Annick Andriahsatovo sits at the table before our interview, cooing over her 9-month-old son, Alydioh. Andriahsatovo is 22, with a disarming smile and an easy, maternal air. She also has a nightmare story to tell. In September 2012, shortly after completing her baccalaureate degree, Andriahsatovo—who lives in a suburb of Antananarivo, the capital of Madagascar—received a visit from a job-placement agency recruiter. The woman assured her that she could make good money working as a domestic servant in Kuwait, and also that there would be none of the labor-abuse problems recently reported in the media.

Andriahsatovo hadn’t the faintest idea how to find Kuwait on a map, but she immediately agreed. Her parents were out of work, and there weren’t enough decent-paying jobs in Madagascar to justify even looking. On November 15, her flight took off from Ivato International Airport. “I was sad to leave my family,” she recalls. “But I had courage.”

Her problems began the moment she set foot in Kuwait City. At the office of the Kuwaiti placement agency, she was “sold” from the employer listed in her contract to a second man, a retiree with a twenty-four-room residence. He wasted no time assigning her an impossible load of chores: cleaning all the rooms, cooking the food, washing the clothes. Her workdays lasted twenty-one hours, and she ate only leftovers from the family’s meals—provided there were any. When her performance failed to satisfy her employer’s exacting standards, he would strike her.

About two months after arriving, Andriahsatovo noticed that she’d stopped menstruating. An exam revealed that she was four months pregnant. Her boss was not pleased. He upped her workload despite her declining physical condition. On April 13, she felt sharp stomach pains. Not for the first time, Andriahsatovo implored him to call a doctor. “Tomorrow, tomorrow,” he said dismissively. Desperate, she asked a Filipino neighbor to call a taxi. The next day, at the hospital, she gave birth to twins—the girl stillborn; the boy alive, but more than two months premature.

Andriahsatovo was transferred to a social hospital as she waited for her newborn son to gain strength. Two weeks later, the police paid a visit; they said that she and Alydioh could soon return to Madagascar. Instead, mother and son were reunited inside a squalid detention facility teeming with former domestic servants from the countries that make up Kuwait’s major labor suppliers: the Philippines, Ethiopia, Nepal. Most had fled abusive employers and now awaited their fate—deportation for most, but for others a prison sentence.

The detention center, Andriahsatovo says, was no place for a human being, let alone a 2-week-old preemie. There weren’t enough beds for everyone inside the cramped cell, so Andriahsatovo and Alydioh slept on the floor. Food and milk were in short supply. The only water came from the toilet. Alydioh was constantly sick.

The other detainees came and went following interventions by their embassies or consulates. Madagascar, however, has no consular representation in Kuwait. As the months passed in their dark, filthy cell, Andriahsatovo was left to wonder whether Alydioh would ever experience Madagascar’s embracing sunshine.

Andriahsatovo’s nightmare, with small variations in place and time and nature, is one that has been shared by tens of thousands of young Malagasy women over the last five years. It is also a nightmare with many fathers: a corrupt and ineffectual Malagasy state, callously indifferent host countries, unscrupulous traffickers, abusive employers, and international donors blinded by protocol and their own professed ideals to the real-world consequences of their actions.

Migrant labor from Madagascar to the Middle East dates back at least to the 1990s. But in 2009, a coup d’état in Antananarivo sent the country’s economy into free fall. Foreign aid, previously 40 percent of the state budget, was slashed across the board as the African Union, the United States and other major donors condemned strongman Andry Rajoelina’s seizure of power. By 2011, according to a report by the Organization for Economic Cooperation and Development, Madagascar was perhaps the most under-aided country in the world.

Rajoelina’s government responded by cutting public expenditures 47 percent between 2008 and 2010. In the water, transportation, communication and energy sectors, the cut was more than 50 percent. Environmental spending was also slashed by half. The consequences rippled through Madagascar’s economy. The World Bank estimates that the poverty rate has climbed about 10 percent since the coup, if not more. Between May and November 2009, the school dropout rate tripled. Millions found themselves out of work and on the streets, and thousands of young Malagasy women went abroad in search of work.

For some enterprising businessmen, the collapse heralded a once-in-a-lifetime opportunity. So-called placement agencies sprang up in Antananarivo and other cities across Madagascar, promising the good life in Middle Eastern “Eldorados,” where monthly salaries usually ran around $200. The agencies would pocket upward of $2,000 for each successful transaction.

Reliable numbers are hard to come by, but few question the overall trend. Norotiana Jeannoda, the president of the Union of Qualified Domestic Workers (SPDTS), estimates that every year since 2009, about 200 people per week have left Madagascar for the Middle East. The numbers before that were “negligible,” she says. Initially, most of the women—some 90 percent of Madagascar’s migrant labor force is believed to be female—went to Lebanon. A former high-ranking official at the Malagasy Ministry of Labor, which is responsible for signing off on all legal contracts, estimates that before 2009, Malagasy workers in Lebanon numbered in the hundreds. In 2009, according to data from the Lebanese Ministry of Labor provided by the Catholic charity Caritas, that figure reached more than 4,000.

The Malagasy government banned further migration to Lebanon in November 2009 due to that country’s woeful labor-rights record. But as Madagascar’s economy spiraled downward, the number of migrants grew anyway. Some headed clandestinely to Lebanon with the collusion of government officials. Samuëlson Ramanitriniony, the director general of the labor ministry and a dissenter from the favorable stance toward migrant labor held by many of his colleagues, thinks the current number in Lebanon could be more than 10,000. Of late, however, the most popular destinations have been Kuwait and Saudi Arabia. The State Department’s 2013 “Trafficking in Persons” report estimated that in the past year alone, some 3,000 female domestic workers had migrated to Kuwait from Madagascar.

* * *

In a back room at the SPDTS office, there are dozens of white boxes lining the rows of bookshelves. Inside are dossiers chronicling an astonishing range of abuse, from physical to psychological to sexual. They describe how the boilerplate contracts signed by every worker and employer are then systematically ignored by the bosses, who exert absolute control over their employees. Few workers are even allowed to leave the house unsupervised, much less enjoy the day off each week, and the month off each year, guaranteed in the contracts. Many are prevented from calling their families. Salaries are routinely withheld without explanation.

Jeannoda says she receives several text messages a day from desperate women. She shows me a few. “I cannot stand it anymore,” reads one from a Saudi number, which goes on to describe the woman’s conditions in gut-wrenching detail: “The food in the trash is a chance for me to eat something, and I hide it in my pants. The work is so tiring, but the food is unsuitable. My stomach hurts. I am going to run away again. Help me, Madame. I want to return to Madagascar. Please, Madame.” Another woman in Saudi Arabia texted last October to say she was being raped.

The workers, whose legal status in countries like Kuwait and Saudi Arabia is bound to their employers by the kafala system, have no real recourse. Under that system, employees require written consent from their employers to change jobs or leave the country. “In any system where the employer has that kind of power…you’re always going to have that situation where abuse is very easy,” says Belkis Wille, the Yemen and Kuwait researcher at Human Rights Watch.

Andriahsatovo finally returned to Madagascar in December after an intervention by the Red Cross. Others have not been as fortunate. More than thirty have died under opaque circumstances. Some of the bodies have been returned missing organs. But the deaths have not been seriously investigated. Powerful figures in Madagascar’s government maintain intimate ties to the industry. Tabera Randriamanantsoa, a presidential candidate in 2013, owned a placement agency in Madagascar while he served as the country’s labor minister, according to multiple well-informed sources, and made a habit of blaming Malagasy migrants for their own abuse. “We are not going to strike this market rich by sending over whores!” he once complained to Le Monde.

Although the government did eventually ban migration to “high-risk” countries (including all of the Middle East) last summer, the interdiction appears to have had little effect: ostensibly clandestine operations with indirect or even direct support from government officials are filling the void. “Migration in Madagascar is no longer limiting itself to workers,” Ramanitriniony wrote to me in February, “but is starting to include clandestine migration, as in the cases of other African countries.” Legal migration could soon resume as well: Madagascar and Saudi Arabia are discussing a draft accord aimed at restarting the flow of labor.

* * *

Just a few years earlier, Andriahsatovo would have known where to look for a job. Madagascar’s textile industry, concentrated in zones franches, or export processing zones, was a rare bright spot in Madagascar’s endemically weak economy. No one benefited more than young, often poorly educated women. A 2007 study by the International Labor Organization found that more than 70 percent of zone franche employees were female.

Half of Madagascar’s textile factories exported to the United States under the African Growth and Opportunities Act of 2000, a law that eliminated import tariffs on various goods. AGOA’s merits have been hotly debated, but its benefits to Madagascar’s economy were undeniable. The Malagasy government estimated that factories exporting to the United States employed 50,000 people while indirectly supporting another 100,000 jobs. The US embassy in Antananarivo estimated that these jobs fed about 500,000 people.

Wages in these factories, which produced clothes for retailers like Walmart, Gap and Kohl’s, were by no means great, but they were a marked improvement over what most Malagasy could earn anywhere else. The US embassy hailed the country’s textile sector as “a poster child for [AGOA].”

The 2009 coup immediately raised the specter of an AGOA suspension. Every year, the US president must certify that beneficiary countries have established or are making progress toward such standards as “the rule of law and political pluralism” and “protection of human rights and worker rights.” These conditions are not hard-and-fast: the current list includes such less-than-democratic countries as Angola, Gabon and Gambia.

The US embassy in Madagascar was acutely aware of the crippling consequences that an AGOA suspension would have. In an unsigned cable to the secretary of state and the Commerce Department on April 3, 2009, the embassy cautioned that there could be “no question that [it] would greatly exacerbate an already delicate political and economic situation in a country that is an AGOA showcase by creating huge additional numbers of hungry and unemployed persons.” The cable also warned: “No amount of public diplomacy would succeed in explaining why our concerns for democracy here outweighed consideration for the well-being of hundreds of thousands of poor Malagasy citizens.”

But the US trade representative to Africa had already started informing exporters that Madagascar’s eligibility could be revoked by the end of the year. The warnings, combined with the ongoing political instability, led some companies to begin laying off workers. By November, production and workforce levels at AGOA factories had fallen by 15 to 20 percent, according to a cable by the US ambassador, R. Niels Marquardt.

Factory owners furiously lobbied the US government for a stay of execution. On his blog Aid Watch, New York University economics professor William Easterly excoriated the rank hypocrisy of the impending suspension. “We can be fairly sure that if Madagascar were pumping oil instead of just looking for it the country’s AGOA status would not even be under consideration,” he wrote with his colleague, Laura Freschi.

Nonetheless, on December 31, 2009, President Obama heeded recommendations from the State Department and suspended Madagascar’s AGOA eligibility. In February, layoffs began en masse. Suresh Sakhrani, the managing director of MKLEN International, which exported pants to American retailers, was forced to let go all 4,500 of his workers. In all, anywhere from 30,000 to 50,000 jobs were lost.

The result, as the April 2009 cable predicted, was thousands of hungry and unemployed young women on the streets. Some turned to begging, others to prostitution. For still others, the Middle East beckoned.

It is impossible to say exactly how many former employees of AGOA factories ended up in the Middle East. Anecdotal evidence suggests the number was substantial. Local media reports in 2009 and 2010 noted a surge in migration by laid-off workers to the Middle East and closer destinations like Mauritius.

“Based on the studies of the cases we did, we noticed that most of the young women are former employees of the zones franches,” says Jeannoda, though she notes that a good part of the migration preceded the layoffs triggered by AGOA’s suspension.

Ramanitriniony is most troubled by the way AGOA essentially chewed up and then spit out masses of undereducated young women who left the countryside to work in factories. Now they refuse to go back to their ancestral villages. Jobs in the Middle East, he says, are viewed as a “godsend.”

The loss of AGOA hurt more than just newcomers. Rina Tatamo had spent two three-year stints in Lebanon between 2003 and 2010—the first without problems, the second full of them—before returning to Madagascar in 2010. She had her first child in November 2011 and searched for a job in the downsized zones franches, where she had worked in a textile factory a decade earlier. But with thirty women often competing for two positions, her efforts came to naught. Out of options, she left Madagascar again in September 2012, this time for Kuwait.

Solange Razafindrasoa had also worked before in a zone franche factory. After the birth of her second child in March 2010, she and her husband, Maurice Pierre Herynirina, realized that his salary as a security guard would no longer suffice. She sought work in a textile factory, but her efforts were also in vain. In March 2013, she left for Saudi Arabia to work as a maid.

In December, I met Herynirina in an Antananarivo cafe. He had been frantically trying to get his wife repatriated ever since learning that she hadn’t been paid in five months and reported that she had been threatened with death by her boss. He contacted Madagascar’s chargé d’affaires in Riyadh, who, Herynirina says, promised to do everything possible. Then, in December, the chargé informed him that the only way to release his wife from her contract would be to pay more than $3,000.

* * *

Five years of political deadlock and ever-deepening misery have led Madagascar’s donors to reconsider their actions after the coup. Haleh Bridi, the World Bank country director, now argues for a more nuanced approach to similar situations. “I must say, every time there has been a crisis like this, we have left,” she says. She points to a chart documenting one political crisis after another since Madagascar achieved its independence from France in 1960. Each has been followed by a significant drop in economic growth, something Bridi chalks up to skittish international donors fleeing at the first sign of trouble.

In 2011, the World Bank cautiously resumed disbursing funds. While taking measures to ensure that aid would not go “through the plumbing of the government,” Bridi says, it has pursued ambitious projects in environmental protection, infrastructure and the social sectors to the tune of more than $200 million.

Steven Lauwerier, the country representative for UNICEF, says that Madagascar’s experience highlights the need for rethinking. “At the end of the day, I think the donors’ withdrawing all the money or reducing the money didn’t really contribute to a better political situation,” he says. “It’s more or less the population that paid for it—and the most vulnerable who paid for it.”

The United States, however, has declined to undertake a similar reckoning. Eric Wong, the chargé d’affaires at the US embassy in Antananarivo (the United States withdrew its ambassador in 2010), rejects any responsibility for Madagascar’s woes. “There’s no denying that the US decided to impose sanctions as a result of the 2009 coup,” he says. “But I would place responsibility for the current political and economic crisis on the current regime as opposed to the United States.”

When I ask Wong about the impact of punitive sanctions, he dismisses the matter as “an academic debate” and touts the millions the United States has given since 2009 to respond to emergencies in the food security and health sectors. “The general economic malaise in Madagascar is largely a result of regime inattention to good governance, democracy, fostering investment. Certainly AGOA has a role to play, but I wouldn’t say that the loss of AGOA was the key catalyst for the current economic crisis.”

On January 25, Hery Rajaonarimampianina, the finance minister from Rajoelina’s regime, was sworn in as president after winning a long-delayed election. What the future holds for foreign aid is unclear. Crucially, the IMF has restored ties with the Malagasy government, but donors emphasize the need for “confidence-building” measures and say it could be months before significant aid flows resume. During a recent visit to Madagascar, Robert P. Jackson, the principal deputy assistant secretary for African affairs, said the United States was prepared to re-evaluate the country’s AGOA eligibility pending the appointment of new ministers, but warned that participants in the 2009 coup “are not necessarily the best choices to participate in this new government.”

It is clear that the costs of the coup and the response to it will continue to be borne by the average Malagasy for some time to come. In mid-February, Herynirina was informed by the Ministry of Foreign Affairs that his wife had died in Saudi Arabia a few weeks earlier. On March 15, her body arrived back at Ivato Airport, its organs missing, according to the local news. A medical report from the Saudi authorities claims they were removed to preserve the body. The cause of death was officially listed as a heart attack.