, so I could travel and wander. … One ought to put a lot from oneself; one has to have the will to grow and adapt. … My parents had set their own goals, and their efforts, despite the sacrifices, paid off. I have never heard them say that they regret their decision to migrate. They were able to see other places and they had their moments. It is very important to know what one wants and to have an idea of how one will try to do that. One must keep on the fight, adapt when necessary, and push ahead. (Luciano, Personal Interview, Santo Domingo, 2017) When analyzing the resilience processes traversed by active and passive migrants, I found that based on their fundamental inner strength, they endured migratory trauma and stress by primarily being reflective about their past and current conditions and keeping in mind a clear and meaningful purpose that looked to the future. These allowed them to, on the one hand, identify challenges and find ways to overcome them, and on the other hand, reaffirm their sense of self and reasons to persevere. Family and community were critical loci, providing both positive and negative feedback into the process. Family could be the key element that would 73

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keep migrants animated and ready to persist through providing emotional support as well as social, cultural, and economic capital. When this occurred, shared family transgenerational goals worked as a guiding light. Contrarily, family could also be the source of conflict, discouragement, and discontent. Then, migrants tried to avoid contact or minimize interactions to keep away from abusive or toxic relationships. Similarly, people in the community could also be seen as fostering migrants’ growth by providing fair treatment, offering opportunities, encouragement, and support, or on the opposite end of the spectrum, detrimental to migrants’ development by being exploitative, discriminatory, minimizing, and demoralizing. Migrants would either seek the company and assistance of enabling community members or try to elude obstructive ones. Supportive community institutions and organizations were similarly approached or avoided, however, when it came to employers, active migrants were less able to simply eschew abuse, especially if their status was irregular. Nevertheless, they still strived to find better employers or labor situations that would promote their well-​being. One of the most typical practices for migrants to evade adverse feelings and situations was to concentrate on something else: younger migrants tended to focus on studying whereas older migrants devoted themselves to work. On many occasions, this shift of attention was done in a way that seemed extreme, but what could be taken as overcompensation only matched the pain and trouble that migrants were experiencing. This diversion aimed to escape malaise was based on their strong drive to survive. But the push beyond endurance, that is, migrants’ efforts to thrive, rested on their migratory purpose. In order to flourish, migrants’ reflexivity and relational and occupational intentionality was combined with personal, familiar, social, and cultural plasticity and resourcefulness. Migrants were flexible regarding their own selves as they adapted to circumstances that tested their character and preferences, so, without changing their core, they worked around contingencies. They also adjusted to family reconfigurations of various types, and socially and culturally, they learned and unlearned customs and norms of interaction. Altogether, migrants restored and fortified their self-​worth, regenerated their identity, and emboldened their life project; and despite the fact they didn’t view themselves as resilient, they clearly were. In sum, migration presented serious challenges which generated several health processes in active and passive migrants, including reflective mourning, active and passive migrant trauma, migratory stress, migrant crises triggers, and return shock. Active and passive migrants traversed these health processes in different ways according to the peculiarities of their migratory experiences. In many cases, they were able to persevere in their personal and family missions to progress. And they came out stronger. Many immigrants had identified how they had handled the hardships they encountered; however, 74

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they did not consider themselves to be resilient or thought of their own resilience as an asset. Some believed they had gathered enough strength to persist, but they thought that it was circumstantial, or “a normal part of being a migrant” (Ryan, Personal Interview, Santo Domingo, 2016). Hence, active and passive migrants tended to experience unrecognized migratory resilience as a concluding health process triggered by the multiple difficulties and related health processes of migration. In the following chapter, I explore specific psycho-​sociocultural mechanisms that active and passive migrants used to cope with the challenges generated by outward and return migration in general, some of which were particularly relevant to develop their unrecognized migratory resilience, such as the previously mentioned transgenerational goals, and others like motivating nostalgia, well-​being ideal, family de/​re-​construction, unspoken pacts, sensible comprehension, setting readjustment, and involuntary return rebound. I also investigate other mechanisms that influenced the fact that resilience went unnoticed or was not taken as an asset, such as paralyzing nostalgia, pain encapsulation, and normalization of malaise. These mechanisms, however, cannot explain on their own why migrants tended not to identify or value their resiliency. Personal and family histories, and structural factors also played a part, especially socioeconomic inequalities both in destination and origin (intersecting with race/​ethnicity and gender), and anti-​immigration contexts and policies abroad.

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Coping with the Challenges of Migration This chapter focuses on the 11 psycho-​sociocultural mechanisms that active and passive migrants utilized to cope with the effects of outward and return migration that were identified and conceptualized in our study of the Ecuadorean case in the context of other similar Latin American migratory processes. Disillusion adjustment, paralyzing nostalgia, motivating nostalgia, denied migrant health, normalization of malaise, pain encapsulation, well-​ being ideal, transgenerational goals, strategic return, settling readjustment, and involuntary return rebound are explained including significant portions of stories of health and migration shared by active and passive migrants in individual and group interviews and community workshops.

Disillusion adjustment Active migrants shared a common experience: the reality of living as a migrant abroad did not coincide with the ideas that they had before they left their country of origin. While in most cases, migrants expressed that they did not really have much information to begin with, they all shared that they wished they had been told a more complete picture about the hardships and sacrifices of migrant life, particularly by relatives and friends who had encouraged them to migrate. The gap between the information found and received, and the migrants’ own ideas about what their migratory experience was going to be like generated serious cracks in their migratory process and future perspectives. Hence, active migrants went through what I conceptualized as disillusion adjustment, that is, a process of adaptation to the reality of living as a migrant, which frequently differed from pre-​ departure expectations and projections. This process was one of the coping mechanisms that active migrants used to overcome challenging migration effects. A strategy allowing active migrants to persevere in their quest for survival that articulated personal histories and family dynamics with broader 76

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Figure 3.1: Illustration of disillusion adjustment

social structures and the political economy of inclusion and exclusion, both nationally and internationally (see Figure 3.1). For instance, Jorge, an active migrant who left Ecuador when he was a young child, shared his memories about the gap between what he had imagined and how things actually developed abroad: At the beginning, it was like an adventure to go to a different country. I remember asking my mother if the sky in the United States was the same sky that we had in Ecuador. Relatives and friends would ask with fascination how things were in the United States, especially in New York, like, how are the houses? How are the cars? And I liked the idea and the feeling that I was going to be in a place that was so special that everyone wanted to know about it. So, when I came to the US, I was happy. But then, I started school, and I still remember the first day there, which was in the middle of the academic year. I didn’t speak any English, my parents either and my brother, worse. So, I arrived at the school, walking up the stairs, lost, unable to find my classroom, without knowing how to communicate with anyone. I still remember the faces, the expressions of the students I met there first. It was so different from my experience in Ecuador. And I realized that my mother could not help me with school, because she didn’t know the language, and I was going to be on my own. Also, in Ecuador we had a very comfortable situation, my mother was a literature teacher and my father worked in a family business. 77

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Here, things were difficult, workwise, we did not have documents, we were scared and uncertain, and the economy was tight, my parents were struggling very much, but the medical reasons that brought us here were worth the sacrifice. So little by little, we adapted to the hard reality of being immigrants. (Jorge, Personal Interview, New Jersey, 2019) Carmen, a return migrant from Spain, shared her own thoughts about the difference between her ideas and the reality of living abroad: I left with the illusion of seeing another country, I had the illusion of meeting friends that were there, and who had told me that they were having an excellent time and that there were plenty of economic opportunities to do well. But reality is not like that. It is all the contrary. You work, but life is more expensive, and, in the end, you can save as much as you could in Ecuador. And you must adjust to finding that nothing is like you imagined or like you were told. (Carmen, Personal Interview, Loja, 2016) Luis, a return migrant, talked about this, too: I went to Spain because my friends told me that I was going to be able to work there, earn and save so my family could do better in Ecuador. So, at first, I left full of hope. But it was very hard. The Mother Land is not like they painted it to us. In reality, you won’t work at an office, there are jobs where the mud reaches all the way to your nostrils, and you are mistreated, even by your paisanos. But I still had to work and make it work out, and I put up with it all for the family. (Luis and Camila, Personal Interview of father and daughter, Loja, 2016) Despite disillusions, migrants adjusted and persevered. Several expressed that their experience taught them a lesson that they wanted to share with people who were considering migrating so they would be better prepared. Norma, a return migrant from Spain, summarized this common feeling: I wouldn’t dare to tell anyone not to migrate. Because not all is bad when one leaves. But I would tell them that they should look for information about the place where they’re going, and to be conscious, because one should not go a lo tonto [blindly], because all of us left blindly because we were being told pretty things about Spain. So, I would tell people who are thinking about leaving the country that they should look for information, think very well about what they’re 78

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about to do, and about what they already have. Because everything has a risk. Even more when one has a family. They need to think deeply about the consequences of breaking the family apart, to think if it’s worth the effort to leave or if it’s better to stay and give your all here, together with the family. (Norma, Group Interview # 5, Loja, 2017) The process of adjustment to the disenchantment felt after arrival was a fundamental mechanism for active migrants to persevere in their attempt to make their migratory venture work. If they succumbed to the sensation of having been cheated by relatives or friends’ stories about how easy and beneficial migrating was, they would have been trapped in anger and resentment, which would have hindered their efforts to succeed. Success, for most, meant being able to find work and earn a living that would allow them to send remittances back home, for their relatives. Alternatively, it meant being able to earn enough money to make ends meet and start saving so they could bring their relatives and reunify abroad. Last, in the rarer cases of active migrants without any family ties, success meant again, earning a living and having a prosperous economic life abroad to be able to settle in the future comfortably. In all cases, overcoming the impact of meeting a very different, harsher reality as an active migrant represented the bridge which would enable them to move forward.

Paralyzing and motivating nostalgia Nostalgia worked in two distinct ways for active migrants: some found it energizing, others counterproductive. Intimately associated with reflective mourning, longing for families, communities, and cultures left behind was common, even if migrants had left their home countries in conflictive terms. Controlling the effects of nostalgia was also linked to overcoming the migratory grief process, and usually, active migrants who had gotten over mourning, either pushed nostalgic sentiments to the back of their minds or transformed them into motivating feelings that projected them to a future that usually involved returning after accomplishing their migratory goals. On the contrary, when nostalgia took over, active migrants felt unable to move on and get over the grief of departing. These feelings had a paralyzing effect, as if migrants were stuck and could not forge ahead, even if they may have been able to start working and slowly begin to achieve their migratory goals. In general, active migrants with paralyzing nostalgia did not overcome their migratory mourning process and felt out of place at their destination. In some cases, paralyzing nostalgia was found in migrants who had spent many years abroad and even if they longed for their past, they were not actively doing things to go back or regain it somehow. One can think of the 79

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Figure 3.2: Illustration of paralyzing nostalgia

freezing effect of nostalgia as a process that holds people in place or pauses their development (see Figure 3.2). In contrast, motivating nostalgia pushed people forward and gave them the strength to carry on despite the odds (see Figure 3.3). When active migrants communicated with their relatives back home, they found solace and hope if they felt motivating nostalgia; however, they felt sorrowful and believed to be sinking if they felt paralyzing nostalgia to the point that sometimes they minimized communication or ceased it altogether to avoid those bleak sensations. In some cases, the paralyzing nostalgia was so strong that the only way out was to return. Motivating nostalgia articulated positively with migratory resilience, while paralyzing nostalgia paired negatively. The words of Benjamín, a Cuban active migrant in Spain, clearly reflect the experiencing of paralyzing nostalgia: To me, it was like I was still there. Here, but there. I could not stop thinking about my family, my country; I didn’t like it here. It was different. Difficult. And back home it was difficult too, that’s why I left, but at least it was home. Not like here. I started to work, of course, as soon as I could. But I could not stand it here. Still, I had to adapt, and couldn’t return for 12 years. I feel like those years, I was just on survival mode. I was able to survive. Sure. But nothing else. It was like time had stopped. Like my feelings had stopped. (Benjamín, Community Workshop # 5, New York, 2017) 80

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Figure 3.3: Illustration of motivating nostalgia

Rafael also experienced paralyzing nostalgia as an active migrant in Europe, in his words: I would cry and think about Ecuador. I wanted to return. It was very sad. It took me about three months to get a job. I had left my children and wife behind. It was very difficult. I didn’t understand much of what was going on and what I had to do, I had to learn a lot. I missed my family and Ecuador. I only wanted to go back. I didn’t want to have anything to do with being a migrant. (Rafael, Group Interview # 3, Loja, 2017) Paula also experienced these paralyzing feelings: “every night I would close my eyes and ask God ‘Make it so tomorrow I wake up laying in my own bedroom back home,’ but I would open my eyes and nothing, I was still in Spain. So, I cried, and cried. I suffered very much” (Paula, Personal Interview, Loja, 2016). In contrast, Soledad, a Colombian active migrant in the United States who migrated on her own, leaving her daughter behind, explained how she felt motivating nostalgia: To me, all I was doing made sense because I was going to return and live calmly, with my daughter, enjoying the breeze of the ocean, good weather, simple life. I missed my homeland terribly, but it

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was the certainty that I was going to make it and come back that helped me overcome all the adversities. I knew I wanted to be back home, with my daughter, and that my present was just a difficult phase that was going to pass. My mother was taking good care of her, and I was soon to return. (Soledad, Community Workshop # 6, New York, 2018) Alejandra, an active migrant from Argentina in the United States for several years, expressed how her motivating nostalgia framed her experience and return: Despite difficulties, I enjoyed being here, I was able to have a good life. But I always kept in touch with my people, my country, and my culture, and I knew that sooner or later, I was going to return. When it was time to retire, I felt at peace with my time abroad and decided to fulfill my dream of going back home. This dream helped me move forward with a positive disposition, even when I fell sick. Being nostalgic was tricky sometimes, but it worked for me because it grounded me and assured me that I was going to go back. (Alejandra, Community Workshop # 5, New York, 2017) Correspondingly, Julia explained how her nostalgia motivated her to endure the challenges of being an active migrant, and how she felt after being able to return to her family in her home country: What gave me strength was that I was going to return home, to be with my family all together, that I was going to be able to have a place to be without worries or concerns, calm. And when I returned, I was happy. Now, that I’ve been back, I say, ‘I prefer a thousand times to be here, relaxed, in my home, no matter how modest or rural, over being there, in a big city without my culture, my food or my family.’ (Julia, Community Workshop # 3, Vicinities of Cuenca, 2017) Nostalgia was indeed a double-​edge sword, and several active migrants expressed traversing different phases in their lives experiencing nostalgia in a paralyzing and a motivating manner. These shifts usually echoed either their reflective mourning process, migratory stress, trauma or crises. The ability to deal with the negative effects of paralyzing nostalgia was affected by the migrants’ trauma and internal degree of resilience as well as external factors such as economic and sociopolitical conditions both in the country of origin and abroad.

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Denied migrant health and normalization of malaise One of the most common mechanisms that active and passive migrants utilized was to deny that they had any health changes or problems and that these were somehow related to migration. Neglecting health changes resulted in a lack of or a delay in treatment, which tended to have negative health effects, depending on the severity of the health condition that was developed (see Figure 3.4). While in some cases this denial was related to having an irregular migratory status and scarce information about how to access health services (which in Spain were open to all, and in the United States were limited, but still available), in most cases ignoring health problems was actually related to either an insistence that they were doing well or that they were able to get through it on their own because they had to persevere to achieve their migratory goals. They perceived health changes as a nuisance, a barrier to their migratory mission. In other words, if they were the ones in charge of making the migratory plans work out, they could not afford to be sick—​they had to be strong and keep going. Passive migrants, who felt they were “on the rear end of the equation” (Frida, Group Interview # 4, Loja, 2017), tended to dismiss their health changes as they considered them unjustifiable given that they felt that they were not the ones sacrificing the most; active migrants were. They usually preferred to ignore any changes to avoid causing their migrating relatives abroad to worry, as they were already going through a difficult period. Last, and similarly to active migrants, they Figure 3.4: Illustration of denied migrant health

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resisted associating their own health changes to migration, even if a vast majority admitted knowing that migration could affect the physical and mental health of active and passive migrants; a contradiction that came out in surveys, individual and group interviews. For example, the survey question “Have you perceived changes in your health since you migrated?” yielded a positive response in 48 per cent of all active migrants and 22 per cent of passive migrants. However, of all the participants who responded negatively to that questions, only 18.5 per cent of active migrants and 45 per cent of passive migrants confirmed “Never feeling poorly, weak or sick” in a follow-​up question, and responded positively to detailed questions about “What did you do when you felt poorly, weak or sick?” including visiting a doctor or physician, going to the Emergency Room, talking to family, friends, and acquaintances, and waiting for their illness to go away on its own. The latter course of action (“When I felt poorly, weak or sick, I didn’t do anything, I waited until it passed”) was indeed the third most frequent response for both active and passive migrants, independent of their access to healthcare, as shown in Figure 3.5. Leonardo’s way of talking about his family’s health experiences illustrates one of the typical manners in which active migrants denied having health issues: Luckily, my mother and I never had major health issues. So, it was not a problem that we didn’t have insurance … [Leonardo stays quiet for a while] Ah! Wait, I’m thinking. … Yes, I did have a problem! I had to have surgery for two abdominal hernias. And my mom, well, she had thyroid problems that worsened first with the stress of being here, and later, with my father’s disease and passing. (Leonardo, Personal Interview, New Jersey, 2019) Even if Leonardo’s and his mother’s health problems were treated at a hospital that provided Charity Care for people who didn’t have insurance or means of paying the entire cost of the interventions and treatments, he had blocked them from his memory. Moreover, while he associated his mother’s health with the stress of migrating (like he associated his father’s illness to migration as well, as explained in Chapter 2), he did not think his own hernias were related to migratory stress although he had clearly articulated how difficult his reflective mourning, migratory stress and trauma were. Another example of migrant health denial is manifested in the experience of Nilda, an active migrant in Spain, where she had free access to healthcare, but she was not aware of how the system worked. She shared: I got pregnant but didn’t go for a checkup until I was about five months advanced. The gynecologist, very alarmed at my lack of care, asked me why I had not gone to a health center before, adding that 84

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they were available and free of cost for everybody all over Spain. But I didn’t know! And I was scared I would get deported! While pregnant, Nilda and her husband lived precariously, with limited income, poor nutrition, and unstable housing arrangements. “Fortunately,” Nilda’s son “was born healthy” (Nilda, Group Interview # 3, Loja, 2017). However, she suffered from severe postpartum depression and had other health complications that put her own life at risk partly due to not prioritizing her health while pregnant. Paula also had some health issues while pregnant in Spain. She shared: I migrated to Spain when I was two months pregnant. I worked during my pregnancy. Everything was fine. I had healthcare there. I found very nice people. I did monthly checkups. I had minor issues, but it all went well. My son was born with a bread under his arm [brought fortune and happiness]. I had to stay hospitalized for 15 days after, but everything went well. (Paula, Personal Interview, Loja, 2016) While Paula first introduced her health condition positively and minimized the trouble she had, later in the interview she mentioned that she had toxoplasmosis and depression. Two serious health problems that deserve treatment: Paula’s toxoplasmosis was treated, but her depression was not. In both cases, Paula processed them as common conditions. Manuel’s experience also refers to fear, although in his case it was due to him being an irregular active migrant in the United States, as well as the language barriers: If we had a toothache, we waited it out. We waited as much as we could until we could not bear the pain any longer. We didn’t know how to express that we had a toothache and were scared to go to a clinic. If we had a belly ache, like, I had an ulcer, we would not dare go to the health center. We were fearful, will we be deported? Will we be understood? Could we afford it? We didn’t even want to go to the pharmacy because we couldn’t understand the labels of the medicines. (Manuel, Group Interview #3, Loja, 2017) Ignacio’s comment ties lack of information, fear, and language barriers to health denial; he had migratory experiences in Brazil and Canada, two places where he didn’t know the language, being a native Spanish speaker from Ecuador: It is difficult. With health matters, for instance, even if one has insurance, one doesn’t know where to go to or how to ask for help 85

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Figure 3.5: Survey data on ‘What did you do when you felt poorly, weak, or sick?’ 47%

23%

23%

20%

18% 19% 9% 5%

4%

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Visited a doctor or Went to the Talked to relatives, physician Emergency Room friends, or acquaintances

Did nothing, I waited until it passed

Consulted the Internet

Active migrants

7%

4%

Visited a psychologist

Passive migrants

2%

2%

Visited a spiritual counselor (shaman, priest, pastor)

3%

2%

Consulted with a nurse

1%

0%

Visited an organization assisting migrants

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22%

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or express oneself to be understood, especially if there’s a language barrier. One doesn’t know how to access a hospital, or one may be a little resistant too, because here, in one way or another, one can go and tell someone how one feels, but there, one doesn’t know how to say things or is fearful that they won’t understand. The cost is also different and how to access medicines. So, what I did, was to wait it out. (Ignacio, Group Interview #4, Loja, 2017) Romina talked about her parents’ experience of health denial and how it affected them upon their return to Ecuador: In Spain, my parents had jobs that were physically very demanding. They also worked outdoors in hard climates. While they did these, they never complained. But now, that they returned, they express their pain. For my mother, hands, and chest, for my father, knees. It’s the consequence of years of hard work and the denial of caring for themselves. They didn’t want to lose time, they took it as part of their job, their responsibility, their effort to make ends meet and achieve their migratory goals. (Romina, Group Interview # 4, Loja, 2017) Unlike Romina who recognized her parents’ health denial, it was also common to hear passive migrants referring to their migrant relatives’ health positively. Affirmations like “No, my relatives did great. They didn’t have any health problems” or “They were fine, nothing happened to them” were the most typical response to the interview question about migrant relatives’ health. However, these affirmations were later contradicted when passive migrants started to list the various health conditions endured by their relatives. For example, when Clara talked about her uncles, first she stated, “In Spain, my uncles didn’t suffer. They found work and did well,” but later in the interview, she shared more information about her uncles’ experiences: But there, in Spain, everything is hard, and there is not much love, so immigrants must fend for themselves, and they become tough. One of my uncles, the one who was married, had some illnesses. The son had cancer, and the wife had a facial paralysis. They suffered a lot, their economy too. And my other uncle had an accident at work. One of his fingers was cut off. But there, the medicine is so good, the science is so advanced, that they did surgery and took one of his toes to replace the finger, and they say he is fine, and that he’s been able to work without any problems. The other uncle of mine is doing fine, he’s been working well. But he fell in love with a woman, and they are not doing well. That affected him very much. He was very sad.

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I think that because he was already sad, he puts up with the trouble that his girlfriend’s family gives him—​they treat him like if he were a workhorse—​because he doesn’t want to be alone. (Etelvina and Clara, Personal Interview of mother and daughter, Loja, 2016) Passive migrants’ denial of their relatives’ health problems is also illustrated by Paula’s response about her brother’s experience: Interviewer: Paula:

How was your brother’s experience in Spain? Did something happen to him? No, no, no, no. I mean, yes, he suffered with his emotional state, but not with his health. But the last time he came back to visit, he came like this [gesture indicating obesity]. He was very fat. I talked with him to convince him to do a medical checkup. I offered to him to do it here in the hospital in Loja. But he didn’t want to. In the end, he did it when he was back in Spain. And they found everything: diabetes, hypertension, cholesterol … he has it all. And he’s only in his forties! He developed these problems there, in Spain. He works a lot, too much. He doesn’t sleep. (Paula, Personal Interview, Loja, 2016)

Similarly, Camila talked about his father’s experiences abroad: “He had a work accident. But nothing serious. He had the flu, some body aches from work and nostalgia. The climate there was like ours, so that made him very nostalgic. But he was fine.” Camila’s presentation of Luis’ health problems edged in denial because later in the interview, when Luis was talking about that accident, he explained that a motor blade had cut his forehead and that the seriousness of it made him decide to return to Ecuador. Moreover, Luis, who insisted, like his daughter, that he “didn’t have health problems,” shared that he had suffered “depression, insomnia, fatigue, diet changes, lack of appetite, and a total deterioration” due to migration (Luis and Camila, Personal Interview of father and daughter, Loja, 2016). Usually, health denial generated what I conceptualized as the normalization of malaise, that is, the understanding of health problems as intrinsic to the migratory condition resulting in their minimization and thus, mistreatment. The normalization of malaise was a mechanism used typically by both active and passive migrants again independently from their access to healthcare. By believing that it was common to suffer as a migrant, they minimized their ill health to focus their attention on other matters so they could go on with their daily lives and, more importantly in their own view, continue to pursue their migratory goals (see Figure 3.6). 88

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Figure 3.6: Illustration of normalization of malaise

Similar to denied migrant health, this mechanism was a double-​edged sword that provided positive outcomes in the short run (allowing migrants to continue to make progress) but usually led to negative outcomes in the mid and long run, especially with regard to health because it resulted in the lack of treatment of health conditions that if left unattended could develop into major health problems and/​or chronic diseases or could result in the signs of other (potentially asymptomatic) health issues being missed. Active and passive migrants’ assessment of illness did not center on health, but rather on the overall well-​being of the family in line with the mechanism I conceptualized as transgenerational goals (to be discussed in depth later in this chapter). Put simply, if normalizing one’s malaise allowed for the family to advance toward reaching their migratory goals, then, it was believed to be a beneficial action. Only on some occasions, when their ill health 89

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Table 3.1: Typical health conditions of normalized malaise General normalized health developments

Specific normalized health conditions

Health instability

Physical weakness, fatigue, body aches, muscular pain, joint pain, arthritis, back pain, migraine

Poor health

Respiratory problems, chronic allergies, frequent throat ache, recurrent colds, periodic flu

Health deterioration Gastritis, colitis, constipation, stomach ache, ulcers Diabetes, high blood pressure, accelerated heart rate, increased cholesterol, hormonal imbalances, menstrual abnormalities, appetite, and/or weight changes Acne, skin rashes, alopecia, varicosis Mood swings, frequent crises, emotional decay, nervousness, anxiety, insomnia, constant sadness, anguish, depression Source: author’s own elaboration

developed into acute, critical, or life-​threatening diseases, did active and passive migrants regret having normalized their malaise. The combination of transnational need with transgenerational purpose led a vast majority of active and passive migrants to employ this mechanism regardless of the negative consequences it would have on them in the future. In surveys, interviews, and workshops, active and passive migrants usually stated that their health was fine, except for “normal” things, which once asked to elaborate, they included a vast list of conditions that were left unattended. In Table 3.1, I present in groups the kind of health conditions that migrants assumed to be normal and point that general health instability, deterioration, and poor health were taken as typical developments and systematically overlooked. Most active and passive migrants who employed this mechanism to normalize their ill health tended to have experienced a set of conditions, but of course, not all of them; and usually underwent them at different points for long periods of time. For example, they suffered from insomnia and depression first, and later experienced hormonal imbalances, joint pain and/​or respiratory problems. If these conditions didn’t prevent them from continuing with their daily chores, they denied them at first, and later incorporated them as normal. On the contrary, they were impelled to attend to them if they became so incapacitating that they could not go on with their responsibilities. Pushing themselves to their limit complicated their health condition, which in the end proved counterproductive. However, migrants had the tendency to keep on 90

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going, carrying their ill health like a backpack while they pressed forward to survive and tried to meet their family migratory goals. This process did not reveal a lack of long-​term perspective, but a tendency to shift to a survival mode and focus on group and transgenerational needs over present, personal well-​being. In other words, migrants preferred to push their health boundaries so they could be self-​sufficient and/​or productive enough not to disappoint or counter their family’s efforts and plans and, if in charge, to provide for their family and generate the means for them to advance even if that meant sacrificing their own personal future. It was a bet. And they trusted the outcome would in the end be positive. Moreover, it showed the challenges of being a migrant worker abroad and migrants’ realistic understanding that if they could, they needed to put work before their personal, current well-​being, in order to earn an income (which secured the transnational and transgenerational well-​ being of the family in the short term, as a minimum, and expectedly, in the medium term). For instance, Etelvina shared what her husband, Armando, who was in the United States as a migrant and overstayed his visa because they were economically broken in Ecuador and things were not improving, would say to her: As migrants here, if we don’t work, we don’t eat. Even if I am ill, I must work. If I don’t, I lose my position and I won’t be able to send money back home and our daughters won’t be able to study and advance their lives. Here being sick is forbidden, but what matters is that our daughters make it as professionals in the future and have a good life. (Etelvina and Clara, Personal Interview of mother and daughter, Loja, 2016) Similarly, Myriam, who was a regular migrant in Spain, expressed that: The only thing we did was work. Work all the time. And save. Save to pay the debt, save to send money back to Ecuador, save so we could eventually return to Ecuador. If we didn’t feel well, we didn’t care, we kept on working. We kept on going because we had our set goal that in the end was harder to reach than what we had anticipated. And we were convinced that if we kept on making the effort, we would make it. (Myriam, Group interview # 4, Loja, 2017) Matías, a regular migrant in the United States, who had a prosperous economic situation, also shared a similar dynamic: We didn’t stop working. We worked all the time, every day, and didn’t spend family time any more. All to make the money that we needed 91

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in theory. And the cost of doing this was our health and well-​being. But we denied that while we were busy working. We believed that it was fine, we didn’t notice it or pay attention to it, but we had resigned having time to rest, to exercise, to take care of our bodies. We gained weight, we didn’t sleep well or enough. We started to have family conflicts too. But we only focused on our work and the money and how this would help us in the future. Eventually, I realized this was not OK. I started to observe other migrants who had been doing the same for many, many years and now, that they had the means, they didn’t have the health to enjoy the fruit of their sacrifice; they were sick, depressed; they had lost trust in others, were phobic and angry. Migrants sacrifice it all for the family and the future, and in the process, they lose sight of the present and themselves. (Matías, Personal Interview, New York, 2019) Passive migrant Cristina shared a similar perspective based on her sister’s experience: “She left, worked, sacrificed, saved, helped her family here, sent money, returned. But now she has a series of health problems she neglected to attend for years and is also dealing with her daughter’s detachment” (Cristina, Community Workshop # 2, Vicinities of Cuenca, 2017). And Lara, a passive migrant, reflected: What happened to us was because we felt the absence of our parents while they were abroad. But we knew why they had sacrificed, and we did not want to create another worry for them. We adapted to the idea that anything that happened was normal, that these were all normal processes that we had to overcome to move forward. (Lara, Group Interview # 4, Loja, 2017) In the case of passive and active migrants who were not yet in the position of working and becoming providers, mainly minors, their behavior was mostly the product of their conscious effort not to disturb their parents’ decisions and plans. For example, Cecilia, who was first a passive and later an active migrant, explained: I never sought any help, personal or professional. I went through it on my own. I simply thought it was normal. And, since I was a small child, I had learned that I had to behave well and meet my family’s expectations if I were to be loved by them. So even if I had lost my appetite and spent every night crying for at least one year after I had joined my father in the US, I never bothered anybody, I would get up early in the morning and leave for school on my own. And I did everything I could to be the best student—​I would stay after school 92

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to improve my English so I could do better at school. I knew I could not become a burden. I had to do fine and be supportive of my father and my stepmother. It did not matter that I was not given a choice, or that I had not seen my father in years, or that I didn’t even know he had remarried, or that my father prevented me from communicating with my grandmother in Ecuador so I wouldn’t miss her more. I had in mind the clear idea that I had to show them that I was worthy to stay with them. (Cecilia, Personal Interview, New York, 2018) In hindsight, then, active and passive migrants realized the negative consequences of having denied their health and normalized their ill health. However, in the present moment, they were positive about their need to do so to make ends meet and/or accomplish their long-​term group goals. There were of course, certain health problems that both active and passive migrants could not neglect or deny. Serious work accidents, severe alcohol and drug abuse, cancer, and other critical illnesses, such as cardiovascular and cerebral vascular accidents, epilepsy, and amyotrophic lateral sclerosis (ALS), that required urgent surgery or hospitalization, and grave psychological problems like clinical depression, bipolar disorders, and suicide attempts, were automatically recognized as health problems, and migrants sought treatment accordingly within their means. These conditions usually led migrants to reconsider their choices and lifestyle, and, on many occasions, they became the reason for alterations to their migratory plans, including returning to their home countries or ensuring a way to be reunified with their relatives (as elaborated in Chapter 2, on migratory crises triggers, and as I will explore later in this chapter in the section on strategic return). However, in these circumstances, both active and passive migrants continued to have a family perspective and a long-​term view of their efforts (as I explain in detail in the sections on well-​being ideal and transgenerational goals later in this chapter).

Pain encapsulation In their search for well-being, both active and passive migrants recurred to the use of another psycho-​sociocultural coping mechanism in response to the challenges arising from their migratory processes, which included the circumstances that motivated their departure pre-​migration, the occurrences during their transit, how they experienced their arrival and settlement in their places of destination (the first one affecting both active and passive migrants, and the other two affecting active migrants directly, and passive migrants indirectly), and how life after migration continued to develop for passive migrants in their home countries. Active and passive migrants who had undergone reflective mourning, trauma, stress, crises, return shock, and/or 93

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unrecognized resilience often confined the pain they had endured to be able to move forward in their transnational and transgenerational pursuit of migratory goals. Pain encapsulation—​defined as the containment of the dreadful feelings caused by migratory processes that active, regular and irregular, and passive migrants undergo in order to carry on with their lives—​was usually paired with the mechanisms of denied migrant health and normalization of malaise. Nonetheless, it also appeared in migrants who had acknowledged health problems and didn’t naturalize them, because the emotional effects of migration transpired in all cases. Even if some migrants were able to process those feelings, be they positive or negative, out of their system, so to speak, many migrants dealt with them by compartmentalizing and sealing the negative emotions inward (see Figure 3.7). As a coping mechanism, pain encapsulation usually worked well (in the sense that migrants could go on with their daily lives without feelings of anguish) while everything else was running smoothly and migrants believed that they were getting closer to their goals. However, it ceased to work when things went off track, particularly with the kind of endogenous and exogenous events that triggered migrant crises (see Chapter 2). Diana, who was born in the US to Ecuadorean parents and lived for about seven years in Ecuador as a child to return to the US as a teenager, put it clearly: “It’s like I learned how to disconnect my emotions, like I would say to myself: ‘Don’t feel anything, no emotions, just do.’ … And if things that happened hurt, I knew I had to move on and keep on doing” (Diana, Personal Interview, New York, 2019). Lila, a passive migrant, expressed that her way of dealing with the sadness and anger she felt with the departure of her parents to Italy was: “Simply not to give it any importance. Not to ever think about it. That way, I don’t have any bad feelings and I can move on with my life” (Lila, Group Interview # 7, Santo Domingo, 2017). Perla, another passive migrant in the same group interview, affirmed that was the way to deal with the pain they felt as relatives who stayed behind, and stated: There is nothing else you can do about it. It is always going to hurt. We are always going to have that feeling of lacking or missing, even if we are doing fine and we have a good life. There is nothing you can do to take out that pain, we carry it within us, but we don’t let it overwhelm or paralyze us. We don’t talk about those feelings either. There is no point because it only makes us feel worse. To talk about them now, here, it’s fine, but this is an exception. (Perla, Group Interview # 7, Santo Domingo, 2017) Edmundo, a return migrant from Spain, asserted, “The life of the migrant is one of the hardest that can be, because you can have it all and still 94

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Figure 3.7: Illustration of pain encapsulation

lacking it all at the same time.” With this phrase, Edmundo hinted at the paradox that migrants face and the strength they require to persevere. His encapsulated pain was underlying his experiences as a migrant, which resulted in positive outcomes economically, but also in negative outcomes. He affirmed, “If I could go back in time, I would. Nothing will ever compensate the emotional suffering of separating from our son” (Edmundo, Group Interview # 3, Loja, 2017). His wife, Nilda, also present in the group interview, assented, crying. Brenda, in the same interview, echoed their words and feelings: 95

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Money is not all. Money doesn’t bring happiness or tranquility. In the end, leaving children behind to provide for them backfires. It is better to be with them, to be present, there for them while they grow up. It hurts, it hurts very much. It really hurts them and us both. And that damage cannot be repaired. We may have provided for them and sacrificed for them, and they have better means now, but if we left them how can we ask to bear the fruits of something we didn’t grow? It hurts them and us as parents. (Brenda, Group Interview # 3, Loja, 2017) Muriel, a return migrant from Spain, also stated: My daughter will always carry with her the pain she felt because I left her for a few years to be able to provide for her. And we as parents also carry that pain and the regret. But what’s done is done and cannot be undone or go back in time. One must put those feelings away and look forward, try to find a way to live better, in harmony, with affection, with love, and little by little, overcome everything we can. (Muriel, Group Interview # 3, Loja, 2017) Lesly, a regular active migrant living in New York, explained his brother’s encapsulated pain: My brother, even if he could afford it, only went back to Ecuador once, and he never wanted to go back again because after that first visit back, he went through the phase of crying, being sad, missing my mother and things like that. Then, he decided not to visit again because he couldn’t deal with those feelings once again. He had to put them away, and move on. (Lesly, Personal Interview, New York, 2019) Matías, a regular active migrant in the United States, commented on the encapsulated pain of his wife’s aunt in this way: My wife’s family business here in New York was very profitable, and they were all able to grow economically very much. But my wife’s aunt, for example, had spent every single day for 20 years in a small room, manually counting the money made in the business. She kept the books and would count all the cash by hand and annotate ups and downs, ins, and outs. She had these deep, dark eye bags. She was always working like that, but none of the business decisions were made by her. It was her husband who ruled. They had property, several cars, but she was always stuck in that room, working. And she had like a sadness, an internal discontent, a hidden anger, or something like that, because you could see that even if they had so much, she could never 96

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really enjoy herself. She was quick to treat people badly, and I always thought that was her way of showing the world she existed, even if she was always stuck in that little room, working, and working. Like a rancor. Like a quiet pain that she held deep inside while she kept the family business in order. (Matías, Personal Interview, New York, 2019) Carmen, a returnee who was in Spain for nine years and left her five-​year-​ old son with her parents, shared: I try not to remember that part about that time. Because it was very sad. It is too sad to bear. I had to put those feelings apart when I was abroad, and now, I still do the same, to be able to go on. Emotionally one suffers very much when leaving children, family behind. And that suffering continues after returning. You must keep those feelings out of reach to survive. (Carmen, Personal Interview, Loja, 2016) Similarly, Mercedes, a passive migrant with a son and a granddaughter who had left many years ago, introduced herself to the group and as soon as she had said that “one suffers very much when one’s children and grandchildren leave,” she started crying. After calming down, she said, “I hear the word migrant and I start crying” (Mercedes, Group Interview # 1, Loja, 2017). Encapsulated pain also became apparent during personal interviews, when active or passive migrants had been presenting themselves in a way that showed that they were very strong and in control, with no room for emotions. Until they broke down in tears and expressed that it had all been very hard, very painful, and that indeed, they had built up a barrier to prevent those feelings from affecting their ability to take care of their daily business, including looking after their family, and pursue their migratory goals. For example, Jorge, who after many years regularized his status as an active migrant in the United States, had narrated his family’s migration history that was motivated by the health needs of his brother, and shared detailed accounts of their efforts to surmount the various adversities that they endured. Jorge, unknowingly, articulated the so many ways in which he had been helping his parents and siblings overcome all kinds of barriers (social, emotional, linguistic, bureaucratic, economic, and so on) since he was a young boy of seven years old until the present, in his early twenties. Next, when he was describing how “some nights, before sleeping,” he felt the pressure from all the responsibilities he had, he began to cry. Quickly he tried to calm down so he could go on with the interview and continue relating the list of things that he still had to take care of, including: “my sister’s entrance to college, and my parents’ buying their own house so they can finally reach their dream, with my brother and I already graduated from college and working independently and my sister in college, with 97

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less economic demands.” Later in the interview, Jorge expressed that as he matured, he learned that he didn’t have to be ashamed of the difficult experiences he had had with his family as immigrants, but he emphasized that it had been very important “not to get lost in bad feelings because we need to be strong and active because we still are in a very delicate situation, we never know when things can go south” (Jorge, Personal Interview, New Jersey, 2019). Antonio, a passive migrant whose brother had left for Spain 15 years ago, had a similar breakdown moment in the interview, which we had to cut short because he was surprised with and ashamed of the fact that he had unexpectedly expressed his sadness. While crying he said: “I am sorry. It is very difficult, very hard. The missing. The sadness all the family has felt. I wish my brother returns. He’s promised our mother he would, but he never does. … It makes me feel very sad” (Antonio, Personal Interview, Loja, 2016). Natalia, who was first a passive, then an active migrant, and finally, a returnee from Spain, narrated the various challenges that her husband experienced in Spain as well as the difficulties of returning to Ecuador, especially for her daughter, who suffered several health conditions after arrival and often expressed that she wanted to go back to Spain. During the interview, Natalia appeared to have been highly resilient, and towards the end, affirmed: “I will not give up. I will keep on struggling.” When I asked her about what had helped them overcome their problems and move forward, she said, “Our daughter,” and burst into tears, repeating “It is hard, very hard.” She expressed that she had accumulated her pain and tried to keep it sealed, but with the development of her daughter’s health problems and her husband’s depression, she was “finding it harder to contain” her feelings (Natalia, Personal Interview, Loja, 2016). Cecilia, who had a very challenging experience as a passive migrant and later as a regular active migrant in the United States, but had managed to endure various traumatic events, persevered in achieving her education and professional goals and found her own well-​being, also revealed her encapsulated pain during the interview when she shared what hurt her the most: not that her mother passed away when she was nine years old, not that her father left and soon stopped visiting, not that her father brought her to the United States because he had legal custody of her and separated her from her grandmother without clearly stating that his plan was not to return to Ecuador, not that she found out that her father had remarried the moment she stepped in his apartment, but the fact that he prevented her from communicating with her grandmother, who had raised her, for an entire year. Cecilia broke down after sharing that: Eventually, I was able to hide and get out of the house to buy the calling cards so I could call her. … I was only allowed to return to 98

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Ecuador and visit my grandmother when I was 16, that’s three years after I was brought here. And I wanted to stay there because here everything was very difficult. Cecilia, later in the interview, was overwhelmed again when she stated that the first year she was in the US, she would go to bed at night and “cry uncontrollably,” but that she would do so quietly, without recurring to her father or stepmother or anyone because, as mentioned in the normalized malaise and denied health subsection, on the one hand, she thought that it was normal to be sad, and on the other hand, didn’t want to become a burden to his family (Cecilia, Personal Interview, New York, 2018). Carina, a passive migrant, articulated her own encapsulated pain: One suffers very much. And even if we persevered, there are feelings that are kept deep inside of us. Because we lacked the present affection and care of our parents and even if now we are all back together and they are proud of us because we are all accomplished and responsible adults, we missed the chance of being able to rely on them for support, to be close to our parents while we were growing up. We basically grew up alone and we really missed them. (Carina, Group Interview # 4, Loja, 2017) Briefly, Estela expressed that encapsulating pain ultimately made migrants “harden their heart”—​which she regretted but recognized had been necessary to survive the difficulties, especially emotionally, in pursuit of their goals of having better living conditions and more prosperous futures (Estela, Group Interview # 3, Loja, 2017). Estela’s comments connect with the following two key psycho-​sociocultural coping mechanisms that active and passive migrants utilized: well-​being ideal and transgenerational goals.

Well-​being ideal and transgenerational goals The well-​being ideal is conceptualized as a belief that a state of holistic welfare will be eventually achieved, which helps active and passive migrants persevere through all the hardships related to the migratory process. This coping mechanism was practically utilized by all research participants. It functioned as their motive to remain alive, to the point that without believing in that ideal, their whole reason for being and enduring migratory challenges would dissipate or even vanish (see Figure 3.8). Psychologically speaking, this well-​being ideal is akin to the life instinct as defined by Freud in 1920, which drives humans to the preservation and recreation of life, 99

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Figure 3.8: Illustration of well-​being ideal

supporting individual and collective well-​being (Freud and Strachey, 1989). The distinction of migrants’ well-​being ideal is how this belief helped them specifically to navigate the difficulties of migration and provided them with a reason to keep on pursuing their migratory goals despite all the odds. While many migrants’ well-​being ideal involved their families and was associated with transgenerational goals, some migrants were on their own and cared for themselves and their own future only. In both cases, however, migrants’ well-​ being ideal was future-​oriented and was manifested as a wish that sooner or later that ideal state of comfort and tranquility would become a reality thanks to their ongoing efforts, persistence, and endurance of sacrifice. Active and passive migrants’ religiosity was not necessarily associated with this belief, but when it was, faith in its realization was also deposited spiritually in God, regardless of denomination. 100

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Active and passive migrants usually relied on pursuing life goals multigenerationally, with a historical, forward-looking, and collective drive that surpassed individualistic interests and day-​to-​d ay occurrences. Conceptualized as transgenerational goals, this mechanism helped migrants to cope with the hardships of migratory processes providing a sense of purpose and meaning to their lives pivotal to gain strength and develop their resilience. The very few migrants who didn’t have a family to care for still projected themselves in the future and considered their family past as a point of reference to value their efforts and frame their achievements (see Figure 3.9). The combination of the two mechanisms, well-​being ideal and transgenerational goals, was the motor that allowed active and passive migrants to prevail regardless of the obstacles they encountered. Overall, these mechanisms had a beneficial effect in the long run and for the group; however, in the short and middle run, they sometimes pushed migrants to bare the unimaginable, with serious health costs at the individual level. These costs, nevertheless, were coded as worthy if the transgenerational goals were met and well-​being was achieved. Active and passive migrants in individual and group interviews and workshops shared in different ways their migratory experiences, their motives, and what allowed them to persevere. For example, Lara, a passive migrant whose parents returned to Ecuador after many years and reunited with their then grown-​u p children articulated:

Figure 3.9: Illustration of transgenerational goals

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The fact that we are altogether now is what compensates all the problems that we had before. I think life is that way, no matter how many problems one must endure, in the end, happiness exists. We overcame our problems and now we are happy. We trusted this day will come and persevered. (Lara, Group Interview # 4, Loja, 2017) Muriel, a returnee, expressed: “In the end, I believe that all of us, migrants, leave the country and return with one end goal, to live well, and have a personal and familiar well-​being. I think that’s what all of us seek” (Muriel, Group Interview # 3, Loja, 2017). Lesly, first a passive and later an active migrant, shared that: My motivation to graduate from college was to be able to provide a good life for a baby in the future, a good life that I was not going to be able to provide if I continued working in the supermarket and didn’t complete university studies. I witnessed how hard it was for my sister and her daughter, my niece, because my sister would spend all day working, and my niece would stay alone before and after school, and we all lived in a room. I wanted to be able to offer well-​being to my baby. Besides, I had seen my mother’s efforts to secure their children’s well-​being. She had always tried to do everything to offer us a good life, even if it was difficult. (Lesly, Personal Interview, New York, 2019) Cecilia, who was also first a passive and then an active migrant, said that when she was finally able to return to Ecuador after three years, her brothers and grandmother, “who missed me very much, convinced me not to stay in Ecuador, because they knew that I was going to have a better life and well-​being in the US in the future.” Cecilia made it through all kinds of adversities, but persevered and graduated from high school, won fellowships, entered college, and obtained a BA and an MA, and after, completed Law School and became an immigration lawyer. She said: I feel fine here now. I live on my own, and since I left my father’s house, I’ve had a peace of mind, an ease. … It doesn’t matter what happens during the day, I arrive home, and it’s my space. I love my work, the legal organization where I work is very good, very cool, it has a beautiful mission, I like my colleagues and staff, most of whom are migrants, and are very caring, and our clients have gone through plenty of trauma, and it’s good to be able to help them reach their well-​being too! (Cecilia, Personal Interview, New York, 2018) Eduardo, a return migrant, expressed his view on the pursuit of well-​ being: “What is gratifying to be able to persevere through the difficulties 102

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of migrant life is that one wishes to bring the family back together to live well” (Eduardo, Group Interview # 4, Loja, 2017). Similarly, Frida, a passive migrant, shared: I believe that what motivated everyone to overcome the problems and difficulties that everyone had abroad and when leaving their children behind was their wish to obtain a little bit of what they were looking for and didn’t have, so they could return and see their family happy, enjoying a good life. To reach the well-​being of the entire family is what eventually can make them feel satisfied with the efforts made to be able to progress. (Frida, Group Interview # 4, Loja, 2017) Transgenerational goals were a main force, as clearly articulated by Jorge, when recalling how his parents didn’t get trapped in their nostalgic memories of Ecuador or their desire to return: “They were reassured that their efforts had paid off and that the US was their place to be because they could see that my brother and I were studious and were advancing to secure a good future with promising opportunities to have a good life.” In reverse, Jorge explained: [M]‌y parents had sacrificed so much for our well-​being, and I had struggled so much to be an excellent student that I was convinced that I had to shoot for the best options, the best universities, as opposed to going the easy route. I had to validate all the efforts that my family had done for our lives with my own efforts to ensure that we would all reach the point to be at ease. … That we all have a college degree, a good job, and that my parents will finally have their own house and be able to work less hours and enjoy themselves. (Jorge, Personal Interview, New Jersey, 2019) Estela, a returnee from Spain, reflected on the difficulties she experienced when she was away from her family who had stayed in Ecuador, while keeping in mind well-​being and transgenerational goals: My family was the motive I had to gather strength, to wake up every morning and say, ‘I will do my best today.’ First, because I want my daughters to learn to be fighters, to bring out the best in them. That is the impulse. Especially when you are away, despite all adversities, with or without a job, having or not a place to sleep, it is thinking about the family, about the people you left behind, and remember that you are doing it for them. That it is worth the effort, the sacrifice. It is worthy that I don’t sleep, that I am sick, that I don’t eat. It doesn’t matter, if it is so I can save and send them some money, or so I can shorten the time I’ll have to spend far away so I can be together with 103

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them again, sooner. It is worthy. The family is the motor, and the reason of the absence, the answer when I wonder ‘What am I doing here? Why am I not there, struggling but together with them?’. (Estela, Group Interview # 3, Loja, 2017) Rosa, a return migrant from Spain, shared the ground for her decision to migrate: “I left alone because we had been married for many years, but we did not have a house; we still lived with my parents. So, I decided to migrate with the goal of providing a better life to our children and giving them a house” (Rosa, Group Interview # 2, Loja, 2017). Similarly, Matías, an active migrant in New York, shared that his wife’s and his principal motive first to migrate, then to change their jobs to reduce the workload and stress, and finally to persevere against all odds was indeed “the family’s efforts to prosper and the well-​being of parents, close relatives, and children” (Matías, Personal Interview, New York, 2019). Last, Ryan’s experience, who was first a passive migrant, then an active migrant in Spain, and finally a returnee, also involved transgenerational goals, which in his case were initially from his parents towards the children, given that “they migrated so we could all have a more promising future,” and later, in reverse: So, my mother, brothers, and myself returned to Ecuador after several years in Spain to take care of some family business of my grandmother and see if we could finally settle here again. My father stayed in Spain working and sent us money. But things here in Ecuador didn’t go well economically. We were struggling to make ends meet. … So, I told my mother: ‘Go back and take my brothers because there they will have a better education, a better life, and a more promising future, without as many needs as here.’ I insisted even if I knew I was going to miss them. But, for me, my brothers are like my children. I am the oldest one … I miss them, and I believe they miss me too, but it is for their well-​being, I know that they’re going to be well there, and that here, it was not going to be that way. My brothers are doing great there now. I wish they weren’t far away, but it’s better for them. Now I am holding on and putting up with the difficulties here and with missing them, but it’s for their well-​being. I am hoping that in two years, I’ll be able to join them in Spain and we will be all fine. (Ryan, Personal Interview, Santo Domingo, 2016) Altogether, these migrants’ expressions show the strength and centrality that transgenerational goals and well-​being ideal had for active and passive migrants to navigate through the multiple hardships that migration presented them and their families. These two mechanisms were also fundamental for 104

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migrants to deal with return migration as they applied strategic return and settling readjustment, or involuntary return rebound, as will be presented next.

Strategic return As opposed to the salmon bias hypothesis which sustains that migrants end up returning to their places of origin as they age or get ill based on a biological instinct to prefer to die where one was born—​just like salmons do (Abraído-​ Lanza et al 1999; Turra and Elo, 2008)—​our sociological research found different dynamics at play. Active migrants were deliberate and strategic about their move back home, or alternatively, found themselves forced to return due to migratory, legal, economic, or political matters, the occurrence of unanticipated events, such as work accidents or illnesses, or being a minor. In this subsection, the focus is on the psycho-​sociocultural mechanism of strategic return, which is followed by the workings of settling readjustment. Last, the mechanism of involuntary return rebound is explored. Based on our qualitative data, strategic return was conceptualized as reverse migration owing to a reflective and instrumental decision-​making process based on transgenerational goals, well-​being ideal, and current circumstances in the destination and place of origin. In general, if active migrants had not yet met some or all their migratory and transgenerational goals, they would try their best to stay in the place of destination despite the hardships and persist in their attempt to forge ahead with their migration project. On some occasions, the reason why active migrants would not return was because “they felt ashamed of either having left and not having been able to achieve anything or returning empty-​handed” (Carol, Personal Interview, Loja, 2016), even if their relatives, passive migrants, would “insist that they would support them upon return and preferred their well-​being than their continued sacrifice abroad” (Etelvina and Clara, Personal Interview of mother and daughter, Loja, 2016). Just like the decision to leave one’s homeland, the decision to go back home and bring the migratory venture to an end was never taken lightly and went beyond instinctual behaviors (see Figure 3.10). The cases of Fernando, Matilda, Carmen, and Luis exemplify how strategic return worked. Fernando had migrated to Spain on his own, leaving his wife and two daughters in Ecuador. He stated: I did well. It was very hard. I left my daughters when they were little and returned when they had already grown up. I returned because of my children. I had reached the goal I had set for myself … that was to save money to build a house for us and leave it to our daughters so they would not have to be renting … and to provide for them so they could study and complete a college degree, and they did, one is a lawyer and the other an engineer. 105

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Figure 3.10: Illustration of strategic return

Fernando, who “felt like returning many times because the job was hard,” waited for when he believed was the right time to move back. He had employed the mechanisms of transgenerational goals and well-​being ideal to endure the hardships and advance toward their aim of securing better life conditions for his family and daughters. Fernando prevailed and put an end to a phase in his life that he found very demanding so he could enjoy the fruits of his efforts, in his words: I met my goal … I have land, a little house, animals, and my daughters have their professions. After returning, my wife and I had more children too. I’m done being a migrant. If I ever were to leave again, I would take all our family. But I would rather have nothing else to do with migrating. (Fernando, Group Interview # 3, Loja, 2017) His case illustrated not only strategic return but also the weight that migratory transgenerational goals to improve living conditions for the future had for a family to decide to migrate, put up with all the associated adversities, and then, reunite. Matilda, a single mother, migrated to Spain and left her daughter in the care of her grandparents. Matilda had a hard time as a migrant worker but was able to earn enough to send remittances back to Ecuador. Matilda spent four years abroad and decided to return because even if she had not been able to save enough to build a house, she didn’t want to miss her daughter growing up any more than she already had. She shared: 106

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I had already missed her First Communion; I missed her Confirmation. So, I decided, and said, ‘No. I have a daughter and I’m going to help her get ahead one way or another, even if I must struggle to make ends meet in Ecuador.’ And it was like that, I came back and helped her complete high school and then go through her university studies to become a medical doctor. And my daughter tells me, ‘Mom, I would not have been able to graduate as a doctor if you had not returned. Because I have many friends that are all alone, with their parents abroad, that lost track. Some got pregnant, some ran away, some dropped out from school or college and didn’t become professionals. But I know that your love and company is what made me who I am today.’ So, I don’t regret having returned, if I were or not able to build a house, a beautiful house, because the most important was my daughter, was that I could be with her. (Matilda, Group Interview # 1, Loja, 2017) Matilda prioritized her children’s emotional well-​being and decided to return sooner instead of waiting to meet economic targets. Her decision was still strategic in the sense that she reflected on her migratory experience, assessed the gains and losses, and estimated the collective future of her family based on the opportunities and challenges abroad and back home in a comprehensive manner. Weighing up past and future pros and cons while keeping transgenerational goals and well-​being ideal as guiding factors was fundamental in making informed decisions regarding reverse migration. Carmen had graduated from Nursing School and was working in her profession for a year before she left for Spain with the illusion of being employed as a nurse there. Also a single mother, Carmen left her son in the care of his grandparents. Her plan didn’t work out because of legalities related to her title and her residency. While waiting to regularize her status, she worked as a live-​in home aid, then, as a housekeeper in a hotel and later, as part of a cleaning crew at a hospital, trying to earn enough to maintain herself and send remittances to Ecuador for her son, which “was very hard, because even if my relatives and friends who were there had told me that it was easy to earn money there, it was not.” When her residency was established, Carmen tried to validate her degree in nursing but too much time since her graduation had passed so she was not able to do it. Then, Carmen: continued to work multiple gigs, but the economic situation in Spain started to change and it became more difficult to find jobs, even if I had my residency already. So, since I had been able to finally pay back my debt of when I bought the ticket to come to Spain and send some money back home, I decided to move back 107

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to Ecuador, restart my professional path as a nurse and be back together with my son. Carmen planned her return based on the material, professional, and emotional hardships she had borne; her achievements, although less than what she had expected, had allowed her to save money for her son and family; overcome new hurdles that had arisen; and reinforce the belief that back in Ecuador she would be able to pursue her career and be reunited with her son and family. Her reverse migration was not easy because she had to complete some actualization courses before she could practice as a nurse. But “after one year, I began a job as a nurse at a hospital and have been working there for four years.” Looking back, Carmen said that she “wished she knew exactly how things were going to be like” in Spain because “being a migrant is very hard, the work you do is hard, and the problem is not so much getting used to another country, but mostly, to leave your children, your family behind.” Carmen also kept to her transgenerational goals and well-​being ideal: Once I was able to travel back to Ecuador and visit, everyone asked me to stay, and I wanted to stay, of course, but I didn’t because I wanted to work and continue earning money to build up our savings. And even if one of the families I worked for as a live-​in home domestic offered me to bring my child along, I declined because I didn’t want us to be there, having that kind of hard life. I wanted us to be here, in our own space with better prospects. So I stayed for as long as I could, and saved, and now, we are all doing well here. (Carmen, Personal Interview, Loja, 2016) As opposed to Matilda, Carmen gauged that her son’s well-​being would not be affected as much if she stayed longer to try to achieve her transgenerational goals. However, all these mothers were strategic in their decision-​making both upon departure and return. Despite the outcomes, they were reflective and intentional, conscious of the debris that migration and separation had generated as well as committed to do as best as they could to improve their family’s living conditions in the future. Luis made a similar assessment of pros and cons to decide his return from Spain. His two daughters had stayed in Ecuador to the care of his wife; he had kept a frequent and open communication with his family and had been able to visit them on several occasions. Like Carmen, whenever he visited, he was tempted with the idea of staying because he had missed his family very much, and his daughters were growing up. But they still needed his income to make ends meet. Luis, however, had investigated the paperwork required for his family to migrate and join him, but he “simply could not 108

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afford it, so we discarded the idea and focused on meeting our goals as soon as possible.” Luis told me: I had been thinking about moving back, but then something happened to me and I took it as a sign. One day at work, I had an accident with the motor blade and cut myself. Luckily, I was wearing a cap that I had recently bought. It was a just a scare, nothing serious; but it was like a sign to me. When I came back to the house and saw the cut in my forehead, I said, ‘That’s it! I’m not up to this any more.’ So, I talked about it with my wife and decided that I would work for three more months to take advantage of the season, save up some extra money, and then I would return home. My relatives in Spain critiqued my decision, they claimed that I was too young to return, that I had many years ahead to work, that I was going to be hungry in Ecuador because I was never going to earn enough money. But I put everything on the scale: what I was earning and what I was losing; and the last time I had visited Ecuador and seen my daughters so grown up, I had realized that I had already lost too much. Luis was very conscious of the importance of keeping transgenerational goals and well-​being ideal as a guiding force. He explained: Migration decisions need to be made as a family. Because all the family suffers. If there’s economic need, and of course, many times the need is so large that the best decision is for a family member to migrate even if the family must separate and sacrifice. But it’s all done with the aim to overcome the problems and be back together with better living conditions in the future. Family is what will save you if you fall. And, when you are abroad, you should focus on working so you can meet the goal of having something of your own dedicated to your family as soon as possible. The decision to migrate ought to be well thought out. Luis opted to embark in reverse migration once he had done everything possible to meet his “dream to live at ease in Ecuador with his wife and daughters, without worrying about rent or debt.” While the family’s efforts were plenty and migration had been physically, psychologically, and emotionally taxing for all, as a family they agreed that it had been “worthy” and were “happy to be back together enjoying the fruits of all the sacrifices they had made” (Luis and Camila, Personal Interview of father and daughter, Loja, 2016).

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Figure 3.11: Illustration of settling readjustment

Settling readjustment Migrants who consciously planned their return were still inclined to go through the health process of return shock. The mechanism of settling readjustment was then employed to prevail over the impact that return migration caused in active and passive migrants by being at peace with the efforts and consequences of the migratory process, including its effects on the family, and the current reality of their homeland (see Figure 3.11). To illustrate this process, let’s continue with Luis’ case. He explained: “The reunification has been difficult. I came back with crap in my head. I had to adapt to them, and they had to adapt to me. … It has been a very demanding change for me. It has been difficult to adapt.” His daughter Camila stated: We were used to living in a house full of women, and now, it all changed completely with my father here. … But now, three years have passed since his return, and we all feel more adapted. We even miss him even if he’s out of the house for a while. … And all of us, my dad, mom, grandma, sister, and I, are feeling better; we are healthier and in better spirits. Luis also had to deal with economic challenges back in Ecuador, and worked random jobs when he could get them, but he stated that “sometimes we

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lack money, but at least, it is the four of us together who deal with it.” And he added later, I feel good because I know that at the end of the day, after working on whatever I worked on, I will be able to come home and be with my wife and daughters. It is not like before, in Spain, when I had to deal with all the problems on my own. With time, Luis’ family got used to them being all together as a family and accepted their new financial situation. Luis readjusted to settling back in Ecuador and was convinced that he “would never leave again” (Luis and Camila, Personal Interview of father and daughter, Loja, 2016). The case of Graciela’s husband also involved settling readjustment. He had migrated to Spain due to poverty and stayed there for 13 years while sending remittances for his wife and two daughters. Gradually, they “had been able to build a small house” and after a work accident that “scared him because it could have been serious, he decided it was time to return.” Graciela’s husband “came back with the idea that he was going to find work because he was still young, but the situation was difficult.” He traversed return shock, including physical and psychological conditions, and his wife and daughters supported him in overcoming these difficulties: I tell him not to worry. That we will be fine. That we are together now and that if we can go to sleep after having had a meal, we are OK. … He is worried because he cannot find a steady job, so he thinks that maybe he should go back to Spain. But our daughters tell him that is not a good idea because they don’t want him to be apart from us again. We are now used to being the four of us together, so my daughters and I don’t want him to leave. … Besides, we remind him that we will never recover the time we spent apart, and that it is better to face difficulties together than separated. Graciela’s husband eventually found temporary work in construction, and while “he worries about not being able to provide for our daughters and support their college studies, I reassure him that we will be fine because I have a steady income and we will persevere together.” With the support of Graciela and the two daughters, he was able to adjust to his new circumstances as a return migrant reunified with his family and finally “make peace with the fact that he’s back and we’re now pulling through together” (Graciela, Personal Interview, Loja, 2016). Similarly to Luis’ case, the mechanism of settling readjustment was put in motion by the whole family and functioned collectively.

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Another case that illustrated this mechanism was Gisella’s. Her return also presented difficulties; she expressed: My son would hide behind my mother’s skirt because he didn’t know me and was scared. My mom would tell him that it was fine, that I was his mother. But he would hide behind my mother. He didn’t even want me to hold his hand. Then, moving back home was like starting from scratch to earn all the love that was lost. That was very, very hard. After that, she added that economically, it was also a difficult because “there were many moments when I simply could not make ends meet.” However, she employed the settling readjustment mechanism and was “at peace with my decision to return, no matter how hard it was because I have been able to be with my children and see them grow up” (Gisella, Group Interview # 3, Loja, 2017). Paula, who migrated, due to economic issues, with her husband to the United States and left her children behind, returned after six months on her own because she “could not get over the idea of being away from my children.” Paula’s reverse migration was “very hard” because: I had thought that the baby was not going to be affected much with my absence, but it was a lie. One thinks that six months is nothing. I moved back after six months, and indeed, six months are a lot, a lot. When I returned, my baby already had hair, curly hair, my older son was already changing his voice, and my daughter, the one in the middle, had started to walk and looked older. That is, the things that one loses, one can never, never regain. Paula’s younger son had some “serious developmental problems” that she believed were the result of her departure. Thus, Paula strived to overcome the negative effects that her separation from her children had generated, “first on my own, because my husband stayed for one more year abroad to try to solve our economic problems, and after, with him.” Her use of the mechanism of settling readjustment focused mostly on helping her son to recover: When I returned, I noticed that my younger son was not like my other children. If you put him down somewhere, he would not move, and he always was looking down, to the floor … so I had him seen by a psychologist, I asked for appointments with all the specialists I could so that my son would recover, so that he would talk. He didn’t start talking until he was five years old. He was affected so much, so much, so much.

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Paula did everything she could to support her son, and “gave him love, safety and spent a lot of time with him, and with time, he recovered. Now he is 12, and he is doing very well.” Paula’s husband also recurred to settling readjustment, mostly by focusing on “gathering strength from being all together as a family and organizing ourselves so we manage our economy, work and save here in Ecuador.” Paula’s family was eventually able to overcome all the hurdles that had first motivated their migration and then had ​emerged because of their separation and upon their return. In her words, “We had reached the very bottom and we were able to rise once again. And we are here, fine, working, trying to get ahead” (Paula, Personal Interview, Loja, 2016). Anahí’s case is also illustrative of the way in which settling readjustment works for return migrants to overcome the effects of going back to their home countries. Anahí had migrated to Madrid when she was nine years old with her parents because of economic issues, and when she was 21 years old, she strategically decided to return to Ecuador: because I already was at an age when I was looking to be independent, and I wanted to go to college and work. But times were difficult in Spain to find jobs and the entrance exams for the university were hard to pass. Then, with my parents’ support and agreement, I moved back to Santo Domingo, applied to college, and began to study for my degree. Despite her carefully thought-​out choice to move back, Anahí found it difficult to adapt to living in Ecuador again: “at the beginning it was horrible, I didn’t want to go around because I found it all too chaotic, the streets were dirty, and public transportation was unsafe; and I also missed my family.” When Anahí returned, she nurtured a relationship she had begun years before with the son of a family friend, and soon, they decided to get married. Within a year, Anahí was pregnant, and when her daughter was born, she took a break from college and continued with her studies later. Anahí expressed: I got used to being in Ecuador with time. A little by force, like, I HAD TO [her emphasis] get used to it. But mostly, because I had returned because I wished to pursue university studies and get ahead, and I did! I am achieving these goals. … Moreover, it is because of my daughter growing up that I’m getting used to being here. My husband has also helped me, and we want to do our best to have a good life. With time, Anahí also “accommodated to the climate, the food and the educational style, all very different from Spain’s” and after having difficulty making friends in college because “they were more reserved and lightly 113

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made fun of my accent and customs,” she managed to form friendships. Anahí’s settling readjustment was based on her achieving her return migration aspirations as well as her recreated well-​being ideal and transgenerational goals now involving her new family, especially her daughter. Anahí also had an optimistic evaluation of her decision to move back despite the difficult process of readaptation she endured: “The change was positive. I was able to study, and I changed—​my personality, my character—​I matured, even more as I became a mother. I became stronger and my life has improved.” Anahí and her husband were thinking ahead about “how to provide a better quality of life” for their daughter and considered “the idea of migrating to Spain in the future, although the details as of exactly how” were still being discussed as they weighed up their professional options and the economic and legal situation (Anahí, Personal Interview, Santo Domingo, 2016). Luján also was a young woman who returned to Ecuador “to pursue university studies because the entrance exam in Spain was very difficult.” In her case, the transition back was not as shocking as Anahí’s, however, it still presented challenges. For Luján, who had left Ecuador aged seven, had spent about three years back in Santo Domingo during her secondary studies, and finally, returned aged 19, the most difficult aspect was: “to learn that life in Ecuador was more controlled, because in Spain, even though I was a minor, my mother would let me be independent, and here, my aunt doesn’t let me and asks me about everything I do even if I’m already an adult!” Luján also missed her mother, who had stayed in Spain with her father and brother. In her case, she was quick to employ the settling readjustment mechanism. She was able to build friendships in Ecuador right away and didn’t feel lonely because her grandparents were around, and her aunt, despite being “too controlling,” lived with her. Luján explained: I had some friends from when I had been here during my high school years, so I reconnected with some of them. And, my aunt is very young, she is only 23, so I went out with her and her friends. Then, at college, I made a very close friend; it is like we are sisters even if we’ve recently met. We also have a group of friends with whom we spend time, go to the movies, go shopping, and party. We always find something to do. Moreover, Luján had a couple of boyfriends with whom she “figured out that relationships in Spain were more liberal … and that men were more jealous and not as romantic.” Still, she continued “to go out with my friends, even if my boyfriend would make a big deal out of it.” With time: I found myself enjoying my being here, having friends, going out, partying. I understood that my aunt was looking out for me because 114

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she felt responsible if something ever happened to me while I was under her watch, so to speak. … And I simply got used to being here; that’s it. I still miss my mother, of course, but that’s all. I’m fine here. (Luján, Personal Interview, Santo Domingo, 2016) In some cases, a family’s strategic return was not felt as such by all members. Usually, the ones who felt that their reverse migration was imposed were the children, who if minors, had to simply obey, and when young adults, felt that they should keep a unit with their family in their migratory decisions and/​or were still unable to provide for themselves. Young adults who had already formed their own family abroad were more inclined to cut ties if they didn’t want to move back. In other situations, partners who were not in complete agreement about returning, still followed the lead of the partner who wanted to do so in order to preserve the family’s union. While these cases cannot be equated to the difficulties of forceful migrations due to deportation, for example, they still triggered the mechanism of involuntary return rebound as opposed to settling readjustment in the family members who felt forced to migrate back to their country of origin. The cases of Luciano and Jackelyn in the next section exemplify this kind of mixed situation.

Involuntary return rebound The mechanism employed to surpass the negative consequences of an imposed return to the migrant’s homeland was conceptualized as involuntary return rebound. This mechanism was like settling readjustment in the sense that it was devoted to overcome the impact of moving back, but different as far as migrants found it more difficult to accept their return because they had not really wanted to do so to begin with. On some occasions, their original disagreement eventually translated into a plan to migrate once again back to the place they had returned from. In other situations, it created conflicts among the returnees that led to family separation. Altogether, involuntary return rebound was more onerous when the reason for departure was more traumatizing, as in the case of life-​threatening accidents, severe illnesses, critical economic conditions, or deportation. The more severe the crisis that made migrants return, the more difficult the rebound. The less severe, like in the case of children of migrants who due to their age returned with their family even if they didn’t want to, the less difficult. However, migrants’ capacity to surmount the negative effects of imposed returns did not depend solely on the severity of the crises that had triggered reverse migration, but also on their own psychological strength, their family and migratory history, and their degree of social and cultural capital to pull through (see Figure 3.12). 115

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Figure 3.12: Illustration of involuntary return rebound

The case of Luciano exemplified how this mechanism worked in migrants who were part of a family who had decided to return strategically but they themselves were not in full agreement with the idea. Therefore, while his family members employed settling readjustment, he recurred to involuntary return rebound. Luciano’s father had been working in construction, and his mother cleaned offices and cared for elderly people. He was an upper-​level high school student, doing pre-​college coursework when his parents decided to move back to Ecuador. He explained: My parents decided to return because with the economic crisis in Spain, it had become more difficult for my father to find work and we had already been able to build our own house here in Ecuador. My mother was still working, but they thought it was the right time to come back. They never asked my sister or me if we wanted to return, even if I was 116

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of age majority. I was more than 18 and I did not have the intention of leaving … but … well … My sister was about 15 years old. Interviewer:

How did you feel about the decision to return?

I felt that it was not what I wanted. My being of age majority, I had a lot of ideas of what I could do over there. So, returning was like a hard blow. I was finishing up my bachillerato, but then, I had to finish it here, in Concordia. Luciano’s return was not easy: “I didn’t know anybody; I didn’t have any friends. All my friends were in Spain. I didn’t go out much. I communicated with my friends back in Spain. And, I don’t know, I was feeling like something was missing, like I missed everything.” However, Luciano felt that because he had his family, he “was ready to make the effort and try to assimilate, to adapt.” In his view, “it was so important what I had here, in Ecuador, that is, my family, that it was a good reason why I should not leave and move back to Spain.” Luciano was able to make new friendships in Ecuador and decided to study Hospitality and Tourism to be able to travel. Luciano tried his best to adjust to his family’s return and through involuntary return rebound, he overcame the negative feelings and experiences that he endured once he moved back to Ecuador. However, he shared that: In the future, I would like to go back to Spain. I’ve had a lot of ideas and I would like to apply them. Of course, it won’t be the same as if I had stayed and studied there. It will be very different. But I would still like to go back to Spain and try to use my studies in Tourism because there’s a lot of tourism there. … I would have to request a visa and would be able to be with some of my cousins who are still there. (Luciano, Personal Interview, Santo Domingo, 2017) Luciano had included future projections of returning to Spain as a way of dealing with the hardships that moving back to Ecuador without his will or full consent had created. This was a typical tactic that migrants utilized as part of their involuntary return rebound, to have a reason to conquer the negative feelings and become stronger to move on with their lives. The case of Jackelyn was similar to Luciano’s. She also considered that her return was “somewhat forced” at 18 years old. Her parents decided to move back because they had achieved their goal of building their own house in Ecuador and because Jackelyn’s father “never fully got used to living in Spain.” Her mother was worried about Jackelyn staying in Spain on her own, and Jackelyn was at first undecided. In the end, she made up her mind “because I wanted to continue my studies and my mother said that for that, 117

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I had to return to Ecuador.” The return of Jackelyn’s family was challenging, especially economically speaking given that “it took my parents a long time figuring out where to work here and how to make ends meet … so they came back with an idea that didn’t match the reality here.” Jackelyn, two years after their return, stated that “they were still struggling.” From her end, she recurred to the coping mechanism of involuntary return rebound mostly by focusing on the positive aspects of being back in Ecuador: In part, it was nice, because one returns to the place where one was born, where one has all the family, and one gets to see them again. And it is like starting from scratch all over again, but the main thing is really the family because you are with them and you can rely on them. … Like, I was very sad before leaving Barcelona. I cried like for five days in a row, because it was very sad to say goodbye to all my life, my friends, all the life that I had. Everything was sad. … At the beginning here, it was sad; we were nostalgic and cried often about memories and because we missed our friends and our life there. … But after a while, I started making friends and connecting with my cousins here, many of whom had also returned from Spain so they understood what I was going through. … And later on, I began to study and concentrated on that … on getting used to the educational style here. Jackelyn overcame the challenges of returning, focusing on her family, friends, and studies, and, like Luciano, used the plans she made for her future as motivation to move on: I believe that I will go back to Barcelona and live there. And if it’s not Barcelona, it will be another place, but it will be abroad. … I have this very clear in my mind. … Depending on how it goes here or when I complete my degree, when I had worked a little and that, I will leave … I had told my mother, two years max and I leave. (Jackelyn, Personal Interview, Santo Domingo, 2016) The case of Natalia and Horacio’s family illustrated a situation of involuntary return rebound on the part of Natalia, who was not in agreement with moving back to Ecuador, but also, on the part of Horacio, whose unilateral decision to return was more the result of a work accident that involved employment and health issues than a strategic plan. The family of three experienced return shock including health, couple, and economic problems. Natalia explained: I didn’t want to return because I wanted to complete graduate studies, but I could not. … Also, after seven years, I had gotten used to being 118

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in Spain; it was my second homeland. … Also, there was more support there, because even if there was a crisis, there were still many ways to make ends meet. For example, with food: there, we would buy and have enough for two weeks, but here, we spend the same and it’s only enough for a day. It is very expensive to live here in Ecuador. … Moreover, when we came back, we could not find work. My husband continued to feel poorly after his work accident. It is only now that he’s starting to recover. He tied himself to the depression. He felt bad. He only passed his time crying. And then, a year ago, his father passed away. … I don’t know if it was because he locked himself inward, but he could not break away from the depression. We tried to get medical and psychological attention, but he was not receptive. I would tell him to persevere and fight back to feel better, but he didn’t want to. … My daughter developed allergies, eczema … and incontinence. Natalia shared her wish to return to Spain because there were “more possibilities.” She was frustrated with the fact that she was still looking for work, but mostly, she was “worried about my daughter who tells me all the time that she wants us to go back to Spain.” Natalia was looking into migrating to Spain again and regretted that they had not filed the paperwork to obtain their daughter’s citizenship, who was born there. Still, she continued to investigate how they could leave and was trying to encourage Horacio, who had begun to express his desire to go back to Spain as well. Compared to her husband and daughter, Natalia seemed to be the only person able to recur to involuntary return rebound. Horacio and their daughter had been more affected and were still traversing their return shock at the time of the interview. However, Natalia was determined to see her family, especially her daughter, prevail. She knew “it was hard,” but was not ready to give up (Natalia, Personal Interview, Loja, 2016). The case of Marta’s family also generated return shock and included involuntary return rebound, however, their migratory, economic, and family crises resulted in the couple’s divorce. Marta had migrated to Spain with her husband and had left their daughter behind, “which was the hardest,” but after six months they were able to bring her with them. Marta and her husband “had calculated that three years of hard work as migrants would be enough” for them to meet their goals and then, move back to Ecuador. However, “it was not like that” and they stayed for 13 years. Marta had traversed a difficult active migrant trauma and suffered from heavy migratory stress: “I only lived working and thinking of saving so we could return, and with the passing of time and the realization that we were not going to make it, I started to damage my own self; I became sour.” Marta and her husband experienced a great deal of anxiety related to work and tried to overcome Marta’s problems as well as their daughter’s, who also had a difficult time 119

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adjusting to living in Spain “at a farm, in a rural, isolated area.” Several years later, once their daughter had grown up and had to attend high school, they decided to rent a house in the nearest town to their working place so she could be closer to the school. But: We then began to spend every penny in expenses and could not save any longer. Then, everything became more complicated, and things got difficult. We lost the house because we could not afford the payments, and that’s when we figured that it didn’t make sense anymore. We decided to return. We moved back with illusion because everyone would tell us that return migrants received several benefits from the government (that the President offered this and that), but after, everything got complicated and nothing was like we had imagined. Marta and her husband’s felt they had been forced to return because of their inability to afford their living costs despite 13 years of working 24/​7. So even if they had met some of their migratory goals, like building a house back in Ecuador, they felt unfulfilled and exhausted from the “disproportionate effort” they had to make. Upon arrival: We had our little house, and family close by, but nothing was the same. Because the excitement lasted a few days but now it’s like we don’t exist. Our relatives had already forgotten us. Before we used to get together for Christmas and New Year, but not anymore. And one thinks that when one comes back, one will find the people just like when one left, but the family is not like that anymore and society has changed too; and the space one used to have is not there any longer. So, it is very hard, because we are not young anymore either. Like, I thought I was going to be able to work, to be a salesperson, but nothing. It is even more difficult to find work now than when I left. So, I was convinced that I was returning to known territory, but I was not. For me, it has been very difficult. It’s been five years since we came back, and it is only recently that I have begun to recover. Marta’s daughter also had a difficult time returning to Ecuador (she had been there from the age of six to 19). Despite being in a relationship and having had a baby with a fellow Ecuadorean, she “cried every day and wanted to return to Spain.” Marta stated that she “would not go back to Spain” herself because she thought she would be “making the same mistake” as when she returned to Ecuador, that is, “to think it will all be the same, that everything stays just like when one left.” Marta’s involuntary return rebound was slow to develop, also because her marriage ended, which “was very hard to take on;” but once it did, it involved her becoming actively involved 120

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with an organization for return migrants in Loja: “where I can help other migrants not to suffer as much. Because if I suffered, I could prevent others from going through things that can be avoided if they know about them in advance. Suffering teaches one to be humble and generous” (Marta, Group Interview # 2, Loja, 2017). Another case that included the use of this coping mechanism was Rocío’s, whose family “was practically forced to return” due to their unemployment during Spain’s economic crisis “so even if we had had in mind the idea of migrating back at some point, we had to rush it because we simply could not make ends meet anymore” Rocío’s family traversed a heavy return shock that included economic strain, family conflicts, and physical, psychological, emotional, and cultural problems (which I shared in detail in Chapter 2). However, in time, the family was able to prevail by employing involuntary return rebound. Rocío, who was “very anguished with the idea of coming back to Ecuador because it was like having to start back from zero again, and adapt to being here,” shared that her “shock dissipated gradually.” Rocío soon started her university studies and was able to counterbalance the difficulties and bad feelings by: focusing on what made me feel better, that is, being in my house, having my own space, being close with my parents and brother … and seeing that my parents are more at ease here makes me feel more at ease myself, like it brings me peace, internal peace. Rocío felt “stronger internally after being able to traverse the hardships of coming back” and also “matured and learned to express better my emotions instead of keeping them to myself and eventually exploding.” Rocío also talked about her brother’s journey from return shock to involuntary return rebound: He was gradually able to pull through his shock. Little by little, he tried to get used to being here in Ecuador … and he started to make plans for college: he wants to study Civil Engineering in Quito, because he is used to and prefers to live in large cities. While Rocío didn’t divulge the details of her parents’ experience, she mentioned a few things that indicated that they were also able to bounce back from their return shock. She stated that “they had been able to settle economically and were doing well.” She also shared that her father was “a very strong person, who doesn’t fear confrontation and pushes for what is fair; speaks up his mind and perseveres,” and that her mother was “finally living a more comfortable, less demanding life, not exhausted from working all day, living in a place of her own” (Rocío, Personal Interview, Santo Domingo, 2016). 121

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As a result of our snowball sampling technique, none of our research participants who had returned had been deported themselves, but several participants had relatives or close friends who had been. If we had more direct experiences of how migrants dealt with deportation, we may have been able to conceptualize coping mechanisms and/​or health processes specific to deportees. However, based on the indirect data collected on deportees’ experiences, we found that they also tended to suffer from return shock and employ involuntary return rebound. We observed that the three most common methods that deportees utilized to rebound were (1) to reaffirm their livelihood and life projects and goals in their homeland, discarding irregular migration as an option; (2) to make plans to migrate again in regular terms to avoid deportation, or (3) to migrate again, irregularly, determined to face known risks and have a better understanding of how to avoid trouble with migration officers. Their path seemed to have been influenced by their own experience as active migrants, including their reflective mourning, active migrant trauma and migratory stress, as well as return shock. Transgenerational goals and well-​being ideal influenced the way they experienced involuntary return rebound, which was also impacted by deportees’ personalities and risk inclination; psychological and physical health history; resilience; family ties and dynamics; their social and cultural capital at home and abroad; as well as the needs and contingencies they were dealing with when making the decision to migrate again or not. This chapter explored how psycho-​sociocultural mechanisms were utilized to cope with the multiple challenges presented by migration. On the one hand, the combination of disillusion adjustment, paralyzing and motivating nostalgia, denied migrant health, normalization of malaise, and pain encapsulation made it possible for active and passive migrants to endure the many obstacles and difficulties created by outward migration. On the other hand, and depending on the type of return migration experienced, active and passive migrants used strategic return and settling readjustment or involuntary return rebound to handle the effects resulting from yet another round of migration. Moreover, be it for outward or return migration, active and passive migrants drew on the overarching coping mechanisms of well-​ being ideal and transgenerational goals to overcome migratory hurdles, including related health processes, and persevere. In the following chapter, I focus on the way active and passive migrants dealt with the changes that migration brought to their family relationships specifically.

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4

Post-​migration Family Relationships People who, upon migration became active or passive migrants, were also a part of their own families, be they more or less united, supportive, or harmonious. These families had their own dynamics, members, ties, conflicts, and history before migration, a configuration that can be categorized as family pre-migration. Once migration occurred, usually triggered by critical reasons, a new phase in these families’ history began, creating a new configuration, that of family post-migration. This was comprised of active and passive migrant family members, plus the possible additions of fresh members due to new unions, and sometimes, later, reunification abroad as a result of the layered migration of relatives who had originally stayed back home. If return migration also happened, another layer to the family post-migration was added regardless of whether or not there was a reunification and it being partial or total. Future rounds of migration continued to add layers to this reconfiguration. These various migratory processes generated the need in active and passive migrants to deal with the novel dynamics, members, ties, and conflicts of the family post-migration as it continued to develop its history. The psycho-​sociocultural mechanism of family de/​re-​construction was at the core of passive and active migrants’ ability to cope with their transformed family realities. This mechanism was complemented by a set of five others: communication distortion, subordination to concealment and deception, unspoken pacts, resentment and detachment, and sensible comprehension (as shown in Figure 1.1 in the Introduction). This chapter explores how active and passive migrants coped with the effects of migration in the family by including significant portions of stories of health and migration shared by active and passive migrants in individual and group interviews and community workshops held during our transnational research.

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Family de/​re-​construction This study indicated that active and passive migrants coped with the disruptive effects that migration had on the family by utilizing a mechanism conceptualized as family de/​re-​construction: that is, migrants’ family units were untangled and refashioned with the departure and/​or return of its members based on the new dynamics generated by the migratory process. The mechanism of deconstruction and reconstruction of the family was activated to deal with the changes and overcome the challenges caused over time by the separations and reunifications of family members. Tied to reflective mourning, migrant trauma, transgenerational goals, and the well-​being ideal, active and passive migrants recurred to this mechanism both instinctively and strategically to be able to move on with their personal and family lives in the various phases of their migratory processes. In other words, the disruption generated by migration was felt by both active and passive migrants, but it did not equate the end of the family. In contrast, it motivated family members to rethink and reorganize their lives, relationships, affections, and future projects. Troubles were addressed (more or less openly) and handled (more or less successfully) with the aim of finding a renewed sense of peace and purpose as a member of a migrant family. The deconstruction and reconstruction of families was a mechanism that was used in all occasions where family dynamics were altered by new migrations including the departure of other family members, reunification abroad, and return migration and reunification (see Figure 4.1). This research revealed that the kind of family de/​re-​construction that developed depended on (1) the family members that migrated, stayed, and returned; (2) their relationships before migration; (3) their migratory plans and goals; and (4) their personalities and well-​being. Based on the first factor (1), six types of family de/​re-​construction were identified as the most frequent: • simultaneous migration of nuclear family with children; • migration of parents alone, leaving children behind with relatives; • migration of father alone, leaving wife and children behind; • migration of mother alone, leaving children behind with husband if present, or close relatives if father was absent; • migration of older sibling; • migration of childless couple. All these types of family de/​re-​construction were affected by the other three factors. Regarding (2) their relationships before migration, I found that the stronger the ties among family members, the more desired and inclusive

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Figure 4.1: Illustration of family de/​re-​construction

the reconstruction of the deconstructed family; contrarily, the weaker the ties, the more fragmentary the reconstruction of what could have been a desired deconstruction to begin with. As far as (3) their migratory plans and goals, I observed that on the one hand, the clearer and more inclusive the family migratory goals and plans, the faster and more enhanced the reconstruction; and on the other hand, when families counted on a higher set of economic, legal, social, and cultural resources, the smoother the family de/​re-​construction. Lastly, in terms of (4) their personalities and well-​ being, I noticed that the more autonomous personalities and the stronger the physical and mental health of active and passive migrants, the more resilient they were in response to the challenges of migration and family de/​re-​construction. These types and general patterns of family de/​re-​construction help us to better comprehend the experiences that migrant families traverse by providing a texture and complexity that differs from the common observation that migration only causes families’ crises and breakups. This categorization is neither exhaustive nor diminishing of the great emotional costs and difficulties caused by family separation. Indeed, when claiming that families deconstructed and reconstructed, disarticulated and rearticulated, it is not implied that passive migrants did not regret their relatives’ departure or that couples that were separated de facto due to migration were always faithful and reunited without any problems. Quite the opposite; what is described here is how these unsettling processes occurred while the family structure and dynamic was consequently recreated. In other words, the conceptualization of family de/​re-​construction departs from idealistic notions of family unity and 125

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harmony to signal instead realistic family forms including separation, conflict, rancor, acceptance, adaptation, recreation of relationships, and the like. In the following sections I present the family de/​re-​construction mechanism that the six most frequently identified types of migration involved.

Simultaneous migration of nuclear family with children One of the ways in which families migrated was by leaving altogether as a unit. This type of migration was found less frequently in our study due to the high costs of migration and the fact that most migrants left because of economic hardships. Despite this burden, there were several cases of nuclear families that had been able to migrate simultaneously. When nuclear families (which in our sample were typically conformed by wife, husband, and one or two children) migrated together, they left parents/​grandparents and other extended family members behind. When these passive migrants had close ties to the departing nuclear family members, first they went through reflective mourning, suffering what they felt as a loss in the family, but later, they reorganized their relationships with their relatives abroad. The active migrants, that is, the nuclear family members that left, also suffered the separation from their close relatives who stayed behind, but then, rearticulated their relationships with them from abroad. Also, active migrant families adjusted to the new environment in which they lived with its cultural and social norms and recoded their intimate family relationships in the new context with its demands. Sometimes, life abroad led to the separation or divorce of couples. The case of Selma provides an example of family de/​re-​construction of a family unit migrating together. Selma migrated with her husband and daughter. In response to other participants in the group interview who had described their difficulties as they left their children behind as well as the conflicts they experienced with their partners due to staggered or solo migration, she said: My daughter came with us. And we still had problems because we started to spend all the time we had working as soon as we arrived in Spain and couldn’t devote the necessary time to her. She has a great resentment. Now that she has grown up and is a mother herself, she continues to complain about it; and I see that it still hurts her. I also see that I spend more time now with my grandchildren than I did with my own daughter. … Regarding my husband, we went together and stayed together, worked incessantly until we decided to return to Ecuador. But like some who separated there, we separated here, after returning. Because, once we were back here, he couldn’t get used to earning less, he was desperate; he was so used to earning good money 126

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in Spain! He would get mad at me, and I would get mad at him—​he would accuse me because I was the one who wanted to return, and I would tell him, ‘We will be fine soon,’ but my words weren’t enough because here there were few work opportunities, and we earned very little—​not enough to buy milk for our children. Our problems started here; we didn’t have them in Spain. It was a little strange. (Selma, Group Interview # 6, Santo Domingo, 2017) Even if Selma felt her case was rare, it was not. Many couples who had left together, or separately but spent many years together abroad, ended their marriages after moving back to their place of origin (see Chapter 2 on return shock). Lucila, for example, expressed: Sometimes we think that leaving together or following one’s husband is going to solve everything. But that is a lie. In my case, I left three months after my husband. We stayed 12 years in Spain. Then, he came back first to take care of some trouble that we were having with property we had bought, and quickly he found a lover. When I returned a couple of months later, he had already gotten involved with a different woman. So, the problems not only happen when one leaves in stages, or when one is abroad, and things get difficult. They don’t even happen once one returns because of the money, because we were all right economically, we had worked, saved, bought property back here. Yet, we ended up divorcing. And I wonder what the point of all this effort was. Now I’m alone. My family is split, I’m divorced, two of my sons stayed in Spain, and one came back with us. We are family, but we are apart, even if we tried staying together from the beginning. (Lucila, Group Interview # 2, Loja, 2017) Other couples who migrated together also separated due to the stress of migrant life and/​or “the curiosity that created meeting people from other countries” and “the fact that the culture abroad was different, more liberated; women were more informal, they smoked, and went to bars on their own; and that tempted Ecuadorean men and also women who wanted to explore that life” (Marta, Group Interview # 2, Loja, 2017). On some occasions, the parents continued to be involved in the lives of their children once they had separated and moved out, but this was not always the case. In both situations, family members restructured their relationships according to their new realities. The process was never easy, but they all traversed it and reconfigured their sense of family. Usually, when couples with children separated, passive migrants worried and tried to offer their support from a distance. They talked more often, tried to arrange visits, reassured their migrant relatives not to worry about them so they could overcome the crisis of the separation, and 127

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suggested they return and rely on their day-​to-​day personal support. That is, separations triggered the reconstruction of passive/​active migrant family members’ relationships as well. Families were apart and fracturing, but in opposition, they were reinforcing their ties. Magdalena’s family experience in Spain illustrates these experiences: after her divorce, she took care of her son on her own financially. However, the father continued to have a relationship with his son, who “was very attached emotionally to his father” (Magdalena, Personal Interview, Barcelona, 2017). After the divorce, Magdalena was depressed, but gathered the strength to work two jobs to provide for her son’s well-​being. She stated: “I never spoke ill of my husband to my son. I explained to him that we had desired his birth and loved him more than life itself, and that we could not understand each other anymore as a couple and separated” (Magdalena, Personal Interview, Barcelona, 2017). Her family back in Ecuador was aware of what was happening and suggested she return to Ecuador with her son so they could help them. But Magdalena’s son “begged me not to leave Spain because he was born and raised here, and he liked it very much, plus he didn’t want to be away from his father” (Magdalena, Personal Interview, Barcelona, 2017). Magdalena wanted to move back but stayed in Spain for the sake of her son. Her parents and siblings were trying to secure a visa to at least go and visit her, but it was expensive and complicated, and they were not able to travel. With these cases, one can observe that family shapes and dynamics changed with migration, going through various stages of disarticulation and rearticulation, which were always challenging, sometimes traumatizing, but mostly, passable; that is, active and passive migrants persevered in reconfiguring their sense of family. Other types of migration presented different ways of family de/​re-​construction.

Migration of parents without their children The departure of parents who left children behind was one of the most typical forms of migration found in this research. Most of the migrant families were leaving their country due to poverty or impoverishment, and the possibility of migrating with their children was prohibitive because of the high costs involved. With a future-​oriented survival strategy in mind, parents’ migration comprised one of two plans: either to leave for a short period of time to earn enough money to help resolve their predicament and return to reunite with their children, or to leave and start saving immediately to be able to afford to bring their children with them. On many occasions, neither of these plans were successful: migrants needed significantly more time to gather the resources to return or bring their children, so this only delayed any prospect of reunion, a delay that resulted in a high, but unavoidable, emotional tax. When plans did succeed and 128

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reunification occurred more promptly, the emotional tax was lower, but still present. Indeed, all parents who left children behind and all children who spent time separated from their parents were unanimous in their assessment of that phase of their lives as being the most difficult ever. When families reunited, they counterbalanced the sacrifice by acknowledging the accomplishment of their family migratory goals and enjoying their being together again despite the hardships. Families who were still apart had different perceptions of the value of being separated, many stating that they doubted economics was as important a factor for their well-​being, others still hopeful that reunions would happen soon and their situation would improve, justifying the strain endured. There were two ways in which parents left on their own: the couple either left simultaneously or in stages. The reflective mourning, passive migratory trauma, and migratory stress that children left behind with other family members traversed was hardest when both parents left simultaneously. However, the alleviating effect that staggered parent migration had was quickly eroded with the departure of the parent who migrated last. Children suffered their parents’ departure and absence. Nonetheless, they created new bonds with their new caretakers (usually their grandparents, but sometimes their uncles and aunts). Grandparents and/​or extended family of the migrating parents also suffered the departure of their relatives but tried to remain strong as they developed their new role as caretakers of the children. As time passed, passive migrants recreated their relationship with their active migrant relatives abroad, forging a new sense of belonging as a transnational migrant family. Regarding the migrating parents, they also suffered the separation from their children, as well as from their parents, siblings, or extended family with whom they had close ties that had stayed behind. Reflective mourning, active migrant trauma, and migratory stress were heightened by the emotional burden they felt leaving their children behind. By relying on the coping mechanisms of transgenerational goals and well-​being ideal, active migrant parents willfully worked to either return soon or gather resources to bring their children, and, if they could, their parents and relatives, with them. In the meantime, they recreated their relationships with them from afar, usually maintaining regular communications and reassuring their love and reunification plans. Concurrently, couples adjusted to the environment of their new place of residence with its cultural and social norms and recoded their relationship according to the demands the new situation raised. This adjustment was usually harder when couple’s migration was staggered (the longer their separation, the more difficult); but many overcame the trial and strengthened their bond. Divorce or a formal end of unions were a common outcome of migration for both couples who left simultaneously and those who migrated separately. As in the previous type of migration 129

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explained earlier, the hardships of the migratory process and the exposure to new cultures triggered problems between couples. The case of Brigit and Lourdes’ family illustrates parents’ solo migration with reunification upon return; they shared: Brigit:

My parents left with the economic crisis. I was five or six years old. The first one who left was my aunt. She went to explore how things were there and set up a base. Then, all my father’s relatives left. This affected us very much because we were like 15 cousins who were left behind in charge of our grandparents, every one of us residing in just one house. There only were three or four adults caring for all of us minors. None of the cousins was an adult. The oldest ones were between 12 and 15. This affected us very much. My parents talked to us very much—​we were three siblings. But my cousins spoke to their parents every one or two weeks. But our parents called us every single day, even twice a day sometimes! The first time they were able to return to visit us was two years after they had left. That trajectory affected our emotional growth very much. The pretty and gratifying thing of this was that we have been responsible people and that my brother has been able to look after us while he pursued his own responsibilities. That motivated my sister and I to move on even if our parents were not there with us.

Lourdes:

My grandmother, even if she had a lot of difficulties, was loving and caring with us, with all her grandchildren. We had everything with her. Despite scarcity and the needs that we had because our parents were far away, she always gave us love and made sure that we went to school and performed well. There were some difficulties with our schooling, especially with adolescence, but some of our uncles and aunts started to return and would take charge of their children again and help them out. We stayed with my grandmother for about five years. After that, our parents had been able to build their house, and my grandmother didn’t want to move to that house, that was larger and more elegant. So, we moved the three of us alone, we were seven, 11, and 14—​my brother, the eldest, took charge. He was a responsible person, educated. He earned his degree and became a professional. Later he got involved with a woman and they had a girl. This created 130

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some problems, but my sister and I continued studying. We have been able to earn a degree as well and we have our careers. My parents always were very affectionate, so at least over the phone, we felt their affection, their love. They would ask us how we were doing, how was school, if we needed anything. That is, we didn’t lack anything. While they were abroad, we were fine. The problems started when they came back. My father wanted to invest here in Ecuador; he set up a construction business. He invested a lot of money but ended bankrupt. Now he is suffering very, very much. Now it is our turn to be strong and start to give them what they gave us. Despite their absence, we always felt like they were with us … even if there were difficult moments and we have some emotional deficits, we have always loved one another, and we are a strong, united family. Brigit’s and Lourdes’ experience included multiple layers of family de/​re-​ construction. First, upon the departure of their parents; second, forming bonds with their grandmother and cousins while readjusting to a relationship afar with their parents; third, living independently without adult supervision; fourth, the brother’s refocusing on his own family of procreation; and last; the return of their parents to Ecuador. Throughout these phases, they maintained a solid sense of unity and family belonging and despite the difficulties, everyone persevered in pursuing their family goals and well-​being. The experiences of some of their cousins were also successful, like Lourdes mentioned, “some were able to become doctors, engineers, lawyers, including a couple who are successfully working abroad.” However, other cousins found it more difficult, “some took drugs, became addicted, single parents, without a career or a profession, unemployed” (Lourdes, Group Interview # 4, Loja, 2017). Brigit’s understanding of these disparities pointed to the fact that in comparison with their parents, their cousins’ parents had less frequent communication and left them unsupervised. But she also recognized that “phone calls sometimes are not enough” and that “it is not easy to gather the strength to care for oneself; not all of us are capable of enduring the distance and become self-​sufficient” (Brigit, Group Interview # 4, Loja, 2017). The case of Frida’s family presents another example of complex family de/​re-​construction including the migration of her parents in turns, the migration of the children later, and finally, the family’s return; she explained: In my family, we are three children. When I was six, my father left for Spain because of economic problems (we had had to move in with our grandparents and things were not getting any better, so they 131

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decided to migrate). When I was seven, my mother left. The three of us were left with our maternal grandparents. But there was a dispute between the maternal and paternal grandparents about who should the grandchildren be left with. They ended up splitting us. … It was very hard. After Frida stopped crying, she continued to share her story: My parents returned. But then, my father left again. After one year, my mother decided to go back to Spain to reunite with my dad, but this time, she took us with her. I was very happy when my mother returned. I was happy to be with my mom. Wherever it was. Also, with my father and siblings. When we went to Spain, we stayed at my aunt’s house. It was not easy to afford a place to live, but thank God, my father found a job where we could also reside. We stayed there, in that place for seven years … and the last three we lived somewhere else. ... In total, we were in Spain for ten years. When I turned 18, we returned to Ecuador. It was because of the economic crisis there. First, my father came back to Ecuador, and after, my mother and the three of us returned. Thank God we all moved back, and we are together again, the five of us. Frida’s emphasis on the happiness and well-​being she felt when they were together was clearly expressed during the group interview. For her, being away from her parents first, then from her brother, and later, from her father, was emotionally very hard. She treasured their company and family unit. The conflict among the grandparents added to the stress of her parents’ departure. But the parents’ various trips and their efforts to keep the family together reassured Frida of their love. In her case, family de/​re-​construction was also multifaceted, challenging, and in the end, rewarding. In her words: “I have always been thankful for having been able to be with my family. … When I had trouble, I was always able to find solace in my mother, in my family. Being able to be with my family is the most important” (Frida, Group Interview # 4, Loja, 2017). Finally, Estefani’s case was an example of how family de/​re-​construction can bring a more divisive and conflictive resolution. Her parents and older brothers left when she was one year old, but she stayed with her grandmother. They returned after ten years. She shared: I don’t remember well, or too much. I was told. They visited once a year. It was not very pretty because I would get attached to them but then they would leave. When they moved back here, my parents started 132

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to have problems and they ended up separating. I stayed with my father and my grandmother. My mother stayed in a different house with my brothers. I don’t get along with her, I never had a good relationship with my mother since she returned. Here it was only fighting, and she only would approach me because of interest. So, as I grew up, I said, ‘No more.’ For me, my family is my grandmother and my cousin. We are very united. … It is not that I don’t love my parents and brothers, but I prefer that they go back to Italy because I feel that since they returned, they only had trouble, because they separated, and the family broke apart. … Sometimes I feel that it was my fault because they wanted everything to work out, but to me, my real family were my grandmother and my cousin, so it was complicated. It would have been better if they stayed there and continued living like they were used to. At the beginning, when they arrived, they moved in with us, but after one year, they were ready to move out on their own, have their own space, and that’s when we had trouble, because they wanted me to move out with them and I didn’t want that; I wanted to continue living with my grandmother and cousin. Also, trouble came because at first, they had work, but later, they didn’t. My father became unemployed and he’s still out of work. Indeed, as far as I know, he wants to go back to Italy. But it is not that easy, because my seven-​year-​old brother is very fond of my father so if he left, he would have to bring him along, and besides, he would have to take me, because now that he is not with my mother anymore, I would have to be the one going with them to cook and take care of them. But I am not going to leave because my grandmother is here, and it would be very difficult to be away from her after living with her for so many years. (Estefani, Group Interview # 7, Santo Domingo, 2017) In Estefani’s case, we see at least five layers of family de/​re-​construction, including the original nuclear family, the split transnational nuclear family, the extended family unit, the reunified return family, and the separated return family. While these layers created rifts and fragmentation, they also generated strong bonds, especially between passive migrants. Such a bond was frequently found in cases of children passive migrants raised by their grandmothers for many years with limited contact with their parents and siblings abroad. In Santo Domingo, the number of children in that situation was so common that: “Schools changed the celebration of Father’s and Mother’s Day to Family’s Day, so we wouldn’t feel bad if our parents were not around and we would be able to celebrate the love we felt for our grandparents or our aunts and uncles who were raising us” (Malena, Group Interview # 7, Santo Domingo, 2017).

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Through the set of cases presented in this subsection, one observes that the migration of parents on their own usually led to more or less challenging reunification processes abroad or upon return. The ways in which the family was able to rebuild their untangled bonds depended heavily on parents’ regular communication with their children and inclusive migratory plans. Time apart and the age of the children were also factors, but our sample cannot provide a conclusive answer since some families were able to solidify their bond even if they were apart for more than a decade and the children were young, while others with only a short period of separation and various ages found it more difficult.

Fathers migrating alone The departure of fathers alone was another one of the most common types of migration found in our study. The children in this case were left behind in the company and care of their mother. Grandparents and extended family members with close ties to the migrating father experienced reflective mourning, migratory stress, and passive migrant trauma, albeit to a lesser intensity than the wife and children. With the passing of time, they recreated their relationship with him from afar. In some cases, the couple maintained their union commitment, although often, the active migrant formed a new family abroad. This development was frequently hidden from the spouse and children, but usually, sooner or later, it was revealed. The main issue at stake in that particular situation was the continuation of the father’s support to the children. That support consisted mainly of remittances, and when possible, in the arrangement of the migration of the children. Emotional support, although considered important, was not as relevant as the other two because the primary transgenerational migratory goals of the family were to improve their life conditions and secure a good future for their offspring. The couples’ formal separation or divorce resulted in another shift in the family that involved restructuring the relationship with the father and his new family abroad. The split of the couple was not directly related to any marital problems pre-​departure, but of course when that was the case, it made the formation of new relationships more appealing. Active migrants’ ability to traverse their reflective mourning, migratory stress, and trauma on their own, that is, without the support of kin, greatly influenced them in looking for new partnerships. Another situation that pushed active migrants in that direction was their legal, migratory and/ or economic needs. Often, active migrants considered getting married to a person who already had residency or citizenship abroad in order to secure their own migratory regularization—​this was very common in the United States. These unions of convenience sometimes developed into more intimate relationships, including the birth of children. Economic 134

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need also propelled active migrants to seek companionship to split their living costs, sometimes leading to a serious relationship abroad. In addition, as mentioned in the previous two types of migration, active migrants also found themselves in a new cultural and social environment that sparked their curiosity and offered the opportunity to explore new relationships. Despite this usual occurrence, it was just as common for active migrants not to form new unions and stay loyal to their migratory family plans. The husband/​father suffered the separation from his wife and children as well as from other close family members who stayed behind. In time, through overcoming the mourning, stress, and trauma, he managed to reshape his relationship with them from afar. He actively worked to keep his promises and worked as much as possible to send back remittances and either return soon or gather resources to bring all the family abroad (especially his wife and children). Last, and least common, active migrants sometimes departed and after some time lost track and ceased communications and relationships altogether with their wife and children. The following three cases illustrate some of these variations of family de/​re-​construction. Camila’s father, Luis, left due to economic scarcity with the intention of staying abroad for three to five years to be able to provide for the family, but he ended up returning 12 years later. Camila was only six months old when he left. She didn’t remember much, only the more recent visits he made, when he would stay for 90 days. However, Camila remembers how the family felt: I would see how difficult it was for my mother. She was alone, although my grandmother helped her a little. For me it was strange to go to family reunions where fathers and mothers were present because I only had my mother. Father’s Day was always very hard; I always had affection for my father, I never felt anger or anything against him. I always had him in a special place, but my mother’s place was even more special. I also remember that it was fun when he visited because he spoiled us. But after his departure, it was very sad. I couldn’t understand much when I was little, but I saw my aunts who were very sensitive become very sad, and how my grandmother had a terrible time, and even how my mother, who was very strong, still suffered plenty. Luis also suffered through the process: It was always difficult to go back to Spain after spending time with my wife and daughters. I had to go back to hard work conditions, and the mistreatment that other Ecuadoreans would put me through, just because they got papers and were in higher positions and believed they were the best of the best. … But I had to go back so we could 135

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achieve our family goal. My wife and I had set the goal of having our own house because we lived in a room in my parents’ house. So, little by little we could start saving to buy a piece of land and build our own home. I also had tried to arrange for all of us to go to Spain, but I could not gather enough money to do it. I was working well and earned well, but not enough to pay for the application for my family. I also had to rent a place to live, but that was very demanding because one had to pay two or three months in advance. I didn’t have enough. Regarding the possibility of migrating to Spain, Camila shared that she didn’t like the idea because “I always had in my mind that I would never leave my grandmother behind.” Luis’ return was triggered by a work accident and given that he had “achieved their goal of having their own house” and he “had no debt” he arranged to move back in three months. The reunification of the family in Ecuador was a difficult transition, but after three years they felt “more adapted” and they “had not regretted the decision” (Luis and Camila, Personal Interview of father and daughter, Loja, 2016). In this example, the family went through several layers of deconstruction and reconstruction. First, with the initial departure, for Luis, being alone abroad, and for Camila, her sister, mother, and grandmother, being away from Luis and on their own. Second, their adjustment to living as a transnational family, for which a strong and shared common goal, their persistence in advancing toward it, and Luis’ frequent communication and visits were fundamental. Third, the reunification of the family in Ecuador that involved all members going through return shock but ended successfully in the sense that despite the difficulties, both passive migrants and returnees improved their health and well-​being, and the nuclear family were reunited. The case of Armando mirrored the previous one, except that he had neither been able to visit nor migrate back to Ecuador. Armando (Etelvina’s husband and Clara and Sofía’s father) had been in the United States for 12 years even if “his idea was to return quickly because he had a tourist visa for three months, but the economic situation was not improving here so it didn’t make sense for him to come home so soon.” Armando’s remittances helped Etelvina and their two daughters get by, but “we also had to sell the taxi and the little piece of land we had, and we almost mortgaged our house. The financial crisis pushed us all to the edge, we practically lost everything.” In that context, Armando and Etelvina “decided that he would stay longer even if we were literally all getting sick from the problems we were having and from being apart.” Despite these challenges, the family persevered in overcoming the mourning, trauma, and stress generated by the migration process, and focused on meeting their transgenerational goals, keeping their well-​being ideal in high regard. Etelvina and Clara valued Armando’s loyalty and perseverance: 136

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Etelvina:

My husband never lost track. Even if he wasn’t paid well, he always sent remittances. He says, ‘The most important is that our daughters achieve their professional goals and become good professionals.’ He feels proud of our daughters’ success. We feel proud of them. They are good daughters. … He always worked extra so we could manage here without me going to work. Instead, I stayed home taking care of our daughters so even if he wasn’t around, I was always there for them.

Clara:

My dad never lost his connection with us. Every day, from Monday to Monday, we receive his phone call, from 7 to 8, one hour. He has always been constant. My daddy never missed a call. We tell one another what we did during the day. … He has been telling us that he’s tired of working so much and being away from us, but here there are still no opportunities for him to assure that we would be able to be all right without the income he generates in the US.

Etelvina, Clara, Sofía, and Armando sought spiritual relief to traverse the adversities and sadness they felt; “going to church and joining praying groups helped us move forward and regain strength.” In reflecting on their experience, both Etelvina and Clara were grateful that they were able to maintain their family unity from afar. They had learned from relatives and acquaintances that “other families had split up, couples got divorced, children took on bad habits, drugs and alcohol, they moved away with their boyfriends or girlfriends when they were still too young, they dropped out of school.” But in their case, they described having been able to grow from the hardships: “It has been like a strengthening process for us. We are apart physically, but we are together as a family” (Etelvina and Clara, Personal Interview of mother and daughter, Loja, 2016). Their family de/​re-​construction was very taxing but successful in the sense that both Armando as an active migrant and Etelvina, Clara, and Sofía as passive migrants were able to recreate their family relationships according to the demanding circumstances they were faced with. A few months after the interview, Clara contacted me to let me know that she was going to visit her father in New Jersey. A visit that “was wonderful, like a dream come true” (Clara, Electronic Personal Communication, Loja/​New York, 2017). The case of Antonio’s brother exemplifies another very common but less constructive experience, that of a father migrating and losing touch with his wife, children, and extended family. In Antonio’s words: My brother left for Spain 15 years ago. He has not returned. He doesn’t talk much with us. I know that he has not sent anything to his wife 137

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and daughters. … He tells our mother he will come visit, but then he does not. … When his daughter graduated, he didn’t come. And when his other, older daughter got married, he didn’t come either. Antonio broke down when he shared this, and then emphasized that it had been a very strenuous situation. From the interview with Antonio, I learned that despite his brother’s departure, his wife and daughters had been able to restructure their family life among themselves and their extended family—​including Antonio, who had been a caring uncle, and their loving grandmothers. In this case then, family de/​re-​construction involved a reorganization of the nuclear family independently from the husband/​ father’s erasure from their lives, while strengthening the extended family ties. As for Antonio’s brother, I didn’t learn if he had formed a new family in Spain, but according to Antonio, it seemed that his brother’s detachment was related to him “not having any work” and having “a hard time in Spain. He tells us that he is fine, but I know he is not telling the truth.” Based on this information, one can deduce that Antonio’s brother failed to overcome the challenges of migrant life, and his way of dealing with being part of a transnational migrant family was not to engage in family life from abroad. His brother’s words showed that nevertheless he still felt his brother close and missed him very much, hoping that “he will return and rejoin the family sooner or later” (Antonio, Personal Interview, Loja, 2016). When compared to one another, these three cases of fathers migrating alone led to disparate outcomes in terms of family integration, some more unifying than others, some more traumatizing than others. However, all showed the layered texture of the deconstruction and reconstruction of family dynamics indicating elasticity and resilience.

Mothers migrating alone In the majority of the cases in our research, the mothers who had migrated alone were single and left their children behind to the care of primarily their own mothers, and with less frequency, their older siblings or extended family, such as aunts and uncles. There were also a few cases where the mother who had migrated was married and left their children to the care of their father and extended family. In general, the migration of mothers alone was the hardest of all, both for the children and the mothers, who deeply suffered the separation. Children who were left with grandparents or aunts and uncles were usually young, sometimes younger than one year old. Mothers usually left to be able to provide a better future for their children, weighing up their limited options in their country of origin and the anticipated difficulties that would arise from separating from their children against the potential well-​being that migration would generate. Mothers had a clear plan to either 138

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return as soon as they could advance their transgenerational goals or reunite with their children abroad (by picking them up themselves or sending for them, depending on their age and care network). While, without exception, mothers went through a taxing process of reflective mourning, migratory stress, and trauma, they all persisted in recreating their connection with their children and the other family members who stayed behind. On the passive migrant side, the mother’s adult relatives also went through reflective mourning, migratory stress, and trauma, but in their heightened role as children’s caretakers, they actively worked on building strong bonds with the children while reaffirming their mother’s commitment to their well-​being. Sons and daughters went through reflective mourning, migratory stress, and passive migrant trauma, but the way they processed the migration naturally changed depending on their age at departure. When they were very young (babies and toddlers), their memories of how they went through the separation are based on stories their caretaker relative told them. All mothers recognized that their young age didn’t prevent them from being negatively affected by their departure and shared their children’s rancor towards them, even when they were able to reunite on good terms. Older children had their own memories about their mothers’ migration and assessed that decision and phase in their lives mainly by considering the length of the separation and what happened after. Longer separations were always more difficult to remount. How children rebuilt their relationship with their mothers from afar varied all the way from strong transnational ties to formal acknowledgment of their relation. Caretakers influenced the mechanism of family de/​re-​construction significantly. In the case of grandmothers, they usually became the children’s de f​ acto mother (more so in the case of babies and toddlers), and in that role, they tended to preserve the children’s love for their mother as much as they possibly could (grandfathers were also influential and tended to support their wives’ actions). In the case of aunts and uncles, their bond was usually not as strong as the one the grandmothers were able to generate. However, the more they could reaffirm the connection with the mother, the better the children could develop those ties. In the rarer case of fathers being present, the main aspect signaling the reconstruction of their relationship from abroad was the couple’s union: if the migratory plan was consensual and they had been able to rebuild their dynamic while apart, the more positive the influence they exercised on their children’s efforts to rearticulate their relationship with their mother. Nonetheless, if the couple already had or started having problems, the father had a more negative impact on their children’s ability to reconstruct their relationship with their mother while away. In all these cases, the way in which the mother maintained her communication and regenerated her ties with her children was essential. In terms of the possibility of mothers finding a new partner and expanding their family abroad, our research found that it happened more frequently 139

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when mothers were single or if they were having marital problems with their partners before departure. If mothers were single, forming a new relationship abroad could either facilitate or hinder her relationship with her children depending on her new partner’s disposition to help her reunite with them and them having more children while abroad. If she was still in an active relationship with her husband, mothers sometimes tried to keep the new relationship a secret for as long as possible, keeping both relationships simultaneously, usually if she didn’t have more children with her new partner. Other times, mothers were honest about it, resulting in a formal separation or divorce, and in most cases, in the continuation of her transnational ties with her children and plans of reuniting abroad to have them join her with her new partner (and children). The reunification of children with mothers who migrated alone was another layer of family de/​re-​construction that included return shock (if she came back to her country of origin) and reflective mourning, migratory stress, and trauma (if the children became active migrants themselves). Generally, in time family ties were rebuilt according to the new context in which they lived, the experiences they traversed while apart, and the manner in which they had been able to communicate and maintain their bond from afar. The cases that follow illustrate different expressions of family de/​re-​construction triggered by the departure of mothers alone. Gisella’s experience is an example of a single mother leaving behind two children and returning after two years because she could not put up with the separation any longer. In her own words: I was abroad for a short time: in my case, my love for my children won over. When I left, my son was six months old and my daughter one and a half years. I had the chance to migrate while it was still easier to get the paperwork ready. Indeed, I was awarded the visa, the plane tickets, everything, because I was going to study there. Here I was not working, so getting a degree was a great promise. But I ended up staying in Spain only for two years. Even if my relatives there insisted that I stayed longer because soon I was going to be able to request my residency and bring my children and family. They would say to me, ‘You are spending too much calling your children,’ but I couldn’t understand how they could call theirs only once a week, every 15 days or even once a month. They would tell me, ‘You are spending your income in calling your family.’ But I had a little daughter so I would sing children’s songs to her on the phone. I would ask my mother to put my daughter on the phone so she could hear my voice singing to her. My son was so little that he didn’t even talk back then. But I still asked my mom to put him on the phone so he could hear my voice. That was fundamental for me, not to break the bond with my children. 140

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My relatives in Spain would tell me not to call them so often because it was making me suffer too much. They would say to me that I was smart and that I could work well. I knew that if I insisted, I could stay there, but I missed my children very much. So, one summer, when I was out of work, my cousin offered to help me find a gig, as she always did, but I told her, ‘Don’t. I have tickets to return to Ecuador.’ She told me that I was crazy and then, she affirmed, ‘You are going to regret it. You are going to regret it because the economy is better here (in Spain) than there (in Ecuador).’ But you cannot compensate the economic situation of a family or a place with family love. That is priceless. So, I told her, ‘I don’t know if I will regret it, but I have my tickets, and I’m going back.’ And, honestly, I did have some moments when I regretted it; when I went through difficult economic situations. … But still, it didn’t compare with being able to see my children grow up; and even if they were little, my daughter was three and a half, and my son, two and a half when I returned, I was a stranger to them. … It was very difficult. Sometimes I question when I talk to other migrants who left for five, ten, 15, 20 years, or others who have another family there, besides the one they left here, and they don’t even care for them. And I don’t know if it is willpower, or personal selfishness, I don’t know how to call it; but personally, I could not stand it, I could not stand it. I had to return. I think that in the long run it was the best decision, because even if sometimes I regretted it because of economic hardships we had here after I moved back, these difficulties were nothing compared to the happiness we all felt being together. (Gisella, Group Interview # 3, Loja, 2017) Gisella’s family de/​re-​c onstruction was challenging, but from their perspective, it ended on a good note: that is, they could maintain their family ties while apart and then, upon return, they could rebuild them. This feeling of accomplishment was commonly found in families who were able to “weather the storm of migration” and despite hardships and efforts, stayed unified as a family (Leonardo, Personal Interview, New Jersey, 2019). The case of Alma illustrates the mechanism of family de/​re-​construction with a mother migrating alone, involving conflictive separations and partial reunifications. Alma decided to migrate to Madrid because she was facing serious economic problems, leaving her four children, aged 16, 14, 12, and nine years old, to the care of her husband, their father, Hernán. He continued to work full-​time: at the power plant in Zamora. I had shifts of 12 hours a day with one week of rest. So, when I left for work, I would leave breakfast, lunch,

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and dinner ready for my children, and when I returned by midnight, I would check on them and wash, iron, and do other house chores. Two years later, Alma returned to Ecuador, but Hernán “perceived that she was distant and suspected something was wrong.” She went back to Spain soon after. Their relationship was strained and despite Hernán’s willingness to work things out, Alma preferred to end their marriage and commit to a new relationship in Spain. According to Hernán, their children suffered very much; he resented that he did not exert “enough control” on them but believed that he had tried his “best to educate them well.” When the older son got married (about five years after Alma’s brief return), she visited again and “convinced our children to go to Spain with her.” Hernán described their departure as “a robbery” committed by Alma. He had to seek professional help because he was not able to cope with the separation—​he had started to drink heavily—​and the psychiatrist that saw him told him that the root of his problem was “the loneliness” he felt. Hernán’s reflective mourning, migratory stress, and passive migrant trauma worsened when he received news that one of his sons “had started to smoke [use drugs], gotten involved in a gang, and been incarcerated.” He tried to help, but “couldn’t do anything from afar,” then, feeling distraught, he attempted to take his own life. His psychiatrist, he recalled, “would tell me that the line between sanity and insanity is so thin that any situation can make us cross it.” With professional help, Hernán stabilized his mental health and overcame his alcohol abuse. His daughter was able to visit her father after several years of being in Spain, despite her mother’s pressure not to do so: She saved money on her own for three years to be able to buy her own ticket. She came and stayed with me for a month. I was determined not to say anything bad about her mother because I didn’t want to hurt her. We spent time looking at photographs from the past. She told me that her brother had been able to resolve his problems and had been leading a responsible life; that he had gotten married and had a child. Hernán eventually met another woman and formed a new relationship. They had a child. He shared that he was happy that his children were doing well in Spain and was thankful that Alma’s partner had been good to their children. Alma had had other children in Spain as well, and he stated that he “appreciated them because they were also part of the family.” The challenges of Alma and Hernán’s family were plenty, and the layers of deconstruction and reconstruction multiple: from the early moments of Alma’s migration to the departure of their children and the formation of new partnerships. Hernán, whom I interviewed, had insisted on keeping the familial ties strong and despite struggling, he had reached a point of well-​being and renewed 142

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sense of family belonging that had broadened. Thus, while at the beginning he had felt his family “broken” and “destroyed,” by the end, he viewed the fractures and changes that had occurred as “part and parcel of his family” (Hernán, Personal Interview, Loja, 2016). Last, the case of Susana’s sister exemplifies staggered parents’ solo migration and women’s rights awareness due to exposure to different environments. She shared: My sister was married when she left for Spain. They had two children. Her husband was a mechanic here, but he was having a hard time. They were unable to make ends meet. She migrated first. Well, in part because she had a terrible life here with him. He abused her. She lied to him to be able to leave. She told him that she would work there and help out so later they could be together again. She left her daughter with our mother, and her son with her husband’s. Three months after she had left, her husband managed to get the paperwork to migrate. But my sister hid and avoided him for a long time. In Spain, she had been told that she had rights and didn’t have to subordinate to his abuse, and things like that. But, well, after she punished him by disappearing, they got together again. Their relationship changed for the better. They are still together. After three years, they were able to arrange for their children to join them there. They have been there all together and are not planning to return. … My mother, who raised their daughter, was very upset when she left. She almost passed away; developed diabetes and hypertension. She had also suffered when my sister had left, of course. Everyone did because we all loved her. But, when the granddaughter left, it was worse. My mother had become very fond of her. For my sister, leaving was also difficult, but she wanted to leave because she was having problems with her husband, but fortunately, he changed, and they have been better. … The children suffered the departure of their mother and later their father. But they got so used to being with their grandparents that at first, the idea of going away with them was scary. The girl would tell her grandma to hide her away so her parents wouldn’t be able to take her. But, once they arrived and spent time together, she loosened up and was satisfied with being abroad. … My sister told me that her son had a hard time adapting to Spain, he even had some health problems. But quickly, they adapted. They miss their grandparents, of course, but they have their life there now. My sister tells me that the only way she would return to Ecuador would be if they came back all together. Even if she misses all the family that is still here, in Ecuador, she would not leave her children behind again or separate from her husband. They

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have been there for about 18 years already, and sometimes, they visit us. (Susana, Personal Interview, Loja, 2016) The experience of Susana’s sister’s family exposes several layers of family de/​ re-​construction as well, including the couple’s separation; the children’s and extended family’s adaptation to being away and creating new bonds among them; the couple’s reunification; their reunification with their children and their new phase of living together abroad and the children’s away from their grandparents. In these various phases, family conflict emerged and was resolved and, in the end, the first one to leave became the last one ready to migrate again with the certainty that keeping their nuclear family close was very important. The cases of mothers migrating alone presented here illustrate the various ways in which their departure generated their family de/​re-​construction. With different degrees of difficulty, each example involved active and passive migrants’ efforts to deal with the effects that being far away represented by rebuilding their sense of family belonging and relationship dynamics. Clearly experienced as traumatizing, active and passive migrants attempted to restore and recreate their bonds from afar and when reunited. An insistence on repairing the de facto fracture that occurred with the mothers’ migration and separation from their children was found across the board, and while akin to the process that fathers’ departure generated, mothers’ migration carried a heavier load in terms of traditional gender roles that centered the emotional development of children in their relationship with their mother. Patriarchal norms added pressure to single mothers as well as wives who were expected to respectively “repair their wrongdoings for being single” (Carmen, Personal Interview, Loja, 2016) or “be loyal to their husbands as good women should” (Hernán, Personal Interview, Loja, 2016). Overall, both single and married mothers regretted having left their children behind. But married mothers who separated from their husbands after migration varied in their assessment of their decisions, especially if they had been able to maintain and recreate their bonds with their children. In all instances, however, the mothers that participated in this research project prevailed in rebuilding their family ties from afar and once reunited.

Migration of older siblings alone Frequently, older siblings migrated alone with the purpose of becoming the main providers of the family, especially in households with single mothers due to widowhood or unwanted separation after their husbands formed a new family abroad and reduced or ceased their financial support. In most cases, older sons were the most inclined to fulfill that role. When the older sibling migrated, the mother (and father, if present), younger siblings, the 144

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grandparents, and/​or extended family with close ties, traversed reflective mourning, migratory stress, and passive migrant trauma. But later, they recreated their relationship with him or her from afar. Older siblings that departed also suffered the separation from the family members who stayed behind, especially the relatives with whom they had a tighter bond. They experienced reflective mourning, migratory stress, and active migrant trauma, and in time, reshaped their relationship with their family from afar. In pursuing their family’s well-being, they tried their best to succeed in their role as main providers transnationally. Usually, they settled abroad, found a partner, and had children. On some occassions, they saved enough money to bring their siblings and parents abroad, and continue to provide assistance. On other occassions, they were able to accomplish their transgenerational goals and migrate back, often to live independently while maintaining their financial support to their family of origin. The cases of Rita and Yvonne’s older sons offer some examples of this type of family de/re-construction. Rita became a widow when she was 27 years old, and consequently, her son migrated to sustain his mother and siblings. Her son lived in Spain for 14 years, got married, and had two daughters. She shared: There is nothing in the world to compare how being separated feels like. It’s been a long time and until today I have not assimilated the distance from him. It is something terrible. … I have three sons and a daughter, all of them are married. And it is something I cannot fully understand. My son now is telling me that I should come with him abroad. But I have resentment against Spain. Spain took my life away from me. My son was only 12 when I became a widow. He dropped out of high school and went to Spain all alone to provide for the family, without knowing anybody. It was with God’s blessing that he did well. He was able to help all his brothers and sister, who were able to study and get ahead. All my children are married now and are doing well. He sacrificed for our well-being. But we resent one another. Because I tell him that ‘he left’ and he tells me that ‘I pushed him out.’ He even talks poorly of his father, even if he’s dead. He says that he left him all his responsibility toward his children. All of these is something that until today I have not been able to fully comprehend, and it hurts me very much. I have not assimilated it yet. (Rita, Group Interview # 2, Loja, 2017) Rita’s family deconstructed and reconstructed in multiple ways. First, in response to widowhood and economic precarity; then, as a transnational migrant family; and later, with the formation of families of procreation by Rita’s offspring. As a passive migrant, Rita clearly had experienced many difficulties in processing his son’s migration. While their 145

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transgenerational goals were met, both Rita and her son resented their separation. He had taken on the role as the main provider of the family but didn’t think this was fair. Nevertheless, he maintained a caring relationship with his mother and siblings from afar. His mother and siblings also recreated their family bonds in the distance despite the emotional cost they fared. Ultimately, Rita’s family was able to maintain a sense of union and belonging, and prospered. A similar resentment was found in the case of Yvonne’s brother, who was encouraged to leave by his mother, who was also a widow. Yvonne explained: My brother was 23 years old when he went to Spain. He’s been there for ten years already. At the beginning it was very difficult for him to be away. He worked delivering packages, as a messenger and then, in a moving company. He is still waiting to receive a residence card, so he has not been able to return to Ecuador in all these years. Now, he wants to go to the United States because the situation in Spain is too difficult. … Honestly, I didn’t miss my brother very much because he drank a lot and would spend all the time playing videogames. He would get very drunk with his friends and things would get very heavy. I was never too attached to him, so for me, when he left, it was a relief. For my mother it was also a relief, but still hurt her to have her son far away. She was very sad when he left, but after a while, she was able to move on with her life. My brother developed some health problems: he has back and knee injuries from his job. He’s only been taking ibuprofen because when he went to visit a doctor, they didn’t prescribe anything else. Because I work here at the hospital, I have my brother talking with doctors from here, and they suggested other medications that we send to him in the mail when we can. Yvonne’s brother, despite his rancor and difficulties, “sent plenty of money” to his family in Ecuador. However: once he got married and had his own children, it became more difficult to earn enough money to send here, even if his wife works at a pizza parlor at night. So, he’s asked our mother to come to Spain and help them take care of their daughters. But our mother cannot afford the trip. Yvonne was married and had two babies. They still lived in her mother’s house and even though she and her husband worked, they “barely earned enough to afford diapers.” They were considering migrating as well, maybe to the United States where they had other relatives who would welcome them. But Yvonne wanted to “migrate well,” she didn’t want to leave without the 146

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proper authorization or certainty about what they would be doing abroad because besides her brother’s experience, other relatives of hers had tried to migrate with coyotes and it didn’t work out. She also was determined to keep her family together; she shared: I even rejected an arrangement that my aunt had made for me to get married with somebody in the United States for the papers. I was scared that my husband would then doubt me and never remarry me. I want for my husband, my two babies, and I to stay together, and if we leave, to leave together. I prefer to have my family altogether and have few resources than doing risky things to migrate, go illegally or separated just to try to have more and do better. (Yvonne, Personal Interview, Loja, 2016) The case of Yvonne’s family includes various layers of family de/​re-​ construction that informed Yvonne as to how to make her own decisions about future migratory plans. While separating from her brother seemed a relief for her, she was well aware of the challenges that lay ahead were she to separate from her partner and offspring. Yvonne’s brother, despite his resentment, maintained his relationship with his mother and siblings, helped them when he was able to, and expected his mother to assist him once their situation changed. Yvonne’s aunts and uncles who had migrated as well had sustained their relationship from afar and offered their assistance through not only remittances but also logistics on how to migrate. In other words, while apart, active and passive migrants recreated their family bonds, preserving the value of their relationships as much as possible. These two cases exemplify the migration of older siblings pointing to a heavy gender dynamic that expects older brothers to take on the space and responsibilities unfulfilled by the husband/​father who either passed away or left. While in some cases older brothers resented the pressure, some embraced it. For example, Lesly’s oldest brother: First, he dropped out of college and left for the US so he could help my mother, brother, sister, and me back home. Later, once my brother and I migrated, he took care of us and continued helping my mother and sister in Ecuador … always with our family’s well-being in mind, no matter what. (Lesly, Personal Interview, New York, 2019) Their experiences abroad sometimes motivated them to rethink gender roles in their own families. But the patriarchal legacy of being a breadwinner stayed present in most cases, including for Yvonne’s brother who wanted his mother to drop her job and life in Ecuador so “she could help him with his own children.” Sisters also struggled with patriarchal mandates. However, 147

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their experiences usually increased both their resilience and awareness about gender patterns, like in the case of Yvonne, who refused to marry a stranger to be able to migrate regularly and was “proud of my mother’s denial to leave it all to go assist my brother and become his babysitter” (Yvonne, Personal Interview, Loja, 2016), or Lesly, who “As soon as I could, I started to help my mother and sister back in Ecuador and become self-sufficient” (Lesly, Personal Interview, New York, 2019).

Childless couples A less frequent but still significant mode of family de/​re-​construction was the migration of couples without children. Their departure impacted the couple’s close relatives including their parents, siblings, and extended family, all of whom traversed reflective mourning, migratory stress, and passive migrant trauma because they felt their migration as a loss in their family. However, in time, they attempted to recreate their relationships with the active migrants from afar. The couple who migrated also suffered their separation from their close relatives and experienced reflective mourning, migratory stress, and active migrant trauma. Also, as an attempt to overcome these, the couple tried to rebuild their relationships with their close relatives in the distance. Moreover, migrant couples adjusted to their new environment with its cultural and social norms and recoded their relationship in the new context. Sometimes, their relationship ended, due to the difficulties of migration or simply them finding other partners. Other times, couples’ relationships lasted, and they had children abroad. Most often, the couple raised their children and stayed there. But sometimes, they decided to move back to Ecuador with their children so they would grow up among their culture and extended family. When they returned, they traversed return shock, and both parents and children found the adjustment process to live in Ecuador quite challenging. If the children had spent several years abroad, they usually were hopeful they could go back to where they had been born and raised. Parents usually regretted their decision to come back because they either realized that what they imagined about their place of origin had dramatically changed, or they reassessed that their children would have more opportunities abroad. Often, migrating again was prohibitive due to financial constraints, age, and legal matters given that it was common for them to have returned to Ecuador because their own working opportunities abroad were diminishing, and they had taken on what was called a voluntary return with a renunciation to any residential rights they might have obtained. Another common occurrence for couples who had children abroad was their decision to send them back to Ecuador to be cared for by grandparents. Reasons for this course of action included parents’ inability to afford caring for their children as they had to work non-​stop and couldn’t count on a family 148

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network abroad to help them, and parents’ interest in having their children raised within Ecuadorean culture, habits, and practices as they disliked the environment they would be growing up in if they were to stay together abroad. The separation of parents and children, regardless of the reason, was usually very traumatic for first, the mother and the children, and then, the father, creating rifts that often ended in the separation of the couple and/​or the return of the mother to reunite with her children. Sometimes, the couple overcame the crisis generated by sending their children back to Ecuador and returned together to reunite with the children as soon as they could. This reunification was always complicated, especially when too many years of separation had passed. The experiences of Nilda and Edmundo’s family exemplify key aspects of these processes. They migrated to Spain soon after getting married; they were only 25 years old. They went alone “to work for a wealthy family who lived in the countryside to take care of them and their large property.” Edmundo oversaw the farmland and Nilda had to cook for the owners, who treated them “like if we were their own children.” Shortly, Nilda got pregnant and once they found out, they let her do the bare minimum. But not long after, Edmundo’s cousins visited them and suggested they go away with them to work on the peach season so “they could earn money faster and return quickly to Ecuador.” Edmundo was tempted, so Nilda suggested he go with them and check if the work his cousins were talking about was truly so profitable while she stayed put, working for the older couple. But Edmundo refused and told her that “if we came all the way here together, we will leave together.” This disagreement created tension between the couple. Nilda insisted that he consider it more carefully because “their employers were good people and soon were going to provide them with their paperwork to regularize their residency in Spain.” Edmundo disagreed and terminated their contract, so they left to work picking peaches. However, “they had to find a hook to work there, and they couldn’t, so we had to spend the money we had been left with from our previous job, that indeed, was not much.” Nilda’s pregnancy advanced, but she didn’t go for any checkups because she was scared of being deported. She started looking for other work opportunities and “found a hook to work picking artichokes.” Edmundo and Nilda tried that job, but “it was very hard; it would leave our hands bleeding” so he thought it was better to quit, and despite all the days they worked, they “were never paid.” After that, with money they borrowed, they got to Madrid and while staying and sleeping at the bus station, one day, they randomly ran into one of Nilda’s cousins who took them in and “didn’t charge” them to stay in his house. They had no money. Eventually Edmundo started work, helping movers but earned very little. They could only afford chicken pieces, and with the bones, they would make soup. Nilda was five months pregnant when she first went for a checkup. She 149

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was malnourished and the gynecologist told her that by neglecting regular checkups she was putting the baby at risk. Nilda never shared this with Edmundo. She was fearful. Still, they continued struggling together. Nilda would tell Edmundo, “We are in this together, we are going to fight together until the end.” Sometimes Edmundo: would break down and say that it was shitty to be there in Spain. That he wanted to return to Ecuador. But we didn’t have any more money. We would find trashed calling cards and check if they had any credit left. When we were lucky, we called home and asked them to help us get connected with relatives and friends who were in Spain to find work. About the time that Nilda was due to give birth, a friend of Edmundo got him a job at a printing press: he had to commute for about two hours to get there. He would wake up at 3 in the morning to get there early. The owner ended up helping him very much; he processed his work papers. And since then, we were blessed. Babies are born with a bread under their arm. And I think that was the case. Because my son was born well and healthy. But, six months later, Edmundo’s mother called them and suggested that they send the baby to Ecuador, so she could care for him while they both worked. Nilda “pleaded not to be separated” from her baby son (Nilda, Group Interview # 3, Loja, 2017). Edmundo, however, decided to do as his mother suggested because Nilda was “physically weak” and he feared for her life. He would tell her “I don’t want to lose you.” In retrospect, Edmundo shared: It was the worst mistake I’ve ever made in my life. I wish I could turn back time because there is nothing that we can do compensate what we did. Now he is doing better, but when we returned after two, three years, he didn’t want to be with us because he was attached to my cousin (Edmundo, Group Interview # 3, Loja, 2017). Nilda, crying, said that “when we arrived, our son was two years old, and I had another baby on the way. Now he is 16, and he still does not call me Mom” (Nilda, Group Interview # 3, Loja, 2017). Edmundo and Nilda had another child later; with three, they were able to live well in Ecuador because Edmundo had managed to work as a welder in Spain and earned a high salary. But after the crisis in Ecuador, they experienced financial problems, so he decided to try his luck abroad again, although this time, he went to the United States. Edmundo “could not stand being 150

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apart from my children and wife. Every evening it was like a nightmare. The only thing I wanted was to be with them.” He migrated back soon and shared that: “If I were to leave again, because here the economy is really bad, I would do it with my wife and children” (Edmundo, Group Interview # 3, Loja, 2017). Nilda and Edmundo’s family traversed several phases of family de/​re-​ construction. Their initial departure as a couple challenged their bond when they disagreed on what to do about work given that Edmundo was eager to return quickly to Ecuador as he missed his family of origin and his country. Then, they went through the separation from their baby son, which affected all three of them. Their son was raised with his father’s sister and mother, and once reunited in Ecuador, had to readjust to who were his parents. That experience was very harmful for Nilda, primarily, but also for Edmundo who regretted being the one responsible for forcing their separation from their son at such an early age. Their firstborn also had to rebuild his sense of family with the birth of a sibling and later, another. This whole process seemed to have been very challenging for him; he still doesn’t call his mother ‘Mom,’ even if they have lived together as a family for many years. On the contrary, Nilda and Edmundo never ceased to reinforce their family as a unit, and when Edmundo migrated again, he could not bear to be away from them for long and he returned promptly. Nilda and Edmundo’s firstborn developed an extensive sense of family, like the experiences of young children who were left behind after their parents migrated on their own. However, his experience worsened his trauma because, even if at a very young age, he still had to go through his own reflective mourning as he left Spain and his parents to grow up in Ecuador with relatives. As stated earlier, family de/​re-​construction is challenging and disruptive, and the efforts family members make to rebuild their relationships from afar and when reunited are imperfect and often problematic. Despite this, family ties don’t disappear and even if ruptured, they leave a legacy that sometimes burdens, and other times helps, migrants to move on with their lives. In brief, various types of migration altered family units, and its members reconfigured their relationships while apart and if reunited. All active and passive migrants in this study turned to the use of family de/​re-​ construction which was central for them to restructure their sense of self and belonging, their sociability, and their capacity to make plans for the future. Typically, family de/re-construction involved multiple layers and was difficult to traverse. It was closely related to the mechanisms of transgenerational goals and well-being ideal, and complemented by communication distortion, subordination to concealment and deception, unspoken pacts, resentment and detachment, and sensible comprehension, to be analyzed next. 151

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Communication distortion Active and passive migrants communicated with each other with various degrees of frequency after departure. For migrants who had left before the widespread access to cell phones and free communication apps like FaceTime and WhatsApp, the rhythm and duration of their calls were limited to their economic resources to buy calling cards. On the contrary, once internet calling appeared and was easily accessible at a low or no cost, migrants were able to communicate more often and speak for longer periods of time as well as video call. The use of email communications and the writing of letters was rarely mentioned by migrants as a means of keeping up with their family affairs. Commonly, migrants sent messages to their relatives through other relatives or friends to take advantage of the opportunity of maintaining the news flowing in between their direct communications. Additionally, relatives and friends of migrants tended to share news about others without their direct consent, creating a web of rumors that on many occasions created issues or conflicts, and on others triggered direct exchanges for clarification. When migrants communicated directly, they were very selective as to what information they shared with their relatives. Migrants rarely maintained an open and transparent flow of communication. Full disclosure was exceptional. Most active and passive migrants normally filtered the information they exchanged, toned down the seriousness or severity of events and circumstances, exaggerated the impact of positive occurrences, and omitted any negative news. Health matters were almost always never mentioned unless they had reached an extremely critical point. Adverse and exuberant emotions were guarded as much as possible by both active and passive migrants with the purpose of respectively minimizing worry on the other party and avoiding feelings of guilt. Conceptualized as communication distortion, this way of sharing thoughts, feelings, and news among migrants was a double-​edged sword. On the one hand, it allowed active and passive migrants to reduce the degree of preoccupation for one another to favor their moving on with their lives as transnational families. On the other hand, it created misleading notions about their respective realities. In the long run, these misrepresentations resulted in disappointments, unpleasant revelations, and feelings of deception and isolation that usually led to family conflicts (see Figure 4.2). However, this mechanism worked in combination with two others: subordination to concealment and deception, and unspoken pacts. And finally, these three mechanisms combined led to the last two: resentment and detachment, and sensible comprehension. The experiences of Marina, Kim, and Franco, all passive migrants, illustrate how communication distortion worked. During a group interview, Marina talked about what happened when her sister left to reunite with their mother and new half-​siblings “with the goal of being able to work abroad and send 152

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back remittances for the family” just like their mother had done for many years. She recalled that before departing, her sister “cried because she didn’t want to leave Ecuador and was afraid of how things were going to be like in Spain.” Marina remembered that in the beginning: I would lay down and think about my sister, in how she would be doing. I would ask her if she was all right and she would tell me that she was fine, that the family was treating her well. She wanted to attend college there, so she had to study for the entrance exams. In the meantime, she started to work at a restaurant and a bar. She was sad because she missed me, but she never told me that. I just knew. I wouldn’t tell her that I missed her either or that our grandmother was also very sad and doing poorly (she had lost a lot of weight). I guess we didn’t want to worry each other. (Marina, Group Interview # 7, Santo Domingo, 2017) In the group interview, Kim reinforced Marina’s thoughts, by succinctly stating that, “In my family, we don’t say much about our feelings to avoid hurting the other person” (Kim, Group Interview # 7, Santo Domingo, 2017). And Franco, who was raised by his aunt, shared: “I’m not sure what I feel about my mother and her migration when I was a young child. I talk a little bit about how I’m doing with my aunt. But I don’t talk with my

Figure 4.2: Illustration of communication distortion

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mother about that. It is a subject that is left aside, untouched” (Franco, Group Interview # 7, Santo Domingo, 2017). In the case of three sisters who stayed in Ecuador while their parents went to Spain to work, the unintended effects of communication distortion as well as how it can develop overtime can be observed. Lara, one of the sisters expressed: We were lucky that our parents were attentive to how we were doing in school and in general. But the calls were not that frequent, and they could never replace being present. Also, many things went unsaid. For example, one of us arrived from school and would share that they had been able to find out from friends how it was to have a boyfriend. Because, who else would explain that to us? Because our mother was not with us, and when we spoke on the phone, we could not really talk about these things. Out mother was there for other things, and our grandparents were not going to talk about that with us either. We had to rely on us, the three sisters. After several years, two of the sisters moved to Spain, but Lara stayed in Ecuador because she was already in college. Once they separated, their own communication, that used to be tight, thorough, and transparent, also changed: When my sisters left, the difficulties we had communicating from afar were different. Like, we could not share our day-​to-​day any more, even if we had the technology to be touch, it was not the same. It was hard not to be together, and calling one another could not replace that (Lara, Group Interview # 4, Loja, 2017). To add to their experience, Milly, one of Lara’s sisters, talked about how their communication as a family changed over time: Now that we have grown up and are independent, we have been able to tell our parents how we felt while they were away. Maybe with a joke, in passing, we have been able to tell them how we’ve felt about the process. For example, my mother tells us, ‘We were working until exhaustion every day there, for you,’ and we respond, ‘Us too! We were alone, taking care of everything. When were you with us?’ We say things like that, not with the intention of offending them or making them feel bad about it. We have like these shielded sentiments, because we missed them, we needed to be close to our parents, but they were far away. Sometimes, as siblings, we would tell one another, ‘They left us alone, but we need them with us.’ Practically, we grew 154

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up on our own, and we had the feeling that our parents were abroad taking it easy, relaxed, while we were here suffering; they were there like in a honeymoon, and here we were sad and lonely. (Milly, Group Interview # 4, Loja, 2017) Milly’s comments reflect the two-​sidedness of communication distortion: both active and passive migrants failed to transmit to one another what was happening to them and how they were feeling, creating an ambiguity that led to misconceptions. In their case, both the children and the parents were unaware of their respective efforts and feelings, even though they had kept in touch and were attentive to their well-​being. Only time and their reunification allowed them to express more fully and vividly their experiences, emotions, and thoughts. Elisa, an active migrant who left for Spain on her own, also reflected on the countereffects of her own use of communication distortion by talking about how her not sharing a more detailed description of her life as a migrant created unachievable expectations on the part of passive migrants: When one talks with the family, they ask, they demand that you send them money. So, one becomes like a manufacturer of sending remittances. And they don’t know. I had three jobs in a day. I left one to go to the next one. I had to run, literally, to arrive from one to the other on time. I took care of a girl, after, I took care of an older woman, and last, I cleaned houses. But my family didn’t know all I had to do to be able to generate the money they asked and waited for. One night, I felt a strong pain in my chest. And I thought, if I die here and now, my family, my children, won’t even know that I died. I thought that the effort of being away was not worth it. But I never told my family what had happened to me or how hard my life was, so they could not possibly understand my predicament. (Elisa, Group Interview # 3, Loja, 2017) Communication distortion was also employed among active migrants living together, usually to prevent the other from worrying and increasing their already high degree of migratory stress. For example, Nilda “never told my husband about the negative report that the gynecologist gave me about our baby or how scared I was” when she went for her first checkup when she was five months pregnant because “I didn’t want to make him worry or stress anymore” (Nilda, Group Interview # 3, Loja, 2017). In general, the intention to not burden the other party was widespread, as Gonzalo put it: “It is difficult to talk with your people when you are having problems because you don’t want to worry them. … So, not to generate concerns, you say that ‘Yes,’ that ‘Everything is just all right’ ” (Gonzalo, Group Interview # 4, 155

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Loja, 2017). Lesly’s case illustrates communication distortion both between active and passive migrants, and among active migrants. She shared: Our older brother would tell us not to cry or complain to our mother when we were on the phone with her because my mother suffered from nervousness, and our departure had made that even worse. So, he would tell us not to say anything to her about feeling sad, being ill, or feeling bad. And we felt that way, we felt bad, and as teenagers, we didn’t know what was happening to us or what we should be doing. But in the moment, we obeyed our older brother and didn’t tell our mother anything, even if doing that was very difficult. I think that keeping our feelings inward and not communicating fully with our mother made our migratory process even more traumatizing. Lesly also shielded her feelings, and selected and distorted what she communicated with her brothers. She explained: “Every afternoon, after I returned from school, I would cry and cry. But, once my older or younger brother arrived, I stopped crying because I had to be strong. I would not tell them that I was feeling sad.” Moreover, Lesly adopted a similar practice with her sister (who had stayed in Ecuador with their mother and her child). Her distorted communication, Lesly reflected, harmed her sister because when she ended up coming to the US to join them, she was “clueless about the emotional and material hardships of living as an immigrant here because I had never shared anything about that with her” (Lesly, Personal Interview, New York, 2019).

Subordination to concealment and deception Closely tied to communication distortion, active and passive migrants recurred to the mechanism conceptualized as subordination to concealment and deception, defined as the systematic use and acceptance of partial and hidden information and deceit as an unavoidable aspect of living as a migrant family (see Figure 4.3). The case of Carol’s sister shows how this mechanism works. Carol referred to her sister’s migration to Spain and her relationship with their parents’ and herself while abroad: “We were worried all the time about her. How is she doing there? Is she all right? Even if we spoke frequently on the phone, it was not the same: ‘Everything is OK’ we would tell one another, but none of us told or knew the truth.” Indeed, even when Carol’s parents developed health problems after the departure of their daughter and she traversed depression before, during, and after her pregnancy, and later on, after her divorce and “the psychological abuse of 156

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Figure 4.3: Illustration of subordination to concealment and deception

her ex-​husband who threatened her to take their child away and stalked her checking where she went and what she did at all times,” which led to episodes of alcoholism, neither the parents nor the sister shared any of this information with one another. Carol’s sister revealed her secret depression and alcoholism many years later to Carol and her mother “after she had overcome them” (Carol, Personal Interview, Loja, 2016). None of the family members held a grudge because they had concealed information or deceived one another, instead, they understood that there was no ill-​intention and were grateful to still be on good terms among themselves. The case of Paula’s husband also illustrates the common use of subordination to concealment and deception among passive and active migrant families. He decided not to tell his wife or children what happened to him when he migrated to the United States: He stayed one year and told us he would never leave Ecuador again. … I don’t know what happened to him, but he doesn’t want to ever leave the country again. He says that ‘No,’ that he would never leave again. Sometimes I suggest to him that we could all migrate together, but he always turns the idea down. Interviewer:

And does he ever tell you why? 157

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No, he just says ‘No. For what? There, things are just like here. We must work and that’s it. Nothing else, we have to organize ourselves.’ After he returned, he simply said, ‘Never again, I’ll never go back to the US.’ I would tell him to at least spend a few months there so we he could work a little and we could stabilize our finances. But no. He wanted to stay. Paula tried to understand what had happened to her husband while he was away, but he never told her, and she respected that. Probably, she could empathize because herself didn’t share what had happened to her or how bad she felt regarding her own migration and the negative effects it had on her baby son whom she had left with his grandparents: “I never asked for help or shared anything. Everything that happened stayed with me. And I carry it until today. They are very sad memories, ugly memories. And even if one tries to get rid of them, they linger” (Paula, Personal Interview, Loja, 2016). Concealing what had occurred abroad was common. Antonio’s sister, to add an example, migrated, but: After eight days she returned. She had left to work taking care of an older person. But she returned and she never wanted to talk about it. We never learned what had happened to her; all we know is that she returned quickly. She never told us anything; nothing. She did not want to. (Antonio, Personal Interview, Loja, 2016) The case of Fernando, who migrated alone to Spain leaving his daughters behind, also exemplifies the use of communication distortion together with the mechanism of subordination to concealment and deception. He talked with regret about his way of communicating with his family: It was very sad to be an emigrant. … Sometimes I would cry and think about returning to Ecuador. But I learned how to be a migrant worker, I stayed and worked very, very much to achieve my goal to save money to build a house for my daughters. … I liked to play volleyball a lot, so I used to play on cement courts in Madrid. One time, I broke my leg. I never told my family. They always asked me if I was doing all right, and I would always tell them that I was fine. My daughters would ask me when I was going to come back home, crying, and I would tell them that I was coming back soon. … But I returned when they had grown up, seven years later. (Fernando, Group Interview # 3, Loja, 2017) The burden brought about by disguise and duplicity was usually observed by passive and active migrants, who despite acknowledging their functionality, identified their risk and unintended consequences. As Hernán claimed, 158

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“the worst mistake migrant families can make is not to communicate. … Gossip and lies destroyed our home” (Hernán, Personal Interview, Loja, 2016). Roque, a Peruvian active migrant in Ecuador, shared that feeling. He expressed: There was something else that happened that was very painful to me. And that, I kept inside. While I was here in Loja, my grandmother died. But my father did not give me the news because it happened during the time of final exams and he believed that if he told me, I was going to lose a year of study or that I was not going to be able to concentrate on my exams. So, I found out three days after the funeral because a cousin of mine called me to reproach me that I had not shown up for our grandmother’s funeral. When he called me, I was confused and shocked, and asked him to explain to me what had happened. For two weeks I didn’t talk to my father. I was very upset. Then, Roque reflected that he had acted similarly to his father in the past: “I had myself concealed information from my parents when I had an accident, although it was not the same, it was still deceiving.” Roque’s experience, like Hernán’s, generated harmful rumors: In the moment, I didn’t tell my parents how I felt or what was happening to me. Now, that time passed and we are older, I shared some experiences I had, but like anecdotes. For example, I tell my mother that once I took the wrong bus and I didn’t have any money left to buy another ticket to get back home. But I don’t give her the details because I don’t want her to feel bad about it, even now. Or, for instance, once I had accident here in Loja, I wondered, ‘How do I tell this to my father? How do I tell my parents without making them afraid and worried?’ I had to use crutches. A friend of mine came to visit me at the hospital, and he made the mistake of telling a cousin of mine: it all went on a downward spiral. He told my family I was all fractured, in the ICU! [laughs] So, my mother called me crying. I calmed her down, I explained that I was in my house, and that I only had to use crutches, nothing else. (Roque, Group Interview # 4, Loja, 2017)

Unspoken pacts Another common occurrence that was usually concealed or communicated partially and generated rumors was when a father or mother formed a new intimate relationship and/​or family abroad. On few occasions they married to regularize their migration status after consulting with their original partner back home. Parents viewed it as a practical strategy that would benefit the 159

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whole family and tended to keep the children uninformed, especially if they were young. Rumors sometimes reached the children, but they tended to keep them to themselves as opposed to asking their parents. When parents agreed to these transactional marriages, they would reinforce the unspoken pact they had made upon migration, that is, that each party would continue to contribute towards their family’s transgenerational goals of utilizing migration to improve their material conditions and future well-​being. If the parent who had migrated and married to regularize his/​her status started to develop feelings for their new spouse and/​or had new children, the tacit agreement meant that he/​she would maintain a relationship with their children back home and keep sending remittances in line with the original family’s financial situation. How openly they communicated either of these developments varied, but in most cases, they were considered a de facto end of the couple’s union. Children were usually left in the shadows if the unspoken pact was respected. Contrarily, when it was broken, the parent who had stayed behind would be franker, although rarely completely honest, about what had happened, usually to preserve their children’s love and respect for the parent who had formed another family abroad. A different sequence developed if the parent who migrated formed a new relationship or family without consulting their spouse back home. If the active migrant maintained its part of the unspoken pact and continued to contribute to the family’s well-​being and maintained a relationship with the children, rumors about or the eventual disclosure of the concealed relationship would be hurtful but tolerated, assuming a de facto end of the couple’s union. However, if the active migrant didn’t respect the unspoken pact, the passive migrant partner would be more inclined to share the facts with the children. Again, the degree of openness varied to preserve both their children’s respect of the parent who had formed a new family and the chance that they would be able to take advantage of the support they could eventually receive from abroad, including the possibility of them migrating to pursue a life with more prosperous living conditions and growth opportunities. The use of  unspoken pacts, conceptualized as tacit agreements between active and passive migrants that are to be respected to keep the family functioning, was a delicate psycho-​sociocultural mechanism needed to keep the process of family de/​re-​construction alive (see Figure 4.4). Broken promises needed the formation of new tacit agreements if the family was to be restructured under the new circumstances. Unspoken pacts worked as an invisible foundation that called for immediate repair if fractured. Dialogue, time, and the mechanisms of transgenerational goals, well-​being ideal, and sensible comprehension were critical in putting the creation of new tacit agreements in motion. Cecilia’s case illustrates this process. Her father migrated before her mother, who stayed behind with the children. He visited the children and advanced 160

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Figure 4.4: Illustration of unspoken pacts

in regularizing his migratory status. However, after some time, the couple began to diverge in their plans to reunite abroad. Years later, Cecilia’s mother passed away. Cecilia had lived with her grandmother and her two brothers for four years until her father claimed custody and brought her to the United States when she was 13 (Cecilia’s brothers stayed in Ecuador; they were above age 18). Cecilia was not aware that her father had another wife: “When I entered my father’s apartment, I saw a woman. I asked him, ‘Who is she?’ That’s how I found out that I had a stepmother. It was terrible, really very difficult.” Cecilia didn’t know about her parents’ relationship either and had heard some rumors: 161

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I think that my father met my stepmother in Ecuador. She was a friend of my aunt at the university. And according to what people say, they met in Ecuador and my father fell in love with her in one of the trips that he made to visit us. Later, she came to the United States and met with my father. They decided to live together and developed a relationship. Interviewer:

Were your parents separated or divorced?

The truth is that until this day, I do not know. What I recall is that while my father was abroad, my mother never had a boyfriend or something like that. She never had a love relationship with anyone. So, I guess that maybe, some of the family quarrels were because my father already had another relationship, and my mother wanted to protect us from that. For example, she no longer agreed with the idea of sending us to the United States, and I imagine, now, that it was because she didn’t want us to live with another person that was not her. The original idea was that my father was going to eventually process the paperwork for all of us to be together in the United States—​the idea was that he was going to fix his migratory status and then request us all. When my father left, the business was sold so he could pay for his way here. My brothers were left with nothing, and my mother did not have a job, so she moved in with my grandmother (her mother). Then she finished her studies, found a job, and started to build up so we could live well, study, etc. So, once she had been able to achieve some stability, she didn’t want to come to the US and start from zero again. This is also why there was conflict between the family: that my father wanted the family to come to the US, but my mother didn’t want that. Cecilia’s limited knowledge of the past came from rumors and snippets of conversations from her relatives. She stated that her father “never talks about his migration here” and that the “one time” she ever asked him about it, he briefly responded that “the reason why he had come to the United States was because the family problems were very difficult.” Cecilia then shared that “he never addresses the issue of my stepmother. For him, everything that happened in the past, stayed in the past and died there.” The mechanisms of distorted communication and subordination to concealment and deception were taken up by Cecilia as well once she migrated. She told me that the first three years were very difficult for her; she cried every night until she fell asleep and stayed out of the house for as much time as possible to avoid being there with her father and stepmother. However, she kept her feelings to herself: “For example, with 162

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my father, we would say hello and goodnight, but we really didn’t have any conversations with each other. With my stepmother either.” Moreover, when she was able to call her grandmother and brothers—​despite her father’s attempts to limit her communications with them so she “would get over the idea of returning”—​she didn’t tell them how she was feeling or what was happening. Cecilia explained to me: Well, when one comes here, one starts to think that the people that you love also are sacrificing plenty, so, with that in mind, when we communicate, we have to be strong for one another to provide the necessary moral support that we need to be able to overcome whatever it is that we’re going through. … For example, when I talked to my grandmother, she didn’t want to tell me that she was sad because she didn’t want to make me feel sad. But I knew she missed me because I was practically raised by her. (Cecilia, Personal Interview, New York, 2018) These kinds of secrets were hurtful to discover. However, the reactions involved not only disappointment but also a call for understanding. In many cases, the deceived party experienced resentment and detachment first, in order to reach sensible comprehension; but in some cases, the latter never arrived.

Resentment and detachment Resentment and detachment, conceptualized as bitterness and indifference felt by relatives who did not participate in the family’s decision-​making process regarding migration or agree with the idea of migration and/​or family separation due to migration, was a commonly employed psycho-​ sociocultural mechanism (see Figure 4.5). In most cases, resentment and detachment was found in minors, although young adults also turned to it. For instance, it was common in young men who were sent abroad to take on the role of breadwinner, usually fulfilled by fathers, like in the case of Yvonne’s eldest brother, who migrated to Spain after their father passed away. He “resented our mother because he was put in the position to sustain all of us (we were four siblings) because he was the eldest one,” although Yvonne’s mother was upset about her son’s departure. Yvonne’s brother was able to send significant remittances at the beginning, so he was able to help his family out and meet their transgenerational goals. But with time, he grew detached from his family in Ecuador and “made his own life; married, had children and never returned” (Yvonne, Personal Interview, Loja, 2016).

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Figure 4.5: Illustration of resentment and detachment

The relationship between Nancy’s daughter and her mother, who migrated on her own, also involved the employment of the mechanism of resentment and detachment. Nancy shared: If I could go back in time, I would have never left. Because the emptiness I have with my daughter … and she is already married and has a son, and it is like she tells me, not directly, because she never says to me, ‘Mom, you left me,’ but she talks and says, for example, if I tell her, ‘Go travel and do graduate studies!’ she responds, ‘No, Mom, I would never be able to leave my son behind.’ With that phrase, she breaks me. Sometimes, I told her, ‘You can leave your son with me,’ and she responded, ‘Are you crazy? I am the one who is his mother!’ So, with those words, she kills me because she is saying, ‘You did leave me.’ Then she says, ‘If I could leave with my son, then, maybe I would consider it. But if not, I will stay here with him, no matter what.’ I conclude that nothing compensates the emptiness one leaves on the children, not the money, the house, the mansion, nothing. And here, I’m talking about one’s children, because with one’s spouse, it’s different, because one may have a spouse, or not, they can leave or come, but with the children, it’s different. Our children were with us from the very beginning in our bellies, and will be with us until we

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die, they never cease to be our children. (Nancy, Group Interview # 2, Loja, 2017) For Carmen, resentment and detachment occurred with her son, who grew up with his grandparents while his mother was abroad for nine years. She shared: Now I realize that my son had problems with my leaving. He is now 19 years old and sometimes he complains that I left him alone. He reproaches me that he had the feeling that I had abandoned him, that I had left him to be on his own. … Migrating had a great emotional cost for us. (Carmen, Personal Interview, Loja, 2016) In the case of  Selma, resentment and detachment was present notwithstanding the fact that her daughter migrated with her parents. Selma explained: Unlike most migrants here, I brought my daughter with us. But I could not give her the time and attention she needed because I was always working. She is very rancorous about it, even to this day, as a grown-​ up and a mother. She still complains about it and I can see that it still hurts her. She also compares her childhood with the one her brothers had and resents that they grew up spoiled because I had more time to spend with them. If I could go back in time, I would not have left. Because the money that I was able to make was not worth the effort and pain it caused. (Selma, Group Interview #6, Santo Domingo, 2017) The case of Estefani showed the way resentment and detachment could be linked to distorted communication and subordination to concealment and deception. Estefani was the youngest sister and was left back in Ecuador with her grandmother by her parents, who traveled with the rest of her siblings to Italy and returned after ten years. The return was not easy for Estefani or her siblings and parents, who ended up separating and experiencing financial problems. She shared: To be honest, I almost never saw them as my family because I was never with them. … And when they returned, they wanted to be the perfect family, but I think it was too late. I was already grown up and had my way of thinking … and they had their own ways. … It is easier to talk about these things with strangers than with people I know or that I lived with all my life. I would not tell my mother, father, or relatives how I really feel. Because my parents left because they wanted a better future, and it is true, it helped all of us economically. But I think they could have achieved the same here, in Santo Domingo, or at least, they 165

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should have migrated all together as a family instead of leaving just one of their children (me) behind. I believe there’s always going to be a rancor against them because the question of ‘Why did you leave and why did you leave me behind?’ will always be there. That I think is the barrier that prevents me from telling them how bad I feel. (Estefani, Group Interview # 7, Santo Domingo, 2017) Another case that illustrated the links between resentment and detachment and distorted communication, was what occurred to Graciela’s daughter. She had stayed with her mother and sister while their father migrated to Spain, but found it difficult to process the separation of the family. She needed psychological support because “she locked herself in her own world, and didn’t want anyone to disturb it,” according to her counselor. Graciela disclosed: My daughter would stay in her room and didn’t want to talk to anybody. If she did, she would be very rude with everyone. She didn’t want to be with anybody. Her psychologist explained to me that she missed her father and was angry at her father’s family and that she had like rancor and was furious … but I don’t know exactly why. … I would talk with her and explain that her father had to leave so we could have enough resources to get by and eventually have a place on our own and secure her future. … After some years, I think that she was able to learn and understand, but it was a long, hard process. Despite Graciela’s daughter eventually overcoming the crisis that her father’s departure had generated and moving from distorted communication and resentment and detachment to sensible comprehension, Graciela herself regretted their decision to migrate in order to advance their family’s living conditions: The positive is that we were able to have some money, but the negative was that we were separated, and despite all the material things we now have and that my husband returned, we will never recuperate all the time that we did not spend together. … Moreover, hardships are better handled together than apart … being apart, a family separated doesn’t really work. Graciela also recognized how they had recurred to distorted communication and subordination to concealment and deception while separated: because we were always in communication, but we didn’t tell one another what was really going on; plus, it was not the same to talk 166

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on the phone as being present. … And my husband was there alone, and he could have found or been with another person, I don’t know. With effort and at a high emotional, psychological, and physical health cost, Graciela and her family were able to traverse the challenges triggered by migration while keeping their unspoken pacts afloat to meet their transgenerational goals. As Graciela expressed, her husband had told her that: “once I am able to build a small house for us, I will return,” and after 13 years of being abroad and sending remittances, he returned. “Now, we are here, together, dealing with new economic and family difficulties but as a couple, so it’s better” (Graciela, Personal Interview, Loja, 2016). Graciela was finding sensible comprehension despite, or because of, all the hardships experienced.

Sensible comprehension Defined as an understanding of otherwise objectionable behavior based on a realistic assessment of living as a migrant family, sensible comprehension was a mechanism that active and passive migrants employed to deal with the challenges of maintaining family relationships through migratory processes that included separation and, on some occasions, reunification. This mechanism was fundamental for migrant family members to overcome the emotional and psychological scars that their counterparts unintentionally and inevitably left on them for the sake of advancing transgenerational goals and achieving the family’s well-​being. Sensible comprehension was usually reached after considerable time given that in most cases, the first reactions to the hardships of migration were closer to sadness and anger than empathy. In general, when all family members had participated in the decision-​making process and agreed with the group’s migratory goals, the sooner sensible comprehension would be triggered. However, unanticipated events that pushed reunification forward also delayed (but not precluded) sensible comprehension (see Figure 4.6). This mechanism was employed both by younger and older migrants, and while passive migrants were the ones who usually most needed to use it, active migrants also had to recur to it when their relatives back home grew independent to the point of not involving them as much in major life decisions. Naturally, the less distorted their communication, the faster and easier it was to switch towards sensible comprehension as opposed to detachment and resentment. Sheila, a daughter of a single mother who left for the United States and stayed there for 23 years, visiting a few times, expressed that: I never told my mother how I felt when she left. And now, I don’t feel angry because she left, but grateful because I don’t know how my life 167

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would have been if she had not migrated. We didn’t have a father, so she had to leave because she didn’t have any other options. Now that I’m an adult, time has passed, and our conditions are different. My mother now tells me how much she suffered. How she spent Christmas crying without us; how she would see a child our age and wished to hug her. It is NOW that she tells me; but BEFORE, she never told me [her emphasis]. I don’t feel anger, but I don’t know how my siblings feel. They were different ages, and everyone feels things differently. I know now that my mother suffered because she finally told me that. But she had never shared that when I was younger. (Sheila, Group Interview # 4, Loja, 2017) Sheila’s comments about her mother show how their communication was distorted as well as the fact that Sheila was able to develop an understanding and acceptance of her mother’s choices based on sensibility towards her predicament. As mentioned in previous subsections, both Cecilia and Roque were also able to cope with the consequences of missing and hidden information, and broken promises despite the pain and disappointment. Cecilia stated that she “was not angry” at her family and elaborated that she had been consciously working on developing a good relationship and better communication Figure 4.6: Illustration of sensible comprehension

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with her father and stepmother, which she was happy to describe as “much improved” (Cecilia, Personal Interview, New York, 2018). Roque explained that after some time of feeling upset with his father about his grandmother’s passing, “I put myself in his shoes. A father always wants the best for his sons. He didn’t want to see me suffering. He wanted that I focused on my studies, for my future” (Roque, Group Interview # 4, Loja, 2017). Last, the case of Lesly shows the workings of sensible comprehension, in combination with resentment and detachment. Lesly’s bitterness and indifference developed toward her father first, after he “basically abandoned” the family in Ecuador, and second, after he withdrew his support once they had arrived in the US and didn’t care for them. The fact that Lesly’s father and his new family was “diminishing and abusive” toward them also increased her rancor and pushed her to become as independent as possible from him. Given that in the end Lesly’s father didn’t do anything but process their migratory status while treating them poorly and utilizing them “to get tax breaks,” she didn’t reach the point of sensible comprehension toward him. In relation to her mother, however, Lesly shared how she grew from feeling resentment and detachment to reaching sensible comprehension: Until recently, I had a feeling of abandonment from my mother as well because I developed a resentment when I was a teenager and she sent us to the US. It was difficult to understand that my mother was doing the best she could. I had conflictive feelings towards my mother, because I loved her, and I would have given my life for her. But I also felt abandoned because she sent us to an unknown world when we were young, and we suffered very much. Now as an adult, I’m able to understand it psychologically, but all these experiences were traumatizing, and as a girl I could not understand why they had put me through all of that. It was after doing therapy that I could forgive my mother and understand maturely that she also suffered as she traversed this process and all the problems she had. She also suffered when she separated from her younger children. It was painful. (Lesly, Personal Interview, New York, 2019) Her case, like many other children who were left behind, sometimes reunited, sometimes not, clearly showed that the process of analyzing problematic and traumatizing behavior on the part of their parents was multifaceted, took lengthy periods of time, and was judiciously, as opposed to arbitrarily, traversed. In sum, the mechanisms of communication distortion, subordination to concealment and deception, unspoken pacts, resentment and detachment, and sensible comprehension complemented one another, and together, sustained the core mechanism of family de/​re-​construction. While not 169

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every active and passive migrant utilized all five mechanisms, they combined a few of these in their attempts to restore their family relationships post-​ migration. Migration processes inevitably affected their family dynamics, which tended to be rearticulated in the long run, especially under the overarching guidance of the mechanisms of transgenerational goals and well-​being ideal. When these two mechanisms weakened, the process of family de/​re-​construction became more challenging, and the complementary communication distortion, subordination to concealment and deception, and unspoken pacts, pushed towards resentment and detachment and away from sensible comprehension. On the contrary, when transgenerational goals and well-​being ideal stayed strong, the mechanisms to cope with family relationships steered toward sensible comprehension, minimizing the use of communication distortion and subordination to concealment and deception, keeping unspoken pacts afloat, shortening or preventing all together resentment and detachment, and resulting in a more rewarding end to the multifaceted mechanism of family de/​re-​construction.

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Transformative Border Politics The experiencing of migratory processes allowed active and passive migrants to engage with what I conceptualized as transformative border politics. To define it, a distinction must be first made between formal and informal border politics—​the former referring to the formal mechanisms that establish geographical, political, and social boundaries from the top-​down, and the latter referring to the informal processes and practices that sustain, reproduce, and challenge these from the bottom-​up. With this contrast in mind, this research showed how active and passive migrants interacted with formal border politics, including geographical boundaries between countries, national and international policies and politics regarding migration, residency, and citizenship, and racial/​ethnic, gender/​sexual, class, and other intersecting social structures and practices of inequality in places of origin, transit, and destination. Active and passive migrants learned how to navigate formal border politics and were able to maintain, recreate, contest, and alter them. In doing so, they enacted their own informal border politics. When these informal border politics resulted in challenging and dismantling formal border politics, a transformative border politics was unearthed. Hence, active and passive migrants were able to traverse, rework, and transcend geographical as well as political, economic, social, and cultural boundaries that had pushed them to the margins. Transformative border politics was transnational in nature and had a radical potential to curb inequality and generate social change. The concept of transformative border politics is grounded in theories of intersectionality that point to people’s location within and action throughout and beyond social matrixes embedded in policies, reflecting hegemonic ideologies, and shaping power relations. Migration allowed people to travel across the social matrixes found in different societies, and these journeys uncovered the variability of individual and familiar location in these various social matrixes and the degree of porosity of their borders. Migratory processes also represented opportunities for people to shift their perception of where they stood in the large scheme of social power, devise strategies 171

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to move through and/​or transform social matrixes and their borders. This research demonstrated the potential of transformative border politics in four areas. First, geopolitical boundaries: migrations occurred because and despite migratory policies (geographical borders were crossed regularly and irregularly, and residency and citizenship policies in various countries were tactically respected and disregarded). Second, gender/​sexual regimes: migratory experiences challenged taken-​for-​granted gender dynamics that prioritized men, masculinity, and heterosexuality (both active and passive migrants questioned heteropatriarchal orders as a result of migration). Third, ethnoracial hierarchies: migrations put in evidence the degree of equality of different ethnoracial cultures and structures (both active and passive migrants became aware of the level of discrimination of and between migrants of color in the Global North, and at the same time, reassessed their own countries’ ethnoracial regimes, reaffirmed their ethnoracial sense of self and pride, and confronted racism, xenophobia, and internalized oppression). Fourth, socioeconomic barriers: migrations allowed for the accomplishment of transnational social mobility (both active and passive migrants endured hardships at home and abroad but could come out on top, leaving poverty behind, and ensuring higher educational levels for younger generations and the promise of better prospects for the family). Usually, migrants enacted transformative border politics in several areas, although to different degrees and at different times. In general, geopolitical borders came first; then, gender/sexual and/​or ethnoracial regimes were affected after active and passive migrants traversed pivotal experiences; and last came social mobility, the fruits of accumulated efforts of working abroad, sending remittances, saving, and reinvesting for future well-​being. Altogether, transformative border politics manifested migrants’ agency to move through, confront, and change social systems of inequality transnationally and transgenerationally (see Figure 5.1). Next, I will share cases characteristic of each sphere, while pointing to how migrants’ transformative border politics was often multifaceted.

Geopolitical boundaries Geographical boundaries, international border politics, and national migratory, residency, and citizenship policies all established barriers of belonging according to place of birth as well as economic, sociocultural, and political criteria that granted certain people rights while excluding others. Migrants, whose understanding of all these parameters ranged from the very fundamental to the most complex, deliberately decided on their migratory path. By considering whether or not they could migrate following established regulations due to their formal eligibility or the resources to fund the process, migrants selected a plan that best fitted their needs. When migrants were able to go through the legal channels, they did so; but when 172

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Figure 5.1: Illustration of transformative border politics

that was not possible, they looked into alternative ways to pursue their goals (which in most cases were devoted to achieving a decent livelihood for their family that would surpass basic survival and promise social mobility transgenerationally). Migrants then would decide on the alternative that best balanced risk and affordability; in other words, migrants didn’t choose the most dangerous irregular option out of spite or unconsciously but only when it was the only chance that they had to pursue what they thought would bring a better future. Sometimes, the alternative didn’t result in migrating irregularly, but the means to migrate regularly included getting into debt (to afford the costs of and related to the application) or making deceptive alliances (like marriages of convenience) that would ensure their eligibility. Other times, the alternative was to migrate irregularly, but the risk varied depending on the route, destination, and the migrant’s nationality, gender, sexuality, age, and ability. Thus, migrations occurred because and despite geographical limits, border politics, and migratory, residency, and citizenship policies. A transformative border politics was generated when migrants’ defiance of geopolitical boundaries opened the way for them to achieve their migratory goals notwithstanding all odds. The cases of Manuel, Marta, Teo, Leonardo, Jorge, and Diana’s families exemplified geopolitical transformative border politics. Manuel went to the United States from Ecuador by land through Honduras and Guatemala. He spent “four days without eating, together with one 173

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hundred and fifty people in a truck, hidden within the cargo.” The people who were in the truck would “cry and they urinated on themselves.” Once they arrived at Chiquimula in Guatemala, the number of people joining the journey rose to four hundred; he shared: The most difficult was to cross Guatemala and Mexico … we had to cross rivers with tires. We stayed at a plantain field and walked through it when we were told to do so. Then, in Ford trucks, they [the coyotes] would make us lay down below oranges and plantains. It was very claustrophobic. The only thing we could do was to pray. Not all four hundred made it to the place we arrived at, which was eight hours away from the border. About 30 people died in the trucks. Those trucks went very fast. One overturned. And what was one to do? One could not cry because the rest would make fun of you and take advantage. One had to demonstrate that one was strong. … We waited for five days to be taken to Mexico City. They would take us in groups of ten people in vans. When it was my turn, there had been accident in the route, so they turned back because there was going to be a lot of police. Two days later we left. After arriving to Mexico City, we had to go to Tijuana, which was 40 hours away. The coyotes stopped if they saw that there were police roadblocks, so we stayed put many nights, slept in the mountains. It was very cold. We waited until the coyotes would come back to pick us up. Sometimes the coyotes would bribe the police and they would be allowed to pass through roadblocks. Sometimes we were given some food, or we would find leftovers that people would leave behind in the stops. I say, one never knows when one is going to have to go through those things: I’ve eaten leftovers out of trashcans, I’ve slept in the street. … Then, when we were in Chihuahua, it was like a desert and very hot. While we were there waiting, about three thousand people started to arrive little by little from all parts of the world, from China, from India, nobody spoke to anyone. All wanted to sleep because they were very tired. There were some Guatemalans who said that close by there were some people selling tamales. We had been drinking water from potholes, dirty water; so, when we ate those tamales, we thought they were delicious. Later we found out they were made with snake meat! That afternoon we parted to Tijuana—​traveled for two days, and at 6 am they told us, ‘Well, now you get out and walk straight.’ So, we walked and walked until we saw barbed wire. A woman gave us some tortillas with meat, and after eating, we fell asleep. We were ten, but when we woke up, there were like 100,000 people, including some people that were very scary! We were very close to the border, like a block away. On the other side of the barbed wire, there was the migra [border patrol officers], 174

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listening to their music, waiting. And on this side, Mexicans cursing at them. There were women of all nationalities. And the coyotes, smoking weed, injecting themselves, inhaling … everything! And one could not say anything! You saw all of that and felt bad and bitter. They would be there, having sex … it was like Sodom and Gomorrah! But one could not say anything. There was a bridge that one had to pass under and there were skulls. … It was about 11 pm and we were desperate to leave. Others had already left. But we had to wait. We waited until 4 am. It was 4 kilometers, and we had to run the fastest possible to go through that mountain. Some people would be screaming: ‘Run! Run! Run!’ At about 6 am, a heavy rain started falling so when we went under that bridge, the soil was all muddy. I was able to cross into the United States. I stayed for 30 years. I did first what Ecuadoreans don’t do. They all leave and focus on working so they can build their own house back in Ecuador. But I focused on legalizing my status first by working and studying so I could get ahead. For example, once I ran into a fellow Cuencaen [a person from Cuenca, Ecuador], and he told me, ‘I work, send money back to my family and once I build the house back in Cuenca, I will return.’ And I told him, ‘Look, here in the US, if you work, you can make it. Better legalize your status, it will be better for you.’ I used to be told by other migrants, especially other Ecuadoreans, that I was not going to be able to make it. But I could. Manuel settled in a small town close to New York City. He went through reflective mourning, active migrant trauma, and migratory stress, but persevered and became more and more resilient with time. He worked “very hard, which Americans liked,” and after some time, began to study English and regularized his status. Manuel was able not only to accomplish but also surpass his own migratory goals before deciding to return to Ecuador after 30 years. His way to defy geopolitical boundaries and regulations in his journey from Ecuador through Latin America, Central America, and Mexico was costly, risky, and traumatizing—​in his words, “One thing is to talk about it, another is to live through it … I am still psychologically affected even if nothing severe happened to me.” However, Manuel, like many of the people he encountered in his journey “up North,” managed to pursue their migratory projects despite the regulations that forbade their passage and penalized their attempts. Moreover, Manuel learned how to regularize his status and became a legal permanent resident. By doing all those things—​crossing borders irregularly, working without employment authorization, learning the language and the culture of the place of destination, and regularizing his migratory status—​he enacted 175

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his transformative border politics in the sense that formal limitations and informal exclusions were challenged and surmounted, proving that his humanity was more consequential than pre-​existing barriers of belonging. Furthermore, Manuel’s transformative border politics were also reflected in his perseverance against all odds (being told you won’t make it, but trying regardless and defiantly) and his achievement of social mobility (he was indeed economically successful, and back in Ecuador, he established his own export/​import business, helping his family to leave poverty behind); as well as his reassessment of ethnoracial structures and relationships across borders—​specifically, by witnessing racism and discrimination both against and between Latin American migrants in the United States, he found himself “changing my way of thinking about race and treating others, no matter where they were from, no matter if here or there, with respect, helping those in need, not judging;” and last, but not least, his re-​evaluation of heteropatriarchal regimes about which he realized that “our culture is sadly very machista, something that we need to change, starting with our own selves” (Manuel, Group Interview # 3, Loja, 2017). Manuel’s experience had a transformational effect inward and outward; arguably, the most radical form of transformative border politics. Other cases that illustrated transformative border politics in relation to geopolitical boundaries were of the many Ecuadoreans who went to Spain because “it was not as risky as crossing the border to the US and one could speak Spanish instead of having to learn English.” Moreover, until 2003, Ecuadoreans did not need a visa to travel to Spain, so “all we had to do was to save enough money to get a passport and buy a round-​trip ticket” (Marcela, Group Interview # 5, Loja, 2017). After 2003, a visa was required, which involved the presentation of the “famous bolsa.” This bolsa de viaje (travel application package) that had to be presented at the Spanish Consulate in Ecuador consisted of funds to prove that one could afford to live in Spain for the duration of the touristic trip, proof of lodging, a return ticket to show that the stay was temporary, and proofs of ties to Ecuador. These requirements were similar to the ones needed to obtain a tourist visa for the United States, and while they left many Ecuadoreans excluded, migration continued to occur regardless due to the heightened need created by the financial crisis in 1998–​99 and the “many stories that we heard from friends and relatives about being able to find work and send money back home without any trouble” (Linda, Group Interview # 1, Loja, 2017). Therefore, many people decided to indebt themselves and take the plunge regardless of the costs and danger involved. Ecuadoreans who traveled as tourists or crossed the border irregularly would start looking for work upon arrival, and as soon as they began to earn money, they embarked on paying back their debts and sending remittances back to their families. If they had arrived as tourists, they overstayed their visas 176

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and remained working irregularly. Ecuadoreans who went to Spain before 2001 could apply to obtain their residency after five years of continuous residency. In 2001, due to the large number of Ecuadorean migrants in Spain, a bilateral agreement that provided legal work visas for approximately 25,000 irregular Ecuadorean immigrants was signed between the two countries; and then, in 2005, Spain implemented a massive regularization law that granted status to nearly 200,000 Ecuadoreans (Jokisch, 2014). Contrarily, the United States did not enact similar measures, and most Ecuadoreans who entered irregularly or overstayed sought other means to regularize their status, such as marrying legal permanent residents or citizens, or if they had children born in the US, obtaining their sponsorship once they were over 18 years old. The cases of Marta and her husband, and Teo illustrate geopolitical transformative border politics in Spain, and the cases of Leonardo, Jorge, and Diana, in the United States. Marta and her husband travelled as tourists to Spain: My cousin had told me that we could stay with him in the room he was renting. But it was very small. We had to rent another room, but it was more expensive, and we could not afford it. We shared a room with many other people, it was terrible. In my poverty, I went there because here we could not make ends meet even if both my husband and I worked. … And I would feel desperate in Madrid, because we had a large debt from applying for the passports and paying for the plane tickets, plus we needed to help our family back home. The only way to do this was working non-​stop, but at the beginning we could not find much work and we were struggling very much. Luckily, after a few months, we were able to get a job because a family who lived in a rural area was looking for a couple like us to take care of the farm and do housework, so we went there, where we would work and reside, that is, we didn’t have to pay rent in Madrid anymore. (Marta, Group Interview # 2, Loja, 2017) Marta and her husband, who had originally planned to stay for three years at the most, ended up staying in Spain for 13; the first six, working as irregular migrants. They had been able to have their six-​year-​old daughter join them six months after their departure; and several years later, they had two sons. Marta suffered the process of reflective mourning very much and developed both migratory stress and active migratory trauma, but overall, the family was able to persevere and meet their transgenerational goals despite all the odds they encountered along the way. Geopolitically, they took advantage of the opportunity to travel to Spain without a visa in 1999 but indebted themselves to be able to afford the passports and roundtrip tickets. Once in Spain, they ignored the time limitation to stay there as tourists and the 177

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restrictions to work without employment authorization. Their transformative border politics regarding geopolitical restrictions had an effect not only in their personal lives given that they were able to pursue better living conditions despite being irregular migrants but also in the larger, public realm. Because Marta and her husband’s defiance happened simultaneously with that of thousands of other Ecuadoreans, it unintentionally resulted in pushing the Spanish and Ecuadorean governments to change their migratory and residency policies in support of regularizing migration flows and migrants’ status and rights. In other words, the transformative border politics of a large accumulation of Ecuadorean migrants challenged the status quo and had an indirect but significant influence at the governmental level nationally and internationally, proving its potential radical effects. Teo had a similar experience to Marta and her husband; he recalled: I had left Ecuador with a backpack with the few things I owned. I borrowed money to buy a ticket to Holland for tourism. But it was a lie. Our real purpose was to arrive in Spain to work. I was with some other guys from Loja; and we were so scared, because in the airport they were sending people back to Ecuador. … But we got lucky and passed migrations! Then, I went to Spain by land, but for two months, I could not find any work. I went around different cities, looking for opportunities to work. In Valencia, I worked harvesting oranges and was detained because I was not authorized to work. But eventually, because of some legal changes, I was able to obtain a work permit and afterwards I found a job at a renovations company. I worked in that company for six or seven years, doing work in various parts of Spain. I worked impermeabilizing, and later learned welding and ended up working in pipeline construction. Teo, like Marta, her husband, and thousands of other fellow Ecuadoreans, indebted himself and risked migrating irregularly through tourism in search of better living conditions. His bending of migration rules and then, his success in regularizing his status, proved his transformative border politics effective. Teo also had many difficulties traversing the challenges “of working from 4 am and getting back home by midnight every day,” feeling “stressed and psychologically drained,” and “not realizing that time passed and one aged” (Teo, Group Interview # 2, Loja, 2017). However, he persevered in pursuing his migratory goals and defied geopolitical constraints. Overstaying tourist visa restrictions was also common for Ecuadoreans who went to the United States. Leonardo and his mother, for example, “traveled as tourists in 1999 with the idea of staying for at least three months to bounce back from the financial crisis” while Leonardo’s father and brother stayed in Ecuador. But Leonardo’s mother “soon realized the benefits of being in 178

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the US,” so they overstayed their tourist visa. Two years later, Leonardo’s father traveled, also with a tourist visa, and overstayed (his brother, however, didn’t join them because he married a Venezuelan woman and moved to Venezuela with her). Leonardo’s family had relatives who were already in New Jersey, including an uncle who ended up sponsoring their petition to become legal permanent residents. But that process “lasted 11 years, meaning that we lived as undocumented migrants for that long.” Leonardo shared that “on many occasions we considered returning to Ecuador, but we were afraid not to be able to return to the US. We had come as tourists, and that’s easier than crossing the border with coyotes, so we didn’t want to risk it.” Leonardo’s mother was a teacher back in Ecuador, but in the US, “even if she tried, she was told that she could not do so, then, she began to work cleaning houses.” Leonardo’s father did the same upon arrival, but “soon got organized to build it as an independent business, without an intermediary person who would hire them.” Leonardo worked with them as well, and when he was studying at the community college, he “looked into how to make their business more profitable;” an effort that paid off because their business grew, “emphasizing that people hired a service that was more than just cleaning, they were getting good, thorough cleaning while being assured that the people entering their homes were trustworthy and safe.” Leonardo’s family succeeded in their economic venture, enacting transformative border politics around social mobility by defying barriers that kept migrant workers in marginalized and subordinate positions. Moreover, Leonardo thrived as a student in high school, then community college, and last at a four-​year college. During his studies, Leonardo in many ways followed his parents’ practice of transformative border politics that had not only led them to defy geopolitical constraints but also persevere in their efforts as “responsible and worthy workers” despite their irregular status as migrants and their “constant fear of being apprehended by migration officers and deported.” Leonardo recalled: I would never tell my professors where I was from or about my migratory status because I was scared. The professors had many times offered me to apply for fellowships because I was a good student, but I never did because I was undocumented. I also remember that once in a Social Studies class, the teacher had us all take the citizenship exam. I scored 85/​100 while all my classmates failed, and she said, ‘Be thankful that you’ve been born here and thus have your citizenship, because others have to gain it’—​and that phrase got stuck in my head. My professors had a good influence on me and offered their support. After high school, I went to my local community college, and then, tried to transfer to a state four-​year college. But they told me that I was going to have to pay as if I were an international student, even if I was a state 179

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resident, without documents. The woman who worked in admissions told me, ‘Be thankful that you are even allowed to study.’ But I didn’t let them discourage me and registered anyway. When I received the bill, they had charged me as a local resident, so I was able to graduate from college without debt (I paid the bills working with my family in our cleaning business). What happened taught me not to be led by what people say. I studied business and accounting, and then began to think of becoming a politician in my community, to advocate for change and the rights of all people, regardless of migratory status or any other background. While I was in college, I was always careful because I was still undocumented and afraid of being picked up and deported. That’s why I appreciated so much what the Dreamers have accomplished. It reduced the fear we feel. For example, I remember that I wrote an essay for Sociology about ‘taxation and representation’ where I argued that undocumented migrants were paying taxes but could not vote, reflecting on my own experience indirectly. When I finally obtained my green card, I was very vocal about it because I realized how important it could be for other undocumented migrants to see the path, so I offered my assistance. Besides these accomplishments, Leonardo carried his transformative border politics to his job after college. He had worked as part of a contracted marketing team for a health insurance company “with the task of designing better strategies to attract the Latino community” because they had not been successful in reaching out to that population. Later, when the company opened a position devoted to the matter, Leonardo applied and secured the job: When I did my interview, I brought up my own experience, including how my father had to maneuver through the health system to get treated for ALS, how my mother and I had to recur to Charity Care at a hospital because as undocumented migrants we could not be insured, and how I had interceded when my uncle and cousin had an accident traveling abroad and because of them having two different insurances, one private, the other Medicaid, they were being treated in drastically dissimilar ways to the point that my uncle, with his public insurance, was being left to die with no care. Once employed, Leonardo “passionately” influenced the leadership and created programs to “address these differences, by bringing awareness in the company, because unless there are leaders with that experience and knowledge, these topics are left unattended; and reach out properly to the Latino community.” Leonardo also worked with his team to “devise ways 180

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to involve undocumented migrants, including community workshops and outreach to explain how to access healthcare and insurance despite migratory status” (Leonardo, Personal Interview, 2019, New Jersey). In this way, Leonardo’s transformative border politics had repercussions in ethnoracial matters as well given that he pushed for thorough understandings of the heterogeneity of Latin American migrants and Latinxs’ experiences and needs, and instrumented means to expand healthcare access in an inclusive manner. His experience also involved transformative border politics in the sphere of gender/​sexual regimes, which I will expand on in the subsection later. The case of Jorge’s family also exemplifies transformative border politics regarding geopolitics. Jorge’s parents had traveled to the United States as tourists, where the cousin of Jorge’s grandfather lived. During that trip, they learned that their cousin worked at a health clinic that provided low-​cost services for underserved populations, including uninsured people and irregular migrants. When years later they discovered that their son had a tumor: “they thought about the possibility of seeking care in the US because they feared treating my brother in Ecuador” due to previous problematic and failed experiences there. After carefully thinking about it, Jorge’s mother decided to travel again to the US with her sick son. They traveled with a tourist visa and made the appointments at the health clinic so Jorge’s brother could be seen. Once they had secured further treatment and applied for child health insurance with help from the clinic, they extended their stay beyond the visa’s time limitation. When the treatment was scheduled to begin, Jorge’s father traveled also as a tourist, and as soon as he could, began to work without an employment authorization to support them and save to pay for healthcare-​ related costs. He also overstayed his visa to accompany his son and wife. Jorge’s parents “had not planned to stay in the US but ended up staying because my brother’s doctors explained that the treatment required long-​term care in case there was remission.” Jorge joined them after his brother’s surgery, utilizing the same strategy of overstaying a tourist visa. The family settled in New Jersey, “leaving behind a good socioeconomic position in Ecuador, to secure my brother’s health.” Jorge’s mom, who was a teacher, worked as a nanny, and his dad, in construction. They were fearful of being deported, especially after September 11, 2001, but they persevered and continued to work as irregular migrants being “very careful.” After a few years, Jorge’s father tried to apply for residency “with the sponsorship of one person who used to hire him often, because he was a very good worker and after a while, people looked for him specifically.” Despite hiring a lawyer, the process didn’t work. At this point, Jorge was about to finish high school, that is, 11 years had passed since their arrival in the US, so: my parents wanted to be able to support my applications and feared that if we didn’t have the residency, I was not going to be able to apply for 181

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financial aid and go to college as an undocumented student. They felt suffocated and desperate because they had tried to obtain the papers the right way, but it had not worked, and they really wanted to be able to support us and see us pursuing college. Then, as a last resort, they decided to get a divorce so they could arrange to marry other people who were citizens and with their sponsorship process the residency application to regularize our status. Once again, then, Jorge’s parents enacted their transformative border politics by defying migratory and citizenship regulations. Marriages of convenience have been a common resource utilized by irregular migrants even if the process is costly and risky. Jorge shared: The legal process to do something like that is very involved. It is very stressful, and my parents were very scared of being caught. It is a complicated and long process too. People think it’s easy, but it’s not. It is not like you get married and automatically, you become a citizen. They had to prove their marriages were legitimate and sustain them for five years. … They had been able to at least find people who were relatives of relatives, originally from Ecuador too, who had already obtained their status. So, they were good people, and they helped us. But of course, we paid them. … In the end, it all worked out. They were not caught, and our status was eventually regularized. Jorge, like Leonardo, had also become an excellent student after struggling a great deal with the transition, language, and culture shock upon arrival, and emulated his parents’ transformative border politics. In high school, he “worked as a volunteer in different organizations and had good marks in all classes and the SAT exam,” and found support from “teachers and counselors who encouraged me to include my many experiences as a volunteer in the college application essays.” Jorge was conscious that he “was not going to be able to apply for funding” because of his “irregular status,” however: I didn’t let any of that discourage me because my parents had sacrificed so much for our well-​being that I was not going to give up or pay attention to the teachers that would tell me that it was going to be hard to get in the better universities. So, I applied to all the best programs in Ivy League universities and to a program that I don’t know if it exists any longer in New York where one enters to study to become a medical doctor after high school and in only seven years you graduate. Jorge was accepted in three universities, including the medical school program. One of the universities was a highly regarded private institution 182

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“that didn’t care about my migratory status and offered me financial support as an international student.” Jorge studied there, and with time and exposure to “classmates, professors, and classes like the one in Geography about Immigrants’ Experiences in the US, I began to understand that my family’s history was nothing to be ashamed of but instead, to be valued.” Jorge’s “learning and maturing process” led him to “share my experiences more openly as opposed to hiding them because of shame and become active to make sure that future generations have a less difficult road ahead of them.” Jorge’s transformative border politics was then both geopolitical and ethnoracial as he became proud and active as a Latin American migrant and Latino. After college, Jorge applied to Teach for America and became a teacher, “conscious and proactive about migrant students’ needs and inclusion.” Moreover, Jorge reflected: My experience and being exposed to the experiences of other people, going to college, being a teacher and doing the Masters in Education helped me better understand the social and political problems that are happening now, including racial problems that I had not thought about before in Ecuador, so I’ve been able to offer support and be a person open to the conversations that this country needs to be a better place for everybody, no matter your racial, ethnic, or national background. The triumphs of Jorge regarding his education and professional career, added to his brother and sister’s similar accomplishments, also proved his family’s transformative border politics in the realm of social mobility. His parents had left Ecuador with a good socioeconomic position, but once in the United States, they sacrificed their careers and social standing, struggling to make ends meet as informal workers. They focused their strengths on the well-​ being of their children and bet on their future. The fact that all their children graduated from high school and two of them already from college, with the third one in line, had proven their transgenerational aims worthy. Jorge shared, “our ultimate goal will be that our parents are able to afford to buy their own house—​we’ve started working on getting a loan approved—​so they can finally make that dream a reality” (Jorge, Personal Interview, New Jersey, 2019). This migrant family’s efforts had paid off, altogether defying exclusionary geopolitical, economic, and ethnoracial borders. With the example of Jorge’s family, the incisive yet arbitrary outcomes that transformative border politics can have become evident. Migrants bet on taking certain paths, risking failure, and incurring material and emotional costs. Sometimes, the results fall within the desired range and bring about a transformative effect, even if the intention was not to cause a great impact. In the United States, as opposed to Spain, the accumulation of migrants’ transformative border politics regarding geopolitical restraints have 183

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not yet produced a change of migratory policies to regularize and extend benefits to the migrant populations that are much relied on economically. It did, however, motivate further restrictions and surveillance, and these only heightened migrants’ efforts to challenge those imposed boundaries. Simultaneously, the continuation of multiple migrants’ acts of defiance had transformative effects culturally and socially. Effects that cannot go unnoticed or considered minor. The experience of Diana’s family provides another example of geopolitical transformative border politics. Diana’s mother had migrated to the US following her brother because of economic problems. They both overstayed their tourist visas and worked irregularly to be able to send remittances back to their relatives in Ecuador. The husband of Diana’s mother traveled months after to be with her and was able to begin to work without employment authorization soon after arrival as well. Two years after they migrated, Diana was born, followed, a year later, by her sister. Diana’s parents stayed in the US for six years, working informally, and managed to save enough money to send to Ecuador and build their own house. When Diana was four years old, they decided to return to Ecuador so “they would be able to raise us in a better environment, because we used to live in the Bronx, in a bad neighborhood, and they didn’t want us to grow up there.” After seven years, Diana’s parents decided to migrate once again, but this time their purpose was “for us to regain our English-​speaking abilities, so we could study in the US and have an American college degree so we would be able to get good jobs when we grew up.” On that occasion, Diana and her sister traveled to New York with their grandmother first, “because we could do it” (Diana and her sister were US citizens, and their grandmother had a tourist visa to visit her son). Months later, Diana’s mother was granted a tourist visa, so she traveled to reunite with her daughters, and finally, Diana’s father managed to do the same. They overstayed their visas again, and just like before, they spent several years working as irregular migrants, “many, many hours because they had a large debt to pay back in Ecuador because they sold property and still had to borrow money to afford the tickets, visas and passports for all of us.” The case of Diana exemplifies recurrent geopolitical transformative border politics: her parents strategically defied migratory regulations not only once, but twice. Moreover, their migratory experience involved testing and transforming gender/sexual, ethnoracial, and socioeconomic boundaries. First, Diana’s mother challenged heteropatriarchal and misogynistic systems and practices in relation to her marriage and in how she raised her daughters; second, Diana’s international upbringing generated a reframed awareness regarding her ethnic and racial background both in Ecuador and in the US; and third, their experience altered socioeconomic boundaries as the family in time achieved social mobility transnationally and transgenerationally. 184

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Gender/​sexual regimes Another sphere where migrants enacted transformative border politics was that of gender/​sexual regimes. Migratory experiences allowed active and passive migrants to challenge hegemonic dynamics that prioritized men, masculinity, and heterosexuality. This affected gender/​sexual regimes in both the places of destination and origin. Moreover, it had a transgenerational effect: active migrant parents (more or less actively) inculcated renovated ideas and practices related to gender and sexuality to their offspring; and active migrant children witnessed these processes and reflectively built their own ways of being and doing, while also going through their secondary socialization process in sociocultural environments that presented more open, less vertical hierarchies and more awareness about the unacceptability of gender and sexual violence. Passive migrants’ gender and sexual transformative border politics was usually an outcome of the changes in the dynamics of care and discipline that occurred in the household with the departure of one parent, with mothers becoming the de facto head of household, or fathers taking up typically female house chores and care duties toward their children. As the examples related to geopolitical transformative border politics showed, migration tended to generate similar change processes in other spheres. Therefore, the cases presented to illustrate modifications related to gender/​ sexual regimes will turn to some of the migrants’ experiences mentioned earlier as well as include other examples specifically representative of this sphere per se. The first two cases will be that of Diana’s and Leonardo’s family, to build on their geopolitical transformative border politics. Then, I will focus on Camila, Rocío, Lesly, Roxana, Andy, Victoria, Miguel, Analisa, Genesis, and Juana. Diana’s case illustrates a twofold effect: on the one hand, Diana’s mother changed her perspective and attitude related to intimate partner violence after living in the US; on the other hand, Diana developed her own views about gender equality based on witnessing her mother’s experiences and transformation and growing up both in the US and in Ecuador, which offered a vivid comparison of the risks associated with gender violence and heteropatriarchal submission. Diana shared: My parents quarreled a lot. … My father even hit my mother. I remember at least two times when they had a fist fight, once in Ecuador, once here. There in Ecuador, when my father hit my mother, my mother didn’t let him, she would fight back, throw things at him, and stuff like that. … The first time, I didn’t do anything, like, for respect, because I wouldn’t push my mother, so instead, I stood in between my dad and mom because I thought that if I was in the middle, they would stop fighting. But no, they continued, 185

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and I ended up with a nosebleed, because it was one punch here, another punch there, and pow!—​I was bleeding. So then, they started screaming at each other: ‘It was your fault!’ ‘No! It was YOUR fault!’ [her emphasis]. Then, the second time, well, before he left there were many fights. Part of me wanted them to separate. I felt guilty because it was a bad thought, but I couldn’t stand it any longer. I wanted to see them separated, divorced, whatever. Because, it was a lot of screaming, lots of cursing. He insulted my mother; he was like, ‘Don’t go out, don’t do this, don’t do that! Why isn’t the food ready? Why are the girls already asleep?’ Like, my mother was his servant. ‘You are fat! You are lazy!’ He insulted her. There was a lot of that. He also had several love affairs. But the last time they had a fist fight, I did not get in between them because I thought they were not going to stop. They didn’t respect my presence. Instead, I grabbed my father, and my sister grabbed my mother. Because my father was stronger, uff! I was like 14 years old, and I was pulling hard. They started throwing things at each other. One of them threw something made of ceramic against a glass, so the glass broke and I again, got hurt. It wasn’t as bad as the first time though. So, it was then that my father left. Oh no! It was us who left the house. And we went towards the beach. ‘Let’s go! Let’s go! Let’s go!’ But, midway, my mother changed her mind and told us that we should go back home. And I was like, ‘No! I’d rather be at the beach!’ But we returned. When we arrived, he had left. He had grabbed his suitcases and left a note. He left. After the departure of Diana’s father, a long and contentious court process began “because he wanted to have our custody,” something that Diana and her sister “obviously didn’t want.” Diana expressed candidly: “I don’t think that my father was born to be a family man; he made a mistake getting married and having children. He was somebody who liked to party. Although he didn’t drink, he had many women!” When I asked Diana if she thought that her parents’ conflict worsened when they returned to the United States, she answered: Hmmm … I think that being here gave my mother more freedom. Because there in Ecuador, it was like a little bit antiquated. Because, they had been fighting forever, but there in Ecuador it was like a divorced woman. … They like shun my mom … it was like it was a horrible thing … even my mother’s family thought that way … they would tell her she ought to be patient with her husband; there, machismo continues to be very present. But, here having a divorce is more normal, so it was less pressure for her to end the relationship. 186

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I think that my mother didn’t tolerate as much his mistreatment here because she had more opportunities than in Ecuador. The resolve of Diana’s mother to separate became more evident to Diana during the process she endured after her father left. She recalled: After my father left the house, he would often come back without notice. He would come and go as he pleased. Until my mother told him, ‘This is not a hotel,’ and took his keys away. She changed the lock afterward. … It was very difficult, because when he decided to leave, he didn’t leave and that’s it. Instead, he decided to leave and continue to fight with my mother, more, more, and more. It was a very difficult time, especially for my mother, but also for us because it was like they were making us pick sides. I obviously picked my mother’s. … Then, the fight continued in court because my father wanted to have full custody, so he invented a lot of lies. My mother even showed me the report from the court that said that she was being accused of being a drug addict. My mom! What? She didn’t do any of those things he was accusing her of. He made up all kinds of lies to gain our custody, only to make her suffer. The court process found in favor of Diana’s mother. She remembers that “my mother told me that during the trial, she was calm while my father was all agitated, accusing her. She showed that she was not afraid because they were just lies.” Diana’s mother also gained confidence in herself as she overcame her fear of not being able to provide for her daughters on her own: After my father left our house, my mother was finally able to work outside, because before, he would not allow her. … It was very hard for my mother … but she was very practical. … She sacrificed very much to be able to give my sister and I what we needed and concentrated on working as much as possible. … When we were older, we also began to help her with work. We would go with her to clean houses, to clean a beauty salon after hours; we would go out and sell homemade pastries outside of church, or to sell food or the bracelets she used to make. After, she got certified to take care of children. First, she took care of a girl. She did that for many years. For a while, she also worked as a sleep-​in domestic worker, so we wouldn’t see her for some time, and we stayed with our grandmother. … So, it was hard, but she managed and did everything she could to provide for us on her own, so we could finish high school and go to college. 187

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This entire process also affected Diana’s perception of relationships and autonomy. She explained: I was convinced that I wanted to be an independent woman. I even wanted to leave the house and be on my own when I was 16! But I thought of my options. There were two: I find a boyfriend and leave with him, or, I go to college, out of state. Obviously, the first option was not the most recommendable. Then, I focused very much on my studies … because I had seen my mother suffer so much because she never earned as much as my father, and in a family, the one who earns more, has power. Then, with my teenager mind, I thought: if I earn my own money, I don’t have to be with anyone. Because my mother didn’t want to leave my father because she was scared that she would not be able to earn enough to pay the rent. She would tell me, ‘If your father leaves, how are we going to pay rent?’ and in that way, she put up with a lot of things. So, I said, ‘No! I want to earn my own money and learn how to live alone’ so in the case a man shows up and starts doing nonsense, I will be able to say, ‘Goodbye, I don’t need you because financially I’m all right!’ … My mom had also educated my sister and I to become independent, so we wouldn’t have to go through a similar situation to hers. Diana graduated as valedictorian and was accepted at a college in Pennsylvania, where she studied engineering with various fellowships, did several internships, and after graduation, worked for a series of construction companies. During her studies, Diana also dated. She recalled: I’ve learned to be a practical, but even more, an analytical person, especially while studying engineering. … Even my sentimental life was an equation [laughs]: if I started not to feel comfortable with a boyfriend, I would prepare an Excel sheet, really! [laughs] and make two columns; one with the reasons why I wanted to stay with him, and the other column, with the reasons why I did not. And if the final percentage was more ‘No’ than ‘Yes,’ it would be ‘Goodbye!’ Even if it hurt, I had to follow my calculations. … For example, I had a boyfriend after college, and we lived together eight months, but it didn’t work. I had moved to live with him in New Jersey, but there was nothing around there. Only old and ugly houses. I would tell him, ‘You are my only source of entertainment here!’ It was horrible, I liked going out, walking around, seeing people, going to stores. And there, there was nothing. Nothing. I would arrive to the house and start crying, because it was like a ghetto, but not a fun ghetto. … At least in the Bronx, in the ghetto I grew up, I could see people, play, 188

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there were barber shops, and bodegas, but there, there was nothing. … I was like, ‘This ghetto is no fun!’ … So, I thought about it, and there were more negatives than positives. I ended the relationship and moved back to New York. At the time of the interview, Diana was living on her own, sustaining herself, and happy to have accomplished her goals. She was also excited because recently, she had been able to change her perception about being Latina: Before I was very shameful of being an immigrant, of not speaking English so much, of having that accent, of not being American. Because, I would say to myself, I am American, but I don’t see myself like American, I don’t sound American. For example, the first time I dated a classmate in college, who was gringo, the first question that her mother asked me was if I was legal—​and me, attending the same school as her son! So, I sent her my resume because she was helping me look for jobs. But, well, after she saw my resume, she started respecting me because it was like that: they would see this face and assumed many things about me. Thus, I would be ashamed because of those things, until one or two years ago. One day, I found out online about a talk that journalist, Jorge Ramos, was going to hold in the Barnes & Noble store in 14th Street, to present his book. Then, I read his book (the one he wrote after he was taken out of an interview) and it was like my mind changed, like I started to feel proud of being here, because he included all the statistics of what we contributed to, of how much presence we have in the US, that maybe in 20 years we will be a majority, and that we have power, so I feel more confident. … I realized that I should be proud of being Hispanic, of being Latina! (Diana, Personal Interview, New York, 2019). Afterwards, Diana became actively involved with a group of young Ecuadoreans in New York and participated in different activities organized by the Ecuadorean consulate. Thus, Diana’s transformative border politics also reached the sphere of ethnoracial hierarchies. The other case that involved significant gender/sexual as well as geopolitical and ethnoracial transformative border politics was that of Leonardo’s. With their tier migration, gender relationships regarding discipline and authority changed as did Leonardo’s perception of masculinity. He had migrated with his mother and stayed in the US for two years before his father joined them. When they were living all together in Ecuador, Leonardo’s father was “the typical patriarch, head of household, breadwinner; a strong man physically speaking as well, who had been economically successful in his business.” 189

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But, with the financial crisis and the move of Leonardo and his mother to New Jersey, his father’s dominance was shaken. Leonardo noticed this when his father reunited with them; he shared: When my father arrived, he was shocked at my behavior. I had gotten unaccustomed to his harsh discipline. With my mother, I had gotten used to talk about things, about how we were feeling. I was unhappy about being in the US, I missed Ecuador and wanted to return; and I shared those feelings with my mother. I had began to misbehave a little; like, I didn’t want to do my share of household chores and my mother was afraid I would start being irresponsible at school too. So, when my father came, he tried to ‘fix us.’ But it was an adjustment process, because while I had to behave more along his lines, he also had to understand how I had changed my way of thinking and interacting. Here, I had learned that relationships are not about imposing, using strength, but that instead, they are about talking, conversing, understanding one another’s point of view, needs, and desires. Leonardo’s father was also affected by the change of life regarding work and status: My father’s ego was more affected than my mother’s regarding the situation they had in the US compared to Ecuador. For my father, it was very hard to work cleaning houses after having been a successful marketing and businessperson with a college degree in Ecuador. He was very frustrated. He had struggled so much in Ecuador and was very frustrated to come here and start from zero, all over again. He was so affected that my mom would sit down with him and count the money they had earned in the day in front of his eyes to remind him why they had decided to come and stay in the United States. Contrarily, Leonardo’s mother, who also sacrificed her career as a teacher in Ecuador: was not as frustrated when she had to start working as a cleaner. Her relatives alleviated that transition for her. She mostly missed being with my father, so she focused on the fact that we were together again, and that we were able to make a living while securing a good future for us. Leonardo attributed his father’s frustration and the different reaction of his mother to gender hierarchies and dynamics; he explained: 190

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My father was very frustrated with the limitations of being an irregular migrant worker in the US and having to live in a house that we shared with other relatives, with no privacy. … He didn’t tolerate when our relatives pointed out that he didn’t have papers. That was very hard for his pride. My father was very much a fighter in Ecuador. He always made himself be respected. He would start a fist fight and solve the problem. It was pure machismo at play. My father was known to be a good fighter, and here, he had to swallow his pride because he could not fight with anybody. Because if he fought, he was scared that he would end up in jail (and that was the worst thing for him) and then, he would be deported back to Ecuador. Leonardo’s parents also used to quarrel after he arrived “because of all of the pressures and how my father was reacting to the changes.” However, “their fights never became too extreme” and they stayed together until Leonardo’s father passed away. He developed ALS (amyotrophic lateral sclerosis) after four or five years of being in the US; a fact that Leonardo connected with the difficulties his father had adjusting to their lives as irregular migrants, including the economic, legal, and cultural aspects. Naturally, Leonardo’s mother suffered her husband’s illness and death: She loved him very much, but the relationship had become more and more difficult; first him being unhappy here, and later, with his disease. My mother would get upset and all her worries and attention were put on him, on him being ill. So, after he died, it was difficult for her to get out of the tunnel of having cared for someone so much. The person one cared for three years passes away and one is sad because one lost someone one loved, but also it is hard because one should recreate oneself apart from the role of caretaker. The process of recovery for Leonardo’s mother was also related to the way their mother/​son relationship had broken away from patriarchal forms as well as his mother’s empowerment as a respected woman in her community; according to him: My mother and I had developed a relationship of mutual support since we had come to the US by ourselves. We built a strong bond that helped us go through the difficulties of migrating first, and then, reuniting with my father, dealing with his rigid ways of being ‘the man of the house’ and his frustrations of not having a position of power privately and publicly. … With time, we were able to get over his death. My mother has always been very positive, and I’m like her. My father was more negative. She would talk with me about my father 191

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and if she felt sad, I cheered her up. Supporting each other helped us go through his illness and decease. I lived with my mother until I got married. Living with her after his death helped her adjust to her new life. She got involved at church, occupied positions of leadership in the community, like overseeing the group devoted to women’s activities. All of these helped her overcome the situation (Leonardo, Personal Interview, New Jersey, 2019). All in all, the experience of Leonardo’s family resulted in gender/​sexual transformative border politics, including challenges to hegemonic masculinity (Connell and Masserschmidt, 2005), reshaped relations of authority and discipline among the family, and the strengthening of women’s roles both in the private and public realms. Another example of transformative border politics related to gender/​sexual regimes was the process that Camila experienced as a passive migrant who stayed with her mother while her father, Luis, migrated to Spain. Her case also illustrates shifts in the dynamics and understanding of patriarchy; she explained: After my father returned [after 12 years of living abroad], the process of adaptation was very difficult. Our house was of only women, and things have been different since my father arrived. He brought different ways of thinking than my mother. And she was the one who had raised my sister and me. Sometimes they contradicted each other, so we would ask ourselves what we should do. Sometimes we all fought. Camila further elaborated: [M]‌y mother was very important to me to be able to endure the sadness and difficulties of being apart from our father. I appreciate her as a role model very much. She is a strong woman, a fighter. … I saw my mother’s efforts to keep everything running smoothly for us, even if it was hard for her to be on her own. … I have always highly regarded my mother, more than I did my father. Together, Camila’s mother and father had made the decision to migrate because “we didn’t have enough to feed our daughters,” and while he was the one who left to become the main economic resource of the family, and Camila’s mother was the one who raised their daughters providing emotional support in a typically patriarchal household order, Camila’s perspective of who was the family leader differed. Given her mother’s constant presence and effort to raise them, and the fact that she was the 192

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person who maintained order in the house, including the establishment of discipline and responsibility, Camila found that it was her who was the real head of the household. The return of Luis confirmed this: “we continued to look up to my mother and made our father change his ways to adapt to our female environment.” Camila’s reliance on the female members of the family also involved her grandmother: “She also raised us, and she is the other person I revere.” Simultaneously, Camila affirmed that: I loved my father and respected him for all the sacrifices he made too. But for me it was clear that our mother and grandma were the ones who kept us in line and motivated us to get ahead, be responsible students, be good people; I would do anything for them both! Luis was aware of the shift in authority that had been created with the passing of time and his absence, and he expressed that “it was hard to take that in and fully let go of my macho temper.” Despite the difficulty processing the new gender dynamics (with Camila, and her sister and mother unwilling to go back to being in a subordinate position to the father/husband, and Luis resenting having been displaced as patriarch), they expressed “happiness of being back together” and shared that they now “have conversations to solve any problems, fight less, and try to reach agreements among the four us instead of imposing one’s point of view” (Luis and Camila, Personal Interview of father and daughter, Loja, 2016). Changed perceptions and behaviors regarding patriarchy and specifically, machismo, were common in adult active migrants and their children, especially when grown up and ready to establish their own relationships and families. The case of Rocío, who lived in Spain since she was 13 years old until she was 26 with her family, and returned to Ecuador due to lack of employment and economic problems abroad, provides an example. Rocío was shocked upon returning with “the way fathers overprotected their daughters even after they were already adults;” she had witnessed this with her college classmates as well as with neighbors and relatives: There are so many young women that are like, tied to their father’s will. For example, let me explain, there are female classmates here in the university that had not been allowed to go out of town to Quito, Riobamba o Puerto Viejo to take exams. They told me, ‘No, it’s that my father did not let me go to Puerto Viejo because of this and of that, because I’m a girl.’ … Or, they said to me, ‘It was so far away that my father didn’t want to let me go on my own, so I couldn’t travel to take the exam.’ … Also, it is uncommon for a female college student to circulate on her own or use public transportation when it’s already dark out. They say it’s because it’s unsafe, but I’ve done it and I don’t 193

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see it as unsafe as they claim it to be. I don’t want to live with fear in my body. … I have had parents of classmates calling me so I would travel together with their daughters in the bus back to our neighborhood, even when it was not late at night or anything. Daughters are very controlled by their fathers. Rocío remembered that “it had always been this way,” but after being abroad for so long, she “cannot get used to it and finds it intolerable.” Rocío shared that she had trouble when trying to date or find a boyfriend: I had a relationship with a guy. It lasted only one month and a half. I didn’t like it. The type of relationship was too controlling, he was too macho. I didn’t like the way it was. Not at all. … Sometimes I joke with my girlfriends and tell them that I will need to go back to Spain to find myself a Spanish boyfriend because he will be able to understand me. Here there is too much machismo. They try to subjugate the woman they’re with, and that’s not how it goes. I mean, I swear that I cannot stand it. Rocío also perceived the unbearable weight of macho culture from people in general who would judge her because she was in her mid-​twenties yet not married; she shared: Look, right now, it is not my plan to get involved in a serious relationship. If I share this with any guy here, they don’t get it. In general, everyone disapproves that I’m this age, but I don’t have a husband, children, or a commitment to marry and have children. They don’t get this here. And this has been very hard for me. A lot of people told me, ‘It’s like you will be a solterona [pejorative for an older bachelorette]. It’s like you’re letting the rice overcook. It’s like this, and it’s like that.’ And I respond, ‘Just leave me alone!’ I tell them ‘It’s my life, not yours!’ This is why I was telling you, with that boyfriend I had, I ended the relationship because I made a comment about not wanting to have children yet and that I was not ready to be in a serious commitment, and he took it like it was the end of this world. Rocío’s position was more liberal than that of her Ecuadorean peers, family, and friends, and while she felt the pressure of reverting to “old ways” and was frustrated, she was determined to follow her own views about gender roles and expectations: What I say is, I don’t feel that I’ve accomplished my personal and professional goals. And until I don’t feel like I made it, I don’t want 194

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to have a commitment, or to have children or anything. No. … But here, nobody understands that. There is no way for them to understand it. Look, last night, some family friends came to our house. They said that because I was already in college, they are hoping that I find a boyfriend to settle down. So, I told them, ‘Well, I’ll be better off if I don’t find a boyfriend.’ They laughed, and told me, ‘No, because it’s already time for you to have a boyfriend, to have children.’ So, I said, ‘Look, to have a child, you don’t need to have a partner. And if I turn 30 years old and I don’t have children by then, I go to a fertilization clinic and choose to have a son myself without the need to have a father bothering me.’ Of course, they don’t like this kind of comments, they tell you, ‘No, you must be married, you ought to follow God’s laws,’ and I don’t know what else. Rocío was open to sharing her views even if she was mostly met with disapproval and resistance. Indeed, she insisted on expressing them and offering new ideas, especially to other young women. She said: I know some girls here who don’t really want to get married to the boyfriend they have, but they feel they must. I tell them, ‘You don’t have to follow these standards; they are not right for us.’ And they agree with me, but then disagree regarding some things. I tell them, ‘When you are in love with someone it doesn’t mean that you’re going to get in their bed, or that you need to make a commitment. Because the day after, or a year later, you may find yourself unhappy with this person, you may have realized that you’re not compatible, or that you don’t feel well with him. If this happens and you’ve already committed to them, what do you do? You end up with a failed marriage instead of a failed relationship. And it would be even worse if you have children already. It’s not only you but the child that suffers. But here, you don’t think about this. You are young, you are 16, enjoy life, live, enjoy your youth, because the house, the husband, and the children will come at the right time, but not now. … I also tell them, respectfully, ‘Look, if you feel like having sex with somebody, do it, use contraception, use a condom or pills. Be cautious. Don’t let yourself get pregnant without thinking about it. Don’t rush it.’ Rocío also intervened when her parents were asked about grandchildren: They ask my parents, ‘How many grandchildren do you have?’ My father answers, ‘One.’ Then, they ask, ‘Is it your daughter’s?’ And my father replies, ‘No, it’s my older son’s child.’ So then, they enquire, ‘And why doesn’t she want to have children?’ And I jump in and say, ‘Because 195

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I don’t want, and the one who decides is me.’ It’s my body, not theirs. I must tell them this way, to be clear and to see if they can understand there are other ways to be a woman besides mothering and marrying! Rocío also found that her way of dressing was criticized: Here it’s common for women to use long pants, even if the weather is hot and humid. And I never liked wearing pants that much—​I still use pants, but also, I wear shorts and skirts, and I keep switching around. And I noticed men reacting to seeing bare legs as if they’ve never seen any before … they are like impacted. Like they’ve never seen a leg, or a woman, or nothing. That’s very shocking to me and bothers me very much. Sometimes they tell me that I’ve dressed very provocatively, sometimes, they tell me that I’ve dressed very demurely, so I tell them, ‘You don’t have a middle ground with me. This is how I like to dress myself. I don’t like to be wearing the same thing that everyone wears here, with pants and sandals. I will dress like I want to.’ Rocío disliked the degree of scrutiny that she received but refused to change her ways and expressed that she identified more with gender norms in Spain. She explained: I identify much more with Spain’s culture and society. Here, I must measure my words, I must control what I say, and I don’t like that. And I can’t stand, I can’t tolerate the fact that men want to be in control of you. I swear, I can’t bear it. I tell my father, ‘The day I get married and my husband tries to tell me what to do or hit me, that will be my limit. I will not support a man directing or controlling me. No. Because I lived enough time abroad and learned that housework is something to be shared, wives don’t have to do it all, and they don’t have to be at their husband’s mercy.’ Despite this discomfort, Rocío had no plans to move back to Spain. She appreciated that in Ecuador “one can enjoy a rhythm of life that allows for more free time and better quality time with your family,” and was sure that she could live within and promote more equal gender dynamics even if people resisted (Rocío, Personal Interview, Santo Domingo, 2016). Lesly, who migrated to the United States, also had an experience that involved transformative border politics regarding patriarchy, hegemonic masculinity, female subordination, and gender violence. Lesly had grown up in an environment where intimate partner violence was common and accepted as part and parcel of family life. Her father had left the family behind promising to sustain it economically from abroad but soon parted 196

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and formed a new family. When Lesly’s older brother, and then, Lesly herself and her younger brother, attempted to reunify with their father in the US, he mistreated them, neglected them emotionally, and used them economically. Lesly’s sister had a partner who was abusive, and Lesly recalled her mother encouraging her sister “to be patient as a wife and never stating that he was wrong hitting her.” Lesly shared that it had taken her “many years and bad experiences to realize that subordinating to men was not the only option,” but that eventually, she understood “what machismo was actually about and how to set oneself free from and avoid abusive relationships.” Lesly had moved to New York when she was 13 years old together with her younger brother because she was expected to care for him as “a good sister,” following patriarchal family dynamics that pushed female siblings to provide emotional support and do the housework for their brothers. Lesly remembered: “I would cook and clean up the room where my brothers and I lived after I returned from school. … I also made sure to look happy in front of them because I needed to make them feel well, especially my younger brother.” Lesly also reflected on her relationship with her father and older brother: My father would say that we were spoiled children because we didn’t do as he pleased. But we didn’t obey him because he was like an unknown person to us, and we would not pay attention to his disciplining. However, for my younger brother and me, it was our older brother who had the authority—​he had become like a father to us since our father left. Then, when our brother said anything to us, we would follow his advice; if he reprimanded us, we cared. … Our father never understood or cared for us, and he always talked poorly about us. For example, he would always say that I was never going to be able to finish high school because I was going to get pregnant any minute. The view that Lesly’s father had of her was not only demeaning but also aligned with stereotypically misogynistic ideas about young women and their sexuality. Lesly “was determined to prove him wrong,” so she studied hard, graduated from high school, and obtained an undergraduate college degree. But her journey was filled with obstacles and “bad relationships,” which, according to her own analysis: were the result of being alone in this country and not having healed the feeling of abandonment that I had with my father first, then with my mother when she sent us to the US, and last with my older brother, once he left us on our own because he had his own relationship. 197

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Lesly’s first romantic relationship was “in high school, with a guy that was older than me and was about to complete his college degree.” She shared: At that time, my only goal was to finish high school, and like any Ecuadorean back then, my thought was that after graduating, I would have to get married with the boyfriend I had and then, have children. I used to think that was what I had to do. But he had gone to college, so he helped me open my eyes. He thought that we could move in and live together, but that I should continue studying. When Lesly graduated from high school, her father made her sign the application to enroll in the Army “because some friends of his had done that with their children and it had worked well, even if he never actually thought that I could ever go to college.” But Lesly ended up joining a program that her father had also made her enroll in, which “was supposed to offer education and job training, but in reality, was more like a jail.” When Lesly attended that program, her boyfriend would visit her, and she became pregnant. Lesly had a miscarriage because the institution she was attending failed to care for her. Lesly was able to leave with the help of her boyfriend, but “I found out that he had been cheating on me, so we ended the relationship and‌moved back with my older brother.” Lesly was “ashamed and afraid of sharing what had happened to me with my brother, so he never understood why I had left that program or why I was so depressed.” Lesly reflected that “back then, I had not yet understood that I depended emotionally on any person who showed me a little bit of love. Then, I had more experiences with men that ended up poorly.” A few years after breaking up with the boyfriend that had been unfaithful, Lesly got involved with a friend “whom I trusted, but also ended up being unfair with me: when I got pregnant, he forced me to have an abortion and threatened me.” When she was telling me this, Lesly also recalled and shared “for the first time” that: When I was 16 years old, I went through something that now I understand was rape, because he was 28 years old, and he took advantage of the fact that he was close to the family and saw that I was alone and needed affection. And I felt very lonely and didn’t know any better. Then, she talked about her last abusive relationship: A couple of years ago, I got married to a guy in Ecuador, with the dream of returning to live there. But soon, I realized that he was a violent person and very macho. … He mistreated me psychologically, emotionally, and physically; he wanted me to be his subordinate. At 198

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first, I had the mentality that wives had to do what husbands told them to. … A divorce was not an option because my mother and everyone in Ecuador would see that as unacceptable … so, I returned to the US, and was so depressed that I sought out mental health care to be able to end that marriage without feeling that it was going to be another failure for me or that I would be abandoning him, which is what he used to tell me. Lesly explained that psychological counseling had been key to identify the abusive character of the experiences she had as a girl, a teenager, and a woman, and how they had been traumatizing as well as give her tools to progress by drawing on self-worth and awareness. In her words: Now, I’ve been in therapy for two years, and recently started to understand what has happened to me and why. It helped set me free from my last relationship. I got a divorce and began to be able to build relationships not from a space of emotional dependency and gender subordination, but as equals. I have been able to empower myself and realize that I don’t need others to have expectations of me to get ahead. It’s me who must have those expectations and trust that I will move forward, that I will study to do what I really would like to do, not what my husband wants and not because of others. Lesly had a major in psychology and had started studying to become a counselor “so I can work with immigrants, erase the taboo that only crazy people go to a psychologist, so commonly held among Ecuadoreans, and provide care related to the difficulties of migrating and being an immigrant” (Lesly, Personal Interview, New York, 2019). Lesly’s experience was one imbued with gender/sexual inequalities; it was difficult to arrive at her transformative border politics, but she did, and in doing so broke out of the rooted belief that the patriarchal order was the only one possible, and heightened the fact that women can be independent and thrive on their own. The cases of Roxana, Andy, Victoria, Miguel, Analisa, Arturo, and Genesis illustrated transformative border politics in relation to sexual identity. Roxana had migrated to the US from Ecuador when she was 12 years old, Andy at 15. Both participated in one of our Community Workshops in New York, organized at a Lutheran Church that celebrated same-​sex relationships and marriages. During our conversations about how migration processes opened up new possibilities despite the many challenges, they shared their own experiences regarding their sexual identity. Roxana said: To me, being a teenager in New York City was like a blessing … I mean, in Ecuador, the culture is very conservative when it comes 199

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to sexuality. It’s like being gay or lesbian is forbidden or taboo. My parents used to think that way. I grew up in that context, so I had always struggled with having feelings and being attracted to other girls. I was convinced that something was wrong with me. And I hid it as much as possible. But, after spending some time in the US, especially in high school, I found myself to be less out of place. I met other girls who had similar feelings … there was an LGBTQ club and well, in New York, being gay is not that weird! [laughs] But, what also helped was that my parents started to come to this church because of all the programs they had to assist migrants. One of the priests, who was from Argentina and led the Latinx congregation of the church, was very open about sexual preferences and identities. They had an LGBTQ group too. My parents at first were surprised, but soon they understood that it was fine. … It took me a while to come out, but when I did, I felt safe to do so. … Eventually, my parents were supportive and accepting of my being a lesbian. (Roxana, Community Workshop # 4, New York, 2017) Andy had a similar but different experience: For me it was like for Roxana, like, it was also a blessing to be here in New York and not back in Ecuador, because, like she said, it’s conservative there. But, in my case, my parents were not supportive at all. They think being gay is like an illness or a sin. For them it was like, ‘Forget about this church! What do you mean that two men are getting married to each other?’ While I was in high school, it was kind of OK, but not as good as Roxana’s experience either. The school I went to did not have an LGBTQ club or anything like that, and a lot of my classmates were kind of homophobic. So, I didn’t open much in that context. I knew I liked other guys and was not interested in girls at all, but I wasn’t ‘out of the closet.’ … But now, I’m already 22, I don’t live with my parents anymore, I’m independent, and have a boyfriend. We come here together sometimes—​although today’s he’s not here—​and we’ve been to Felipe and Jerry’s wedding. … It was so beautiful to see them getting married and it was also reassuring for us, it was like a message sent to us, like a hashtag, #wearefine #nothingwrongwithus [laughs]. (Andy, Community Workshop # 4, New York, 2017) Andy and Roxana were good friends, and the Argentinean Priest was happy to confirm that they felt that “they belonged” (Maximiliano, Community Workshop # 4, New York, 2017). Andy later shared with me that: “I believe that someday my parents are going to turn around and support me because 200

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we love one another, and for us family is a treasure,” reflecting a future-​ oriented approach, coincidental with migrants’ transgenerational goals and well-​being ideal (Andy, Community Workshop # 4, New York, 2017). Other participants in the Community Workshop expressed their support for Andy and Roxana, and in general, their approval of gender fluidity and sexual diversity. Some added that they had children or friends who had had a similar experience even if they were from other Latin American countries, upon which Victoria, an active migrant from Argentina, stated: Absolutely! Ecuador is not the only place where being gay is taboo. And it also depends on if you’re coming from a larger or a smaller town. For my friend, who grew up in Buenos Aires, it was not so strange to be lesbian, but for my brother who, like me, was raised in a small town close to Tucumán, in the interior of Argentina, it was like a nightmare being gay. … In any case, I think that once we move away from where we grew up and learn about alternative lifestyles, we dare explore who we are and express ourselves more freely. (Victoria, Community Workshop # 4, New York, 2017) Moreover, Maximiliano shared that LGBTQ migrants who participated in the support groups usually had “left their countries of origin because they were persecuted and attacked because of their sexual identity” (Maximiliano, Community Workshop # 4, New York, 2017). Dora, the psychologist who provided counseling for the Latinx community there, added that: many of the migrants that attend the LGBTQ group expressed to have found much safer conditions here in comparison to their places of origin. There are several LGBTQ migrants who were severely punished physically and psychologically back home. There were cases with brain damage, convulsions, and sight loss because of the beatings they endured for being homosexual. Sexual violence was also common, including rape and the contraction of sexually transmitted diseases like HIV/AIDS. We provide support for them in unison with other programs in the city. When we work with transgender migrants, we usually assist them in elaborating all the trauma they have experienced because of their sexual identity and reassure them that they are not to be blamed or judged. It is a hard process. (Dora, Personal Interview, New York, 2019) The priest and psychologist were of course bound by confidentiality, so they could not share further details, but they both agreed in their appreciation that the LGBTQ migrants they had met had been able to transcend rigid gender/​sexual boundaries through migration. 201

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Miguel, a Venezuelan active migrant in New York, briefly shared his experience in another Community Workshop: I’m married to Esteban. We got married here, in New York. He is from Portugal. We met here and fell in love. I migrated here because of the hardships in Venezuela, and Esteban moved because professionally, the US was more promising plus there was a recession in Portugal. … I always knew I was gay, but I didn’t act on it back home. Even now, that I’m married, I hide it from my family, who is still there. Like, if we were to visit, I would not be able to tell them Esteban is my husband! He would be my good friend to them. … It’s hard, but that’s how it is. On the contrary, Esteban’s family in Portugal is aware of everything and they are kind of OK with it—​actually, I think they mind more that the person who is with their son is Venezuelan as opposed to gay! Miguel was by himself in the workshop, so I could not talk directly with Esteban. But, after the group dispersed, Miguel talked with me a little longer and said, “I didn’t leave Venezuela because of my sexual identity, but I’m happy I did because here I’ve been able to really be who I am” (Miguel, Community Workshop # 5, New York, 2017). The case of Miguel exemplified how gender/​sexual transformative border politics may be more resonant in places of destination, especially if these are more liberal and progressive, and find more resistance in places of origin, because they may be more conservative or host more rigid members of the family. Moreover, it pointed to how gender/​sexual openness may be undermined by ethnoracial hierarchies, given that Esteban’s family resisted more his origin from the Global South than his sexual identity. In other community workshops with a mix of Latin American participants, a few active migrants mentioned that their views about sexual diversity had changed after living in the United States; Analisa’s words summarized this: Before I came here, I had not thought about people having same-​sex boyfriends and girlfriends … that was something that appeared in some movies, but not something that I saw happening back home. After a while, I realized that was not so strange … and who am I to judge? If they love each other, that’s all that matters! I talked about this with my relatives back home, when I visited them, and heard their prejudice, the same prejudice I used to have. They were surprised to see how flexible or understanding I had become and even if they were not like, ‘yes, we agree with it,’ they were more ready to listen and accept that there were more ways to live than the one they were used to. (Analisa, Community Workshop #7, New York, 2017)

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Analisa’s changed perception and attitude toward sexual diversity echoed many comments shared by return migrants from Spain in group interviews held in Loja. For example, Arturo expressed: one of the things I was shocked to see in Palma was how many men were together with other men, walking around, having a good time … and I’m not going to lie and say that I was totally comfortable with that at first. It took me a while, but eventually, I was fine. I learned that love comes in all forms and shapes! (Arturo, Group Interview #1, Loja, 2017) Similarly, Genesis, a passive migrant in Ecuador, shared that her mother used to call her from Spain on WhatsApp and ask her, “How are you doing? Are you dating somebody?” to which she usually answered, “No, Mom, please, don’t bother me with that!” until one day, to Genesis “surprise,” her mom said, “It’s OK if you don’t want to tell me, but if you liked girls, it would be fine. You can love anyone you want!” Genesis laughed when she shared this with the group and added, “I was so shocked to hear my mom say that! It was like I was watching a show or something, but I guess Spain did that to her, I mean, it opened her mind” (Genesis, Group Interview # 7, Santo Domingo, 2017). Analisa’s, Arturo’s, and Genesis’ cases were demonstrative of gender/​sexual transformative border politics in the sense of the adoption of more open mindsets and practices that broke away from hegemonic heterosexual regimes because of international migration and contributed to the dismantling of exclusionary categories transgenerationally. Juana’s case illustrated transformative border politics regarding another aspect of gender/​sexual regimes: labor segregation. Upon arrival in Spain, she worked as a sleep-​in domestic worker, a job “I found extremely depressing because I could not leave that house, it felt like if I were in jail! And I didn’t really like doing housework and nurse-​type of tasks non-​stop.” Then, as soon as Juana regularized her migratory status, she looked for another job. She narrated: I started to work at a company where there were only men. I had gone looking for work to one company after the other, and they would all tell me that they were only looking to hire men. They were factories of furniture and things like that, where men were the ones who usually did those kinds of jobs. But I would insist, I would tell them that as a woman I could do the same than men could do. They would tell me that, ‘No! You’re crazy!’ They would tell me, ‘When have you picked up a drill? What do you know about that?’ So, I would reply, ‘Well, I have not. But I can learn!’ Then, someone told me about a factory that made sinks. And I was very nervous about it because I had never done something like that before. But I told myself, ‘Yes, I can do it!’ 203

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and was able to calm down. I went to the factory, and they showed me around. They would tell me, ‘See? Only men work here!’ And it was true, each and every one of them were men! Then, he would say to me, ‘It’s not like I don’t want to give you a job, but no woman works here.’ And I told him, ‘It doesn’t matter. I can learn!’ So, the manager assigned me to a young guy who was from Guayaquil so he would teach me. But, as a fellow Ecuadorean, he didn’t want me to get ahead. He stared at me from head to toe and said, ‘No, I don’t think that she will be able learn how to do this!’ But I insisted and told the owner to please test me out. The owner agreed. He asked me to return the next day dressed accordingly, with an overall, and ready to start working. And I learned. A month later, he gave me a contract for six months and told me that he was going to update the factory to accommodate me—​like he had to build a bathroom, a locker room for me because he had never had women work there, so all the facilities were for men. And I could see the rejection that the men had against me, especially the Ecuadorean men, who would have their lunch break and never included me. So, I would get close to the Spaniards, who did talk with me. Juana was able to break through gender barriers in the labor sector—gender segregation that also overlapped with ethnic, nationality, and migration matters, as “it was supposed that Ecuadorean women could only work as maids, nannies, or home care aides, and that Ecuadorean men could work on construction and other heavy physical labor in Spain.” Juana broke the mold and her employer appreciated her for having done that as well as for the good work that she did in the factory. She shared that her boss “trusted” her and that after the first contract for six months, “he made me a contract that had no end date.” She explained: I demonstrated that I could. Besides, I did the work even better than my coworkers. Because there were things that my coworkers could not do: sometimes, they left sinks aside, saying that there was nothing that could be done to fix them. But I would then tell them, ‘Let me see … I can fix it!’ They were surprised, and would ask me, ‘Where did you learn to do that? How is it possible?’ And I would tell them, ‘Don’t worry, leave it to me. I’ll work on it;’ and I would fix them. Juana worked there for four years and decided to return to Ecuador so she could be reunited with her daughter. She had positive memories of that period: 204

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The experience I had working there was very good. My bosses were good people, trustworthy. They always paid me on time. I am very grateful to them. When I left, they told me that if I ever decided to return to Spain, they would be waiting for me and they offered to help me if I ever needed anything. Juana’s courage to enter a male-​dominated workforce was doubled with the pressure she felt from fellow Ecuadoreans, who she found to be “more macho than the Spaniards” and also “jealous to see women, especially Ecuadorean women, thrive” (Juana, Group Interview # 2, Loja, 2017). The rivalry among migrants abroad seemed to be a common affair. Many migrants echoed that “it was not them, the gringos or the Spaniards; it was other Ecuadoreans or Latin Americans who were the ones placing obstacles in our way!” (Mimi, Group Interview # 2, Loja, 2017). What has been conceptualized as ‘double consciousness’ and ‘internalized oppression’ (Du Bois, 1989[1903]; Padilla, 2001; Pyke, 2010; David, 2013), brings us to the next subsection focusing on ethnoracial transformative border politics.

Ethnoracial hierarchies The process of transformative border politics regarding ethnic and racial hierarchies was also multifaceted. Migratory processes triggered the experiential realization that ethnoracial orders and one’s position within these vary from country to country and with time, and that one’s ethnoracial sense of self, community, and practice can change the tenor of social relations. Moreover, migrations highlighted the degree of inequality of different ethnoracial structures, cultures, and practices. On the one hand, migrants became aware of the level of discrimination toward and between migrants in the Global North. On the other hand, migrants reassessed their own countries’ ethnoracial regimes. When enacting ethnoracial transformative border politics, migrants were able to overcome racist barriers and behaviors by reaffirming their sense of self and pride as Latin American migrants, and in the specific case of Ecuadoreans, as mestizos, and by confronting racism, nativism, xenophobia, and internalized oppression. This transformative outcome usually required the passing of time and a significantly deep level of reflection. Furthermore, this process frequently was transgenerational: with the younger generations of passive and active migrants becoming the ones with a stronger awareness of not only the pervasiveness but also the historicity and fluidity of what were previously taken-​for-​granted rigid ethnoracial orders. Like the cases of geopolitical and gender/​sexual transformative border politics showed, migration tended to generate change processes in various spheres. Specifically, the experiences of Manuel, Leonardo, Jorge,

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Diana, and Juana had involved ethnoracial transformative border politics as well as geopolitical, gender/sexual, and/​or socioeconomic. The cases that follow highlight ethnoracial transformative border politics due to discriminatory practices (1) against immigrants by people who were native citizens of the countries of destination; (2) among immigrants abroad; and (3) in the countries of origin. The migrants referred to below were aware to various degrees of their own countries’ mestizaje, the multiplicity of indigenous communities, and the grassroots and political efforts that had been made to recognize and better respect native cultural practices and Afro descendants. However, and not surprisingly, none of them had thought about international ethnoracial politics while they lived in Ecuador. Thus, when they traversed a new racialization process abroad and experienced racism, they, like many other migrants who participated in this research, were “shocked” because they had always identified themselves “plainly and simply as mestizo, as Ecuadoreans” and they were “proud of it” (Marta, Group Interview # 2, Loja, 2017). Carina had reunited with her parents in Spain, she recalled: When I went to Spain, I started going to school. I had classmates from everywhere, from Dominican Republic, Colombia, Puerto Rico, Mexico. The Spaniards excluded us. … Discrimination existed, even the professors always treated us like if we were less, and that affects one’s morale. I felt diminished, belittled … I even ended up asking my father to take me out of that school, but he wouldn’t because he was paying a lot of money for it, so he asked me to give it a try. … So I did, and with time, I began to get used to it and started to develop friendships with some Colombians and Spanish girls. At the end, I felt better, and was able to loosen up and be more comfortable with being myself: a mestiza, Ecuadorean immigrant. (Carina, Group Interview # 4, Loja, 2017) Carina’s experience of discrimination at school was shared by many other active migrants in Spain, like Frida who expressed, crying, that “school was hard when I arrived, now when I tell people what happened to me, they tell me it was bullying” (Frida, Group Interview # 4, Loja, 2017), and the United States, like Diana who said “they made fun of me, they cursed and ridiculed me because I could not speak in English like them” (Diana, Personal Interview, New York, 2019). Language barriers made the process of integration more difficult, and these barriers existed in both the US—​“I didn’t speak any English … I arrived at school … without knowing how to communicate with anyone” (Jorge, Personal Interview, New Jersey, 2019)—​and Spain with the many dialects that were spoken regionally—​

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“I thought I was going to be able to speak in Spanish, but the school instruction was all in Catalan and nobody helped me; then, I stayed quiet, didn’t open my mouth. It was very difficult” (Ryan, Personal Interview, Santo Domingo, 2016). However, it was ethnoracial politics that marked migrants as “different and lesser because we were identified as people who were coming from underdeveloped countries, with no culture or education, to take advantage of the riches of Europe or North America” (Gastón, Group Interview # 2, Loja, 2017). Ethnoracial transformative border politics allowed migrants to resist, challenge, and overcome this kind of discriminatory exclusion. Carina suffered the impact of her classmates and professors’ racism but learned to face them not through assimilation but instead a solidification of her sense of identity and pride in being Ecuadorean, mestiza, and migrant: “I realized that I had nothing to be ashamed of. I was not a criminal or a bad person. And my national origin, the color of my skin, my accent should not matter, should not be what determines how people treat me or how I treat them” (Carina, Group Interview # 4, Loja, 2017). Marta experienced ethnoracial transformative border politics as an adult migrant worker in Spain. She recalled: Our job was very demanding. I was the cook and my husband the waiter in the country estate of a very rich couple. I had to calculate the exact timing not just to cook things but how long it would take for my husband to bring it to the dining room. The owners controlled everything; they would tell me: ‘Very bad, Marta. It is not salty enough,’ or sweet enough, it was never right. … They were very demanding and to me that was like a psychological attack. I lived with nerves and fear of messing things up. Sometimes, they would bring guests to the house for dinner, journalists, important people with money, and we were like guinea pigs or exotic pets for them; like they showcased us as if they owned something extraordinary, different. When we went to town to buy supplies for the house, they stared at us like if we were something especial—​ we were like the only Ecuadoreans there. We were young and dark, and we were like a curiosity for the people who lived there. They thought we were Moroccan. They would look at us in the stores and asked us if we were Moroccan. We would say that we were not, so then they would ask if we were Gypsies or what. … They also would ask us questions like, ‘In your homeland, do you have TVs? What kind of food do your people eat? Do you bathe?’ And they would talk to us like we were coming out of a National Geographic magazine. Then, they would treat us like if we were stupid, incompetent.

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There were also people from the area that passed judgment on us because it seems that the owners of the estate had originally been looking to hire Spaniards but ended up hiring us, two young Ecuadoreans, so they would tell us that at least one should be 40 years old to work for those millionaire masters—​that’s how they called them in town. We felt very bad with all these things, everyone looked down on us. But with time, we made ourselves be valued and respected because we were honest and serious workers. … We didn’t let them make us feel ashamed of who we were. We were Ecuadorean migrants, mestizos with dark skin, but that should not have been a mark for them to diminish us. We were and are proud of our origin and identity. Marta and her husband persevered in their efforts to meet their migratory transgenerational goals and succeeded despite the odds. Marta repeated that “it took us longer than expected, but in the end, we were able to build our house back in Ecuador and secure a good future for our daughter and sons.” Marta and her family moved back to Ecuador, and that new migration opened up another opportunity for Marta to rethink ethnoracial politics: As a returnee, I’ve been very conscious not to flaunt my success. I have witnessed this attitude before, and I always found it regrettable. Instead, I’ve shared what I learned and offered my support to people who want to migrate and to other returnees. After suffering so much discrimination abroad, why would I discriminate against fellow Ecuadoreans now? Because I ‘made it’? That’s ridiculous! People think that because of their skin color, nationality, or riches they can be above others. They are wrong. We are people, we are the same. I didn’t come back to Ecuador to show off or make others feel less. I’m here, I’ve been through plenty, I won’t repeat the behavior of those who mistreated me. I’m here and I’ve learned to be humble. I will share with others my experience, so they don’t have to suffer like we did. It’s our actions that can change how we treat one another. We can act with respect and care and in that way get rid of these absurd ways to get ahead making the others pay the price—​what’s the point of that? In the end, it hurts us all. (Marta, Group Interview # 2, Loja, 2017) Several other return migrants, like Gastón, echoed Marta’s view, emphasizing that: In the end, it was a learning experience to be abroad. We all went through plenty, true. We were treated as lesser because we were Latin Americans, Ecuadoreans, mestizos, ‘Indians’ like they used to call us 208

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too, brown people. … But we persevered. We showed them that we were decent, honest, good workers, good people; and that our children should be treated equally with respect. So now that we are back, we need to behave our best. We should have all learned that mistreating, being racist, exploiting those who are struggling is simply deplorable. Why would we now do that? We see other people who returned with money taking advantage of others with less. That is sad, and wrong. Like Marta, we believe that we should help and respect everybody. Just like we wished we had been treated abroad. (Gastón, Group Interview # 2, Loja, 2017) Racial and ethnic discrimination were also rampant in the United States; Manuel expressed: As migrants we also feel racism every day. I was robbed many times: I worked hours and hours and never got paid. They took advantage of me not having documents or any knowledge of what rights I had as a worker, regardless of having papers or not; and of course, they took advantage of my very limited English. I didn’t know how to defend myself and really felt like I was less than them. (Manuel, Group Interview # 3, Loja, 2017) Matías, an active migrant devoted to business and financial matters, also referred to the pressure that migrant workers experience in the US because “of a combination of lack of papers, language, legal and economic knowledge, on the one hand, and racism on the other hand.” He elaborated: Ecuadorean and Latin American migrants come here as they can, with desperate economic needs. They must work whatever job they can find so they can pay back the debt they incurred to travel and send remittances to their families so they can survive first, and later, move out of poverty or precarity. They work informally, with no contracts, benefits, security, or anything. They get used to being treated as slaves in the sense that they are considered just ‘bodies-​who-​work’ at the mercy of whomever is promising to pay something at the end of the day or week. They get used to being discriminated because they don’t speak English, because they are brown skin, ‘unworthy illegal immigrants who came to take advantage of us.’ And they also get used to working like ‘animals,’ non-​stop. Even after they regularize their status, they continue to work as much, like they don’t know what else to do with their lives because they’re so focused on saving enough money to send home and make their own house for their children.

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In Matías’ view, ethnoracial transformative border politics was the basis for migrants breaking free from that alienating cycle; he explained: What we, migrant workers, do is unsustainable. Because all of us do it, not only migrants who don’t have papers. Migrants who have papers do it also. It’s like we all must prove that we can be the best or that we are able to and will do everything possible to meet our goals, despite all the racism, the discrimination, and the exploitation that are part of the structure of these country’s capitalism. So, with a few fellow Ecuadorean colleagues, we created a program specifically devoted to empowering migrants by educating them economically, financially, and legally. We offer community workshops as well as services for businesses to improve their profitability by learning about the Latin American and Latino market. The key is to re-​evaluate who we are ethnically as migrants. To believe in our strength and understand our weaknesses to improve them. To move beyond how mainstream US sees us and instead capitalize on our real capacities and potential. (Matías, Personal Interview, New York, 2019) Matías and his colleagues’ community workshops, which I attended a few times and did participant observation with their consent, were energetic and energizing, filled with Latin American migrants who shared their experiences of discrimination and struggle while also pointing to their perseverance and desire to overcome hurdles and get ahead. For several participants at a workshop focused on women, “being Latina was first a burden, but then I realized how to make that an asset to resist and grow as a worker” (Mirna, Matías’ Group Community Workshop # 2, New York, 2019). Other women echoed that process: I had never thought of myself as Latina before. I thought of myself as Ecuadorean. Like you probably thought of yourself as a national of your country. When I arrived here, the label Latina was put on me. And I hated it at first because it was never a positive thing. I was also perceived as a ‘person of color,’ whatever that means! And in my country, I’m as brown as anyone else. It was all very shocking. But lately, I started to realize, thanks to other fellow migrants, that being Latina is a good thing. We have many cultural attributes that are valuable and that make me who I am. Because I’m a devoted mother and a dependable worker, and I’m strong, stronger than many people who were born here, because I persevered despite all the obstacles and the many ways I was told that I was good for nothing else but to be a nanny or a domestic worker—​like if any of those jobs were morally wrong! All the many times that I was told that ‘people like me,’ that is 210

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a brown Latina immigrant, ‘did not belong.’ All the many times I was told to ‘go back.’ But no. I’m here. And I’m doing things right. And I deserve more. (Maricruz, Matías’ Group Community Workshop # 2, New York, 2019) Samantha, who was also a businesswoman and Matías’ wife and partner in this initiative, expressed: I got tired of being told that I could not. That I could not because I was an immigrant. That I could not because I was Ecuadorean. That I could not because I had an accent. That I could not because I was a woman. That I could not because I was a mother and a wife. But before getting tired of these, I had started to believe that all these lies were true! Until I realized that they were lies. That they were ways to keep us down, quiet, docile. But no. That’s not happening. I’m here. I’m loud. I’m Latina. I’m a woman. I’m a mother. I’m a wife. And I am a successful businesswoman who will make sure that there are many, many other more Latinas who leave all that toxic nonsense behind. Samantha’s words and the workshop itself encouraged “Latinas to grow economically and break mobility frontiers, regardless of their migratory status,” and in that way, connected the four spheres of transformative border politics in a practical manner (Samantha, Matías’ Group Community Workshop # 2, New York, 2019). Their community workshops attracted one to two hundred people when they were in person, and about five hundred when they organized them through their virtual platform, proving the resonance that themes like how to overcome oppression, discrimination, racism, and sexism, and Latino empowerment and economic growth had in the community. Matías and his colleagues led several workshops focused on becoming “financially savvy and economically prosperous as Latino workers and entrepreneurs;” which included business tips, taxation issues, loan management, and marketing strategies “all blended with realizing how racism and discrimination work and more importantly, how to get rid of our own traumas, so we value our Latinidad.” In one of his workshop presentations, Matías told the audience—​formed of Latin American migrants of different nationalities: I know because I studied, but more importantly, I know because my family went through this. As Latinos, we’re used to being treated as disposable people. Or we are invisible. But watch out! We are neither of those things. We are good workers. Sometimes we take work so seriously that we become workaholics! Like, what else can we do if we don’t work? We are valuable assets. We have business ideas. We 211

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can learn to become even better. The key is not to believe that we cannot do more. There is no reason why you cannot explore opening your own business in construction services. Or that you cannot form your own company providing cleaning services. Or that you can grow your street-​food-​vending gig into a mobile lunch bar. The problem is that first, we were told we could not; second, we were afraid; third, we didn’t know how. All these problems can be solved, and that starts with you being here to learn and get rid of that fear that became a part of you. But trust me, see my colleagues here. We can do it! We are Latin American immigrants. We are Latinos. We are Ecuadorean, Colombian, Mexican, Salvadorean. … And we should be proud of who we are. We cannot let their racism sideline us forever. (Matías, Matías’ Group Community Workshop # 1, New York, 2019) Migrants in the audience were excited to hear this, but also shared their doubts. For example, Oscar said, “But, I think that it doesn’t matter how much I love being from my country. What matters more is that here they see me as an animal, as hands, or as they tell me, as a ‘shitty illegal immigrant’ ” (Oscar, Matías’ Group Community Workshop # 1, New York, 2019). When other participants agreed, Matías insisted, “That is why we need to do this. We need to keep trying. We need to show them that how they see us is not who we are.” When I asked Matías, Samantha, and his colleagues about these comments, they agreed in acknowledging that: It is not easy to breakdown the stereotypes and heal the harm that has been done, plus, it is difficult too because most migrants are really struggling to make ends meet here and back home. So, we see that it’s like they are interested in believing in the possibility of growing and getting rid of all the crap that has been dumped on them, but then, their current needs push them to go on with their daily gigs so they can make rent here and send something back home. We know this is hard. But we believe that in the long run, it’s the best way out of subordination and stalemate. (Matías, Matías’ Group Community Workshop # 1, New York, 2019) Matías and his colleagues also agreed in articulating that “the non-​Latino business community, White Anglo people who dominate business and finance, also need to be educated so they stop seeing us only as cheap workforce because they are also missing out” (Roberto, Matías’ Group Community Workshop # 1, New York, 2019). Matías added, “missing out economically, because they could be doing much more productive business with us, but also culturally, like I feel this country is stuck in time racially” (Matías, Matías’ Group Community Workshop # 1, New York, 2019). The 212

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perception of “backwardness” with regard to racial hierarchies was commonly shared by migrants, especially younger generations who were more inclined to “learn about racial injustice and be ready to do our part in dismantling it” (Cecilia, Personal Interview, New York, 2018). As Guillermo put it: “It’s crazy to see how the US is so advanced in many ways, yet so retrograde in many others. How is it possible that still immigrants are systematically treated like scum and African descendants are killed like animals?” (Guillermo, Personal Interview, New York, 2017). Or Jorge, who said: I learned so much about race, racism, and discrimination here that now, when I visit Ecuador, I’m much more aware of these things than before and notice the problem we have there too. But, at the same time, it’s hard to believe that there still so much inequality in the US. Like, it’s like the history is there, the social movements are there, but police brutality, White supremacy, and nativism are stronger. As a teacher, I’ve been doing the most I can to resist and dismantle these; but sometimes you feel you’re trying to slash a dragon with a plastic fork! (Jorge, Personal Interview, New Jersey, 2019) Likewise, Cecilia, an active migrant who became an immigration lawyer after overcoming many hurdles, expressed: I thought nothing especial of my life as a migrant. I thought my predicaments were common. It was my high school teacher who helped me think of my story in the context of migration and how migrants live in the US. … I learned about racism, xenophobia, discrimination, exclusionary immigration laws, and all of that. I had experienced all of these, but never realized they were so widespread. It was hard to believe that with everything this country had to offer, there was also that. … I ended up studying sociology and law, and now work as an immigration attorney devoted to the Mexican/​US border crisis with the Central American caravans. It’s hard to witness how unfair all is still, to this day. But we need to confront this, especially us, Latina lawyers. Insist that we are all human beings, that we all have rights. That there’s no room for racism, exclusion, or gender violence anymore. (Cecilia, Personal Interview, New York, 2018) The other main area where ethnoracial transformative border politics emerged was regarding discrimination within Latin American migrants abroad. In general, migrants expected their fellow compatriots to help them or at least, not to interfere negatively in their own efforts as newcomers. However, and to their surprise, many found exactly the opposite not only with random nationals and other Latin American fellow migrants, but also, 213

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with members of their own families abroad. This was referred to in previous subsections in the cases of Marta, Gastón, Juana, Leonardo, and Lesly—​the first three experiencing and resisting discrimination from other Ecuadoreans in the workplace, the last two finding it among their relatives who on the one hand, “misled my mother in her attempt to work as a teacher and tormented my father because he didn’t have papers and was scared to be deported in the US” (Leonardo, Personal Interview, New Jersey, 2019), and on the other hand, “always told me that I was good for nothing and was never going to be able to graduate from high school, let alone going to college or doing anything good with my life, with my broken English and my looks.” Their attempts to overcome this kind of offense consisted of persevering in showing their capacity to surpass hurdles, belittlement, and prejudices while at the same time ensuring that they “would not engage in similar despicable and destructive behavior” (Lesly, Personal Interview, New York, 2019), “which in the end destroys us all” (Leonardo, Personal Interview, New Jersey, 2019), and “strengthens the position of those people from Spain, the United States, or wherever we migrated to who insist on labeling us as lesser people, like they can say: they are the ones harming one another, not us!” (Gastón, Group Interview #, Loja, 2016). Being true to this commitment was their manifestation of ethnoracial transformative border politics regarding intra-​group discrimination and “defensive othering” (Pyke, 2010, 557). The cases that follow further illustrated this practice. Natalia shared her experience with intra-​g roup discrimination while she was in Spain with her husband, Horacio, and their daughter: When I think back about our time in Spain, I have mixed feelings. … Because … yes, I think it is better to be in one’s own country, but at the same time, I found the experience of living in Spain as a good opportunity to socialize and learn from other cultures. … It is not easy to migrate though. For example, getting used to new food, and mostly, the social change because sometimes is like it prevents you from getting ahead. It’s like they want to crush you, but I’m not talking about the Spaniards, because there are Spaniards that are magnificent people. I worked with them, and they always behaved very well with me. The ones who really want to crush you are other Ecuadoreans. For example, they want to make you feel less. Sometimes they act very selfishly. For example, my husband, when he had his accident at work in which he hurt his arm and hand, he was going through a difficult time, he was very depressed; he wasn’t doing well. He told me that sometimes at work he would fall asleep because of how bad he was feeling. And once, his friends saw him, and they took a photograph while he was asleep. Then, they gave the photograph to their boss (even if this didn’t happen when he had his accident). So, his boss told 214

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him that he could use the photograph against him if he chose to go to trial instead of arranging with the company for the accident. My husband with this news felt even worse and decided against going to trial and presented his resignation even if his boss advised him to request disability and a compensation instead of resigning. … So his fellow Ecuadorean co-​workers, who he thought were his friends, were the ones who hurt him the most. Natalia, Horacio, and their daughter returned to Ecuador and each one of them, at their own time, regretted their decision to come back because of economic and health matters. They were thinking about how to migrate to Spain again, “which is not easy because we requested the voluntary return and don’t have Spanish residency,” but still were looking into it because “my sisters and brothers in law are still there and they tell us that even if it’s not as good as before, the situation in Spain is still better than here in Ecuador.” For them the experience of intra-​g roup discrimination reassured them in their belief of “never doing that to anyone, especially people like us, who are struggling to make ends meet.” Natalia also insisted on teaching her daughter: not to behave that way, like I tell her, see how much harm can be done? I explain to her and encourage her to be a good person, to be kind in school with her classmates, not to judge them, not to take advantage of anybody, and especially to be considerate with people who are new to town or her school. (Natalia, Personal Interview, Loja, 2016) This case also showed the transgenerational character of ethnoracial transformative border politics given that parents used discriminatory and racist experiences as counterexamples to instill beliefs and practices that debunked racial and ethnic barriers and fostered civil empathy and inclusion in their children. The case of Luis also involved intra-​ethnoracial discrimination. For example, when he talked about his experience abroad in Spain and how difficult it was for him to return to Spain after visiting his family in Ecuador, he stated: It was so hard to take the plane back to Spain! Because I knew that I was going back to hard work—​like you’re not going to work in an office; you’re going to work jobs where sometimes you will have mud up to your nose. And, that you’re going to be working in places where even your own people, fellow compatriots, will mistreat and harass you. Like for me, the worst part was always how other Ecuadoreans treated me. They were the worst. Not the Spaniards or other Europeans, but my fellow nationals. For example, migrants who already had their papers 215

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in order were put in higher positions, and as soon as they became ‘the boss,’ their attitude changed. If you looked at them funny, they would tell you not to come back to work the next day. They thought they were the very best, that they were better than you and that they had the right to abuse you. Luis, like Natalia, used these experiences to motivate his daughters to be conscious of their attitude towards others. He explained: I tell them not to even think they are better than others because they are studying, for example, or because they had the opportunity to live in their own house. With their mother, I talked to them about how poor the behavior of fellow Ecuadoreans was in Spain, and insist that no matter what papers you have, or what position you obtain, you always need to treat others right. My wife and I also follow that, we give them our example, and we see that our daughters have grown to be good people. Camila agreed with her father’s comment and expressed: At first, I could not understand why my father was mistreated by our own. I wondered why. Had he done anything wrong to them? But as I grew up, I learned that in the end, it’s our responsibility to be respectful and to help instead of hurt others. My parents taught us that, and we grew up aware of it. We often saw classmates who changed their ways because they had more money or moved to a better house. But we remembered what we were taught about those things and tried our best not to let that get to us. … It doesn’t matter where you’re from or how much you earn, what matters is how you are as a person. (Luis and Camila, Personal Interview of father and daughter, Loja, 2016) Similarly, Graciela shared the experience of her husband, which involved intra-group discrimination and ethnoracial transformative border politics: He lived with six or seven other migrants in an apartment where every room and even the living-​room, was rented. They were from many parts of the world, Morocco, Brazil. … He made friends there. … But he had trouble with other Ecuadoreans. He told me that actually Spaniards were very good people, but that the ones who misbehaved were our compatriots who never supported one another. … Like for example, he told me that he saw Ecuadoreans refusing to help others even if they could; or at work, when another Ecuadorean was like the boss, he would never do any favors, while on the contrary, Spanish bosses would be ready to help you out when you needed it. 216

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Graciela’s husband “didn’t like that kind of behavior” and when he returned to Ecuador, “he was not like other people who returned who flaunted about their time in Spain while trashing our country; he has been very humble about it.” Moreover, “he makes sure that our daughters are kind and helpful towards others; even if he doesn’t speak much, he shows them how much he cares about us being good people” (Graciela, Personal Interview, Loja, 2016). This kind of intentional attitude about how to treat others in a way that countered ethnoracial and socioeconomic hierarchies was common among many of the returnees that participated in group interviews, like Nancy who stated that: selfishness is something that in the end harms us all. Many returnees are conceited because they think having been abroad and earned money makes them better than the rest; but others, instead, return wiser, because they lived through and understand the harm that discrimination, racism, and classism generates, and are committed to treat others with the respect they deserve as human beings. (Nancy, Group Interview # 2, Loja, 2017) Salomé added that “sometimes people suffer so much there that they become defensive and pedantic; but others are able to learn from it and turn away from all of that” (Salomé, Group Interview # 2, Loja, 2017). Gastón followed by stating that “what’s most important of all is what we teach our children to be like based on what we were able to learn and distinguish what are the things that really matter” (Gastón, Group Interview # 2, Loja, 2017). Then, in agreement, Mimi expressed: In Spain there was racism, but like many of us experienced, the worst racism was from the Ecuadoreans and other Latin Americans. In my case, it was the Chilean woman who had to train me the one who mistreated and boycotted me. The bosses, who were Spaniards, were actually very good people. Indeed, the wife of my boss gave me bonuses because of the affection that she had for me. I worked well and she celebrated it, she appreciated and compensated it as well. Here, in Ecuador, we are racists, and we mistreat one another because we have a degree in something or because we think that we know more than the others. But we should learn to be better people. We should stop trying to take advantage of others by minimizing them! (Mimi, Group Interview # 2, Loja, 2017) Moisés, who was the leader of the community organization of return migrants in Loja, built on the discussion that was developed about endogenous and exogenous discrimination as well as how these can be debunked. He shared: 217

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I remember stories of going to the airport to pick up friends and relatives of mine and witnessing how other Ecuadoreans who were already established in Spain would take advantage of newcomers. They would talk to them, promise that they would get them jobs, and asking them for some money to ‘reserve’ these opportunities for them. Once I was able to help a woman not get tricked by these people, and another time, I was able to assist another woman that I ran into in the subway. She was crying because she had been left there on her own after being told they would help her out to find where to stay and work. She didn’t have anybody or any money. I told her that passing the night in the subway was going to be dangerous and gave her some ideas of what she could do that would not be fraudulent. Moisés agreed with other migrants in the group that migrating was difficult and that “the first year is the most challenging,” and asserted that “the obstacles that we find are usually in the less expected places or from the less expected people.” When he talked about his own experience, he shared that: with time I was able to overcome the hardships, not just the economic ones, but also the most strenuous, that is, the personal ones, like racism and discrimination both from Spanish and our own people and being apart from my family. … But the experience overall was very rewarding. I learned very much. I became a better person as I reflected on all these. That’s why when I returned and met other migrants like me, I realized that we needed to talk about our experiences so we could both feel better and help one another and people who were thinking of migrating. I realized that we had left knowing nothing or almost nothing about what it meant to leave and that there’s more than enough harm being done. Instead, we need to help one another, here and there. What’s the point of taking advantage of our brothers abroad? What’s the point of thinking you’re better than the rest because you were abroad when you return? These are all petty. This is what we need to avoid. We need to behave differently, and we need to collectively realize that this way of being and doing does not really help anybody. Because, really, what’s the gain of belittling others? What’s the gain of taking advantage of those who have less? It’s pathetic. But unless we change our ways, we talk about it and we spread these ideas and practices, we won’t do better as a community, as human beings. Moisés’ ethnoracial transformative border politics was community-​oriented and as a leader, he had been able to not only mobilize migrants and their relatives’ ideas and behaviors, but also push for policy changes especially regarding return migrants “who were promised the sun and the moon 218

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to come back but received an empty shell from the government.” This organizational type of initiatives had spread across Ecuador due to the failing governmental promises and the unexpected effects of reverse migration, as articulated in the previous sections of this book. Moreover, many return migrants felt empowered by both their good and bad experiences abroad, and as Moisés put it, “we are resilient people, we survived all kinds of things that we never imagined possible, and now that we’re back, we are not ready to give up!” (Moisés, Group Interview # 2, Loja, 2017). Nina, another return migrants’ organizer located in Guayaquil, shared a similar perspective: For all of us, whether we had some money or borrowed it, whether we were able to regularize our status or not, migrating was a big risk and a great challenge. But we grew from it. And now that we’re back home, we want the best from our dear Ecuador. We returned because we believed in our country’s potential, because we loved our country and missed it very much while we were abroad. Also, we moved back hopeful and trusting the government’s promises. But returning was not as easy as we thought it would be. There’s much that must get done here! We now have new ideas from the experiences we had when we were away, as well as a better understanding of what can be possible. (Nina, Personal Interview, Guayaquil, 2017) Ronaldo, a fellow member of the return migrants’ organization in Guayaquil, who had lived in Italy for about a decade, expanded on Nina’s comments: Migration was definitely hard, both outwards and back. Before we were young and naïve, but now, we are wiser. We learned very much from the hardships we endured, but also from the countries where we were at, Spain, Italy, United States. These places have better economic opportunities, but they also have many social problems, including how migrants are treated (because they want and need us, but they don’t really want us fully there), so it was not easy being an immigrant, an outsider, a minority. However, we were able to learn from all of that. And we are convinced we can do better as people, as a society, as a country. Keep the good, get rid of the bad, so to speak. For example, members of our organization suffered from discrimination because they didn’t have documents or because they could not speak the language, or simply because they were seen as foreigners from the underdeveloped side of the world who were trying to take advantage of the riches of the North, or because they looked indigenous or had brown skin. Sometimes the discrimination they suffered was unfortunately from their own compatriots or other Latin American migrants. But the most important thing that happened to them was that they were able 219

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to stand up to them and show them that they were good people, that they were, actually, better than them because they didn’t behave in that manner! Now these immigrants are back and we’re working together to help other migrants, to talk about how to improve our lives, to think about how we can do better. We are also together because we learned that organizing ourselves as a group strengthens us to raise our claims to the government. We returned with ideas and ideals, and if we are to stay, we should do better here. (Ronaldo, Personal Interview, Guayaquil, 2017) Nina and Ronaldo’s return migrants’ organization collaborated with other similar groups across Ecuador virtually to share experiences, resources, and mobilization strategies. These migrants’ activism reflected transformative border politics in its various dimensions by spreading information about how to navigate outward and reverse migration policies; raising issues related to women’s rights and gender violence; addressing outer and inner racism and discrimination internationally and domestically; and emphasizing that economic standing was not to be equated with entitlement. By acknowledging and reflecting on the complexity of the migratory experience, returnees claimed their rights to be respected as human beings, regardless of their background or current status. Lessons learned about racial and ethnic discrimination constituted the third dimension of ethnoracial transformative border politics, that of the reassessment of ethnoracial regimes in the country of origin, as the cases of Ryan, Ignacio, and Roque illustrated. Ryan, who had been in Spain since he was nine years old and moved back to Ecuador after finishing high school, talked about his return shock and shared: When I returned, I didn’t feel integrated here, not at all. I felt like a foreigner in my own country. … And that was very hard to accept because it was like the society and the very country that I had idealized so much was disappointing me. Because here, there even is racism: between the people that live on the coast and those who live in the mountains; they don’t get along—​they call one another ‘monkeys’ and ‘Indians’ and I don’t know what else. … So when I saw that upon return, I was like ‘Fuck!’ Like, when you are abroad, you see racism against foreigners, and that’s bad; but then, you are in your country, and you see racism within us! It’s terrible. … For example, if I go to Quito, they call me ‘monkey’—​here, in Santo Domingo, we are located in between the two areas: so, when I go to the coast, they call me ‘Indian’—​It’s like, there’s no way around it! When I settled in, I realized how much distinction there is in our country, not just racially, but also economically. Like, when you have money, you have everything, so to 220

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speak: they treat you right, they look at you nicely, everybody greets you. But, when you don’t have money, you have nothing, so people don’t even register or look at you! … When we were in Spain, we lived in a small town where there was not much of a class difference among its population—​I don’t know if Madrid or Barcelona would have had more difference—​but there we were very even and people didn’t treat one another differently because of their riches or where people were from. … So, when I returned to Ecuador, it was difficult to accept the high degree of racism and classism that existed because I had lived in a different context and learned a different way of thinking, being, and relating to other people. Ryan’s transformative border politics after his return involved primarily ethnoracial and socioeconomic dimensions which he expressed by intentionally behaving in a way that was not racist or classist. He was not sure about “how to change other people’s minds” because he noticed that when he tried to speak about these issues, fellow Ecuadoreans “got mad or offended very easily and were quick to end the conversation.” However, he was able to have “conversations about these things and the hypocrisy that I had also noticed and didn’t like with some of my closer friends.” Moreover, he checked the accuracy of his perceptions by talking with friends and relatives who were also return migrants: “I was relieved to see that they also felt this way and didn’t feel comfortable engaging in calling others monkeys or Indians or diminishing people who seemed not to have means.” Ryan reflected: I think that moving back to Ecuador helped me realize of all these things. Like, when I was in Spain, I didn’t really think about it. It was coming back and seeing it happening here that made me aware of it. I think that both migrating and returning helped. Before, I feel like I was kind of blind about many things. (Ryan, Personal Interview, Santo Domingo, 2016) Ignacio, who had migrated to Brazil and Canada and then returned to Ecuador, had a similar learning experience to Ryan’s. He shared: When I was in Brazil, I had the opportunity of meeting other migrants from Latin America. I soon realized that I knew very little about my neighboring countries and noticed how many prejudices we all had about one another, mostly based on stereotypes and lack of information. I spent my time mostly with other Latin Americans who spoke Spanish because even if Portuguese was not too different, it was challenging at times. This experience to me was very enriching because I learned 221

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about other Latin American cultures and dropped attitudes that I had not realized were negative—​we are so ignorant! The friendships I made there taught me to be more open-​minded and curious about other places. Also, it helped me when I returned to Ecuador because I realized how discrimination worked here as well. I became more aware of this and tried not to hold stereotypes and prejudices about people from certain areas of the country. Ignacio reflected on how his first migration shaped his second one: When I went to Canada, I had had the experience of being abroad and learned to be open-​minded and not let myself behave based on racial prejudices. In Canada there were migrants from many parts of the world. I met people from African countries, China, and India. If I had been as prejudiced as I was before having been in Brazil, I would have not been able to make friendships with other migrants. Instead, I was able to be with them and learn about many other cultures beyond Latin America and from the experiences of migrants from places that I was unfamiliar with. We would spend time together hoping to make the experience of being a foreigner easier—​we had difficulties with the language (we were in Montreal where they speak in French), but because it was a very diverse city, we didn’t feel too uncomfortable. Ignacio’s ethnoracial transformative border politics involved both the internal and external aspects of discrimination, provoking a change in his ideas and behavior toward people of different racial and ethnic backgrounds, both within and outside of Ecuador. He concluded that “discrimination, racism, prejudice harm not only those who are being attacked or excluded, but also oneself and society all together” (Ignacio, Group Interview # 4, Loja, 2017). Roque, who was a Peruvian migrant in Ecuador, agreed with Ignacio and talked about his own process: Something similar occurred to me here in Ecuador. In my case, there was prejudice against me because I’m Peruvian. I didn’t like that, of course, but at the same time, I was not surprised to see it happening because in Peru, there’s discrimination against Ecuadoreans. So, when I hear about your experiences of suffering racism when you were Spain or the United States, I immediately think that we do the same! I wonder why it is that even if we are all humans, we are all trying to find a difference among one another to separate, to take advantage. … It’s crazy! We need to learn about this and change our ways of thinking and treating one another because we are all one race: the human race. … I also agree with Ignacio when he said that being abroad helped 222

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him think about his own country: when I visit Peru now, I’m more aware of the many ways we mistreat one another: because we’re from this area or that one, because we’re indigenous or European, because we’re Japanese or whatever. It’s very sad to see this because like he said, in the end, it’s good for nobody. (Roque, Group Interview # 4, Loja, 2017) The experiences of Ryan, Ignacio, and Roque, together with those of the migrants mentioned earlier, showed how migration clearly entailed racism, nativism, and xenophobia. However, they also proved that these damaging processes often generated constructive ones as far as these migrants learned from them and actively worked against them by behaving differently and encouraging others to do so as well.

Socioeconomic borders The fourth area in which migrants manifested their transformative border politics was that related to the transcendence of the barriers preventing upward social mobility. Migratory processes involved a journey through various socioeconomic states. To begin with, migratory decisions were usually made to escape and overcome poverty or impoverishment. Then, in the majority of cases, active migrants began their work trajectory abroad in precarious labor and living conditions which signaled their location in the lower class in the country of destination, but at the same time, allowed them to begin to send remittances back to their country of origin. Due to international economic and currency disparities, remmitances slowly helped their family meet and surpass survival conditions at first, and later accumulate savings which were generally used to acquire or build their own house while ensuring a path for their children’s education and professional advancement. Active migrants with children abroad also intended to secure their future through education, aiming for their economic independence so they could move upward from the lower to the middle class. In the case of migrants who decided to strategically return to Ecuador, they usually enjoyed the fruits of their savings, settled in their own house, and in some cases, continued to work but in a context of security and better living conditions compared both to the initial situation that drove them away and the demanding and undervalued dynamics of being a migrant worker. This long process allowed for migrant families to accomplish social mobility transnationally and transgenerationally: both active and passive migrants endured hardships at home and abroad but managed to come out on top, resisting impoverishment or leaving poverty behind, and ensuring higher educational levels for younger generations, and the promise of better

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prospects for the future. The following cases of migrants to Spain and the United States illustrated socioeconomic transformative border politics. In the case of Anahí, her family as well as uncles, aunts, and their children, all migrated to Spain because of “economic strains due to the bad situation in Ecuador at the time.” Anahí left when she was nine years old and returned after 12 years, when she was 21 because she wanted to be autonomous, work, and study, which she could not do in Spain at the time due to their economic crisis. She returned to Ecuador on her own to maintain the socioeconomic status that her parents had achieved through their migratory efforts. Accordingly, her parents were not interested in returning because they were comfortable with their situation in Spain; she explained: My parents were able to meet their objective of securing better living conditions. It was hard, but with time, our conditions improved. For example, at the beginning, in Madrid, they had to rent a room where we all lived; but after some years, they were able to buy an apartment (with a mortgage) and a car. Besides, they were also able to build a house here in Ecuador. When I considered returning, they were not ready to do so because they still ought to pay the mortgage for the apartment, and they were working well. Also, my brother, who was born there, was still attending school, and they all thought it was better for them to stay. The family of Anahí’s socioeconomic transformative border politics was not only transnational and transgenerational, but also created a sense of responsibility to preserve the achievements in the long term both in parents and children “who didn’t want to dismiss the fruits of so much sacrifice” and a shared belief in the possibility of overcoming the new challenges that had emerged and prospering as a family. Specifically, for Anahí, that involved a strategic return (to get a college degree and become a self-​sufficient professional) and traversing a hard process of return shock (involving depression), which once surpassed, generated settling readjustment on her part, but also ignited her desire to plan to migrate to Spain again to live there. This desire was a combination of her will to conserve the economic gains mentioned earlier, but also, her preference to live in a context that was: less exclusionary, where class differences are not as stark so you can live similarly to others, eat well, have similar clothes, and access to things like a cell phone or even a car—​while here, in Ecuador, people exclude and discriminate against those who have less resources. … Also, I dislike the degree of racism that we have here, which is much higher than in Madrid … and prefer to have the right of free expression. In Spain, you have the option of thinking and doing whatever you wish, 224

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but here, there are many taboos and restrictions, and people are like checking on you and gossiping. At the time of the interview, Anahí was on track to meet her own return migration goals; in her words, “I wanted to study and prosper, and I’m doing that, I’m achieving that.” Moreover, Anahí and her husband had a child, and she “planned for her to also have the Spanish nationality so we can move there for her to have a better quality of life … good nutrition, good habits, a good education, better surroundings, hygiene; everything” (Anahí, Personal Interview, Santo Domingo, 2016). Therefore, Anahí intended to further her multifaceted transformative border politics in the future of her child, continuing with transgenerational and transnational life strategies to pursue familiar well-​being. The case of Jorge’s family also involved transnational and transgenerational social mobility. The main purpose of their migration to the United States was to find good-​quality healthcare for Jorge’s brother, who was diagnosed with cancer in Ecuador. Jorge’s family had a good socioeconomic standing in Manabí—​“we had a very comfortable life; we had our house downtown and we even had a nanny who took care of us while my parents worked;” the mother was an economist and a teacher, and the father had a stable job in a family business. However, their move meant downward mobility given their irregular migratory status. In New Jersey, Jorge’s mother managed to work as a nanny and his father as a construction day laborer, and they were able to afford to rent a modest apartment in a small town close to where the cousin of Jorge’s grandfather—​the only relative they had in the US—​lived. Jorge’s parents “didn’t mind their economic hardships; they were happy to see my brother well, and also, to see us getting used to going to school here. … They sacrificed for us to have a good future.” Jorge was very conscious of this at an early age and was determined “to learn English fast so I could help my family.” When Jorge reflected on his commitment to “doing well at school” and “making sure not only to go to college but to go to the best college possible,” he included a similar transgenerational transformative border politics to Anahí’s: They sacrificed so much for us to have been able to be where we are, so we could be fine, go to school, complete our high school studies … so, I was not going to be convinced by my school counselor to apply to community colleges or local universities that were easy to get into. … Instead, I did my own research and applied to the best liberal arts schools I liked and also to a program with City College to study medicine. I was accepted to several good programs, including the medicine one, but I picked Dartmouth College because it promised to be a richer experience allowing me to gain more exposure to a 225

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variety of topics and have free time, something that the students of the medicine program told me they didn’t really have. … When I graduated, I started to work as a teaching fellow and completed graduate studies in education. … I have been working as a public school teacher in New York for a few years … but have not dropped my plans to go to medical school to become a doctor. … I have my personal and my family’s goals. Personally, I want to take the entrance exam to go to med school. … For my family … now, my goal is that my sister goes to college (we will hear back from the schools I helped her apply to this April) … and that my mom buys a house, so my parents can accomplish that dream. … And we are working on that already, because my father got a mortgage approved, so now we’re looking for a house to buy, which will be easier to find once my sister goes to college (because my parents wanted to stay in the area where my sister went to high school, but there the houses are too expensive). … The idea is that the house they buy will not be too expensive so the mortgage payments are affordable, and my father can stop working as many hours as he works now … he has two full-​time jobs in maintenance, and during the weekend he does his construction jobs independently, so he doesn’t sleep. Besides being transgenerational, the family of Jorge’s socioeconomic transformative border politics was the result of their persistence and strategic, long-​term perspective. Through the children, Jorge’s family reversed their downward mobility: both Jorge and his brother became self-​sufficient young men with college degrees, their sister was set to follow a similar path, and with that, the parents were reaching the point of becoming homeowners with less need to work so many hours in excess (Jorge’s mother had switched from caring for children to working in housekeeping at nursing homes, “for which she became the manager of other employees which was good for her self-​esteem because it was hard for her not to ever be able to use her two degrees here.” They had also been able to regularize their migratory status, as explained earlier in the geopolitical transformational border politics subsection, and Jorge “felt confident that even if things were still difficult, there will be a reward in the future” (Jorge, Personal Interview, New Jersey, 2019). In contrast, the case of Lesly exemplified socioeconomic transformative border politics despite her father’s mistreatment and neglect, and her mother’s “naivety about what it really meant for two teenagers to be transplanted far away from everything they knew to have a better future.” Lesly’s achievement of social mobility was a long-​term outcome of her own doing and resilience. Moreover, Lesly’s older brother had set an example for her: 226

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he had completed high school in Ecuador, and he had even been accepted to attend college, because for us being able to study was the most important. So even if my father and his new family discouraged me from doing so, I knew I had to do it. … My brother had to sacrifice college to come to the US so he would take care of us economically, and I owed him that. … I also was pushed forward by my father’s family’s rejection: them not having any hope that I was going to do something with my life or be somebody in this country actually gave me strength to prove them wrong. Besides, Lesly was motivated by one of her boyfriends who was attending college who “encouraged me to keep studying after high school.” After high school, Lesly first attended a program that provided her with some occupational training. Disappointed with the poor quality and conditions of the institution, she enrolled in community college because she was “eager to have a good education.” Later, she transferred to a four-​year college. Lesly worked as a supermarket cashier to “pay for my college fees and eventually, a professor suggested that I did an internship at a nonprofit organization that offered services to migrants so I would get some professional experience.” At first: I felt that I had advanced because I used to get paid $7 per hour in the supermarket, and as an intern I was paid $15! I was very grateful because with that income I was able to afford college without much debt. … Once I completed my BA, I had been working there for two years and had been promoted to be the coordinator, so I had many responsibilities. However, they had never adjusted my salary and I started to feel frustrated because I was still being paid as an intern, so I asked for raise. … They didn’t give it to me for a long time and eventually, when I told them that I was going to leave, they offered me $18 per hour. I was not convinced so I decided to travel to Ecuador for the holidays (I had never used any vacation days before) and think about it. … When I returned, they wanted to make sure I stayed working for them, so they offered me a raise to $21, so I continued working there. At the time of the interview, Lesly had started to do some graduate certification studies to further her Psychology major and was looking into the options of doing a graduate degree “so I could fully help other migrants through the difficulties they encounter when coming here” (Lesly, Personal Interview, New York, 2019). Her trajectory was clearly one of upward social mobility: from living in a very poor area in Ecuador and working as a child to help her mother, and then living together with her two brothers in a small room in New York, to graduating from high school, earning an associate’s and 227

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then a bachelor’s degree, and being able to be self-​sufficient by working in a field related to her studies while renting her own apartment. Moreover, Lesly had been able to sponsor her mother to obtain her legal permanent residency once she had obtained her citizenship and proved financial solvency. Her socioeconomic transformative border politics manifested transgenerationally and transnationally towards her mother in Ecuador, as well as her sister and niece who migrated to the US and received her support as well. The case of Armando and Etelvina’s family showed socioeconomic transformative border politics in a slightly different way given that he migrated to the US irregularly to “save the family from total collapse after the economic crisis in Ecuador.” Armando was never able to regularize his status and stayed abroad for 12 years (and at the time of the interview, it was not clear when he was going to return). By working “in very harsh conditions since arrival and never giving up,” he had been able to send remittances “continuously” to his family in Ecuador for them: “first to be able to afford enough food daily, and years later, to start saving so his two daughters could complete their schooling and later go to the university and become professionals who would have a good future.” Armando’s devotion to his family’s well-​being and his work ethic was deeply appreciated and learned by his daughters, like in the case of Anahí, Jorge, and Lesly. Clara stated: My sister and I always had something very clear in our minds: if our father left for us to be able to keep studying, we always will have to excel; and we did, we always had good grades. … We have the responsibility to do well, to make our parents proud. … He sacrificed for us, so we have made sure not to disappoint him or our mother … and we know that when he returns, we will be there for him. Armando and Etelvina’s family then were able to achieve upward social mobility transnationally (Armando’s income in the US was invested in his family’s well-​being, education, and future) and transgenerationally (both daughters completed high school, one finished her college degree and was a successful working professional, and the other was still in the process of completing her higher education). His irregular migratory status had enabled him to live within modest means in the US; however, his income, even if subpar in comparison to regular migrant workers, saved his family in Ecuador from destitution, and the constant flow of remittances helped them secure “a good education that promised them to have a better future than ours” (Etelvina and Clara, Personal Interview of mother and daughter, Loja, 2016). Given that in many cases transformative border politics was manifested in several dimensions, I have already mentioned how other migrants achieved upward social mobility despite the difficulties that migration brought about. For example, the families of Leonardo, Diana, Manuel, Juana, Marta, 228

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Teo, Cecilia, and Ryan transcended socioeconomic boundaries with their persistent work, savings, remittances, and ingenuity in how to make ends meet under constraining circumstances. Their resilience together with their commitment to their well-​being ideal and transgenerational goals fed their ability to keep on going, defying explicit and implicit barriers to their realization both domestically and abroad. Matías and Samantha’s organization picked on this and ignited their interest in “fertilizing the potential that migrants have but unfortunately, is not recognized, validated or legitimized” (Samantha, Matías’ Group Community Workshop # 1, New York, 2019). They believed that nurturing that strength was fundamental to advance migrants’ well-​being; similarly, Lesly believed that her work with migrant communities had to “go beyond providing services, it has to involve political work but also the very difficult work of making migrants realize of their own value and potential” (Lesly, Personal Interview, New York, 2019). Diana agreed with this idea and recognized that “part of the problem is that migrants are so used to working non-​ stop and being treated like they are worth nothing that in the end, they can’t even understand how powerful they are” (Diana, Personal Interview, New York, 2019). And Leonardo agreed, adding that “we have much ahead to do, but the potential is immense” (Leonardo, Personal Interview, New York, 2019). This recognition was also present in return migrants from Spain, who, according to one of the community leaders, “realized they had been able to persevere and succeed and had much to offer to our country and communities,” while acknowledging that it was “not easy to deal with the negative psychological impact that migration had generated as well” (Moisés, Group Interview # 2, Loja, 2017). This tension, although hard to resolve, seemed to promote consciousness and collective action; as Marta said, “I’m back, and I may not have much, but what I experienced and learned as a migrant, I will share so others can prosper” (Marta, Group Interview # 2, Loja, 2017). To conclude, the multiple cases mentioned to illustrate how active and passive migrants manifested their agency in surpassing and changing formal geopolitical, gender/​sexual, ethnoracial, and socioeconomic barriers showed the power of transformative border politics transnationally and transgenerationally. Clearly, not every active and passive migrant engaged in this radical way of defying systems and practices of exclusion and marginalization, but many did. Migratory processes originated from and prompted a series of trying and traumatizing circumstances. Migrants tried their best to persevere, and in doing so, they were able to bring about revolutionary consequences. Revolutionary because of them being, on the one hand, unexpected in the imaginary of the dominant groups who perceive migrants as intruders, rudimentary, and/​or disposable people, and on the other hand, significantly far-​reaching beyond countries and across 229

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time. The value of transformative border politics must be emphasized, just like migrants’ remarkable resilience, so instead of being unacknowledged and underplayed, it becomes a predominant asset to be cherished by migrants and non-​migrants for the advancement of migrant communities and society overall.

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Conclusion This transnational sociological activist research of Ecuadorean migrations to the United States, Spain, and back uncovered the nuances of how these migratory processes affected the health and well-​being of both the migrants and the relatives who stayed behind. By building on a feminist intersectional perspective on the social determination of health as defined by Latin American critical epidemiology, health processes and psycho-​sociocultural coping mechanisms were detected and conceptualized from the ground up. Through the accounts of active and passive migrants, this book exposed the various ways in which migration as a social determinant of health impacted them, and how they manifested their agency in responding to the many challenges they encountered along the way. Guided by the psycho-​ sociocultural coping mechanisms of well-​being ideal and transgenerational goals, active and passive migrants traversed vexing health processes including reflective mourning, active migrant trauma, passive migrant trauma, migratory stress, and/​or migrant crises triggers. In order to deal with the effects generated by migration, active and passive migrants resorted to the use of other mechanisms like disillusion adjustment, paralyzing and motivating nostalgia, denied migrant health, normalization of malaise, and/​or pain encapsulation. With the aim of attending to the changes in the relationships between active and passive migrants brought about by migratory processes, they put in practice another set of mechanisms centered on family de/​re-​ construction: communication distortion, subordination to concealment and deception, unspoken pacts, resentment and detachment, and/​or sensible comprehension. If migrants moved back to their countries of origin, they experienced the health process of return shock, and made use of the mechanisms of strategic return, settling readjustment, and/​or involuntary return rebound to cope with the difficulties of migrating again, back home, and reuniting with family members who had stayed there. Ultimately, all these processes and mechanisms that were part of the migratory experience furthered the strengthening of active and passive migrants, albeit without them feeling ownership or taking advantage of it, that is, they generated 231

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the health process of unrecognized migratory resilience. The other major outcome that migrations sometimes provoked was transformative border politics: active and passive migrants’ transcendence and alteration of repressive and marginalizing geographical, political, economic, social, and cultural boundaries transnationally. This study offered a unique and multifaceted contribution to the literature on health and migration. First, it combined the riches of sociology with a set of critical theories including Black, postcolonial, and decolonial feminisms; critical race, ethnic, and migration studies; Latin American critical epidemiology; and critical medical anthropology to investigate the intersectional embodiment of the social determination of health transnationally and transgenerationally in the case of Ecuadorean (Global South) migrants to the United States and Spain (Global North). Second, it took an activist research praxis to pursue an understanding that was created from the bottom-​up, centering migrants as creators of knowledge and protagonists of their experiences—an approach that was interdisciplinary, including the perspectives of medical doctors, psychologists, anthropologists, and health and migration advocates; and constructive, to generate concrete courses of action with, in and for the community. Third, it interrogated the dominant biomedical approach to migrant health, which often pathologizes, exoticizes, banalizes, demeans and/​or marginalizes it, by uncovering the spectrum of social, cultural, political, and economic aspects underlying migrants’ experiences, care practices, and access to health services. Fourth, it included the viewpoint of non-​migrating relatives (passive migrants) and returnees, two groups typically overlooked, in addition to the participation of Ecuadorean migrants who, as opposed to originating from the two main cities in the country (Quito and Guayaquil), came from areas less studied (Loja and Santo Domingo). Moreover, it compared the experiences of regular and irregular migrants in two destinations of the Global North (the United States and Spain) each one with different health and migration policies; and contextualized the experiences of Ecuadorean with other Latin American active migrants to infer if the findings of the study were commonly found in migrants from other countries of the region with similar destinations. Fifth, it involved action programs, such as community workshops about health and migration, the organization of congresses, lectures, and trainings to health professionals and migrant advocates in Ecuador, the United States, and Spain, offered in Spanish, English, and bilingually; as well as radio, TV, and social media live-​streamed presentations; and the creation of a website with accessible and free materials; all with the aim of sharing the knowledge gathered and developed about the junction of health and migration while simultaneously taking each opportunity to collect input from participants, interlocutors, and audiences to further refine it. 232

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Indeed, the level of comprehension achieved through this project could only attain a valuable meaning if it was translated into the promotion of collective health and the betterment of migrant communities (Dubet, 2012). Some degree of success was reached through the various initiatives mentioned earlier. For example, participants in community workshops usually expressed that they had been positively impacted by learning about these processes and mechanisms because before then, “we had thought that what happened to us was exceptional, but now, we know we were not abnormal” (Florencia, Community Workshop # 11, 2019, New Jersey). Moreover, participants often communicated that after the workshops they felt their “experiences validated” and were able to “put a name to something that before was there, but was nameless” (Benjamín, Community Workshop # 5, New York, 2017); or as Cindy stated, “When I was listening to this, I felt that you were talking about my experience as a migrant” (Cindy, Community Workshop # 4, New York, 2017). Workshop and group interview participants recurrently stated that even if these were not intended to be therapeutic, they found themselves “self-​analyzing” their past and current situations as active and passive migrants (Lucas, Community Workshop # 8, New York, 2018), and felt “much better after being with other migrants and sharing their processes, emotions and thoughts” (Brenda, Group Interview # 3, Loja, 2017). Several participants believed these workshops and interviews contributed to “building community” (Sandro, Group Interview # 8, New York, 2019) and “could generate collective initiatives, support groups, networking, and mobilization to push for political change” (Moisés, Group Interview # 2, Loja, 2017). Training sessions with health professionals and migrant advocates also generated positive outcomes. Many doctors and nurses agreed that “we need more of these trainings because we are not exposed to this kind of knowledge about migration and health even if we constantly work with relatives of migrants and returnees” (Catalina, Training # 2, Loja, 2017). Moreover, they agreed that “even if we had a sense that migration affected our patients, we could not tell exactly how,” hence “the relevance of learning about migration and how it may impact migrants and relatives” (Enrique, Training # 2, Loja, 2017). The co-​organizers of training sessions in Ecuador, family doctors Johanna Montalvo, Xavier Astudillo, and Yadira Gavilanes, insisted on the importance of “contextualizing our patients’ experiences with broader knowledge about migration and develop further research to improve our services” (Johanna Montalvo, Training # 1, Loja, 2016). They also shared their own experiences with the health professionals that attended the trainings as a tool to motivate introspection and revision of their medical praxis. For example, Xavier Astudillo talked about the importance of having been exposed to the concept of cultural sensitivity when he was doing his residency in a rural area close to Cuenca: 233

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At the university, we had learned about cultural sensitivity mostly because here in Ecuador, we are a multi-​ethnic nation and are committed to respecting indigenous practices and beliefs. When I was a resident, I was able to apply this and realized it was priceless; in other words, if I tried to impose a medical opinion based on Western beliefs, patients did not respond at all and went untreated. However, when I applied a culturally sensitive approach, they responded well, accepted, and completed treatment because it was modified to follow or include their ancestral practices and beliefs. We need a similar sensitivity when we work with migrants and migrant families. If we ignore how migration may have affected them, we cannot reach them, and we would be mostly off target. Learning about how migration can affect health is fundamental if we want to help them feel better. (Xavier Astudillo, Training # 2, Loja, 2017) To build on this, our trainings included the discussion of the concept of Salgari’s syndrome (Geraci, 2006) which described how unmet expectations between health professionals (who imagined they would be working with stimulating cases of tropical diseases but instead were treating common health problems) and migrant patients from the Global South living in Europe (who thought they would be treated in sophisticated health facilities but usually found themselves in basic healthcare units) had a negative effect on diagnosis and treatment. Moreover, we added that while participants in our research project sometimes suffered from that kind of poor doctor-​patient relationship; in most cases they were impaired by a different phenomenon. On the one hand, active migrant patients were not at all convinced about the medical efficacy of the countries of destination despite their degree of economic development and did not believe that health professionals abroad would be able to care for them properly because of possible prejudice against their migrant condition, and language and cultural barriers. On the other hand, some health professionals doubted migrants’ intellectual and cognitive abilities, and rarely thought they would become extraordinary medical cases. Indeed, health professionals did not tend to show any enthusiasm in treating migrant patients due to the commonality or simplicity of their conditions. Therefore, our research participants experienced a doctor-​patient relationship based on distrust, contempt, underestimation, and suspicion, and as a result, mutual disqualification, which like Salgari’s syndrome, engendered counterproductive effects including poor diagnosis and either partial or no treatment. This kind of patient-​doctor relationship of mutual disqualification resonated with health providers in the United States and Spain, who became aware of their biases during trainings and research presentations. For example, Adela, a gynecologist in Barcelona, expressed: 234

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It’s not nice to say it, but it’s true. We are tired of seeing migrants repeatedly in our offices, complaining about a new pain here or there, while, in reality, it’s nothing. Plus, it’s also true that migrant patients are kind of suspicious of and disappointed at us because they don’t always find what they wish to find here. (Adela, Participant at Research Presentation, Barcelona, 2018) Additionally, health professionals repeatedly expressed unease concerning their limited ability to be able to help active migrants; as Concepción, a leading physician working at a Center for Primary Attention in the vicinities of Barcelona, put it: Migrants come to our Centers to check all kinds of aches and pains that are not medical problems. The problems they have are because they are migrants; they are social and economic problems that cannot be cured medically. But what can we do about that? We cannot solve political or policy issues or solve housing, employment, or cultural problems. These migrants need a different type of care. Not medical attention. … And we feel frustrated because we understand that we’re failing them, but it’s not really our fault. It’s limited what we can do for them, and we feel very bad about it. (Concepción, Participant at Research Presentation, Barcelona, 2018) Likewise, a counselor claimed: It is very difficult to keep balanced. Professionally, we know that what we can achieve through counseling is moderated or even minimum in the context we live in. We frequently question ourselves and wonder if it’s ethical to provide migrant patients the illusion that their mental health condition will improve with psychological treatment, because many times we are conscious that unless the context changes, the chances that, let’s say, their depression gets better or their addictions are controlled, are low. (Dora, Personal Interview, New York, 2019) Overall, the health providers who participated in our trainings, workshops, and research presentations were receptive, contemplative, and enthusiastic to learn more to improve their individual and collective praxis. An equally positive and self-​reflective response was gathered from migrant service providers and advocates who attended workshops and trainings on health and migration. They tended to underline their usefulness, as an advocate working in New York with the Latinx community expressed: “this training was truly very useful because I could put a name to things that 235

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I commonly observed but did not have a way to systematically handle” (Alberto, Training # 3, New York, 2018). Several participants emphasized that “these kinds of trainings will help us better serve our communities, by offering appropriate resources and connecting migrants with the right providers” (Bárbara, Training # 3, New York, 2018). At the same time, there was consensus about three matters that required revision. First, migrant service providers and advocates felt that they “knew much about migration but very little about its health aspects,” recognizing this discrepancy as problematic (Felipe, Training # 3, New York, 2018). Second, and like the uneasiness experienced by health professionals, they found their assistance to be limited and were conscious that while their actions could benefit migrants, their reach depended on structural forces that were out of their hands. As Verónica, a social worker, articulated: I can guide them to shelters, welfare services, free language schools, employment offices, but I know I cannot change the economics or migration policies of this country, or the affordable housing shortage in New York City. Then, while I do my best to bring a positive outlook to migrants and offer solutions, I’m also cautious and realistic because I cannot paint them a brighter picture than what it is. I would be misleading them. (Verónica, Training # 3, New York, 2018) Third, and relatedly, migrant advocates appreciated the activist and political work that some of them engaged with: “Not all of us can or have to do it, but it’s important that some of us become politically active and push for policy changes to have more welcoming contexts for migrants and generate more prosperous conditions for all” (Alberto, Training # 3, New York, 2018). Furthermore, they emphasized the urgency of improving coordination across the various fields and their workers to improve service provision to the migrant community, as Dora explained: We all appreciate the very many efforts that each part does. However, we also know that we need to be better organized among ourselves. Doctors and nurses ought to be more aware of the psychological aspects of migrant health; counselors ought to acknowledge when doctors must get involved to treat migrants; all health professionals should learn more about migration and the umbrella of services they can access to deal with their various problems; and vice versa, migrant service providers need to know about migrant health and be ready to make referrals. For all of this to happen, political and programmatic coordination are fundamental. We have good intentions, but we need to do better and be more strategic. (Dora, Personal Interview, New York, 2019)

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Generally, migrant service providers and advocates tended to be mindful of the national and international political economy that affected the migrant experience; a quality that health professionals, especially doctors, recognized they lacked. Nonetheless, trainings and workshops’ participants from all sectors, regardless of their degree of political awareness and activism, were ready and eager to discover and do more to improve their praxis, convinced that health and migration must be addressed comprehensively. Similar positive reactions about expanding our understanding of how health and migration are interrelated and how we can do better were received after radio shows, TV interviews, and live-​streamed social media presentations. Audiences celebrated learning about migration and health, “something we all know it’s connected but rarely hear the why and how, and even worse, what to do about it” (Radio show caller, Loja, 2016). They shared that their “experiences are much alike the cases brought up in the presentation” (Comment left on Facebook live-​streamed talk on Migration, Health, and Gender, New York, 2019), and repeatedly expressed “the urgency to learn more and count with more resources to prevent and treat migrants and their relatives” (Radio show caller, Loja, 2017). These comments reflected the responses to survey questions in which 80 per cent of active and passive migrants combined responded that they knew migration could affect their physical and mental health; 94 per cent knew that the right to health was a human right; and 95 per cent believed that it would be useful to learn about how migration impacts health before they migrated. Last, but not least, the feedback collected in preliminary access to the website was equally encouraging. Viewers appreciated the availability of free resources that can be utilized for trainings, workshops, events, or research; the option to share personal experiences anonymously and safely to contribute to the project; and especially the way in which the information was made accessible to a wide audience through a series of visual resources complemented by demonstrative migrants’ quotes and simple explanations of the health processes and coping mechanisms that active and passive migrants may traverse and put in practice (visit www.saludymigracion.com). Nonetheless, the positive outcomes of our community actions while meaningful are modest. Much remains to be accomplished in terms of scale, reach, diffusion, and the systematization of how to incorporate this data, concepts, and theoretical reflections in health and migration policymaking and professional education across borders. The gap between health and migration policies and programs both in the Global North and the Global South remains extensive, to say the least. Likewise, the lack of education about migration matters in the field of health, and in reversal, the lack of education about health matters in the field of migration, continues to be alarming and counterproductive. This disconnection reflects rigid

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disciplinary margins and a marked tendency to become narrowly hyper-​ specialized professionally. Moreover, it shows the pervasiveness of a dominant global discourse that deprecates migrants, especially those who come from destitute backgrounds, while pushing them to the margins and ignoring their health and other needs, and how these relate and affect all members of a community, regardless of their status. For this research to have an impact at the levels of policymaking and curricular development, political and strategic connections that are out of the author’s reach are essential. Yet, here are some ideas that could be considered in relation to these voids. To begin with, people in the health field, particularly those who work in areas witnessing growing or high migration flows, must be methodically educated on the specific plight of active and passive migrants so they can provide prevention plans and treatments that consider the various ways in which their migratory experience may be the cause of the health conditions they may be experiencing. In parallel, migrants’ service providers and advocates ought to learn about how active and passive migrants’ health could have been or is affected by migratory processes comprehensively for them to provide better services, resources, and referrals, and understand why migrants may or may not follow their guidelines. In terms of curricular development and praxis, health professionals and advocates would benefit greatly from taking a family, collective, and psychosocial approach to health, prevention, care, and recovery that is transgenerational, transnational, and transculturally sensitive, while taking the social determination of health seriously by incorporating the global political economy of migration into the equation. A community, educational, preventive approach should complement treatment and rehabilitation for active and passive migrants in non-​threatening environments, in collaboration with migrant advocates. Health and other services providers devoted to active and passive migrant populations should pay close attention to migrants’ expressions of concern and behavioral changes, in whatever way they are manifested, considering typical migratory stress symptoms in the depressive, anxious, cognitive, and somatic areas, as well as active and passive migratory trauma, and migratory crises triggers, given their tendency to recur to denied migrant health, normalization of malaise, and pain encapsulation. Moreover, health and migrant advocates ought to identify, value, and validate active and passive migrants’ resilience to counterbalance their habit not to do so, as well as distinguish and celebrate their exercise of transformative border politics and its progressive effect both for the migrant community and society overall. At the same time, these measures must be sustained by securing access to healthcare in a manner that is completely free of cost or realistically affordable, and the insistence that healthcare systems should not in any fashion be associated with punitive migratory law enforcement for migrants to be able to trust their status will not affect access and treatment, and vice 238

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versa. Recognizing that health and migrant services providers and advocates are one of the main brokers between migrants and the state but not the ones who control these policies, the need for them to be politically aware and/​or active becomes even more salient; a point that connects with the centrality of policymaking to advance migrant health as a whole as opposed to making small contributions at the individual, family, or local level that while life-​changing for a few migrants, remains exceptional in the broader scheme of things. Indeed, health and migration policies must be designed not only in dialogue with one another, but also with an international and transgenerational point of view to achieve any degree of effectiveness and deflect the migration and health crises that typically occur due to the lack of coordination between the two sectors. The principle that accessibility to healthcare is a basic human right should be followed and respected worldwide, regardless of migratory status, racial, ethnic, socioeconomic, gender, sexual, and other intersecting social factors, and the economic or political circumstances in place. In our study, 75 per cent of surveyed active migrants reported that in their experience their human right to health had been frequently honored, with a higher percentage in Spain than the United States, reflecting these countries’ health and migration policies. Passive migrants’ reports on whether they thought their relatives’ right to health had been respected abroad was slightly lower than what active migrants answered (69 per cent responded positively). However, their responses about their own human right to health being respected in Ecuador were poorer, with a majority reporting that it had been rarely (52 per cent) or never (52 per cent) respected. These statistics are both troubling and encouraging and can be added to support the argument for the utilization of a human rights approach to health as one of the pillars on which to base coordinating efforts to advance migrant health both within and across geographical borders. While a human rights approach may be critiqued as too liberal, it can still be particularly strategic to attempt a universalization of minimum standards that all countries should follow to develop both their public health and migration policies. However, this tactic would only work if the critical sociological, anthropological, feminist, racial, ethnic, and migration studies contributions to the understanding of cultural relativism, power, and the need to historicize agency and embody intersectionality is included in the human rights framework, especially when we consider the social determinants of health as defined by Latin American critical epidemiology. Clearly, for this kind of international and internal coordination among governing bodies to occur, a belief that all human lives regardless of their origin or status deserve respect and attention would also be indispensable. If divisive and exploitative economic and political logics continue to rule, caring for migrants’ well-​ being becomes an exception given their instrumental role as disposable 239

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workers and scapegoats typical not only in the Global North but also the Global South. It can therefore be argued that a sweeping paradigmatic and power shift that involves “a political project committed to equality” that cares and treats all people “not making exceptions” recognizing all “forms of life as life” (Ticktin, 2011, 223; emphasis in original) may be a pre-​requisite for real and sustainable change to occur to dismantle systems and practices that reproduce and amplify health and social inequalities. Besides these ethical reasons why migration and health ought to be seriously and urgently considered worldwide, there are substantial practical matters to contemplate. The less coordination among countries in migration and health policymaking, the more problems arising at the personal and community levels, undermining public health transnationally—​a fact that became even more prominent with the eruption of the COVID-​19 global pandemic and the various inequalities it unearthed and intensified (World Health Organization, 2021). Historically, repressive migratory measures have not deterred people from moving to other places that promise better living conditions. On the contrary, they generated more dangerous migrations that inexorably worsened migration-​related health outcomes and consequently, their effect on collective health. To continue enforcing prohibiting migratory policies in a context characterized by extreme economic and sociopolitical inequalities within and across geopolitical borders will simply result in mounting irregular migration with its increased risks and negative health effects. Moreover, not to end the lack of coordination between health and migration policies nationally and internationally will undoubtedly result in raising rates of migrant trauma and health problems, and consequently, worsen collective welfare. Future research to strengthen this study should include a replication of the qualitative work in migrant communities of other countries and migratory destinations, be complemented with probability, representative samples to collect data on health and migration via structured surveys, and include more systematically and on a larger scale the practices and thoughts of health and migration providers as well as policymakers who could share the reasons why migration and health policies run in parallel lines from their own viewpoint and what could be done about it. Interdisciplinary and transnational research teams would be necessary to carry out the expanded project while paying close attention to not only funding limitations but also ideological and political conflicts that may arise given the sensitivity of the subject matter. Furthermore, an activist research approach would ensure that scholarship does not undercut practical, public work, or reproduce unfair hierarchies. Given the critical needs of migrant communities, especially in the new context of global pandemics, economic recession, and a political turn to the right, bridging academia with community and action is more essential than ever. While research on the junction of health and migration 240

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can be done by utilizing non-​participatory methodologies and then applied to improve collective health; activist, participatory, and community-​based research promises to be more attuned to the actual needs of migrants and relevant milieus. Indeed, the protagonism of migrants in the research process is essential for scholarship to be inclusive and relevant. To better understand the nuances and complexities of migration and health, and generate constructive solutions, an activist sociology from the ground up that transcends disciplinary, geographical, and social borders is fundamental, as this study demonstrated. The difficulties that this approach may present, mirroring the challenges that a democratically oriented, horizontal, consensual, and egalitarian praxis entails, do not undermine but rather intensify its intrinsic social and moral worth, and concrete significance.

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The colleagues with whom I worked at the Institute were Riccardo Colasanti, Johanna Montalvo, Xavier Astudillo, and Yadira Gavilanes. Marcelo Rodrigo worked as a research assistant for the Institute in 2017. I was invited as a Visiting Researcher with the support of the Rielo Institute for Integral Development in 2015. We received a Social Action Award from Sociologists for Women in Society (SWS) for the creation of visual materials for the website in 2018. Visit the site at www.saludymigracion.com​. I was awarded the Fulbright Foreign Scholarship Grant to Ecuador (Council for International Exchange of Scholars) to develop this project from 2016 to 2017, and a Catholic Relief Services (CRS) Global Grant to develop fieldwork in Spain from 2017 to 2018. This research project was approved by the Institutional Review Board of St. John’s University (Protocol # 0915-​058) on October 5, 2015. I would like to thank Josephine Beoku-​Betts for inviting me to take part in her Sociologist for Women in Society’s Presidential Panel on Migration and the Politics of Borders at the organization’s Winter Meeting in January 2020, for which I elaborated this concept for my presentation ‘Traversing and Transcending (Border) Politics: Latin Americans’ Quest for Well-​being’ and had the rich opportunity to discuss the idea with various colleagues, including Erika Marquez.

Chapter 2 1

See Villalón and Kraft (2022) for a more quantitatively focused analysis of migratory stress and gender.

242

References Abraído-​Lanza, A.F., Dohrenwend, B.P., Ng-​Mak, D.S., and Turner, J.B. (1999) The Latino Mortality Paradox: A Test of the ‘Salmon Bias’ and Healthy Migrant Hypotheses. American Journal of Public Health, 89(10), 1543–​8. Achotegui, J. (1999) Los duelos de la migración: una perspectiva psiocopatológica y psicosocial. In E. Perdiguero and J.M. Comelles (comp.) Medicina y cultura. Barcelona: Bellaterra, pp 88–​100. Achotegui, J. (2004) Emigrar en situación extrema: el síndrome del inmigrante con estrés crónico y múltiple (Síndrome de Ulises). Revista Norte de Salud Mental, 21(5), 39–​52. Achotegui, J. (2009) Ulysses Syndrome: The Immigrant Syndrome of Chronic and Multiple Stress. Barcelona: El mundo de la mente. Acker, J. (2006) Inequality Regimes: Gender, Class, and Race in Organizations. Gender and Society, 20(4), 441–​64. Agustín, L. (2006) Atreverse a cruzar fronteras: migrantes como protagonistas. Viento Sur, 87, 73–​82. Agustín, L. (2007) Sex at the Margins: Migration, Labour Markets and the Rescue Industry. London: Zed Books. Almeida-​Filho, N. (1989) Epidemiologia sem números: uma introdução crítica a ciência epidemiológica. Rio de Janeiro: Campus. Almeida-​Filho, N. (2000) La ciencia tímida: ensayos de deconstrucción de la epidemiología. Buenos Aires: Lugar Editorial. Berger, P. and Luckmann, T. (1967) The Social Construction of Reality: A Treatise in the Sociology of Knowledge. New York: Anchor Books. Bertoli, S., Fernández-​Huertas Moraga, J., and Ortega, F. (2010) Crossing the Border: Self-​selection, Earnings and Individual Migration Decisions. IZA Discussion Papers, No. 4957. Bonn: Institute for the Study of Labor (IZA). Biehl, J. and Petryna, A. (2013) When People Come First: Critical Studies in Global Health. Princeton: Princeton University Press. Bourbeau, P. (2015) Migration, Resilience, and Security: Responses to New Inflows of Asylum Seekers and Migrants. Journal of Ethnic and Migration Studies, 41(12), 1958–​77.

243

MIGRATION, HEALTH, AND INEQUALITIES

Breilh, J. (1977) Crítica a la interpretación capitalista de la epidemiología: un ensayo de desmitificación del proceso salud-​enfermedad. Mexico City: UAM-​X. Breilh, J. (2003) Epidemiología crítica: ciencia emancipadora e interculturalidad. Buenos Aires: Lugar Editorial. Breilh, J. (2010a) Epidemiología: economía política y salud (7th edn). Quito: Corporación Editora Nacional/​Universidad Andina Simón Bolívar. Breilh, J. (2010b) Las 3 ‘S’ de la determinación de la vida: 10 tesis hacia una versión crítica de la determinación social de la vida y la salud. In R.P. Nogueira (ed) Determinação social da saúde e reforma sanitária. Rio de Janeiro: CEBES, pp 87–​125. Breilh, J. (2013) La determinación social de la salud como herramienta de transformación hacia una nueva salud pública (salud colectiva). Revista Facultad Nacional Salud Pública, 31(1), S13–​27. Brown, T., Andrews, G., Cummins, S., Greenhough, B., Lewis, D., and Power, A. (2017) Health Geographies: A Critical Introduction. Chichester, UK and Hoboken, NJ: Wiley-​Blackwell. Cabieses, B. (2014) La compleja relación entre posición económica, estatus migratorio y resultados de salud. Value in Health Regional Issues, 5, 1–​6. Caplan, S. (2007) Latinos, Acculturation, and Acculturative Stress: A Dimensional Concept Analysis. Policy, Politics, & Nursing Practice, 8(2), 93–​106. Castillo Sanchez, A.V. and Londoño Gaoña, E.P. (2013) Migración parental y salud en Bolivia y Ecuador. Tendencias de literatura publicada entre los años 2000 y 2013. Thesis. Pontificia Universidad Javeriana, Facultad de Enfermería, Departamento de Salud Colectiva, Bogotá, Colombia. Castles, S. (2009) Development and Migration—​M igration and Development: What Comes First? Theoria: A Journal of Political and Social Theory, 56(121), 1–​31. Castro, A. and Singer, M. (eds) (2004) Unhealthy Health Policy: A Critical Anthropological Examination. Maryland: Altamira Press. Chabram-​Dernersesian, A. and de la Torre, A. (2008) Speaking from the Body: Latinas on Health and Culture. Tucson: University of Arizona Press. Cho, S., Crenshaw, K., and McCall, L. (2013) Toward a Field of Intersectionality Studies: Theory, Applications, and Praxis. Signs, 38(4), 785–​810. Commission on the Social Determinants of Health (2008) Closing the Gap in a Generation. Final Report: Executive Summary. World Health Organization. Available at: www.who.int/​publications/​i/​item/W ​ HO-I​ ER-C ​ SDH-0​ 8.1 [accessed 30 July 2015]. Connell, R. (2007) Southern Theory: The Global Dynamics of Knowledge in Social Science. Cambridge: Polity Press. Connell, R. and Messerschmidt, J. (2005) Hegemonic Masculinity: Rethinking the Concept. Gender and Society, 19(6), 829–​59. 244

References

Crenshaw, K. (1995) Mapping the Margins: Intersectionality, Identity Politics, and Violence Against Women of Color. In K. Crenshaw, N. Gotanda, G. Peller, and K. Thomas (eds) Critical Race Theory: The Key Writings that Formed the Movement. New York: The New Press, pp 357–​83. Crenshaw, K., Gotanda, N., Peller, G., and Thomas, K. (eds) (1995) Critical Race Theory: The Key Writings that Formed the Movement. New York: The New Press. Cuestas, F. (2011) Sobre locura y emigración en el mundo globalizado. Psicoperspectivas, 10(1), 21–​45. Available at: www.scielo.cl/s​ cielo.php?script=​ sci_​arttext&pid=S​ 0718-6​ 9242011000100003&lng=​es&tlng=​es. 10.5027/​ psicoperspectivas-​Vol10-​Issue1-​fulltext-​137 [accessed 30 July 2015]. David, E.J.R. (ed) (2013) Internalized Oppression: The Psychology of Marginalized Groups. New York: Springer Publishing Company. Donnangelo, M.C. (1979) Saúde e sociedade. São Paulo: Duas Cidades. Du Bois, W.E.B. (1989[1903]) The Souls of Black Folk. New York: Penguin. Dubet, F. (2012) ¿Para qué sirve realmente un sociólogo? Buenos Aires: Siglo Veintiuno. Esterberg, K. (2002) Qualitative Methods in Social Researc h . New York: McGraw-​Hill. Falconí Trávez, D. (ed) (2014) ‘Me fui a volver’: narrativas, autorías y lecturas teorizadas de las migraciones ecuatorianas. Quito: Corporación Editora Andina/​ Universidad Andina Simón Bolívar. Farmer, P. (2001) Infections and Inequalities: The Modern Plagues. Berkeley: University of California Press. Farmer, P., Kleinman, A., Yong-​Kim, J., and Basilico, M. (eds) (2017) Reimagining Global Health: An Introduction. Berkeley: University of California Press. Foucault, M. (1980) Power/​Knowledge. New York: Pantheon Books. Freud, S. and Strachey, J. (1989) Beyond the Pleasure Principle. New York: Norton. Freund, P., McGuire, M., and Podhurst, L. (2002) Health, Illness, and the Social Body: A Critical Sociology (4th edn). New Jersey: Prentice Hall. Garfield, G. (2005) Knowing What we Know: African American Women’s Experiences of Violence and Violation. Piscataway: Rutgers University Press. Geraci, S. (2006) La sindrome di salgari 20 anni dopo. Janus. Medicina: Cultura, Culture, 21, 21–​9. Glenn, E. (2000) Citizenship and Inequality: Historical and Global Perspectives. Social Problems, 47(1), 1–​20. Hale, C. (ed) (2008) Engaging Contradictions: Theory, Politics, and Methods of Activist Scholarship. Los Angeles: University of California Press. Haney-​Lopez, I. (1996) White by Law: The Legal Construction of Race. New York: New York University Press.

245

MIGRATION, HEALTH, AND INEQUALITIES

Hankivsky, O. and Christoffersen, A. (2008) Intersectionality and the Determinants of Health: A Canadian Perspective. Critical Public Health, 18(3), 271–​83. Herrera, G. (Coordinación) (2008) Ecuador: la migración internacional en cifras. Quito: UNFPA/​FLACSO. Hill Collins, P. (1986) Learning from the Outsider Within: The Sociological Significance of Black Feminist Thought. Social Problems, 33(6), S14–​32. Hill Collins, P. (1998) Fighting Words: Black Women and the Search for Justice. Minneapolis: University of Minnesota Press. Hill Collins, P. (2019) Intersectionality as Critical Social Theory. Durham: Duke University Press. Hing, B.O. (2004) Defining America Through Immigration Policy. Philadelphia: Temple University Press. Illingworth, P. and Parmet, W. (2017) The Health of Newcomers: Immigration, Health Policy, and the Case for Global Solidarity. New York: New York University Press. Iniciativa de Salud de las Américas (2017) The Health Initiative of the Americas Fact Sheet. Berkeley: School of Public Health. Available at: https://​hia​ucb.files.wordpr​ess.com/​2017/​11/​hia_​f acts​heet​_​2pa​ges_​ nov2​017_​span​ish.pdf [accessed 4 February 2019]. International Organization for Migration (2013) International Migration, Health and Human Rights. Geneva: IOM. International Organization for Migration (2018) Migration Health Annual Report 2016. Geneva: IOM. Iriart, C., Waitzkin, H., Breilh, J., Estrada, A., and Merhy, E.E. (2002) Medicina social Latinoamericana: aportes y desafíos. Revista Panamericana de Salud Pública, 12(2), 128–​36. Jaggar, A. (2008) Just Methods: An Interdisciplinary Feminist Reader. Boulder: Paradigm Publishers. Johnson, K. (2007) Opening the Floodgates: Why America Needs to Rethink its Borders and Immigration Laws. New York: New York University Press. Jokisch, B. (2014) Ecuador: From Mass Emigration to return migration? Migration Policy Institute. Available at: http://​migr​atio​npol​icy.org/​arti​cle/​ecua​dor-​ mass-​emi​grat​ion-​ret​urn-​migrat​ion [accessed 30 July 2015]. Jokisch, B. and Pribilsky, J. (2002) The Panic to Leave: Economic Crisis and the ‘New Emigration’ from Ecuador. International Migration Review, 40(4): 75–​101. Krieger, N. (2012) Epidemiology and the People’s Health: Theory and Context. New York: Oxford University Press. La Parra Casado, D., Mateo-​Pérez, M.A., Albert-​Guardiola, M.C., and López, S. (2007) Estado de salud y demanda de servicios de salud de la población Ecuatoriana en España. Inguruak, 44, 193–​208. Available at: http://​dial​ net.uniri​oja.es/​serv​let/​artic​ulo?cod​igo=​2572​553 [accessed 30 July 2015]. 246

References

Lara, M., Gamboa, C., Kahramanian, M.I., Morales, L.S., and Hayes-​ Bautista, D.E. (2005) Acculturation and Latino Health in the United States: A Review of the Literature and its Sociopolitical Context. Annual Review of Public Health, 26, 367–​97. Laurell, A.C. (1982) La salud-​enfermedad como proceso social. Revista Latinoamericana de Salud, 2, 7–​25. Lu, Y. (2011) Household Migration, Social Support, and Psychosocial Health: The Perspective from Migrant Sending Areas. Social Science and Medicine, 74(2), 135–​42. Mahmood, S. (2001) Feminist Theory, Embodiment, and the Docile Agent: Some Reflections on the Egyptian Islamic Revival. Cultural Anthropology, 16(2), 202–​36. Malmusi, D., Borrell, C., and Benach, J. (2010) Migration-​related Health Inequalities: Showing the Complex Interactions between Gender, Social Class and Place of Origin. Social Science and Medicine, 71(9), 1610–​19. Mani, L. (1998) Contentious Traditions: The Debate on Sati in Colonial India. Berkeley: University of California Press. Martínez-​Andrade, L. (2019) Feminismos a la contra: entre-​vistas al sur global. Santander: La Vorágine. Meñaca, A. (2006) Familias rotas y problemas de salud: la medicalización de las familias migrantes Ecuatorianas. Quaderns de l’Institut Català d’Antropologia, 22, 161–​78. Menon, R. and Bhasin, K. (1998) Borders and Boundaries: Women in India’s Partition. New Jersey: Rutgers University Press. Miranda, J., Siddique, J., Der-​Martirosian, C., and Belin, T. (2005) Depression among Latina Mothers Separated from their Children. Psychiatric Services, 56(6), 717–​20. Mooney, E. (2005) The Concept of Internal Displacement and the Case for Internally Displaced Persons as a Category of Concern. Refugee Survey Quarterly, 24(3), 9–​26. Naples, N. (2003) Feminism and Method: Ethnography, Discourse Analysis, and Activist Research. New York: Routledge. Navarro, V. (2009) What We Mean by the Social Determinants of Health. International Journal of Health Services, 39(3), 423–​41. Navarro, V. and Shi, L. (2001) The Political Context of Social Inequalities and Health. Social Science & Medicine, 52(3), 481–​91. Nazroo, J.Y. (2003) The Structuring of Ethnic Inequalities in Health: Economic Position, Racial Discrimination, and Racism. American Journal of Public Health, 93(2), 277–​84. Ong, A. (1999) Cultural Citizenship as Subject Making: Immigrants Negotiate Racial and Cultural Boundaries in the US. In R.D. Torres, L.F. Mirón, and J.X. Inda (eds) Race, Identity, and Citizenship: A Reader. Malden, MA: Blackwell Publishing, pp 262–​93. 247

MIGRATION, HEALTH, AND INEQUALITIES

Ortner, S. (2006) Anthropology and Social Theory: Culture, Power and the Acting Subject. Durham: Duke University Press. Padilla, L. (2001) ‘But You’re Not a Dirty Mexican’: Internalized Oppression, Latinos and the Law. Texas Hispanic Journal of Law and Policy, 7(1), 59–​113. Passos Nogueira, R. (2010) Determinação social da saúde e reforma sanitária. Rio de Janeiro: Cebes. Pyke, K. (2010) What is Internalized Racial Oppression and Why Don’t We Study It? Acknowledging Racism’s Hidden Injuries. Sociological Perspectives, 53(4), 551–​72. Ramírez, J. (2013) La política migratoria en Ecuador: rupturas, tensiones, continuidades y desafíos. Quito: Editorial IAEN. Raphael, D. (2009) Social Determinants of Health: Canadian Perspectives. Toronto: Canadians’ Scholars Press. Renzaho, A. (ed) (2016) Globalisation, Migration and Health: Challenges and Opportunities. London: Imperial College Press. Ríos-​Marín, A. and Hernández-​Londoño, L. (2014) Descripción de procesos migratorios en Almería-​España y su repercusión en la salud mental. Revista Facultad Nacional de Salud Pública, 32(1), S67–​77. Roberts, D. (2002) Shattered Bonds: The Color of Child Welfare. New York: Basic Civitas Books. Romero, M. (2008) Crossing the Immigration and Race Border: A Critical Race Theory Approach to Immigration Studies. Contemporary Justice Review, 11(1), 23–​37. Romero, M. (2011) The Maid’s Daughter: Living Inside and Outside the American Dream. New York: New York University Press. Ron Encalada, E.S. (2010) Impacto de la migración en la salud mental en niños y adolescentes. Thesis. Universidad de Cuenca, Facultad de Ciencias Médicas, Escuela de Medicina, Postgrado de Pediatría. Rubalcava, L.N., Teruel, G., Thomas, D., and Goldman, N. (2008) The Healthy Migrant Effect: New Findings from the Mexican Family Life Survey. American Journal of Public Health, 98(1), 78–​84. Samaja, A. (1992) Epistemología y epidemiología. Campinas: Congreso Brasileño de Epidemiología. Sanchez, G. and Romero, M. (2010) Critical Race Theory in the US Sociology of Immigration. Sociology Compass, 4(9), 779–​88. Sayad, A. (2007) The Suffering of the Immigrant. Cambridge: Polity Press. Segato, R. (2003) Las estructuras elementales de la violencia: ensayos sobre género entre la antropología, el psicoanálisis y los derechos humanos. Buenos Aires: Prometeo/​Universidad Nacional de Quilmes. Segato, R. (2016) La crítica de la colonialidad en ocho ensayos. Buenos Aires: Prometeo. Shayne, J. (ed) (2014) Taking Risks: Feminists, Activism, and Activist Research in the Americas. Albany: SUNY Press. 248

References

Singer, M. and Baer, H. (2017) Critical Medical Anthropology (2nd edn). New York: Routledge. Sjoberg, G. and Nett, R. (1997) A Methodology for Social Research: With a New Introductory Essay. Prospect Heights, IL: Waveland Press, Inc. Southwick, S., Bonanno, G., Masten, A., Panter-​Brick, C., and Yehuda, R. (2014) Resilience Definitions, Theory, and Challenges: Interdisciplinary Perspectives. European Journal of Psychotraumatology, 5. Available at: https://​ doi.org/​10.3402/​ejpt.v5.25338 [accessed 15 January 2020]. Spivak, G. (1988) Can the Subaltern Speak? In C. Nelson (ed) Marxism and the Interpretation of Culture. Urbana: University of Illinois Press, pp 271–​313. Ticktin, M. (2011) Casualties of Care: Immigration and the Politics of Humanitarianism in France. Berkeley and Los Angeles: University of California Press. Turner, J. and Simmons, A. (2006) Transnational Resilience and Resistance: Key Concepts for Working with Refugees. American Family Therapy Academy, Monograph Series, 1(2), 6–​22. Turra, C. and Elo, I. (2008) The Impact of Salmon Bias on the Hispanic Mortality Advantage: New Evidence from Social Security Data. Population Research and Policy Review, 27(5), 515–​30. Ullman, H., Goldman, N., and Massey, D. (2011) Healthier Before They Migrate, Less Healthy when they Return? The Health of Return Migrants in Mexico. Social Science and Medicine, 73(3), 421–​8. Villalón, R. (2010a) Violence against Latina Immigrants: Citizenship, Inequality, and Community. New York: New York University Press. Villalón, R. (2010b) Passage to Citizenship and the Nuances of Agency: Latina Battered Immigrants. Women’s Studies International Forum, 33(6), 552–​60. Villalón, R. (2011) Feminist Activist Research and Strategies from within the Battered Immigrant Women’s Movement. Interface: A Journal for and about Social Movements, 3(2), 246–​70. Available at : www.interfacejournal. net/​wordpress/​wp-​content/​uploads/​2011/​12/​Interface-​3-​2-​Villalon.pdf [accessed 15 January 2020]. Villalón, R. (2014) Latina Battered Immigrants, Citizenship and Inequalities: Reflections on Activist Research. In J. Shayne (ed) Taking Risks: Feminists, Activism, and Activist Research in the Americas. Albany: SUNY Press, pp 245–​77. Villalón, R. (2015) Violence Against Immigrants in a Context of Crisis: A Critical Migration Feminist of Color Analysis. Journal of Social Distress and the Homeless, 24(3), 116–​39. Villalón R. (2019a) Activismo académico en las Américas del siglo XX. Revista CS, 29, 11–​17. Villalón, R. (2019b) Una aproximación sociológica crítica activista al estudio de salud y migración: el caso ecuatoriano. Revista CS, 29, 103–​38.

249

MIGRATION, HEALTH, AND INEQUALITIES

Villalón, R. and Kraft, S. (2022) Migratory Stress, Health and Gender: An Intersectional Analysis of the Ecuadorean Case. In J.J. Kronenfeld (ed) Health and Health Care Inequities, Infectious Diseases and Social Factors (Research in the Sociology of Health Care, Vol. 39), Bingley: Emerald Publishing, pp 89–​106. Waitzkin, H., Iriart, C., Estrada, A., and Lamadrid, S. (2001) Social Medicine Then and Now: Lessons from Latin America. American Journal of Public Health, 91(10), 1592–​601. Williams, G. (2003) The Determinants of Health: Structure, Context and Agency. Sociology of Health & Illness, 25(3), 131–​54. World Health Organization (2019) Promoting the Health of Refugees and Immigrants: Draft Global Action Plan 2019–​2023. Report by the Director-​ General. Available at: https://a​ pps.who.int/g​ b/​ebwha/​pdf_​fil​ es/​WHA72/​ A72​_​25-​en.pdf [accessed 15 January 2020]. World Health Organization (2021) Refugees and Migrants in Times of COVID-19: Mapping Trends of Public Health and Migration Policies and Practices. Geneva: World Health Organization. Available at: www.who. int/publications/i/item/9789240028906 [accessed 17 May 2022]. Zuberi, T. and Bonilla-​S ilva, E. (eds) (2008) White Logic, White Methods: Racism and Methodology. Lanham: Rowman & Littlefield.

250

Index References to figures appear in italic type; those in bold type refer to tables.  A accidents  51–​2, 53, 57, 87, 88, 93, 105, 109, 111, 115, 118–​19, 136, 159, 214–​15 Achotegui, J.  5, 10, 21, 22, 40, 45 active migrant trauma  10, 21, 22, 26, 119, 122 definition of  11 and emotional burden  129 experiences of  28–​38 and geopolitical boundaries  175 illustration of  27 and pain encapsulation  94 and pre-​migration personal/​family troubles  31 activist research  6–​7, 17, 232, 240–​1 and ethics  9–​10 and feminist theory  4 fundamental principles of  6 methodology  6–​7 agency  4, 6, 11, 13–​14, 20, 172, 229, 231, 239 see also transformative border politics attention shift/​diversion, as resilience  74, 88 authorized migrants  5 and migratory stress  42–​3 see also regular migrants B border policies  54–​5 formal and informal  13–​14 see also transformative border politics C childless couples  experiences of  149–​51 children of active migrants  26, 33, 37–​8, 57 cultural learning and unlearning  70–​2 graduation of  53–​4 of passive migrants  27 of return migrants  71–​2 separated from parents  148–​49

stress due to parents’ migration for  43–​4 and trauma  26–​7, 34–​8, 57 communication distortion  123, 152, 158, 169, 170, 231 definition of  12 experiences of  152–​6 illustration of  153 conceptual map  14–​16, 15 coping, with migration challenges  see psycho-​sociocultural coping mechanisms couples  childless  148–​51 non-​migrant partner, and trauma  26–​7 reunification, and trauma  38 separation, and trauma  38–​9 separation due to migration  39 critical medical anthropology  4, 5, 232, 239 critical race, ethnic, and migration studies  4, 5, 13, 232, 239 cultural learning and unlearning  70–​2 cultural sensitivity  233–​4 D denied migrant health  definition of  12 experiences of  84–​8 illustration of  83 reasons for  83–​4 deportation  33, 42, 51, 54–​5, 115, 122 disillusion adjustment  definition of  12 experiences of  77–​9 illustration of  77 process of  76–​7 documentation lack, and trauma  32–​3 E economic conditions, and trauma  30–​1 endogenous and exogenous discrimination  217–​18 ethnic and racial hierarchies  205–​6 see also ethnoracial hierarchies

251

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ethnoracial hierarchies  205–​6 experiences of  206–​23 reassessment of  220–​1 European Office of the World Health Organization  2 exogenous incidents, and migrant crises  54–​5 F family de/​re-​construction  124 childless couples  148–​51 definition of  12 fathers migrating alone  134–​8 illustration of  125 migration of older siblings alone  144–​8 migration of parents without children  128–​34 mothers migrating alone  138–​44 reasons for  124–​6 simultaneous migration of nuclear family with children  126–​8 family relationships, post-​migration  123 communication distortion  152–​6 family de/​re-​construction  124–​51 resentment and detachment  163–​7 sensible comprehension  167–​9 subordination to concealment and deception  156–​9 unspoken pacts  159–​63 fathers, migrating alone  experiences of  135–​8 new relationship abroad  134 reasons for  134–​5 fear, and health denial  85 feminist theory, Black, postcolonial, decolonial  3–​4, 5, 11, 231, 232, 239 and activist research  4, 6 and ethics  9 see also intersectionality financial crisis (1999)  17 financial crisis (2008)  54, 55 and return shock  57–​9 forced migrants, and international law  5 formal border politics  13 Freud, Sigmund  99 friendships, and resilience  72–​3 G gender and sexual regimes  185 experiences of  185–​205 labor segregation and  203–​5 masculinity and  189–​90 patriarchy and  192–​4, 196–​9 geopolitical boundaries  172 experiences of  173–​84 grandparents  and birth of grandchildren  53–​4 illness and passing of  52 grief and migratory mourning, comparison of  21

H healthcare, access to  2, 238–​9 and denied migrant health  83, 84, 85 and normalization of malaise  88 ‘healthy but vulnerable migrant’  2 healthy migrant effect  2 heteropatriarchy  14, 172, 176, 184–​6 human rights approach, to health  2, 239 I infectious diseases  5 informal border politics  13 Institute for Health and Migration (Ecuador)  2, 9, 233 intentional attitude  217, 221 International Organization for Migration  2 intersectionality  3, 4, 5–​6, 13, 14, 171–​2, 229, 239 see also feminist theory; transformative border politics intra-​group discrimination  214–​17 involuntary return rebound  definition of  13 experiences of  116–​21 illustration of  116 process of  115 irregular migrants  5, 83, 122, 232, 240 and health denial  85 health processes and  32, 33, 42, 46, 51 and migratory stress  41–​2 and transformative border politics  177, 178, 181, 182, 184, 191, 225, 228 and trauma  32–​3 unrecognized migratory resilience  61–​2 K Knowledge Hub on Health and Migration  2 L labor segregation  203–​5 language barriers, and health denial  85 Latin American critical epidemiology  4, 231, 232, 239 Latino paradox  2–​3, 5 M malaise, normalization of  12, 88–​90 experiences of  91–​3 illustration of  89 reasons for  88–​91 typical health conditions of  90 marginalization between migrant populations  5 marriages  36, 51, 160, 182, 199 masculinity, perception of  189–​90 medical crisis  53 mestizos  19, 205, 206, 208 migrant crises triggers  10, 22, 50–​1, 75, 231 definition of  11 endogenous incidents  51

252

Index

exogenous incidents  51 experiences of  52–​6 illustration of  51 migrant health denial  see denied migrant health migration-​related health processes  21 active and passive migrant trauma  26–​40 definition of  11 migrant crises triggers  50–​6 migratory stress  40–​50 reflective mourning  21–​6 return shock  56–​61 unrecognized migratory resilience  61–​75 migratory mourning  10 definition of  21 effect of  21–​2 and grief, comparison between  21 stages of  22 see also reflective mourning migratory resilience  see resilience migratory stress  8, 10–​11, 231, 238 coping with challenges  82–​4, 94, 119, 122 definition of  11 and geopolitical boundaries  175 health impacts  45–​6, 48–​9, 84 and health processes  22, 40–​50, 55–​6, 60, 74 illustration of  41 and post-​migration family relationships  129, 134, 139, 140, 142, 145, 148, 155 symptoms of  40–​1, 45–​6, 48–​9 transformative border politics  175, 176 mothers, migrating alone  experiences of  140–​4 reasons for  138–​40 motivating nostalgia  definition of  12 experiences of  81–​2 illustration of  81 process of  80 multiple chronic stress disorder  3 see also Ulysses syndrome N 9/​11 attacks, aftermath of  54–​5 normalization of malaise  see malaise, normalization of nostalgia  79, 82 see also motivating nostalgia; paralyzing nostalgia nuclear family with children, simultaneous migration of  experiences of  126–​8 reasons for  126 O older siblings, migrating alone  experiences of  145–​8 reasons for  144–​5

‘Other Latin American Countries’ (OLAC)  48, 49 see also other Latin American cases other Latin American cases  9, 19, 49–​50, 80, 81–​2, 159, 201, 202, 210–​12 see also ‘Other Latin American Countries’ (OLAC) overworking  68–​9 P pain encapsulation  definition of  12 experiences of  94–​99 illustration of  95 process of  93–​4 paralyzing nostalgia  definition of  12 experiences of  80–​1 illustration of  80 process of  79–​80 parents’ migration, without children experiences of  130–​3 reasons for  128–​30 parents of migrants, and trauma  27–​8, 39 passive migrant trauma  10, 26, 142 of childless couples  148 definition of  11 experiences of  30–​40 and family migration  35, 36–​7 and fathers migrating alone  134 illustration of  28 and migration of older siblings alone 145 and mothers migrating alone  139 and pain encapsulation  94 parent–​child separation, due to  33, 39 patient–​doctor relationship, of mutual disqualification  234–​6 see also Salgari’s syndrome patriarchy  144, 147, 189, 191–​4, 196–​9 post-​migration health changes  45–​6 pre-​migration personal/​family troubles, and trauma  31 prejudice  214, 222–​3, 234 pre-​migration health  45 psycho-​sociocultural coping mechanisms  11, 12, 14–​16, 15, 76 communication distortion  152–​6 disillusion adjustment  76–​9 family de/​re-​construction  124–​151 involuntary return rebound  115–​21 migrant health denial and normalization of malaise  83–​93 pain encapsulation  93–​9 paralyzing and motivating nostalgia  79–​82 resentment and detachment  163–​7 sensible comprehension  167–​9 settling readjustment  110–​15 strategic return  105–​9

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MIGRATION, HEALTH, AND INEQUALITIES

subordination to concealment and deception  156–​9 unspoken pacts  159–​63 well-​being ideal and transgenerational goals  99–​105 public health impact  1–​2, 238–​40 R racial and ethnic hierarchies  205–​6 see also ethnoracial hierarchies reflective mourning  10, 175, 177 coping with challenges and  79, 82, 84, 93, 122 definition of  11 and geopolitical boundaries  175 and health processes  22–​6, 61 health processes and  40, 51, 56, 75 illustration of  24 meaning and significance of  22–​3 post-​migration family relationships and  124, 126, 129, 134, 139, 140, 142, 145, 148, 151 see also migratory mourning refugee crises  1–​2 regular migrants  32, 34–​5, 91–​2, 228 health denial  91–​3 pain encapsulation  96–​7, 98 trauma  33–​6 resentment and detachment  definition of  13 illustration of  164 reasons for  163–​7 resilience  10, 61, 175, 219, 226, 229, 230, 238 and coping with challenges  80, 82, 98, 101, 122 and friendships  72–​3 and post-​migration family relationships  125, 138, 148 see also unrecognized migratory resilience return dates changes, and trauma  30–​1 return migrants  2, 3, 5, 7–​8, 231 coping with challenges  78–​9, 82, 87, 92, 94–​9, 101–​4 cultural learning and unlearning  71–​2 disillusion adjustment  78–​9 health denial  87 health processes  23–​5, 29–​31, 53, 55 involuntary return rebound  13, 115–​21 pain encapsulation  94–​6, 97 post-​migration family relationships  126–​7, 130–​3, 135, 136, 140–​2, 148–​51, 158, 165–​7 settling readjustment  13, 110–​15 strategic return  13, 105–​9 transformative border politics  184, 186, 192–​3, 203–​5, 208–​9, 215, 217–​25, 227, 229 return shock  10, 136, 140, 148, 220–​1, 224

coping with challenges and  110, 111, 118–​19, 121, 122 definition of  11 experiences of  57–​60 health processes and  22, 56, 71–​2, 73, 74–​5 illustration of  56 symptoms  60 reunion with relatives abroad, and trauma  27, 35–​8 reverse migration  see involuntary return rebound; return migrants; settling readjustment; strategic return S Salazar, Abraham G.  9, 16–​17 Salgari’s syndrome  3, 234 see also patient–​doctor relationship, of mutual disqualification salmon bias  3, 5, 105 same-​sex relationships and LGBTQ  199–​201 second wave of migration  37–​8 sensible comprehension  definition of  13 experiences of  167–​9 illustration of  168 process of  167 settling readjustment  110–​15 definition of  13 experiences of  110–​15 illustration of  110 process of  110 social change  6, 14, 171–​2, 229, 240 see also transformative border politics Social Determinants of Health model  4 social determination of health  4–​5, 20, 232, 239 socioeconomic borders  223–​30 strategic return  105 definition of  13 experiences of  105–​9 illustration of  106 stress  41–​2 see also migratory stress studying, and resilience  65–​8, 74 subordination to concealment and deception  156 definition of  12 experiences of  156–​9 illustration of  157 syndrome of chronic and multiple stress  3 see also Ulysses syndrome T training sessions, benefits of  233 transformative border politics  13–​14, 171–​2 ethnoracial hierarchies  205–​23 gender and sexual regimes  185–​205 geopolitical boundaries  172–​84 illustration of  173 socioeconomic borders  223–​30

254

Index

transgenerational goals  14, 15, 18, 69–​70, 231, 232, 238, 239 and coping with challenges  76, 89, 90, 94, 101, 105–​9, 114, 120, 122 definition of  12 experiences of  103–​4 and health processes  69, 74 illustration of  101 and migratory mourning  21–​2 and post-​migration family relationships  124, 129, 134, 136, 139, 145, 151, 160, 163, 167, 170 shared family goals  73–​4 transformative border politics and  172–​3, 177, 183–​5, 201, 203, 205, 208, 215, 223–​6, 228–​9 see also strategic return transit-​related trauma  29–​30 transnationality  1–​5, 7, 11, 14, 20 coping with challenges and  90, 91, 94 overview of  231, 232, 238, 240 post-​migration family relationships and  123, 129, 133, 136, 138, 139, 140, 145, 152 transformative border politics and  171, 172, 184, 223–​5, 228, 229 tropical infectious diseases  5 U Ulysses syndrome (multiple chronic stress disorder)  3, 10, 22, 40, 41 unauthorized migrants  5, 181, 184 and trauma  29, 32–​3, 178

see also irregular migrants unrecognized migratory resilience  10, 16, 22, 94, 232 definition of  11 experiences of  61–​75 illustration of  62 see also resilience unspoken pacts  123, 151, 152, 167, 169, 170, 231 definition of  12 experiences of  160–​3 illustration of  161 process of  159–​60 W well-​being ideal  1–​6, 8–​9, 14, 18, 19, 231 and coping with challenges  89, 91, 92, 93, 114, 122 definition of  12 experiences of  101–​3 and health processes  25, 26, 63, 69 illustration of  100 and post-​migration family relationships  124, 128, 129, 131, 132, 136, 138–​9, 142, 145, 147, 151, 155, 162, 167, 170 and transformative border politics  172, 201, 225, 228, 229 see also strategic return; transgenerational goals work, as solace and distraction  68–​9 see also overworking World Health Organization  2, 4

255

“A rare and unique book. Deeply important read for human rights and immigration activists, and for health providers working with migrants and their families.” Mary Romero, Arizona State University

“A very relevant interdisciplinary study of current migrations, successfully integrating health and mental health perspectives.”  Joseba Achotegui, University of Barcelona and Hospital Sant Pere Claver of Barcelona

Roberta Villalón is Professor of Sociology at St. John’s University, New York City.

Drawing from an activist research project spanning Loja, Santo Domingo, New York, New Jersey, and Barcelona, this book offers a feminist intersectional analysis of the impact of migration on health and well-being. It assesses how social inequalities and migration and health policies, in Ecuador and destination countries, shape the experiences of migrants. The author also explores how individual and collective action challenges health, geopolitical, gender, sexual, ethnoracial, and economic disparities, and empowers communities. This is a thorough analysis of interpersonal, institutional, and structural mechanisms of marginalization and resistance. It will inform policy and research for better responses to migration’s negative effects on health, and progress towards greater equality and social justice.

G L O B A L M I G R AT I O N A N D S O C I A L C H A N G E This series showcases ground-breaking research that looks at the nexus between migration, citizenship, and social change. It advances new scholarship in migration and refugee studies and fosters cross- and interdisciplinary dialogue in this field.

Series Editor Nando Sigona, University of Birmingham

ISBN 978-1-5292-0710-1

@BrisUniPress BristolUniversityPress bristoluniversitypress.co.uk

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