The Cause and Consequence of Human Trafficking: Human Rights Violations

Jacquelyn C.A. Meshelemiah and Raven E. Lynch

Columbus

The Cause and Consequence of Human Trafficking: Human Rights Violations by Jacquelyn Meshelemiah is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, except where otherwise noted.

This book was produced with Pressbooks.

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Dedication

This book is dedicated to “Queen” and every trafficking victim and survivor in the world. I know that you are out there and this book is intended to amplify your voice, describe your horrid experiences and to seek justice and action on your behalf. Human rights are a “right” and not a privilege.  Everyone deserves to live freely!

“branch” is licensed under CC0 1.0

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About the Authors

Dr. Jacquelyn C.A. Meshelemiah is a three-time alum of The Ohio State University. She currently holds a joint appointment as an Associate Professor in the College of Social Work and as a Faculty Fellow and Director of Leadership Initiatives for Women of Color in the Office of Diversity and Inclusion at The Ohio State University.  She earned her Bachelor of Science in Social Work (BSSW), Master of Social Work (MSW) and Doctorate (PhD) from the College of Social Work. She taught at the State University of New York (SUNY) at Buffalo (1995-1998) before returning to OSU in 1998. She is the author and co-author of numerous publications, presentations, and trainings on human rights and anti-trafficking work at the university, local, national and international levels. Professional travels have taken her to over half of the United States as well as to Africa, Europe, Asia and Central America in the capacity of a visiting scholar, presenter and researcher. Dr. Meshelemiah is a former Graduate Studies Chair, President and Provost’s Leadership Institute graduate, BSSW Program Director, MSW Program Director, President and Provost’s Council on Women (PPCW) Chair/Past Chair/Member, and Office of Academic Affairs (OAA) Faculty Fellow.

Raven E. Lynch, MSW, is a two-time alum and current PhD student at The Ohio State University, earning her BA in Psychology in 2014 and MSW in 2017.  She also serves as a Graduate Research Associate to Dr. Meshelemiah in the College of Social Work, and a Graduate Administrative Associate for Leadership Initiatives for Women of Color (LIWOC) in the Office of Diversity and Inclusion.  Her current research interests beyond human trafficking and human rights include racial identity and multiracial adolescents.

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Acknowledgements

Jacquelyn C.A. Meshelemiah

The writing of this book was partially funded by the Affordable Learning Exchange (ALX) program at The Ohio State University.  I am thankful for the weekly check-ins with Alexis Duffy who kept me on track and apprised me of tips to make my writing smoother.   I am also thankful to Dr. Tom Gregoire, the Dean of the College of Social Work, who allowed me time away from the classroom to write this book. My co-author, doctoral student, Graduate Research Associate, Graduate Administrative Associate, and mentee—Raven E. Lynch, thank you for writing this book with me.  I could not have written this book without you. You are simply amazing!!

My children—thank you for allowing me to write for hours at a time without interruptions while applauding me for caring so much about human rights and trafficked children, women and men.

My siblings—thank you for believing in your “smart”, “go-getter” and “focused” sister. I cannot ask for better siblings.  You are the best.

My friends—thank you for encouraging me to write this book.

My mom… I wish you were here to read this book.

Raven E. Lynch

To the Affordable Learning Exchange Program and the College of Social Work at The Ohio State University, I am so appreciative of the opportunity to co-write this book. Specifically, to Dr. Jacquelyn Meshelemiah, I thank you for choosing and putting your trust in me as a student to collaborate on such a big project, as well as your guidance and mentoring throughout this whole process.

My cohort friends and colleagues – thank you for all the reference suggestions, hours spent in coffee shops, and pep talks along the way!

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Introduction

This book, “The Cause and Consequence of Human Trafficking: Human Rights Violations” is a call for education and action.  The authors of this book are both social workers who are passionate about justice, human rights, and anti-trafficking work.  We have written this book in an effort to educate the reader about human trafficking and human rights violations from multiple lenses.

The book is broken down into six sections. They include:

1. Introduction to Human Trafficking

2. Sex Trafficking

3. Labor Trafficking

4. Various Forms of Human Trafficking

5. Action

6. Resources

The sections contain chapters that include an abstract, learning objectives, key words, definitions, content on a specific aspect of trafficking, images, interactive quiz items, a case study, a summary and supplemental learning materials.  Each chapter is intended to educate the reader, engage the reader and equip you with the tools (information, steps, etc.) to do something.  “Doing something” will look different from person to person, but this book is a call to action. We all can do something. As you read through this book, you will start to realize what you are able to do.

Section I is intended to give an Overview of Human Trafficking. Content includes social work’s background and charge to promote social justice and human rights; the United Nations Universal Declaration of Human Rights articles; landmark trafficking legislation; Trafficking in Persons (TIP) ratings, and theories to provide a context for human trafficking. This introductory chapter gives the reader the basics of human trafficking and human rights.

Section II covers Sex Trafficking. Content includes sex trafficking in the context of forced prostitution, the male entertainment industry, pornography and Domestic Minor Sex Trafficking. This section also contains a chapter on substance use and sex trafficking.

Section III covers Labor Trafficking and Supply Chains.  Common household products that most people consume on a regular basis will be discussed along with the behind the scenes processes in the making of the product as it relates to supply chains.

Section IV highlights Various Forms of Human Trafficking as it presents around the world. Content includes child brides, child soldiers and organ trafficking.

Section V includes content on how to go into Action mode based on a diverse range of trafficking situations. Chapters are on survivor led leadership, certification of foreign nationals who are sex trafficked, and  identifying trafficking victims in healthcare settings.

Section VI is a list of Resources available to deepen your understanding of human trafficking and to equip you with tools to take action.

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Preface

How Queen Changed My Career Trajectory

While living in Buffalo, I met a woman in 1996 who I will call, “Queen”.  She was a 26 year old African American female who had been forced into prostitution for 10 years prior to our meeting. Although I met her when she was 26, her story, however, goes back to when she was 16.  Back then, minors like Queen were called child prostitutes.  They were viewed as promiscuous girls, incorrigible youth, and kids who were “too grown for their own good”.  Well, Queen was not any of those things.  She was a child who met a man in his 20s, fell in love for the first time and was manipulated into believing whatever he said.  When Queen met and started to date “Marcus”, he gave her everything that she was not getting at home— security, attention, material things, a clean place to live, peace, good food and more importantly—love.  She fell hard and fast for Marcus. Their first few months together was a honeymoon.  Marcus was the best “boyfriend” that Queen could have hoped for.  She could not believe her good fortune.  Her life was now going to be better.  And it was—for a while. Then Marcus slowly started to criticize her, then he verbally abused her and then he progressed to the point of physically abusing her.  Queen was lost, confused and madly in love with Marcus.  Her world did not make sense.  Her home life made even less sense—returning there was not an option. So she stayed hoping and praying that the old Marcus would surface again.  Little did she know or understand that the emotional and physical abuse that she was enduring was about to be compounded with sexual violence.  Marcus violently raped her to let her know that she had better not “try” him. Then he started to “loan” her out to his relatives and friends.  He convinced her that if she really loved him, that she would “do this” for their family. After all, she had to “contribute” to the family too—as he put it. The sexual violence progressed quickly over a short period of time—she was later instructed to entertain his “boys” in groups at a time.  Now, she was a victim of gang rape.  Queen became depressed and hopeless after a short period of time.

As I sat in the audience as Queen told her story, I could feel my blood pressure rising. I was furious. I was outraged and I wanted to give Marcus a piece of mind.  No…wait, I wanted him in prison for life.  But wait, Queen was not done. She was not done telling her story.  By this time, she is crying while facing the audience. She was prompted to stop telling her story if doing so was re-traumatizing to her.  She insisted on continuing as she turned her body to the side.  The audience now sees her profile on stage.  She starts to gently bounce in a slow motion like she is shaking away the pain or something.  She is crying uncontrollably but yet she is not done telling her story.  I could feel the tears welling up in my eyes out of sheer compassion for her suffering.  She then tells the group how Marcus broke her spirit.  She goes on to tell us how Marcus decided to take his level of sexual violence to another level—a level that none of us in the room had ever heard of.  She told us that Marcus and his boys had started to film her having sex—but not sex with them because that would incriminate them in a court of law if the footage ever got leaked.  Instead, Marcus started to film Queen having sex with… DOGS!

When Queen said the word, “DOGS”, everyone started to look around with confused faces and asked in a whisper like voice, “Did she just say dogs?” We all thought she said dogs, but we could not believe that she had just said “dogs”.

“Let that sink in for a moment…a teenage girl was having sex with dogs in Buffalo, New York in the United States of America!”

“The Matthews-Northrup up-to-date map of Buffalo and Towns of Tonawanda, Amherst, Cheektowaga and West Seneca” by Norman B. Leventhal Map Center at the BPL is licensed under CC BY 2.0

Queen did not tell the group how long this went on, but she vividly described smelling the dog’s breath as he excitedly penetrated her, and how his nails would claw into her body as he steadied his footing during the thrusting. Keep in mind, dogs enter into other dogs from the back in a humping fashion.  The dogs that were used to violate Queen were groomed to have sex with women in a frontal opening fashion so that she could see the animal violating her.  This was a particularly vile method used by Marcus to break down Queen.  She finishes her talk—still crying—with a comment to the effect, “I was a prostitute for 10 years before I was rescued”.

I remember yelling to myself, “That is not prostitution.  I don’t know what that is called, but that is NOT prostitution!” More importantly, I decided that day that I would commit my professional career to understanding “prostitution” and the element of “seasoning” victims because I was certain of two things: 1) that Queen was not the only one being forced to have sex with dogs by their “boyfriends” during the “seasoning ” stage, and 2) that what Queen had just described was not prostitution.

Unfortunately, years ahead, I was proven correct on both points. As for a name to capture the essence of what Queen lived through, two landmark pieces of legislation were enacted in 2000—which was four years after I had met Queen.  They were 1) the United Nations Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children, Supplementing the United Nations Convention Against Transnational Organized Crime and 2) the Victims of Trafficking and Violence Protection Act. According to these pieces of critical legislation, Queen would not have been a child prostitute or an adult prostitute.  She would have been identified as a trafficking victim had her victimization taken place during another time period.

The “Protocol”

The United Nations (UN) document is often referred to as the “Protocol”.  This international protocol defined human trafficking for the first time.  Article 3 of the said Protocol reads as follows:

a) Trafficking in persons shall mean the recruitment, transportation, transfer, harbouring 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 of 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 a minimum, the exploitation of the prostitution of others or other forms of sexual exploitation, forced labour services, slavery or practices similar to slavery, servitude or the removal of organs;

b) The consent of a victim of trafficking in persons to the intended exploitation set forth in sub paragraph (a) of this article shall be irrelevant where any of the means set forth in sub paragraph (a) have been used;

c) The recruitment, transportation, transfer, harbouring or receipt of a child for the purpose of exploitation shall be considered ‘trafficking in persons’ even if this does not involve any of the means set forth in sub paragraph (a) of the article;

d) ‘Child’ shall mean any person under eighteen years of age.

(United Nations, 2000, p.3)

Trafficking Victims Protection Act (TVPA)

The United States also released its first iterative of the Victims of Trafficking and Violence Protection Act in 2000. It has been reauthorized 5 times since then. This Act is best known for its section on trafficking, which is known as the Trafficking Victims Protection Act (TVPA). According to the TVPA, Severe Human Trafficking activities are primarily categorized as Sex trafficking or Labor trafficking.  Sex trafficking involves the elements: force, fraud or coercion. These means are used to induce others into commercial sex activities.  Force, fraud or coercion are not necessary elements for those less than 18 years of age given their minor status. Labor trafficking, through the use of force, fraud and coercion, involves making a person provide labor services for free; for far less than what was agreed upon; or under terms that were not agreed upon prior to employment (Okech, Morreau, & Benson, 2011; Meshelemiah, In Press; Pub. L. 106-386).

As for Queen…

Although I could not have known at that time that these pieces of legislation were in the making, I knew that someone needed to figure out a better term to describe Queen’s ordeal. Prostitution was by far—inadequate to say the least.

As for my other point on there being others like Queen who had been subjected to having sex with dogs, it is true.  Queen is not the only one—unfortunately.  I have since met other survivors while serving on panels discussing human trafficking.  No one has ever publicly disclosed this type of sexual violence to me since Queen, but women have come to me privately and thanked me for telling the audience about Queen because they too were subjected to the same thing as she.  As one survivor stated, “I couldn’t believe it when I heard her story.  I thought I was the only one. I had planned to go to my grave with my story because of the shame I still feel about having sex with dogs.”

Fast forward to 20+ years later, I am still committed to understanding “forced” prostitution (a.k.a. sex trafficking) to this day.  Little did I know that when I co-developed surveys to be used with men who buy sex (Johns), community residents, and women labeled as prostitutes in 1996 in Buffalo, New York that meeting Queen in my preparation for such research would change my life.  At the time, I thought I was simply going to develop some meaningful surveys, administer them to three diverse populations and get to know a few people along the way. Never did I imagine that I would spend the next two decades (and counting) shedding light on human trafficking.  Queen changed my life and set the stage for my entire career.  As for Queen, I never saw her again after that day, but I have met other sex trafficked women just like her. It is because of Queen and all of them that I do this work.

Dr. Jacquelyn C.A. Meshelemiah

References

Meshelemiah, J.C.A. (In Press). Training social workers in anti-trafficking service. International Handbook on Human Trafficking:  An Interdisciplinary and Applied Approach. Abingdon-on-Thames: Routledge/Taylor & Francis.

Okech, D., Morreau, W., & Benson, K. (2011). Human trafficking: Improving victim identification and service provision. International Social Work, 55(4), 488-503.

Pub. L. 106-386. (2000). Trafficking Victims Protection Act of 2000, H. R. 3244, (2000). 106th Cong., 2nd Sess.

United Nations. (2000). UN: Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children, Supplementing the UN Convention against Transnational Organized Crime, 2000. International Documents on Corporate Responsibility.

Overview of Human Trafficking Section

This section is intended to give an overview of Human Trafficking. Content includes social work’s background and charge to promote social justice and human rights; the United Nations Universal Declaration of Human Rights articles; landmark trafficking legislation; Trafficking in Persons (TIP) ratings, and theories to provide a context for human trafficking. This introductory chapter gives the reader the basics of human trafficking and human rights.

“Human Trafficking Awareness” by The ACF Photo Gallery is licensed under CC BY-NC 2.0

Chapter 1: Social Work, Social Justice, Human Rights and Human Trafficking

ABSTRACT

Trafficking in Persons, which is commonly known as human trafficking, is a human rights issue that is grossly misunderstood and mostly undetected. It is a criminal enterprise that is estimated to impact millions of individuals and families around the world. The lack of identification of victims by victims, law enforcement, the general public and service providers plays a major role in the clandestine nature of human trafficking. Social workers, however, must take on a more proactive role in addressing human trafficking.

Learning Objectives

By the end of this chapter, the student will be able to:

- Understand social work as a profession

- Define trafficking in persons as stipulated by the United Nations Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children, Supplementing the United Nations Convention Against Transnational Organized Crime

- Define human rights in accordance with the United Nations Universal Declaration of Human Rights (UN UDHR)

Key Words: Social Work, Social Justice, Trafficking in Persons, Human Rights

GLOSSARY

Social Work: A profession that is charged with promoting social justice and preserving human rights; persons who work under the umbrella of social work are called social workers. They are licensed/certified persons with college degrees from accredited institutions of higher learning—primarily from units that offer social work programs

Social Justice: Social justice is the view that everyone deserves equal economic, political and social rights and opportunities

Trafficking in Persons: Trafficking in persons shall mean the recruitment, transportation, transfer, habouring 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 of receiving of payments or benefits to achieve the consent of a person having control over another person, for the purpose of exploitation

Human Rights: Basic rights and freedoms that all people are entitled to regardless of nationality, sex, national or ethnic origin, race, religion, language or other status

Social Work, Social Justice, Human Rights and Human Trafficking

Social work began over 100 years ago with Mary Richmond who founded the Charity Organization Society (COS) and Jane Addams who founded the settlement house movement (Lesser & Pope, 2007; Tannenbaum & Reisch, 2001). Specifically, COS came into existence in 1877 in Buffalo, New York under the leadership of Mary Richmond (COS) while Jane Addams opened the Hull House in Chicago, Illinois in 1889.  The Charity Organization Society was responsible for sending out “friendly visitors” to European immigrant communities to help them assimilate into American culture. They were the profession’s first case managers.  Mary Richmond also established the first school of social work at Columbia in 1898 (Segal, Gerdes, & Steiner, 2013). Jane Addams, on the contrary, felt strongly that it was important to live among the people she was to serve.  As a result, she founded the Hull House where social services could be delivered right in the heart of the community where clients lived.  She was an innovative agent of change and an activist who was unwavering in her pursuit of justice (civil, social, political, legal, and economic) and empowerment of all (Addams, 1959; Gil, 2013; Meshelemiah, 2016, in Press).

JANE ADDAMS

One of social work’s first activists.

Despite their opposing approaches to social justice as founders of social work, both Jane Addams and Mary Richmond sought to serve vulnerable groups of people. Unlike Mary Richmond, however, Jane Addams embraced social action and macro approaches to advocacy by speaking out against World War I, environmental injustices (i.e., garbage removal in poor communities), child workers, the lack of a juvenile justice system, women’s right to vote, adult education, and the inhumane treatment of immigrants (Addams, 1959; Segal, Gerdes, & Steiner, 2013).  Despite Jane Addams’s legacy of confronting people and systems that oppress and marginalize vulnerable groups of people, the profession of social work in the 21st century is still not at the forefront of explicitly articulating its stance on human rights (Healy, 2008, 2015).  This includes the profession’s lack of involvement in anti-trafficking activities.  Human trafficking is a widespread form of modern day enslavement that strips victims of their human rights on a daily basis.  It is a form human profiteering (Alvarez & Alessi, 2012) that captured the attention of the United Nations and the United States in 2000 through its seminal pieces of legislation.

Severe Human Trafficking is a term that was officially coined and adopted in 2000 through the enactment of the Victims of Trafficking and Violence Protection Act (VTVPA).  This Act is best known for its subsection on human trafficking, which is known as the Trafficking Victims Protection Act (TVPA). Human trafficking activities are primarily categorized as Sex trafficking or Labor trafficking.  Sex trafficking involves the elements: force, fraud or coercion. These means are used to induce others into commercial sex activities.  Force, fraud or coercion are not necessary elements for those less than 18 years of age given their minor status. Labor trafficking, through the use of force, fraud and coercion, involves making a person provide labor services for free; for far less than what was agreed upon; or under terms that were not agreed upon prior to employment (Okech, Morreau, & Benson, 2011; Meshelemiah, in Press, Pub. L. 106-386).  It presents in the form of debt bondage, peonage, indentured servitude or slavery (Pub. L. 106-386). The most comprehensive definition of trafficking, however, is the one adopted by the UN Office of Drugs and Crime in 2000, which is known as the United Nations Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children, Supplementing the United Nations Convention Against Transnational Organized Crime (United Nations, 2000, p.3):

Article 3 of the said Protocol reads as follows:

1. a) Trafficking in persons shall mean the recruitment, transportation, transfer, habouring 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 of 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 a minimum, the exploitation of the prostitution of others or other forms of sexual exploitation, forced labour services, slavery or practices similar to slavery, servitude or the removal of organs;

2. b) The consent of a victim of trafficking in persons to the intended exploitation set forth in sub paragraph (a) of this article shall be irrelevant where any of the means set forth in sub paragraph (a) have been used;

3. c) The recruitment, transportation, transfer, harbouring or receipt of a child for the purpose of exploitation shall be considered ‘trafficking in persons’ even if this does not involve any of the means set forth in sub paragraph (a) of the article;

4. d) ‘Child’ shall mean any person under eighteen years of age.

Prevalence

Due to the clandestine nature of human trafficking, researchers rely on estimates and proxies when determining the prevalence of human trafficking.  The International Labor Organization (2014) espouses that there are at least 12.3 million people who are enslaved in some form worldwide – more than at any time in history. The Global Slavery Index estimates it to be over 40 million (Global Slavery Index, 2018). While there is no official estimate of the total number of persons who are human trafficked in the United States, Polaris estimates that the actual number of victims in the USA reaches into the hundreds of thousands when estimates of sex and labor trafficking are aggregated for adults and minors (Polaris, 2017). Since 2007, Polaris has received 156,312 calls related to suspected human trafficking activities, 11,601 web form completions, and 11,058 emails.  Of this number, 43,564 were rated as a high indicator for severe human trafficking while 45,241 were rated as a moderate indicator for severe human trafficking.  Those with a moderate indicator lacked details related to force, fraud and/or coercion (Polaris, 2017). Although not exactly precise in numbers, Polaris statistics serve as frequently quoted proxies for the prevalence of human trafficking in the United States.

The United States falls 134th out of 162 nations ranked for their trafficking estimates (Walk Free Foundation, 2013).  Although the USA’s count of human trafficked persons is based on the legal definition as espoused by the Trafficking Victims Protection Act (TVPA), the most frequently cited definition of trafficking is the one adopted by the United Nations Office of Drugs and Crime (UN, 2000; Zimmerman & Stockl, 2012).  As previously stated, this document is known as the United Nations Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children, Supplementing the United Nations Convention Against Transnational Organized Crime (United Nations, 2000).  The United States is a member state of the United Nations (United Nations, 2014) and is a signatory on this protocol (Hendrix, 2010). On a domestic level, the Trafficking Victims Protection Act (TVPA) of 2000 defines sex trafficking as commercial sex activities (CSA) that include forced prostitution in brothels, private homes, dancing bars, strip clubs, and massage parlors, for instance.  It also includes pornography (Meshelemiah & Sarkar, 2015; Public Law No. 106-386).

Regardless of which definition that one subscribes to, enslaving others is situated as wrong and illegal by all governments around the world.  Slavery, modern day slavery, trafficking in persons, and human trafficking are all interchangeable terms and refer to the same phenomenon.   It is estimated that 14,500 to 17,500 foreign nationals are trafficked into the United States annually (Fedina, Trease, & Williamson, 2008) as there is a high demand for “exotic” women in the United States (Robertson, 2012).  Other researchers estimate the number at a much higher rate by asserting that 45,000- 50,000 persons are trafficked into the USA annually (George, 2012; Miko & Park, 2001).  Most trafficked persons in the USA come from South East Asia and South Asia, followed by Central/Eastern Europe, Latin America, the Caribbean and Africa (Miko & Park, 2001; Okech, Morreau, & Benson, 2011). Since the inception of the TVPA, the focus of the anti-trafficking legal discourse in the United States has been primarily on foreign victims who are sex trafficked into the country (Public Law 106-386).  This focus on foreign national victims appears to be mainly the result of the fact that 83% of alleged human trafficking incidents in the United States involve sex trafficking allegations and nearly half of them are foreign nationals (Polaris, 2017; Sager, 2012). According to Polaris (2017), of the 8524 cases reported in 2017, 7067 involved women and girls; 5278 involved adults.  Of the 3457 identified by nationality, 1947 were identified as US citizens while 1510 were identified as foreign nationals.

Intersection Between Human Rights and Human Trafficking

Almost 30 years ago, the  International Federation of Social Workers (IFSW) declared social work to be a human rights profession (IFSW, 1988). Despite this proclamation, most social workers do not identify as human rights champions although social workers are inculcated with a value system that believes in promoting social justice given that the NASW Code of Ethics espouses that social workers must promote social justice (Healy, 2015; NASW, 1996, 2017). “Social justice is the view that everyone deserves equal economic, political and social rights and opportunities” (NASW, 2017a, paragraph 2) while human rights are broadly defined as the “basic rights and freedoms that all people are entitled to regardless of nationality, sex, national or ethnic origin, race, religion, language or other status” (Amnesty International USA, 2015, Human Rights section).  Specifically, social workers believe that all humans deserve to be treated with dignity and worth and afforded access to basic necessities as role modeled by our Founding Mothers. The social justice lens is quite apparent in the social work profession (Lesser & Pope, 2007; Segal, Gerdes, & Steiner, 2013). Somewhere along the way, however, social workers as a whole have failed to move along the spectrum of justice and evolve into agents who adopted the responsibility to understand and protect human rights. Transitioning to brokers of human rights has been slow in coming (Healy, 2008, 2015; Reichert, 2001).

Human Rights Articles

Many people do not recognize human trafficking as modern-day slavery, nor as a human rights issue. The authors argue that human trafficking must be understood as a human rights issue and approached accordingly in all policies and practices. This includes viewing access to social services as a human rights issue. Specifically, Article 25 of the United Nations Universal Declaration of Human Rights (UDHR) states that, “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services…” (United Nations, 1948, Article 25). The United Nations UDHR articles speak directly to living with basic necessities and accessing needed social services as a human right. When a person is under the power of control of another as shown in Figure A [the Power and Control Wheel], however, she or he is deprived of his or her human rights.

Figure A. Power and Control Wheel

In 1948, the United Nations painstakingly established the unarguable rights that every human is innately entitled to at birth through its 30 Articles in the Universal Declaration of Human Rights (UDHR) (United Nations, 1948). The signatories of this document (including the United States) intended to promote and commit to a mutual respect and recognition of dignity of all people. Many of the 30 Articles within the UDHR either directly or indirectly denounce and/or address the ramifications of slavery in its numerous forms, but two are arguably the most explicit: Article 4 states, “No one shall be held in slavery or servitude; slavery and the slave trade shall be prohibited in all their forms” (United Nations, 1948, Article 4); and Article 23 states that, “Everyone has the right to work, to free choice of employment, to just and favorable conditions of work…” (United Nations, 1948, Article 23). Modern day slavery is clearly in violation of these two UDHR’s. Pescinski (2015) asserts that a human rights approach to trafficking demands that the rights of trafficking victims serve as the impetus for all policies designed to benefit them. Okogbule (2013) concurs and states that human trafficking is a gross violation of human rights. He asserts that a human rights framework is an important legal mechanism for combating human trafficking.

The UN issued the Universal Declaration of Human Rights (UDHR) in 1948. The UN did this in an attempt to bring attention to the inalienable rights of all people (United Nations, 1948). The UDHR contains 30 articles.  These articles address civil, political, economic, social, and cultural rights (United Nations, 1948, Articles 1-30).  As seen in Figure B, Article I of the UDHR states that all humans are equal in dignity and worth. Articles 2–15 address political and individual freedoms. Articles 16–27 address economic, social, and cultural rights. Articles 28 and 29 address collective rights among and between nations and Article 30 states that no one can take away a person’s human rights (United Nations, 1948). See Figure B for a summary of the UN Universal Declaration of Human Rights. The complete wording of the Universal Declaration of Human Rights can be found at the end of this chapter.

Figure B. Universal Declaration of Human Rights Summary

Recommendations

Social work practice, by virtue of its mission and charge, aligns closely with the promotion of the Universal Declaration of Human Rights. Whether consciously recognized or not, social workers work daily to ensure and provide access to basic needs like food, housing, education, healthcare, and employment for the people they work with and work for. These service provisions are consistent with the promotion of human rights as stated in Articles 23 and 25 of the UDHR (Riches, 2002; United Nations, 1948). Despite these service provisions by social workers, it appears that social work students and practitioners view these activities as “helping” people, being a “do-gooder” or “just doing my job”.  In reality, however, providing access to basic necessities to people exceeds helping.  These activities are in direct accordance to imperatives of the Universal Declaration of Human Rights. It is time that social work educators start to emphasize the language around human rights by using it so frequently that “human rights” as a term becomes official nomenclature of the profession.

Education

The Council on Social Work Education (CSWE) accredits undergraduate and graduate social work programs throughout the United States and its territories.   Accreditation of these institutions is based on CSWE’s Educational Policy and Accreditation Standards (EPAS). All accredited programs must adhere to these standards.  The explicit curriculum requires programs to integrate a human rights perspective (as a component of its nine competency-based requirements).  The adoption of this component must be evident in an institution’s social work education (competency-based education) and the field practicum (field education) (CSWE, 2015; Meshelemiah, 2016). Students, educators, field education supervisors and practitioners must pay full attention to this language and buy into it as a part of their professional responsibilities.

CSWE requires that students work to Advance Human Rights and Social, Economic, and Environmental Justice.

Specifically, Competency 3 of the EPAS states that:

Social workers understand that every person regardless of position in society has fundamental human rights such as freedom, safety, privacy, an adequate standard of living, healthcare, and education.  Social workers understand the global connections of oppression and human rights violations, and are knowledgeable about theories of human need and social justice and strategies to promote social and economic justice and human rights.  Social workers understand strategies designed to eliminate oppressive structural barriers to ensure that social goods, rights, and responsibilities are distributed equitably and that civil, political, environmental, economic, social, and cultural human rights are protected.  Social workers: apply their understanding of social, economic, and environmental justice to advocate for human rights at the individual and system levels; and engage in practices that advance social, economic, and environmental justice (CSWE, 2015, pp. 7–8).

The charge around human rights and social work is clear.  It is time that social work’s paradigm reflects this directive. This text, The Cause and Consequence of Human Trafficking: Human Rights Violations, is intended to convey the importance of understanding how the violation of human rights is a cause and consequence of human trafficking. In other words, human rights violations are egregious and they compound destitution.  They deprive the man, woman and child of their basic humanity. Whenever any dimension of one’s humanity is deprived, it puts the person in a compromised state.  Compromised states lead to some degree of impairment, distress or suffering. Impairment, distress or suffering leads to a disequilibrium in a person’s life. In an effort to quiet that compromised state, the individual may unknowingly make decisions that further compromises his or her state of being or result in human trafficking.  These compromises can present in the form of an impoverished Sri Lankan husband who is denied the right to work so he takes out a predatory loan that leads to debt bondage. It could be an ostracized young widow from Ethiopia with no safety net who takes a domestic job abroad that leads to indentured servitude.  It could be the Romanian bride who is refused work due to her nationality so she decides to marry a foreigner abroad for love but is forced into selling her body instead. It could be the homeless Ugandan teenager who cannot pay school fees to attend school so he decides to join the army as a cook, but is forced to serve as a murderous child soldier instead; or it could be the Indian from a lower caste that cleans the sewage without a uniform or even gloves that decides to sell his kidney for a large amount of money but only ends up gravely ill and receiving only a fraction of the promised amount. In all of these scenarios, the person began in a compromised state due to human rights violations, became ensnared in some form of trafficking and then was subjected to further violations of human rights. This is how human rights deprivations work—they are full of consequences.

Quiz

An interactive or media element has been excluded from this version of the text. You can view it online here:
https://ohiostate.pressbooks.pub/humantrafficking/?p=23

An interactive or media element has been excluded from this version of the text. You can view it online here:
https://ohiostate.pressbooks.pub/humantrafficking/?p=23

Now, let’s shift gears and turn to a case study.

KIM

Much of her childhood was spent in poverty, and when she thinks of her life then, she says, “We were really poor. We could barely make ends meet. We needed money for my siblings’ education.” Kim was 12 years old and vulnerable to the lies of criminals whose only aim was to prey on and exploit her. Criminals like AJ. AJ was Kim’s neighbor, and he promised to put her in school if she moved with him to Manila. He even promised her a job to help her siblings pay their school fees. Never in their worst dreams did Kim’s parents think AJ would hurt her, so they allowed her to go with him. At first, nothing seemed wrong. In fact, Kim had a more comfortable life than she had ever experienced. AJ sent her to a good school and treated her well. But that was all about to change. A few months after Kim arrived at AJ’s home, he took a photo of her. A nude photo. Kim’s exploitation had begun. What started out as a nude photo turned into posing naked in front of a webcam, as well as sexual abuse by AJ himself. These horrific images were then streamed over the internet to pedophiles and predators across the world. This is cybersex trafficking. Kim endured this unimaginable pain for three years. She recalls the abuse and her fear of AJ, saying, “It was like he had a total grasp on me and it was so difficult to break away.” The abuse of Kim didn’t stop with online exploitation. One night, AJ brought Kim to a hotel, thinking it would be another night of selling Kim’s body to a stranger. Kim was also expecting another night of abuse, but when the hotel room door opened, she saw the faces of law enforcement officers. She was afraid she was going to be arrested, but IJM social workers on the scene were able to reassure Kim that she wasn’t in trouble. She was free, and AJ was the one being arrested.

(International Justice Mission [IJM], 2019 Case Study-verbatim account)

As shown in the case of Kim, trafficking can and sometimes do involve trusted neighbors pretending to care about the economics of one’s family only to have malevolent intentions from the onset. Fortunately, for Kim, AJ was arrested for his trafficking crimes—but not before he subjected her to three years of cybersex trafficking and sexual abuse.

Summary of Key Points

- Social workers are charged with promoting social justice.

- Social workers are charged with preserving human rights.

Supplemental Learning Material

Table 1. Universal Declaration of Human Rights

United Nations Universal Declaration of Human Rights

The Universal Declaration of Human Rights (UDHR) is a milestone document in the history of human rights. Drafted by representatives with different legal and cultural backgrounds from all regions of the world, the Declaration was proclaimed by the United Nations General Assembly in Paris on 10 December 1948 (General Assembly resolution 217 A) as a common standard of achievements for all peoples and all nations. It sets out, for the first time, fundamental human rights to be universally protected and it has been translated into over 500 languages.

Preamble

Whereas recognition of the inherent dignity and of the equal and inalienable rights of all members of the human family is the foundation of freedom, justice and peace in the world,

Whereas disr egard and contempt for human rights have resulted in barbarous acts which have outraged the conscience of mankind, and the advent of a world in which human beings shall enjoy freedom of speech and belief and freedom from fear and want has been proclaimed as the highest aspiration of the common people,

Whereas it is essential, if man is not to be compelled to have recourse, as a last resort, to rebellion against tyranny and oppression, that human rights should be protected by the rule of law,

Whereas it is essential to promote the development of friendly relations between nations,

Whereas the peoples of the United Nations have in the Charter reaffirmed their faith in fundamental human rights, in the dignity and worth of the human person and in the equal rights of men and women and have determined to promote social progress and better standards of life in larger freedom,

Whereas Member States have pledged themselves to achieve, in co-operation with the United Nations, the promotion of universal respect for and observance of human rights and fundamental freedoms,

Whereas a common understanding of these rights and freedoms is of the greatest importance for the full realization of this pledge,

Now, Therefore THE GENERAL ASSEMBLY proclaims THIS UNIVERSAL DECLARATION OF HUMAN RIGHTS as a common standard of achievement for all peoples and all nations, to the end that every individual and every organ of society, keeping this Declaration constantly in mind, shall strive by teaching and education to promote respect for these rights and freedoms and by progressive measures, national and international, to secure their universal and effective recognition and observance, both among the peoples of Member States themselves and among the peoples of territories under their jurisdiction.

Article 1.
All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood.

Article 2.
Everyone is entitled to all the rights and freedoms set forth in this Declaration, without distinction of any kind, such as race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status. Furthermore, no distinction shall be made on the basis of the political, jurisdictional or international status of the country or territory to which a person belongs, whether it be independent, trust, non-self-governing or under any other limitation of sovereignty.

Article 3.
Everyone has the right to life, liberty and security of person.

Article 4.
No one shall be held in slavery or servitude; slavery and the slave trade shall be prohibited in all their forms.

Article 5.
No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment.

Article 6.
Everyone has the right to recognition everywhere as a person before the law.

Article 7.
All are equal before the law and are entitled without any discrimination to equal protection of the law. All are entitled to equal protection against any discrimination in violation of this Declaration and against any incitement to such discrimination.

Article 8.
Everyone has the right to an effective remedy by the competent national tribunals for acts violating the fundamental rights granted him by the constitution or by law.

Article 9.
No one shall be subjected to arbitrary arrest, detention or exile.

Article 10.
Everyone is entitled in full equality to a fair and public hearing by an independent and impartial tribunal, in the determination of his rights and obligations and of any criminal charge against him.

Article 11.
(1) Everyone charged with a penal offence has the right to be presumed innocent until proved guilty according to law in a public trial at which he has had all the guarantees necessary for his defence.
(2) No one shall be held guilty of any penal offence on account of any act or omission which did not constitute a penal offence, under national or international law, at the time when it was committed. Nor shall a heavier penalty be imposed than the one that was applicable at the time the penal offence was committed.

Article 12.
No one shall be subjected to arbitrary interference with his privacy, family, home or correspondence, nor to attacks upon his honour and reputation. Everyone has the right to the protection of the law against such interference or attacks.

Article 13.
(1) Everyone has the right to freedom of movement and residence within the borders of each state.
(2) Everyone has the right to leave any country, including his own, and to return to his country.

Article 14.
(1) Everyone has the right to seek and to enjoy in other countries asylum from persecution.
(2) This right may not be invoked in the case of prosecutions genuinely arising from non-political crimes or from acts contrary to the purposes and principles of the United Nations.

Article 15.
(1) Everyone has the right to a nationality.
(2) No one shall be arbitrarily deprived of his nationality nor denied the right to change his nationality.

Article 16.
(1) Men and women of full age, without any limitation due to race, nationality or religion, have the right to marry and to found a family. They are entitled to equal rights as to marriage, during marriage and at its dissolution.
(2) Marriage shall be entered into only with the free and full consent of the intending spouses.
(3) The family is the natural and fundamental group unit of society and is entitled to protection by society and the State.

Article 17.
(1) Everyone has the right to own property alone as well as in association with others.
(2) No one shall be arbitrarily deprived of his property.

Article 18.
Everyone has the right to freedom of thought, conscience and religion; this right includes freedom to change his religion or belief, and freedom, either alone or in community with others and in public or private, to manifest his religion or belief in teaching, practice, worship and observance.

Article 19.
Everyone has the right to freedom of opinion and expression; this right includes freedom to hold opinions without interference and to seek, receive and impart information and ideas through any media and regardless of frontiers.

Article 20.
(1) Everyone has the right to freedom of peaceful assembly and association.
(2) No one may be compelled to belong to an association.

Article 21.
(1) Everyone has the right to take part in the government of his country, directly or through freely chosen representatives.
(2) Everyone has the right of equal access to public service in his country.
(3) The will of the people shall be the basis of the authority of government; this will shall be expressed in periodic and genuine elections which shall be by universal and equal suffrage and shall be held by secret vote or by equivalent free voting procedures.

Article 22.
Everyone, as a member of society, has the right to social security and is entitled to realization, through national effort and international co-operation and in accordance with the organization and resources of each State, of the economic, social and cultural rights indispensable for his dignity and the free development of his personality.

Article 23.
(1) Everyone has the right to work, to free choice of employment, to just and favourable conditions of work and to protection against unemployment.
(2) Everyone, without any discrimination, has the right to equal pay for equal work.
(3) Everyone who works has the right to just and favourable remuneration ensuring for himself and his family an existence worthy of human dignity, and supplemented, if necessary, by other means of social protection.
(4) Everyone has the right to form and to join trade unions for the protection of his interests.

Article 24.
Everyone has the right to rest and leisure, including reasonable limitation of working hours and periodic holidays with pay.

Article 25.
(1) Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.
(2) Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection.

Article 26.
(1) Everyone has the right to education. Education shall be free, at least in the elementary and fundamental stages. Elementary education shall be compulsory. Technical and professional education shall be made generally available and higher education shall be equally accessible to all on the basis of merit.
(2) Education shall be directed to the full development of the human personality and to the strengthening of respect for human rights and fundamental freedoms. It shall promote understanding, tolerance and friendship among all nations, racial or religious groups, and shall further the activities of the United Nations for the maintenance of peace.
(3) Parents have a prior right to choose the kind of education that shall be given to their children.

Article 27.
(1) Everyone has the right freely to participate in the cultural life of the community, to enjoy the arts and to share in scientific advancement and its benefits.
(2) Everyone has the right to the protection of the moral and material interests resulting from any scientific, literary or artistic production of which he is the author.

Article 28.
Everyone is entitled to a social and international order in which the rights and freedoms set forth in this Declaration can be fully realized.

Article 29.
(1) Everyone has duties to the community in which alone the free and full development of his personality is possible.
(2) In the exercise of his rights and freedoms, everyone shall be subject only to such limitations as are determined by law solely for the purpose of securing due recognition and respect for the rights and freedoms of others and of meeting the just requirements of morality, public order and the general welfare in a democratic society.
(3) These rights and freedoms may in no case be exercised contrary to the purposes and principles of the United Nations.

Article 30.
Nothing in this Declaration may be interpreted as implying for any State, group or person any right to engage in any activity or to perform any act aimed at the destruction of any of the rights and freedoms set forth herein.

United Nations. (1948). United Nations Universal Declaration of Human Rights. New York: Author.

References

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Meshelemiah, J.C.A. (2016). Human rights perspectives in social work education and practice.  Encyclopedia of Social Work. Washington, DC: National Association of Social Workers Press/Oxford University Press.

Meshelemiah, J.C.A. & Sarkar, S. (2015). A comparative study of child trafficking in India and the United States. Journal of Trafficking: Organized Crime and Security, 1(2), 126-137.

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Chapter 2: Landmark Policies in Trafficking in the USA and Trafficking in Persons Ratings Across the Globe

ABSTRACT

The Trafficking Victims Protection Act (TVPA) and its subsequent reauthorizations are landmark polices in the United States of America.  Along with the TVPA, annual Trafficking in Persons (TIP) reports detail the efforts of over 100 countries and their attempts at eliminating trafficking in persons. This chapter will discuss the TVPAs and the ranking of TIP reports.

Learning Objectives

By the end of this chapter, the student will be able to:

- Understand the basic tenets o f Trafficking Victims Protection Acts

- Describe the purpose of Trafficking in Persons reports

- Understand TIP ratings

Key Word: Trafficking in Persons

GLOSSARY

Trafficking in Persons [TIP]: The recruitment, transportation, transfer, habouring 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 of receiving of payments or benefits to achieve the consent of a person having control over another person, for the purpose of exploitation

Trafficking Victims Protection Acts (TVPA)

This chapter will examine the Trafficking Victims Protection Act (TVPA) of 2000 and its subsequent reauthorizations in 2003, 2005, 2008, 2013 and 2017 that were implemented to combat trafficking in persons.  The TVPA is a seminal piece of federal legislation. Before the landmark Trafficking Victims Protection Act (TVPA) in 2000, however, there was the 13th Amendment in 1865 that abolished the slavery of Africans and their descendants (except for any person who is imprisoned).  The TVPA attempts to prevent and protect all victims of modern day slavery, who are outside the penal system.

According to the TVPA, sex trafficking involves the recruitment, harboring, transportation, provision, or obtaining of a person for the purpose of a commercial sex act (CSA), in which a CSA is induced by force, fraud, or coercion, or in which the person induced to perform such act has not attained 18 years of age. Labor trafficking involves the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud, or coercion, for the purpose of subjection to peonage, debt bondage, involuntary servitude or slavery (Pub. L. 106-386).

The first Trafficking Victims Protection Act has evolved since its inception in 2000.  More populations are included in subsequent reauthorizations and attempts at better protecting victims and prosecuting perpetrators are indicated in language and approaches in the revised Acts.  The following is a summary of these Acts.

Summaries of Trafficking Victims Protection Acts

Pub. L. 106-386. (2000). Trafficking Victims Protection Act of 2000, H. R. 3244, (2000). 106th Cong., 2nd Sess. Retrieved from https://www.congress.gov/106/plaws/publ386/PLAW-106publ386.pdf

This is the first of several federal laws enacted in the United States of America that has been put into place to address human trafficking. Specifically, it was enacted to protect trafficking victims and punish traffickers. Its three thrusts include: protection, prosecution and prevention (ATEST, 2017). This Act is 86 pages in length.

Pub. L. 108-193. (2003). Trafficking Victims Protection Reauthorization Act of 2003, 108th Cong., 1st Sess. Retrieved from https://www.govinfo.gov/content/pkg/PLAW-108publ193/pdf/PLAW-108publ193.pdf

This Act allowed for materials to be developed and disseminated to alert travelers that sex tourism is illegal. It also allowed for trafficking survivors to sue their traffickers in federal district court. Additionally, it required the Attorney General to report on anti-trafficking efforts on a yearly basis (ATEST, 2017). This Act is 13 pages in length.

Pub. L. 109-164. (2005). Trafficking Victims Protection Reauthorization Act of 2005, 109th  Cong., 1st  Sess. Retrieved from https://www.govinfo.gov/content/pkg/PLAW-109publ164/pdf/PLAW-109publ164.pdf

This Act added measures to protect US citizens who are survivors.  Earlier editions of the TVPA focused on foreign nationals.  Measures in this Act included: rehabilitative facilities; comprehensive service facilities; grant programs to assist state and local law enforcement in fighting human trafficking and to expand victim assistance; and the provision of extraterritorial jurisdiction over trafficking offenses committed overseas by government contractors (ATEST, 2017). This Act is 17 pages in length.

Pub. L. 110-457 (2008). William WilberforceTrafficking Victims Protection Reauthorization Act of 2008, H. R. 7311, 110th Cong., 2nd Sess. Retrieved from https://www.govinfo.gov/content/pkg/PLAW-110publ457/pdf/PLAW-110publ457.pdf

This Act was named in honor of William Wilberforce, an instrumental figure and abolitionist in the fight against transatlantic slavery.  This Act strengthened the Department of Justice’s efforts to protect human trafficking victims; prevent human trafficking and to prosecute human traffickers.  It also gave the Department of Labor more tools to better document forced labor and labor trafficking. The Department of Health and Human Services was also assisted in providing services to trafficked victims, especially children (ATEST, 2017). This Act is 49 pages in length.

Pub. L. 113-4. (2013). Trafficking Victims Protection Reauthorization Act of 2013, H.R. 898, 113th Cong., 1st Sess.  Retrieved from https://www.govinfo.gov/content/pkg/BILLS-113hr898ih/pdf/BILLS-113hr898ih.pdf

This Act was passed as an amendment to the VAWA (Violence Against Women Act).  It is intended to ensure that US citizens do not purchase goods produced by trafficked persons; to prevent child marriages; improve the ease of charging and prosecuting traffickers; and to put in place emergency provisions (US State Department) to quickly respond to disaster areas/crises where vulnerable persons are at risk for being trafficked (ATEST, 2017). This Act is 66 pages in length.

Publ. L. 115-427.  (2017). Trafficking Victims Protection Act of 2017, H.R. 4061, 115th Cong., 2nd Sess. Retrieved from https://www.govinfo.gov/content/pkg/BILLS-115s1312enr/pdf/BILLS-115s1312enr.pdf

This Act serves to prevent human trafficking; promote justice for trafficking survivors; provide services to trafficking survivors; promote federal coordination between FBI, Congress, and Department of Homeland Security; and to provide training to federal/tribal law enforcement and judges on human trafficking (Grassley et al., 2017). This Act is 16 pages in length.

Publ. L. 115-392. (2017). Abolish Human Trafficking Act of 2017, S. 1311/H.R. 2803, 115th Cong., 2nd Sess.  Retrieved from  https://www.govinfo.gov/content/pkg/BILLS-115s1311enr/pdf/BILLS-115s1311enr.pdf

This act strengthens and reauthorizes key initiatives that support human trafficking survivors. It also provides resources to law enforcement officials (Office on Trafficking in Persons, 2018). This Act is 15 pages in length. Specific measures include:

- restitution for victims;

- funding of investigations of offenses relating to sexual abuse of children;

- grants to states and localities and other entities for victim service assistance;

- training of health, victim service, and federal law enforcement personnel, including through the use of a victim screening protocol by the Department of Homeland Security;

- penalties imposed for slavery offenses, sex trafficking of children, and repeat convictions for transportation for illegal sexual activity and related crimes;

- travel for the purpose of engaging in any illicit sexual conduct;

- designation of additional Department of Justice resources for prosecution and service coordination;

- penalties for offenses involving organized human trafficking, sexual abuse, sexual exploitation, or transportation for prostitution or any illegal sexual activity; and

- studies of the physical and psychological effects of serious harm to victims

(Congress.gov, 2018, “Summary” section)

Pub. L. 115-425. (2018). Frederick Douglass Trafficking Victims Prevention and Protection Reauthorization Act of 2018, H.R. 2200, 115th Cong., 2nd  Sess. Retrieved from https://www.congress.gov/115/bills/hr2200/BILLS-115hr2200enr.pdf

This Act was named in honor of Frederick Douglass. He was a former slave, outspoken abolitionist and orator. This Act establishes programs to fight human trafficking, forced labor, and the use of child soldiers. It also includes mechanisms to better analyze and rank countries in their efforts to eliminate trafficking; exempt restitution for trafficking survivors from federal taxes; and bolster efforts to prevent products made from forced labor from entering into the United States.  Last, it increases support for the United States Advisory Council on Human Trafficking (Polaris, 2019; Pub. L. 115-425, 2018). This Act is 17 pages in length.

Trafficking in Persons Reports

The Trafficking in Persons (TIP) report comes out of the Office to Monitor and Combat Trafficking in Persons. This office releases annual ratings of nations around the world. The ratings are based on a country’s adherence to the USA’s recommendations for eradicating trafficking. The annual production of the TIP Report is a requirement of the Trafficking Victims Protection Reauthorization Act of 2008 (H.R. 7311, 2008).

Office to Monitor and Combat Trafficking in Persons

The TIP Report ranks nations as Tier I, Tier II, Tier II Watch List, and Tier III based on their attention and efforts to address human trafficking as set by the minimum standards of the Trafficking Victims Protection Reauthorization Act. These standards address the three P’s: Punishment of traffickers, Protection of its victims, and Prevention efforts related to trafficking.

Tier Rankings

- Tier I countries fully comply with the minimum standards of the TVPA.

- Tier II countries do not fully comply with the minimum standards of the TVPA but are making significant efforts to do so.

- Tier II Watch List countries do not fully comply with the minimum standards of the TVPA but are making progress towards being in compliance but have additional barriers to address related to high numbers or increasing number of victims; failure to prove increasing efforts to address severity of trafficking; or a prior commitment to make great improvements that has not been upheld.

- Last, Tier III countries do not fully comply with the minimum standards of the TVPA and are not making progress towards such goals.

The following table ranks the countries that are assessed and scored on their anti-trafficking efforts (Office to Monitor and Combat Trafficking in Persons, 2019). Please see below.

Tier 1

Tier 2

Tier 2 Watch List

Tier 3

Argentina
Australia
Austria
The Bahamas
Bahrain
Belgium
Canada
Chile
Colombia
Cyprus
Czech Republic
Estonia
Finland
France
Georgia
Guyana
Israel
Japan
Korea, South
Lithuania
Luxembourg
Netherlands
New Zealand
Norway
Philippines
Portugal
Slovenia
Spain
Sweden
Switzerland
Taiwan
United Kingdom
United States of America

Albania
Antigua & Barbuda
Armenia
Aruba
Benin
Botswana
Brazil
Bulgaria
Burkina Faso
Cabo Verde
Cameroon
Chad
Costa Rica
Cote d’Ivoire
Croatia
Denmark
Djibouti
Dominican Republic
Ecuador
Egypt
El Salvador
Ethiopia
Eswatini
Germany
Ghana
Greece
Guatemala
Guinea
Haiti
Honduras
Hong Kong
Iceland
India
Indonesia
Ireland
Italy
Jamaica
Jordan
Kenya
Kosovo
Kuwait
Latvia
Lebanon
Macau
Macedonia
Madagascar
Mali
Malta
Mauritius
Mexico
Micronesia
Moldova
Mongolia
Morocco
Mozambique
Namibia
Nepal
Niger
Nigeria
Oman
Pakistan
Palau
Panama
Paraguay
Peru
Poland
Qatar
Rwanda
St. Lucia
St. Maarten
St. Vincent & The Grenadines
Senegal
Serbia
Seychelles
Singapore
Slovakia
Solomon Islands
Suriname
Tajikistan
Thailand
Timor-Leste
Togo
Tonga
Trinidad & Tobago
Tunisia
Turkey
Uganda
Ukraine
United Arab Emirates
Uruguay
Zambia
Zimbabwe

Afghanistan
Algeria
Angola
Azerbaijan
Bangladesh
Barbados
Belize
Brunei
Bolivia
Bosnia & Herzegovina
Cambodia
Central African Republic
Congo, Republic of the
Curacao
Fiji
Gabon
Guinea-Bissau
Hungary
Iraq
Kazakhstan
Kyrgyz republic
Laos
Lesotho
Liberia
Malawi
Malaysia
Maldives
Marshall Islands
Montenegro
Nicaragua
Romania
Sierra Leone
South Africa
Sri Lanka
Sudan
Tanzania
Uzbekistan
Vietnam

Belarus
Bhutan
Burma
Burundi
China (PRC)
Comoros
Congo, Democratic Rep. of the
Cuba
Equatorial Guinea
Eritrea
The Gambia
Iran
Korea, North
Mauritania
Papua New Guinea
Russia
Saudi Arabia
South Sudan
Syria
Turkmenistan
Venezuela

Tier Placements

As the reader can see from this table, the United States of America, Canada and many European countries are ranked Tier 1.  Most countries in the world, however, rank as Tier 2 and no countries in Africa rank as Tier 1.  China, a country with over 1 billion people and is persistently accused of human rights violations is ranked as Tier 3, along with other countries, for example, that are deemed problematic for trafficking offenses that include North Korea, Iran, South Sudan, the Congo and Mauritania.  Mauritania is the last country in the world to outlaw slavery, which was in 1981 (Guardian, 2018).

While Tier 1 is the highest and most desired ranking, it does not mean that a Tier 1 country does not have a human trafficking problem; nor does it mean that a country is doing enough to eliminate trafficking.   A Tier 1 ranking indicates that a government has made efforts to address human trafficking in a manner that meets the TVPA’s minimum standards. To maintain a Tier 1 ranking, however, those governments must demonstrate continued progress on an annual basis in combating human trafficking (Office to Monitor and Combat Trafficking in Persons, 2019).

In addition to Tier rankings in the TIP report, countries are presented with a narrative that reflect an assessment of the following:

1. enactment of laws prohibiting severe forms of trafficking in persons, as defined by the TVPA, and provision of criminal punishments for trafficking offenses;

2. criminal penalties prescribed for human trafficking offenses with a maximum of at least four years’ deprivation of liberty, or a more severe penalty;

3. implementation of human trafficking laws through vigorous prosecution of the prevalent forms of trafficking in the country and sentencing of offenders;

4. proactive victim identification measures with systematic procedures to guide law enforcement and other government-supported front-line responders in the process of victim identification;

5. government funding and partnerships with NGOs to provide victims with access to primary health care, counseling, and shelter, allowing them to recount their trafficking experiences to trained social counselors and law enforcement in an environment of minimal pressure;

6. victim protection efforts that include access to services and shelter without detention and with legal alternatives to removal to countries in which victims would face retribution or hardship;

7. the extent to which a government ensures victims are provided with legal and other assistance and that, consistent with domestic law, proceedings are not prejudicial to victims’ rights, dignity, or psychological well-being;

8. the extent to which a government ensures the safe, humane, and to the extent possible, voluntary repatriation and reintegration of victims;

9. governmental measures to prevent human trafficking, including efforts to curb practices identified as contributing factors to human trafficking, such as employers’ confiscation of foreign workers’ passports and allowing labor recruiters to charge fees to prospective migrants; and

10. governmental efforts to reduce the demand for commercial sex acts and international sex tourism

(Office to Monitor and Combat Trafficking in Persons, 2019, “Tier Placement” section)

FUNDING RESTRICTIONS FOR TIER 3 COUNTRIES

Pursuant to the TVPA, governments of countries on Tier 3 may be subject to certain restrictions on assistance that include:

- the President of the USA may decide not to provide U.S. government nonhumanitarian, nontrade-related foreign assistance

- the President may decide to withhold funding for government official or employee participation in educational and cultural exchange programs

- the President may also decide to instruct the U.S. Executive Director of each multilateral development bank and the International Monetary Fund to vote against and use his or her best efforts to deny any loans or other uses of the institutions’ funds to a designated Tier 3 country for most purposes (except for humanitarian, trade-related, and certain development-related assistance)

- At the same time, the President [of the United States of America] may waive application of the foregoing restrictions upon a determination that the provision to a Tier 3 country of such assistance would promote the purposes of the TVPA or is otherwise in the national interest of the United States. The TVPA also authorizes the President to waive funding restrictions if necessary to avoid significant adverse effects on vulnerable populations, including women and children

(Office to Monitor and Combat Trafficking in Persons, 2019, Funding Restrictions section)

Quiz

An interactive or media element has been excluded from this version of the text. You can view it online here:
https://ohiostate.pressbooks.pub/humantrafficking/?p=24

Now, let’s shift gears and turn to a case study.

ADÉLAÏDE SAWADOGO | BURKINO FASO

Adélaïde Sawadogo is a proven, unwavering force against human trafficking in Burkina Faso. For the past 26 years, she has worked unrelentingly to protect vulnerable populations. Sawadogo is a social worker at Keoogo, an NGO specializing in child protection and advocacy. At the helm of Keeogo’s human trafficking efforts, Sawadogo has directly assisted more than 1,500 human trafficking victims, including those whom the government does not have the resources to support. Serving on more than a dozen national and international committees, she has represented Keeogo’s rights-based model for victims and influenced government policy on human trafficking and child protection. She has accompanied human trafficking victims back to their country of origin to ensure safe passage through insecure regions and across borders, liaising with border officials and police along the journey. She has worked together with human trafficking survivors to design reintegration programs focused on income-generating skills that foster economic stability. Sawadogo not only secured pro-bono legal counsel for survivors wishing to press charges against their traffickers, she also followed up with the Burkinabe government to ensure these cases progressed.

Undaunted by discrimination and threats of violence, Sawadogo has challenged traditional norms and religious precepts to combat forced begging of children by corrupt Quranic teachers and worked to increase access to health care for children in some of Ouagadougou’s most dangerous neighborhoods.

(Office to Monitor and Combat Trafficking in Persons, 2019, TIP Heroes section)

Summary of Key Points

- The annual release of the Trafficking in Persons report is critical to understanding diverse international governments’ response to human trafficking activities.

- The TIP Report ranks nations as Tier I, Tier II, Tier II Watch List, and Tier III based on their attention and efforts to address human trafficking as set by the minimum standards of the Trafficking Victims Protection Reauthorization Act.

Supplemental Learning Materials

Office to Monitor and Combat Trafficking in Persons. (2019, June). Trafficking in Persons Report. Retrieved from https://www.state.gov/wp-content/uploads/2019/06/2019-Trafficking-in-Persons-Report.pdf

References

Alliance to End Slavery & Trafficking [ATEST]. (2017). Summary of the Trafficking Victims Protection Act (TVPA) and Reauthorizations FY 2017. Retrieved from https://endslaveryandtrafficking.org/summary-trafficking-victims-protection-act-tvpa-reauthorizations-fy-2017-2/

Bacon, C., & Breevort, L. (2018, August 8). 2018 TIP Report: Important rankings to know. Retrieved from https://humantraffickingcenter.org/2018-tip-report-important-rankings-to-know/

Congress.gov. (2018). S.1311 – Abolish Human Trafficking Act of 2017. Retrieved from https://www.congress.gov/bill/115th-congress/senate-bill/1311

Grassley et al. (2017, June 7). Trafficking Victims Protection Act of 2017. Retrieved from https://www.judiciary.senate.gov/imo/media/doc/TVPRAOnePager7June2017.pdf

Guardian (The). (2018, June 8).  The unspeakable truth about slavery in Mauritania. Retrieved from theguardian.com

Office on Trafficking in Persons. (2018, December 21). President signs the Abolish Human Trafficking Act of 2017 (S. 1311). Retrieved from https://www.acf.hhs.gov/otip/news/s-1311

Office to Monitor and Combat Trafficking in Persons. (2019, June 20). 2019 Trafficking in Persons Report. Retrieved from https://www.state.gov/reports/2019-trafficking-in-persons-report/

Polaris. (2019). Reauthorizing the Trafficking Victims Protection Act.  Retrieved from https://polarisproject.org/blog/2017/06/29/reauthorizing-trafficking-victims-protection-act

Pub. L. 106-386. (2000). Trafficking Victims Protection Act of 2000, H. R. 3244, (2000). 106th Cong., 2nd Sess. Retrieved from https://www.congress.gov/106/plaws/publ386/PLAW-106publ386.pdf

Pub. L. 108-193. (2003). Trafficking Victims Protection Reauthorization Act of 2003, H.R. 2620, 108th Cong., 1st Sess. Retrieved from https://www.govinfo.gov/content/pkg/PLAW-108publ193/pdf/PLAW-108publ193.pdf

Pub. L. 109-164. (2005). Trafficking Victims Protection Reauthorization Act of 2005, H.R. 972, 109th  Cong., 1st  Sess. Retrieved from https://www.govinfo.gov/content/pkg/PLAW-109publ164/pdf/PLAW-109publ164.pdf

Pub. L. 110-457 (2008). William WilberforceTrafficking Victims Protection Reauthorization Act of 2008, H. R. 7311, 110th Cong., 2nd Sess. Retrieved from https://www.govinfo.gov/content/pkg/PLAW-110publ457/pdf/PLAW-110publ457.pdf

Pub. L. 113-4. (2013). Trafficking Victims Protection Reauthorization Act of 2013, H.R. 898, 113th Cong., 1st Sess.  Retrieved from https://www.govinfo.gov/content/pkg/BILLS-113hr898ih/pdf/BILLS-113hr898ih.pdf

Publ. L. 115-392. (2017). Abolish Human Trafficking Act of 2017, S. 1311/H.R. 2803, 115th Cong., 2nd Sess.  Retrieved from  https://www.govinfo.gov/content/pkg/BILLS-115s1311enr/pdf/BILLS-115s1311enr.pdf

Pub. L. 115-425. (2018). Frederick Douglass Trafficking Victims Prevention and Protection Reauthorization Act of 2018, H.R. 2200, 115th Cong., 2nd  Sess. Retrieved from https://www.congress.gov/115/bills/hr2200/BILLS-115hr2200enr.pdf

Pub. L. 115-427.  (2017). Trafficking Victims Protection Act of 2017, H.R. 4061, 115th Cong., 2nd Sess. Retrieved from https://www.govinfo.gov/content/pkg/BILLS-115s1312enr/pdf/BILLS-115s1312enr.pdf

Sharedhope International. (2019). What is the TVPRA and why is it important? Retrieved from https://sharedhope.org/what-we-do/bring-justice/legislative-action-center/2017-federal-advocacy-115th-congress-2017-2018/tvpra/

Chapter 3: Theories and Human Trafficking

ABSTRACT

Theories inform the way many disciplines approach research, practice, and knowledge building. The field of social work as a whole borrows theories from a number of fields including medicine, psychology, and sociology. In this chapter, a few basic theories common in social work research will be discussed. Specifically, the theories will be explored in relation to human trafficking and human rights violations.

Learning  Objectives

By the end of this chapter, the student will be able to:

- Recognize common theories applied to human rights violations and human trafficking

- Apply theories to understand intervention development strategies

Key Words: General Systems Theory, Bronfenbrenner’s Ecological Systems Theory,

Conflict Theory, Functional Theory, Labeling Theory, Maslow’s Hierarchy of Needs

GLOSSARY

General Systems Theory: A theory based on interactions between varying sizes of systems in maintaining equilibrium through inputs, throughouts, outputs, and feedback loops

Bronfenbrenner’s Ecological Systems Theory: A theory used to understand the bidirectional influence of varying levels of ecological systems on an individual

Conflict Theory: A theory aimed at understanding oppression and power structures through examining structural conflict

Functional Theory: A theory used to understand human rights violations by exploring the functional role they play in a society

Labeling Theory: A theory that explores the behavioral implications of labeling a person deviant or criminal

Maslow’s Hierarchy of Needs: A pyramid style model that sets out the needs of all individuals in a hierarchical manner

Chapter on Theories

In this section, the authors discuss a range of theories to provide a context for human trafficking.  Theories include general systems theory, Bronfennbrenner’s ecological systems theory, conflict theory, functional theory, labeling theory and Maslow’s Hierarchy of Needs.

General Systems Theory & Bronfenbrenner’s Ecological Systems Theory

General Systems Theory was introduced to the social work field in the late 1950’s and early 1960’s, and was based on a biological model (Kondrat, 2013). The biologist credited with General Systems Theory is Bertalanffy, who was concerned about the practice of studying phenomenon as isolated entities instead of players in feedback systems and hierarchical orders (Kondrat, 2013). The social work understanding of General Systems Theory, much like the name suggests, is a theory based on understanding a system – a series of components that interact with and influence one another (Berg-Weger, 2005). General Systems Theory considers all systems subsystems of other systems, and considers large systems as environments for other systems, thus always exploring the flow and impact of different systems between and against each other (Forder, 1976). General Systems Theory has mostly been replaced by Bronfenbrenner’s Ecological Model, but is still used in some areas of social work (Kondrat, 2013).

The systems that influence the individual in the social work perspective can be social or physical entities – family, culture, workplace, communities, etc. (Berg-Weger, 2005). The purpose of using General Systems Theory in social work is to begin understanding the “person in environment” which is the perception of each individual as a participant influenced by larger physical, social, and environmental systems (Berg-Weger, 2005). Taking a person in environment approach gives social workers more opportunities to intervene—understanding the various systems in place that allow or perpetuate a problem creates more intervention points. However, arguments against the use of Systems Theory in social work have included concerns about the model not accounting for values and ideology as well as concerns about application of the model to the complexities of the human experience (Kondrat, 2013; Shriver, 1998). General Systems Theory assesses the relationship of inputs on the individual, or throughput, and the following consequences, or outputs, in a feedback loop relationship that is aimed at some type of regulation (Skyttner, 1996). The General Systems Theory in social work shifted the focus on interventions to understanding the transactions that happen between an individual and their larger systems (Kondrat, 2013).

There is some debate about the differences between General Systems Theory and Ecological Systems Theory (Schriver, 1998). A critique of General Systems Theory in its application to social work is that it focuses on elements of an individual’s life as components of a system, which comes with an assumption of equilibrium – both that the system needs it and that the system can achieve it (Leighninger, 1977). Ecological Systems Theory also explicitly defines the environmental systems as including nonliving elements, something sometimes assumed but never explicitly stated in General Systems Theory (Shriver, 1998). Bronfenbrenner’s Ecological Systems Theory mostly replaced General Systems Theory in the late 1970s and early 1980s and is a continuation of understanding the person in environment (Kondrat, 2013). The Ecological Systems Theory explores the relationship of an individual’s environment on their behavior, whereas General Systems Theory seeks to understand the changes an individual’s system undergoes when a change in a subsystem is made (Berg-Weger, 2005).

Bronfenbrenner argues that people develop within five systems of influence, the systems being: microsystem, mesosystem, exosystem, macrosystem, and chronosystem (Bronfenbrenner, 1994). The model is set up as a growing set of nesting circles, with each larger circle encompassing a larger system, and each circle influencing each other bi-directionally. Newer versions of the ecological model sometimes call the chronosystem a policy level system, showing how policy and greater institutional level processes impact a person’s smaller systems (Sallis & Owen, 2015). This means that at the policy and institution level, changes can influence how a person lives and operates because they have to develop and mature with constraints or supports from these powers. The individual is at the center of these five systems, and the ways in which they all interact to influence the individual is the basis of Bronfenbrenner’s Ecological Systems Theory. See figure A.

Figure A. Bronfenbrenner’s Ecological Theory

https://sites.google.com/site/dsmktylenda/content/bronfenbrenner-s-ecological-theory

In relation to human trafficking and human rights, both General Systems Theory and Bronfenbrenner’s Ecological Systems Theory are often already present and applied when thinking about interventions, even if not explicitly. Clawson and colleagues (2003), completed a needs assessment for trafficking victims and agencies that provide services to victims. In their assessment, they looked at the inputs of current efforts and services available on the throughput of victim care. The outputs, or the current state of victim care as a result of the services available, were analyzed in relation to how they can feedback into informing future efforts and services available to victims. Since it has been several years since the analysis, a General Systems Theory approach could be taken again to look at current inputs, influenced by previous outputs and feedback loops, on victim care. Bronfenbrenner’s Ecological Systems theory can be seen when evaluating risk factors for human trafficking and human rights violations. Poverty, a history of abuse and neglect, substance-use issues, political instability, homelessness, and marginalized identities have been highlighted in other chapters as risk factors for an individual to become a human trafficking victim. Risk factors can be understood within the Ecological Systems Model, which assists social workers in identifying areas for intervention and prevention for at-risk populations.

Conflict Theory & Functional Theory

Conflict Theory emerged in the late 19th century from Karl Marx and Friedrich Engels (Hutchison, 2013). Conflict Theory explores power structures and power disparities – that is, how do power differentials affect social inequality (Hutchison, 2013; Parillo, 2012; Rӧssel, 2013). Conflict Theory serves as the opposite to Functional Theory (Shriver, 1998; Parillo, 2012), which will be explored next. Conflict theory operates on the premise that humans are self-interested and competitive by being forced into conflict over scarce resources and wealth (Rӧssel, 2013; Shriver, 1998). Within Conflict Theory, wealthier classes are able to maintain power over lower-income and ethnic minority groups by allowing oppressed groups to believe that the advancement of another oppressed group will be to their detriment; therefore oppressed groups assist in the oppression of each other in the hopes that they will be the ones to advance (Parillo, 2012). From this perspective, social order exists through coercion of oppressed and less powerful groups by the ruling and more powerful classes (Shriver, 1998). Similarly, social change occurs through a conflict, evoking human response in the political, economic, and cultural spheres (Hutchison, 2013). There is a lot of social work practice that evolves from addressing social injustice through Conflict Theory. Early social work efforts at eliminating oppression of immigrants, women, and children were based in Conflict Theory, and efforts continue today through development of empowerment strategies for non-dominant groups (Hutchison, 2013). However, critics of Conflict Theory say that the theory does not account for social unity and shared values; stating the theory is too radical (Parillo, 2012).

Functional Theory states that every part of a society serves a function in maintaining the solidarity and stability of the whole (Parillo, 2012). Ideally, all the parts of a society maintain equilibrium and a state of balance under perfect conditions (Parillo, 2012). However, when problems arise, it is because a part of the social system has become dysfunctional; usually caused by some type of rapid change, which the other parts of the system are not able to adjust and compensate for quickly enough (Parillo, 2012). At this point, the society must decide if it will adjust by returning to its pre-conflict state or work to find a new equilibrium (Parillo, 2012). Functional Theory acts as the opposite of Conflict Theory because it operates on the premise that humans are inherently cooperative and caring, each playing their role in maintaining the harmony of the society (Schriver, 1998). Functionalists believe that all problems regarding minority groups can be solved by small adjustments in the social system to return to equilibrium (Parillo, 2012). Critics of Functionalist Theory, who often prefer Conflict Theory, argue that the focus on stability ignores the inequalities of class, gender, and race that often are the creators of conflict (Parillo, 2012).

In relation to human trafficking and human rights, Conflict Theory aims to offer a broad explanation for why and how social inequality, power imbalance, and oppression are able to occur. Sexism, racism, and classism are often contributors to human rights violations, as highlighted in the case of child brides, sex trafficking, organ trafficking, and other forms of victimization. Barner, Okech, and Camp (2014) highlight how socio-economic inequality not only between classes on a small scale but globally between developed and underdeveloped nations fuels sex trafficking, violence, and political strife and civil war. From a similar perspective, Functional Theory and taking a Functionalist view requires one to question how and why oppression are able to occur but through a lens that examines the utility of human rights violations and their place in maintaining an equilibrium. For example, Functionalists argue that gender roles exist because they played a functional role in systematically meeting the needs of society with men doing labor and wage-earning tasks and women doing homemaking and nurturing tasks (Parillo, 2012). In order to address human rights violations, it is important to identify the function the violation plays in maintaining a system within society, and then determining what changes need to be made to move to a new form of harmony absent of the violation. Human trafficking in the form of labor trafficking fulfills the need of cheap labor to create more profits; sex trafficking meets the demand for sex from johns and provides money or other things of value to pimps; child soldiers play various roles in meeting the needs of militant groups during armed conflict; and organ trafficking supplies a limited resource to an evergrowing list of needy recipients. Human rights violations as a whole can always be examined from the perspective of the function they play in a larger picture. In order to prevent human rights violations, it is important for social workers and other professionals to understand the need the violation fulfills and intervene at a point that prevents the need for the violation to occur.

Labeling Theory

Labeling Theory is a sociological theory based in understanding criminal behavior when a criminal is named as such, and emerged in the 1960’s and 70’s from two sociologists named Howard Becker and Edwin Lemert (Crewe & Guyot-Diangone, 2016). This theory sought to untangle the inherent criminality of an individual versus the impact of labels on the criminalization of those deemed deviant (Crewe & Guyot-Diangone, 2016; Restivo & Lanier, 2013). Lemert posited that the act of labeling and creating stigma around what is or can be considered deviant behavior only serves to further marginalize and force conformity to criminal status, as internalizing the label and stigma alters one’s view of self and their social roles (Crewe & Guyot-Diangone, 2016). This further marginalization and conformity is called secondary deviance, which is associated with a shift in self-concept and social expectations, increased association with deviant peers, and an alter in the psychic structure (Crewe & Guyot-Diangone, 2016; Restivo & Lanier, 2013). Labeling Theory has also been applied to mental illness, where it is called Modified Labeling Theory. Modified Labeling Theory is essentially the same as Labeling Theory, in which the labeling of an individual with a mental illness or as mentally ill often has a negative effect and causes social withdrawal (Crewe & Guyot-Diangone, 2016; Davis, Kurzban & Brekke, 2012).

Some forms of human trafficking, especially sex trafficking, involve criminal activity on the victim’s part, and result in the criminalization of the victim rather than the trafficker (Dempsey, 2015). In these cases, the victim may begin to fit into the traditional model of Labeling Theory and view themselves as a deviant criminal, thus perpetuating their involvement in trafficking because they believe this is a lifestyle they chose. This is evidenced by some victims having extensive criminal backgrounds, serving time for prostitution and drug charges, and thinking of themselves as willing participants in prostitution and drug trafficking (Meshelemiah & Lynch, 2019), before they are rescued and identified as victims. Hoyle, Bosworth, and Dempsey (2011) highlight the power of the label “victim” in a person’s ability to leave their trafficker, seek supportive services, and move forward with their lives. However, they also explore the notion of an ideal victim through the definitions of trafficking that exist and the images of modern day slavery that are put out to the world. In some ways, the creation of a victim label through the media that is available is invalidating to those whose lived experience with trafficking may be seen as complicit or not fit the image of slavery (Hoyle, Bosworth, & Dempsey, 2011). Victims may not believe they are deserving of services unless they were “forced enough”, and see other victims who fit the kidnapped and forced narrative as more deserving of services (Brunovskis & Surtees, 2012, page 34). Labeling Theory exemplifies the power of self-perception as well as the perceptions of law enforcement and service agencies in ensuring victims are correctly identified and receive appropriate services.

Maslow’s Hierarchy of Needs

Maslow’s Hierarchy of Needs is one of the most basic theories of social work and informs much of the field’s practice. Maslow’s hierarchy is designed as a pyramid to showcase the importance of needs being met in order to reach optimal wellness. Psychological and safety needs make up the bottom two tiers, and operate as the components of basic needs (Maslow, 1943). Belongingness and love, and esteem needs are the middle two tiers as well as the components for psychological needs (Maslow, 1943). Then, finally, self-actualization tops the pyramid as the component for self-fulfillment needs (Maslow, 1943). In order to reach self-actualization, the most basic of human physical and psychological needs must be met first (Maslow, 1943). If basic needs are not met, like hunger and shelter, the body will focus all efforts on finding these things and the mind will not be able to focus on things of personal interest until basic needs are met (Maslow, 1943). However, critics of Maslow’s Hierarchy state the model is too simplistic, and fails to account for cultural norms and drives (Gambrel & Cianci, 2003). Additionally, few things in life are linear, and the hierarchy implies a linear route to self-actualization.

In terms of human-trafficking, Maslow’s Hierarchy of Needs can help practitioners understand why victims are drawn to and controlled by traffickers. As highlighted in other chapters, risk factors for victims include homelessness, prior neglect and abuse, and poverty. A lack of housing, food, clothing, safety, and financial security cover most of the two rungs of basic needs in Maslow’s Hierarchy. Traffickers are able to offer these things to victims, which both draws victims to traffickers as well as makes it difficult to leave (Hopper, 2016; Hopper & Hidalgo, 2006; Stotts & Ramey, 2009). Traffickers also offer intimate relationships and friendships, even if temporarily, meeting some aspects of psychological needs and further bonding victims to them – this is especially true in the case of sex trafficking of minors (Reed, Kennedy, Decker, & Cimino, 2019; Smith, Vardaman, & Snow, 2009). In addressing the recovery and healing of human trafficking victims, service providers must work up the pyramid to be effective; first addressing basic needs like housing, clothing, food, and a sense of security and safety from their trafficker (Gezinski & Karandikar, 2013; Hopper, 2016). Once basic needs have been met, psychological needs can be addressed through group settings, therapeutic interventions, trauma therapy, and a sense of accomplishment in healing. Then survivors, following Maslow’s Hierarchy, will be on track to reach self-actualization. See Maslow’s diagram in Figure B.

Figure B. Maslow’s Hierarchy of Needs

The theories covered in this chapter are in no way an exhaustive list of the only theories that can be applied to human trafficking and human rights violations. They are, however, some of the most common theories used in understanding these topics. In many cases, the theoretical approach is not explicitly outlined, or is assumed because of the field of focus. However, it is easy to see how some of these theories are applicable in a variety of contexts when understanding human trafficking and human rights.

Quiz

An interactive or media element has been excluded from this version of the text. You can view it online here:
https://ohiostate.pressbooks.pub/humantrafficking/?p=25

Now, let’s shift gears and turn to a “thought” on theories.

THEORY AND HUMAN TRAFFICKING

Using a theoretical framework in academic research, intervention development, and policy-making takes out some of the guessing work about efficacy and risk of failure. Theories are empirically-based and developed on a set of consistent assumptions that set the context and background for existing knowledge. For example, theories about human development and needs can set the groundwork for studies on understanding behavior within a certain stage of development, with or without certain needs being met, or when adverse experiences occur during a stage. Using theory allows researchers to get directly to the questions they need answered without having to do multiple studies to set a background and context. For intervention development and policy-making, theory gives a set of basic assumptions about societal and individual contexts that the interventions and policies must exist and work within.

In relation to human trafficking and human rights work, using theory allows us to have a context for how and why injustice occurs. It provides a basic understanding of the needs of those whose rights have been violated. It allows us to predict how effective interventions and policies will be based on how they fit into the assumptions of the chosen theoretical foundation. Applying theory to understanding human rights is important because it ensures that scholars, activists, policymakers, and more are functioning under the same umbrella of understanding about the extant knowledge, context, and basic assumptions of a phenomenon; this allows us to work toward the same goal through unique disciplinary and interdisciplinary lenses without working backwards in re-studying the same foundational groundwork again and again. Theory allows human rights advocacy to continually move forward.

Summary of Key Points

- The social work profession utilizes theories from a variety of fields. Some cover basic human development while some are more complex and can explain criminal and deviant behavior.

- Utilizing theories that explore power, control, development, and deviant behavior can help social workers and other professionals to develop impactful interventions informed by theory and years of research on the topic.

Supplemental Learning Materials

Lutya, T.M. & Lanier, M. (2012). Chapter 27: An integrated theoretical framework to describe human trafficking of young women and girls for involuntary prostitution. In J. Maddok (Ed.). Public Health – Social and Behavioral Health. (555-570). DOI: 10.5772/37064

References

Berg-Weger, M. (2005). Social Work & Social Welfare: An Invitation. McGraw-Hill. New York, NY.

Bronfenbrenner, U. (1994). Ecological models of human development. International Encyclopedia of Education, Vol. 3, 2nd. Ed. Oxford: Elsevier. Retrieved from http://edfa2402resources.yolasite.com/resources/Ecological%20Models%20of%20Human%20Development.pdf

Brunovskis , A., & Surtees, R. (2012). Leaving the past behind? When victims of trafficking decline assistance: Summary report. Fafo AIS (OSLO) & Nexus Institute. Retrieved from https://www.digiblioteket.no/files/get/McxE/20258.pdf

Clawson, H. Small, K., Go, E., & Myles, B. (2003). Needs Assessment for Service Providers and Trafficking Victims. Caliber Associates, Inc. Retrieved from https://www.ncjrs.gov/pdffiles1/nij/grants/202469.pdf

Crewe, S.E., & Guyot-Diangone , J. (2016). Stigmatization and labeling. Encyclopedia of Social Work. DOI: 10.1093/ acrefore /9780199975839.013.1043

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Dempsey, M. M. (2015). Decriminalizing victims of sex trafficking. American Criminal Law Review, 52 (2), 207-230. Retrieved from https://heinonline.org/HOL/P?h=hein.journals/amcrimlr52&i=227

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Meshelemiah, J. & Lynch, R. (2019). Sex Trafficking: The Intersection of Race, Drugs, “Dope Boys” – and Emergent Leaders. (Presentation). The Kirwan Institute, Columbus, OH.

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Sex Trafficking Section

This section covers sex trafficking. The content includes sex trafficking in the context of forced prostitution, the male entertainment industry, pornography and Domestic Minor Sex Trafficking. This section also contains a chapter on substance use and sex trafficking.

“Prostitution” by Nils Hamerlinck is licensed under CC BY-SA 2.0

Chapter 4: Sex Trafficking

ABSTRACT

Forced prostitution in sex trafficking is the most common perception of what human trafficking is. Forced prostitution, however, is not the only way a person can be trafficked for sex. In this chapter, forced prostitution is explored along with pornography, the male entertainment industry, and Domestic Minor Sex Trafficking (DMST).

Learning Objectives

By the end of this chapter, the student will be able to:

- Define sex trafficking and understand who the most common victims are

- Understand the various ways that sex trafficking may present

- Understand the unique problem of Domestic Minor Sex Trafficking

Key Words: Sex Trafficking, Prostitution, Domestic Minor Sex Trafficking, Pimp

GLOSSARY

Sex Trafficking: The recruitment, harboring, transportation, provision, or obtaining of a person for the purpose of a commercial sex act (CSA), in which a CSA is induced by force, fraud, or coercion, or in which the person induced to perform such act has not attained 18 years of age

Prostitution: The act of engaging in sexual intercourse or performing sexual favors for money or other things of value

Domestic Minor Sex Trafficking: The commercial sexual exploitation of American children within U.S. borders

Pimp: The person exploiting a prostitute or sex trafficked person; considers themselves an owner of the person; generally, lives off of the profits generated by the person who is prostituted or sex trafficked

John: A buyer of sex

Sex Trafficking

Sex trafficking in the United States, according to the Trafficking Victims Protection Act (TVPA), is “the recruitment, harboring, transportation, provision, or obtaining of a person for the purpose of a commercial sex act (CSA), in which a CSA is induced by force, fraud, or coercion, or in which the person induced to perform such act has not attained 18 years of age” (Trafficking Victims Protection Act, 2000, p. 8). Globally, the United Nations in its “Protocol” defines human trafficking as the following, specifically mentioning the inclusion of exploitation through sex at the end:

“the recruitment, transportation, transfer, harbouring 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. Exploitation shall include, at a minimum, the exploitation of the 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” (United Nations, 2003, Article 3, page 43).

Statistics

Labor trafficking is the most common form of human trafficking globally, but sex trafficking and debt bondage trail close behind (San Francisco Human Rights Commission, n.d.). Sex trafficking, though, is the most detected form of human trafficking globally (United Nations, 2018). It was estimated that in 2016, 4.8 million women, men, and children were trapped being trafficked for the purpose of sexual exploitation around the world (International Labor Organization, 2017). Sexual exploitation is the most common form of human trafficking in the Western hemisphere and makes up 71% of identified victims (United Nations, 2018). In 2016, 68% of all identified human trafficking victims in North America were identified within their own countries borders, meaning most trafficking is domestic, contrary to popular beliefs held about trafficking victims being foreign women and children kidnapped (United Nations, 2018). The United States specifically was ranked as a Tier 1 country by the U.S. Department of State’s Annual Trafficking in Persons report (2018), meaning the government was in full compliance of the minimum requirements put forth by the TVPA. However, domestic human trafficking continues to be a major problem in the United States, with California, Texas, Florida, and Ohio ranked as the top 4 states in the country for reports of human trafficking, with 75.26%, 70.99%, 71.11%, and 81.27% of cases being sex trafficking, respectively (Human Trafficking Hotline, 2017). Sex trafficking in the United States is estimated to be a $3-billion-dollar industry every year, with major sporting events like the Super Bowl and other events that are male-oriented, as hubs for increased sex trafficking activity, sometimes drawing up to three times the volume of sex trafficking (O’Day, 2018). Feeding that $3-billion-dollar industry, the United Nations (2018) estimates that in North America, the expected criminal income per case of sexual exploitation is $390 per day.

“Money” by free pictures of money is licensed under CC BY 2.0

Forced Prostitution

Forced prostitution is the most commonly known form of human trafficking in general (San Francisco Human Rights Commission, n.d.). Forced prostitution victims are recruited, controlled, and exploited in many ways and by a number of people. Generally, victims are women and girls, with approximately 83% of identified women human trafficking victims and 72% of identified female child victims being trafficked for the purpose of sexual exploitation, as opposed to 10% of men and 27% of boys (United Nations, 2018). Girls, on average, are recruited between the ages of 11-13 for forced prostitution, although some are much younger, with many of them having been sexually abused as children and left in a vulnerable position (Kotrla, 2010; Shared Hope International, 2019). While there is no set profile of a victim, there are people who are considered more at risk of forced prostitution. For forced prostitution victims, the complex risks of drug or substance use, poverty, history of abuse, age, and marginalized identities is important to note. Women (especially women of color), immigrants, LGBTQ individuals, homeless or runaway youth, and domestic violence and sexual assault victims are common recruits and victims of sex trafficking (Lillie, 2014; National Human Trafficking Hotline, n.d.A.; Polaris Project, 2017). The venue of forced prostitution is not limited just to the streets where it is commonly believed that sex workers will be found. It is more common for forced prostitution to occur in homes and “businesses” than on the streets (Stark & Hodgson, 2003). Erotic massage parlors, health or beauty fronts, and escort services are common businesses where forced prostitution is masked as a legitimate service (Polaris Project, 2017). Victims may either be forced to provide sexual favors to patrons, be unpaid or underpaid for their services, or a combination of both (Polaris Project, 2017).

Pimps are Traffickers

The “owners” of individuals forced into prostitution are commonly called pimps and traffickers. They are the perpetrators who control the actions and live off of the profits of the people they prostitute (Grough & Goldbach, 2010). Contrary to common beliefs about pimps, traffickers are not only strangers who kidnap women and children, but they are more likely to be intimate partners, family members, acquaintances, or friends of victims—especially in the case of minors (National Human Trafficking Hotline, n.d.B.; Reed, Kennedy, Decker, & Cimino, 2019; Smith, Vardaman, & Snow, 2009) The pimps use tactics similar to those of domestic violence batterers to control their victims – isolation of the victim, minimizing or denying abuse, threats and intimidation, and physical, emotional, and sexual abuse (Stark & Hodgson, 2003). Not surprisingly, forced prostitution is heavily interrelated with domestic violence. The Polaris Project’s Human Trafficking Power and Control Wheel is based off of a domestic violence model of power and control, and highlights how a trafficker can exploit a family member or intimate partner, and how even mimicked familial or relationship ties can strengthen a victim’s loyalty to their trafficker making the exploitative situation even more complicated and harder to leave (Cody, 2017). In addition to physical and verbal abuse of intimate partners or the creation of relationships that seem loving, pimps may use pre-existing drug addiction, or create a drug addiction, as a means of control over the victims (Currier & Feehs, 2019). Over 1/3 of sex trafficking cases in 2018 reported exploitation of substance use issues by traffickers to control victims (Currier & Feehs, 2019). Victims with a pre-existing drug addiction believe that this is just part of their addiction and they have hit an all-time “low” in their use. Victims whose drug addiction is created by their pimps begin thinking that this is what they deserve for getting caught up in drug use. Both lines of thinking are beneficial to the pimp, as the victims place blame on themselves for their situation instead of their abuser, making them less likely to seek help (Meshelemiah & Lynch, 2019).

“drugs” by gregorfischer.photography is licensed under CC BY-ND 2.0

The buyers of forced prostitution are generally men, called johns or tricks, and they keep the sex trafficking industry alive. Without buyers there would be no forced prostitution. In a study comparing online sex buyers to a national sample of men, researchers found that buyers were generally White (69.5%), working full-time (60.3%), had completed high school (53.2%), and married (51.8%) (Monto & Milrod, 2014). The researchers found that there is no peculiar quality that makes men who have purchased sex any different from men who have not (Monto & Milrod, 2014). The prostituted women and girls who are battered, raped, and murdered by tricks and johns know that the men who exploit them are just average, everyday men (Stark & Hodgson, 2003). Many of the biggest consumers of prostitution are from developed nations, and two out of every three men who pay for sex are aware that the majority of sex workers are trafficked (Fight the New Drug, 2018).

Unfortunately, the trauma of forced prostitution victims often does not end at the pimps and johns. It is common for victims to have a criminal history riddled with prostitution charges, drug charges, theft, or charges for crimes their traffickers forced them to commit, which makes accessing employment, housing, and other resources more difficult, sometimes forcing victims to go back to their traffickers (Farmand, n.d.; Ohio Justice and Policy Center, n.d.). This has caused a stir in discussions about the re-victimization and trauma of trafficking victims by the criminal justice system. It is also common for law enforcement officials to be untrained in identifying and helping victims, and for traffickers to train victims on what to say in the case of an arrest, causing further complications in assisting victims when they enter the criminal justice system (Farmand, n.d.; Ohio Justice and Policy Center, n.d.). Victims also usually have a distrust of the criminal justice system, either because of previous negative experiences, or because traffickers have made them believe that they will go to jail, be deported, or the traffickers themselves will inflict harm on the victim or their loved ones if they go to law enforcement (Department of Health and Human Services, n.d.; Hopper & Hidalgo, 2006; Ohio Justice and Policy Center, n.d.).

Barnellbe [CC BY-SA 3.0 (https://creativecommons.org/licenses/by-sa/3.0)]

Male Entertainment Industry/Pornography

When thinking about human trafficking, sometimes images from popular media come to mind. In the case of sex trafficking, there is a scene in the film Taken (2008), where Liam Neeson’s American daughter is kidnapped in France, drugged, dancing in a glass case in lingerie, and about to be sold to the highest bidder. While an example like this is not an accurate portrayal of commercial sex exploitation of American girls and women, the idea that women and girls are trafficked to fuel the male entertainment industry and pornography holds some truth. Most of the pornographic industry is online, and many of the women who act in the films are coerced or forced (Luzwick, 2017). Peters, Lederer, and Kelly (2012) highlight major court cases of online pornography that were determined to be labor or sex trafficking, like a 1999 “Rape Camp” website where viewers could make demands of sexually violent acts against Asian victims. In 2011, there was a case in Florida where two men would recruit women to be models, then drug, rape, and record videos of them without consent at their auditions to be shown and sold online. While not all cases of trafficking for pornography are this extreme, it is more common that fairly paid actors are pressured into performing new sexual acts by their agents and directors, which can quickly cross into sexual assault and trafficking (Peters, Lederer, & Kelly, 2012). Despite there being many adult film actors who are consenting and fairly paid, the danger is that there is no way for the viewer to know who did and did not fully and openly consent, therefore consumption of any online pornography is fueling the sex trafficking industry (Fight the New Drug, 2018). Additionally, with the consumers of violent forms of pornography, it is not only difficult to tell if the actors in the film agreed to the sexual acts, but also the consumers are continuously desensitized to the violence and may become consumers of trafficked persons to act out their fantasies (Luzwick, 2017; Peters, Lederer, & Kelly, 2012).

“Dancers at Love and Music bar, Angeles City” by Blemished Paradise is licensed under CC BY-SA 2.0

The Polaris Project (2017), using 10 years of data from calls, emails, and webforms sent to the National Human Trafficking Hotline, had 616 cases of sex trafficking through pornography, where most victims were U.S. citizens and women, and the non-consenting pornographic material was created by family members, intimate partners, and individual sex traffickers. There were also 78 reported cases of “Remote Interactive Sexual Acts” or commercial sex acts through webcams, phone sex chats, or texting lines. In the case of remote interactive sexual acts, the LGBTQ population was documented as 12% of the cases, which is odd considering usually the LGBTQ population makes up 2-3% of the exploited population in other cases of sex trafficking (Polaris Project, 2017).

A more recent variation of sex trafficking in relation to pornography is the idea of “revenge porn”. Revenge porn, or nonconsensual porn, is the threatened distribution, or actual distribution, of sexually explicit materials in order to control, blackmail, or shame a victim (The National Domestic Violence Hotline, 2016). Some victims willingly shared the materials initially with the recipient but did not consent to the additional distribution, while other victims are forced into making the materials by an individual who plans to use them as leverage for control (The National Domestic Violence Hotline, 2016). Revenge porn is a growing problem in the internet age, prompting some states to begin enacting legislation to criminalize the distributors (Kamal & Newman, 2016). While not yet widely considered a part of human trafficking, revenge porn utilizes force and coercion for the sexual exploitation of a victim. The long-term mental health effects of being a victim of revenge porn are similar to those of victims of child pornography, and include symptoms of depression, paranoia, guilt, and suicidal ideation (Kamal & Newman, 2016).

Pornography is not the only male entertainment industry involved in sex trafficking. While escorts, massage parlors, or health and beauty covers for prostitution are forms of male entertainment, they are covered more in forced prostitution. Strip clubs, bars, and cabanas, however, are a form of male entertainment that are not covered in forced prostitution. Victims trafficked in strip clubs, bars, and cantinas are often being sex and labor trafficked under the guise of male-focused restaurants and businesses (National Human Trafficking Hotline, n.d.c.; Polaris Project, 2017). The victims are forced to flirt with patrons and entice them into paying for more expensive products at the business, with the implicit or explicit agreement that sexual acts will be included (National Human Trafficking Hotline, n.d.C.; Polaris Project, 2017). From 2006-2017, there were 792 reports of trafficking in the United States fitting this description (Polaris Project, 2017).

Women being detained after a massage parlor was busted in a human trafficking ring
https://lorrab.wordpress.com/2014/12/05/15-women-arrested-in-prostitutionhuman-trafficking-sting-at-brooklyn-massage-parlors/

Domestic Minor Sex Trafficking

Globally, children are common targets for sex trafficking recruitment. Yearly, traffickers exploit approximately 1 million children for the purpose of sex trafficking around the world (International Labor Organization, 2017). A conservative estimate of the number of children domestically involved in the sale of sex, pornography, escort services, stripping or other sexual acts is around 200,000 annually, with an estimated 244,000-325,000 additional children annually at risk (Goldberg & Moore, 2018). In 2018, 51.6% of criminal human trafficking cases were cases of sex trafficking of children (Currier & Feehs, 2019). The National Center for Missing and Exploited Children (2018) estimates that 1 in every 7 missing children is likely a victim of sex trafficking. Reported cases of missing children are present in all 50 states.

SHARED HOPE

The term Domestic Minor Sex Trafficking (DMST) was coined by Shared Hope International and is used to describe the commercial sexual exploitation (CSE) of American children on US soil (Smith, Vardaman, & Snow, 2009). By virtue of being young, impulsive, and novelty seeking, children and adolescents are at an increased risk of being trafficked or sexually exploited (Smith, 2014). Additional risk factors for children becoming sex trafficking victims include: being runaways or homeless; being in foster care; prior abuse or neglect; substance abuse issues; poverty; missing or absent parents; difficulty in school; and being LGBTQ or other children who have been abandoned or ostracized by their family (The National Center for Missing and Exploited Children, 2018; Shared Hope International, 2019; Smith, 2014). The three most common routes for the recruitment of children victims are social media, their local neighborhood, and clubs and bars (Shared Hope International, 2019). The average age a child is recruited into sex trafficking in the United States is 12-14 years old, but some children are exploited as toddlers and infants (Goldberg & Moore, 2018; Thorn, 2018). Similar to other sex trafficking victims, the exploiters of domestic minor sex trafficking victims can be peers, family members, significant others, or in some cases, strangers (Goldberg & Moore, 2018; Kotrla, 2010). Peers or perceived friends are reported to be the recruiters of individuals into minor sex trafficking in 44-68% of cases, with a peer being the actual trafficker in 28% of cases (Goldberg & Moore, 2018). While there are some instances where youth are approached and engaged in sexual acts one on one, in almost every case, a minor involved in DMST has a pimp (Smith, Vardaman, & Snow, 2009).

Not surprisingly, the internet and social media not only play a major role in the recruitment of domestic minor sex trafficking victims, but also in their sale (Goldberg & Moore, 2018; Kotrla, 2010). In 2018, 95% of teens reported having or having access to a smartphone, with 51% of teens using Facebook, 69% using Snapchat, 72% using Instagram, and 85% using YouTube (Anderson & Jiang, 2018). A report by the Polaris Project (2017) reported all of these platforms, plus chat apps and dating apps are being used to recruit trafficking victims, as seen in the figure below. Traffickers use social media apps to find, build relationships with, and groom potential victims, and then use social media and the internet to advertise and sell their victims (Goldberg & Moore, 2018; Kotrla, 2010). Preying on the insecurities of teens, traffickers will build relationships, especially with young girls, telling them they are beautiful and mature, creating an insincere romantic relationship, promising gifts, or promising careers in modeling, acting, and dancing (Polaris Project, 2019; Smith, 2014). In a study on domestic minor sex trafficking victims recruited since 2015, 55% of victims met their traffickers through social media, with 85% of the entire sample reporting that their trafficker spent a significant amount of time with them face-to-face building what seemed to be a meaningful relationship (Thorn, 2018).

Social media recruitment for human trafficking
Retrieved from The Polaris Project https://polarisproject.org/sites/default/files/Polaris-Typology-of-Modern-Slavery.pdf

Warning signs that a youth is engaged in DMST include but are not limited to: evidence of abuse, tattoos or branding, history of or recurring STIs, being withdrawn, asking for permission to speak or allowing another person to speak for them, having large amounts of money, and having expensive items with no way to pay for them such as electronics or designer clothes (Goldberg & Moore, 2010; The National Center for Missing and Exploited Children, 2018). Smith, Vardaman, and Snow (2009) found misidentification of victims to be the primary barrier to rescuing minors who are being sex trafficked, and attributed misidentification to the frequent criminalization of victims.

https://www.haaretz.com/israel-news/.premium-ta-judge-prostitutes-working-in-brothels-arent-breaking-law-1.5389545

Interventions

The needs of sex trafficking victims span a number of disciplines that include medicine, law, and social work. Traffickers use drug-addiction, access to housing and basic needs, physical abuse, criminal offenses, immigration-related tactics and blackmail to maintain control over their victims. Therefore, interventions must be able to break the dependence victims have on their traffickers. The first step in assisting sex trafficking victims is identification. Medical personnel in hospitals, emergency rooms, clinics, and shelters can act as first responders in identifying potential victims through knowing warning signs or red flags (Hodge, 2014). For DMST victims specifically, it is important for child protective service and child welfare workers, school officials and law enforcement officers to learn warning signs, have proper screening tools, and know what questions to ask (Meshelemiah, Poole, & Michel, 2013). This also applies to healthcare workers. Frontline workers in these arenas must put forth efforts to learn the warning signs, acquire screening tools, and familiarize themselves with protocol to intervene in instances of sex trafficking. These signs and red flags are detailed in Chapter 12: “Identifying Trafficking Victims in Healthcare Settings”. In the meantime, warning signs and red flags include behavioral cues like being fearful, anxious, depressed or submissive and show signs of drug use. Physical cues include poor hygiene and signs of physical abuse. Other indicators include not being free to speak or leave when they want to, having no control of one’s agency or money, having little to no possessions and being constantly monitored. Last, having no sense of person, place or time is a red flag when all or many of these elements interact with those previously listed (Polaris, 2019).

After identification, ensuring access to resources that can provide basic needs like housing, food, and clothing is essential (Gezinski & Karandikar, 2013; Hodge, 2014). Knowing the availability of resources and programming, as well as eligibility and documentation needed for said programming is an essential skill for those assisting sex trafficking survivors (Baldwin, 2003). Micro-practice therapeutic social workers and other mental health service providers will need to: help victims in addressing and living with their trauma; provide substance abuse counseling; and assist in developing victims’ coping skills to establish physical and psychological safety (Office for Victims of Crime Training and Technical Assistance Center, n.d.).

On a macro level, social workers should advocate for inter-agency collaboration, information sharing, specialized trainings, and coalition building to create streamlined community and large scale efforts to best serve trafficking victims (Clawson, Small, Go, & Myles, 2003). It is also important to increase awareness and understanding of the TVPA and trafficking in persons, develop protocols specifically for working with victims of trafficking, promote awareness and understanding for victims on their rights and legal protections, and expand outreach efforts (Clawson, et al., 2003). Shared Hope International (2019) specifically focuses on DMST and evaluates federal and state level legislation and policy efficacy and annual progress; social workers interested in policy work should undertake similar tasks to provide a social work lens on policy and legislation evaluation, implementation, and creation.

Quiz

An interactive or media element has been excluded from this version of the text. You can view it online here:
https://ohiostate.pressbooks.pub/humantrafficking/?p=26

Now, let’s shift gears and turn to a case study.

SARAH

Sarah is a 17-year-old girl living at home with her parents while she finishes high school. Sarah and her mother fight often, and her mother has people coming and going from their apartment several nights a week for drug transactions. One of the men starts talking to Sarah occasionally, telling her it’s not fair how her mom talks to her or treats her. Sarah begins thinking he understands her and cares about her point of view. After a few months of speaking occasionally, Sarah and the man, called Trip, begin texting. Trip tells her how she’s too pretty and smart to be single and not spoiled and begins buying her clothes, purses, and shoes and giving her money to treat herself. Sarah thinks that Trip genuinely cares about her and accepts the gifts, and spends time with Trip outside of when he comes to see her mom. Then, one day Trip tells Sarah he needs a favor because he is in a tight spot. He says he will come pick her up. After picking her up, Trip tells Sarah that he is running low on money and owes someone a lot. They have agreed that if they can spend some time with Sarah that they will cancel the debt. Since Sarah has received so much from Trip, she feels she owes it to him to “spend some time” with his friend. Trip takes Sarah to a motel and introduces her to his friend in one of the rooms. He then leaves and says he’ll be right back, he’s going to get something out of the car. While Trip is gone, the man threatens her and rapes her, telling her if she ever wants to leave the hotel room again she’ll comply. The man leaves shortly after he is finished with Sarah and she sees him talking to Trip in the parking lot before handing him a lot of money. When Trip comes back to the hotel room Sarah asks what took him so long and tells him what happened. Trip tells her that if she expects to receive extravagant gifts she has to help him out sometimes, too. He says he’s sorry she is upset and it won’t happen again. Since Sarah believes that Trip cares about her she believes him. However, it does happen again, and soon it happens more regularly. It takes Sarah over a year to realize that Trip does not care about her and is making money off of her. At that point, however, Trip was the only person Sarah had consistently in her life and she felt like she brought it on herself. Sarah does not know how to leave Trip or who to turn to for help.

Real case study: https://sharedhope.org/2016/09/09/southwest-washington-girl/

Summary of Key Points

- Sex trafficking is the most common perception of human trafficking and affects millions of people around the world, with an estimated 1 million children being sex trafficked every year.

- Sex trafficking is not only forced prostitution, but it is a complex arena involving pornography, the male entertainment industry, escort services, massage and health parlors, and the buying and selling of children.

Supplemental Learning Materials

Websites

Globalslaveryindex.org

Traffickingmatters.com

Crimes Against Children Research Center: unh.edu/ccrc/prostitution/

FCASV.org

Demandabolition.org

Fightthenewdrug.org

Books

Half the Sky, Nicholas Kristof & Sheryl WuDunn

Girls Like Us, Rachel Lloyd

Invading the Darkness, Linda Smith

Articles

Center for Court Innovation. (n.d.). The Intersection of Domestic Violence, Sexual Assault, and Human Trafficking. Retrieved from https://www.courtinnovation.org/sites/default/files/documents/UnderstandingHumanTrafficking_2.pdf

Gewirtz-Meydan, A., Walsh, W., Wolak, J., & Finkelhor, D. (2018). The complex experience of child pornography survivors. Child Abuse & Neglect, 80, 238-248. DOI: 10.1016/j.chiabu.2018.03.031

O’hara, M. (2018). Making pimps and sex buyers visible: Recognising the commercial nexus in ‘child sexual exploitation’. Critical Social Policy, 39(1), 108-126. DOI: 10.1177/0261018318764758

References

Anderson, M. & Jiang, J. (2018). Report: Teens, Social Media & Technology 2018. Pew Research Center. Retrieved from https://www.pewinternet.org/2018/05/31/teens-social-media-technology-2018/

Baldwin, M. (2003). Living in Longing: Prostitution, Trauma Recovery, and Public Assistance. Prostitution, Trafficking, and Traumatic Stress Ed: Melissa Farley. Routledge. New York, NY.

Clawson, H. Small, K., Go, E., & Myles, B. (2003). Needs Assessment for Service Providers and Trafficking Victims. Caliber Associates, Inc. Retrieved from https://www.ncjrs.gov/pdffiles1/nij/grants/202469.pdf

Cody, H. (2017). Domestic Violence and Human Trafficking. UNICEF. Retrieved from https://www.unicefusa.org/stories/domestic-violence-and-human-trafficking/33601

Currier, A. & Feehs, K. (2018). 2018 Federal Human Trafficking Report. The Human Trafficking Institute. Retrieved from https://www.traffickingmatters.com/wp-content/uploads/2019/04/2018-Federal-Human-Trafficking-Report-Low-Res.pdf

Department of Health and Human Services. (n.d.). Resources: The Mindset of AHuman Trafficking Victim. Retrieved from https://www.acf.hhs.gov/sites/default/files/orr/understanding_the_mindset_of_a_trafficking_victim_1.pdf

Farmand, R. (n.d.). Criminalization of Human Trafficking Victims. Wi-Her. Retrieved from http://www.wi-her.org/criminalization-of-human-trafficking-victims/

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Gezinski, L.B. & Karandikar, S. (2013). Exploring needs of sex workers from Kamathipura red-light area of Mumbai, India. Journal of Social Service Research, 39(4), 552-561. DOI: 10.1080/01488376.2013.794758

Goldberg, A. & Moore, J. (2018). Domestic minor sex trafficking. Child and Adolescent Psychiatric Clinics of America, 27(1), 77-92. DOI: 10.1016/j.chc.2017.08.008

Grough, M. & Goldbach, T. (2010). Relationship Between Pimps and Prostitutes. Cornell University Law School Student Projects. Retrieved from https://courses2.cit.cornell.edu/sociallaw/student_projects/PimpsandProstitutes.htm

Hodge, D. (2014). Assisting victims of human trafficking: Strategies to facilitate identification, exit from trafficking, and the restoration of wellness. Social Work, 59(2), 111-118. DOI: 10.1093/sw/swu002

Hopper, E., & Hidalgo, J. (2006). Invisible chains: Psychological coercion of human trafficking victims. Intercultural Human Rights Law Review, 1, 185-210. Retrieved from https://heinonline.org/HOL/P?h=hein.journals/ichuman1&i=198

International Labor Organization. (2017). Global Estimates of Modern Slavery. Geneva. Retrieved from https://www.ilo.org/wcmsp5/groups/public/—dgreports/—dcomm/documents/publication/wcms_575479.pdf

Kamal, M., & Newman, W. (2016). Revenge pornography: Mental health implications and related legislation. Journal of the American Academy of Psychiatry Law, 44, 359-367. Retrieved from https://pdfs.semanticscholar.org/9283/a01263d26c34dfe2f7943ee18ea311a4a8da.pdf

Kotrla, K. (2010). Domestic minor sex trafficking in the United States. Social Work, 55(2), 181-187. Retrieved from https://pdfs.semanticscholar.org/dcd1/adff7da96a9363e80854a77cc2d54652ee8d.pdf

Lillie, M. (2014). Human Trafficking: Not All Black and White. Human Trafficking Search. Retrieved from https://humantraffickingsearch.org/human-trafficking-not-all-black-or-white/

Luzwick, A. (2017). Human trafficking and pornography: Using the Trafficking Victims Protection Act to prosecute trafficking for the production of internet pornography. Northwestern University Law Review, 111, 137-153. Retrieved from https://www.acf.hhs.gov/sites/default/files/orr/understanding_the_mindset_of_a_trafficking_victim_1.pdf

Meshelemiah, J. & Lynch, R. (2019). Sex Trafficking: The Intersection of Race, Drugs, “Dope Boys” – and Emergent Leaders. (Presentation). The Kirwan Institute, Columbus, OH.

Meshelemiah, J.C.A., Poole, A., & Michel, E. (2013). Creating a standard protocol for domestic minor sex trafficking victims: How child welfare workers can better facilitate better protections under the guise of the TVPA. (NASW). Specialty Practice Sections. Children, Adolescents, Youth and Family Section Connection. (Winter). Retrieved from https://www.socialworkers.org/assets/secured/documents/practice/cayawinter2013.pdf

Monto, M. & Milrod, C. (2014). Ordinary or peculiar men? Comparing the customers of prostitutes with a nationally representative sample of men. International Journal of Offender Therapy and Comparative Criminology, 58(7), 802-820. DOI: 10.1177/0306624X13480487

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National Human Trafficking Hotline. (n.d.b.). The Traffickers. Retrieved from https://humantraffickinghotline.org/what-human-trafficking/human-trafficking/traffickers

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Chapter 5: The Weaponization of Drugs

ABSTRACT

Drug use among sex trafficked victims is common and is used in a variety of ways in the sex trafficking arena.  Drugs are used to induce compliance; create dependency; feed a “habit”; punish an unwilling victim; cope with the stress of sex trafficking; lure in a vulnerable and unsuspecting individual; criminalize a victim; and to incapacitate a victim. In essence, they are weaponized in the trafficking arena. This chapter will discuss how drugs are used as weapons.

Learning Objectives

By the end of this chapter, the student will be able to:

- Define substance use

- Understand the symptoms of Posttraumatic Stress Disorder

Key Words: Substance Use Disorders, Posttraumatic Stress Disorder

GLOSSARY

Substance Use Disorders: A cluster of behavioral, cognitive and physiological symptoms that result from the persistent use of a substance (e.g., a drug or toxin) despite its negative consequences

Posttraumatic Stress Disorder: The development of a cluster of symptoms following exposure to one or more traumatic events

Substance Use and Sex Trafficking of Adults

According to Hughes (as cited in Reichert & Sylwestrzak, 2013), more than 70% of trafficking victims surveyed reported using substances. Many meet the Diagnostic and Statistical Manual (DSM-5) of Mental Disorders clinical criteria for substance use disorders as described in the table below.  In the human trafficking arena, drugs are used for multiple purposes and in a variety of ways. Traffickers use drugs to lure in persons with an established drug use problem, which is reported to be a small number of victims. They also use drugs to entice or lure in an inexperienced victim to get her “hooked”. Later, drugs are often used as a reward (for compliance) and as a punishment for the drug dependent victim. The trafficker also sometimes forces the consumption of addictive substances because it will guarantee the trafficker that: 1) the victim will become dependent; 2) drug dependencies will make the victim incur debt to the trafficker; 3) the trafficker will be able to control the victim through drug use, and 4) the victim may become unduly influenced to stay due to trauma bonding despite how bad the trafficking experience may be (Bernat & Winkfeller, 2010; Kara, 2009; Meshelemiah, Gilson & Prasanga, 2018; Williamson, Dutch & Clawson, 2007). Drugs are also used to incapacitate the client so that conforms to the demands of the trafficker. In this chapter, the authors discuss drug use among domestic and foreign national sex trafficking survivors.

Cumulatively, drugs are used to control the victim and to create dependency on the perpetrator once dependency on the drug is established (Becky Owens Bullard Consulting, 2012).  It is also believed that some trafficking victims may resort to drug use to help cope with the victimization (Latin American and Caribbean Health Network, 2003; US Department of Health and Human Services, 2014). Foreign victims, for example, who have been sex trafficked have reported 1) being required to have daily sex with men in the double digits; 2) having to meet a daily money quota; and 3) have sex without condoms, which puts them at greater risk for HIV, Herpes Simplex Virus-2 (HSV-2), and other sexually transmitted infections (STI) (Derseh, Wasie, & Edris, 2012; Kara, 2009). In addition to these demands, sex trafficking victims are subjected to constant threats and complete isolation (US Department of State, 2014).

According to Meshelemiah, Gilson and Prasanga (2018), drugs are sometimes deliberately entered into the equation—again, for the purposes of compliance, incapacitation, and dependency/addiction. The researchers argue, however, that there are still more reasons for why traffickers utilize drugs with trafficking victims.  In some cases, the trafficker’s motivation for drug use may be to set up the trafficking victim in case she is ever arrested on prostitution and/or prostitution-related charges.  If apprehended by law enforcement while under the influence or in possession, drug using victims may lose their credibility and presumed innocence. The trafficker knows that her arrest will distract from her victimization.

DRUGS AS WEAPONS

Drugs are weaponized against sex trafficked women.

When a sex trafficked victim uses a drug and subsequently develops a dependence, it further increases her vulnerability.  Increased vulnerability and drug dependence are integral tools used by the trafficker to get what he wants— more “work” from a person who is viewed as property and as a commodity. In the case of foreign nationals, women with confiscated passports/identification cards, undocumented statuses, language barriers, and are long distances from their biological families are at great risk for increased exploitation (Kara, 2009; Sigmon, 2008).  These factors coupled with instilled fear, lack of knowledge of the law and her rights, and fear of law enforcement, makes the victim susceptible to the harshest of conditions (Sigmon, 2008).

In the case of sex trafficked women as a whole, drugs are used like weapons—they are used as a tool of mass destruction; as a tool to gain advantage over an already vulnerable victim; and as a tool to disarm a victim due to its power. Drugs are weaponized in the sex trafficking world. Commonly used drugs with sex trafficking victims include tobacco, alcohol, hallucinogens, cocaine, heroin, sedatives, and marijuana (Kara, 20009; McGaha, 2011; Raymond & Hughes, 2001; Williams et al., 2013). Heroin, which is an opioid, is particularly addictive (American Psychiatric Association [APA], 2013). Heroin and other opioids are frequently used drugs by trafficking victims (Office on Trafficking in Persons of the Administration of Children and Families, nd). As seen in the slide on Opioid Use Disorders, impairment and distress can take place in a number of areas that include the cognitive, behavioral and physiological (APA, 2013).

The emotional consequences of forced prostitution among sex trafficked victims can be extreme and sometimes more severe than the physical consequences (Raymond & Hughes, 2001). Specific to these authors’ basic premise here, Substance Abuse and Mental Health Services Administration Program (SAMHSA) based services are critical to the trafficking survivor.  The Substance Abuse and Mental Health Services Administration (SAMHSA) is a branch of the U.S. Department of Health and Human Services. It has the responsibility of improving the quality and availability of services to those who suffer from substance use and mental disorders  (SAMHSA, 2014a).  SAMHSA’s mission and goal is to protect and promote the human, civil, and legal rights and moral freedoms of those served through its activities (De Jong & Reatiq, 1998).

Many sex trafficked victims suffer from disorders that fall under the auspice of the SAMHSA administration. For example, many sex trafficking victims suffer from substance use disorders along with depressive disorders, anxiety disorders, dissociative disorders, borderline personality disorder, eating disorders, and suicide attempts (Farley, 2010; Raymond & Hughes, 2001; Sigmon, 2008; Williamson, Dutch & Clawson, 2007). According to the most current version of the Diagnostic and Statistical Manual (DSM) of Mental Disorders, trafficking victims are especially at high risk for developing Posttraumatic Stress Disorder (PTSD) (APA), 2013).

SAMHSA’s working definition of trauma purports that it involves an event, a series of events, or a set of circumstances that the individual experiences in a physically or emotionally harmful or threatening way.  One’s response to the events then results in long lasting adverse effects on the individual’s functioning and overall psychosocial and spiritual well-being. Trauma is considered to be a combination of the event, the experience, and the effect (SAMHSA, 2014b). Consistent with the previously stated disorders, Raymond and Hughes (2001) report that many survivors report numbness, depression, lethargy, self-blame/guilt, poor concentration, loss of appetite, and sleep disturbances. The American Psychiatric Association shows that trauma is oftentimes co-morbid with substance misuse and other DSM disorders (APA, 2013).

*Social Determinants of Health

An important layer to add to the discussion on human trafficking is the social determinants of health framework. According to this framework, extenuating circumstances contribute to one’s position, environment and opportunities in life.  These factors, when compromised, preemptively undermine a person’s potential, by leading them to fall into situations of vulnerability and/or danger.  As outlined in a joint report by the World Health Organization (WHO) and the Commission on Social Determinants of Health, a person’s access to healthcare, education, and adequate housing along with work conditions and the immediate environment all affect one’s outcomes (WHO Commission on Social Determinants of Health & World Organization, 2008).

While there is a large variance in health factors between countries, often determining life outcomes by region, is it the inequality of social determinants specifically within the same areas (varying on an individual level) that creates great divides and prove health to be an outcome impacted by various social factors (Navarro, 2009). From a public health perspective, these social determinants of health can lead to the development of risky behaviors and increased exposure to harmful outcomes such as human trafficking.

At its most basic level, the premise of a human right is that every individual in the world is entitled to it. Safety, security, and freedom are all standard human rights, but they can be compromised in environments where unequal social determinants of health leave some populations/groups more at risk than others. For human trafficking victims surrounded by multiple social determinants which breed insecurity and enable manipulation (such as food and job insecurity, unstable housing and limited access to healthcare and other support systems), the chances of force, fraud and coercion are heightened (Perry & McEwing, 2013). In their systematic review with a specific focus on Southeast Asia, Perry and McEwing (2013) point out that social determinants, including citizenship, level of education, and gender were found to be compromised in populations of foreign national human trafficking victims.

As sex trafficking is examined among foreign nationals in this context, it is juxtaposed that basic needs are unmet in the country of origin (Jones, Engstrom, Hilliard & Diaz, 2007; Okogbule, 2013).  As victims become trafficked, their needs are further denied, beyond their compromised determinants of health. This is especially exacerbated among those who develop substance use issues. Upon exit from trafficking, victims will commonly experience unstructured freedom and (for some) an untreated drug problem in a foreign country without proper support and services. As pointed out by Zimmerman et al. (2008) in an extensive study conducted to understand the health needs of victims post-trafficking in Europe, the trauma experienced by trafficking victims often leads to an inability to judge one’s environment and to understand what is safe. This instability only perpetuates vulnerability to trafficking, manipulation, and further suffering—disconcertingly mirroring the beginning of their journey, in which compromised determinants of health created disadvantage in the first place.  Thus, human rights violations are the cause and consequence of human trafficking.

In order to combat this phenomenon, it is important to strategically approach human trafficking as an issue initiated and perpetuated by the unequal determinants which create outcomes contradictive of the rights that people share as human beings.  By taking an approach informed by the role that social determinants play, one can more holistically understand the circumstances upon which victims’ experiences are established, and continue with a mindset more attentively focused on creating equitable approaches to survivors and their needs post-trafficking.

*Written by Jacquelyn Meshelemiah and Carra Gilson (Master of Public Health Student)

SHANDRA WOWORUNTU

The following is the true story of a foreign national victim named Shandra Woworuntu.  Her story is a common trajectory of a foreign national victim of sex trafficking. This case illustrates the journey of a woman traveling to a foreign country for a better opportunity only to be lured and trapped into trafficking and drug use (Woworuntu, 2016).

In 2001, Shandra was a recently unemployed 24-year-old-woman from Indonesia.  She had a 4-year degree and a 3-year-old daughter to provide for. She arrived to the United States in pursuit of a job in a hotel. Upon landing at the JFK Airport, she was led to a car by a man under the impression that he was taking her to her place of employment.  After being shuffled between three different vehicles and across various stopping points throughout New York, she realized that something was wrong. By the end of her first night on US soil, Shandra was forced into having sex with a man she did not know, thus beginning her traumatic journey as a victim of human trafficking.

The use of manipulation, both physically and mentally, pervaded the months in which Shandra was trafficked.  Her traffickers forced her to have sex with lots of men. Shandra explains that on the first occasion her trafficker told her, “It won’t happen again”, as he rubbed her back.  Initially, after this reassuring encounter, Shandra asserts, “I trusted him”, but this manipulative behavior, combined with fear tactics effectively kept Shandra (and the other women whom she was enslaved with) in submission. Having witnessed an act of violence against another woman early on, Shandra knew that she had to do what was told of her.  In addition to acts of physical and sexual violence, and triggering mental distress, the traffickers induced passivity in Shandra and the other women through forced drug use.  “The traffickers made me take drugs at gunpoint…maybe it helped make it all bearable”, she shared in recollection of her trauma.

While Shandra quickly recognized that her situation was compromising and unsolicited, a physical dependency on drugs (in addition to other forms of coercion to which she was being subjected to) kept her entrapped. The experience quickly induced emotional trauma. She explains, “…it was like I was numb, unable to cry. Overwhelmed with sadness, anger, disappointment, I just went through the motions, doing what I was told and trying hard to survive”. The traffickers were forceful and ceaseless in their treatment of Shandra, as they worked to keep her in a compromised state. Drug use and abuse continued to be the tactic relied upon to create submission and dependence. Shandra remembers, “I was often high on drugs”. Despite these horrifying conditions and traumatic treatment, Shandra was able to successfully escape on her third attempt.

Left to Right: Business cards from groups that helped Shandra; Shandra’s 2001 application photo; Shandra with her trafficker. https://www.safehorizon.org/tag/shandra-woworuntu/

Shandra’s story highlights vulnerability, forced drug use, mental anguish, violence and sexual assaults associated with human trafficking.  It also depicts the push and pull factors of trafficking.  Push factors relate to those variables that make one vulnerable to being deceived and manipulated into a trafficking situation. This includes being impoverished; having few supports; being homeless; having a lack of knowledge; having few employment opportunities and being subjected to gender stereotypes, for example. Pull factors relate to those variables that draw in victims to a potential harmful situation. This includes looking for a potential marriage; gainful employment; housing and other material gains (International Labor Organization (ILO), 2011; Krehbiel, 2016; Okech, Morreau, & Benson, 2011; Wooditch, 2011). More importantly, it reiterates the importance of supporting sex trafficking victims and survivors through access to substance use treatment and mental health services, in order to redress the detrimental effects that human trafficking has on one’s mental and physical health outcomes as shown in Shandra’s story.

Quiz

An interactive or media element has been excluded from this version of the text. You can view it online here:
https://ohiostate.pressbooks.pub/humantrafficking/?p=27

An interactive or media element has been excluded from this version of the text. You can view it online here:
https://ohiostate.pressbooks.pub/humantrafficking/?p=27

Now, let’s shift gears and turn to a case study.

Summary of Key Points

- Drug use is common in the sex trafficking arena.

- Drugs are used to induce compliance, create dependency, feed a “habit”, punish an unwilling victim, to cope with the stress of sex trafficking, to lure in a vulnerable individual, to criminalize a victim and to incapacitate a victim.

Supplemental Learning Materials

Shandra Woruntu Full Story 2018. Video (7:35 minutes)

https://www.youtube.com/watch?v=EGpcM_bxdh4

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC:  Author.

Becky Owens Bullard Counseling. (2012). Human trafficking intersections with drug endangered children.  Issue Brief. Retrieved from www.beckyowensbullard.com

Bernat, F.P., & Winkeller, H.C. (2010). Human sex trafficking:  The global becomes local. Women & Criminal Justice, 20, 186-192.

De Jong, J. & Reatiq, N.  (1998). SAMHSA philosophy and statement on ethical principles. Ethical Behavioral Journal, 8(4), 339-343.

Derseh, L., Wasie,B., & Edris, M. (2012). Unsafe sexual practice among cross-border commercial sex workers in Mettema Yohannis, Northwest Ethiopia. Ethiopian Journal of Health Biomedical Science, 5(1), 11-20.

Farley, M. (Ed.). (2010). Prostitution, trafficking, and traumatic stress. New York:  Routledge.

International Labor Organization. (2011). Trafficking in persons overseas for labor purposes:  The case of Ethiopian domestic workers. ILO Country Office:  Addis Ababa.

Jones, L., Engstrom, D.W., Hilliard, T., & Diaz, M. (2007).  Globalization and human trafficking.  Journal of Sociology & Social Welfare, 34(2), 107-122.

Kara, S. (2009). Sex trafficking: Inside the business of modern slavery. New York: Columbia University Press.

Krehbiel, S. (February 24, 2016). The victim narrative on sex-trafficking:  An interview with Yvonne Zimmerman (Part 1). Our untold stories: World Press.

Latin American and Caribbean Health Network. (2003). The trafficking of women: A human rights issue. Women’s Health Journal, 2, 19-21.

McGaha, J. (2011). An integrated approach to anti-human trafficking task force development in Eastern Europe. National Science Science Journal, 36(2), 87-93.

Meshelemiah, J.C.A., Gilson, C., & Prasanga, A.P.A.  (2018). Use of drug dependency to entrap and control victims of human trafficking: A call for a US federal human rights response. Dignity:  A Journal on Sexual Exploitation and Violence, 3(3), Article 8.

Navarro, V. (2009). Social determinants of health: What we mean by social determinants of health. International Journal of Health Services, 39(3), 423-441.

Office on Trafficking in Persons of the Administration of Children and Families. (nd). Retrieved from https://www.google.com/search?q=opioids+used+by+sex+trafficked+persons&rlz=1C1GCEU_enUS820US820&oq=opioids+used+by+sex+trafficked+persons&aqs=chrome..69i57.11901j1j7&sourceid=chrome&ie=UTF-8

Okech, D., Morreau, W., & Benson, K. (2011). Human trafficking: Improving victim identification and service provision. International Social Work, 55(4), 488-503.

Okogbule, N.S. (2013). Combating the “new slavery” in Nigeria: An appraisal of legal and policy responses to human trafficking.   Journal of African Law, 57(1), 57-80.

Perry, M., & McEwing, L. (2013). How do social determinants affect human trafficking in Southeast Asia, and what can we do about it? A systematic review. Health and Human Rights, 15(2), 138-159.

Raymond, J.G., & Hughes, D.M. (2001). Sex trafficking of women in the United States:  International and domestic trends. Retrieved from http://bibliobase.sermais.pt:8008/BiblioNET/upload/PDF3/01913_sex_traff_us.pdf

Sigmon, J.N. (2008). Combatting modern-day slavery: Issues in identifying and assisting victims of human trafficking worldwide. Victims and Offenders, 3, 245-257.

SAMHSA. (2014a).  About us. Retrieved from http://beta.samhsa.gov/about-us

SAMHSA. (2014b).  Trauma definition. Retrieved from http://www.samhsa.gov/traumajustice/traumadefinition/definition.aspx

US Department of Health and Human Services. (2014).   Resources:  Common health issues seen in victims of human trafficking. Retrieved from http://www.justice.gov/usao/ian/htrt/health_problems.pdf

WHO Commission on Social Determinants of Health, & World Health Organization. (2008). Closing the gap in a generation: Health equity through action on the social determinants of health: Commission on social determinants of health final report. International Government Publication. Retrieved from http://osu.worldcat.org/oclc/248038286

Wooditch, A. (2011). The efficacy of the Trafficking in Persons report:  A review of evidence. Criminal Justice Policy Review, 22(4), 471-493.

Williamson, E., Dutch, N.M., & Clawson, H.J. (2007). Evidence-based mental health treatment for victims of human trafficking.  Retrieved from http://aspe.hhs.gov/hsp/07/humantrafficking/mentalhealth/index.pdf

Woworuntu, S. (March 30, 2016). My life as a sex trafficking victim. Magazine. Retrieved from http://www.bbc.com/news/magazine-35846207

Zimmerman, C., Hossain, M., Yun, K., Gajdadziev, V., Guzun, N., Tchomarova, M., …Watts, C. (2008). The health of trafficked women: A survey of women entering post trafficking services in Europe. American Journal of Public Health, 98(1), 55-59.

Labor Trafficking Section

This section covers Labor Trafficking and Supply Chains.  Common household products that most people consume on a regular basis will be discussed along with the behind the scene processes in the making of the product as it relates to supply chains.

“Farm workers picking cucumbers” by Bread for the World is licensed under CC BY-NC-ND 2.0

Chapter 6: Labor Trafficking and Supply Chain Transparency

ABSTRACT

According to the International Labor Organization, labor trafficking is a high profit-low risk criminal enterprise that entraps millions of people around the world into horrendous working conditions. Although individual perpetrators are common, so are businesses that do not prevent trafficking from taking place in their supply chains. Consumers, however, can play a role in fighting trafficking by conscious consumerism. This chapter discusses labor trafficking and conscious consumerism.

Learning Objectives

By the end of this chapter, the student will be able to:

- Define labor trafficking

- Understand supply chains

- Become a conscious consumer

Key Words: Labor Trafficking, Debt Bondage or Peonage, Slavery, Fraud, Coercion, Smuggling

GLOSSARY

Labor Trafficking: The recruitment, transportation, transfer, habouring 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 of receiving of payments or benefits to achieve the consent of a person having control over another person, for the purpose of exploitation

Debt Bondage or Peonage: Occurs when traffickers demand labor of the victim as a means of repayment for a real or alleged debt. The offenders do not reasonably apply a victim’s wages toward the payment of the debt. Another strategy of the offender is to limit or define the type and length of the debtor’s services. The victims may actually be charged fees by the traffickers, such as money for transportation, rooms, food, incidentals, interest, fines, and other charges such as those for “bad behavior”. Wages may be withheld or excessively reduced that even violate previously made agreements. Debt bondage ensnares a victim in a debt cycle that he or she can never pay down.

Slavery:The condition of being under the control of another person, in which violence or the threat of violence, whether physical or mental, prevents a person from exercising her/his freedom of movement or free will Indentured Servitude: The condition in which an individual enters into a contractual agreement, freely or otherwise, binding him/her to work for an employer for a fixed term in order to repay a debt Force: Includes the use of physical restraint or causing severe physical harm; physical violence such as rape, assault, and restriction of movement or physical confinement is often used as a way to control victims

Fraud: Can involve promises which are not truthful, usually regarding employment, wages, working conditions, or other subjects; for example—persons may be promised a high paying position in another country, but when they arrive they find themselves manipulated into forced labor

Coercion: Includes threats of serious harm to or physical restraint against the victim. A scheme, plan, or pattern intended to cause the victim to believe that failure to perform an act would result in severe harm to or physical restraint against that person. It also encompasses the actual or threatened abuse of the legal process.

Smuggling:Although there is a connection to human trafficking, human smuggling is another issue. Smuggling is the illegal transport of a person across a country’s border, and is transnational. With smuggling, individuals consent to being smuggled. Rather than a crime against a particular individual, this is a crime that is committed against a country. Criminals take advantage of the desperation and humanitarian crises for financial gain. Human smuggling may result in trafficking, but are considered two separate crimes

Sources

AMN Healthcare Education Services. (2018, March 25). Human Trafficking: Implications for Health Care Professionals. Retrieved from https://lms.rn.com/getpdf.php/2227.pdf

Human Trafficking Center. (2019). Definitions/Taxonomy Database. Retrieved from https://humantraffickingcenter.org/problem/database/

Labor Trafficking: Food for Thought

Unlike the previous chapters, this chapter is set up a little different. It starts with a commentary from one of the authors and then moves on to labor trafficking facts, supply chains and conscious consumerism.

COMMENTARY ON LABOR TRAFFICKING AND CONSUMERISM:

WAKE UP!!

As so eloquently stated by Fannie Lou Hamer, an American voting and women’s rights activist, community organizer, and a leader in the civil rights movement, “I am sick and tired of being sick and tired!” I am sick and tired of meeting children in Ghana who work long hours on cocoa plantations, but do not attend school or even get to taste chocolate themselves. I am sick and tired of seeing coco cola products throughout many rural areas in Africa but see no economic prosperity in that same region. I am sick and tired of getting emails from Immokalee activists about the tomato pickers in Florida who laboriously tote 50 pound loads on their shoulders each and every day but cannot convince many owners of major grocery stores and restaurant chains to simply pay the workers one more penny per pound. I am sick and tired of seeing immigrants treated like bottom feeders in countries they migrate to—like the Nicaraguans in Costa Rica and the Mexicans in America who are relegated to the slums or ghettos and/or the worst jobs available. I am sick and tired of seeing children being forced to beg in Ghana, Uganda, and Mexico. I am still horrified by the long-haired, shoeless child from Niger who grabbed my hand in Accra, Ghana and wouldn’t let go until I gave him or her money. To this day, I still don’t know if the child was a girl or boy because he or she was so browned with dirt from head to toe that gender detection was not a possibility. Last, I am sick and tired of reading these three words—“Made in China”. Aren’t people curious as to why and better yet, how so many products sold around the world—not just in the USA—are made in China? Do we think that all of these products can be made at the low prices that we purchase them at by adults working 9 to 5, five days a week at a living wage? I know that there are 1.3 billion people in China—and that’s a lot of people—but are you serious? Please do the math! The numbers simply do not add up for the rate and volume of mass production of the millions of products we love, enjoy, and consume…unless you factor in slavery, forced labor and child labor. Folks, if prices are too good to be true, they are too good to be true. I know what you are thinking. “She has it all wrong. Those people are happy to have those jobs! A dollar is a lot of money over there!” Or better yet, you are probably saying, “If I stop shopping, the economic structure of the entire country will collapse because I singlehandedly keep Michael Jordan rich; keep iPhone revenues in the billions; keep the diamond industry executives smiling at the end of each quarter, and I keep Wal-Mart as the mega-business to chase.” Wait Mr. and Ms. Money Burns My Pocket, let me assure you that if you become a more conscious consumer, the World Bank will not collapse and in the famous words of Celine Dion, [your] heart will go on and so will the Dow Jones numbers in New York City.

The authors are going to focus on labor trafficking for the purposes of merchandised goods in this chapter because it is something that we are all complicit in as consumers. It is also something that we all can do something about. Let me tell what I mean by that statement. Suppliers of material goods bank on a few things: ignorant shoppers, unconscious shoppers, bargain shoppers, gluttonous shoppers, and shoppers in a hurry to get what they want in the most convenient way possible by any means necessary no matter how it is made, who made it, and under what condition. Which one of these (or all) best describes you? It’s a good chance I have just described just about every shopper in the Western world.

As much as I hate to say it, retailers just hit the nail right on the head. They know each and every one of us personally. They do greet us by name when they send us emails and text messages, right? Well maybe they don’t know us personally and only know our names because we would have given it to them during a previous shopping excursion. Maybe they are simply mind readers, eh? On the other hand, they do not need a sixth sense or have to break any telecommunication laws to know us—we will tell them all of our innermost secrets and deepest desires if only they ask. Think about it, those little surveys we are constantly asked to complete after we make a purchase (to be eligible to be put in a drawing for a $25 gift card) are not really designed to increase customer satisfaction; they are really designed to assess what it will take to bring our gluttonous urges to an all-time high thereby resulting in an emergency shopping spree or as some would say—retail therapy. Aren’t you even a little curious as to why store clerks ask for your telephone number and email address during routine purchases? Are they for warranty purposes? To cut down on the use of paper by emailing receipts? No, I don’t think so—at least not for the primary reason for requesting these data. They simply want our contact information so that they can entice us into spending more money with them. You do know that retailers are separatists, don’t you?—They believe in separating you from your money. Well, the Bible teaches me that a fool and his or her money will soon part. Oh yeah, that’s the last thing that retailers bank on—they bank on the possibility that we are all fools.

After I teach a course or present on human trafficking anywhere in the world, I am always asked, “What can I do?” Well, this is what you can do. You can read this chapter. Tell all of your friends to read this book. Tell your family members to read this book. Just tell everyone to read this book. This book will help guide you (and all of them) in becoming a more conscious consumer. Basically, I am going to tell you to do your homework before you buy a diamond (or maybe encourage you to buy a lab-created diamond in its place). I am also going to tell you to think about everything you eat, every pair of sneakers you purchase, every label you put on your body, and every electronic you intend to buy. Basically, I am going to challenge you to take the time to question the origin of your goods. We all must wake up and do something! James Keady (an activist, former athlete, former coach, politician) said it best when he said, “You have tremendous power [as a consumer].” I agree completely. Let’s use what we have for the greater good of a global society.

Dr. Jacquelyn Meshelemiah

How Many Slaves Do You Earn?  That’s right, as a consumer, you probably have numerous items in your home, closet, car, book bag, purse or office that was produced by a slave. Take just a few minutes to assess how many slaves you earn.

Let’s start How Many Slaves Do You Own?

https://slaveryfootprint.org/

After taking this “survey”, how many slaves do you earn? 100? 45? 25? 10? Unless you are committed to living a minimalist lifestyle, you are probably feeling very surprised by how your impulsive, extravagant or excessive shopping contributes to slave labor (at some stage in the supply chain). Well, now that you know this, what do you plan to do about it?

Labor Trafficking

Labor traffickers include a wide range of perpetrators who use force, fraud, violence, threats, lies, coercion, torture, sexual abuse/rape, intimidation, attempted murder, confiscation of identity documents and debt bondage to ensnare their victims into trafficked scenarios. These varied perpetrators include:

- Recruiters

- Contractors

- Employers

- Brothel and fake massage business owners and managers

- Employers of domestic servants

- Gangs and criminal networks

- Growers and crew leaders in agriculture

- Intimate partners

- Family members

- Labor brokers

- Factory owners and corporations

- Pimps

- Small business owners and managers

(National Human Trafficking Hotline, n.d.; NIJ, 2016; Polaris, 2019)

In a study by the National Institute of Justice (2016), the researchers found that 66% of traffickers were male; mostly were in their 30s and 40s; and approximately 50% were U.S. citizens. In the agriculture industry, 82% of suspected traffickers were U.S. citizens, while suspected traffickers in the hospitality, restaurant and domestic servitude cases were mainly non-citizens.

Victims of labor trafficking include a diverse group of vulnerable persons who are in high debt, impoverished, homeless, orphaned, seeking high paying jobs, seeking love/marriage, wanting an education or to travel, and/or who are undocumented, and lack strong labor protections. They include people in the United States and all over the world who are:

- Women

- Men

- Children

Contrary to popular beliefs, labor trafficking occurs in the United States—not just in developing countries around the world. Domestically, labor trafficking takes place in the form of domestic servants, farmworkers, factory workers, door-to-door sales crews, restaurants, construction sites, carnivals, nail salons, and massage parlors (National Human Trafficking Hotline, n.d.; Polaris, 2019). In a study by the National Institute of Justice (2016), the researchers found that 71% of trafficked persons in their foreign national sample entered into the United States legally on H-2A visas (agriculture purposes) and H-2B visas (hospitality, construction and restaurants purposes), while trafficked persons who entered into the USA illegally, were mostly found in agriculture and domestic work. Additionally, trafficked persons mainly escaped on their own and did not receive specialized services until months later.

Businesses or Services that Traffickers Exploit

Not only do traffickers exploit men, women and children, but they also exploit businesses and services. The following are examples of just some of the businesses and services that traffickers take advantage of:

- Advertising (Online and Print)

- Airlines, bus, rail, and taxi companies

- Financial institutions, money transfer services, and informal cash transfer services

- Hospitality industry, including hotels and motels

- Labor brokers, recruitment agencies, or independent recruiters

- Landlords

- Travel and visa/passport services

(National Human Trafficking Hotline, n.d.)

Given this reality, it is critical that all persons employed in these businesses and service areas be properly trained to identify trafficking victims, know who to contact in suspected cases of human trafficking and care enough to act when known trafficking activities are uncovered. How to identify trafficking victims are discussed in detail in Chapter 12: “IdentifyingTrafficking Victims in Healthcare Settings”. In the meantime, the following are important indicators for you to be familiar with. They are related to atypical conditions, unusual behavior signs, physical signs of abuse/neglect, loss of control, etc.

The Tea Industry

Let’s talk about tea. Do you drink tea? If so, do you drink it hot, cold or both ways? Do you ever think about how tea is made or which countries primarily produce it? Do you ever think about the supply chain involved in tea? Well, take a moment to read more about the many countries who are guilty of human rights violations throughout the supply chain of tea.

TEA

“Tea” by ransomtech is licensed under CC BY-NC-SA 2.0

Now that you know this, does drinking tea seem so much more complicated?

Let’s shift gears to tobacco. Please view this 8-minute video on tobacco farms.

Hazardous Child Labor on Indonesian Tobacco Farms 8:31 minutes

https://youtu.be/wJnrsCGDpOY

By this point, we all are familiar with the dangers of consuming tobacco in any form. Have you considered, however, the hazardous conditions and risks of the work on tobacco farms? Have you ever considered that children—even very young children are work on tobacco farms? Please examine the supply chain infographic for tobacco in Indonesia. As you can see, there are numerous weak links in the chain that allows for rampant labor exploitation to take place.

Source: Business & Human Rights Resource Center. (2019). Indonesia: Hazardous child labour in tobacco farming exposed in Human Rights Watch report. Retrieved from https://www.business-humanrights.org/en/%E2%80%9Cthe-harvest-is-in-my-blood%E2%80%9D-hazardous-child-labor-in-tobacco-farming-in-indonesia

Now, you are probably patting yourself on the back and saying, “I don’t own any slaves—well just maybe a few; I don’t drink tea and I don’t smoke or chew tobacco…so, I am a pretty good consumer.” Right? Wait, you are probably wrong. What about clothing? I am 100% certain that you own clothing—if you are reading this chapter, you are more than likely not living in a very remote island where your clothing is handmade from animal skin killed by your bare hands or a bow and arrow. With that being the case, it is a very good chance that you have clothing that was produced in part or whole by someone exploited or enslaved in a supply chain. As seen in the infographic by AGILE ME (2017) below, our favorite “duds” go through a series of stages in the the supply chain that includes processing raw materials, spinning, weaving/knitting, dyeing/finishing, producing/sewing and getting it to the customer. From the supplier’s perspective, the production/sewing stage has several more layers to it that includes fabric supplies, accessory supply, sub-contractors and in-house production.

Sweatshops

How many of us are able to wear an article of clothing and feel 99.9% confident that “This is not a sweat shirt” that was made in a sweatshop or under some form of coercive condition in the supply chain?  That is, how many of us are confident that our consumption is not blemished by the reality that a child, forced laborer or slave had a “hand in it”  during some stage of its production in the chain supply?  Until, you are able to confidently and affirmatively answer that question, the authors would encourage more conscious consumerism.

Sudara’s “Not a Sweatshirt” sweatshirt aims to help victims of sex trafficking by raising awareness and using funds to train and employ former victims in India. Retrieved from https://inhabitat.com/ethically-produced-not-a-sweatshirt-sweatshirt-helps-victims-of-sex-trafficking/not-a-sweatshirt/

Diamonds:  A Girl’s Best Friend?

Over the years, diamonds have been marketed as a “girl’s best friend”.  The beauty, price tag, carat and clarity are all marketed as the key to a lover’s love and fondness of the receiver. On the dark-side, however,  the mining of diamonds have been long associated with slavery, murders and the supply of funding of terrorist acts by war loads.  In response to this reality, the Kimberley process has been implemented as well as the option to be a conscious consumer by purchasing a lab-created diamond. The Gemesis Diamond is one such option for those wanting something different.

Retrieved from https://i.pinimg.com/originals/e2/06/03/e206039106466336ed6af68bea1cd635.jpg

Not all diamonds are “bad” or are “blood diamonds”, but there is enough concern about “conflict” diamonds, that the Kimberley Diamonds Process Certification (KDPC) was put in effect through the Clean Diamond Trade Act on July 29, 2003. “The KPCS is a joint government internationally recognized certification system that imposes extensive requirements on its members to enable them to certify shipments of rough diamonds as ‘conflict-free’ and prevent conflict diamonds from entering legitimate trade” (U.S. Customs and Border Protection, 2019, para 2).

Even with the Kimberley Diamonds Process Certification being in effect, it is still difficult to guarantee that the conflict free stone that you would like to purchase is actually conflict free due to loopholes in the system, lack of political will, and diamond sellers producing fake Certificates (Armstrong, 2011).

The following countries are top producers of diamonds by volume, value and price by carats. As indicated here, 7 of the 10 countries are located in Africa.

(Laniado, 2015)

Immokalee Farmworkers

The Coalition of Immokalee Workers (CIW) is a worker-based human rights organization. It is  internationally recognized for these major accomplishments:

- Fighting human trafficking

- Fighting gender-based violence at work

- Pioneering the design and development of the Worker-Driven Social Responsibility paradigm (the Worker-Driven Social Responsibility is a worker-driven, market-enforced approach to the protection of human rights in corporate supply chains)

(Coalition of Immokalee Workers, 2019)

Since 2011, the CIW has come to be known for its Fair Food Program.  The Fair Food Program (FFP), an innovative model for Worker-Driven Social Responsibility (WSR), is based on partnership among farmworkers, Florida tomato growers, and participating retail buyers that include:

- Ahold USA (2015)

- Fresh Market (20150

- Walmart (2014)

- Chipotle Mexican Grill (2012)

- Trader Joe’s (2012)

- Sodexo (2010)

- Aramark (2010)

- Compass Group (2009)

- Bon Appetit Management Company (2009)

- Subway (2008)

- Whole Foods Market (2008)

- Burger King (2008)

- McDonald’s (2007)

- Yum Brands (2005)

(Coalition of Immokalee Workers, 2019; Fair Food Program, 2019)

Under the Fair Food Program:

- The Coalition of Immokalee Workers conduct worker-to-worker education sessions, which are held on-the-farm and on-the-clock, on the new labor standards set forth in the program’s  Fair Food Code of Conduct;

- The Fair Food Standards Council, which is a third-party monitoring system that was created to ensure compliance with the FFP, conducts regular audits and carries out ongoing complaint investigation and resolution; and

- Participating buyers pay a small Fair Food premium. Tomato growers then pass this premium on to workers as a line-item bonus on their regular paychecks. (Between January 2011 and October 2018, over $30 million in Fair Food premiums were paid into the Program.)

(Coalition of Immokalee Workers, 2019)

“DSC_0038” by Mark Auer is licensed under CC BY-NC 2.0

Sri Lankan Migrants

Many researchers attempt to explain human trafficking and persons most vulnerable to being trafficked.  The following demonstrate at-risk factors for Sri Lankans. These at-risk factors, sometimes referred to as push and pull factors, place migrants in vulnerable positions that make them susceptible to being trafficked, especially by organized criminal groups and smugglers.  Push factors are those variables that make people inherently vulnerable to being preyed on. They may include preventing a person from accessing opportunities or blocking a person from achieving their fullest potential (Hodge, 2008).  Pull factors are those misperceptions, false securities, and in-experiences that lead people to believe that the impossible is possible; the realization of “the dream” is accessible to them; and that entering into “shady” or questionable contracts outweigh the perceived possible risks (Logan, Walker, & Hunt, 2009).

PULL FACTORS: Reasons Why Sri Lankans Leave Their Homes for Work Abroad

- Poverty

- Economic hardship

- Economic disparities

- Lack of education

- Low status of women

- Low skill levels

- Government’s encouragement of export labor

- Sexual/physical/emotional abuse in the home (family of origin)

- Abuse by a husband

- Desertion or death of a husband

- Poor supports in the family system

- Drug addiction in the family/individual

- Conflict/wars

PUSH FACTORS: Reasons Why Sri Lankans Choose Arab States and Elsewhere

- Labor market opportunities

- Belief in opportunity to have a good life abroad

- Opportunity to send home remittances

- Perceived freedom from a bad home life

- Opportunity to travel abroad

- Perception that destination country will accept them

- Temporary housing, food and gifts

- Opportunity to send home remittances

- Belief in opportunity to have a good life abroad

- Perceived freedom from a bad home life

- Opportunity to travel abroad

- Perception that destination country will accept them

- Government agreements with other countries to receive Sri Lankans as laborers

- False promises of love and fake marriages

As a destination country, the USA is home to hundreds of thousands of foreign nationals who end up trafficked here. Impoverished men and women end up exploited in wealthier countries with little to no recourse for the abuses that they suffer at the hand of traffickers. In the case of Sri Lanka,  it is estimated that 10% of the Sri Lankan population are registered migrant workers. This translates into 20% (or 1.8 million persons) of actively employed Sri Lankans (Colombo Telegraph, 2015). Approximately 20% of this population of Sri Lankans, however, find themselves in trafficking situations in the Middle East and elsewhere (Amirthalingam, Jayatilaka, Lakshman & Liyange, 2011). Sri Lankans are sometimes trafficked in Sri Lanka, but most Sri Lankans are labor trafficked in Arab States that include Saudi Arabia, Kuwait, United Arab Emirates, Qatar, Jordan, Oman,  Bahrain and Lebanon.  Other countries include Afghanistan, Iraq, Maldives, Australia, and Singapore (Amirthalingam, Jayatilaka, Lakshman & Liyange, 2011; “India busts human trafficking racket…”, 2014; Jureidini & Moukarbel, 2004; U.S. Department of State, 2017).  Sri Lankan men tend to end up labor trafficked as migrants in  construction and other sectors while women report being primarily labor trafficked in private homes as domestics or as migrant workers too. Some end up sex trafficked as well (Colombo Telegraph, 2015).

Sri Lankans are like most foreign nationals who emigrate from their home countries in pursuit of a better life and labor market opportunities.  Push and pull factors are almost identical.  Unfortunately, many foreign nationals who end up trafficked come from vulnerable backgrounds in developing countries where opportunities for adequate incomes are far-fetched.   Economic depravity coupled with misconceptions of life abroad, often result in foreign nationals. Poverty, economic hardships, abusive home situations, addiction, lack of supports, desperation, and the perception that things are better far away from one’s home, are traits that unlicensed contractors, smugglers, and human traffickers target.  According to the Sri Lanka Bureau of Foreign Employment (SLBFE), the official licensing agency that oversees foreign work placements, nearly a half million Sri Lankan women work as domestics in the Middle East. The danger in this widespread, remittance sending (back to Sri Lanka) practice is that it leaves this massive group of already vulnerable women at risk for human rights abuses like human trafficking and even death (Dias, 2016).

To make matters worse, Sri Lankan women are not viewed favorably in the Middle East.  Jureidini  and Moukarbel (2004) found that Sri Lankan women were paid less than their Filipino female counterparts and were rated as more inferior than their Ethiopian counterparts in Gulf-rich countries because of their 1) low skill level, 2) lack of assertiveness, and 3) lack of education.  On average, the live-in domestic Filipino woman was paid $200 to $350 per month as a contract laborer, while the Sri Lankan and Ethiopian woman was paid just $100 to $150 per month.  The Ethiopian domestic has more positively viewed in the Middle East, however, because they usually have more education than the Sri Lankan woman as a whole.  In addition to being paid lower rates and viewed less favorably than her Filipino and Ethiopian peers, respectively, many Sri Lankan contract workers are subjected to complete isolation, little food, long work days, and no social life. This is often the case due to employers abroad changing the terms of the contract upon arrival (Jureidini  & Moukarbel, 2004).  This “switch and bait” pattern conforms to the criteria for labor trafficking.  As previously stated, labor trafficking involves making a person provide labor services for free or far less than what was agreed upon through the use of fraud, force, or coercion (Pub. L. 106-386).  As a contract “slave”, there is little to no recourse to being labor trafficked in this way except to work out the three year term and endure the abuses—for the most part (Dias, 2016; Jureidini  & Moukarbel, 2004).

“Sri Lankan New Year” by Indi Samarajiva is licensed under CC BY 2.0

Respecting Human Rights Through Transparency in Supply Chains

Labor trafficking can take place at any stage of the supply chain as evidenced by the previous infographics, video and survey on your consumerism. In an attempt to address this, in part, the state of California enacted the California Transparency in Supply Chains Act that went into effect January 1, 2012. The four page Act can be found at https://oag.ca.gov/sites/all/files/agweb/pdfs/cybersafety/sb_657_bill_ch556.pdf

The California Transparency in Supply Chains Act requires companies that do business in the State of California to practice transparency throughout its chain through disclosures.

Terms of the California Transparency in Supply Chains Act

- Retail sellers or manufacturers doing business in the state of California with annual worldwide gross receipts in excess of $100,000,000.

- Required Disclosures

- Companies subject to the Transparency in Supply Chains Act must disclose the extent of their efforts in five areas: verification, audits, certification, internal accountability, and training. Specifically, in its supply chains disclosure, a company must disclose to what extent, if any, it:

- Engages in verification of product supply chains to evaluate and address risks of human trafficking and slavery. The disclosure shall specify if the verification was not conducted by a third party.

- Conducts audits of suppliers to evaluate supplier compliance with company standards for trafficking and slavery in supply chains. The disclosure shall specify if the verification was not an independent, unannounced audit.

- Requires direct suppliers to certify that materials incorporated into the product comply with the laws regarding slavery and human trafficking of the country or countries in which they are doing business.

- Maintains internal accountability standards and procedures for employees or contractors failing to meet company standards regarding slavery and trafficking.

- Provides company employees and management, who have direct responsibility for supply chain management, training on human trafficking and slavery, particularly with respect to mitigating risks within the supply chains of products.

(State of California Department of Justice, 2019, Required Disclosures section)

Conscious Consumerism

CONSCIOUS CONSUMERISM

This is a critical component in the fight against labor trafficking.

So what now? There are federal and state laws in place to keep labor trafficked produced goods out of the hands of U.S. citizens, yet exploiters continue to find ways to break the law and violate the human rights of men, women and children in the United States and around the world. How do you become a conscious consumer and respect human rights? Please start with the infographic below. After you do that, please read the “List of Goods Produced by Child Labor or Forced Labor” (2018) that can be found in the supplementary readings near the end of this chapter. This annual report is produced in accordance to the Trafficking Victims Protection Reauthorization Act (TVPRA) of 2005. Next, please download the free APP, “Good on You”. It is available for mobile devices as well as other electronic devices (lap top, desk top, iPad, etc.). It too is found in the supplementary readings near the end of this chapter. This free and handy app allows you to look up brands and products and it immediately provides you with thorough information so that you are able to make a conscious consumer decision before going with that product. As a consumer, it is important to take action. Now.

In addition to consumers—corporations, and the government must all play active roles in being concerned about and addressing the unethical and inhumane production of goods that are consumed by men, women and children. Human rights violations are rampant in the mass production of goods used by billions of people around the world. Demand an end to Child Labor and Trafficking. UNICEF USA has concrete steps for you to take as indicated in this short pamphlet. Please read it here.

www.unicefusa.org/sites/default/files/UUSA%20Conscious%20Consumerism%20and%20You.pdf

Easy Steps Include:

1. Reduce: Consume less. Period!

2. Reuse: Restyle what you have. Don’t buy more things.

3. Recycle: Buy used and swap with others.

4. Research: Read before you purchase.

[Consumers] “can contact companies to inquire about their corporate policies and practices regarding human trafficking. Consumers may also purchase goods identified as slavery-free. There are even numerous online retailers of products made by formerly trafficked persons and purchases would help support their new endeavors. Individuals can also raise awareness by encouraging their friends, family and colleagues to use their consumer purchasing power to address modern slavery.”

(GlobalFreedomCenter.org, n.d., “Consumers” section).

Quiz

An interactive or media element has been excluded from this version of the text. You can view it online here:
https://ohiostate.pressbooks.pub/humantrafficking/?p=28

Summary of Key Points

- Become a conscious consumer!

- Contact brands or stores and ask them about their supply chains.

Supplemental Learning Materials

U.S. Department of Labor. (2018). List of Goods Produced by Child Labor or Forced Labor. Retrieved from https://www.dol.gov/sites/dolgov/files/ILAB/ListofGoods.pdf

APP: Good On You https://goodonyou.eco/

References

Amirthalingam, K., Jayatilaka, D.,  Lakshman, R.W.D.,  & Liyange, N.( 2011). Victims of human trafficking in Sri Lanka:  Narratives of women, children and youth. Sri Lanka: International Labor Organisation.  Retrieved from https://editorialexpress.com/cgi-bin/conference/download.cgi?db_name=IAFFE2011&paper_id=75

Armstrong, P. (2011, December 5). What are ‘conflict diamonds?’ Retrieved from https://www.cnn.com/2011/12/05/world/africa/conflict-diamonds-explainer/index.html

Coalition of Immokalee Workers. (2019). Harvard Business Review:  The Fair Food Program is among the 15 “most important social-impact success stories of the past century”. Retrieved from http://ciw-online.org/about/

Colombo Telegraph. (2015, June 16). Sri Lanka takes action against traffickers. Retrieved from https://colombotelegraph.com/index.php/sri-lanka-takes-action-against-traffickers/

Dias, K. (2016, October 17). SL women employed as domestic workers in the Middle East:  The bigger picture. News 1st. Retrieved from http://newsfirst.lk/english/2016/10/sl-women-employed-domestic-workers-middle-east-bigger-picture/152026

Fair Food Program. (2019). Partners. Retrieved from https://www.fairfoodprogram.org/partners/

Global Freedom Center. (n.d.). Labor Trafficking in Supply Chains. Retrieved from https://humantraffickinghotline.org/sites/default/files/Labor%20Trafficking%20in%20Supply%20Chains%20-%20GFC.pdf

Hodge, D.R. (2008). Sexual trafficking in the United States:  A Domestic Problem with Transnational Dimensions. Social Work, 53(2), 143-152.

India Busts Human Trafficking Racket: Sri Lankans Transported for Cash.  (2014, August 26).  News 1st.  Retrieved from  http://newsfirst.lk/english/2014/08/major-sri-lankan-human-trafficking-racket-busted-india/50860

Jureidini, R., & Moukarbel, N. (2004). Female Sri Lankan domestic workers in Lebanon:  A case of ‘contract slavery”? Journal of Ethnic and Migration Studies, 30(4), 581-607.

Laniado, E.A. (2015). World’s top diamond-producing countries. Retrieved from https://www.ehudlaniado.com/home/index.php/news/entry/world-s-top-diamond-producing-countries

Logan, T.K., Walker, R., & Hunt, G. (2009). Understanding human trafficking in the United States. Trauma, Violence, & Abuse, 10(1), 3-30.

National Human Trafficking Hotline. (n.d.). The traffickers. Retrieved from https://humantraffickinghotline.org/what-human-trafficking/human-trafficking/traffickers

National Institute of Justice [NIJ]. (2016, September 20). How does labor trafficking occur in U.S. communities and what becomes of the victims? Retrieved from https://www.nij.gov/topics/crime/human-trafficking/Pages/how-does-labor-trafficking-occur.aspx

Polaris. (2019). Labor trafficking. Retrieved from https://polarisproject.org/human-trafficking/labor-trafficking

Pub. L. 106-386. (2000). Trafficking Victims Protection Act of 2000, H. R. 3244, (2000). 106th Cong., 2nd Sess.

U.S. Customs and Border Protection. (2109, August 6). Kimberley Diamonds Process Certification. Retrieved from https://www.cbp.gov/trade/programs-administration/kimberley-diamonds-process-certification

U.S. Department of State. (2017a). Office to Monitor and Combat Trafficking in Persons. Trafficking in Persons Report: Country Narrative – Sri Lanka. Washington, DC:  Author.

Various Forms of Human Trafficking Section

This section highlights various forms of Human Trafficking as it presents around the world. Content includes child brides, child soldiers and organ trafficking.

“Nujood” by bbcworldservice is licensed under CC BY-NC 2.0

Chapter 7: Child Brides and Mail Order Brides

Abstract

Arranged marriages are usually a cultural practice in which families will choose spouses for their children. Child marriage is a form of arranged marriage for children under the age of 18, and puts young girls at risk for domestic abuse, pregnancy/child birth complications, and HIV. Mail-order brides are also a form of arranged marriage where a spouse is bought on the internet through a broker, generally by a wealthier foreign man. These forms of arranged marriages are also forms of human trafficking and violate the rights of women and children. This chapter will explore the injustices and exploitation within these forms of matrimony.

Learning Objectives

By the end of this chapter, the student will be able to:

- Define child bride and child marriage

- Define mail order bride

- Understand how child brides and mail order brides are human trafficking

- Identify efforts to stop these practices

Key Words: Child Bride, Child Marriage, Arranged Marriage

GLOSSARY

Child Bride: A child under the age of 18 who is married, or is to be married, to an older man; generally child brides’ marriages are arranged by their parents for the girls’ financial safety or to take the financial burden off of the family

Child Marriage: Any marriage where at least one of the people to be married is under the age of 18

Arranged Marriage: A marriage in which the family, usually parents, of each of the spouses decide and agree upon the marriage Mail Order Bride: A woman ordered over the internet through a broker for a fee to be married to a man in a foreign country

Child Brides

Child brides are girls married before the age of 18, and a child marriage is a marriage in which one or both of the people to be married are under the age of 18. Some child marriages are formally arranged by family members in a cultural context, and others may be more informal (Selby & Singer, 2018; United Nations, 2013). Child brides are mostly girls who often have to marry much older men. Many brides are under the age of 15 (Selby & Singer, 2018; United Nations, 2013). The practices of child brides and child marriages are a global issue, with an estimated 12-18 million girls being married before the age of 18 every year (Girls Not Brides, 2019; Selby & Singer, 2018; United Nations, 2013). One of the reasons that child brides are so prevalent is because despite 88% of countries worldwide have laws that forbid marriage before the age of 18, exceptions can be made if the parents of the child consent to the marriage (World Policy Analysis Center, 2015). Twenty-seven percent of the countries that do have laws that require parental consent also have legal loopholes where parents can consent for girls two to four years earlier than for boys (World Policy Analysis Center, 2015). (See Figure A. Map that illustrates the number of countries with lax laws about 15 year olds getting married.)

Figure A: Map

Retrieved from https://www.worldpolicycenter.org/sites/default/files/WORLD_Fact_Sheet_Legal_Protection_Against_Child_Marriage_2015.pdf

Marrying children is a worldwide problem crossing cultural, regional, and religious lines. Though it is more common in developing countries in the Southeast region of Asia and Africa, it still happens in developed countries like the United States (Selby & Singer, 2018; United Nations, 2013; United Nations International Children’s Emergency Fund (UNICEF), 2018). Globally, 21% of girls are married off before the age of 18, which is tens of thousands of girls every single day, and that number doubles to 40% in developing countries with 12% of those girls being under the age of 15 (UNICEF, 2018; United Nations Population Fund, 2018).

Areas with high poverty levels and lax (if any) laws surrounding child marriage typically produce more child brides, along with areas where young girls marrying older men is a cultural norm (International Center for Research on Women (ICRW), n.d.; Selby & Singer, 2018; United Nations, 2013). Due to gender inequality in many regions of the world, girls are not considered wage-earners, but instead a drain on family funds. Therefore, especially in regions with unstable political climates and where war and conflict are prominent, families will marry off their daughters to ensure that she is taken care of financially by her husband instead of them (Selby & Singer, 2018; United Nations Population Fund, 2018). Again, despite being more common in developing countries, child brides are prevalent in the developed world as well. In the United States, over 200,000 children were married between 2000 and 2015, with 86% of them being married to adults (Tahirih Justice Center, 2017). In many cases, the girl to be married was pregnant, the soon-to-be husband was decades older, and the girl was marrying her rapist in a case of statutory rape (Tahirih Justice Center, 2017). If current worldwide trends continue uninterrupted, more than 140 million girls will become child brides in the next decade alone (International Women’s Health Coalition, n.d.).

Reasons for Child Marriages

The context for child marriage varies across cultures and regions. In some situations, especially in the United States, child brides are married in a “shotgun” wedding style, like in the statutory rape cases mentioned above. In poverty and war-stricken countries, parents may marry off their children for her financial security or protection, or because they cannot afford to care for her (United Nations, 2013). One mother reported knowing it was wrong to marry off her daughter but believed she would be safer and more respected when married than not, given the state of their community and the fact her daughter could not attend school (Selby & Singer, 2018). There are also some parents who believe that marrying off their children will protect them from sexual violence, because they will be protected by their partners. This is not always the case, however, given that sexual violence is often exacerbated by child marriage as the children are physically underdeveloped and vulnerable (United Nations Population Fund, 2018; United Nations, 2013). In some cultures, the value of a girl’s dowry to be paid goes up as she ages because her childbearing years are decreasing, therefore family members will try to marry her off younger (Selby & Singer, 2018; United Nations Population Fund, 2018).

The Dangers of Child Marriages

Girls who are married young are at risk of sexual violence, physical abuse, HIV, and pregnancy complications (End Child Prostitution and Trafficking (ECPAT), 2015; ICRW, n.d.; International Women’s Health Coalition, n.d.; United Nations, 2013; United Nations Population Fund, 2018). Some girls are forced to make themselves sexually available not only to their husbands but also other male family members at any time (ECPAT, 2015). Girls who resist advances from their husbands are at a high risk of sexual violence and verbal or physical abuse from their husbands who may force them into submission (ECPAT, 2015). Moreover, as a result of their lack of physical maturity, child brides are at a high risk for pregnancy complications like obstetric fistula and early or still births, which can sometimes result in death (United Nations Population Fund, 2013). Because of some religious and cultural beliefs, there is a lot of pressure on girls to prove their fertility. Therefore despite pregnancy complications, girls may be pressured or forced to have frequent or close pregnancies—they have little control over their family planning (ECPAT, 2015; United Nations Population Fund, 2013). Finally, when girls are married young and take on wife and mother roles, they no longer have access to education and are put in a place where systems of inequality, poverty, and low levels of education are perpetuated with their female children (ECPAT, 2015; United Nations, 2013; United Nations Population Fund, 2013, 2018; Selby & Singer, 2018).

Retrieved from https://www.washingtonpost.com/news/morning-mix/wp/2015/08/28/the-saddest-bride-i-have-ever-seen-child-marrige-is-as-popular-as-ever-in-bangladesh/?utm_term=.c9d2924c92fd

Mail Order Brides

A quick google search of “mail order bride” will pull up dozens of websites where a person can find a woman to marry from a foreign country for a fee. The idea of mail order brides has even become mainstream and romanticized through shows like TLC’s 90 Day Fiance. A mail order bride is a woman “ordered” for marriage by a usually more affluent man. The man pays a broker a fee for the match, and then pays for the travel expenses for the woman to come to him to be married. The brides (or occasionally husbands) are often leaving financially unstable families and/or politically unstable countries in search of a more stable life, which is expected to be found with the husband (Jackson, 2002; Jones, 2011). As the new spouse usually pays for the travel arrangements for the incoming bride or husband, the bride is often financially reliant on the new husband, and sometimes stuck in a relationship that is not what they expected in a country they do not know the language or customs, and where they do not have the money to return to their home country (Tyldum, 2013). Brides are primarily ordered by men in the US, Australia, and Western Europe, and also in areas of Asia like Taiwan, Korea, and Japan – areas where affluent men can be found (Tyldum, 2013; Yakushko & Rajan, 2017).

Retrieved from https://www.eonline.com/news/981124/90-day-fiance-couples-status-check-who-s-still-together-and-who-got-divorced

The practice of mail order brides is centuries old, but is more prevalent in the modern day because of the ease of access through the internet (Jones, 2011; Minervini & McAndrew, 2005; Yakushko & Rajan, 2017). In some cases, brides and grooms are genuinely looking for life partners on their own. Yakushko and Rajan (2017) highlight the existence of self-described mail order brides who are older and educated and sought out foreign spouses because cultural norms deemed them undesirable. One study found that women were choosing to date men internationally because they did not like the attitudes towards women from men in their own cultures and believed the values and attitudes toward women from American men would be different (Minervini & McAndrew, 2005). Ironically, the men interested in purchasing brides are often looking for women who embody the exact stereotypes and attitudes the women are trying to escape (Minervini & McAndrew, 2005; Starr & Adams, 2016). Men are drawn to mail order brides because they feel the women available to them domestically have a lack of traditional family values, are spoiled, and will not be good, caring wives; they believe Asian women will be timid and caring, Latina women exciting and fiery, and European women refined (Jones, 2011; Starr & Adams, 2016). In many cases, the situation of mail order brides is similar to that of child brides. Girls are no longer seen as desirable wives within their communities either because of age, infertility, not being a virgin, or some other reason, so brokers find men willing to marry them for a fee and girls and women are sold to men as their brides in arranged and forced marriages.

Human Trafficking Connection

At least for mail order brides, there is an element that seems consenting – women seek husbands online, meet them before marrying, and have specific things they are looking for, in some cases (Minervini & McAndrew, 2005). Some researchers argue that there is a disproportionate amount of scholarship dedicated to comparing the mail order bride industry to human trafficking (Yakushko & Rajan, 2017). However, in many cases, brokers are selling people for profit, the girls do not know their soon-to-be husbands or the lived reality they are marrying into, and there is a power differential between the bride and her husband (Jackson, 2002; Jones, 2011; Tyldum, 2013). This means that mail order brides is a form of human trafficking that needs to be addressed, even if it is not trafficking in every situation. Additionally, sometimes the international marriage broker sites are covers for prostitution rings, and act as sites where pimps can buy new girls and sell girls who are no longer of use to them (Jackson, 2002). Immigration status is often used by husbands and buyers as a way to control their mail order brides, stating that if they report abuse, try to leave the relationship, or do not comply with orders, they will be deported (Narayan, 1995; Jackson, 2002; Weller & Junck, 2014). In the case of child brides, the trafficking is a bit more obvious: families are being paid for the possession of their daughters, and children are being sold into dangerous and controlling relationships. In both cases (child brides and mail order brides), women and children are in a vulnerable position and being exploited through fraud, deception, and coercion; which is directly outlined as human trafficking and a human rights violation in the United Nations’ definition of trafficking and the Universal Declaration of Human Rights (United Nations, 2003; United Nations, 1948).

Legislation

Child marriage not only meets the United Nations’ definition for human trafficking, but it is also a human rights violation in the context of several international rulings, such as: Universal Declaration of Human Rights (1948); Supplementary Convention on the Abolition of Slavery, the Slave Trade, and Institutions and Practices Similar to Slavery (1956); Convention on Consent to Marriage, Minimum Age for Marriage, and Registration of Marriage (1964); International Covenant on Economic, Social and Cultural Rights (ICESCR) and International Covenant on Civil and Political Rights (ICCPR) (1966); the Inter-American Convention on Human Rights (1978); Convention on the Elimination of Discrimination Against Women (1981); Convention on the Rights of the Child (1989); and Vienna Declaration on Programme and Action (1993) (Girls Not Brides, n.d.). Reviewing the years of some of these documents shows how long child marriage has been an international issue. The United Nations, UNICEF, and the world YWCA have initiated efforts to end child marriages by 2030 by promoting proven practices in reducing child marriages like: increasing girls’ access to education and health care, ensuring parents are informed on the risks and dangers associated with child marriage, fighting poverty, and strengthening minimum age of marriage laws (United Nations, 2013; UNICEF, 2018; United Nations News, 2016). Additionally, as of June 2019, the deputy grand Iman of Al Azhar, the highest authority in Sunni Islam, issued a fatwa (a formal ruling in Islamic law) that all children, especially girls, must be at least 18 years of age and consenting before being married (Mogoatlhe, 2019). Sunni Islam accounts for around 75-90% of Muslims globally (Mogoatlhe, 2019), which means the fatwa has the potential for a widespread impact. Unless there is a significant increase in not only efforts but also efficacy, however, it is unlikely that the 2030 goal will be met (UNICEF, 2018).

Mail order brides legislation is a bit more difficult because the human rights violations within it are more covert, especially with the growth of the internet being a tool in partner-finding and the romanticizing of transnational relationships through shows like TLC’s 90 Day Fiancé. The United States included provisions specific to mail order brides in the Violence Against Women Act and enacted the International Marriage Broker Regulation Act in an effort to prevent exploitation of international brides by American men (National Network to End Domestic Violence (NNEDV), 2019). Reauthorization of the Violence Against Women Act expired in February 2019, and as of March 2019 was awaiting approval from the Senate, and the efficacy of the International Marriage Broker Regulation Act is difficult to assess (NNEDV, 2019; Sims, 2015). The Philippines enacted an anti-mail order bride law, in which it is illegal to facilitate the marriage of Filipina women and foreign men as a business (Sims, 2015). The law has largely been ineffective with the use of the internet for marriage brokering, and for lack of designation of an enforcement agency by the Philippine government (Sims, 2015). Alternatively, Taiwan’s legislation has been effective. Since 2003 Taiwan has enacted strict laws controlling advertisements of mail order brides, setting minimum age requirements and spousal age difference limits, and began closely monitoring marriages with foreign brides in an effort to combat human trafficking and prostitution (Sims, 2015). As a result, marriages involving foreign brides has dropped 40%, mail order bride industry profits have been affected by the age limits, and Taiwanese police have begun offering trainings to recognize human trafficking (Sims, 2015).

Action

Social workers are charged with advocating for social, economic, and political justice (National Association of Social Workers, 2017). Therefore, in the case of child brides, it is imperative that micro practice social workers engage in educating individuals, parents, and communities on the warning signs of intimate partner abuse, the physical and emotional consequences of child sexual abuse, and the dangers of pregnancy and child birth on young, underdeveloped girls (Sossou & Yogtiba, 2009). On a macro level, social workers must advocate for girls’ rights to pursue education, 18 and over marriage laws, sex and reproductive health education, and domestic violence prevention. UNICEF (n.d.) also highlights the importance of: more research on this topic to create a strong evidence base for policy, programming, and tracking progress; shifting social expectations of young girls; strengthening services offered to victims of child marriage or those at risk; and tackling the challenges that perpetuate child marriage like gender inequality, lack of education, and poverty. All of these are areas where a social work presence and practice lens can be beneficial. For mail order brides, it is important that the Violence Against Women Act is renewed in 2019 and be continually renewed in the future. Additionally, social workers working with immigrant women need to know the signs of abusive relationships, sex trafficking and prostitution, and know resources to assist women in leaving abusive relationships while protecting their immigrant status.

Quiz

An interactive or media element has been excluded from this version of the text. You can view it online here:
https://ohiostate.pressbooks.pub/humantrafficking/?p=29

Now, let’s shift gears and turn to a case study.

AMIRA

Amira was a 14 year-old, oldest child of four. Amira’s parents were married when her mother was 13 and her father was 20 years old; similar to each of their parents. Amira’s mother never attended school and had her first child, Amira, at the age of 15. Unlike her mother, Amira was able to attend school until she was 13 years old. Around the age of 12 to 13, Amira hit puberty, and her parents were concerned about her walking to school and attracting male attention because of her developing body. Since Amira was then just staying home, her parents felt it was time for her to learn wifely duties and to start a family of her own. Amira’s parents had known Adeel’s parents since they were young, and knew Adeel would be able to care for Amira financially, as he was in his 20’s and taking over his family’s business. Amira and Adeel’s parents arranged for the marriage of Amira to Adeel before her 15th birthday. Amira met Adeel a few times with both of their families before their marriage, but did not know him well. After their marriage, Amira moved in with Adeel and took care of their home until she became pregnant with their first child shortly after turning 15. Amira, now 21, and Adeel, in his early 30’s, are about to have their third child.

Summary of Key Points

- Child brides and child marriage are persistent issues in violation of several international and national legislation efforts affecting millions of girls every year. Initiatives have begun to end child trafficking by 2030, but will need to increase exponentially if this goal is to be achieved.

- Mail order brides is a covert, and hotly debated form of human trafficking. Some scholars claim there is an over emphasis on the trafficking and prostitution cases and not enough on the instances of educated women entering into international marriages willingly. Nonetheless, there are instances of mail order brides that are trafficking, therefore attention and prevention efforts need to be directed to this issue.

- Both child brides and mail order brides are often coerced into forced relationships, have limited protections in place for their safety, and are sold for profit into relationships.

Supplemental Learning Materials

Books

A True Story: A Father’s Betrayal by Gabriella Gillespie

American Child Bride: A History of Minors and Marriage in the United States by Nicholas Syrett

Films

Tall as the Baobab Tree (2012); Dukhtar (2014)

Websites

www.tooyoungtowed.org

Globalcitizen.org

Girlsnotbrides.org

Care.org

Stopthetrafik.org

Articles

Aptel, C. (2016). Child Slaves and Child Brides. Journal of International Criminal Justice, 14(2), 305-325. DOI: 10.1093/jicj/mqv078

Greene, M. (2014). Ending Child Marriage in a Generation: What Research is Needed? Ford Foundation. Retrieved from https://www.fordfoundation.org/media/1890/endingchildmarriage.pdf

Hedayat, N. (2011). What is it like to be a child bride? BBC News. Retrieved from https://www.bbc.com/news/magazine-15082550

International Center for Research on Women. (2013). Solutions to End Child Marriage: Summary of the Evidence. Retrieved from https://www.icrw.org/publications/solutions-to-end-child-marriage-2/

Naveed, S. & Butt, K. (2015). Causes and consequences of child marriages in South Asia: Pakistan’s perspective. South Asian Studies, 30(2), 161-175. Retrieved from http://pu.edu.pk/images/journal/csas/PDF/10%20Khalid%20Manzoor%20Butt_30_2.pdf

Peyton, N. (2017). 27 African Countries Just Met and Agreed to End Child Marriage. Global Citizen. Retrieved from https://www.globalcitizen.org/en/content/african-child-marriage-ending-meeting/

References

End Child Prostitution and Trafficking. (2015). Thematic Report: UnrecognisedSexual Abuse and Exploitation of Children in Child, Early and Forced Marriage. Retrieved from https://www.ecpat.org/wp-content/uploads/2016/04/Child%20Marriage_ENG.pdf

Girls Not Brides. (n.d.). Provisions of International and Regional Instruments Relevant to Protection from Child Marriage. Retrieved from https://www.girlsnotbrides.org/wp-content/uploads/2015/03/Intl-and-Reg-Standards-for-Protection-from-Child-Marriage-By-ACPF-May-2013.pdf

Girls Not Brides. (2019). Child Marriage Around the World. Retrieved from https://www.girlsnotbrides.org/where-does-it-happen/

International Center for Research on Women. (n.d.) Child Marriage Facts and Figures. Retrieved from https://www.icrw.org/child-marriage-facts-and-figures/

International Women’s Health Coalition. (n.d.). The Facts on Child Marriage. Retrieved from https://iwhc.org/resources/facts-child-marriage/

Jackson, S. H. (2002). To honor and obey: trafficking in “mail-order brides”. George Washington Law Review, 70(3), 475-569. Retrieved from https://heinonline.org/HOL/P?h=hein.journals/gwlr70&i=487

Jones, J. (2011). Trafficking internet brides. Information & Communications Technology Law, 20(1), 19-33. DOI: 10.1080/13600834.2011.557525

Minervini, B. & McAndrew, F. (2005). The mating strategies and mate preference of mail order brides. Cross-Cultural Research, 5(X), 1-20. DOI: 10.1177/1069397105277237

Mogoatlhe, L. (2019). The Highest Authority in Sunni Islam Just Declared an End to Child Marriage in Africa. Global Citizen. Retrieved from https://www.globalcitizen.org/en/content/end-child-marriage-sunni-islam-africa4girls/

Narayan, U. (1995). “Male-order” brides: Immigrant women, domestic violence and immigration law. Hypatia, 10(1), 104-119. Retrieved from http://www.jstor.org.proxy.lib.ohio-state.edu/stable/3810460

National Association of Social Workers. (2017). Code of Ethics. Retrieved from https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English

National Network to End Domestic Violence. (2019). Violence Against Women Act. Policy Center. Retrieved from https://nnedv.org/content/violence-against-women-act/

Organization of American States. (1969). American Convention on Human Rights, “Pact of San Jose”. Costa Rica. Retrieved from https://www.oas.org/dil/access_to_information_American_Convention_on_Human_Rights.pdf

Selby, D. & Singer, C. (2018). Child Marriage: Everything You Need to Know. Global Citizen. Retrieved from https://www.globalcitizen.org/en/content/child-marriage-brides-india-niger-syria/

Sims, R. (2015). A comparison of laws in the Philippines, the U.S.A., Taiwan, and Belarus to regulate the mail order bride industry. Akron Law Review, 42(2), Article 7. Retrieved from http://ideaexchange.uakron.edu/akronlawreview/vol42/iss2/7

Sossou, M., Yogtibo, J. (2009). Abuse of children in West-Africa: Implications for social work education and practice. British Journal of Social Work, 39, 1218-1234. DOI: 10.1093/bjsw/bcn033

Starr, E. & Adams, M. (2016). The domestic exotic: Mail-order brides and the paradox of globalized intimacies. Signs: Journal of Women in Culture & Society, 41(4). DOI: 0097-9740/2016/4104-0010

Tahirih Justice Center. (2017). Child Marriage in the United States: A Serious Problem with a Simple First Step Solution. Retrieved from https://www.tahirih.org/wp-content/uploads/2016/11/Tahirih-Child-Marriage-Backgrounder-2.pdf

Tyldum, G. (2013). Dependence and human trafficking in the context of transnational marriage. International Migration, 51(4), 103-115. DOI: 10.1111/imig.12060

UNICEF. (n.d.). Preventing Child Marriage. Retrieved from https://www.unicef.org/eca/what-we-do/child-marriage

United Nations. (2003). Protocol to prevent, suppress, and punish trafficking in persons. (Resolution 55/25). Retrieved from https://www.unodc.org/unodc/en/human-trafficking/what-is-human-trafficking.html#What_is_Human_Trafficking

United Nations. (2013). Child Marriages: 39,000 Every day – More than 140 million girls will marry between 2011 and 2020. Office of the Secretary-General’s Envoy on Youth. Retrieved from https://www.un.org/youthenvoy/2013/09/child-marriages-39000-every-day-more-than-140-million-girls-will-marry-between-2011-and-2020/

United Nations Economic and Social Council. (1956). Supplementary Convention on the Abolition of Slavery, the Slave Trade, and Institutions and Practices Similar to Slavery. (608 [XXI]) Geneva. Retrieved from https://www.ohchr.org/EN/ProfessionalInterest/Pages/SupplementaryConventionAbolitionOfSlavery.aspx

United Nations General Assembly. (1948). Universal Declaration of Human Rights. (217 [III] A). Paris. Retrieved from http://www.un.org/en/universal-declaration-human-rights/

United Nations General Assembly. (1964). Convention on Consent to Marriage, Minimum Age for Marriage, and Registration of Marriage. (1763 [XVII] A). New York. Retrieved from https://www.ohchr.org/EN/ProfessionalInterest/Pages/MinimumAgeForMarriage.aspx

United Nations General Assembly. (1966). International Covenant on Civil and Political Rights. (2200 [XXI] A). Retrieved from https://treaties.un.org/doc/publication/unts/volume%20999/volume-999-i-14668-english.pdf

United Nations General Assembly. (1966). International Covenant on Economic, Social and Cultural Rights. (2200 [XXI] A). Retrieved from https://www.ohchr.org/en/professionalinterest/pages/cescr.aspx

United Nations General Assembly. (1979). Convention on the Elimination of All Forms of Discrimination Against Women. (Resolution 34/180). Retrieved from https://www.un.org/womenwatch/daw/cedaw/

United Nations General Assembly. (1989). Convention the Rights of the Child. (Resolution 44/25). Retrieved from https://www.ohchr.org/en/professionalinterest/pages/crc.aspx

United Nations General Assembly. (1993). Vienna Declaration and Programmeof Action. (Resolution 48/121). Vienna. Retrieved from https://www.ohchr.org/EN/ProfessionalInterest/Pages/Vienna.aspx

United Nations International Children’s Emergency Fund. (2018). Child Marriage: Latest Trends and Future Prospects. Retrieved from https://data.unicef.org/resources/child-marriage-latest-trends-and-future-prospects/

United Nations News. (2016). New UN initiative aims to protect millions of girls from child marriage. Retrieved from https://news.un.org/en/story/2016/03/523802-new-un-initiative-aims-protect-millions-girls-child-marriage#.Vt8pqfkrK71

United Nations Population Fund. (2013). Motherhood in Childhood: Facing the challenge of adolescent pregnancy. Retrieved from https://www.unfpa.org/sites/default/files/pub-pdf/EN-SWOP2013-final.pdf

United Nations Population Fund. (2018). Child Marriage. Retrieved from https://www.unfpa.org/child-marriage

Weller, S. & Junck , A. (2014). Human Trafficking and Immigrant Victims: What Can State Courts Do?. A Guide to Human Trafficking for State Courts , pages 47-77. Retrieved from http://www.htcourts.org/wp-content/uploads/Full_HTGuide_desktopVer_140902.pdf

World Policy Analysis Center. (2015). Fact Sheet: Assessing National Action on Protection from Child Marriage. Retrieved from https://www.worldpolicycenter.org/sites/default/files/WORLD_Fact_Sheet_Legal_Protection_Against_Child_Marriage_2015.pdf

Yakushko, O., & Rajan, I. (2017). Global love for sale: Divergence and convergence of human trafficking with “mail order brides” and international arranged marriage phenomena. Women & Therapy, 40, 190-206. DOI: 10.1080/02703149.2016.1213605

Chapter 8: Child Soldiers

Abstract

The use of children in warfare is against international legislation that protects the rights of children. Yet it still remains a persistent issue in conflict torn areas of the world. Children are used in direct combat, support roles like cooks and messengers, and as suicide bombers, to name a few duties—as child soldiers. International social work can take on roles in protecting these children and combatting their recruitment and abuse.

Learning Objectives

By the end of this chapter, the student will be able to:

- Define child soldiers and understand legislation enacted to protect them

- Identify ways children are recruited into warfare

- Identify efforts social workers can make to end child engagement in warfare

Key Word: Child Soldier

GLOSSARY

Child Soldier: A person under the age of 18 recruited either voluntarily or by force to participate in an armed forces group in any capacity

Child Soldiers

A child soldier or a child associated with an armed force group, according to the Paris Principles in 2007, is any person, 18 years of age or younger, who is or has been recruited or used by an armed group in any capacity (United Nations International Children’s Emergency Fund (UNICEF), 2007). The role of children in armed forces conflict is often direct combat, but they also act as spies, cooks, messengers, porters, and sex slaves among other roles (Child Soldiers International, 2016a; Bleasdale, 2013; United Nations, n.d.; UNICEF, 2007). The number of children involved in armed conflicts has risen 159% since 2012, with almost 30,000 verified cases of recruitment in 17 countries around the globe (Child Soldiers International, 2019).

Retrieved from https://www.accord.org.za/conflict-trends/understanding-recruitment-child-soldiers-africa/

Children are recruited for armed forces conflicts because they are often easier to manipulate and more obedient than adults, do not have a developed sense of danger, and do not require many resources to maintain (Child Soldiers International, 2016a; Dudenhoefer, 2016; Their World, 2016). Some children are forcibly recruited by being born into militant groups or by their families and communities being overcome by militant groups (Dudenhoefer, 2016; Their World, 2016). Children who are forced are often abducted, coerced, or abused into submission and participation (Dudenhoefer, 2016; Singer, 2005; Their World, 2016). Other children “voluntarily” join. Reasons children choose to join militant groups may be: their families identify with a side of the conflict and they feel they are honoring their families and their countries by choosing to fight; a survival tactic where militant groups promise safety and a sense of family; they are promised some type of pay-off; or they have a sense of vengeance for lived inequalities that they feel war can correct (Dudenhoefer, 2016; Singer, 2005; Their World, 2016). Children who voluntarily join militant groups often do not have a full understanding of the consequences of joining, or of the severity and danger of their tasks; which is also a reason they are recruited, as highlighted above. Therefore, though they may not have needed to be forced into submission, aside from not being adults able to consent, their choice in participation is not fully-informed and therefore not really voluntary.

Roles of Child Soldiers

As previously mentioned, child soldiers can take on a number of roles in armed conflicts and are recruited as young as the age of 8 (Bleasdale, 2013; Singer, 2005; United Nations, n.d.). Many of them will be used in direct combat, as early as the age of 10, because modern assault rifles are easily managed by small children making child soldiers as useful and deadly in combat as adult soldiers (Dudenhoefer, 2016). Besides combat, common roles for child soldiers are patrolling and surveillance, scouting or spying, and prisoner guard (Singer, 2005). These traditional soldier roles are often taken on by boys more often than girls. Not surprisingly, given what we know about human and sex trafficking worldwide, girls who are recruited into armed conflict are more often used as sex slaves (United Nations, 2013; United Nations, n.d.). The involvement of girls in armed conflict more than quadrupled between 2017 and 2018, growing from 216 to 893 reported cases (Child Soldiers International, 2019). Former child soldiers who had been rescued reported having to commit horrific acts, such as killing their own parents, as a form of initiation and showing allegiance; others have reported having to participate in killing war captives, or hurting other child soldiers (Klasen, Reissmann, Voss, & Okello, 2015; Their World, 2016; Thomason, 2016). Child soldiers who survive war are left traumatized, vulnerable to re-recruitment, and sometimes re-victimized by being detained and punished for involvement in war crimes (Klasen, et al., 2015; United Nations, 2018).

Retrieved from https://theirworld.org/explainers/child-soldiers

Child Soldiers of the World

The United Nations’ Secretary-General releases an annual report on children in armed conflict which includes a “Name and Shame” list of the countries participating in child soldier recruitment. The 2017 report highlighted violations by 19 countries—stating there were over 6,000 violations by government forces and over 15,000 by non-state armed force organizations worldwide (United Nations, 2018).

Child Soldiers International’s Annual Report (2018) also shed light on some startling statistics about child soldiers worldwide:

1. Since 2016, child soldiers have participated in at least 18 conflicts around the world;

2. Over 19,000 children have been recruited into armed forces in South Sudan alone just in the past four years;

3. In 2017 alone there were 203 reports of children being used as suicide bombers in Cameroon and Nigeria;

4. Approximately 14,000 children have been recruited into armed groups in the Central African Republic over the past six years; and

5. Approximately 240 million children live in countries affected by ongoing conflict putting them at risk of recruitment into child soldier roles. While most of the countries highlighted are in the Eastern hemisphere, child soldiers have also been recruited and used in the Western hemisphere in Colombia, Ecuador, Mexico, El Salvador, Guatemala, Nicaragua, Paraguay, and Peru since the 1990s (Singer, 2005).

Retrieved from https://www.child-soldiers.org/myanmar

International Legislation

International efforts at protecting the rights of children started in 1924 with the Geneva Declaration of the Rights of the Child. The Geneva Declaration of the Rights of the Child was just 5 articles adopted by the League of Nations, stating that “mankind owes to the Child the best that it has to give, declare and accept it as their duty that, beyond and above all considerations of race, nationality or creed” (League of Nations, 1924, paragraph 1). Following this legislation, the United Nations’ Declaration of the Rights of the Child was adopted in 1959, was included in the Universal Declaration of Human Rights, and consisted of 10 principles to ensure for all children that “he may have a happy childhood and enjoy for his own good and for the good of society the rights and freedoms herein set forth” (United Nations, 1959, The General Assembly). Following these short declarations, in 1989 a 54 article long Convention on the Rights of the Child was ratified with thorough explanations of who is considered a child and the responsibilities of the state to ensure protection and education to children in their varying cultural and political contexts (United Nations, 1989). These three documents laid the framework for the:

- 1997 Cape Town Principles and Best Practices on the Prevention of Recruitment of Children into the Armed Forces and on Demobilization and Social Reintegration of Child Soldiers in Africa

- The 2002 Optional Protocol to the Convention on the Rights of the Child on the Involvement of Children in Armed Conflict

- The 2007 Principles and Guidelines on Children Associated with Armed Forces or Armed Groups

- The 2009 list of the Six Grave Violations Against Children During Armed Conflict

- A number of resolutions from the United Nations written to further expand the responsibility and efforts of citizens and governments on an international level to intervene in and prevent the recruitment of child soldiers, protect the rights of children, and to react to the engagement of children in warfare

(United Nations, 2002; United Nations, 2013; UNICEF, 1997; UNICEF 2007)

The main factor that makes legislation effective is the consequences of violation. These documents, however, are declarations, proclamations, conventions, and statements of best practices. Therefore, only countries who are members of the United Nations, sign the optional protocol, and subscribe to the ideas and articles presented in the other documents are expected to abide by them. Within that, each governing body is assigned the responsibility of ensuring their enactment and establishing consequences of violations. This is also an issue with the United Nations Universal Declaration of Human Rights, as there is no clear authority given to the United Nations or any other member state to interfere or persecute violations (Dolinger, 2016). While countries may be highlighted by human rights watch organizations, “shamed” by the UN secretary general, or other countries may refuse to engage in trade with them, there are rarely any concrete and legal consequences unless initiated and handed out by the governing state. Some countries, like the United States, have passed legislation like the 2007 and 2017 Child Soldiers Prevention Acts, in which providing U.S. military assistance to countries actively using child soldiers is prohibited except in cases where a President of the United States waives the prohibition for national security reasons. Unfortunately, as of 2016, the President had issued a waiver in 26 of 33 cases where the Child Soldiers Prevention Act would have been utilized (Human Rights Watch, 2016).

Ending the Use of Child Soldiers

Engagement with the armed forces using child soldiers resulted in the formal release of over 10,000 child soldiers in 2017, with an unknown number being released through informal pathways (United Nations, 2018). Additionally, even countries within the UN’s report, like Afghanistan and Sudan, began enacting legislation that resulted in a decrease in recruitment, despite prevalence of child soldiers in general in these regions (United Nations, 2018). Therefore, despite startling numbers and prevalence of child soldiers, work is being done that is effective, and the number of child soldiers since the enactment of The Paris Principles and the Optional Protocol to the Convention on the Rights of the Child on the Involvement of Children in Armed Conflict has steadily been on the decline and the number of countries adopting legislation to protect children has steadily been growing (United Nations, 2018).

The United Nations highlights the need to continue to engage and collaborate with countries worldwide to expand legislation and support efforts to end child engagement in warfare (United Nations, 2018). Preventing recruitment is also an important element through not only within- borders legislation, but across-borders legislation to prevent children from crossing borders for engagement with warfare. Similarly, it is important to interrupt the cycles that allow recruitment of child soldiers – educational inequality/lack of access to education, poverty, and political instability. Post-war, child soldiers experience physical injuries and disabilities, loss of family and homelessness, long-term memories of trauma and war, guilt or shame, stigma and rejection, and social marginalization (Denov, 2010). Therefore, ending the re-victimization or re-recruitment of these children by detaining and punishing them post-war engagement for their affiliations with militant groups is an imperative step toward re-integration and healing of children who have been used as child soldiers. They need restorative, therapeutic efforts to be made toward their resocialization.

All of this in mind bears the question of what social workers, other practitioners and policymakers can do to eliminate the use of child soldiers. A lot of these efforts begin with policy work – international and national policy, local policy, and ensuring divestment from intentional and unintentional support of countries using child soldiers. The trauma and horrors of war that the children have witnessed has to be addressed for successful reintegration, which lends itself to the crux of social work – mental health care, interpersonal relationship building, trauma care, and addressing stable family and housing needs. Assistance with accessing education and breaking cycles of poverty is also imperative to prevent child recruitment into warfare. Child Soldiers International, War Child, and UNICEF are all organizations working toward addressing trauma and reintegrating children into safe communities post-war engagement (Borgen Project, 2017).

Quiz

An interactive or media element has been excluded from this version of the text. You can view it online here:
https://ohiostate.pressbooks.pub/humantrafficking/?p=30

Now, let’s shift gears and turn to a case study.

ATEEF

Ateef is a 12 year-old boy from South Sudan whose family has always lived outside of Yambio. His father and two older brothers have been soldiers in a rebel military group for as long as he can remember. Wanting to be emulate the leadership and protective characteristics of the other men in his family, Ateef voluntarily begins training as a child soldier. He begins engagement with the army by being a messenger between stationed groups, and soon begins training on use of weapons. By the age of 13, Ateef has been trained in the use of assault rifles and is a frontlines combat fighter. He fights for two years before the United Nations and South Sudan’s People Defence Force negotiate for the release of hundreds of children from the armed forces. Ateef is now 15 years old, struggles with nightmares about the wars he participated in, and faces stigma from the community he has been placed in. He has been assigned a case worker who helps him with his school work and has enrolled him in a program for him to learn tradesmen skills, but he often wonders what has become of his father and brothers still involved in the army, and if he will ever be reunited with them.

Summary of Key Points

- Child soldiers have been utilized all over the globe and thousands of violations of international declarations occur every year. These violations are easiest to track through the United Nation’s Secretary-General’s report.

- The most important efforts to decrease and eliminate the use of child soldiers lie in getting more countries and non-state sanctioned military organizations on board with the Children, Not Soldiers campaigns and to pledge to prohibit military involvement for anyone under the age of 18.

Supplemental Learning

Films – Ballad of the Little Soldier (1984); Beasts of No Nation (2015); Children of War (2009); Grace, Milly, Lucy…Child Soldiers (2010); Johnny Mad Dog (2008)

Websites

Child Soldier International’s OPAC and Hostility Tracking Maps: https://childsoldiersworldindex.org/opac-status

Human Rights Watch Children’s Rights Articles: https://www.hrw.org/topic/childrens-rights#

Child-soldiers.org

Globalcitizen.org

Warchild.org

Books

A Long Way Gone: Memoirs of a Boy Soldier by Ishmael Beah

Child Soldier: When Boys and Girls are Used in War by Michel Chikwanine & Jessica Humphrey

Articles

Kimmel, C. E., & Roby, J. L. (2007). Institutionalized child abuse: The use of child soldiers. International Social Work, 50(6), 740–754. https://doi.org/10.1177/0020872807081901

Kiyala, J. C. K. (2015). Challenges of reintegrating self-demobilised child soldiers in North Kivu province: Prospects for accountability and reconciliation via restorative justice peacemaking circles. Human Rights Review, 16(2), 99-122. DOI: 10.1007/s12142-015-0361-7

Mazurana, D. & Carlson, K. (2006). The girl child and armed conflict: Recognizing and addressing grave violations of girls’human rights. United Nations Division for the Advancement of Women. Florence, Italy. Retrieved from https://www1.essex.ac.uk/armedcon/story_id/000770.pdf

Vandenhole, W., Derluyn, I., Parmentier, S., & Mels, C. (2015). Victims and/or perpetrators? Towards an interdisciplinary dialogue on child soldiers. BMCInternational Health and Human Rights, 15(1), 1-13. DOI: 10.1186/s12914-015-0068-5

Vindevogal, S., Coppens, K., Derluyn, I., Schryver, M., Loots, G., & Broekaert, E. (2011). Forced conscription of children during armed conflict: Experiences of former child soldiers in northern Uganda. Child Abuse & Neglect, 35(7), 551-562. https://doi.org/10.1016/j.chiabu.2011.03.011

References

Bleasdale, M. (2013). Child Soldiers. Human Rights Watch. Retrieved from https://www.hrw.org/topic/childrens-rights/child-soldiers

Borgen Project. (2017). Organizations Helping Child Soldiers Recover. Retrieved from https://borgenproject.org/organizations-helping-child-soldiers-recover/

Child Soldiers International. (2016a). Who are Child Soldiers? Retrieved from https://www.child-soldiers.org/who-are-child-soldiers

Child Soldiers International. (2016b). Where are Child Soldiers? Retrieved from https://www.child-soldiers.org/where-are-there-child-soldiers

Child Soldiers International. (2018). Child Soldiers International Annual Report 2017-2018. Retrieved from https://www.child-soldiers.org/Handlers/Download.ashx?IDMF=841fa200-9315-4e8a-9a6c-cdf63a0af22a

Child Soliders International. (2019). Child soldier levels doubled since 2012 and girls’ exploitation is rising. Retrieved from https://www.child-soldiers.org/news/child-soldier-levels-have-doubled-since-2012-and-girls-exploitation-is-rising

Child Soldier Prevention Act, H.R. 3028, 110th Congress. (2007).

Child Soldier Prevention Act, H.R. 1191, 115th Congress. (2017).

Denov, M. (2010). Coping with the trauma of war: Former child soldiers in post-conflict Sierra Leone. International Social Work, 53(6), 791–806. https://doi.org/10.1177/0020872809358400

Dolinger, J. (2016). The failure of the Universal Declaration of Human Rights. University of Miami Inter-American Law Review, 47(2). Retrieved from https://repository.law.miami.edu/umialr/vol47/iss2/4/

Dudenhoefer, A. (2016). Understanding the Recruitment of Child Soldiers in Africa. African Centre for the Constructive Resolution of Disputes (ACCORD). Retrieved from https://www.accord.org.za/conflict-trends/understanding-recruitment-child-soldiers-africa/

Human Rights Watch. (2016). US: Don’t Fund Child Soldiers Abroad. Retrieved from https://www.hrw.org/news/2016/06/30/us-dont-fund-child-soldiers-abroad

Klasen, F., Reissmann, S., Voss, C., & Okello, J. (2015). The guiltless guilty: Trauma-related guilt and psychopathology in former Ugandan child soldiers. Child Psychiatry & Human Development, 46(2), 180–193. https://doi-org.proxy.lib.ohio-state.edu/10.1007/s10578-014-0470-6

League of Nations. (1924). Geneva Declaration of the Rights of the Child. Retrieved from http://cpd.org.rs/wp-content/uploads/2017/11/01_-_Declaration_of_Geneva_1924.pdf

Singer, P. W. (2005). Child soldiers: The new faces of war. American Federation of Teachers, Winter 2005/2006. Retrieved from https://www.aft.org/periodical/american-educator/winter-2005-2006/child-soldiers

Their World. (2016). Explainer: Child Soldiers. Their World: A Brighter Future for Every Child. Retrieved from https://theirworld.org/explainers/child-soldiers

Thomason, K. (2016). Guilt and child soldiers. Ethical Theory & Moral Practice, 19(1), 115–127. https://doi-org.proxy.lib.ohio-state.edu/10.1007/s10677-015-9595-3

United Nations. (n.d.). Child Recruitment and Use. Office of the Special Representative of the Secretary-General for Children and Armed Conflict. Retrieved from https://childrenandarmedconflict.un.org/six-grave-violations/child-soldiers/

United Nations. (1959). Declaration of the Rights of the Child. Retrieved from http://hrlibrary.umn.edu/instree/k1drc.htm

United Nations. (1989). Convention of the Rights of the Child. Retrieved from https://www.ohchr.org/en/professionalinterest/pages/crc.aspx

United Nations. (2002). Optional Protocol to the Convention on the Rights of the Child on the involvement of children in armed conflict. Office of the Special Representative of the Secretary-General for Children and Armed Conflict. Retrieved from https://childrenandarmedconflict.un.org/tools-for-action/optional-protocol/

United Nations. (2013). The Six Grave Violations Against Children During Armed Conflict: The Legal Foundation. Office of the Special Representative of the Secretary-General for Children and Armed Conflict. Retrieved from https://childrenandarmedconflict.un.org/publications/WorkingPaper-1_SixGraveViolationsLegalFoundation.pdf

United Nations. (2018). Children in Armed Conflict: Report of the Secretary-General. General Assembly Security Council. Retrieved from https://www.un.org/ga/search/view_doc.asp?symbol=S/2018/465&Lang=E&Area=UNDOC

United Nations International Children’s Emergency Fund (UNICEF). (1997). Cape Town Principles and Best Practices. Retrieved from https://www.unicef.org/emerg/files/Cape_Town_Principles(1).pdf

United Nations International Children’s Emergency Fund (UNICEF). (2007). The Paris Principles: Principles and Guidelines on Children Associated with Armed Forces or Armed Groups. Retrieved from https://www.unicef.org/emerg/files/ParisPrinciples310107English.pdf

Chapter 9: Organ Trafficking

ABSTRACT

Organ trafficking is possibly one of the most covert forms of human trafficking. A global shortage of organs has driven the industry, relying on poor populations to be donors and wealthy foreigners to be recipients. In this chapter, the prevalence of organ trafficking will be explored, especially in relation to transplant tourism. Suggestions to stop trafficking will also be explored.

Learning Objectives

By the end of this chapter, the student will be able to:

- Define organ trafficking and transplant tourism

- Identify contributing factors to illegal organ trade

- Recognize countries commonly engaged in organ trafficking

- Have a basic understanding of efforts aimed at stopping organ trafficking

Key Words: Organ trafficking, transplant tourism

GLOSSARY

Organ Trafficking: The practice of using exploitation, coercion, or fraud to steal or illegally purchase or sell organs

Transplant Tourism: The act of traveling to a foreign country for the purpose of buying, selling, or receiving organs

Organ Trafficking

Over 114,000 people are on the organ waitlist in the United States, and a new person is added every 10 minutes (American Transplant Foundation, 2018). On average, 20 people die every day waiting for an available organ in the United States alone (American Transplant Foundation, 2018). The legally available organs for transplant only satisfy about 10% of the global organ transplant need (Negri, 2016, United Nations, 2018; Yousaf & Purkayastha, 2016). The long waitlists and grim results of waiting too long drive a lot of people to participate in transplant tourism and organ trafficking (ACAMSToday, 2018; American Transplant Foundation, 2018; Broumand & Saidi, 2017; United Nations, 2019). Organ trafficking is the practice of stealing or buying organs through exploitation to be sold on a black market for profit, and transplant tourism is traveling to another country for the purpose of buying, selling, or receiving organs (Broumand & Saidi, 2017; Shimazono, 2007; United Nations, 2011; United Nations, 2018).

There is no reliable data on organ trafficking, but the World Health Organization (2004) believed it to be steadily on the increase, with brokers charging wealthy recipients $100,000+ and giving impoverished donors as little as $1000, both amounts in U.S. dollars. It is also estimated that 10% of the organ transplants done globally are completed using black market organs (Negri, 2016; United Nations, 2018). Cultural and religious customs ban or discourage some individuals from donating organs willingly or receiving post-mortem organ donations (World Health Organization, 2004). Illegal organ harvesting generally is not harvesting organs from willing donors going against cultural laws for the sake of philanthropy, but harvesting from unwilling or uninformed donors through exploitation of impoverished, indebted, homeless, uneducated, and refugee people (United Nations, 2018). It is difficult to know exactly how many people have been victims or recipients of illegally harvested organs because of the complex nature of organ trafficking, like human trafficking in general, which leads to unreliable statistics and underreporting (Yousaf & Purkayastha, 2016).

Retrieved from https://bigthink.com/philip-perry/what-you-need-to-know-about-human-organ-trafficking

Targets of Organ Trafficking

Organ trafficking victims, as with most human trafficking victims, are generally poor, vulnerable populations (United Nations, 2018). There are rare instances where victims are put under anesthetic and wake to find their organs missing or are murdered for their organs. As a whole, coercion of living donors is more common (Future for Advanced Research and Studies, 2016; United Nations, 2011). It is most common for victims of organ trafficking to be recruited through brokers, who are individuals who recruit organ suppliers and connect them with organ recipients (Kelly, 2013; United Nations, 2011; United Nations, 2015). Recruiters/brokers are usually people who may be from the same communities or ethnicity of a vulnerable population so as to build trusting relationships easier. The recruiters then make promises to the organ suppliers like large sums of money or release from debt, and convince them that the organ is not needed. Specifically in the case of kidneys, the most commonly harvested organ from living donors, recruiters will tell victims that the kidney will grow back, having two kidneys is unnatural, or that they have a large and a small kidney and removal of the small kidney is harmless (United Nations, 2011; United Nations, 2015). Victims rarely receive the full amount of money promised, if they receive any compensation at all (United Nations, 2011; United Nations, 2015). In some cases, the post-removal healthcare costs for a living organ trafficking victim add to their previous debt and worsen their financial situation (Kelly, 2013).

Retrieved from https://www.acamstoday.org/organ-trafficking-the-unseen-form-of-human-trafficking/

There is a difference between “trafficking organs” and “trafficking persons for the purpose of organ removal”, which makes it difficult to combat both forms of trafficking and also to identify victims (United Nations, 2015).

TRAFFICKING ORGANS

Trafficking organs is an instance where the crime is buying and selling of organs, as a product, illegally.

vs.

TRAFFICKING PERSONS FOR THE PURPOSE  OF ORGAN REMOVAL

Trafficking persons for the purpose of organ removal occurs when the person is the product and the purpose of trafficking them is for their organs.

Victims who “willingly” sell organs are sometimes treated as criminals involved in an illegal transaction, which would be trafficking in organs (Yousaf & Purkayastha, 2016). This criminalization is a deterrent for victims to pursue their compensation when they have been recruited and exploited by brokers.

The recipients of trafficked organs are generally wealthy, and participating in transplant tourism (European Union, 2015; United Nations, 2015). One study estimates that 70% of organ recipients are not registered organ donors, which some advocates argue is an unfair distribution of an already limited resource (Kelly, 2013). Recipients may have reached a point of desperation, cannot wait any longer for a legal donation, be deemed unsuitable for transplant domestically, or may not want to ask relatives for a living donation (United Nations, 2011; United Nations, 2015). Some recipients may even be unaware of organ trafficking and are responding to ads that seem legitimate from hospitals and medical professionals abroad that promise the organ transplant for one flat fee (United Nations, 2015).

Places and People

China is especially well-known for organ trafficking, with reports of prisons executing prisoners to illegally harvest their organs against their consent when they are a potential match for a recipient (Paul, Caplan, Shapiro, Els, Allison, & Li, 2017). The United States, Canada, the Czech Republic, and Israel have begun to take action to prevent their citizens from engaging in transplant tourism involving China (Doctors Against Forced Organ Harvesting (DAFOH), 2019). Alternatively, organ procurement through purchase in Iran is sometimes legal, as Iran is the only country in the world where it is legal to sell organs (Krishnan, 2018). Iran has established a base price for organs at $4,600, but that is only when the organs are procured legally – which is often not the case, as poor people still go through brokers and are paid an unknown, under the table price (Krishnan, 2018). One would hope that only a few isolated countries are major participants in organ trafficking, but unfortunately it is a global business where organs are bought from the poor and sold to the wealthy (European Union, 2015). Organ recipients participating in transplant tourism are mostly traveling from the U.S., Canada, Saudi Arabia, the Gulf states, Japan, and Taiwan into the U.S., Costa Rica, Panama, Ecuador, Colombia, Egypt, Kosovo, Cyprus, Israel, Azerbaijan, China, and the Philippines to receive organs (European Union, 2015). While not necessarily hot locations for transplant tourism, the following countries have been identified as organ recipients: Australia, Canada, Israel, Japan, Oman, Saudi Arabia, and the United States (Shimazono, 2007). India, Pakistan, China, Bolivia, Brazil, Iraq, Israel, Moldova, Peru, Turkey and Colombia have all been identified as common organ sellers (Shimazono, 2007).

One of the difficulties with organ trafficking is the participation of the medical field and medical professionals in maintaining the industry (United Nations, 2011; United Nations, 2015; European Union, 2015). Doctors, nurses, ambulance staff, and entire hospitals participate in illegal organ harvesting and transplanting (European Union, 2015; United Nations, 2011; United Nations, 2015). The medical field is not the only industry upholding illegal organ trade, though. The United Nations (2011) cites that travel agents, insurance agents, and faith-based organizations that call on “organ hunters” also act as major players in maintaining the illegal buying and selling of harvested organs.

Action

In the United States, there have been 26 pieces of legislation passed aimed at regulating organ transplanting and donation (Health Resources and Services Administration (HRSA), n.d.). These regulations range from what constitutes being dead, to what constitutes consent for organ donation, to national honors for organ donation (HRSA, n.d.). In 1984 the United States passed the National Organ Transplant Act (NOTA) which banned the buying and selling of organs for transplant, created a task force on organ transplanting, and created an administrative unit in the Department of Health and Human Services to manage a registry of organ donors and recipients (HRSA, n.d.). The United States, however, remains a top recipient of trafficked organs (European Union, 2015; Shimazono, 2007). Additionally, the United States does not include organ removal in its definition of human trafficking in the Trafficking Victims Protection Act, and therefore has had few prosecutions related to organ trafficking—the prevalence of organ trafficking in the United States is difficult to estimate (Kelly, 2013).

The Declaration of Istanbul (2008) was drafted by over 150 representatives from 78 countries around the world to become the legal and professional framework for ethical practices of organ procurement and transplantation. The Declaration of Istanbul (2008) defined organ trafficking, transplant commercialism, and transplant tourism, as well as gave specific guidelines for care, reimbursement, and recruitment of living donors. The revised 2018 edition of The Declaration of Istanbul further defines organ trafficking, specifically trafficking in persons for the purpose of organ removal, self-sufficiency in organ donation, and financial aspects of organ donation. Following the Declaration of Istanbul, the World Health Organization, the World Medical Association, and the European Convention on Human Rights and Biomedicine have released guidelines and principals for the ethical obtainment of organs from consenting living and deceased donors, and ethical boundaries for medical professionals performing organ transplants (European Union, 2015). Unfortunately, though, none of these documents, with the exception of the European Convention on Human Rights and Biomedicine, are legally binding, and the European Convention is only legally binding to those European member states that have signed and ratified it, leaving a very large portion of the world unaccountable (European Union, 2015). The Declaration of Istanbul (2018) calls on “designated authorities in each jurisdiction” (page 3) to ensure accountability and ethical practice. The United Nations Office on Drugs and Crime (2015) states that a lack of specific and adequate legislation is a major inhibitor to preventing trafficking in persons.

The United Nations Global Report on Trafficking in Persons (2018) states that the areas where human trafficking as a whole has decreased are countries that have adopted legislation, have detailed action plans, and are dedicated to identifying victims and perpetrators of trafficking. In regards to organ trafficking specifically, the United Nations (2018) highlights the importance of: coordination among United Nations entities in efforts against organ trafficking; taking on full implementation of provisions against organ trafficking; focusing on protection of vulnerable populations and preventing abuses of power; increasing efforts at identifying victims; and addressing international supply and demand and increasing awareness. Similarly, the European Union (2015) also created a series of recommendations to address organ trafficking specifically, they are: taking measures to address the legally obtained organ shortage; speed up implementation of national and international law; hold recipients criminally liable; address health professionals’ role in organ trafficking; improve organ traceability systems; prohibit payment for illegally obtained organs and seize criminal profits; and prohibit organ solicitation. See criminal cases below.

Recent international cases of organ trafficking
Source: http://www.europarl.europa.eu/RegData/etudes/STUD/2015/549055/EXPO_STU%282015%29549055_EN.pdf

Quiz

An interactive or media element has been excluded from this version of the text. You can view it online here:
https://ohiostate.pressbooks.pub/humantrafficking/?p=31

Now, let’s shift gears and turn to a case study.

CASSANDRA

Cassandra is in need of a kidney donation due to persistent issues with kidney disease leading her to need hers removed and replaced. Cassandra is far down on the kidney waitlist, with an expected wait time of over a year and a half. Her husband does some research and finds a hospital in China that promises top doctors, state of the art medical facilities, a donor kidney, and the surgery for a flat fee of $50,000. The price is steep, but Cassandra and her husband believe they can get a second mortgage on their home to cover the cost and can afford the travel out of pocket. A few months after speaking with a representative from the hospital, they travel to China to have the surgery, stay for a few weeks of recovery, and then return home. Though they were unaware, the hospital they went through was involved with an underground, illegal organ trade business, and they had just engaged in transplant tourism. Cassandra was told that the kidney was from an “anonymous donor”, but in reality, there was a person who was exploited for their organ unwillingly.

Summary of Key Points

- Global organ trafficking is driven by an international shortage of organs and a growing number of deaths as a result of waiting too long for an organ.

- Organs generally come from vulnerable populations in countries with lax laws on organ trade, and go to recipients in wealthier countries.

Supplemental Learning Materials

Articles

Archer, D. (2013). Body snatchers: Organ harvesting for profit. Psychology Today. Retrieved from https://www.psychologytoday.com/us/blog/reading-between-the-headlines/201311/body-snatchers-organ-harvesting-profit

Martin, D., Van Assche, K., Dominguez-Gil, B., Lopez-Fraga, M., Gallont, R., …, Capron, A. (2019). Strengthening global efforts to combat organ trafficking and transplant tourism: Implications of the 2018 edition of the Declaration of Istanbul. Transplant Direct, 5(3). DOI: 10.1097/TXD.0000000000000872

Ralph, A., Alyami, A., Allen, R., Howard, K., Craig, J., Chadban, S., Irving, M., & Tong, A. (2016). Attitudes and beliefs about deceased organ donation in the Arabic-speaking community of Australia: A focus group study. BMJ Open, 6(1). DOI: 10.1136/bmjopen-2015-010138

Small-Jordan, D. (2016). Organ harvesting, human trafficking, and the black market. Decoded Science. Retrieved from https://www.decodedscience.org/organ-harvesting-human-trafficking-black-market/56966

Srour, M. (2018). Human trafficking for organs: Ending abuse of the poorest. Inter Press Services News Agency. Retrieved from http://www.ipsnews.net/2018/04/human-trafficking-organs-ending-abuse-poorest/

Report on organ harvesting in China’s prisons: Kigour, D., Gutmann, E., Matas, D. (2016). Bloody harvest/The slaughter: An update. Retrieved from https://endtransplantabuse.org/wp-content/uploads/2016/06/Bloody_Harvest-The_Slaughter-June-23-V2.pdf

Videos

Harvested Alive Documentary: https://www.youtube.com/watch?v=Od3Q6O7HMy8

Famous Cases

Kendrick Johnson Case: https://www.cbsnews.com/news/kendrick-johnson-death-missing-organs-are-reason-to-suspect-foul-play-in-ga-teens-gym-mat-death-victims-parents-say/

Chinese boy’s eyes gouged out: https://www.bbc.com/news/world-asia-china-23846633

Books
Opportunities for Organ Donor Intervention Research: https://www.ncbi.nlm.nih.gov/books/NBK458645/

Websites
www.dafoh.org

www.humantraffickingsearch.org

References

ACAMSToday. (2018). Organ Trafficking: The Unseen Form of Human Trafficking. Retrieved from https://www.acamstoday.org/organ-trafficking-the-unseen-form-of-human-trafficking/

American Transplant Foundation. (2018). Facts: Did you know? Retrieved from https://www.americantransplantfoundation.org/about-transplant/facts-and-myths/

Broumand, B. & Saidi, R. (2017). New definition of transplant tourism. International Journal of Organ Transplant Medicine, 8(1), 49-51. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5347406/

Doctors Against Forced Organ Harvesting (DAFOH). (2019). The United States, Canada, the Czech Republic, and Israel Act Against Organ Trafficking. Retrieved from https://dafoh.org/newsletter/the-united-states-canada-the-czech-republic-and-israel-act-against-organ-harvesting/

European Union. (2015). Trafficking in Human Organs. European Union Directorate-General for External Policies Policy Department. Retrieved from http://www.europarl.europa.eu/RegData/etudes/STUD/2015/549055/EXPO_STU%282015%29549055_EN.pdf

Future for Advanced Research and Studies. (2016). Why rates of human trafficking are on the rise in the Middle East. Retrieved from https://futureuae.com/m/Mainpage/Item/2309/why-rates-of-human-organ-trafficking-are-on-the-rise-in-the-middle-east

Health Resources and Services Administration. (n.d.). Selected Statutory and Regulatory History of Organ Transplantation. Retrieved from https://www.organdonor.gov/about-dot/laws/history.html

Kelly, E. (2013). International organ trafficking crisis: Solutions addressing the heart of the matter. Boston College Law Review, 54(3), Article 17. Retrieved from https://lawdigitalcommons.bc.edu/cgi/viewcontent.cgi?referer=https://scholar.google.com/&httpsredir=1&article=3324&context=bclr

Krishnan, M. (2018). Legalizing trafficking: Iran’s unjust organ market and why legal selling of organs should not be the resolve. Berkeley Political Review. Retrieved from https://bpr.berkeley.edu/2018/05/03/legalizing-trafficking-irans-unjust-organ-market-and-why-legal-selling-of-organs-should-not-be-the-resolve/

Negri, S. (2016). Transplant ethics and the international crime of organ trafficking. International Criminal Law Review, 16(2016), 287-303. DOI 10.1163/15718123-01602001

Paul, N., Caplan, A., Shapiro, M., Els, C., Allison, K., & Li, H. (2017). Human rights violations in organ procurement practice in China. BMC Medical Ethics, 18(11). DOI: 10.1186/s12910-017-0169-x

Ralph, A., Alyami, A., Allen, R., Howard, K., Craig, J., Chadban, S., …, Tong, A. (2016). Attitudes and beliefs about deceased organ donation in the Arabic-speaking community in Australia: a focus group study. BMJ Open, 6(1). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4735320/

Shimazono, Y. (2007). The state of the international organ trade: a provisional picture based on integration of available information. Bulletin of the World Health Organization, 85(12), 901-980. Retrieved from https://www.who.int/bulletin/volumes/85/12/06-039370/en/

Steering Committee of the Istanbul Summit. (2008). The Declaration of Istanbul on Organ Trafficking and Transplant Tourism (2008 Edition). Retrieved from https://www.declarationofistanbul.org/images/Policy_Documents/2008_Edition_of_the_Declaration_of_Istanbul_Final.pdf

Steering Committee of the Istanbul Summit. (2018). The Declaration of Istanbul on Organ Trafficking and Transplant Tourism (2018 Edition). Retrieved from http://www.declarationofistanbul.org/images/Policy_Documents/2018_Ed_Do/2018_Edition_of_the_Declaration_of_Istanbul_Final.pdf

United Nations. (2011). Conference of the Parties to the United Nations Convention against Transnational Organized Crime. Working Group on Trafficking in Persons. Vienna. Retrieved from https://www.unodc.org/documents/treaties/organized_crime/2011_CTOC_COP_WG4/2011_CTOC_COP_WG4_8/CTOC_COP_WG4_2011_8_E.pdf

United Nations. (2015). Assessment Toolkit: Trafficking in Persons for the Purpose of Organ Removal. United Nations Office on Drugs and Crime. Retrieved from https://www.unodc.org/documents/human-trafficking/2015/UNODC_Assessment_Toolkit_TIP_for_the_Purpose_of_Organ_Removal.pdf

United Nations. (2018). Global Report on Trafficking in Persons. United Nations Office on Drugs and Crime. Retrieved from https://www.unodc.org/documents/data-and-analysis/glotip/2018/GLOTiP_2018_BOOK_web_small.pdf

United Nations. (2019). Organ Trafficking. United Nations Office on Drugs and Crime. Retrieved from https://www.unodc.org/unodc/en/organized-crime/intro/emerging-crimes/organ-trafficking.html

World Health Organization. (2004). Organ trafficking and transplantation pose new challenges. Bulletin of the World Health Organization, 82(9). Retrieved from https://www.who.int/bulletin/volumes/82/9/feature0904/en/

Yousaf, F., Purkayastha, B. (2016). Social world of organ transplantation, trafficking, and policies. Journal of Public Health Policy, 37(2), 190-199. DOI: 10.1057/jphp.2016.2

Action Section

This section includes content on how to go into Action mode based on a diverse range of trafficking situations. Chapters are on survivor led leadership, certification of foreign nationals who are sex trafficked, and  identifying trafficking victims in healthcare settings.

“Anti Human Trafficking Day 2010” by thomaswanhoff is licensed under CC BY-SA 2.0

Chapter 10: Leadership Among Survivors in the Anti-Trafficking Movement

ABSTRACT

Anti-trafficking efforts tend to be spearheaded by law enforcement agencies at the federal, national, state and local levels. These agencies are critical macro approaches to eradicating human trafficking. Trafficking survivors, however, are also critical to anti-trafficking efforts at all levels given their experiences as trafficking victims. Proponents of the Survivor Leadership Model advocates for the treatment of trafficking victims, preparation for leadership, and opportunities for trafficking survivors to be leaders.

Learning Objectives

By the end of this chapter, the student will be able to:

- Define sex trafficking

- Understand trauma

- Breakdown the Survivor Leadership model

Key Words: Sex Trafficking, Trauma and Survivor Leadership

GLOSSARY

Sex Trafficking: Involves the recruitment, harboring, transportation, provision, or obtaining of a person for the purpose of a commercial sex act (CSA); if the person (foreign national or U.S. citizen) is 18+ years of age, the CSA must be induced by coercion, fraud or force

Trauma: A deeply distressing or disturbing event that tends to be acute, chronic or complex

Survivor Leadership: Anti-trafficking efforts that are led by survivors of sex trafficking
Sex Trafficking, Trauma and Survivor Leadership

Survivors as Leaders

SURVIVORS AS LEADERS

Survivors often engage in public speaking in the anti-trafficking arena.

According to the Office of Victims of Crimes (OVC), it is imperative to engage sex trafficking survivors in anti-human trafficking leadership and decision-making in order to provide effective services to victims (Office of Justice Programs [OJP], 2018). As a result, the OVC continues to find opportunities to engage survivors in the anti-trafficking movement and to support survivor leadership (OJP, 2018). In 2015, the US Government enacted the United States Advisory Council on Human Trafficking.  This Council is made up of eight human trafficking survivors who offer their expertise to various levels of governments, NGOs, scholars, students, activists,  survivors, trafficking task forces, and others committed constituent groups (United States Advisory Council on Human Trafficking, 2019). Membership on this Council is considered one of the most influential leadership positions that a survivor can hold.

According to the Trafficking Victims Protection Act (TVPA) of 2000, sex trafficking involves the recruitment, harboring, transportation, provision, or obtaining of a person for the purpose of a commercial sex act (CSA). If the person (foreign national or U.S. citizen) is 18+ years of age, the CSA must be induced by coercion, fraud or force (Public Law 106-386). Sex trafficking is widespread in the United States (Kara, 2009). Between 2007 and 2014, 12,508 cases of sex trafficking were reported throughout the United States. In 2014, 90% of the 3598 cases reported were composed of females (Orme & Ross-Sheriff, 2015). While there is no official estimate of the total number of persons who are human trafficked in the United States, Polaris (a nationally recognized clearinghouse for trafficking information) estimates that the actual number of victims in the USA reaches into the hundreds of thousands when estimates of sex and labor trafficking are aggregated for adults and minors. Since 2007, Polaris has received 156,312 calls related to suspected human trafficking activities, 11,601 web form completions and 11,058 emails (Polaris, 2017). Although not exactly precise in numbers, Polaris statistics serve as frequently quoted proxies for the prevalence of human trafficking in the United States.

Many sex trafficked victims suffer from depressive disorders, anxiety disorders, dissociative disorders, borderline personality disorder, eating disorders, substance disorders and suicide attempts (Farley, 2010; Raymond & Hughes, 2001; Sigmon, 2008; Williamson, Dutch & Clawson, 2007). According to the most current version of the Diagnostic and Statistical Manual (DSM) of Mental Disorders, trafficking victims are especially at high risk for developing Posttraumatic Stress Disorder (PTSD) (American Psychiatric Association [APA], 2013). Trauma is considered to be a combination of the event, the experience, and the effect (SAMHSA, 2014). Consistent with the previously stated disorders, Raymond and Hughes (2001) report that many survivors report numbness, depression, lethargy, self-blame/guilt, poor concentration, loss of appetite and sleep disturbances. The American Psychiatric Association shows that trauma is oftentimes co-morbid with substance misuse and other DSM disorders (APA, 2013). As a result, many of these women seek out social services at some point in their lives (Williamson, Dutch & Clawson, 2007). It is during these times of formal social service interventions that many sex trafficking women learn empowerment strategies, gain their independence, come to identify as victims for the first time and then move onto identifying as survivors. Some then move on and learn how to be leaders in the anti-trafficking movement (Lloyd, 2008).

Despite the tragic ordeals of trafficked persons, the Survivor Leadership Model does not consider sex trafficking victims as victims—it views them as survivors given that the person has survived a horrible injustice. The word “victim” is a legal term, which suggests that the person has experienced criminal harm, whereas the word survivor emphasizes that the person is strong and can recover (Office for Victims and Crimes—Training and Technical Assistance Center, 2018). During and after recovery, many survivors go on to become leaders. Survivors need the same skills to fulfill leadership roles as anyone else but their trainings tend to be situated in a clinical context instead.

The Survivor Leadership Model has five main components as shown in Figure 1. It recognizes the need for multilateral services for trafficking victims with the intent to heal her, empower her and provide her with a skill set that prepares her to be a leader in the anti-trafficking arena as an expert. The model acknowledges the trauma in the life of the trafficked person and the need to approach victims in a trauma informed manner. It calls for soliciting the expertise of the survivor in service delivery. It demands adequate resources to deliver services. It moves the victim to a state of being a survivor through empowerment services and it calls for continued support of the survivor post treatment (Family and Youth Services Bureau, 2015).

Figure 1. Survivor Leadership Model

Components of a Survivor Leadership Model

Trauma-informed approach. A trauma informed approach recognizes: “that survivors need to be respected, informed, connected, and hopeful regarding their own recovery; the interrelation between trauma and symptoms of trauma such as substance abuse, eating disorders, depression, and anxiety; and the need to work in a collaborative way with survivors, family and friends of the survivor, and other human services agencies in a manner that will empower survivors…” (SAMHSA, 2018, “Trauma-Specific Interventions” section). The five guiding principles of trauma informed care include ensuring safety; giving the victim choices and control;collaborations via shared decision-making; exuding trustworthiness and prioritizing empowerment and skill-building (Buffalo Center for Social Research, 2019). A framework of this nature requires an organization and its staff to develop and implement policies and practices that do not re-traumatize those who it provides services to.

Input and direction from survivors. A primary assumption of this model is that no one understands sex trafficking better than a sex trafficking survivor. These women are believed to be experts on the subject matter because they have lived the life as trafficked victims who are now survivors. Her expertise is important as a survivor offering input, because she is able to garner trust among other survivors with similar lived experiences (Gerassi, 2018). This is particularly important given the stigma associated with prostitution, even when forced and outside the control of the victim. Prostitution in all forms is highly stigmatized in society and being around other survivors decreases the shame these women may feel—especially when the survivor can take on leadership roles in agencies offering services to her and her peers. Lloyd (2008) states that being able to lead others teaches survivors communication skills and the ability to speak up for oneself. From an empowerment perspective, seeing survivors further along in recovery provides a goal for other survivors to work towards. As for leadership, when survivors step up to leadership positions and are paid for these roles, it shows these women that they can be valued for more than their bodies and that they have a place in society (Lloyd, 2008). O’Hagan (2009) asserts that broad definitions of leadership is important and a respect for diversity of lived experiences is imperative.

Adequate resource allocation by the organization’s upper management. Due to the complexity of human trafficking and the ensuing trauma, it is important for organizations to be properly equipped with resources to offer proper treatment. This may include safe longterm housing, food, medical treatment, psychological treatment, substance abuse treatment and rehabilitation services (Palmiotto, 2014). Thus, multi-lateral support is required as well as the use of multiple agencies to supply survivors with comprehensive social services.

Empowerment of the survivor. Empowerment is essential to keeping the survivor in treatment. Lessons learned in treatment allows her to see that she is capable of recovery and rebuilding her life. As trafficking victims, women lose control over their lives in every way (when they eat, how they dress, where they live, how long they sleep, who they have sex with, how long they work, etc.) (Palmiotto, 2014). Treatment, however, helps to transfer that control and power back to the survivor. When a survivor gains agency in her life, it increases the likelihood that she will remain in treatment (Gerassi, 2018)). From a theoretical perspective, anti-trafficking service is best expressed through the use of empowerment as a framework. Empowerment is an important goal when working with any client (Segal, Gerdes, & Steiner, 2007), but it is particularly important in the anti-trafficking arena where there is a need to empower a survivor of human trafficking to take control of her life. Empowerment strategies involve helping clients to gain individual power over one’s self, one’s actions, and one’s environment. It allows for self-determination and a transferring of power from external players and the environment to the client. It allows the trafficked person to shift her language from “victim” to “survivor”. The adoption of empowerment requires the clinician to understand the biography of the client so that her thoughts and actions are properly understood in the context in which the individual has experienced the world (Payne, 1997).

Post-graduation support. The effects of sex trafficking can last one’s entire life. To jumpstart recovery, some sex trafficking victims participate in long-term treatment programs whereby she commits to lengthy (e.g.,18-24 months) and highly regulated service and treatment. Upon the successful completion of core requirements, participants are awarded certificates at a graduation. The CATCH court is one such program in Columbus, Ohio (Miner-Romanoff, 2015). Once graduating or discharging from a program, however, it is not inconceivable that a survivor will return to her trafficker. If in a stable environment that offers long term support, however, survivors have a much lower chance of being re-trafficked (Twigg, 2017). Even if graduations and certificates are not part of a survivor’s regiment, supportive services after treatment are often cited as being needed post-trafficking (US Department of Health and Human Services, 2012).

Recommendations

A Survivor Leadership Model espouses that the sex trafficking victims turned survivors are experts and as experts should be given the opportunity to lead anti-trafficking efforts. The model purports that sex trafficking survivors know firsthand and up-close human traffickers—their recruitment strategies, their grooming practices, their violent tendencies, their weaknesses, their mentality, the tactics used to evade the law and who they are as perpetrators. This makes them experts. They are key experts in understanding the mindset of traffickers, how to conduct outreach to survivors, how to outsmart traffickers, how to enact legislation that is victim-centered, how to offer victim-centered empowerment-based services and address human trafficking in a practical and useful manner. Survivors are experts who must be heavily relied on, listened to, consulted with and given a platform to use their leadership skills.

As a practitioner, it is imperative to always utilize the expertise of survivors when developing programming for this unique population. The 2019 Trafficking in Persons reports offers a check list (Office to Monitor and Combat Trafficking in Persons, 2019) for establishing a survivor-informed practice.

Checklist for Establishing a Survivor-Informed Practice

- Assess the degree to which your organization is survivor-informed

- Identify gaps and opportunities

- Provide paid employment opportunities for survivors

- Staff positions

- Consultants

- Trainers

- Seek input from a diverse community of survivors

- Include both sex and labor trafficking perspectives

- Diversity in age, gender, race, national origin, sexual orientation, disability, etc.

- Create a plan for accessing survivor input throughout all stages of a project

- Program development and design (at inception is critical)

- Implementation

- Evaluation

Utilization of their skills and ideas include:

1. Consulting with survivors at the onset of any potential programming ideas

2. Soliciting their suggestions as programming starts to unfold

3. Recruiting them as collaborators when offering services (i.e., outreach, counseling, group activities, etc.)

4. Providing opportunities to develop and utilize leadership skills

Quiz

An interactive or media element has been excluded from this version of the text. You can view it online here:
https://ohiostate.pressbooks.pub/humantrafficking/?p=32

Barbara Freeman, a Survivor and Leader in the Anti-Trafficking Movement

https://www.10tv.com/article/human-trafficking-survivor-honored-woman-achievement

Summary of Key Points

- Many sex trafficking survivors have the capacity to become leaders, especially in the anti-trafficking movement.

- The Survivor Leadership Model is a five-part, survivor-centered model that focuses support and empowerment of the sex trafficked person

Supplemental Learning Materials

Administration for Children & Families. (2018, February). National Human Trafficking Training and Technical Assistance Center. Toolkit for Building Survivor-informed Organizations: Trauma-Informed Resources and Survivor-informed Practices to Support and Collaborate with Survivors of Human Trafficking as Professionals. Retrieved from https://freedomnetworkusa.org/app/uploads/2019/01/SurvivorWhitePaperDigitalFinalJan2019-1.pdf

Freedom Network USA. (2018, November). Human trafficking survivor leadership in the United States. Retrieved from https://www.acf.hhs.gov/sites/default/files/otip/toolkit_for_building_survivor_informed_organizations.pdf

Human Rights Funders Network. (2018, March 29). Survivor leadership in the anti-trafficking movement. Retrieved from, https://www.hrfn.org/event/survivor-leadership-in-the-anti-trafficking-movement/

Youth Laboratory. (2018, October 19). Victim-centered and survivor-led practices. Retrieved from https://youthcollaboratory.org/resource/victim-centered-and-survivor-led-practices

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Bengtsson, M. (2016). How to plan and perform a qualitative study using content analysis. NursingPlusOpen, 2, 8–14.

Berg, B.L. (2008). Qualitative research methods for the social sciences: International edition (7th ed.). Harlow, Essex: Pearson: Allyn & Bacon.

Brodsky, A.E. (2014). Field notes: Sage Research Methods. Retrieved from http://srmo.sagepub.com/view/sage-encyc-qualitative-research-methods/n172.xml

Buffalo Center for Social Research. (2019). What is trauma-informed care? Retrieved from http://socialwork.buffalo.edu/social-research/institutes-centers/institute-on-trauma-and-trauma-informed-care/what-is-trauma-informed-care.html

Family and Youth Services Bureau. (2015). Runaway and Homeless Youth Training & Technical Assistance. Using a survivor leadership model to address human trafficking. Retrieved from http://www.chhs.ca.gov/Child%20Welfare/FYSB%20Survivor-led%20model.pdf

Farley, M. (Ed.). (2010). Prostitution, trafficking, and traumatic stress. New York: Routledge.

Gerassi, L.B. & Nichols, A.J. (2018). Sex trafficking and commercial sexual exploitation: Prevention, advocacy, and trauma-informed practice. New York, NY: Springer Publishing Company, LLC.

Kara, S. (2009). Sex trafficking: Inside the business of modern slavery. New York: Columbia University Press.

Lloyd, R. (2008). From victim to survivor, from survivor to leader. Girls Education and

Mentoring Services, Gems. Retrieved from http://www.gems-girls.org

Miner-Romanoff, K. (2015). An evaluation study of a criminal justice reform specialty court –CATCH Court: Changing Actions to Change Habits: Full Report. Retrieved from https://services.dps.ohio.gov/OCCS/Pages/Public/Reports/CATCH%20FULL%20REPORT%20for%20Court%20CL%205.30.15.pdf

Office for Victims and Crimes—Training and Technical Assistance Center. (2018). Human trafficking task force e-guide. Retrieved from https://www.ovcttac.gov/taskforceguide/eguide/1-understanding-human-trafficking/13-victim-centered-approach/

Office of Justice Programs [OJP]. (2018). Justice for victims, justice for all. Retrieved from https://ovc.ncjrs.gov/humantrafficking/survivors.html/survivors.html

Office to Monitor and Combat Trafficking in Persons. (2019, June 20). 2019 Trafficking in Persons report. Retrieved from https://www.state.gov/reports/2019-trafficking-in-persons-report/

O’Hagan, M. (2009). Leadership for empowerment and equality: A proposed model for mental health user/survivor leadership. International Journal of Leadership in Public Services, 5(4), 1-13.

Orme, J., & Ross-Sheriff, F. (2015). Sex trafficking: Policies, programs and services. Social Work, 60(4), 287-294.

Palmiotto, M.J. (2014). Combating human trafficking: a multidisciplinary approach. Boca Raton: CRC Press.

Payne, M. (1997). Modern social work theory (2nd ed.)/. Lyceum Books, Inc: Chicago, IL.

Polaris. (2017). Hotline statistics. Retrieved from https://humantraffickinghotline.org/states

Public Law 106-386. (2000). Trafficking Victims Protection Act of 2000, H. R. 3244, (2000). 106th Cong., 2nd Sess.

Raymond, J.G., & Hughes, D.M. (2001). Sex trafficking of women in the United States: International and domestic trends. Retrieved from http://bibliobase.sermais.pt:8008/BiblioNET/upload/PDF3/01913_sex_traff_us.pdf

Ryan, G.W. (2014). What are standards of rigor for qualitative research? RAND Corporation. Retrieved from, http://www.wjh.harvard.edu/nsfqual/Ryan%20Paper.pdf

Segal, E.A., Gerdes, K.E., & Steiner, S. (2013). An introduction to the profession of social work: Becoming a change agent (4th ed.). Belmont, CA: Thomson—Brooks/Cole.

Sigmon, J.N. (2008). Combatting modern-day slavery: Issues in identifying and assisting victims of human trafficking worldwide. Victims and Offenders, 3, 245-257.

Substance Abuse and Mental Health Services Administration [SAMHSA]. (2014). Trauma definition. Retrieved from http://www.samhsa.gov/traumajustice/traumadefinition/definition.aspx

Substance Abuse and Mental Health Services Administration [SAMHSA]. (2018). Trauma-Informed approach and trauma-specific interventions. Retrieved from, https://www.samhsa.gov/nctic/trauma-intervention

Twigg, N. M. (2017). Comprehensive care model for sex trafficking survivors. Journal

of Nursing Scholarship, 49 (3), 259-266.

US Advisory Council. (2019 May). United States Advisory Council on Human Trafficking Annual Report 2019. Washington DC:  US Department of State.

US Department of Health and Human Services. (2012). Services available to victims of human trafficking: A resource guide for social service providers. Washington DC: Author.

Williamson, E., Dutch, N.M., & Clawson, H.J. (2007). Evidence-based mental health treatment for victims of human trafficking. Retrieved from http://aspe.hhs.gov/hsp/07/humantrafficking/mentalhealth/index.pdf

Chapter 11: Certification of Foreign National Sex Trafficking Victims

ABSTRACT

In order to legally remain in the United States, post trafficking, undocumented foreign nationals who are sex trafficking survivors must apply for certification. Certification allows the survivor to obtain a T-Visa and to apply for social services. This visa is also referred to as the T-1 visa. In order to be certified, however, the individual must agree to cooperate with the prosecution of the trafficker. This process is discussed in this chapter.

Learning Objectives

By the end of this chapter, the student will be able to:

- Describe the certification process for foreign national sex trafficking victims

- Understand what the T-Visa is

Key Words: Certification, Foreign National, and T-Visa/T-1 Visa

GLOSSARY

Certification: The process involved to receive and to be ultimately rewarded benefits as a sex trafficked survivor

Foreign National: A non-US citizen

T-Visa/T-1 Visa: A special visa that affords the foreign national the legal right to remain in the United States post-trafficking; derivatives of this visa are also available for the relatives of victims.

Certification of Foreign Nationals Who Are Sex Trafficking Survivors

According to the Trafficking Victims Protection Act (TVPA) of 2000, sex trafficking involves the recruitment, harboring, transportation, provision, or obtaining of a person for the purpose of a commercial sex act (CSA). If the person (foreign national or U.S. citizen) is over 18 years of age, the CSA must be induced by coercion, fraud, or force (Public Law 106-386). Sex trafficking is widespread in the United States (Kara, 2009). Between 2007 and 2014, 12,508 cases of sex trafficking were reported throughout the United States. In 2014, 90% of the 3598 cases reported were composed of females and 13% of them were foreign nationals (Orme & Ross-Sheriff, 2015). As foreign national sex trafficking victims, many women arrive to the destination country under false, coercive, or forceful pretenses (Public Law 106-386). According to Orme and Ross-Sheriff (2015), sex trafficking victims include men and boys too but the focus of this chapter is on women who are foreign nationals.

As a primary means to ensure control over sex trafficked women, force oftentimes include gang rapes, violent beatings, confinement, deprivation of food, kidnappings, and compulsory drug use (Public Law 106-386; SAWA, 2008). These traumatic experiences later result in the need for social services (i.e., medical care, mental healthcare, substance use treatment, etc.) for sex trafficking victims. The current protocol for foreign national adult trafficking victims, once removed from a trafficking situation, is to first certify the survivor for eligibility for a host of social services after application and approval of continued presence in the USA. As a result, the Health and Human Services Office of Refugee Resettlement (HHSORR) issues a letter to trafficking survivors indicating their eligibility for a range of social service benefits usually afforded to refugees upon certification (HHSORR, 2002). Not all trafficking survivors are eligible for all social services, however. Only those who are assessed and determined to be an authentic victim of severe human trafficking by the Department of Health and Human Services and granted a legal presence in the USA are eligible to be certified (USDHHS, 2012a). The fact that access to social services is not an automatic right—but instead is only afforded to foreign national human trafficking victims who meet stringent federal criteria for certification, is the authors’ main point of contention in this chapter. The complexity surrounding the certification process, drug use by sex trafficked persons and arguments for open access to social services for foreign national sex trafficked victims as a human right will be explicated throughout this chapter. Additionally, strong recommendations for changes in policy related to certification are proposed. See table 1 for a brief description of how the United Nations Universal Declaration of Human Rights apply in this situation. More human rights Articles apply to sex trafficking victims as discussed earlier in this text, but a few obvious ones are listed here.

UN UDHR Articles

Sex Trafficking Relevance

Article 4.
No one shall be held in slavery or servitude; slavery and the slave trade shall be prohibited in all their forms.

This Article explicitly forbids human trafficking (modern day slavery) in any form.

Article 23.
(1) Everyone has the right to work, to free choice of employment, to just and favourable conditions of work and to protection against unemployment.
(2) Everyone, without any discrimination, has the right to equal pay for equal work.
(3) Everyone who works has the right to just and favourable remuneration ensuring for himself and his family an existence worthy of human dignity, and supplemented, if necessary, by other means of social protection…

Trafficking strips victims of their dignity and rights related to employment. Traffickers determine type of employment (form of trafficking), payment (if any), and hours of work.

Article 25.
(1) Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control…

Trafficking victims do not enjoy the right to a decent standard of living.  They receive the bare minimum (if any) of everything available in the social service arena.  This human rights Article speaks to the primary services that should be accessible to all persons including trafficking victims/survivors (foreign national or otherwise) by social workers and other providers. Certification allows for access to these services.

Table 1. Select United Nations UDHR Articles

Certification of Adult Victims (18 years of age or more) of Trafficking

Shandra’s story (as told in Chapter 5) is not very unique for foreign national sex trafficking victims. Her perilous state surrounding false employment promises to lure her to the USA, rape upon arrival to the country, forced drug use, and protracted trafficking ordeal epitomizes the importance of these victims receiving social services related to substance use treatment, mental health, and physical health—to start—upon release and encounter with law enforcement, other front line workers and immigration services.

According to the US Department of Health and Human Services (2012a), a trafficked foreign national who is over the age of 18 is eligible to apply to receive a range of benefits and services under Federal or State programs as is afforded to refugees. The process involved to receive and to be ultimately rewarded these benefits is called certification. (See Figure 1.) In order to receive certification, foreign national adult victims (18 or older) of sex trafficking must:

1. Meet the criteria for a severe human trafficking victim (the legal term for human trafficking per federal USA legislation) as defined by the Trafficking Victims Protection Act;

2a. Be willing to assist in every reasonable way in the investigation and prosecution of severe human trafficking cases

(or 2b. if unable to cooperate it must be due to extreme physical or psychological trauma and an exception of this nature will only be accepted on rare instances); and

3a. Have made a bona fide application for a T-visa that has not been denied; or

3b. Have received Continued Presence (CP) from the Department of Homeland Security in order to participate in the prosecution of traffickers in persons.

Criteria 1 and 2a or 2b are required for certification in addition to criteria 3a or 3b. In addition to the previously stated criteria, in order to be eligible for the T visa, the trafficking activities must 1) be in violation of the law(s) of the United States government or 2) have occurred in the United States or one of its territories and possessions. Finally, the victim must also be physically present in the United States due to the trafficking (US Department of State, 2013). As noted here, there are many layers to the Certification process.

By no means, however, is the process for certification an easy one. This is due to the lack of knowledge of the process by the victim, language barriers of the victim, and a very strict and conservative stance by law enforcement agencies and the U.S. Custom and Immigration Services related to 1) qualifying an individual as a severe human trafficking victim and, 2) meeting eligibility for a T visa or Continued Presence. For instance, Clawson, Small, Go, and Myles (2003) report that foreign national sex trafficking survey respondents indicated the application process for the T visa and its derivatives (T visas for relatives) was complex, rigorous, tedious, and difficult to access. Many did not appear to be very familiar or pleased with the meticulous requirements needed to fill out the government paperwork given their language barriers as foreign national victims (Clawson et al., 2003).

On the rare occasion that a foreign national sex trafficking victim meets all federal criteria for a severe human trafficking victim, the person is then deemed eligible to receive a Certification Letter from the US Department of Health and Human Services (DHHS) Office of Refugee Resettlement (ORR). This is said to take a few days after DHHS notifies ORR that the person has met eligibility criteria (US Department of Health and Human Services, 2012a). This does not happen often, however. Between 2000 and 2007, only 1175 persons were determined to be and certified as a severe trafficking victim (Fedina, Trease & Williamson, 2008). As of 2008, less than 2300 persons applied for a principal T visa (versus a T visa derivative for the relative of the trafficked person). Exactly 1308 of them were approved between 2000 and 2008 (US Department of Homeland Security, 2009). As shown by these statistics, only a small number of trafficking victims ever enjoy the full benefits and services offered through health and human services agencies. Although some benefits are time limited, certification letters do not expire (US Department of Health and Human Services, 2012b; 2016).

Benefits and Services

SOCIAL SERVICES

Imperative to the Wellness of Trafficking Victims

Eligible services for certified foreign national sex trafficked adults from the US Department of Health and Human Services (2012b) include: Temporary Assistance to Needy Families (TANF); services that fall under the auspice of Medicaid, Health Resource and Services Administration Program; and services that fall under the auspice of Substance Abuse and Mental Health Services Administration Program (SAMHSA) benefits. Services offered by SAMHSA are farmed out to substance use and mental health agencies at the state level. As administrators over these programs, decisions regarding eligibility for services and types of treatment are made by the designated provider and vary by state (US Department of Health and Human Services, 2012b).

In the following table, specifics surrounding types of services and federal providers are illustrated for eligible persons in the USA with additional services indicated for those with HHS Certification letters.  As seen in Table 2, medical, mental health, and substance use services are available.

Potential Federal Need-Based Services for Trafficking Survivors and Others

Type of Service

Programs

Nutrition

Child Nutrition Program; Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)

Medical Services

Health Resources and Services Administration Programs

Mental Health

Substance Abuse and Mental Health Services Administration Programs (SAMHSA)

Monetary Assistance

Victims of Crime Act (VOCA) Victim Compensation

Employment

Career One-Stop Centers Core Services

Witness Protection and Services During Investigation

Victims Rights and Services; Emergency Witness Assistance; Witness Security Program

Other Potential Services

Services for Survivors of Torture

Additional Services for Trafficked Adults with HHS Certification Letters

Type of Service

Administering Units/Programs

Housing

Public Housing Program; Tenant-Based Vouchers

Medical Services

Medicaid; Refugee Medical Assistance; Office of Refugee Resettlement (ORR) Medical Screenings

Monetary Assistance

Temporary Assistance for Needy Families (TANF); refugee cash assistance; Supplemental Security Income (SSI)

Employment

Job Corps

Education

Title IV Federal Student Financial Aid

Multiple Needs Assistance

Public housing program; tenant-based vouchers

Other Potential Services

Victims of Crime Act (VOCA) services; Office for Victims of Crime (OVC) Human Trafficking Services

(US Department of Health and Human Services, 2012b; 2016)

Through the Office of Refugee Resettlement, certified adults are eligible for medical screens related to parasites, Hepatitis B, tuberculosis, contagious illnesses and an array of medical disorders that prevent the individual from being independent and self-sufficient. Through the US Department of Agriculture (USDA), the certified person is eligible for the Supplemental Nutrition Assistance Program (SNAP), which provides for food-related purchases. The US Department of Housing and Urban Development (HUD) offers housing through its programs. The US Department of Justice (USDOJ) offers in certain cases Victim of Crime emergency funds, the witness security program, emergency witness assistance, and victim rights and services (Federal Victim—Witness Coordinators) for those helping in the investigation and prosecution of severe human trafficking cases. The US Department of Labor offers one-stop career centers core services, one stop career center intensive services, and the job corps. The US Social Security Administration provides Supplementary Security Income while the US Department of Education provides offers Title IV Federal Student Financial Aid (US Department of Health and Human Services, 2012b).

Of this vast array of services, housing, mental health and substance use services are a high priority according to foreign national sex trafficking survivors. According to Clawson, Small, Go, and Myles (2003), housing was noted as a need by 98% of respondents in their study with trafficking victims and 95% identifying a need for mental health services. Approximately 52% of these same individuals also indicated a need for substance use treatment.

Recommendations for Changes in Policy

Balch and Geddes (2011) assert that an opportunity to do good to fight human trafficking in the United Kingdom can come out of the crisis of human trafficking in that country. The authors argue the same lesson can be learned by the United States. There is nothing that the United States can do to take away the grave injustice and horrors of human trafficking for a foreign national human trafficking victim in this country, but paving the way for access to a legal status, legitimate employment, and benefits and services for those who are trafficked on this soil is a good first step. In doing so, Shigekane (2007) argues that the US government must adopt a victim-centered approach that entitles trafficking survivors to social services assistance that is not predicated on one’s willingness to assist with prosecution. The United Nations agree as explicitly stated by its UN High Commissioner for Human Rights, “Separating protection and support from victim cooperation is a fundamental tenet of the human rights approach to trafficking. The requirement that protection and support should not be made conditional on a trafficked person’s capacity or willingness to cooperate in legal proceedings against their exploiters is echoed throughout the Trafficking Principles and Guidelines” (United Nations, 2010, p. 42). A victim-centered approach in the United States would completely do away with requirements to cooperate with legal proceedings as a contingency for services and benefits, which is the first and primary recommendation in policy change in the United States government. This seems very unlikely, however, given the hard and fast criteria established for certification. If the United States government is unwilling to adopt such human rights practice at this time, there are other progressive steps that could be taken. They include proactively working to improve the processes related to 1) proper identification of a trafficking victim; 2) mandatory referrals for mental health and substance use treatment upon contact with the trafficking victim; 3) increased support to complete and approval of the T visa; and 4) increased granting of letters of certification to the trafficking victim.

Referrals for Mental Health and Substance Use Treatment

Once identified, service providers must work collectively to provide foreign national trafficking survivors with critical and comprehensive services, especially those related to mental health and substance use. Shigekane (2007) emphasizes the importance of social services being delivered in a way that is culturally sensitive and appropriate and in a linguistically accommodating manner that may include the use of bilingual or bicultural professionals. Service delivery of any type can only be accomplished, however, after the victim is first deemed eligible for such services through the US government and law enforcement agencies.

[As a recommended change in policy, the authors strongly recommend that all foreign national sex trafficked persons be referred to compulsory physical exams, mental health evaluations, and substance use screenings upon first point of contact with officials; immediate receipt of their applications for certification; or immediately upon application for a T visa–not months or years afterward.]

Delaying these screenings and evaluations puts the trafficking victim at further risk for more harm related to suicide, mental disorders, relapse, exacerbated trauma, or even a desire to return to the trafficker. Rather than assume that these women will be stable until they are legally certified to remain in the USA and become eligible for a host of social services, the United States should instead seek to assess the woman’s current state of well-being at the first point of contact. The writer argues that a comprehensive system should be put in place that offers a full range of pre-certification services to applicants during the application process or at the point of contact with law enforcement or other frontline workers. This is critical given that the application process can be lengthy due to backlogs (US Department of Homeland Security, 2009).

After such a system is put into place, it is imperative to increase the trafficking victim’s awareness of available services. According to Clawson et al. (2003) who interviewed trafficking survivors and service providers to trafficking survivors, the identified needed services include: housing, medical care, advocacy, legal services, transportation, outreach, food, information & referrals (I&Rs), mental health services, service coordination, employment, protection, education, counseling, crisis intervention, life skills, an interpreter, job training, court orientation, dental services, victim’s compensation, child care services, self-help groups, and drug treatment (Clawson, Small, Go, & Myles, 2003). Clawson, Small, Go, and Myles (2003, p. 25), however, found that there are challenges related to providing the extensive services required to help trafficking victims. Service providers indicated the following as barriers when providing services to trafficking victims:

- Fear of retaliation

- Lack of knowledge about available services

- Fear of deportation

- Lack of social support

- Lack of trust in the system

- Language differences

- Lack of knowledge about victims’ rights

- Feelings of shame

- General fear

- Not able to identify self as a victim

- Held in captivity

- Culturally inappropriate services

- No transportation

Despite these challenges, first responders and other service providers must be proactive in assisting foreign national sex trafficked victims in accessing necessary services. Coordination among domestic violence non-governmental organizations (NGO’s), law enforcement agencies, attorneys, social workers, consulates, the media, faith-based organizations, local governments, mental health agencies, and substance use centers, for instance, is imperative (Clawson, Small, Go, & Myles, 2003). All involved parties must make concerted efforts to better identify victims, identify barriers to service delivery, and provide greater access to services. Foreign national sex trafficking victims present with a unique set of needs that must be met with the utmost urgency, confidentiality, patience, and competence.

Specific to law enforcement, barriers must be attenuated better by increased and or improved law enforcement officer training at many levels. This group of personnel is particularly critical in the certification process given their integral role in issuing letters of support for the T visa application process. They are a major mediator between the trafficking victim and immigration services. Increased awareness by law enforcement will likely increase understanding of the indicators of trafficking among victims and survivors of human trafficking. Moreover, given that multiple organizations are a part of the certification process, it is also important that service providers from multiple disciplines are properly trained so that accurate communications could be offered by interpreters; culturally sensitive practice modalities could be utilized; the certification process could be better explained; and assistance could be provided in completing paperwork. Proper and immediate mental health and substance use screenings and services should be offered to all victims upon initial contact with first responders (i.e., law enforcement, social workers, hospital personnel, etc.) or immigration services so that emotional and substance use issues could be addressed. Last, transportation services are important so that victims and survivors are able to access services.

The T Visa

The rate of T visa approvals must also increase. Being awarded a T visa by the U.S. government provides a legal pathway for persons to become Lawful Permanent Residents (LPRs) or green card holders as persons agreeing to assist in trafficking investigations and prosecutions (U.S. Department of Homeland Security, 2009). The US government can award up to 5,000 T visas a year, but only a small fraction of this amount of trafficking victims have been approved for T visas between 2002 and 2012 according to U.S. Citizenship and Immigration Services (2012). This indicates that potentially hundreds of thousands of women and men who have been trafficked into this country do not have legal pathways for residency or opportunities to legally work in the United States because of their undocumented statuses. This may mean that they do not have access to benefits and services that they need as foreign national sex trafficked victims.

Severe human trafficking victims are eligible for T or T-1 visas while close relatives are eligible for T-2 visas (for spouses of T-1 applicants); T-3 visas (for children of T-1 applicants); and T-4 visas (parents of T-1 applicants when the applicant is a child). T-1 visa applicants must meet one of the following eligibility criteria: 1) the person came to the United States illegally to engage in commercial sex work, involuntary servitude, peonage, debt bondage, or slavery; 2) they participated in commercial sex acts or agreed to come to the United States as a result of force, fraud, or coercion; 3) they would suffer extreme hardship if deported; 4) they have reported their trafficking captivity to federal authorities and, if is at least 15 years old, 5) will help with investigations and prosecutions whenever the risk for re-traumatization is assessed as being low. Last, and very importantly, T-1 visa applicants must include an endorsement from a law enforcement agency with their application in an effort to increase the likelihood of approval of their visa applications by U.S. Citizenship and Immigration Services [USCIS] (U.S. Department of Homeland Security, 2016; USCIS, 2012).

Certification

Being certified allows foreign national trafficking victims to begin the process of healing by giving them access to services that would serve to address mental health and substance use issues. These are the same benefits and services afforded to refugees (US Department of Health and Human Services, 2012a; US Department of Homeland Security, 2009). Logistically, certification requires law enforcement agencies, US Custom and Immigration Services, US Department of Homeland Security, US Department of Health and Human Services, US Department of Justice, the victim, and many others to work together in a coherent, efficient, and trustworthy manner. Given there is oftentimes a seed of doubt and/or sometimes complicity in cases involving sex trafficking among foreign national victims, certifications are few in number. This must change. Certification must be more widespread and in proportion to the estimated number of foreign national trafficked victims in the country. Right now there is gross incongruence between the number of those certified for services as “severe” trafficked persons and the number of persons estimated to have crossed into the country as trafficked persons. For example, it is estimated that approximately 800,000 persons are trafficked across international borders in the world and 14,500 to 17,500 of these persons are trafficked into the United States annually (Fedina, Trease, & Williamson, 2008; Reichert & Sylwestrzak, 2013). Yet, less than 2,000 persons were certified in the first seven years of the Trafficking Victims Protection Act’s existence (Fedina, Trease, & Williamson, 2008). This is problematic. There appears to be a huge gap between estimated victims, rescued/released victims and certifications.

Recommendations

As shown here, the trafficking of foreign national sex trafficked victims in the United States is a harsh reality —sometimes so horrible that some have a hard time digesting the possibility that it is real and as gruesome as the victim reports. This may explain the rigorous process for certification. Although there is a great appreciation for the US government’s thorough approach to assisting and certifying those who are truly vulnerable and exploited through trafficking activities, it is imperative that the government make the application process more victim-centered and person-friendly. The low numbers of applications among the trafficked and subsequent low approval rates of applicants suggest that there may be problems with 1) law enforcement identifying victims of severe human trafficking; 2) victims’ low awareness of their own trafficking statuses (self-identification); 3) barriers in the application process; and/or 4) serious impenetrable gaps in the system given the high estimates of human trafficking victims believed to be in the USA. Moreover, the low numbers may also be attributed to the reality that trafficking survivors know that they must assist in the prosecution of the trafficker, which may be an intimidating, scary, life-threatening (self or family member) and traumatic process to partake in.

Due to the high prevalence of drug use among sex trafficked victims, it is also imperative that attention to the possible presence of substance use disorders be attended to immediately for all sex trafficking victims when they come into contact with first responders, and well as when they are at the point of beginning the certification process. Once screened and evaluated for mental health and substance use disorders, victims/survivors who need services should be referred to and immediately linked to agencies that can provide such services.

As previously stated in Chapter 5, Social Determinants of Health asserts that one’s position in society, access to healthcare, education, work; and the immediate environment (home, local community, city, country, etc.) ultimately affects one’s circumstances or outcome in life. As shown in the case of Shandra Woworuntu who traveled great distances from an impoverished country with limited opportunities in hopes of a better life for herself and her family but only to find herself entrapped in sex trafficking and drug dependent in the United States illustrates the importance of anti-trafficking legislation that supports the trafficking survivor from a human rights victim-centered perspective. In the case of the United States, the Trafficking Victims Protection Act allows for the certification of victims of trafficking, which then allows them access to social services and the legal grounds to remain in the United States under special circumstances through the T visa. The challenge is access, however. Access in the case of foreign national trafficking victims relate to the 1) proper identification of a trafficking victim; 2) referrals for mental health and substance use treatment upon contact with the trafficking victim; 3) support to complete and approval of the T visa; and 4) increased granting of letters of certification to the trafficking victim.

As previously stated, access to social services is a human right as declared by the United Nations Universal Declaration of Human Rights. As espoused by the Office of the United Nations High Commission, access must not be grounded in the requirement to assist in the prosecution of the trafficker. The victim/survivor must be the primary focus of all policies and practices related to human trafficking interventions. The intersection between drug use by sex trafficking victims; the urgent need for social services post-trafficking; and the challenges of becoming certified as a foreign national human trafficking survivor are issues that deserve the U.S. government’s full and immediate attention. Practitioners on the ground must take actionable steps to support and protect the human rights of all people they work with and work for. This includes advocating for foreign nationals needing a range of social services.

Quiz

An interactive or media element has been excluded from this version of the text. You can view it online here:
https://ohiostate.pressbooks.pub/humantrafficking/?p=33

An interactive or media element has been excluded from this version of the text. You can view it online here:
https://ohiostate.pressbooks.pub/humantrafficking/?p=33

An interactive or media element has been excluded from this version of the text. You can view it online here:
https://ohiostate.pressbooks.pub/humantrafficking/?p=33

California

Services provided to trafficking survivors pursuing the T visa vary state by state. This is an example of state benefits that trafficking survivors are eligible in the State of California.

CALIFORNIA

In California, trafficking survivors who are taking steps to pursue a T visa are eligible for state benefits including eight months of cash assistance, Medi-Cal, and food stamps. Evidence that the survivor is taking steps to obtain a T Visa can include a statement by the survivor, an advocate, or a law enforcement official; a receipt or copy of the T Visa application; or proof that law enforcement has requested Continued Presence (CP) authorization for the survivor. (CP allows trafficked persons to work, live, and receive certain benefits and services while the trafficking investigation is ongoing. CP can only be requested by law enforcement on behalf of the survivor) (Kahmi & Prandini, 2007, p. 3).

Kahmi, A., & Prandini, R. (2017, April). T Visas: What They Are and How They Can Help Your Clients. https://www.ilrc.org/sites/default/files/resources/t_visa_advisory-20170509.pdf

Summary of Key Points

- Undocumented foreign nationals who are sex trafficked survivors must apply for certification in order to remain in the United States.

- In order to be certified as a foreign national sex trafficked survivors, the person must agree to cooperate with the prosecution of her trafficker.

Supplemental Learning Materials

Seltzer, S.B., Kim, S., Egyes, L., Panjwani, A. (2018, March). T Visa Manual: Identification and legal advocacy for trafficking survivors (4th ed.). Retrieved from http://theseltzerfirm.com/wp-content/uploads/2018/03/T-Visa-Manual.pdf

U.S. Department of Homeland Security. ( ). U and T Visa Law Enforcement Resource Guide for Federal, State, Local, Tribal and Territorial Law Enforcement, Prosecutors, Judges, and Other Government Agencies. https://www.dhs.gov/sites/default/files/publications/U-and-T-Visa-Law-Enforcement-Resource%20Guide_1.4.16.pdf

U.S. Immigration and Customs Enforcement. (2010). Continued Presence: Temporary Immigration Status for Victims of Human Trafficking. Retrieved from https://www.ice.gov/doclib/human-trafficking/pdf/continued-presence.pdf

References

Clawson, H.J., Small, K.M., Go, E.S., & Myles, B.W. (2003). Needs assessment for service providers and trafficking victims. Document No: 202469. Retrieved from https://www.ncjrs.gov/pdffiles1/nij/grants/202469.pdf

Fedina, L., Trease, J., & Williamson, C. (2008). Human trafficking in Ohio: A resource guide for social service providers. Toledo, Ohio: Second Chance.

Kara, S. (2009). Sex trafficking: Inside the business of modern slavery. New York: Columbia University Press.

McGaha, J. (2011). An integrated approach to anti-human trafficking task force development in Eastern Europe. National Science ScienceJournal, 36(2), 87-93.

Orme, J., & Ross-Sheriff, F. (2015). Sex trafficking: Policies, programs and services. Social Work, 60(4), 287-294.

Public Law 106-386. (2000). Trafficking Victims Protection Act of 2000, H. R. 3244, (2000). 106th Cong., 2nd Sess.

Shigekane, R. (2007). Rehabilitation and community integration of trafficking survivors in the United States. Human Rights Quarterly, 29, 112–136.

SAWA. (2008). Trafficking and prostitution of Palestinian women and girls: Forms of modern day slavery. A Briefing paper. United Nations: UNIFEM.

U.S. Citizenship and Immigration Services. (2012). Service-wide receipts, approvals, and denials Form I-914 – Application for T Nonimmigrant Status and Form I-918 – Petition for U Nonimmigrant Status Visa: Fiscal Years 2002-2012. Retrieved from http://www.immigration.com/sites/default/files/t_u_visas_stat.pdf

US Department of Health and Human Services. (2012a). Fact sheet: Certification for adult victims of trafficking. Retrieved from http://www.acf.hhs.gov/programs/orr/resource/fact-sheet-certification-for-adult-victims-of-trafficking

US Department of Health and Human Services. (2012b). Services available to victims of trafficking: A resource guide for social service providers. Retrieved from https://www.acf.hhs.gov/sites/default/files/orr/traffickingservices_0.pdf

US Department of Health and Human Services. (2016). Services available to victims of trafficking. Retrieved from https://www.acf.hhs.gov/otip/victim-assistance/services-available-to-victims-of-trafficking

US Department of Homeland Security. (2009). Improving the process for victims of human trafficking and certain criminal activity: The T and U Visa. Retrieved from http://www.dhs.gov/xlibrary/assets/cisomb_tandu_visa_recommendation_2009-01-26.pdf

U.S. Department of Homeland Security. (2016). U and T Visa law enforcement resource guide for federal, state, local, tribal and territorial law enforcement, prosecutors, judges, and other government agencies. Retrieved from https://www.dhs.gov/sites/default/files/publications/U-and-T-Visa-Law-Enforcement-Resource%20Guide_1.4.16.pdf

US Department of State. (2013). Unclassified. https://travel.state.gov/content/dam/visas/policy_updates/T_and_U_Visa_Changes_June_2013.pdf

Chapter 12: Identifying Trafficking Victims in Healthcare Settings

ABSTRACT

The healthcare industry has an important and unique role to play in the identification and service of trafficked persons. Understanding the signs of sex and labor trafficking are first steps in the positive identification of a trafficked person. This chapter will discuss the warning signs and red flags associated with sex and labor trafficking.

Learning Objectives

By the end of this chapter, the student will be able to:

- Understand the implications of ACEs for sexual victimization

- Identify risk factors for trafficking

- Identify red flags for sex and labor trafficking

- Describe a potential protocol for assisting trafficking victims in healthcare settings

Key Word: Adverse Childhood Experiences

GLOSSARY

Adverse Childhood Experiences (ACES): The term used to describe abuse (physical, emotional and sexual), neglect (physical and emotional), and other potentially traumatic experiences that occur to minors less than 18 years of age. This 10 item scale ranges from 0-10 points. The higher number of ACES, indicates greater risk for vulnerability.

Adverse Childhood Experiences

According to the Center for Disease Control (2019), Adverse Childhood Experiences (ACE) is the term used to describe abuse, neglect and other potentially traumatic experiences that occur to minors less than 18 years of age. Adverse Childhood Experiences include 10 dimensions: 1) physical abuse, 2) emotional abuse, 3) sexual abuse, 4) physical neglect, 5) emotional neglect, 6) substances in the home, 7) parental separation/divorce, 8) mental illness, 9) a battered mother and 10) criminal behaviors/incarceration of family members. The 10 ACEs are assessed using a 10 item scale that results in a total score of 0-10. [See Table 1 for ACEs questions.] As the number of ACEs increases, so does the risk for risky health behaviors, chronic health conditions, and early death. Specifically, the ACE quiz asks the following questions:

ADVERSE CHILDHOOD EXPERIENCES (ACEs)

Prior to your 18th birthday:

1. Did a parent or other adult in the household often or very often… Swear at you, insult you, put you down, or humiliate you? or Act in a way that made you afraid that you might be physically hurt?
No___If Yes, enter 1 __

2. Did a parent or other adult in the household often or very often… Push, grab, slap, or throw something at you? or Ever hit you so hard that you had marks or were injured?
No___If Yes, enter 1 __

3. Did an adult or person at least 5 years older than you ever… Touch or fondle you or have you touch their body in a sexual way? or Attempt or actually have oral, anal, or vaginal intercourse with you?
No___If Yes, enter 1 __

4. Did you often or very often feel that … No one in your family loved you or thought you were important or special? or Your family didn’t look out for each other, feel close to each other, or support each other?
No___If Yes, enter 1 __

5. Did you often or very often feel that … You didn’t have enough to eat, had to wear dirty clothes, and had no one to protect you? or Your parents were too drunk or high to take care of you or take you to the doctor if you needed it?
No___If Yes, enter 1 __

6. Were your parents ever separated or divorced?
No___If Yes, enter 1 __

7. Was your mother or stepmother:
Often or very often pushed, grabbed, slapped, or had something thrown at her? or Sometimes, often, or very often kicked, bitten, hit with a fist, or hit with something hard? or Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?
No___If Yes, enter 1 __

8. Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
No___If Yes, enter 1 __

9. Was a household member depressed or mentally ill, or did a household member attempt suicide?                        No___If Yes, enter 1 __

10. Did a household member go to prison?
No___If Yes, enter 1 __

Scores range from 0-10 based on “No” or “Yes” responses (ACEs Too High News, 2019).

Figure 1. Adverse Childhood Experiences

As shown in Figure 1, Adverse Childhood Experiences put a person at risk for physical injuries, mental health problems, maternal health challenges, infectious diseases, chronic diseases, chronic health problems, risky behaviors and poor socioeconomic statuses (CDC, 2019). ACEs have also been linked to early death (CDC, 2019).

Figure 1. Early Adversity Has Lasting Impacts – Diagram courtesy of the Center for Disease Control and Prevention. (2019). Violence Prevention: About ACES. Retrieved from

https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/aboutace.html

Specific to sex trafficking, ACEs have been linked to risky behaviors that include alcohol and other drugs as well as unsafe sex. As previously stated in this text, human traffickers use drugs to lure in potential trafficking victims with an already established substance use disorder. They also use drugs to entice or lure in an inexperienced victim to get her “hooked” on drugs. Once dependent on drugs, drugs are often used as a reward (for compliance) as well as a punishment for non-compliance for trafficked women. In the case of non-drug using victims, the trafficker sometimes forces the consumption of addictive substances because it will guarantee the trafficker that: 1) the victim will become dependent; 2) drug dependencies will make the victim incur debt to the trafficker; 3) the trafficker will be able to control the victim through drug use, and 4) the victim may become unduly influenced to stay in a trafficked situation due to trauma bonding (and drug dependence) despite how bad the trafficking experience may be (Bernat & Winkfeller, 2010; Kara, 2009; Meshelemiah, Gilson & Prasanga, 2018; Williamson, Dutch & Clawson, 2007). Drug use also insures more cooperation on the victim’s part. In the case of sex trafficked persons, ACEs and substance use disorders appear to interact with one another.

Ports, Ford and Merrick (2016) found that as one’s ACE score increased, so did the risk of experiencing sexual victimization later in adulthood. Each of the ACE variables was significantly associated with adult sexual victimization with childhood sexual abuse being the strongest predictor of adult sexual victimization. Additionally, the results of their study indicate for those who reported childhood sexual abuse, there was a cumulative increase in adult sexual violence risk with each additional ACE experienced. This relationship suggests that early adversity is a risk factor for adult sexual victimization. In terms of prevention, given the interconnectedness between childhood adversity and adult sexual victimization, practitioners must take into consideration how other violence-related and non-violence-related traumatic experiences may exacerbate the risk conferred by childhood sexual abuse on later victimization in adulthood.

ACEs and Physical Disorders

Categorically, Adverse Childhood Experiences have also been linked to the following classes of physical disorders along with mental disorders. According to Lederer and Wetzel (2014), these same types of disorders are commonly found among sex trafficking survivors.

- Neurologic

- Gastrointestinal

- Cardiovascular

- Musculoskeletal

- Dermatological

- Reproductive

- Sexual

- Dental

- Mental Health (including substances)

Red Flags of Trafficking

In terms of identification of trafficked persons in healthcare settings, the following are red flags in a patient’s presentation when sex trafficked (Greenbaum, Dodd & McCracken, 2018; Orme & Ross-Sheriff, 2015).

- Broken Bones

- Traumatic Brain Injury & Concussions

Risk Factors make people vulnerable to be being trafficked while Red Flags are signs of being trafficked (Schwarz, Unruh, Cronin, Evans-Simpson, Britton & Ramaswamy, 2016).

- Back & Stomach Pain

- Exhaustion

- Malnutrition

- Burns

- Hepatitis

- HIV/AIDS

- Vaginal Tearing

- Multiple Sexually Transmitted Infections (STIs)

- Pelvic Inflammatory Disease

- Unplanned Pregnancies

- Miscarriages/Abortions

The following are red flags in a patient’s presentation when labor trafficked (National Human Trafficking Resource Center, 2019; Office on Trafficking in Persons, 2019; Orme & Ross-Sheriff, 2015).

- Body Injuries

- Back Pain

- Exhaustion

- Respiratory illnesses

- Hypothermia

- Amputations

- Heat stroke

- Dehydration

- Skin Infections

- Chemical burns from pesticides

Mental Disorders

According to the most current version of the Diagnostic and Statistical Manual, Fifth Edition (DSM-5) of Mental Disorders, trafficking victims are especially at high risk for developing Posttraumatic Stress Disorder (PTSD), which is a mental disorder (American Psychiatric Association [APA], 2013). Substance disorders are also found in this particular Manual. Commonly used drugs by sex trafficked persons include Alcohol, Crack Cocaine, and Heroin (and other opioids). The misuse of these highly addictive drugs tend to result in substance use disorders (Greenbaum, Dodd & McCracken, 2018; Orme & Ross-Sheriff, 2015). In addition to substance use disorders, the following classifications of mental disorders tend to present among trafficked persons as well (Greenbaum, Dodd & McCracken, 2018). They include:

ARTICLE 25

Healthcare is a human right.

- Posttraumatic Stress Disorder (PTSD)

- Anxiety/Panic Disorders

- Depressive Disorders

- Insomnia/Sleep Disturbances

- Dissociative Disorders

- Somatic Symptoms

- Suicidal ideations and attempts

Victims are not Invisible:  Know the Signs

The physical and mental disorders just discussed are common disorders that present among sex and labor trafficked persons in healthcare settings. In their study, Lederer and Wetzel (2014) found that 99.1% of their 106 trafficking survivors reported to a healthcare facility while a trafficking victim with at least one physical health problem. Other researchers have found similar findings. Greenbaum, Dodd and McCkracken (2018) reported that 108 minors reported to two metropolitan pediatric emergency departments and one child protection clinic in their study. This indicates that trafficked adults and children are not always hidden or invisible. Trafficked children and adults have sought treatment from emergency rooms, free clinics, child protection clinics, pediatric emergency departments, hospitals, private physicians and clinical treatment facilities (Greenbaum, Dodd & McCkracken, 2018; Schwarz, Unruh, Cronin, Evans-Simpson, Britton & Ramaswamy, 2016). Given this reality, it is critical that healthcare practitioners are better prepared to identify victims when they seek healthcare.

According to the Texas Human Trafficking Prevention Task Force (2014), signs of a school-aged child being trafficked includes academic, behavioral, physical, emotional and social indicators as shown below.

According to Polaris (2019), signs of labor and sex trafficking include work-related conditions, mental health/behavioral flags, physical health flags, lack of control and other indicators as shown below.

Screening for Child Sex Trafficking Victims in Healthcare Settings

In an effort to screen child sex trafficking in the healthcare setting, a group of researchers developed a Brief Screening Tool (Greenbaum, Dodd, & McCkracken, 2018). The following questions compose the tool:

1. Is there a previous history of drug and/or alcohol use?

2. Has the youth ever run away from home?

3. Has the youth ever been involved with law enforcement?

4. Has the youth ever broken a bone, had a traumatic loss of consciousness, or sustained a significant wound?

5. Has the youth ever had a STI?

6. Does the youth a history of sexual activity with more than 5 partners?

Greenbaum, Dodd and McCkracken (2018) found that answering yes to just two of these questions properly identified child sex trafficked victims with a sensitivity of 92%; specificity of 73%, positive predictive value (PPV) of 51% and a non-positive predictive value of 97%. These percentages mean that this is a useful tool for early screening of child sex trafficking in a healthcare setting.

The U.S. Department of Health and Human Services (n.d.) recommends that healthcare providers discretely ask the following questions to suspected victims of human trafficking. Confidentiality should be insured and the questions asked should be in the language of the person spoken to. The following questions should be asked after rapport is developed and the patient appears comfortable asking questions.

- Can you leave your job or situation if you want?

- Can you come and go as you please?

- Have you been threatened if you try to leave?

- Have you been physically harmed in any way?

- What are your working or living conditions like?

- Where do you sleep and eat?

- Do you sleep in a bed, on a cot or on the floor?

- Have you ever been deprived of food, water, sleep or medical care?

- Do you have to ask permission to eat, sleep or go to the bathroom?

- Are there locks on your doors and windows so you cannot get out?

- Has anyone threatened your family?

- Has your identification or documentation been taken from you?

- Is anyone forcing you to do anything that you do not want to do?

Detecting red flags for children and adults is an important first step in providing services to trafficked persons in healthcare settings. Despite the healthcare model used in the United States and many other countries around the world, access to healthcare is a human right—not a privilege.

Barriers to Disclosure

Despite the care and attentiveness of the most well-meaning healthcare practitioner, the individual may not be successful at getting trafficked persons to open up in some instances. According to researchers (Baldwin, Eisenman, Sayles, Ryan & Chuang, 2011; Greenbaum, Dodd, & McCkracken, 2018; Orme & Ross-Sheriff, 2015), there are a host of barriers to disclosure of trafficking victimization. They include:

- Feelings of shame

- Trauma bonding with the trafficker

- The victim being trained to “lie”

- A sense of hopelessness

- Language barriers

- Distrust of authorities

- Fear of the trafficker or legal authorities [being arrested]

- Presence of the trafficker [accompanies victim to healthcare facility]

- Lack of self-identification as a trafficking victim

In the event that the healthcare practitioner is able to get the trafficked person to open up, it is important to adhere to a trauma informed protocol to avoid re-traumatizing the victim. All practitioners seeking to screen, identify and assist trafficked persons should seek professional development training on trauma informed care. Trauma informed care is one that recognizes the impact of trauma on one’s mental health, physical health, social capacity, and brain development (Enrile & De Castro, 2019). Key principles include awareness, safety, trustworthiness, choice and collaboration.

The above table is specified for youth, but is appropriate for adults as well. According to Enrile and De Castro (2018), evidence-based and evidence-informed practices for trauma informed care points to 1) safety and acceptance; 2) adaptation over disease; 3) collaboration and peer support, 4) empowerment/choice of self-identification; and 5) context and cultural sensitivity. These concepts overlap with the trauma informed youth approach to service delivery.

National Human Trafficking Resource Center (NHTRC) Framework for HT Protocol in Healthcare Settings

Healthcare practitioners must advocate for hospital level policies that incorporate a protocol for suspected cases of sex and labor trafficking. The framework must be multidisciplinary in nature and include the following disciplines when possible:

- Physicians

- Nurses

- Social Workers

- Pastoral Care

- Addiction Specialists

- Behavioral Health Personnel

- Anti-Trafficking Task Forces

- Local Law Enforcement

- Local Social Service Agencies

- U.S. Immigration and Customs Enforcement (ICE)

As seen in the diagram below, there are proper steps to take that include knowing red flags, discussing them with the patient, calling the National Human Trafficking Resource Center if indicators are present, assessing the level of potential danger, and then deciding if law enforcement involvement is needed or a referral to local resources. Regardless of one’s discipline, Baldwin et al. (2011) recommends that all practitioners in health care settings use good common sense, notice visual cues, observe patients’ body language and interact with patients in a sensitive manner. Being indifferent and too busy are not acceptable alternatives.

Quiz

An interactive or media element has been excluded from this version of the text. You can view it online here:
https://ohiostate.pressbooks.pub/humantrafficking/?p=34

Now, let’s shift gears and turn to a case study.

MAXI

WARNING: GRAPHIC CONTENT!!

“Maxi” is a young African American female who was sex trafficked for over 10 years. She participated in a research project in 2019 conducted by the authors. This is a description of a medical emergency of hers.

Despite bleeding through her jeans due to a miscarriage that turned into hemorrhaging, Maxi continued to smoke crack and “turn tricks” for two hours before she passed out and nearly died due to blood loss. Several male customers asked for and paid for a “blow job” while Maxi knelt down with blood soaked jeans on.  One even wanted vaginal sex with her despite her heavy bleeding, but she refused.  It was not until another sex trafficked woman who had been smoking crack cocaine with Maxi earlier in a “trap house” began to insult her for being so “trifling” for not going to see a doctor after clearly miscarrying her fetus, that Maxi finally decided to seek medical care.

The woman warned her that she was going to bleed to death if she did not seek medical attention right away.  It was at that point that Maxi decided to seek out a police officer for help.  As she approached the law enforcement officer’s vehicle, she passed out from blood loss.

Maxi reports that not one healthcare provider screened her for sex trafficking while hospitalized after her miscarriage. Instead, she reports, that they concluded that she was a “junkie” who needed substance use treatment and later discharged her. Despite this horrific loss, Maxi continued to use drugs for many years after this miscarriage and near death experience. Her pimp trafficked her for many years as well.

Summary of Key Points

- According to Article 25 of the United Nations Universal Declaration of Human Rights, access to healthcare is a human right.

- It is critical that healthcare providers better identify and are better prepared to serve trafficking victims when they seek medical care. Below are a list of resources that may be helpful.

Supplemental Learning Materials

References

ACEsTooHighNews. (2019). Got your CE Score. Retrieved from https://acestoohigh.com/got-your-ace-score/

Center for Disease Control and Prevention. (2019, April 9). About adverse childhood experiences. Retrieved from https://www.cdc.gov/violenceprevention/childabuseandneglect/acestudy/aboutace.html

Baldwin, S.B., Eisenman, D.P., Sayles, J.N. Ryan, G., & Chuang, K.S., (2011). Identification of human trafficking victims in healthcare settings. Health & Human Rights, 13(1), 1-14.

Bernat, F.P., & Winkeller, H.C. (2010). Human sex trafficking: The global becomes local. Women & Criminal Justice, 20, 186-192.

Enrile, A., & De Castro, W. (2018). Trauma Informed Care. In A. Enrile(Ed.), Ending Human Trafficking & Modern-Day Slavery: Freedom’s Journey (pp. 79-98). Thousand Oaks: SAGE Publications.

Greenbaum, V.J., Dodd, M., & McCkracken, C. (2018). A short screening tool to identify victims of child sex trafficking in the healthcare setting. Pediatric Emergency Care, 34(1), 33-37;

Kara, S. (2009). Sex trafficking: Inside the business of modern slavery. New York: Columbia University Press.

Lederer, L.J., & Wetzel, C.A. (2014). The health consequences of sex trafficking and their implications for identifying victims in healthcare facilities. Annals of Health Law, 23, 61-90.

Meshelemiah, J.C.A., Gilson, C., & Prasanga, A.P.A. (2018). Use of drug dependency to entrap and control victims of human trafficking: A call for a US federal human rights response. Dignity: A Journal on Sexual Exploitation and Violence, 3(3), Article 8.

Meshelemiah, JCAM, Poole, A.L., & Michel, E. (Winter 2013). Creating a standard protocol for Domestic Minor Sex Trafficking Victims: How child welfare workers can better facilitate protections under the guise

of the TVPA. Washington, DC: NASW.

National Human Trafficking Resource Center. 2019). (Identifying victims of human trafficking: What to look for in a healthcare setting. Retrieved from https://humantraffickinghotline.org/sites/default/files/What%20to%20Look%20for%20during%20a%20Medical%20Exam%20-%20FINAL%20-%202-16-16.pdf

Office on trafficking in persons. (2019, February 4). National advisory council on migrant health: Recommendations on labor trafficking. Retrieved from https://www.acf.hhs.gov/otip/news/nacmh-0

Orme, J., & Ross-Sheriff, F. (2015). Sex trafficking: Policies, programs, and services. Social Work, 60(4), 287-294.

Polaris. (2019). Recognize the signs. Retrieved from https://polarisproject.org/human-trafficking/recognize-signs

Ports, K.A., Ford, D.C., & Merrick, M.T. (2015). Adverse childhood experiences and sexual victimization in adulthood. Epub, 51, 313-322. doi: 10.1016/j.chiabu.2015.08.017

Protocol for Serving Victims of Human Trafficking in Ohio. (2017, August). Protocol toolkit for community response to child victims of human trafficking. Retrieved from https://humantrafficking.ohio.gov/links/HT-Child-Protocol.pdf

Roudometkina, A. & Wakeford, K. (15 June 2018). National Women’s Association of Canada. Trafficking of Indigenous Women and Girls in Canada: Submission to the Standing Committee on Justice and Human Rights. Retrieved from https://www.ourcommons.ca/Content/Committee/421/JUST/Brief/BR10002955/br-external/NativeWomensAssociationOfCanada-e.pdf

Schwarz, C., Unruh, E., Cronin, K., Evans-Simpson, S., Britton, H., & Ramaswamy, M. (2016). Human trafficking identification and service provision in the medical and social service sectors. Health and Human Rights Journal, 18(1), 181-192.

Texas Human Trafficking Prevention Task Force. (2014). Introduction to human trafficking: A Guide for Texas education professionals. Austin, TX: Retrieved from http://www.texasattorneygeneral.gov

U.S. Department of Health and Human Services. (n.d.). Resources: Screening tool for victims of human trafficking. Retrieved from https://www.acf.hhs.gov/sites/default/files/orr/screening_questions_to_assess_whether_a_person_is_a_trafficking_victim_0.pdf

Williamson, E., Dutch, N.M., & Clawson, H.J. (2007). Evidence-based mental health treatment for victims of human trafficking. Retrieved from http://aspe.hhs.gov/hsp/07/humantrafficking/mentalhealth/index.pdf

Resources Section

This section is a list of resources available to deepen your understanding of human trafficking and to equip you with tools to take action.

“Assignment: Circles” by MaryScheirer is licensed under CC BY-NC-SA 2.0

Chapter 13: Resources

The Cause and Consequence of Human Trafficking: Human Rights Violations

On the surface, it is quite apparent that human trafficking or modern day slavery is awful, disgusting, violent, targeted towards the most vulnerable populations in society, and illegal. What’s missing from many conversations on human trafficking, however, are the many human rights that are violated in the name of human trafficking. This book, “The Cause and Consequence of Human Trafficking: Human Rights Violations” centers this important issue. Kara Napolitano, of the Laboratory to Combat Human Trafficking, once used the phrase, “The Cause and Consequence of Human Trafficking: Human Rights Violations” in an interview on the systemic forces under-girding human trafficking. It eloquently captures the essence and realities of human trafficking and that is how the authors came about in entitling this book. When a person’s human rights are violated, it makes them vulnerable to gross mistreatment. When this mistreatment rises to the level of human trafficking, then additional human rights are violated during the trafficking ordeal. It looks like this in reality…

A well-known African Proverb asserts that “It takes a village to raise a child!” The authors completely agree with this observation. In step with this wisdom, the authors would argue that “It takes a world to eradicate slavery!” Slavery is around today and it has been around for centuries. Despite its persistence, it does not make it right. All humans deserve to live freely. The United Nations (UN) issued the Universal Declaration of Human Rights (UDHR) in 1948. The UN did this in an attempt to bring attention to the inalienable rights of all people (United Nations, 1948). The UDHR contains 30 articles. These articles address civil, political, economic, social, and cultural rights (United Nations, 1948, Articles 1-30). The UDHR states that all humans are equal in dignity and worth. Articles 2–15 address political and individual freedoms. Articles 16–27 address economic, social, and cultural rights. Articles 28 and 29 address collective rights among and between nations and Article 30 states that no one can take away a person’s human rights (United Nations, 1948). Although Article 30 prescribes that no one’s human rights cannot be arbitrarily violated, it happens on a daily basis. Trafficked persons have their civil, political, economic, social, and cultural rights violated time and time again while under the control of a trafficker. According to the Laboratory to Combat Human Trafficking (2019), frequently violated human rights of trafficked persons include:

Article 1: The right to be free.

Article 2: The prohibition of discrimination on the basis of race, color, sex, language, religion, political or other opinion, national or social origin, property, birth, or other status

Article 3: The right to life, liberty and security of person

Article 4: The right not to be subjected to slavery or servitude

Article 5: The right not to be subjected to torture and/or cruel, inhumane, degrading treatment or punishment

Article 8: The right to an effective remedy

Article 13: The right to freedom of movement

Article 14: The right to seek asylum

Article 17: The right to freedom of association

Article 23: The right to just and favorable conditions of work

Article 24: The right to rest and leisure

Article 25: The right to an adequate standard of living and social security

Article 26: The right to an education

As demonstrated in the above UN Universal Declaration of Human Rights Articles, many of these human rights are often denied to:  impoverished women, men and children all over the world; people of color as a whole; many people in developing countries; immigrants/migrants/asylum seekers; and people where corrupt governments rule even when the person is not trafficked. By virtue of membership in one or more of these groups, some people’s human rights are routinely violated as a part of life. For instance, due to an inability to find employment and earn a livable wage [Article 23], for instance, some of these individuals will become desperate and especially vulnerable to being manipulated, deceived, coerced or forced into a trafficked situation under the guise of pursuing legitimate employment. Desperation leads to extreme vulnerability and high risk for gross mistreatment—including being trafficked. As if human rights violations are not bad enough prior to a trafficking situation, it actually gets worse for virtually all trafficked persons. Once under the control of a trafficker, the person will be further subjected to human rights violations that may escalate to gendered violence (sex trafficking/sexual assault), lack of access to healthcare as needed, restricted movement, poor housing/living conditions, persistent threats to one’s life, lack of protection/process when arrested, nonpayment of wages, and inhumane treatment as a whole—to start. It could also lead to death. The violations vary and often present in tandem with one another for a trafficked person. Human rights violations are the most egregious offences committed BY humans TOWARD humans.

Human rights are inalienable and fundamental rights that must be afforded to all people. They are legal, ethical and social in principle and must be embedded in the infrastructure of each nation in the form of policies, practices and legislation (Enrile, 2018). Therefore, in this chapter, it is important to reiterate that understanding human rights as broken down in Chapter 1: Social Work, Social Justice, Human Rights and Human Trafficking is critical. This is an imperative. Anyone wanting to understand human trafficking must understand human rights and how the violation of human rights is a cause and consequence of human trafficking.

In an effort to provide you with a context for how scholar activists, varied governments, governmental organizations and non-governmental agencies (NGOs) are fighting trafficking, the authors have compiled a list of individuals and organizations that have taken on this work. The content shows you how researchers and organizations play integral roles in addressing it, supporting victims, and creating legislation to criminalize perpetrators. This chapter highlights the work of a limited number of scholars from multiple disciplines who engage in anti-trafficking scholarship. It also highlights several organizations that engage in these activities.

Scholarship on Human Trafficking

The following article abstracts give the reader a sense of the breadth of scholars in the anti-trafficking arena. Due to the complexity of human trafficking, it requires scholars from the arts & entertainment, criminal justice, dentistry, dietetics, informatics, law, law enforcement, media & technology, medicine, migration, nursing, political science, public affairs, public health, social work, and so many other disciplines to address the issue. Here, just some of these disciplines are represented by a select group of scholars.

Criminal Justice

Dandurand, Y. (2017). Human trafficking and police governance. Police Practice & Research, 18(3), 322-336. DOI: 10.1080/15614263.2017.1291599

Human trafficking in its various forms continues to offer significant challenges for law enforcement agencies. There is a growing body of research that addresses some of the police governance and management issues associated with the prevention and control of human trafficking and the protection of victims of this type of crime. This article reviews the literature on the implementation of effective detection, investigation, prosecution, and victim protection strategies; the need for more effective international cooperation; and, the struggle to keep up with the illusive criminal organizations and networks that often defy law enforcement tactics. It also considers some of the specific challenges that result from the frequent conflation of human trafficking enforcement with immigration control strategies. It offers a few suggestions on how these issues may be addressed from a police governance standpoint and concludes with a call for better data on human trafficking and the relative effectiveness of different law enforcement strategies.

Farrell, A., Bouche, V., & Wolfe, D. (2019). Assessing the impact of state human trafficking legislation on criminal justice system outcomes. Law & Policy, 41(2), 174-197. DOI: 10.1111/lapo.12124

Since 2003, state legislatures in the United States have been active in passing legislation aimed at combating human trafficking. To date, all states have passed laws that criminalize acts of human trafficking, though with significant variation in the penalty structure and associated legal provisions. This article examines what aspects of state human trafficking laws are most impactful at increasing the arrest and prosecution of human trafficking suspects. Using panel data on state laws and associated enforcement actions from 2003 to 2012, this study confirms that more comprehensive state laws that invest in anti-trafficking resources are most strongly associated with human trafficking arrests and prosecutions. States that make legislative provisions for victim assistance, law enforcement training, statutory task forces, and mandatory reporting have higher anti-trafficking criminal enforcement. The political environment in which state human trafficking laws are enacted also influences their enforcement.

Farrell, A. & Cronin, S. (2015). Policing prostitution in an era of human trafficking enforcement. Crime, Law, & Social Change, 64(4/5), 211-228. DOI: 10.1007/s10611-015-9588-0

Prostitution and commercialized vice have been variously prioritized as urban crime problems across U.S. history. In response, lawmakers have historically been guided by a prohibititionst view where people selling, buying or facilitating the sale of sex are considered to be immoral and criminal. In recent years, public concern about the trafficking of persons for sex has reframed prostitution and the expectations of government response. The U.S. federal government and all fifty states have passed legislation that is guided by an abolitionist view of prostitution where people who are forced or coerced to sell sex are redefined as victims. State, county and municipal police officers are now receiving training on how to identify human trafficking cases and investigators are being trained to investigate and prepare cases for prosecution. Despite these efforts under the new legal regime, confusion exists about how sex trafficking differs from prostitution and correspondingly necessitates different types of law enforcement responses. Adding to this complication is the fact that in many major cities the responsibility for identifying and eradicating human trafficking has fallen to the same group of investigators who are responsible for enforcing vice and prostitution laws. As a result, prostitution enforcement is expected to change as police increasingly focus on identifying sex trafficking victims. Using data on police arrests for prostitution from 1980 to 2012, we examine the impact of federal and state anti-trafficking legislation on the local enforcement of prostitution. Our findings inform debate about legal reform as a response to urban crime problems and illustrate the complexities of policy implementation and interpretation.

Kulig, T. & Butler, L. (2019). From “whores” to “victims”: The rise and status of sex trafficking courts. Victims & Offenders, 14(3), 299-321. DOI: 10.1080/15564886.2019.1595242

Views of people involved in the commercial sex trade have shifted. Once seen as prostitutes or “whores,” they are increasingly perceived as exploited “victims.” The behavior associated with commercial sex has been redefined from voluntary and disreputable to coerced and deserving of rescue. This new framework is part of a broader anti-trafficking movement in society to recognize and save vulnerable individuals who are exploited for sex. In this context, the model of problem-solving or specialty courts has been extended to sex trafficking cases. The goal first is to identify trafficking victims–also known as “victim-defendants”–and then to address their risk factors with services. The current review examines the prevalence and the effectiveness of sex trafficking courts. Although some promising evaluations have been conducted, it remains unclear whether such courts are addressing the unique needs of victim-defendants. Investigating this question is essential, given that trafficking courts are likely to grow in popularity and in number.

Van Der Watt, M. & Van Der Westhuizen, A. (2017). (Re)configuring the criminal justice response to human trafficking: A complex-systems perspective. Police Practice & Research, 18(3), 218-229. DOI: 10.1080/15614263.2017.1291560

The multidimensional complexities associated with the criminal justice response to human trafficking are well documented. The transient and subversive nature of human trafficking as organised crime and the large number of multidisciplinary role-players involved in coordinating cross jurisdictional efforts to prevent, investigate and prosecute such cases, contribute to this complex undertaking. Complex systems theory suggests that a complex social problem such as human trafficking cannot be approached by using a linear or simplified lens, and requires a holistic perspective on the complex interactions between actors, and emergent behaviour in both the criminal justice system and the human trafficking system that it seeks to combat. This paper explores the characteristics of complexity, and uses illustrations from the lived experiences of actors in South Africa’s efforts to combat human trafficking, in order to demonstrate how complex systems theory could be considered and integrated into the criminal justice response to human trafficking.

Villacampa, C. & Torres, N. (2017). Human trafficking for criminal exploitation: The failure to identifying victims. European Journal on Criminal Policy & Research, 23(3), 393-408. DOI: 10.1007/s10610-017-9343-4

Human trafficking for criminal exploitation is one of the lesser-known forms of human trafficking. The failure of the criminal justice system to identify the victims of this type of trafficking can lead to a failure to take the victim-centered approach to trafficking espoused in the international legal instruments that regulate the matter, an approach that emphasizes the protection of victims and respect for their rights. In light of earlier findings of the existence of unidentified victims of human trafficking for criminal exploitation in several European countries – the UK, Ireland, Spain, the Czech Republic and the Netherlands – a qualitative study was conducted, consisting of 37 in-depth interviews with practicing criminal justice professionals and victim service providers in Spain. Because undetected victims of human trafficking for criminal exploitation are usually treated as offenders, the main aim of this research with professionals was to determine the causes of the criminal justice system’s failure to identify the victims of this specific form of trafficking in order to prevent them from remaining hidden victims.

Ward, T. & Fouladvand, S. (2018). Human trafficking, victims’ rights, and fair trials. Journal of Criminal Law, 82(2), 138-155. DOI: 10.1177/0022018318761680

Cases of human trafficking are known to be difficult to prosecute. In this article we identify several issues in the law of evidence that may contribute to these difficulties. We argue for the victims’ rights as an important factor in evidential decisions, coupled with an insistence that such rights cannot trump the defendant’s right to a fair trial. Restrictions on evidence of a witness’s bad character or sexual history should not be interpreted in such a way as to prevent the defence from introducing evidence, or asking questions, that are of substantial probative value, even if they are potentially distressing to witnesses; but such evidence and questioning should be limited to what is necessary for a fair trial. The protection of victims and witnesses may also justify a relatively flexible approach to the admission of hearsay evidence, which avoids prejudging the truth of a witness’s evidence in order to establish that s/he is in fear.

Education

Bajaj, M. (2011). Human rights education: Ideology, location, and approaches. Human Rights Quarterly, 33(2), 481-508. Retrieved from https://www.jstor.org/stable/23016023

As human rights education (HRE) becomes a more common feature of international policy discussions, national textbook reform, and post-conflict educational strategies, greater clarity about what HRE is, does, and means is needed. This article reviews existing definitions and models of HRE, and argues that ideology—as much as location or other variables—offers a means of schematizing varying approaches to HRE. This article reviews models organized around principles of global citizenship, coexistence, and transformative action in the context of one nation-state (India), and suggests that the mutability and adaptability of human rights education are its strength.

Lemke, M. (2017). Trafficking and immigration policy: Intersections, inconsistencies, and implications for public education. Educational Policy, 31(6), 743-763. DOI: 10.1177/0895904817719528

A growing body of interdisciplinary research examines the dynamics of, policies concerning, and implications of large-scale contemporary displacement in the United States. Yet less of this research explores the intersections of policies concerned with and normative understandings of displacement as both relate to U.S. schooling. This article discusses distinctive features of global displacement also highlighting concerns about student experience within the current political climate. It then synthesizes key U.S. policies and interdisciplinary literature that address aspects of displacement, including immigration, human trafficking, and asylum. In doing so, it illuminates how laws designed to protect vulnerable youth populations often conflict with the goals and normative politics of immigration enforcement. It concludes with implications for educational policy research and practice within U.S. schools serving high percentages of displaced populations.

Lewis, M., Rappe, P., & King, D. (2018). Development and promotion of student advocacy skills within a human trafficking course. Social Development Issues, 40(2), 24-35. Retrieved from https://proxy.lib.ohio-state.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=sih&AN=134671293&site=ehost-live

Human trafficking is a complex, highly profitable, and increasingly widespread social problem impacting countries across the globe. This article will provide an overview of international and national human trafficking and highlight the development and implementation of high-impact advocacy skills using course content to enhance student learning. Assignment examples related to community engagement and student advocacy activities will also be described. This article seeks to inspire educators to embrace multifaceted high-impact approaches as a means to educate and promote the development of student advocacy skills, preparing students to speak up and educate others on contemporary social problems impacting human rights.

Mihr, A. & Schmitz, H. P. (2007). Human rights education (HRE) and transnational activism. Human Rights Quarterly, 29(4), 973-993. Retrieved from https://www.jstor.org/stable/20072833

Transnational human rights activism occupies today a significant place in the practice and scholarship of current global affairs. This article reviews the past successes and limits of this activism and suggests Human Rights Education (HRE) as a strategic tool currently underutilized by activists and rarely taken seriously by academics. We argue that the current practice of transnational human rights activism frequently lacks solid and reciprocal ties to local activists and emphasizes “shaming” and exposure of human rights abuses over their prevention. The professionalization and campaign driven character of rights activism often increases the distance between transnational activists and local causes and beneficiaries and disconnects the general public from human rights struggles. While claims of impartial activism based on legalistic strategies have the benefit of lifting human rights groups above the fray of politics, the promotion of human rights norms remains a deeply political and contentious struggle. We argue that a greater emphasis on HRE strengthens transnational ties and local support for international human rights standards and leads to societal mobilization beyond the narrow nongovernmental sector.

Preble, K., Cook, M., & Fults, B. (2019). Sex trafficking and the role of institutions of higher education: Recommendations for response and preparedness. Innovative Higher Education, 44(1), 5-19. DOI: 10.1007/s10755-018-9443-1

In the perceptions of most persons, sex trafficking is a recognized global human rights abuse. The U.S. Department of Health and Human Services has articulated a call to action with its four “P” policy agenda: prevent, protect, prosecute, and partnership (Office of Trafficking in Persons, 2017). Institutions of higher education are positioned to bolster these initiatives through research, work force and policy development, and education. It is our purpose with this article to begin a discussion within academic institutions and the field of sex trafficking to explore what actions might assist survivors who wish to pursue higher education as well as what protections should be in place to serve students who may become victimized while attending an institution of higher education. We consider human trafficking, the role of institutions of higher education, current policies related to colleges and universities, the vulnerability of college age individuals to potential trafficking, and the unique needs of those who exit trafficking and enter higher education. We offer some recommendations that will enable institutions to engage with and address the intersection of sex trafficking and higher education.

Suarez, D. (2007). Education professionals and the construction of human rights education. Comparative Education Review, 51(1), 48-70. DOI: 10.1086/508638

This article builds on previous comparative education research by analyzing the current discourse surrounding this emerging education model— human rights education. The first section provides a brief history of human rights education in formal education. The second section reviews research on international reforms, emphasizing analyses of processes in global diffusion and variation at national or local levels. Closely related, the third section discusses linkages and relational and associational processes that spread ideas and construct new models such as human rights education. The fourth section focuses on the current state of human rights education, exploring the creation of an epistemic community of human rights educators and the theorization (Strang and Meyer 1993) of human rights education within the community. Specifically, the section analyzes discussions among members of the epistemic community about why to teach human rights education, how to teach human rights education, and how to assess the reform. Discussions among education professionals help to demonstrate the active debates about the content of human rights education and clarify how education professionals integrate the human rights movement into part of the education process. In addition, the interactions among education professionals highlight the intermediate step between global diffusion and local adaptations or responses. Education professionals translate global models of human rights education into local contexts, but professionals also help to build and refine the content of human rights education.

Tibbitts, F. (2002). Understanding what we do: Emerging models for human rights education. International Review of Education, 48(3-4), 159-171. Retrieved from https://link-springer-com.proxy.lib.ohio-state.edu/content/pdf/10.1023%2FA%3A1020338300881.pdf

The author presents three approaches to contemporary human rights education practice: the Values and Awareness Model, the Accountability Model and the Transformational Model. Each model is associated with particular target groups, contents and strategies. The author suggests that these models can lend themselves to theory development and research in what might be considered an emerging educational field. Human rights education can be further strengthened through the appropriate use of learning theory, as well as through the setting of standards for trainer preparation and program content, and through evaluating the impact of programs in terms of reaching learner goals (knowledge, values and skills) and contributing to social change.

Watson, S., Loizzo, J., Watson, W., Mueller, C., Lim, J., & Ertmer, P. (2016). Instructional design, facilitation, and perceived learning outcomes: An exploratory case study of a human trafficking MOOC for attitudinal change. Educational Technology Research & Development, 64(6), 1273-1300. DOI: 10.1007/s11423-016-9457-2

This exploratory case study describes the design and facilitation of a massive open online course (MOOC) for attitudinal change regarding human trafficking. It examines the course from the learners’, instructor’s, and instructional designer’s perspectives. Two interviews with the instructor and instructional designer were conducted, and data from a sample of learners via an end-of-course survey (n = 54) and follow-up questionnaire (n = 319) were gathered. Learners’ discussion posts and sample assignments were also reviewed. Findings show that the instructor and instructional designer perceived the design and facilitation of the MOOC as highly complex and challenging. Learner feedback was contradictory, possibly due to different expectations and needs within the MOOC. Six instructional design considerations for MOOCs in general and for attitudinal change are discussed, including: (a) MOOCs as a unique platform for attitudinal change, (b) the support needed from platform providers and universities, (c) personal and flexible learning paths, (d) instructional activities for attitudinal dissonance, (e) creating a collaborative community, and (f) MOOC instructor preparation.

Law

Beale, S. (2018). The Trafficking Victims Protection Act: The best hope for international human rights litigation in the U.S. courts?. Case Western Reserve Journal of International Law, 50(1/2), 17-47. Retrieved from https://proxy.lib.ohio-state.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=lft&AN=130957808&site=ehost-live

The article focuses on use of the Alien Tort Statute as a vehicle for litigating human rights abuses in both civil and criminal prosecutions in the U.S. Topics discussed include developments in International Criminal Law in addressing human rights violations; judicial attitudes that could affect the interpretation of the Trafficking Victim Protection Act; and Sosa v. Alvarez-Machain court case.

Clawson, H., Dutch, N., Lopez, S., & Tiapula, S. (2008). Prosecuting Human Trafficking Cases: Lessons Learned and Promising Practices. (Executive Summary). National Institute of Justice. Retrieved from https://www.ncjrs.gov/pdffiles1/nij/grants/223972.pdf

In an effort to increase the understanding of prosecutors’ ability to use the tools available to prosecute and convict traffickers while balancing the needs of trafficked persons, the National Institute of Justice (NIJ) awarded a grant in the fall of 2006. NIJ awarded, ICF International (formerly known as Caliber Associates, an ICF Consulting Company) and subcontractor the American Prosecutors Research Institute (APRI), a grant to design a study that examined the effects of existing federal and State legislation from the perspective of the prosecution and identified critical challenges and barriers to successful prosecution of cases.

DiRienzo, C. (2018). Compliance with anti-human trafficking policies: The mediating effect of corruption. Crime, Law, & Social Change, 70(5), 525-541. DOI: 10.1007/s10611-018-9780-0

Human Trafficking is an atrocious crime that represents a gross assault on human rights and the United Nations states that it is among the fast growing types of criminal activity. Recognizing the need for counteractive measures, in 2000, the United Nations General Assembly adopted the Convention against Transnational Organized Crime and its Protocol to Prevent, Suppress and Punish Trafficking in Persons, especially Women and Children (Protocol). Using measures of country compliance with the Protocol, past research offers empirical evidence that corruption is a primary deterrent to compliance. Further, previous field studies and surveys suggest that a greater share of women in government should positively contribute to country compliance; however, this result is largely not borne out in empirical studies. It is hypothesized that the effect of the share of women in government on compliance is fully mediated by corruption, indicating that there is an indirect effect of women in government on compliance, rather than a direct effect. This hypothesis is empirically tested using a mediation model and the results indicate that the indirect effect is statistically significant. The empirical results presented suggest that a greater percentage of women in government reduces country corruption, which in turn increases country compliance with the Protocol. The policy implications of these findings are discussed and include suggestions to enhance female participation in government.

Fouladvand, S. & Ward, T. (2019). Human trafficking, vulnerability, and the state. Journal of Criminal Law, 83(1), 39-54. DOI: 10.1177/0022018318814373

This article looks at human trafficking from a perspective influenced by the ‘vulnerability theory’ developed by Martha Fineman and her associates. It draws particularly on empirical studies of human trafficking from Albania to the UK and elsewhere. It suggests that Fineman’s approach needs to be modified to see the state not only as ameliorating vulnerability, or failing to do so, but as actively creating and using vulnerability to control or exploit its population. The fact that people are placed, for political, social and economic reasons, in situations of heightened vulnerability does not of itself deprive them of agency or responsibility. People should, however, be understood as ‘vulnerable subjects’ whose capacity for autonomy may be lost when they are deprived of supportive social relationships. The implications of this view for the criminal responsibility of trafficking victims are explored.

Johnson Jr., C., Beraldi, F., Broecker, E., Brown, E., & Maslow, S. (2019). The business case for lawyers to advocate for corporate supply chains free of labor trafficking and child labor. American University Law Review, 68(5), 1555-1619. Retrieved from https://proxy.lib.ohio-state.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=lft&AN=137063976&site=ehost-live

This Article considers the legal and ethical obligations that should propel lawyers to advocate for a corporate supply chain free of labor trafficking and child labor–both of which this piece will expose as an extension of the workforce of many corporations. By embracing the business case supported in the Carrol Corporate Social Responsibility Model, this Article continues to champion the Corporate Social Responsibility Model’s economic groundings. Why lawyers? Because lawyers are the guardians of the rule of law, and both human trafficking and child labor are gaps in the rule of law that taint a client’s supply chain and its goods. Despite many excellent laws in this area, the lack of enforcement contributes to this gap in the rule of law. As such, this Article illustrates why lawyers need to be on the vanguard of eradicating human trafficking and child labor in supply chains. It does so by describing, as noted by Professor David Snyder in The New Social Contracts for International Supply Chains, a set of Model Clauses designed to incorporate human rights protections in supply contracts developed by the ABA Business Law Section Working Group to Draft Human Rights Protections in International Supply Contracts. This Article also discusses why other ethical business case rationales such as the rule of law, moral, and legal ethics considerations likewise support the legal profession taking the lead on eradicating labor trafficking and child labor. Finally, the issue of diversity is advanced as a new way to think about solutions to this problem.

Judge, S., & Boursaw, B. (2018). The impact of the Trafficking Victims Protection Act of 2000 on trends in federal sex trafficking cases. Criminal Justice Policy Review, 29(8), 823-848. DOI: 10.1177/0887403416655430

In this study, we addressed the need for empirical research on human trafficking by compiling unique data relating to criminal charges filed in federal judicial districts and using these data to examine trends in sex trafficking-related cases, as well as the impact on those trends of the Trafficking Victims Protection Act of 2000 (TVPA). Results from our regression models indicate that the proportion of all charges filed by federal prosecutors that involved sex trafficking and related cases increased significantly between 1994 and 2007. The rate of increase, however, slowed in the time period following the passage of the TVPA, suggesting that the TVPA may have helped to mitigate increases in new cases. In addition, our results show statistically significant inverse relationships between immigration and sex trafficking-related charges filed, providing new evidence to support the possibility that some sex trafficking-related cases may be being prosecuted as immigration cases instead.

Kendis, B. (2019). Human trafficking and prostitution courts: Problem solving or problematic?. Case Western Reserve Law Review, 69(3), 805-841. Retrieved from https://proxy.lib.ohio-state.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=lft&AN=136877258&site=ehost-live

The article focuses on laws governing victimization in commercial sex in the U.S. Topics discussed include country’s approach on individuals involved in the sex industry and prostitution; human trafficking and prostitution courts effectiveness in addressing human trafficking and commercial sexual exploitation; and the enactment of Trafficking Victims Protection Act of 2000 for addressing the same.

Planitzer, J. & Katona, N. (2017). Criminal liability of corporations for trafficking in human beings for labour exploitation. Global Policy, 8(4), 505-511. DOI: 10.1111/1758-5899.12510

Legal instruments at the European level clearly define that States have an obligation to establish corporate liability for trafficking in human beings ( THB). The monitoring of the implementation of the Council of Europe Convention on Action against Trafficking in Human Beings shows that, in general, the respective legislation for corporate criminal liability already largely exists in the States’ Parties. However, application of the legislation seems to lag behind, since relevant cases were identified in only a few States. By analysing these legal mechanisms with a focus on Austria, studying case law in Belgium and Cyprus, and conducting interviews with stakeholders, the authors identify obstacles for the application of corporate criminal liability in the context of THB. Based on case law, the paper analyses the potential of corporate criminal liability for exploited persons to have access to compensation and describes challenges in this field. Cases on corporate criminal liability for THB seem to focus on sanctioning the companies and ensuring compensation might be seen as a rather secondary priority.

Small, K., Adams, W., Owens, C., & Roland, K. (2008). An Analysis of Federally Prosecuted Commercial Sexual Exploitation of Children (CSEC) Cases Since the Passage of the Victims of Trafficking and Violence Protection Act of 2000. (Research Report). Urban Institute. Retrieved from https://www.urban.org/research/publication/analysis-federally-prosecuted-commercial-sexual-exploitation-children-csec-cases-passage-victims-trafficking-and-violence-protection-act-2000

This study examined the prosecution of the commercial sexual exploitation of children and youth (CSEC) in the United States. The research took the form of a national analysis of federal prosecutions since the passage of the Trafficking Victims Protection Act (TVPA) in 2000, answering the following research questions: (1) Is the United States enforcing existing federal laws related to CSEC? (2) What are the key features of successfully prosecuted CSEC cases? (3) Have the U.S. courts increased penalties associated with sexual crimes against children? (4) What are the effects of CSEC legislation on service providers who work with victims? This assessment provides policy makers with a means of assessing the effects of legislation aimed at combating CSEC.

Medical & Nursing

Dovydaitis, T. (2010). Human trafficking: The role of the healthcare provider. Journal of Midwifery & Women’s Health, 55(5), 462-467. DOI: 10.1016/j.jmwh.2009.12.017

Human trafficking is a major public health problem, both domestically and internationally. Health care providers are often the only professionals to interact with trafficking victims who are still in captivity. The expert assessment and interview skills of providers contribute to their readiness to identify victims of trafficking. The purpose of this article is to provide clinicians with knowledge on trafficking and give specific tools that they may use to assist victims in the clinical setting. Definitions, statistics, and common health care problems of trafficking victims are reviewed. The role of the health care provider is outlined through a case study and clinical practice tools are provided. Suggestions for future research are also briefly addressed.

Fraley, H. & Aronowitz, T. (2019). Systematic review of human trafficking educational interventions for healthcare providers. Western Journal of Nursing Research. DOI: 10.1177/0193945919837366

Human trafficking is a global population health threat. Trafficking minors threatens the safety and well-being of youth. Limited studies measure health care providers’ awareness and attitudes toward trafficking. This systematic review synthesized retrospective and current knowledge and identified gaps in educational interventions aimed at increasing providers’ awareness and attitudes toward trafficking. A systematic search of four databases identified peer-reviewed published papers between January 1, 2000 and September 1, 2018. The Cochrane Collaboration’s Preferred Reporting Items for Systematic Reviews was followed. Study quality was assessed using the Downs and Black checklist. The Psychometric Grading Framework was used to assess the validity of instruments. Findings across studies (N = 7) reveal providers (mostly social workers and physicians) have low awareness of trafficking and can have negative attitudes toward victims. Multiphase educational approaches and use of content experts, including survivors, in developing interventions enhanced sustainability of outcomes. Targeting multidisciplinary health care teams, including nurses, enhanced interventions.

Hansen, S., Melzer-Lange, M., Nugent, M., Yan, K., & Rabbitt, A. (2018). Development and assessment of an online training for the medical response of sex trafficking of minors. Academic Pediatrics, 18(8), 965-968. DOI: 10.1016/j.acap.2018.07.009

The article presents a study which examines the use of an online training for medical professionals to improve their trauma-informed responses to sex trafficking (ST) of minors. The study used electronic learning development software and Fisher’s exact test to assess the technology. Results show that the innovative online training helps improve confidence, awareness and knowledge on the provision of medical response to ST victims.

Judge, A., Murphy, J., Hidalgo, J., & Macias-Konstantopoulos, W. (2018). Engaging survivors or human trafficking: Complex health care needs and scarce resources. Annals of Internal Medicine, 168(9), 658-663. DOI: 10.7326/M17-2605

Human trafficking, also known as modern-day slavery, is an egregious human rights violation associated with wide-ranging medical and mental health consequences. Because of the extensive health problems related to trafficking, health care providers play a critical role in identifying survivors and engaging them in ongoing care. Although guidelines for recognizing affected patients and a framework for developing response protocols in health care settings have been described, survivors’ ongoing engagement in health care services is very challenging. High rates of disengagement, lost contact, premature termination, and attrition are common outcomes. For interventions to be effective in this marginalized population, challenges in engaging survivors in long-term therapeutic primary and mental health care must be better understood and overcome. This article uses the socioecological model of public health to identify barriers to engagement; offers evidence- and practice-based recommendations for overcoming these barriers; and proposes an interdisciplinary call to action for developing more flexible, adaptable models of care.

Macias-Konstantopoulos, W. (2016). Human trafficking: The role of medicine in interrupting the cycle of abuse and violence. Annals of Internal Medicine, 165(8), 582-588. DOI: 10.7326/M16-0094

Human trafficking, a form of modern slavery, is an egregious violation of human rights with profound personal and public health implications. It includes forced labor and sexual exploitation of both U.S. and non-U.S. citizens and has been reported in all 50 states. Victims of human trafficking are currently among the most abused and disenfranchised persons in society, and they face a wide range of negative health outcomes resulting from their subjugation and exploitation. Medicine has an important role to play in mitigating the devastating effects of human trafficking on individuals and society. Victims are cared for in emergency departments, primary care offices, urgent care centers, community health clinics, and reproductive health clinics. In addition, they are unknowingly being treated in hospital inpatient units. Injuries and illnesses requiring medical attention thus represent unique windows of opportunity for trafficked persons to receive assistance from trusted health care professionals. With education and training, health care providers can recognize signs and symptoms of trafficking, provide trauma-informed care to this vulnerable population, and respond to exploited persons who are interested and ready to receive assistance. Multidisciplinary response protocols, research, and policy advocacy can enhance the impact of anti-trafficking health care efforts to interrupt the cycle of abuse and violence for these victims.

Macias-Konstantopoulos, W. (2017). Caring for the trafficked patient: Ethical challenges and recommendations for health care professionals. AMA Journal of Ethics, 19(1), 80-90. Retrieved from https://journalofethics.ama-assn.org/sites/journalofethics.ama-assn.org/files/2018-05/msoc2-1701.pdf

Human trafficking is an egregious human rights violation with profound negative physical and psychological consequences, including communicable diseases, substance use disorders, and mental illnesses. The health needs of this population are multiple, complex, and influenced by past and present experiences of abuse, neglect, and exploitation. Effective health care services for trafficked patients require clinicians to consider individual patients’ needs, wishes, goals, priorities, risks, and vulnerabilities as well as public health implications and even resource allocation. Applying the bioethical principles of respect for autonomy, nonmaleficence, beneficence, and justice, this article considers the ethics of care model as a trauma-informed framework for providing health care to human trafficking victims and survivors.

McClain, N. & Garrity, S. (2011). Sex trafficking and the exploitation of adolescents. Journal of Obstetric, Gynecological, & Neonatal Nursing, 40(2), 234-252. DOI: 10.1111/j.1552-6909.2011.01221.x

Human trafficking affects a surprisingly large number of adolescents around the globe. Women and girls make up the majority of sex trafficking victims. Nurses must be aware of sex trafficking as a form of sexual violence in the adolescent population. Nurses can play a role in identifying, intervening, and advocating for victims of human trafficking as they currently do for patients that are the victims of other types of violent crimes.

Sabella, D. (2011). The role of the nurse in combatting human trafficking. American Journal of Nursing, 111(2), 28-37. DOI: 10.1097/01.NAJ.0000394289.55577.b6

Human trafficking, also called modern slavery, happens worldwide-and the United States is no exception. Within our borders, thousands of foreign nationals and U.S. citizens, many of them children, are forced or coerced into sex work or various forms of labor every year. Nurses and other health care providers who encounter victims of trafficking often don’t realize it, and opportunities to intervene are lost. Although no one sign can demonstrate with certainty when someone is being trafficked, there are several indicators that clinicians should know. This article provides an overview of human trafficking, describes how to recognize signs that a person is being trafficked and how to safely intervene, and offers an extensive resource list.

Schwarz, C., Unruh, E., Cronin, K., Evans-Simpson, S., Britton, H., & Ramaswamy, M. (2016). Human trafficking identification and service provision in the medical and social service sectors. Health & Human Rights: An International Journal, 18(1), 181-191. Retrieved from https://proxy.lib.ohio-state.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=p4h&AN=116633657&site=ehost-live

The medical sector presents a unique opportunity for identification and service to victims of human trafficking. In this article, we describe local and site-specific efforts to develop an intervention tool to be used in an urban hospital’s emergency department in the midwestern United States. In the development of our tool, we focused on both identification and intervention to assist trafficked persons, through a largely collaborative process in which we engaged local stakeholders for developing site-specific points of intervention. In the process of developing our intervention, we highlight the importance of using existing resources and services in a specific community to address critical gaps in coverage for trafficked persons. For example, we focus on those who are victims of labor trafficking, in addition to those who are victims of sex trafficking. We offer a framework informed by rights-based approaches to anti-trafficking efforts that addresses the practical challenges of human trafficking victim identification while simultaneously working to provide resources and disseminate services to those victims.

Public Affairs

Bonilla, T. & Mo, C. H. (2019). The evolution of human trafficking messaging in the United States and its effect on public opinion. Journal of Public Policy, 39(2), 201-234. DOI: 10.1017/S0143814X18000107

Despite a near unanimous agreement that human trafficking is a morally reprehensible practice, there is confusion around what qualifies as human trafficking in the United States. Adopting a mixed-method strategy, we examine how human trafficking is defined by the public; how contemporary (mis)understanding of human trafficking developed; and the public opinion consequence of this (mis)understanding. The definition of human trafficking has evolved over time to become nearly synonymous with slavery; however, we demonstrate that media and anti-trafficking organisations have been focussing their attention on the sexual exploitation of foreign women. We show that general public opinion reflects this skewed attention; the average citizen equates human trafficking with the smuggling of women for sexual slavery. Using a survey experiment, we find that shining light on other facets of human trafficking – the fact that human trafficking is a security problem and a domestic issue – can increase public response to the issue.

Public Health

Cannon, A., Arcara, J., Graham, L., & Macy, R. (2018). Trafficking and health: A systematic review of research methods. Trauma, Violence & Abuse, 19(2), 159-175. DOI: 10.1177/1524838016650187

Trafficking in persons (TIP) is a human rights violation with serious public health consequences. Unfortunately, assessing TIP and its health sequelae rigorously and reliably is challenging due to TIP’s clandestine nature, variation in definitions of TIP, and the need to use research methods that ensure studies are ethical and feasible. To help guide practice, policy, and research to assess TIP and health, we undertook a systematic literature review of 70 peer-reviewed, published articles to (a) identify TIP and health research methods being used, (b) determine what we can learn about TIP and health from these varied methodologies, and (c) determine the gaps that exist in health-focused TIP research. Results revealed that there are various quantitative and qualitative data collection and analysis methods being used to investigate TIP and health. Furthermore, findings show that the limitations of current methodologies affect what is known about TIP and health. In particular, varying definitions, participant recruitment strategies, ethical standards, and outcome measures all affect what is known about TIP and health. Moreover, findings demonstrate an urgent need for representative and nonpurposive recruitment strategies in future investigations of TIP and health as well as research on risk and protective factors related to TIP and health, intervention effectiveness, long-term health outcomes, and research on trafficked people beyond women trafficked for sex. We offer recommendations for research, policy, and practice based on review results.

Haase, E. (2014). “Human trafficking, public health, and the law”: A comprehensive analysis of intersections. Journal of Public Health, 22, 121-129. DOI: 10.1007/s10389-013-0603-6

Aim. The extraordinary topic of “Human Trafficking, Public Health and the Law” was subject of an interdisciplinary and international Spring School that took place in March 2013 in Italy. The aim of the meeting was a comprehensive examination of the human trafficking issue.

Subject and method. In collaboration with seven expert lecturers, a group of students particularized the issues and claims related to human trafficking and public health from the angles of all relevant disciplines. Past legal decisions were evaluated in order to recommend future solutions in the common interest with respect to human dignity.

Results. The main outcome of the two weeks of lectures, group work and a field trip are practical approaches and the document: Siena Principles on Human Trafficking and Public Health.

Conclusion. The costs for society that arise due to the adverse effects of human trafficking encompass the degradation of human rights, poor public health, weakened social development, and disturbed communities. Human trafficking therefore is a critical health issue with serious social implications that requires both medical and legal attention.

Macias-Konstantopoulos, W., Ahn, R., Alpert, E., Cafferty, E., McGahan, A., Williams, T., …, Burke, T. (2013). An international comparative public health analysis of sex trafficking of women and girls in eight cities: Achieving a more effective health sector response. Journal of Urban Health, 90(6), 1194-1204. DOI: 10.1007/s11524-013-9837-4

Sex trafficking, trafficking for the purpose of forced sexual exploitation, is a widespread form of human trafficking that occurs in all regions of the world, affects mostly women and girls, and has far-reaching health implications. Studies suggest that up to 50 % of sex trafficking victims in the USA seek medical attention while in their trafficking situation, yet it is unclear how the healthcare system responds to the needs of victims of sex trafficking. To understand the intersection of sex trafficking and public health, we performed in-depth qualitative interviews among 277 antitrafficking stakeholders across eight metropolitan areas in five countries to examine the local context of sex trafficking. We sought to gain a new perspective on this form of gender-based violence from those who have a unique vantage point and intimate knowledge of push-and-pull factors, victim health needs, current available resources and practices in the health system, and barriers to care. Through comparative analysis across these contexts, we found that multiple sociocultural and economic factors facilitate sex trafficking, including child sexual abuse, the objectification of women and girls, and lack of income. Although there are numerous physical and psychological health problems associated with sex trafficking, health services for victims are patchy and poorly coordinated, particularly in the realm of mental health. Various factors function as barriers to a greater health response, including low awareness of sex trafficking and attitudinal biases among health workers. A more comprehensive and coordinated health system response to sex trafficking may help alleviate its devastating effects on vulnerable women and girls. There are numerous opportunities for local health systems to engage in anti-trafficking efforts while partnering across sectors with relevant stakeholders.

Modi, M., Palmer, S., & Armstrong, A. (2014). The role of the Violence Against Women Act in addressing intimate partner violence: A public health issue. Journal of Women’s Health, 23(3), 253-259. DOI: 10.1089/jwh.2013.4387

Intimate partner violence (IPV) is defined as violence committed by a current or former boyfriend or girlfriend, spouse or ex-spouse. Each year, 1.3 to 5.3 million women in the United States experience IPV. The large number of individuals affected, the enormous healthcare costs, and the need for a multidisciplinary approach make IPV an important healthcare issue. The Violence Against Women Act (VAWA) addresses domestic violence, dating violence, sexual assault, and stalking. It emphasizes development of coordinated community care among law enforcement, prosecutors, victim services, and attorneys. VAWA was not reauthorized in 2012 because it lacked bipartisan support. VAWA 2013 contains much needed new provisions for Native Americans; lesbian, gay, bisexual, transgender, gay, and queer (LGBTQ) individuals; and victims of human trafficking but does not address the large amount of intimate partner violence in America’s immigrant population. There are important remaining issues regarding intimate partner violence that need to be addressed by future legislation. This review examines the role of legislation and addresses proposals for helping victims of IPV.

Todres, J. (2012). Assessing public health strategies for advancing child protection: Human trafficking as a case study. Journal of Law and Policy, 21(1), 93-112. Retrieved from https://heinonline.org/HOL/P?h=hein.journals/jlawp21&i=100

Ensuring the well-being of all children is one of the great challenges of our time. Despite concerted efforts in the United States to protect children, research reveals that millions of children suffer harm each year.’ This symposium, which aimed to explore the potential benefits of public health perspectives on child protection, provided an important opportunity to reexamine children’s experiences and child protection strategies from a different perspective. Typically, when policymakers and child advocates speak of “child protection,” they focus primarily on abuse and neglect in the home. Often, child protection does not contemplate violence against children in the community. The inside/outside-the-home divide is somewhat of a false dichotomy, however, as the two realms are interrelated. Children who suffer abuse and neglect in the home are frequently at heightened risk of exploitation outside the home. This essay focuses on the community-based issues of trafficking and commercial sexual exploitation of children, with a view to elucidating the merits of public health approaches to harm against children. Trafficking and commercial sexual exploitation of children are significant issues in the United States. Although many individuals still think of these problems as occurring elsewhere in the world, these forms of child exploitation occur regularly in the United States, and most experts agree that the number of intra-country trafficking cases exceeds the number of cross-border cases. This essay briefly outlines the current framework for responding to child trafficking. It then discusses what a public health approach could add to anti-trafficking efforts. Finally, this essay seeks to draw lessons from a public health approach to child trafficking that might inform child protection strategies more broadly.

Social Work

Dalla, R.L., Erwin, S., & Kreimer, L.M. (2018). Children of Mumbai’s Brothels: Investigating Developmental Prospects, Primary Relationships, and Service Provision. Family Relations: Interdisciplinary Journal of Applied Science, 68, 104-118. Retrieved from https://doi.org/10.1111/fare.12347

Objective. To understand the context of the lives of children reared in India’s red‐light brothel districts.

Background. Substantial empirical insight has emerged on the commercial sexual exploitation of children (CSEC). Yet the extant literature on brothel‐based children (BBC), a uniquely vulnerable subset of at‐risk children, is paradoxically deficient. Understanding the developmental needs of BBC is critical to mitigating risk.

Method. In‐depth, semi-structured interviews were conducted with 9 service providers and 30 women residing in 2 red‐light brothel districts of Mumbai. Phenomenological inquiry informed the research methodology and data analysis.

Results. Mothers’ goals for children included survival, academic success, and future employment. Formal services were critical in meeting the basic needs of BBC, ensuring access to developmentally appropriate education, and maintaining safety overnight.

Conclusion. BBC are at considerable risk for an array of developmental challenges. Multisector service providers must work together and with the mothers of BBC to mitigate intergenerational sexual exploitation in the formal sex economy.

Implications. Results provide key areas for further research including longitudinal assessment of BBCs’ educational and occupational outcomes, as well as incidence of complex trauma among BBC and treatment options. Service gaps include outreach to older male BBC as well as shame reduction intervention.

Fedina, L., Williamson, C., & Perdue, T. (2016). Risk factors for domestic child sex trafficking in the United States. Journal of Interpersonal Violence, 34(13), 2653-2673. Retrieved from https://doi.org/10.1177/0886260516662306

Despite increased effort to respond to human trafficking at national and state levels, very little empirical research has been conducted on domestic child sex trafficking. This study retrospectively examines associations between multiple risk factors and domestic child sex trafficking (i.e., entry into the commercial sex industry under the age of 18) in a sample of individuals aged 16 and older currently involved in the commercial sex industry (N = 273). Two primary research questions are addressed: (1) What set of risk factors, prior to entering the commercial sex industry, are associated with domestic child sex trafficking and (2) what group differences, if any, exist in risk factors between current or former domestic child sex–trafficking victims and non-trafficked adults engaged in the commercial sex industry? A cross-sectional survey was administered using Respondent-Driven Sampling (RDS) in five cities in one Midwestern state. Overall, 115 participants (48.3%) were identified as current or former domestic child sex–trafficking victims. Bivariate results suggest that childhood emotional and sexual abuse, rape, ever running away from home, having family members in sex work, and having friends who purchased sex were significantly associated with domestic child sex trafficking. Multivariate results indicate that domestic child sex trafficking victims were significantly more likely to have ever run away and to be a racial/ethnic minority than non-trafficked adults engaged in the commercial sex industry. Findings can inform state-level policies on human trafficking and assist child protection and juvenile justice agencies in developing prevention and intervention responses to commercial sexual exploitation.

Karandikar, D., Gezinski, L.B., & Meshelemiah, J.C.A. (2011). A qualitative examination of women involved in prostitution in Mumbai, India: The role of family and acquaintances. International Social Work, 56(4), 496-515. Retrieved from https://doi.org/10.1177/0020872811425804

In this qualitative study, 48 female prostitutes from Mumbai, India were interviewed to understand their experiences related to their entry into prostitution. Respondents’ vulnerabilities and the role of family and acquaintances in entry were researched. The findings of the study indicate that poverty, marital abuse, sexual abuse and the death of a parent or husband were the main reasons for entry into prostitution. The majority of the respondents were sold into prostitution by family members or acquaintances. This research provides recommendations for policy, practice and research in the area of sex trafficking.

Meshelemiah, J.C.A. (2016). Human Rights Perspectives in Social Work Education and Practice. Encyclopedia of Social work: National Association of Social Workers & Oxford University Press.

The social work profession has evolved extensively since its inception in 1898. The profession began with a focus on helping others and recognizing social injustices as its core charges. The profession is now being called to view human rights as its professional responsibility, too. As driving forces behind this new charge, the Council on Social Work Education (CSWE) and the National Association of Social Workers (NASW) are taking concrete steps to ensure that the human rights perspective is being integrated into social work education and practice.

International

This section focuses on the international organizations that fight human trafficking. The list is not exhaustive.

Agape International Missions

Agape International Missions was founded in 2005 by Don and Bridget Brewster who moved to Cambodia after learning about rampant sex trafficking. Their focus is on preventing human trafficking. They also engage in rescuing, restoring and reintegrating survivors into society

Website: https://agapewebsite.org/about/

Anti-Slavery International

Anti-Slavery International is a UK based organization with over 180 years of anti-trafficking efforts to speak of. Using their theory of change, this organization works in the UK, Mauritania, Niger, Senegal, Tanzania, India, Lebanon, Uzbekistan, Turkmenistan, and Nepal to fight descent-based slavery forced child begging, child domestic workers, debt bondage, migrant women, bonded labor and other forms of trafficking. Their macro approach to anti-trafficking work includes working to develop major laws again slavery, offering a 24 hour hotline and mobilizing communities to demand respect for their human rights.

Website: https://www.antislavery.org/what-we-do/how-we-work/

Child Rescue Nepal

Child Rescue Nepal is an organization that focuses on child rescues, support and reunifications, prevention and prosecutions. They work closely with the local police to raid organizations where children are held captive; provide basic necessities for rescued children; and work to reunify children with their families.

Website: https://www.childrescuenepal.org/

ECPAT International

ECPAT International is a large international organization with 109 members in 96 countries of varying sizes that include national coalitions and small grassroots organizations. ECPAT coordinates research efforts and actionable steps to end the commercial sexual exploitation of children. They also coordinate efforts around advocacy for children. Specifically, ECPAT supports shelters for survivors, training for law enforcement and conducts research.

Website: https://www.ecpat.org/

Free the Slaves

Free the Slave has a mission: liberating slaves and changing the conditions that allow slavery to persist. Its vision includes a community-based model for freedom. Since its inception in 2000, Free the Slaves community-based mode for freedom has resulted in over 14,000 people freed from slavery and 300 traffickers arrested.

Website: https://www.freetheslaves.net/about-us/mission-vision-history/

Global Alliance Against Traffic in Women (GAATW)

Global Alliance Against Trafficking is an alliance of 80 non-governmental organizations in Africa, Asia, Europe, Latin America & the Carribean (LAC) and North America. As systems thinkers, GAATW links trafficking with gender, migration, and labour frameworks. They engage in advocacy, research and communications based on their rotational three year strategic thematic directions.

Website: https://www.gaatw.org/what-we-do/2011-2013-strategic-direction

HAART Kenya

HAART stands for Awareness Against Human Trafficking. It is a non-governmental organization in Nairobi, Kenya that fights trafficking in Kenya and other parts of East Africa. It was founded in 2010 by lawyers, missionaries, and humanitarians. This organization works on efforts related to: prevention of trafficking, victim protection and the prosecution of offenders.

Website: https://haartkenya.org/

International Justice Mission (IJM)

International Justice Mission boasts of being the largest anti-slavery organization in the world. They work to set slaves free, incarcerate traffickers and to stop slave trading forever. They also address land theft, sex trafficking, police abuse of power, citizenship rights abuse, sexual violence against children and labor trafficking.

Website: https://www.ijm.org/our-work

La Strada International

La Strada International (LSI) operates from a human rights perspective among eight member stats in Belarus, Bulgaria, the Czech Republic, Macedonia, Moldova, the Netherlands, Poland and the Ukraine. This European organization adopts a collaborative approach to service delivery that asserts that trafficked persons are in control of their agency and not passive actors in need of instructions and rescue.

Website: http://lastradainternational.org/

Reaching out Romania

Reaching out Romania has been in operation since 1998. It primarily serves Romanian women and girls who have traveled and suffered sexual abuse in European countries. Their focus is on saving and improving lives. To date, they have assisted over 470 trafficking victims.

Website: http://www.reachingout.ro/about-reaching-out-romania/

Shared Hope International

Shared Hope International has a single mission: to eradicate sex trafficking. Its three prong approach include 1) prevention; 2) restoration through strategic guidance and funding for local organizations in an effort to expand shelter housing and services; and 3) to bring justice by accelerating legislative and policy solutions.

Website: https://sharedhope.org/

National

This section focuses on the domestic organizations that fight human trafficking. The list is not exhaustive.

ECPAT – USA

ECPAT – USA’s mission is to protect every child’s human right to live free of trafficking and threats of sexual exploitation. It is a member of ECPAT International. They engage in legislative advocacy, youth education, community education and private sector engagement.

Website: https://www.ecpatusa.org/

National Human Trafficking Hotline

The National Human Trafficking Hotline  is run by the Polaris Project. It is a national, toll-free hotline, available to answer calls, texts, and live chats from anywhere in the United States, 24 hours a day, 7 days a week. The Call Center has diverse personnel available who speak in more than 200 languages. The National Hotline’s mission is to link human trafficking victims and survivors to critical support and services. This linkage helps victims and survivors to get help and to stay safe. Additionally, the hotline is there to equip the anti-trafficking community with the tools to effectively combat human trafficking.

The National Hotline offers 24-hour access to a safe space to report tips, seek services and ask for help. They can be reached at 1-888-373-7888 | Text BeFree (233733).

Website: https://polarisproject.org/get-assistance/national-human-trafficking-hotline

Not for Sale

Not for Sale is grounded in an economical approach to labor trafficking. The “Not ForSale methodology builds viable, successful companies that bakes our DNA into the company to create value throughout the whole business — from the sourcing of the goods, to the manufacturing of products, to the way we sell it — and return profits back to the community through our Not For Sale projects. We fight vulnerability to exploitation at its core by strengthening communities with economic opportunity” (Not for Sale, 2016, para 2). Their projects support anti-trafficking efforts in Peru, the Republic of the Congo, Romania, Thailand, the Netherlands, Uganda, the USA and Vietnam.

Website: https://www.notforsalecampaign.org/why-exploitation/

Polaris

Take action. Join the fight by joining Polaris at this link. When you join, you will receive action alerts and updates related to human trafficking.

The National Human Trafficking Hotline is operated by Polaris. Annually, it receives thousands of phone calls, online tip reports and emails. These communications are referred to as signals. These are some of the statistics (national vs Ohio specific) regarding signals and human trafficking cases.

Below, you will find marketing materials in Spanish and English on how to contact the National Human Trafficking Hotline.

In this section, you will find federal government resources that fall under the auspices of the U.S. Department of Justice, U.S. Department of Health and Human Services, U.S. Department of State, U.S. Department of Homeland Security, the U.S. Department of Defense and the U.S. Department of Labor. The breadth of departments involved in addressing human trafficking at the federal level indicates the vastness of the problem in the USA. Contrary to popular belief that human trafficking is only a developing nation’s problem, please believe that the US government would not invest this many resources into a problem if it did not exist in this country. Human trafficking is a blight on this country’s reputation. Human rights are grossly violated every day in every person who is trafficked. America has a serious problem with human trafficking and human rights violations.

Resources & Research: Federal Government Resources

U.S. Department of Justice

Bureau of Justice Assistance
The Bureau of Justice Assistance, Office of Justice Programs, develops training for law enforcement and communities to identify trafficking in persons and funds task forces based on a sound strategy of collaboration among state and local enforcement, trafficking victim service providers, federal law enforcement, and U.S. Attorneys’ Offices.

Child Exploitation and Obscenity Section
The Child Exploitation and Obscenity Section (CEOS) works to combat incidences of child exploitation and trafficking of women and children. Issues under the CEOS umbrella include child pornography, illegal interstate or international transportation of women and children, international parental abduction, computer-related exploitation of children, and child victimization on federal and Indian lands.

Federal Bureau of Investigation
The Federal Bureau of Investigation (FBI) is responsible for investigating human trafficking. The FBI also runs the Innocence Lost Initiative, focusing on sex trafficking of children within the United States.

Human Trafficking Prosecution Unit
The U.S. Department of Justice’s Human Trafficking Prosecution Unit works closely with Assistant United States Attorneys and law enforcement agencies to streamline fast-moving trafficking investigations, ensure consistent application of trafficking statutes, and identify multijurisdictional trafficking networks.

National Institute of Justice
The National Institute of Justice, Office of Justice Programs, funds research on human trafficking in the United States and around the world.

Office of Juvenile Justice and Delinquency Prevention
The Office of Juvenile Justice and Delinquency Prevention, Office of Justice Programs, implements a number of training and capacity-building initiatives related to the commercial sexual exploitation of children and funds the Internet Crimes Against Children Task Forces, which investigate Internet-related crimes of child pornography and enticement.

U.S. Department of Health and Human Services

Administration for Children & Families
The Administration for Children and Families (ACF) is committed to ensuring that victims of all forms of human trafficking – adults and children; foreign nationals, U.S. citizens, and lawful permanent residents; survivors of labor and commercial sexual exploitation – have access to the support they need to foster health and well-being.

Runaway and Homeless Youth Program
Through the Runaway and Homeless Youth Program, the Family and Youth Services Bureau, Administration of Children & Families, supports street outreach, emergency shelters, and longer-term transitional living and maternity group home programs to serve and protect these young people.

The Family Violence Prevention and Services Program
The Family Violence Prevention and Services Program of the Family and Youth Services Bureau, at the Administration of Children & Families, administers the Family Violence Prevention and Services Act, the primary federal funding stream dedicated to the support of emergency shelter and related assistance for victims of domestic violence and their children.

Office of Refugee Resettlement
The Office of Refugee Settlement (ORR), at the Administration of Children & Families, helps refugees and other special populations, such as adult victims of severe forms of trafficking, obtain economic and social self-sufficiency in the United States. ORR is responsible for certifying adult victims of human trafficking so that they may receive federally funded benefits and services to the same extent as refugees. ORR manages the Campaign to Rescue and Restore Victims of Human Trafficking—a public awareness Web site to combat human trafficking—and supports the National Human Trafficking Hotline—a referral hotline that connects victims with programs in their local area.

U.S. Department of State

Office to Monitor and Combat Trafficking in Persons
Office to Monitor and Combat Trafficking in Persons conducts awareness-raising activities, diplomacy with other countries, and funding for international anti-trafficking initiatives.

U.S. Department of Homeland Security

Blue Campaign
The Blue Campaign provides information on training and outreach, how traffickers operate, and victim assistance to help keep the public informed.

U.S. Citizenship and Immigration Services
U.S. Citizenship and Immigration Services adjudicates applications for T and U visas, which are available to foreign national victims of trafficking. Lawyers and advocates may check on the status of an already submitted case by calling the Violence Against Women Act Unit Helpline at 802-527-4888.

U.S. Department of Defense

Combating Trafficking in Persons
The Combating Trafficking in Persons Program Office establishes policy and ensures that the services, combatant commands, and defense agencies have the necessary tools to prevent trafficking.

U.S. Department of Labor

Office of Child Labor, Forced Labor and Human Trafficking
The Office of Child Labor, Forced Labor and Human Trafficking publishes reports on international child labor, forced labor, and human trafficking and provides funding to combat international child labor.

Wage and Hour Division
The Wage and Hour Division enforces federal labor laws including the Fair Labor Standards Act and the Migrant and Seasonal Agricultural Workers Protection Act and assists with human trafficking investigations involving the violation of these laws.

[The authors gratefully acknowledge the U.S. Department of Justice, Office of Justice Programs, Office for Victims of Crime, for allowing us to reproduce, [in part/in whole], “Resources & Research: Federal Government Resources”. This list was prepared by the Office for Victims of Crime.

Local Organizations

CATCH (Changing Actions to Change Habits) Court

This court serves to try to help women who have been arrested for prostitution. The court views them as victims, not as criminals. Judge Herbert is the presiding officer in this court.

The CATCH Court is a specialized docket that is located at Franklin County Municipal Court. 375 South High Street

Columbus, Ohio 43215

(614) 645-8214

CENTRAL OHIO RESCUE AND RESTORE COALITION (CORRC)

This coalition of community agencies provides information and resources through their 24-hour hotline. CORRC provides free workshops and training on human trafficking. The Coalition focuses on public awareness, social services, law enforcement and legislation.

966 East Main Street

Columbus, Ohio 43215

(614) 285-4357

swo.salvationarmy.org/ rescueandrestore

FREEDOM A LA CART

Provides employment opportunities in the culinary arts arena for sex trafficking women survivors.

5000 Arlington Centre Blvd

Columbus, OH 43220

info@freedomalacart.org

(614) 992-3252

GRACEHAVEN

Gracehaven’s mission is two-fold: to eradicate child sex trafficking in Central Ohio, and to provide rehabilitative, trauma informed care to survivors.  Gracehaven was founded to care for the growing number of victims of domestic minor sex trafficking. More than 1,000 minors are sexually trafficked in Ohio annually. To effectively care for victims and prevent others from being enslaved in this life, Gracehaven employs a comprehensive approach to combating domestic minor sex trafficking:

5000 Arlington Centre Blvd, Columbus, OH 43220

(614) 302-9515 https://gracehaven.me/

REINS OF FREEDOM

An agency that provides trauma-informed mental health care focusing on children, adults and families who have experienced sexual abuse/trafficking, while also making services available to those with anxiety, depression, PTSD and addiction. Their scope of expertise is offering equine (horse) assisted psychotherapy, where clients can interact with horses as part of their treatment plan.

3 West Main Street, Westerville, Ohio 43081

(614) 633-5946 reinsoffreedom.org

THE SWITCH NATIONAL ANTI-HUMAN TRAFFICKING NETWORK

This is a national network providing support, resources, housing, protection to victims of human trafficking, street prostitution, homeless and vulnerable youth. SWITCH advocates and works towards awareness, enforcement, community connections and prevention programs.

178 West Schrock Road, Westerville, Ohio 43081

(614) 285-4433 jointheswitch.org

Assessment Tools

Several assessment tools that are well established and validated are available to identify human trafficking victims. They include:

Administration for Children & Families. Office on Trafficking in Persons. (2018, January). Adult Human Trafficking Screening Tool and Guide.

Available at https://www.acf.hhs.gov/sites/default/files/otip/adult_human_trafficking_screening_tool_and_guide.pdf

National Human Trafficking Resource Center. (2011). Comprehensive Human Trafficking Assessment tool.

Available at https://humantraffickinghotline.org/sites/default/files/Comprehensive%20Trafficking%20Assessment.pdf

Vera Institute of Justice. (2014). Screening for Human Trafficking: Guidelines for Administering the Trafficking Victim Identification Tool (TVIT).

Available at https://www.ncjrs.gov/pdffiles1/nij/grants/246713.pdf

Additional human trafficking screening tools can be found below.

[Source: Administration for Children & Families. Office on Trafficking in Persons. (2018, January). Adult Human Trafficking Screening Tool and Guide. Retrieved from https://www.acf.hhs.gov/sites/default/files/otip/adult_human_trafficking_screening_tool_and_guide.pdf]

Additional tools are listed below.

The previously stated sources are a good start to getting a sense of the depth of human trafficking in this country and abroad. “It takes a world to eradicate slavery!”

References

Enrile, A. (2018). Ending Human Trafficking & Modern-Day Slavery: Freedom’s Journey. Thousand Oaks: SAGE Publications.

Laboratory to Combat Human Trafficking. (2019). Human trafficking: A human rights violation. Retrieved from https://combathumantrafficking.org/2018/12/human-trafficking-human-rights-violation/

Not for Sale. (2016). Your story is touched by modern slavery. Retrieved from https://www.notforsalecampaign.org/why-exploitation/

United Nations. (1948). United Nations Universal Declaration of Human Rights. New York: Author.

[See above websites or hyperlinks for all organizations listed.]