fear of other negative outcomes. Some trafficking survivors are deported by authorities, returned to their original country only to be re-trafficked by traffickers, repeating the trafficking cycle (De Vries & Pharrell, 2018; UNDOC, 2020). Detention may also include time spent in legal custody (e.g., prisons, deportation facilities) – a period of time when the person may be separated from the trafficker but not yet integrated back into society. While being detained, trafficked persons may be deprived of their basic needs, such as healthcare and sanitary living conditions, and may also face security concerns (Zimmerman & Kiss, 2017). When cooperating with authorities to prosecute traffickers, survivors may risk retaliation and re-traumatization as they recall harmful events that occurred during their trafficking. These stressors may contribute to existing health conditions from the trafficking, making integration/reintegration difficult and possibly influencing the survivor’s return to trafficking. Negative experiences with authorities may also limit trafficked individuals’ ability to report the crimes committed by their traffickers (De Vries & Pharrell, 2018; UNDOC, 2020). Integration/Reintegration When a person is able to leave a trafficker’s exploitation and is not detained, the integration/reintegration stage of the human trafficking process begins. Integration and reintegration are similar terms that both reflect the long- term process of a person either entering fully into the cultural, civil, and political life in their new country or returning in those same domains to their country of origin (UNDOC, 2018). The difference between integration and reintegration lies in the differences between trafficked persons who may wish to stay in their current location (integration) or return to their original home (reintegration). Integration/reintegration can include removal procedures, criminal prosecution (possibly for the trafficker and the survivor), and survivor services, such as T visas and U visas (see Resources). However, it is likely that the trafficked person will return to many of the same factors that led to his or her initial trafficking, such as poverty and/or abuse (Zimmerman & Kiss, 2017). Additionally, many new obstacles can impede reintegration/integration, including negative stigmas and discrimination. These could translate into difficulty finding employment, securing housing, and reconnecting with previously established relationships. Other obstacles may include remaining safety concerns and threat of retrafficking. Additionally, survivors may be living with health issues acquired during their time of being trafficked. Trafficking crimes and those at risk The demand for cheap agricultural labor, prostitution, fertility services, pornography, and other forced labor has perpetuated the trafficking. New programs and international laws have sought to prohibit human trafficking. In 2003, the United Nations developed regulations that defined trafficking and criminalized human trafficking beyond prostitution and included the exploitation of forced labor or services and even organ trafficking (UNDOC, 2020). The United States Victims of Trafficking and Violence Protection Act of 2000 (TVPA), officially made human trafficking a federal offense and provided initial legal definitions. The act also created the Office to Monitor and Combat Trafficking in Persons, which, along with the Department of State, publishes the Trafficking in Persons (TIP) Report annually (U.S. Department of State, 2019). By 2010, most states
The integration/reintegration process is considered complete when the individual believes he or she has been accepted by the community and included in its economic, cultural, and political aspects (Zimmerman & Kiss, 2017). Retrafficking Previously trafficked persons may find themselves exiting and re-entering the trafficking system at various stages of the cycle. This can occur for numerous reasons. In some cases, the trafficker may still be a part of their shared social groups and track the survivor in his or her daily movements (De Vries & Pharrell, 2018). The trafficker may even employ past recruitment techniques (e.g., substance use, threats, violence, intimacy) to regain control of the person. In other cases, the survivor may simply return to the same conditions that made him or her vulnerable initially. For example, the person may have limited economic opportunities or may now have increased debt due to health issues acquired while being trafficked. Additionally, while being trafficked a person may incur legal issues, incurring charges for illicit substance possession, illegal weapons used for protection, and other charges. These charges can lead to legal fees and additional stressors that may increase their risk of becoming trafficked. Other risk factors may be present as well, making these survivors susceptible to retrafficking (De Vries & Pharrell, 2018). CASE STUDY 1 Zelda, a 22-year-old nanny, was hired from Colombia to care for two toddlers for an affluent California family. She came to the United States on a Domestic Employee visa with promises of a good life and opportunities to advance her education by taking courses at the local community college. In reality, this was a 24/7 job consisting of cooking, cleaning, and childcare with no free time. Although she was provided room and board, she was expected to pay for all of her personal needs, clothing, and phone use. After fees for taxes were taken out by her employer, she took home less than $200 a month with no benefits or vacation. This abuse was compounded by sexual advances by her employer and frequent verbal hostilities from the children’s mother. Zelda was able to run away and ultimately turned to prostitution to support herself. Zelda’s case is an example of forced labor. She should be entitled to the same protections for safe working conditions and minimum wage standards as others employed in the United States. Although this was an abusive situation, she may have felt that she was trapped because she knew she must work as a nanny to fulfill her visa requirements. Tragically, this situation is not unusual. Once victims are removed from their native country and family support systems, they are essentially prisoners.
RISK FACTORS AND WARNING SIGNS
had passed laws with specific provisions against trafficking (Department of State, 2016). Reporting suspected human traffickers can be complicated by the fact that some victims know little or nothing about their perpetrators. In other cases, the trafficked person may not understand that they are being trafficked according to the law (De Vries & Pharrell, 2018). For example, with youth experiencing homelessness, they may become involved in survival sex, exchanging sexual favors for food, lodging, money for medication, and or illicit substances. Others may see their trafficker as a romantic partner or family member. With such varied experiences among trafficked individuals, it can be challenging for healthcare providers to recognize cases of trafficking. Having a clear comprehension of the definition of trafficking, as well as its scope, enables healthcare providers to more accurately identify and provide
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Book Code: MFL1227
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