THE HEALTH CONSEQUENCES
OF HUMAN TRAFFICKING
DR. SHANE ALEXIS
HEALTH…
 A state of complete physical, mental and social well-
being and not merely the absence of disease or
infirmity”.
TRAFFICKING…
 “The recruitment, transportation, transfer,
harbouring or receipt of persons by means of
threat or use of force or other forms of
coercion, of abduction, of fraud, of deception,
of the abuse of power, or of a position of
vulnerability or of the giving or receiving of
payments or benefits to achieve the consent of
a person having control over another person,
for the purpose of exploitation. Exploitation
shall include, at minimum, the exploitation of
prostitution of others or other forms of sexual
exploitation, forced labour or services, slavery
or practices similar to slavery, servitude or the
removal of organs.
5 STAGES OF TRAFFICKING…
1.
2.
3.
4.
5.
Pre-departure Stage
Travel & Transit Stage
Destination Stage
Detention, Deportation, Criminal Evidence Stage
Integration, Re-Trafficking & Re-Integration Stage
It appears that most of the focus of policy makers has
been towards the legal and immigration
considerations and not the health concerns of
Human Trafficking.
PRE-DEPARTURE STAGE
“The period before a woman enters the trafficking
situation.”
 Personal history; chronic illness, violence,
reproductive health
 Quality of health services & health promotion
 Epidemiological & Socioeconomic conditions
TRAVEL & TRANSIT STAGE
 “The travel and transit stage begins at the time of
recruitment when a woman agrees to, or is forced to
depart with a trafficker (whether she is aware that
she is being trafficked or not). This stage ends when
she arrives at her work destination. It includes travel
between work destinations and often involves one or
numerous transit points.”
DESTINATION STAGE
 “The period that a woman is in the location where
she is put to work and subjected to coercion,
violence, exploitation of her labour, debt-bondage or
other forms of abuse associated with trafficking.”
DETENTION, DEPORTATION & CRIMINAL
EVIDENCE STAGE
 “The period when a woman is in the custody of police
or immigration authorities for alleged violation of
criminal or immigration law, or co-operating,
voluntarily or under threat of prosecution or
deportation, in legal proceedings against a trafficker,
pimp or madamme, exploitative employer or other
abuser.”
INTEGRATION & RE-INTEGRATION STAGE
 “The period that consists of a long-term and multi-
faceted process that is not completed until the
individual becomes an active member of the
economic, cultural and civil and political life of a
country and perceives that she has oriented and is
accepted.”
PHYSICAL ABUSE
 Murder
 Physical Attacks – beatings, knifing etc
 Torture – ice baths, cigarette burns etc
 Physical Deprivation- sleep, food, light etc
 Physical Restraint – ropes, cuffs, chains etc
 Withholding Medical or Essential care
CONSEQUENCES: PHYSICAL HEALTH
 Death
 Acute or Chronic Physical Injuries
 Acute or Chronic Physical Disabilities
 Fatigue
 Poor nutrition
 Deterioration of pre-existing conditions leading to
illness or death
SEXUAL ABUSE
 Forced vaginal, oral, or anal sex, gang rape,
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degrading sexual acts
Forced prostitution, inability to control number or
acceptance of clients
Forced unprotected sex, and sex without lubricants
Unwanted pregnancy, forced abortion, unsafe
abortion
Sexual humiliation, forced nakedness
Coerced, missuse of oral contraceptives or other
methods
CONSEQUENCES: SEXUAL HEALTH
CONSEQUENCES: SEXUAL HEALTH
 HIV/AIDS
 STI’s & related complications
 Amenorrhea & Dysmenorrhea
 Acute or chronic pain during sex
 Tearing & other damage to vaginal tract
 Negative outcomes from unsafe abortion
 Irritable bowel syndrome
 Inability to negotiate sexual encounter
PSYCHOLOGICAL ABUSE
 Intimidation of and threats
to women
 Lies, deception & blackmail
to coerce women
 Emotional manipulation
CONSEQUENCES: MENTAL HEALTH
 Suicidal thoughts, self harm and suicide
 Chronic Anxiety, sleep disturbances
 Memory loss, memory defects and dissociation
 Somatic complaints
 Depression, frequent crying, withdrawal
 Aggressiveness, violent outbursts etc
 Substance abuse, addiction
 Loss of trust
 Changes in self esteem, guilt, shame
 Difficulty maintaining intimate relationships
SUBSTANCE ABUSE
Non-consensual administration & Coercive use of
alcohol or drugs in order to:
1. Abduct, rape, or prostitute women
2. Control activities
3. Coerced compliance
4. Decreased self protective defenses, increased
compliance
5. Prevent women from leaving or escaping
CONSEQUENCES: SUBSTANCE ABUSE
 Overdose, self-harm, death, suicide
 Participation in unwanted sexual acts
 Addiction
 Brain or liver damage
 Needle introduced infections
 Dependence on drugs, alcohol or cigarettes to cope
SOCIAL RESTRICTION & MANIPULATION
 Restricted movement, time, activities
 Frequent relocation
 Absence of social support, denial
 Loss of contact with family, friends
 Emotional manipulation by boyfriend
 Denial of privacy
CONSEQUENCES: SOCIAL WELL BEING
 Feelings of isolation, loneliness, exclusion
 Inability to maintain supportive relationships
 Poor overall health; lack of exercise
 Vulnerability to infection
 Difficulty with reintegration, shunned, rejected by
family etc
ECONOMIC EXPLOITATION & DEBT
BONDAGE
 Re-Trafficked, enter into high risk relationships
 Economic exploitation and debt bondage
 Turning women over to immigration, police
 Forced to accept long hours, number of clients
CONSEQUENCES: ECONOMIC WELL-BEING
 Inability to afford basic hygiene, nutrition, housing,
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condoms etc
Pharmaceuticals
Increased vulnerability to STI’s
Punishment – retribution for escaping
Rejection
HARSH WORKING & LIVING CONDITIONS
 High Risk, Abusive Working & Living Conditions
 Long work hours
 Dangerous working & living conditions
 Punishment
CONSEQUENCES: OCCUPATIONAL HEALTH
Occupational & Environmental Health: Vulnerability to infection, parasites, communicable
diseases
 Exhaustion
 Poor nutrition
 Injuries & anxiety
GUIDING PRINCIPLES: HEALTH RIGHTS
 The right to health of trafficked women
 State authorities must ensure women’s health & well-
being; negative impact of legal proceedings, physical
security
 Appropriate collaboration of Government agencies,
health professionals, & NGO’s
 Trafficked women should not be subject to
mandatory medical inx, or procedures (eg. HIV)
GUIDING PRINCIPLES CONT’D
 The right to privacy & confidentiality; interviews,
tests, treatments etc
 The right of trafficked women to their Medical &
Health Records
 The right to timely forensic exams & relevant reports
to pursue cases of rape, physical violence
GENERAL RECOMMENDATIONS
 Recognize trafficking as a health issue
 Recognize trafficked women & adolescents rights to
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health services
Develop health & health related prevention &
intervention strategies
Increase awareness of health risks & consequences
Fund, develop & implement training & education
programs
Strengthen public health promotion campaigns
DISCUSSION
REFERENCES
“The Health Risks and Consequences of Trafficking in
Women and Adolescents” (Cathy Zimmerman;
2003).
THANK YOU.