Ms. Alekseva’s story is typical of many migrant workers from Eastern Europe. She grew up in Bulgaria under bureaucratic socialism, where she began a career at Balkantourist, the state-owned tourism agency famous throughout the Eastern Bloc for its Black Sea vacation packages. She continued to work in the hospitality industry after the company was privatized in the 1990s, but, as she grew older, she found that many hotels preferred younger workers and was forced to take on low-paying odd jobs to make ends meet.

Her difficult situation became increasingly untenable when her husband suffered a series of strokes. She was forced to care for him full-time, only working when her schedule and his health allowed. Bulgaria’s health care system has the second-highest share of out-of-pocket payments in the EU, and soon the couple were up to their ears in debt for hospital bills and medications. Eventually, her husband passed away, and she was left, as she puts it, “alone with a lot of expenses and loans.”

Realizing she would never be able to repay her debts on the money she was earning in Bulgaria, she began scouring the local newspaper, hoping the foreign language skills she acquired in her previous career would help her find a better-paying position abroad. She soon applied to a recruiting agency hiring Eastern European workers to care for elderly people in Germany and left home in 2013. Yet rather than solve her financial problems as she hoped, working abroad simply added a new layer to them.