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Introduction: Human trafficking has received increasing global attention over the past decade. Initially, trafficking of women and girls for forced sex work and, to a lesser extent, domestic servitude, were the sole focus of advocacy and assistance. Today, there is recognition that women, children and men are trafficked into many different forms of labor, and for sexual exploitation.

Labor-related trafficking occurs in a wide range of sectors, such as agriculture, fishing, manufacturing, mining, forestry, construction, domestic servitude, cleaning and hospitality services. Trafficked people may also be forced to work as beggars or soldiers, and women and children can be made to serve as ‘wives’.

Definitions of trafficking vary in practice within and among sectors involved with policy, service entitlements, criminal justice and research. However, the most widely accepted definition of human trafficking is found in the United Nations “Protocol to Prevent, Suppress and Punish Trafficking in Persons”, which is: ‘The recruitment, transportation, transfer, harboring or receipt of persons, by means of the 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.’


How common is human trafficking?

Precise figures at the global or even local level remain elusive. Reliable data on trafficking are difficult to obtain owing to its illegal, often invisible, nature; the range and severity of trafficking activities; and variations in how trafficking is defined. These and other factors also blur the distinction between trafficked persons, extremely vulnerable migrants and exploited laborers. Individuals may be trafficked within their own country or across international borders. Trafficking is reported to involve nearly every part of the world – as places of origin/recruitment, transit or destination – and this illegal trade in humans is believed to reap enormous profits for trafficking agents. Although women, men and children may all be trafficked for various purposes, trafficking is often a ‘gendered’ crime. Current evidence strongly suggests that those who are trafficked into the sex industry and as domestic servants are more likely to be women and children. Reports on trafficking of males indicate that men and boys are more commonly trafficked for various other forms of labor, and that these trafficking sectors generally differ by country or region.


What are the health effects of human trafficking?

To date, evidence on health and human trafficking is extremely limited. A systematic review published in 2012 identified 16 studies, all of which focused on the violence and health problems experienced by trafficked women and girls. Most studies focused on trafficking for forced sex work and only two included data on trafficking for labor exploitation. The health-service needs of victims and survivors have received woefully limited attention – particularly when compared with law-enforcement and immigration responses to trafficking. Because research on health and trafficking has been conducted almost exclusively on sexual exploitation, evidence generally focuses on sexual health (especially related to HIV), and, to a lesser degree, mental health. Knowledge about the health risks and consequences among people trafficked for non-sexual purposes remains scarce. Many trafficking studies rely on data from case-records from services providing care to repatriated sex-trafficked girls and women. Data have been collected on, for example, HIV status or other sexually transmitted infections (STIs) and health conditions such as tuberculosis .

There have also been a small number of studies conducted with women who were still in sex work settings, but the application of varying criteria on who was ‘trafficked’ means it is difficult to draw reliable conclusions. At each stage, women, men and children may encounter psychological, physical and/or sexual abuse; forced or coerced use of drugs or alcohol; social restrictions and emotional manipulation; economic exploitation, inescapable debts; and legal insecurities. Risks often persist even after a person is released from the trafficking situation and only a small proportion of people reach post-trafficking services or receive any financial or other compensation.


What are the best approaches to deal with human trafficking?

For policy-makers and other decision-makers

At a policy level, regulatory steps are needed to increase awareness of the risks of human trafficking, especially among individuals intending to migrate. Migrant workers in destination settings should have the same protections and legal redress mechanisms as those in the domestic workforce. Recent positive developments include the 2011 adoption of the Convention on Domestic Workers, which includes special measures to protect vulnerable members of this employment group, and the Dhaka Principles, a guide for companies on responsible recruitment and employment of migrant workers. Governments should mandate acute and longer-term provision of health care to trafficked persons. This could be achieved, for example, by granting such individuals immediate rights to state-supported health services, regardless of their ability to pay or willingness to participate in a criminal action against traffickers, and committing the necessary financial and human resources.

For health-care providers

Health care providers and organizations involved with trafficked persons should increase their capacity to identify and refer people in trafficking situations and provide sensitive and safe services to people post-trafficking. Examples of support for health practitioners working with trafficked people include Caring for trafficked persons: guidance for health providers, a guide by the International Organization for Migration and the London School of Hygiene and Tropical Medicine and Human trafficking – key messages for primary care practitioners, an online resource provided by the Health Protection Agency in England.

researches and funding agencies.

Empirical research on human trafficking is limited. Particularly lacking are studies on larger, more potentially representative samples of trafficked people, and longer-term studies to better understand post-trafficking health changes. Empirical data on trafficking of men, their health needs and service access, is especially scarce. Similarly, more data are needed on trafficking across the full range of labor sectors involved. Rigorous evaluation studies of policies and programmers are needed to identify the most effective counter-trafficking strategies and most appropriate care for the people affected.

Assistant professor in English at Mehran university of engineering and technology Jamshoro


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