The NGO Diary: Health Care and Victims of Human Trafficking

Health Care and Victims of Human Trafficking


I recently came across a petition asking people if they recognized a victim of trafficking? To that I would say, NO, we cannot recognize a victim of trafficking so easily unless and until there are circumstances which seem geographically, psychologically and emotionally disagreeable to a common individual.
But all too often, most human trafficking victims pass through the health care system unnoticed and unaided. Many medical professionals haven’t been trained to recognize the signs and symptoms of human trafficking and abuse. Ideally, doctors and nurses should know to be wary of controlling companions (traffickers, abductors/suitors) — and suspicious when patients do not speak for themselves or do not have control over their own identification documents. Other signs include marks of physical abuse, fearfulness, depression, and extreme submission.
In India, human trafficking victims – for example troubled young girls working as domestic workers, labourers, nannies would be seen going to local gynecologists on their own or forcibly taken by the controllers to get an abortion done. At this point of time, the doctor or the health practitioner is somewhat doubtful but not in full confidence of handling the situation well. Many a times there have been girls who were trafficked for work to a metropolitan city and they had to return back to their village/hometown to give birth. In this process, they get socially excluded, harassed and doubly vulnerable again to more such instances.
I want to draw your attention to the some “Visible Indicators of Trafficking in Person” given by the website – www.humantrafficking.org

Visible Indicators May Include:
* Heavy security at the commercial establishment including barred windows, locked doors, isolated location, electronic surveillance. Women are never seen leaving the premises unless escorted.
* Victims live at the same premises as the brothel or work site or are driven between quarters and “work” by a guard. For labor trafficking, victims are often prohibited from leaving the work site, which may look like a guarded compound from the outside.
* Victims are kept under surveillance when taken to a doctor, hospital or clinic for treatment; trafficker may act as a translator.
* High foot traffic especially for brothels where there may be trafficked women indicated often by a stream of men arriving and leaving the premises.
Trafficking victims are generally kept in bondage through a combination of fear, intimidation, abuse, and psychological controls. While each victim will have a different experience, they share common threads that may signify a life of indentured servitude. Trafficking victims live a life marked by abuse, betrayal of their basic human rights, and control under their trafficker. The following indicators in and of themselves may not be enough to meet the legal standard for trafficking, but they indicate that a victim is controlled by someone else and, accordingly, the situation should be further investigated.

Understand the profile of a trafficked person
What Is the Profile of a Trafficking Victim? Most trafficking victims will not readily volunteer information about their status because of fear and abuse they have suffered at the hands of their trafficker. They may also be reluctant to come forward with information from despair, discouragement, and a sense that there are no viable options to escape their situation. Even if pressed, they may not identify themselves as someone held in bondage for fear of retribution to themselves or family members. However, there are indicators that often point to a person held in a slavery condition. They include:
1. Health Characteristics of a Trafficked Person:
Trafficked individuals may be treated as disposable possessions without much attention given to their mental or physical health. Accordingly, some of the health problems that may be evident in a victim include:
* Malnutrition, dehydration or poor personal hygiene
* Sexually transmitted diseases
* Signs of rape or sexual abuse
* Bruising, broken bones, or other signs of untreated medical problems
* Critical illnesses including diabetes, cancer or heart disease
* Post-traumatic stress or psychological disorders
2. Other Important Signs:
In addition to some of the obvious physical and mental indicators of trafficking, there are other signs that an individual is being controlled by someone else. Red flags should go up for police or aid workers who notice any of the following during an intake. The individual:
* Does not hold his/her own identity or travel documents
* Suffers from verbal or psychological abuse designed to intimidate, degrade and frighten the individual
* Has a trafficker or pimp who controls all the money, victim will have very little or no pocket money
Questions to ask if you suspect you are in the presence of a trafficking victim
Screening Questions
1. Is the person free to leave the work site?
2. Is the person physically, sexually or psychologically abused?
3. Does the person have a passport or valid I.D. card and is he/she in possession of such documents?
4. What is the pay and conditions of employment?
5. Does the person live at home or at/near the work site?
6. How did the individual arrive to this destination if the suspected victim is a foreign national?
7. Has the person or a family member of this person been threatened?
8. Does the person fear that something bad will happen to him or her, or to a family member, if he/she leaves the job?
Anyone can report suspected trafficking cases to the responsible local authorities/NGO’s etc. If the victim is under 18, professionals who work in law enforcement, health care, social care, mental health, and education are mandated to report such cases. Through a grass-roots community-wide effort and public awareness campaign, more professionals on the front line can readily identify the trafficking victim and have him/her treated accordingly.

Contributed by Karuna Dayal in the Health Care Intelligence Forum
(The author is with Multiple Action Research Group in New Delhi and has extensive experience of dealing with trafficked victims during her association at Human Rights Law Network)