The Health Consequences of Human Trafficking

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 cooperating, 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,
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
STIs & 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,
condoms etc
Pharmaceuticals
Increased vulnerability to STIs
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 womens health &
well-being; negative impact of legal proceedings,

physical security
Appropriate collaboration of Government agencies,
health professionals, & NGOs
Trafficked women should not be subject to
mandatory medical inx, or procedures (eg. HIV)
GUIDING PRINCIPLES CONTD
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
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.

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THE HEALTH CONSEQUENCES

A state of complete physical, mental and social well-

being and not merely the absence of disease or

harbouring or receipt of persons by means of

It appears that most of the focus of policy makers has

TRAVEL & TRANSIT STAGE

The travel and transit stage begins at the time of

recruitment when a woman agrees to, or is forced to

The period that a woman is in the location where

she is put to work and subjected to coercion,

DETENTION, DEPORTATION & CRIMINAL

The period when a woman is in the custody of

police or immigration authorities for alleged

INTEGRATION & RE-INTEGRATION STAGE

The period that consists of a long-term and multi-

faceted process that is not completed until the

CONSEQUENCES: PHYSICAL HEALTH

degrading sexual acts

CONSEQUENCES: SEXUAL HEALTH

CONSEQUENCES: SEXUAL HEALTH

Intimidation of and threats

CONSEQUENCES: MENTAL HEALTH

Suicidal thoughts, self harm and suicide

Non-consensual administration & Coercive use of

CONSEQUENCES: SUBSTANCE ABUSE

Overdose, self-harm, death, suicide

SOCIAL RESTRICTION & MANIPULATION

Restricted movement, time, activities

CONSEQUENCES: SOCIAL WELL BEING

Feelings of isolation, loneliness, exclusion

ECONOMIC EXPLOITATION & DEBT

Re-Trafficked, enter into high risk relationships

CONSEQUENCES: ECONOMIC WELL-BEING

Inability to afford basic hygiene, nutrition, housing,

HARSH WORKING & LIVING CONDITIONS

CONSEQUENCES: OCCUPATIONAL HEALTH

GUIDING PRINCIPLES: HEALTH RIGHTS

well-being; negative impact of legal proceedings,

GUIDING PRINCIPLES CONTD

The right to privacy & confidentiality; interviews,

tests, treatments etc

The Health Risks and Consequences of Trafficking in

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