HUMAN TRAFFICKING AND HUMANCONSEQUENCES

Most vulnerable groups fortrafficking:

Children and young adults,particularly females

Children from rural and urban areasand the streets.

Children sexually abused. Children to adults in search ofjobs.

Victims of previous trafficking From disempowered background andcountries with economic and socialdifficulties.

Where debts are owed From ethnic minority groupssubjected to discrimination in thecountry of origin.

From countries having significantgender inequalities.

From countries where conflicts areongoing or recent/armed conflictareas.

Displacement of families as aresult of ethnic clashes withintheir country.

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Environmental degradation Abuse of office and power From areas when the authorities,especially law enforcementofficials, are involved in thetrafficking of the person

From countries/areas where thereexists corruption among highlyplaced individuals in the society.

Refugees or displaces persons. Few safe and legal avenues formigration Lack of skills andtraining.

Lack of appropriate employmentopportunities lack of safemigration

Trafficked Persons are ParticularlyVulnerable to Health risks:

Initially from a disempoweredbackground

Coercive and stressful nature oftheir mobility (violence,deception, coercion, abuse, etc.)

Nature of the activities for whichthey are exploited (e.g. forcedlabour, sexual exploitation)

Stigma and isolation upon return

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Physical, psychological and sexualviolation

Abusive living/working conditions Limited/no access to healthservices

Exposure to disease. Women areparticularly vulnerable toreproductive and other gender-specific health problems.

Extreme cases similar to victims oftorture and inter-personal violence

Psychological problems,particularly depression and PTSD

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Most trafficked people will notwillingly go the authorities forprotection because of:

Fear of identification by foreignauthorities and deportation orincarceration

Fear of reprisal from traffickers,employer, etc. and possibly ongoingcontrol by them

Fears of being returned to familyof origin, who may have beeninvolved n the trafficking

Feelings of shame and of reprisalor punishment by family orcommunity

Fear of legal authority working incollusion with trafficker

Fear of reprisal by home countryauthority

Fear that it is their fault andhave committed a crime

Fear they will put their loved onesin danger

Pressure to support their families Do not identify themselves asvictims but as having had bad luck.

Identification with the trafficker

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Fears of returning to pastcontinuing economic difficultiesand lack of supports and/oremployment opportunities at home

Are vulnerable to extreme stressreactions once out of the situationand have relinquished previouspsychological survival mechanisms

Failure to recognise or namecertain types of episodes orviolence

Have normalised or minimised theviolence in their lives

Find that talking about theexperience is to relive it

Believe services available orimmigration status depends on theinterview so may say what they feelis in their best interest

Difficult, particularly for women,to quantify and rate frequency ofoccurrences of violence

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Failure to recognise or namecertain types of episodes ofviolence

Have normalised or minimised theviolence

Have become accustomed to lowlevels of violence or certain formsof repeated abuse on a daily basis

Shame in talking about what theywere subjected to

Under the effects of trauma – PTSD.

Trauma can affect a person’s wholebeing – psychologically,physically/medially, behavioural andsocially. It can also impair memoryand the perceptions of the event. Mostpeople recover from trauma withinmonths following the event. Recurrenttrauma, however will affect recoveryand this will be delayed till afterthe traumatic experiences have ended.Without professional assistance, somewill proceed to develop PosttraumaticStress Disorder (PTSD)

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Anyone can develop PTSD following atraumatic event but people are atgreater risk if:

The event involved physical orsexual assault

They have had repeated traumaticexperiences such as sexual abuse orliving in a war zone

Trafficked or forced migration Have prior vulnerability factors,e.g. genetics, early age onset andlonger-lasting childhood traumas,lack of functional social supportand concurrent stressful lifeevents

From a social environment thatproduces shame, guilt,stigmatisation or self-hatred

Those who report greater perceivedthreat or danger, suffering, upset,terror and horror or fear

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Girls, women and parents are moreaffected for events involvinguncertain threats

Having a neurotic personality Having suffered from PTSD in thepast.

PTSD can affect a person’s ability towork, perform day-to-day activities orrelate to their family and friends. Aperson with PTSD can often seemdisinterested or distant as they trynot to think or feel in order to blockout painful memories. They may stopparticipating in family and sociallife, ignore offers of help or becomeirritable. This can lead to loved onesfeeling and friends shutting out.

Signs and symptoms Reliving the traumatic event. Being overly alert or ‘wound up’ Avoiding reminders of the event andfeeling emotionally numb

People with PTSD can also have“depersonalisation”, which makes themsee the experience as happening tosomeone else. Others experience

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‘dissociation”, which is characterisedby statements such as:

‘It was as though I wasn’t eventhere.’

‘Time was standing still.’ ‘I felt like I was watching thingshappen from above.’

‘I can’t remember most of whathappened.’

In some extreme cases of ongoingtraumatic abuse some children willcope with it by developing IdentityPersonality Disorder.

Up to 80 per cent of people who havelong-standing PTSD develop additionalproblems, most commonly depression andanxiety. Many also start misusingalcohol or drugs as a way of coping.

Because of the reactions to traumapeople may not remember events or keyfactors and some will deny it evenoccurred or keep changing theirstories (could be due to increaserecall of the events once they feelsafe, yet it is usually considered as

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fabrications and person loosescredibility as a witness).

Trying to interrogate or providecounselling may bring forth apathy,hostility or avoidance. Thesebehaviours create difficulties forlegal officers investigating the caseand for health professionals trying toassist with the trauma. In some cases,because of the lack of symptoms orbehaviours victims give the appearancethat either nothing happened or thatthey gave consent to the situation andmay also be seen as reluctant tocooperate.

Common Reactions to Trauma

Fear and anxietyTriggers or cues

Re-experiencing of the trauma

Changes in sleeping patterns and alertnessNightmares

Increased arousal

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Avoidance

Anger

Guilt andsShame

Grief and depression

Negative self-concept

Impaired sexual relationships

Use of alcohol or other substances

Understanding common reactionsThe way a person reacts to trauma willdepend on many things, such as thetype and severity of the event, thesupport the person has, other stressesin their lives, their personality andtheir ability to cope. Common

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reactions include a range of physical,cognitive (thinking), emotional andbehavioural factors. These reactionsare normal and show how the event hasaffected the person.

Physical reactions: Fatigue or exhaustion Disturbed sleep Nausea Severe sleep difficulties Nightmares Flashbacks Restlessness Constant agitation and looking outfor danger

Headaches Gastrointestinal complaints Immune system problems Dizziness Chest pain Discomfort to various parts of thebody

Feeling shaky and sweaty Having heart pound or havingtrouble breathing

Excessive alertness and beingeasily startled.

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Thinking reactions: Poor concentration Poor attention and memory Visual images of the event Intrusive thoughts Disorientation Confusion Trouble concentrating or thinking Cognitive impairment

Emotional reactions: Fear Feeling empty, numb and detached Avoidance Getting upset when reminded of thetrauma

Depression Guilt Oversensitivity Constantly on edge or irritable Anxiety and panic Anger or aggressive feelings – needto self-defend

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Feeling mentally drained Withdrawal and tearfulness.

Behavioural reactions: Avoiding reminders of the event Inability to stop focusing on it Getting immersed in working forrecovery

Losing touch with normal routines Losing time – not knowing where thetime went

Difficulty doing anything exceptfamiliar routines

Alcohol and drug abuse Gambling Infringement of the law

Help for victim should be soughtwhen the person:

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Is unable to handle the intensefeelings or physical sensations

Doesn’t have normal feelings butcontinues to feel numb and empty

Continues to have physical stresssymptoms

Continues to have disturbed sleepor nightmares

Lacks adequate social/familialsupport

Stress and anxietycontinues/escalates

Are thinking of hurting themselves,hurting others or ending theirlives

Stress is impacting on theirability to work or study

Stress is impacting theirrelationships and day-to-day life.

Coping/survival strategies oftrafficked/long term victims

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Victims of long-termabuse/exploitation/systematicviolence over a period of time maybelieve that they may not survivethe abuse and thus may use a varietyof coping mechanisms to survive.Because of the ongoing, consistentpatterns of abuse, in a coerciverelationship, the victim slowlyadapts to the situation. Theirbehaviours change according to whatthey believe may reduce abusivesituations.

Some strategies are:

Identifying with the aggressor:

Avoidance of the abusive experience

Avoidance of the memory

Numbing

Apathy

Dissociation

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Taking responsibility for theirsituation

Recovering from traumaRecuperating from the trauma oftrafficking is a complex, long termprocess that will require theintervention of highly specialisedprofessionals. Trafficked people willalways have some of the effects of theconsequences of trauma (e.g. inabilityfor desired career because of lack ofeducation from childhood/illiteracy),but with specialised help can attain ameaningful and productive life. Notreceiving professional treatment willincur in permanent and severepsychological and possibly medicaldamage. The following general tips mayhelp recovery from trauma:

Recognise that they have been through adistressing experience.

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Accept that they will feel bad for atime but that it will also eventuallypass.

Remind themselves daily that they arecoping – don’t be angry when they getupset.

Avoid making major decisions or biglife changes until they feel better.

Don’t bottle up feelings – talk tosomeone who can support and understandthem.

Try to keep a normal routine and staybusy.

When they feel exhausted, make surethey set aside time to rest.

Make time for regular exercise; ithelps cleanse body and mind of tension.

Relax – use relaxation techniques suchas yoga or do things they enjoy likelistening to music.

When the trauma brings up memories orfeelings, try to confront them.

Help the acquire skills in gaining selfefficacy and mastery of situations.

Seek professional help. Renew a good supporting social system.

In the process of recovery, fourstages can be identified that thevictim goes through:

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Hostility towards those that carefor them, particularly lawenforcers

Loss of orientation

Reconstruction and remembering

Social re-integration

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Implications for Interviewers andInvestigators when dealing withvictims of trauma suffering from PTSD:There are various effects/symptomsexperienced by victims of trauma thatwill make it difficult forprofessionals to assist or interviewthem, even when they agree to bewitnesses. Some of these may be:

Altered sense of time and lack ofmemory of the event, due to loss ofmemory or dissociation. This willcause:o Inability to tell their storyo Gaps in their storyo Changes in the story, withtime, as memory is recovered

Denial of the trafficking, evenwith evidence of its occurrencebecause of:o Identification with theaggressor

o Dissociation

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o Fear of retribution from theabuser (to self or loved ones)

o Feelings of guilt Inconsistent and contradictorystatements, due too Impaired memory and need tofill in gaps

o Changes in the story, withtime, as memory is recovered

The above symptoms will make itdifficult to firstly, identify thevictim and secondly, decide if theperson has the capacity for and isable to give informed consent, makewell informed decisions and cooperatewith the legal system or the healthprofessional.

Procedures and Approaches WhenRelating With Victims of Trafficking:

Firstly, it is important to adopt anappropriate, safe and ethicalprocedure. The timing of the interviewis important. The longer the timebetween the trafficked person’scontact with the trafficker and the

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interview, the more likely the personwill feel safe to disclose.

1. There are four stages for theinterview:

2. Selection of the interviewer

3. Identifying time and place forthe interview

4. Conducting the interview

5. Ongoing observations of safety

6. Closing the interview

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Interview Approaches

1. Be well informed about theperson you are interviewing and beaware of the symptoms

2. Gather information to determinetheir immediate needs and concerns.

3. Begin simply, with anintroduction saying you are thereto help and listen

4. Establish their trust beforeexpecting them to trust you

5. Let the person lead

6. Ask questions that follow theperson’s narrative

7. Always work with permission

8. Create space for the person tomove into discussing moreemotionally difficult material

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9. Do no harm - Ensure the victimis safe and protected

10. Be prepared for an emergencyintervention

11. Be culturally sensitive

12. Ensure anonymity andconfidentiality as much as possible

13. Get informed consent and adviceof “rights” before attempting theinterview

14. Initiate contact and engage ina non-intrusive, compassionate andhelpful manner

15. Listen to their story andbelieve them

16. Pay attention to their feelingsand allow their expression

17. Lead away from emotionallypainful material if the clientseems overwhelmed

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18. Make them feel accepted – benon-judgmental in your approach –be neutral

19. Reflect what you hear and see

20. Do not re-traumatise the person

21. Do not make promises that youcannot keep

22. Ensure they are provided withstability and ongoing safety

23. Provide them with informationon the effects and symptoms oftrauma

24. Empathise

25. Keep constant vigilance

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26. Respect their boundaries

27. Make it known to them that theycan leave if they want

28. Do not touch them if they donot want to be

29. Focus on body sensations

30. Help them recognize and developtheir resources

31. Face complex situations inproviding safe, appropriate care.

32. Do not enhance trauma or re-traumatise

33. Keep them informed

34. Have an impartialorganisation/professional do a riskassessment and help facilitatetheir safe return

35. Put the information collectedto good use

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The Well Being of theInterviewer/Worker

Interviewing and working with victimscan be emotionally stressful and mayalso put them in danger from thoseinvolved in the trafficking. They mayexperience some trauma symptoms, suchas anxiety, distress, helplessness andas well as physical ones. Thesesymptoms could be aggravated if theprofessional has had personaltraumatic experiences that are revivedby the victim’s stories, even if theythink they may have dealt successfullywith them in the past. This may causefailure to be sensitive to and respondto the victim’s needs. In somesituations it may bring feelings ofwanting to be the victim’s saviour andmake unrealistic promises. It is

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important that they are supported andsupervised through these experiences.Interviewers should feel: They have received appropriate trainingand information.

They are aware of their capabilities andlimitations and are free to bring themout and seek help as needed.

The location is safe. If location not considered safe, ensurethere is outside support contact that isaware of the time, etc. of the interviewor have someone standing nearby. Contactwith the support person should bearranged immediately after the interview.

If victim has information that may putthe interviewer in danger (e.g. aboutcorrupt officials), tactfully dissuadeperson from telling their story until theappropriate officer is present.

Have access to regular supervision andongoing support as needed.

Treatments for PTSDThe cornerstone of treatment for PTSDinvolves accepting the traumaticmemory and working through thoughts

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and beliefs associated with theexperience. Trauma-focussed treatmentscan:

Reduce PTSD symptoms Lessen anxiety and depression Improve a person’s quality of life. They are also effective for peoplewho have experienced prolonged orrepeated traumatic events, but moretime may be needed.

Available Interventions or PTSD: Cognitive models of posttraumaticstress disorder (PTSD).

Cognitive-behavioural therapy Eye-movement desensitization and reprocessing

Group therapy . Exposure therapy Joint EMDR-Solution focused Pharmacotherapy Other Medications can also be usedfor depression and anxiety.

Who can help: A General Practitioner with trauma experience

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A mental health specialist, such asa psychiatrist, psychologist or social worker, with experience in PTSD

The local community health centre

The difference between post-traumaticstress and PTSD:The difference between post-traumaticstress and PTSD is in the symptoms.Post-traumatic stress may include somePTSD symptoms such as nightmares andflashbacks, but it can also includedepression, eating disorders, heavydrinking, and gambling. These are notnormally symptoms of PTSD.

Post-traumatic stress symptoms areusually short-lived – but if you don’tdeal with them, the symptoms couldprogress to PTSD.

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SummaryMany trafficked individuals aredeceived with promises of good jobs,marriage or education opportunitieswith a small percentage reportingforced recruitment. Trafficking aswell as re-trafficking occurs within acomplex array of interacting economic,social, cultural and psychological

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factors. The ramifications of atrafficking experience are far-reaching and the effects of havingbeen trafficked often continue afterexit and/or upon return to the countryof origin. Physically exiting atrafficking situation does not alwaysequate to escaping the ramificationsof having been exploited. The controlmechanisms involved in trafficking donot necessarily end at exit and/orescape from a trafficking situation,as trafficker(s) may still exertcontrol over the victim throughthreats and/or “debts” owed. Moreover,when trafficked persons return to thesame socio-economic situation thatcontributed to their trafficking inthe first instance, they arepotentially vulnerable to furthertrafficking harm. Other difficultieson return, such as “debts owed”,stigma of having been trafficked,ongoing threats to family, poverty andinability to find jobs in the countryof destination may cause re-trafficking. Re-trafficking may alsooccur because a trafficked person is

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not able to access the necessary helpand assistance in the country ofdestination, or before he/she is ableto get such help. The samecircumstances that rendered the personvulnerable to trafficking in the firstinstance may remain, making themvulnerable to re-trafficking. Withoutmedical, psychological or psychiatricsupport the trauma of being traffickedwill continue to have permanenteffects and debilitating outcomes inall areas of life

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