From the 16th to the 19th centuries, approximately 645,000 slaves were brought to what is now the United States.1 By the 1860 Census, the U.S. slave population grew to 4 million.2 The Emancipation proclamation and the 13th Constitutional Amendment of the mid 1860s were thought to have abolished slavery in the United States -- until the global recognition of human trafficking brought modern day slavery to light.
Human Trafficking Defined
The Trafficking Victims Protection Act of 2000 provides for protection of victims, prosecution of traffickers, and international prevention strategies to address this crime. This law defines trafficking as any commercial sex act induced by force, fraud, or coercion; or, in which the person induced to perform acts is not 18 years old. The definition also includes recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through use of force, fraud, or coercion, for the purpose of involuntary servitude, debt bondage, or slavery.3
Modern Day Slavery
Of the 600,000 to 800,000 people coerced or forced into crossing international borders each year, about 14,500 to 17,500 end up in the United States. Millions more are internally trafficked within the borders of their own countries.4
Threat to Communities
After drug dealing, human trafficking is tied with the illegal arms industry as the second largest criminal industry in the world today, and it is the fastest-growing.5 Many of the world’s major sex traffickers may be connected to organized crime groups, who may use the profits to fund other criminal activities. This may equate to more drugs, crime and terrorism in our communities.
Identifying and Protecting Trafficking Victims
The Department of Health and Human Services’ Office of Refugee Resettlement (ORR) “certifies” trafficking victims for eligibility to receive the same rights and benefits as refugees. These include social service systems under the Medicaid program, including health care. Nongovernmental organizations provide shelter, clothes, food, psychological services and immigration services. Since 2004, there have been 1,175 certified victims of human trafficking from 77 countries.6
Health Implications
Human trafficking is a global public health issue. Health issues are ignored until they are critical or life-threatening. Dirty and crowded living conditions, coupled with poor nutrition, cause health conditions such as scabies, tuberculosis and other communicable diseases.
Chronic back, hearing and vision problems may occur from working in dangerous agriculture, sweatshop or construction conditions. Long-term untreated issues such as cardiovascular or respiratory problems, diabetes or cancer may be present. Bruises, scars and other signs of physical abuse and torture may be visible.7
Sexually transmitted infections, human papillomavirus, pelvic inflammatory disease, permanent damage to reproductive organs, and HIV/AIDS are often the result of forced prostitution.8,9 Victims may be coerced, or in desperation to escape their pain, willingly succumb to drug use.10
Victims of trafficking often endure brutal conditions that may result in psychological trauma, such as anxiety, depression, sleep disorders, and post-traumatic stress disorder, disorientation, confusion, phobias and panic attacks. They may suffer feelings of helplessness, shame, humiliation, denial, disbelief or culture shock from being in a strange country.11
Malnourishment may be present especially in child victims, as are dental issues. Additionally, children denied social, moral and spiritual development may suffer growth and developmental problems.12
Public Health’s Role
In public health, the identification, support and service coordination for victims of sexual and domestic violence has made significant progress. In Florida, public, private and nonprofit agencies on state and community levels work together to establish protocol and build infrastructure to ensure comprehensive care is provided to each victim. This same effort is needed in public health for the identification and support of victims of trafficking.
Create and maintain awareness
Consider who may be victims working in restaurants, hotels, tourism; or panhandling. Incorporate health and human trafficking information into existing programs, policies, education and curricula. Display and distribute trafficking awareness resources, including Rescue & Restore materials found at www.acf.hhs.gov/trafficking. Free posters, brochures, fact sheets and cards are available in several languages and include tips on identifying victims.
Take action
If you think you have identified a trafficking victim, call the National Human Trafficking Resource Center at (888) 373-7888. The hotline has assisted more than 4,000 callers in determining if a person is a trafficking victim, and finding local resources to help victims.13
Conclusion
Trafficking denies women, children and men basic freedom. Trafficking robs communities of potential productive members of society,and exposes victims to violence, injury, disease and death. Trafficking is a detriment to public health, both economically and in the potential for widespread health issues.
References
1. Slavery in America: An Educators Site, New York Life (http://www.slaveryinamerica.org/)
2. Population of the United States in 1860, compiled from the original returns of the eighth census, under the Direction of the Secretary Interior, by Joseph C. G. Kennedy, Bureau of Census Library, Government Printing Office, 1864 (http://www2.census.gov/prod2/decennial/documents/1860a-15.pdf)
3. Trafficking Victims Protection Act of 2000 (TVPA), Public Law 106-386 22 United States Code, § 7102(8)
4. Attorney General’s Annual Report to Congress on U.S. Government Activities to Combat Trafficking in Persons Fiscal Year 2006 (released May 2007), (http://www.usdoj.gov/ag/annualreports/tr2006/agreporthumantrafficing2006.pdf)
5. Campaign to Rescue and Restore Human Trafficking: Human Trafficking Fact Sheet (January 2008), US Department of Health & Human Services, Administration of Children & Families, (http://www.acf.hhs.gov/trafficking/about/fact_human.html)
6. Attorney General’s Annual Report to Congress on U.S. Government Activities to Combat Trafficking in Persons Fiscal Year 2006 (released May 2007)
7. Campaign to Rescue and Restore Human Trafficking: Common Health Issues Seen in Human Trafficking Victims Fact Sheet (October 2007), US Department of Health & Human Services, Administration of Children & Families, (http://www.acf.hhs.gov/trafficking/campaign_kits/tool_kit_health/health_problems.pdf)
8. Stolen Smiles: The physical and psychological health consequences of women and adolescents trafficked in Europe, Cathy Zimmerman, Mazeda Hossain, Kate Yun, Brenda Roche, Linda Morison and Charlotte Watts. London School of Hygiene and Tropical Medicine (LSHTM), 2006, http://www.lshtm.ac.uk/genderviolence/recent.htm
9. Health Consequences of Trafficking in Persons Fact Sheet (August 2007), US Department of State Office to Monitor and Combat Trafficking in Persons (TIP), (http://www.state.gov/documents/organization/91537.pdf)
10. Campaign to Rescue and Restore Human Trafficking: Common Health Issues Seen in Human Trafficking Victims Fact Sheet (October 2007), US Department of Health & Human Services, Administration of Children & Families, (http://www.acf.hhs.gov/trafficking/campaign_kits/tool_kit_health/health_problems.pdf)
11. Stolen Smiles: The physical and psychological health consequences of women and adolescents trafficked in Europe, C. Zimmerman, M. Hossain, K. Yun, B. Roche, L. Morison, C. Watts, LSHTM, 2006
12. Campaign to Rescue and Restore Human Trafficking: Child Victims in Human Trafficking Fact Sheet (November 2004), US Department of Health & Human Services, Administration of Children & Families, (http://www.acf.hhs.gov/trafficking/campaign_kits/tool_kit_social/child_victims.pdf)
13. Attorney General’s Annual Report to Congress on U.S. Government Activities to Combat Trafficking in Persons Fiscal Year 2006 (released May 2007)
By Florida Surgeon General Ana M. Viamonte Ros, MD, MPH, and Rhonda Thomas-Poppell, Government Operations Consultant