Health at Risk: Health Implications of Human Trafficking in the Context of Globalization and Migration
Human trafficking affects approximately 40.3 million people worldwide, and has come to be known as ‘modern slavery’ (Zimmerman & Kiss, 2017). It is defined by the United Nations (2000) as the recruitment, transport, transfer, harbouring, or receipt of persons by coercive means (such as force, abduction, fraud) for the purpose of exploitation. International and national policies driving globalization have facilitated the flow of goods, services, ideas, and people across and within borders. The resulting interconnectedness between people and nations has concurrently exacerbated the illicit trade of persons in the form of human trafficking and labour exploitation (Kavinya, 2014., Zimmerman & Kiss, 2017). The interdependence of immigration and globalization has been apparent in human history. However, growing economic demands have accelerated migration rates and the global scope of immigration in recent years (Ciariene & Kumpikaite, 2008). Research on globalization and migration has not sufficiently delved into how the pre-existing and post-trafficking vulnerability of immigrants makes them susceptible to exploitation, leading to adverse health outcomes.
This article will examine the economic drivers of human trafficking, its impact on physical and mental health, the challenges with victim return and reintegration into society, and how future policies and governance could address the issue. We argue that human trafficking is a product of poverty and a response to changing economic and social dynamics due to globalization. It is crucial to understand the driving mechanisms behind human trafficking in a time when growing economies seek cheap labour and individuals stricken by poverty seek the prospect of a better life.
Human trafficking has been called “one of the dark sides of globalization” (Cho, Dreher, & Neumayer, 2014). Economic globalization has led to an increase of international trade flow of goods and services, extending to the forcible trade of humans (Hall & Lawson, 2014., Heller, 2016). It has been argued that an increased demand for cheap labour is the main driving force of human trafficking, as companies in wealthy countries desire cheap labour to produce goods for consumers. However, research does not support the notion that increased economic power is directly correlated with increased human trafficking. In fact, evidence suggests that wealthy countries are more likely to enforce anti-human trafficking policies (Heller, 2016).
The primary driver of human trafficking is global economic neoliberalism, which reinforces global inequality and economic hierarchies (Regilme Jr, 2014). Neoliberalism, understood as free-market economic policy, “makes wreckage of efforts at democratic sovereignty or economic self-direction” in the Global South (Brown, 2006. pp. 691), and increases income inequality in Organization for Economic Co-operation and Development (OECD) countries (Regilme Jr, 2014. pp. 283). In this sense, neoliberalism acts as a distal force behind the economic drivers of human trafficking. Impoverished individuals who are not the beneficiaries of neoliberalist policies are increasingly desperate for income to fulfill their basic needs, and are therefore more susceptible to exploitation (Brown, 2006). Exploited individuals are consequently at greater risk of multidimensional oppressions resulting in adverse health outcomes (Zimmerman & Kiss, 2017).
Physical Threats to Health
The literature on human trafficking centers around the idea that women and children are the most affected groups. However, it is important to realize that the crime also affects men and boys. Trafficked individuals are involved in a wide array of occupations. It is common to think of sex trafficking, but it is important to understand the other industries that may use trafficked labour, such as food packaging, chemical manufacturers, slaughterhouses, and construction (Turner-Moss et al., 2014). This means that trafficking can cause a wide range of symptoms. Human trafficking affects every system of the body. For example, some of the most common physical symptoms recorded by trafficked women who were returning to their home in Moldova include: headaches, stomach pain, memory problems, back pain, lack of appetite, and tooth pain (Oram et al., 2012). When including a study on male victims, symptoms such as fatigue and vision loss were added to the list (Turner-Moss et al., 2014).
Many of these symptoms are associated with occupational hazards. Occupational hazards not only include close proximity to dangerous chemicals or contagious diseases, they also include physical violence. In fact, a study in the United Kingdom found that trafficked workers reported high rates of being hit or kicked intentionally, being hurt with a gun or a knife, and even intentionally burned (Turner-Moss et al., 2014). These disturbing images help create a realistic picture of how trafficked workers experience their day-to-day lives.
While the working conditions of trafficked victims are unsafe, it is important to understand that the working conditions are not the only cause for concern: it is often the employers themselves who are a form of occupational hazard. Other than abuse from superiors in the workplace, there is also limited access to healthcare and limited, if any, safety measures in place. The concealed identity and vulnerability of trafficked workers deprioritizes their needs (Richards, 2014).
As a competitive global market has made for power imbalances, human health is being devalued to an afterthought while revenues and profits remain at the forefront. The physical health of trafficked individuals is being compromised as their worth is being placed in their productivity, as opposed to their well being.
Threats to Mental Health
Survivors of human trafficking commonly experience mental health disorders including anxiety, mood, and dissociative disorders. Post-traumatic stress disorder (PTSD) is the most prevalent disorder amongst trafficked individuals (Pascual-Leone et al., 2016). Osterovschi et al. (2011) observed that around 48% of Moldavian women who have returned to Moldova after being trafficked are diagnosed with PTSD within one to five days after their return. They experience symptoms such as recurrent thoughts/memories of terrifying events, difficulty sleeping, feeling detached/withdrawn, guardedness, and feeling hopelessness. Another relatively undiscussed condition is Stockholm Syndrome. Stockholm Syndrome is a condition arising from captors inducing extreme terror into their victims, rendering them powerless with no means of escape (Adorjan et al., 2012). Victims often develop positive feelings towards their captors, and negative feelings towards the police (Adorjan et al., 2012). Due to the nature of trafficking this condition is difficult to assess and relatively undocumented or discussed in any qualitative or quantitative research. Nevertheless, it is possible to draw parallels between trafficked victims and hostages, since victims in both situations are taken against their will.
Individuals may develop mental illness prior to their trafficking experience (Pascual-Leone et al., 2016). Individuals who suffer from pre-trafficking mental illness often experienced other forms of violence, such as war or domestic disputes (Pascual-Leone et al., 2016). These individuals were initially in a vulnerable position and were therefore susceptible to human trafficking and exploitation. If individuals develop mental illness during trafficking, they likely do not have the ability to access or afford counselling and mental health services (especially in the cases where victims of trafficking were already financially strained). Furthermore, victims may not have the ability to improve their socioeconomic status after being trafficked. This is especially pertinent with regards to perpetuating a cycle of re-trafficking, given the fact that many victims become trafficked due to desperation and poverty (Adams, 2011).
Return and Reintegration of Human Trafficking Migrants
The return and reintegration of victims is perhaps the least understood phase of trafficking, as this transition is mediated by many interacting factors. The health implications and trauma associated with one’s trafficking experience persists even if victims return to their countries of origin. Additionally, the process and conditions under which a victim returns to their country significantly affect their overall well being. Although reintegration facilities offer immediate support, their inability to provide long-term care makes victims of trafficking susceptible to re-trafficking. The lack of research on the causes of re-trafficking and poor reintegration programs supports the need for a deeper understanding of the influence of poverty and inequality on victims, the gaps in current guidelines and action plans, and the structure of anti-trafficking policies. As the need to curtail the re-trafficking cycle in vulnerable populations is urgent, countries with high trafficking rates must alter their migration and reintegration policies by adopting valuable lessons from anti-trafficking pilot projects.
Moving Forward: Preventing and Eliminating Human Trafficking
To end human trafficking, efforts need to be made to address the root causes of the crime. Here, we lay out a framework for potential policies and interventions that can reduce, and potentially eliminate, all forms of human trafficking. Addressing poverty, poor education, high unemployment, and political instability could reduce human trafficking (United Nations General Assembly, 2000). Most human trafficking occurs with a flow of migrants from poorer, less developed nations to wealthier nations (Adams, 2011). Governments of ‘source’ countries should therefore prioritize providing their citizens with opportunities for prosperity in their own nations. A focus on sustainable development, and promoting the sustainable use of resources could help to create more employment opportunities. Additionally, investments in education can give youth the skills to obtain jobs and break cycles of poverty. Financial desperation is a key component of how victims of human trafficking find themselves being exploited (Adams, 2011); addressing poverty is an effective way of preventing human traffickers from capitalizing on an individual’s low socioeconomic status.
Moving Towards Human Rights-Based Policies and Interventions
An international problem requires international cooperation and governance. International policies, such as the United Nations Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Girls (commonly referred to as the Palermo Protocol) and regional policies, such as the Council of Europe’s Convention on Action Against Trafficking in Human Beings, emphasize a human rights-based approach (Adams, 2011). This approach places the primary focus on successful reintegration into society through providing access to physical and mental health services, such as healthcare and counselling. Many state policies, however, focus on criminal justice and punishing the trafficker, with only a secondary focus on helping the victim (Adams, 2011). In order to have policies and interventions that effectively reduce human trafficking, these policies should change to emphasize human rights, putting the victim’s wellbeing and recovery first, and criminal justice second.
International Advanced Anti-Money Laundering Techniques
Human trafficking is a lucrative crime, with estimated annual proceeds of $32 billion (Adams, 2011). In order for the funds of crime to be useful, they must be “cleaned” whereby the origins of criminal proceeds are masked, making funds appear legitimate; a process called money laundering. Therefore, an effective way to prevent human trafficking is to remove the ability to “clean” criminal proceeds, rendering the funds of human trafficking virtually useless. This can be accomplished through stricter, more advanced anti-money laundering (AML) procedures internationally, across all financial institutions and higher risk sectors, including real estate and casinos. Currently, AML procedures can be slow, inefficient, and costly, with an estimated $50 billion spent each year to detect less than 1% of laundered funds (Barefoot, 2018). Advances in modern technology, such as machine learning and artificial intelligence, could facilitate more advanced detection of money laundering, including predictive models to trace origin funds, while substantially reducing these costs (Barefoot, 2018).
In addition to the implementation of advanced technologies to predict, detect, and prevent money laundering, more open system-to-system collaboration between financial institutions, higher risk sectors such as real estate, and law enforcement is required. Currently, communication and collaboration between financial institutions and law enforcement regarding money launderers is siloed, with linear reporting channels that hinder the ability to prevent money laundering in real time (Barefoot, 2018). Moving forward, financial institutions and law enforcement need to have real time reporting with system-to-system collaboration, so that law enforcement officials can keep up with the rapid flow of laundered funds and ever evolving fund concealment schemes (Barefoot, 2018). New AML processes, including greater collaboration, real time reporting, and the implementation of advanced technologies, can facilitate greater detection of laundered funds while simultaneously reducing the costs associated with detection, thereby removing the financial incentive of human trafficking.
Conclusion
The link between globalization, migration, and human trafficking is apparent. The trans-national flow of goods, services, and people has made it easier for perpetrators of human trafficking to transport victims across borders. The search for better economic opportunities in impoverished populations makes these populations vulnerable to trafficking. Trafficking victims with compromised physical and mental health continue to face obstacles even if they manage to return to their country of origin. The subsequent cycle of re-trafficking is largely dependent on the lack of availability of economic, educational, and social support. This has raised an important topic among researchers: will tighter border controls and migration policies curtail trafficking rates, or do policies need to address influences of illiteracy, poor economic opportunities, corruption, and poor government infrastructure as the root causes of trafficking? Overall, more research is needed to effectively evaluate the ways in which neoliberal political agendas drive national and international policy, creating the conditions for human exploitation.
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