They also note several obstacles to a victim's disclosure of the trafficking situation, including fear for themselves or their families, shame, a language barrier, concern that they would be ridiculed or not believed, and the limited interaction between the victim and health care staff. This limited interaction can often be attributed to the behavior of traffickers who accompany and speak on behalf of the victim or seek to monitor or control the victim's communication during the health care visit.
To ensure that health care services are not a missed opportunity for victim identification, training must go beyond raising awareness of the plight of victims and recognizing the signs of human trafficking. It should also cover guidance on interacting with potential victims, interviewing techniques, recommended responses, and resources. There was less agreement in the literature, however, about what a human service provider should do in response to a suspected case, including how providers should interact with potential victims, how they should screen for sex trafficking safely and sensitively in the context of a single encounter, and what their immediate response should be once a sex trafficking victim is identified.
Acknowledging that these are topics for further practice development and research, studies agree that human service providers should have more training on victim identification and resources for trafficking victims before undertaking screening strategies. A publication designed for an international audience of health care providers, Caring for Trafficked Persons: Guidance for Health Providers , 29 provides more detailed guidance to help all types and levels of health care providers meet the challenges of diagnosing and treating trafficked persons.
It discusses the health problems associated with sex trafficking and labor trafficking, the risks and safety issues when encountering a suspected trafficking situation, and safe and appropriate approaches to providing health care for trafficked persons.
It has been translated into Arabic, Chinese, and Spanish. Building on this effort, the U. State Department's TIP Office supported the development of the companion training facilitator's guide, Caring for Trafficked Persons: Guidance for Health Providers, Facilitator's Guide , 30 to promote wider training of health care professionals globally. For instance, the Belgian government has a cooperation project with hospitals to improve detection of trafficking victims who may be seeking medical treatment; preliminary findings of the project indicate that victims are more willing to talk to medical staff than to police.
Secretary of State John Kerry in , is also working to expand the knowledge base of health professionals working on human trafficking and to link them with others doing similar work. CAST supports the exchange of trafficking and health-related information across an interdisciplinary network of health professionals physicians, nurses, dentists, psychologists, counselors, public health workers, health educators, researchers, social workers, administrators, and other health professionals through its website: www.
The purpose is to share best practices, expand evidence-based practices, and promote improved systems of care for victims of human trafficking. Restoring the physical and mental health of trafficking survivors is a critical part of protection and assistance services, and the role of global health professionals in meeting this challenge is evolving rapidly.
Researchers and clinicians have called for more specialized education and training for health care professionals, the development of new protocols for the identification of trafficking victims in health care settings, culturally sensitive and safe procedures for responding when a victim is identified, and the provision of comprehensive care post-trafficking. While modern slavery is unique in its manifestations and impact on victims, global health professionals are encouraged to build on lessons learned from decades of experience shaping the public health response to other forms of abuse, such as domestic violence, in order to improve and expand upon current practices.
In addition, global health professionals are uniquely positioned to conduct research on the epidemiology of human trafficking, as well as to evaluate the effectiveness of various treatment approaches and direct services provided to victims of trafficking. Depending upon their specialty and position, global health professionals can provide leadership and can contribute in numerous ways to improve the response to human trafficking, only a few of which are listed below:.
Become informed about the contexts in which human trafficking is found today and be able to identify a person who may be a victim of human trafficking.
Trafficking in Persons Report
Develop and teach human trafficking courses in education and training programs for health professionals who serve in a wide range of health care settings and who may come into contact with victims of human trafficking or be called on to support services for victims. Such training is needed for the full range of health professionals, including physicians, nurses, physician assistants, dentists, psychologists, social workers, drug abuse counselors, health administrators, and others.
Build on the existing body of human trafficking-related research and evaluation by conducting studies that examine key health issues resulting from human trafficking and that explore effective means of health care delivery. Become informed about local laws and government policies and procedures related to human trafficking, and identify ways to improve health-related responses and the delivery of comprehensive, coordinated services for survivors.
Establish linkages with interagency partners that have responsibility for policies and procedures related to human trafficking, and participate in interagency task forces and other efforts aimed at developing coordinated, interdisciplinary anti-trafficking protocols. Work to develop trauma-informed policies and procedures in health care delivery settings that ensure recognition of the signs of human trafficking, the establishment of protocols to follow for suspected cases of human trafficking, linkages with appropriate resources, and staff training to ensure implementation.
Work with NGOs and faith-based communities that are providing services to survivors of human trafficking to help expand and improve services to address the physical and mental health needs of survivors. Join or create an online network of health professionals to share information on challenges and advances in health care responses to human trafficking. Vannak Prum's journey to freedom described earlier is an inspiration, and his unique contributions to ending modern slavery reflect the resilience displayed by many survivors of horrendous abuses suffered at the hands of traffickers.
His experience also highlights the challenges we face going forward.
Combating trafficking in persons: a call to action for global health professionals
From the time he escaped the fishing boat on which he was enslaved, Mr. Prum encountered police, nurses, doctors, and jailers who did not recognize his circumstances to be those of human trafficking.
Most of the people with whom he came in contact did not see him as a trafficking victim in need of help, but rather as an illegal alien, a migrant worker, or an arrestee. The tragedy of Mr. Prum's situation going unrecognized, untreated, and unserved is repeated countless times every day around the world.
With in-depth training, improved protocols, and enhanced interagency coordination, health professionals can change previously missed opportunities into concrete steps toward our common goal—a world without slavery. Combating trafficking in persons: a call to action for global health professionals.
Glob Health Sci Pact. National Center for Biotechnology Information , U. Glob Health Sci Pract. Published online Jul 8. Luis CdeBaca a U. Jane Nady Sigmon a U. Author information Article notes Copyright and License information Disclaimer. Correspondence to Jane Nady Sigmon vog. Received Sep 26; Accepted May This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited.
This article has been cited by other articles in PMC. A report from the International Labour Organization ILO provided additional information about the victims of human trafficking 1 : An estimated 21 million to 30 million people worldwide are living in servitude. The majority of victims of human trafficking are women and girls. Most countries prohibit human trafficking, but it remains a hidden crime. Depending upon their specialty and position, global health professionals can provide leadership and can contribute in numerous ways to improve the response to human trafficking, only a few of which are listed below: Become informed about the contexts in which human trafficking is found today and be able to identify a person who may be a victim of human trafficking.
Notes Competing Interests : None declared. ILO global estimate of forced labour: results and methodology. Geneva: ILO; Walk Free Foundation.
The global slavery index Department of State. Trafficking in persons report, June Washington DC : U. Department of State; Department of State: diplomacy in action [Internet]. Department of State; Dec 3 [cited Apr 14]. What is modern slavery? United Nations Treaty Collection [Internet]. New York: United Nations; c Protocol to prevent, suppress and punish trafficking in persons, especially women and children, supplementing the United Nations Convention against Transnational Organized Crime; Nov 15 [cited Apr 11]; [about 11 screens].
The Protection Project review of the trafficking in persons report. Understanding human trafficking in the United States. Trauma Violence Abuse. Listening to victims: experiences of identification, return and assistance in South-Eastern Europe. Rosenberg R. Trafficking of adult men in the Europe and Eurasia region: final report. Co-published by JBS International. Surtees R. Trafficking of men — a trend less considered: the case of Belarus and Ukraine. Geneva: International Organization for Migration; Trafficked men as unwilling victims. The health of trafficked women: a survey of women entering posttrafficking services in Europe.
Am J Public Health. The relationship of trauma to mental disorders among trafficked and sexually exploited girls and women. HIV prevalence and predictors of infection in sex-trafficked Nepalese girls and women. Prevalence and risk of violence and the physical, mental, and sexual health problems associated with human trafficking: systematic review.
PLoS Med. During police raids, victims are often treated as complicit in the trafficking activity and typically face rapid deportation.
For this reason, victims are hesitant to report trafficking and to seek help from service providers. Having NAPs or NRMs in place, however, is not sufficient to fully protect victims of human trafficking unless underlying laws are comprehensive enough to cover all types of victims.
For example, Myanmar has launched its second NAP for —16 but its legislation does not include male victims. This is also true of Cambodia and Laos, where men are particularly targeted for trafficking in the fishing industry. This means, for example, that male victims are not provided with shelters to escape from their abusers. Victim identification is not systematic and it is often left to NGOs to carry out investigations. This puts pressure on NGOs, which are typically constrained by access to funding. There are a number of reasons for this including the lack of institutional capacity among regional countries, asymmetric economic development, and low levels of democracy and a lack of transparency and the rule of law.
First, a particular challenge in building institutional capacity is that governments do not systematically collect data on human trafficking. The data that is collected is often not accurate or up to date. The absence of a national or regional database on human trafficking makes it difficult to design policies to tackle human trafficking. This is one area Australia can help with more through training local researchers. As Anne Gallagher has noted, the lack of accurate data has prevented Laos from identifying gaps in its legal structure for drafting anti-trafficking law.
Rapid growth in some countries has led to growing demand for unskilled labour, and with it constant flows of migrants and trafficked labour from less developed to more developed countries in the region. Relative wealth and the opportunity to send remittances home continue to be enticements that traffickers can use to coerce potential victims from poor villages into forced labour. This has an impact on the rights available to victims of trafficking who often need legal protection within host countries.
For example, the government of Myanmar denies citizenship to an estimated one million men, women and children from a particular ethnic group, increasing their vulnerability to trafficking. In Cambodia, under the highly corrupt Hun Sen regime, little is allocated for access to justice and social services for victims of human trafficking.
Australia has taken a whole-of-government approach to the issue of human trafficking in Asia. The Department of Immigration and Border Protection DIBP undertakes capacity-building activities and provides technical assistance to a number of countries to support efforts to address all forms of irregular migration, with particular focus on human trafficking and slavery.
Specialist immigration officers, who focus on human trafficking issues and aim to prevent trafficking in source countries, are posted in Thailand, China, the Republic of Korea, and the Philippines. DIBP also continues to build relevant capacity through activities including border assessments, alert systems design and implementation, and development of border management systems including biometric capabilities, passport systems, identity verification, legal and regulatory frameworks, and protection frameworks. Australia also has a range of bilateral agreements on human trafficking with Cambodia, Indonesia, Malaysia, Philippines, and Thailand, as at June Given some of the gaps in the regional anti-trafficking regime identified in the previous section, there are a number of areas where Australian support for anti-trafficking efforts could focus in coming years.
One area is the protection of victims. More work could be done on the third P — protection. As noted above, regional governments have made slow progress on the protection of trafficking victims. While prevention and prosecution are important, what most victims want is a safe return to their home communities and to find sustainable and safe employment there.
Without greater efforts on the sustainability of return, the risk is that returnees may once again become victims of trafficking and retrafficking. Greater support for victims is particularly important when it comes to the trafficking of children. Any support also needs to be tailored to their particular needs. Simply sending children back to school is often insufficient. In one study in , Save the Children found that only 25 per cent of school-age trafficked children wanted to go back to education after they were returned.
Diplomacy in Action
Recent findings from the Australian Institute of Criminology support this argument for Indonesian victims of human trafficking. In some ASEAN countries, the lack of provision for victim protection reflects broader capacity questions, but not in every case. Singapore, for example, has been slow on the prosecution of traffickers and exploitative employers, as well as on the protection of foreign victims.
Singapore only enacted its anti-trafficking legislation in and still has no NRM in place. However, there have been some positive developments over the past year. In order to strengthen NRMs, AAPTIP should further encourage states to come up with more participatory victim identification, rescue, and investigation processes, as well as reintegration programs.
The report also warranted strengthening victim-witness support services and piloting new models based on structured multi-agency memorandum of understanding between justice and victim support agencies, partnership agreements with the government social welfare authorities, or embedding a victim-witness coordinator within a justice agency. Within these two mechanisms, only a few programs have directly supported community outreach or engaged with local or regional companies. There are, however, some positive developments in recent years.
The Bali Process has also started recognising the role of businesses in this area. Human trafficking in Southeast Asia is a significant problem. Even if it does not affect Australia directly, its effects are felt through its connection with other types of forced and irregular migration that do concern Australia. Australia has already played a significant role in strengthening the anti-trafficking regime in the region.
However, as the analysis in this working paper has shown, within ASEAN states significant gaps remain in the implementation of legislation and policies to combat trafficking, especially in relation to victim protection and sustainable return. Preventing and prosecuting human traffickers should be the immediate priority for combating trafficking in persons in Southeast Asia. However, greater efforts aimed at protecting victims and reintegrating them back into their communities are also critical to building a sustainable anti-trafficking regime in the region over the long term.
Tier 1 indicates countries whose governments fully meet the minimum standards for the elimination of human trafficking under the US Trafficking Victims Protection Act TVPA , which are generally consistent with the Palermo Protocol. A Tier 3 ranking means countries whose governments do not fully meet the minimum standards and are not making significant efforts to do so. Google Tag Manager. Latest Research. Foreign territory: Women in international relations.
Behind the Veil: Women in jihad after the caliphate. Averting a global calamity? Trump and Xi at the G See all events. Australia in the World. Global Economy. Latest Articles, by Issue. Emerging Threats. Log in Sign up Back Login Sign up. Australia and the anti-trafficking regime in Southeast Asia. Reports 15 November