I had to watch every frame of a recent stabbing video ... It will never leave me," says Harun*, one of many moderators reviewing harmful online content in India, as social media companies increasingly move the challenging work offshore. Moderators working in Hyderabad, a major IT hub in south Asia, have spoken of the strain on their mental health of reviewing images and videos of sexual and violent content, sometimes including trafficked children. Many social media platforms in the UK, European Union and US have moved the work to countries such as India and the Philippines. While OpenAI, creator of ChatGPT, has said artificial intelligence could be used to speed up content moderation, it is not expected to end the need for the thousands of human moderators employed by social media platforms. Content moderators in Hyderabad say the work has left them emotionally distressed, depressed and struggling to sleep. "I had to watch every frame of a recent stabbing video of a girl. What upset me most is that the passersby didn't help her," says Harun. "There have been instances when I've flagged a video containing child nudity and received continuous calls from my supervisors," [said moderator Akash]. "Most of these half-naked pictures of minors are from the US or Europe. I've received multiple warnings from my supervisors not to flag these videos. One of them asked me to 'man up' when I complained that these videos need to be discussed in detail."