Human trafficking (A Borici, A Reidel, T Stilwell

Human trafficking (HT) is defined as the action or practice of illegally transporting people from one area to another. However, human trafficking is not always the transportation of people and does not always mean people are confined. Two types of human trafficking are labor and sex trafficking. The subtopics that will be described in this presentation are: mental health, preventative health care, addiction, and chronic illness. This is a growing problem around the world that is leading to increased adverse health effects.

Introduction

Effects on Mental Health

Higher likelihood of developing mental disorders like schizophrenia [1] “15 percent of trafficked persons in contact with mental health services in South London between 2006 and 2012 met criteria for schizophrenia and related disorders in the International Statistical Classification of Diseases and Related Health Problems” [1] People that are trafficked with pre-existing psychological disorders will require more support than those suffering from the same mental illness Survivors tend to have higher instances of PTSD, anxiety, depression, self-harm, and attempted suicide [1] Stockholm syndrome (i.e., traumatic bonding with perpetrator) is commonly seen [2] Dissociative disorders involving varying degrees of detachment from self/reality Sleep disorders (e.g., sleep disturbances, nightmares, and insomnia) [1] Trafficker will claim that they have a mental disorder- may be an indicator to a physician that this might be a trafficking scenario. [1]

I believe this is of greatest importance. This effects most everyone that goes through HT. It seems to be both what is targeted by HT leaders, but it can also be an important indicator for health professionals to recognize HT is going on. Since this effects so many HT patients in a traumatic and life altering way, I think that this is the greatest health concern with HT patients and the most emphasis on getting treatment for HT patients should be put on mental health. ~ A Reidel

https://ceufast.com/course/human-trafficking

https://news.un.org/en/story/2019/01/1031552

Access to Preventive Healthcare

Difficult for health care professionals to do proper assessments of HT victims due to their increased sensitivity and possible recent abuse HT victims are at an increased risk of contracting sexually transmitted infections and reproductive issues such as unplanned pregnancy, abortions, and dyspareunia [3] It is common for abortions to be preformed by persons that are not qualified and lead to later pregnancy complications and infection It is common that HT victims have never had any sort of medical care, specifically preventative Poor access to barrier protection or other contraceptive HT victims have been forced to be sterilized HT victims can be forced to give birth childbirth or be forced to terminate a pregnancy [4]

I think that reproductive health in HT is important because it not only affects the person that was trafficked but also the child, if that is the outcome of a lack of preventative healthcare. Not to mention the effects of the illness that can come along with a lack of preventative health care, including abortion that could cause infection and take away a woman's ability to have another child. ~ T Stilwell

• Survivors who are vulnerable are made even more vulnerable when addicted to substances • Traffickers administer drugs to force someone to cooperate which may lead to addiction [5] • Mental and physical traumas associated with trafficking are dealt with by drug addiction • “...an anti-trafficking service provider in Maine found that 66 percent of its clients reported that substance use led to their being trafficked while only 4.5 percent reported that it arose after their being trafficked.” [1] • US sex trafficking survivors survey found that substances were used by 84.3% of survivors during their trafficking [1] • Same survey found that greater than 50% of survey participants used cocaine, alcohol, and marijuana, and heroin was used by close to 25% of the participants [1] • There is a link between US human trafficking and the opioid epidemic • Opioids are beneficial for traffickers to give to survivors, because they relieve their physical and emotional pain • Treatment centers for substance abuse have been areas where survivors have been taken for trafficking [1] • Survivor: “He made me believe that he cared and that he loved me, and he was going help get me off the streets.... Instead he got me addicted.... [The drugs] were all bought illegally for the purpose of addicting me and controlling me” [1]

Addiction

I think survivors with addiction problems need special treatment facilities where they can get help from professionals that communicate with other human trafficking survivors. Also, I think there should be more awareness brought to treatment centers for substance abuse about trafficking that may occur there. ~A Borici

Conclusion

The trauma experienced has a significant impact on mental well-being. Many times this can cause disorders such as PTSD or generalized anxiety. However, there is a flip side to the mental health aspect in that if someone seeks treatment from a physician and the person that brought them in claims they have a mental disorder and won't let the patient talk this can be a sign that there is HT going on.

The lack of access to preventative healthcare for HT victims is cause for breeding grounds of STI and STDs. The outcome of this for a woman specifically could take away her ability to bare children and start a family.

Addiction is a method that is used by the traffickers to make sure that the survivor will cooperate with them. In some cases, the survivors were substance abusers before being trafficked. The addiction problems of survivors of human trafficking is important to treat, in order to have productive citizens.

1.Stoklosa, Hanni, Marti MacGibbon, and Joseph Stoklosa. 2017. Human Trafficking, Mental Illness, and Addiction: Avoiding Diagnostic Overshadowing. AMA Journal of Ethics 19 (1): 23-34.

References

2. Ottisova L, Hemmings S, Howard L, Zimmerman C, Oram S. Prevalence and risk of violence and the mental, physical and sexual health problems associated with human trafficking: an updated systematic review. Epidemiology and Psychiatric Sciences. 2016;25(4):317- 341. doi:10.1017/s2045796016000135

3.Greenbaum J, Crawford-Jakubiak JE. Child Sex Trafficking and Commercial Sexual Exploitation: Health Care Needs of Victims. Pediatrics. 2015;135(3):566-574. doi:10.1542/peds.2014-4138

4. Bick, Debra, et al. “Maternity Care for Trafficked Women: Survivor Experiences and Clinicians’ Perspectives in the United Kingdom’s National Health Service.” Plos One, vol. 12, no. 11, 2017, doi:10.1371/journal.pone.0187856.