Texas Physician Ebook Continuing Education

Human Trafficking and Exploitation: The Texas Requirement _______________________________________

In the United States, forced labor is predominantly found in five sectors [35]: • Prostitution and sex industry (46%) • Domestic servitude (27%) • Agriculture (10%)

social consequences [41]. Work that is exploitative for children has been defined as working long hours at a young age, work that is poorly compensated, and work that produces physical, social, and psychological stress that will hamper development, access to education, and self-esteem [42]. The ILO adds that child labor is work that “interferes with their schooling by: depriving them of the opportunity to attend school; oblig- ing them to leave school prematurely; or requiring them to attempt to combine school attendance with excessively long and heavy work” [40]. It is important to remember that child labor occurs in the United States. Runaway and homeless youths are at greatest risk, often lured by promises of work and housing [43]. The Polaris Project found that the top three forms of child labor trafficking in the United States were begging, peddling, and traveling sales crews [43]. CHILD CONSCRIPTION In some cases of trafficking, children are kidnapped and traf- ficked to serve as soldiers. Other times, children are coerced by a narrative indicating they will be serving a higher purpose and avenge the deaths of family and friends; this is known as comradeship [44; 45]. Some children are actively recruited and may be promised a small salary to “voluntarily” join. It is estimated that at any one time up to 300,000 children younger than 18 years of age are serving as child soldiers [46; 47]. Traffickers prefer to recruit children to serve as soldiers because they are inexpensive and more easily molded and shaped to comply and obey without question [48]. It can be difficult to comprehend the atrocities that these children wit- ness and experience [49; 50].

• Sweatshops and factories (5%) • Restaurant and hotel work (4%)

It is speculated that most of the forced labor occurs in California, Florida, New York, and Texas, all major routes for international travel [35]. Domestic servitude refers to a category of domestic workers (usually female) who work in forced labor as servants, house- keepers, maids, and/or caregivers, often in private homes. In some cases, young women are lured with the promise of a good education and work, and when they arrive in the United States, they are exploited economically, physically, and/or sexually. Their passports or identification papers are taken away, and they are told they have to pay off the debt incurred for their travel, processing fees, and any other bogus expenses. Because they do not speak English, they find they have no other recourse but to endure exploitative working conditions [36]. Unfortunately, as in many sectors of forced labor, there are no regulations to monitor the conditions under which domestic servants operate [35]. CHILD LABOR Child labor can be viewed as a specific form of bonded labor or forced labor. However, not all child laborers have been traf- ficked. Child labor is defined by International Labour Organi- zation (ILO) as economic labor performed by a child younger than 15 years of age or hazardous labor done by a child 18 years of age or younger. Child labor is deeply rooted in poverty and the infrastructure and political stability of the country as well as market forces [37]. The ILO estimates that there were 160 million child laborers in the world in 2020 (63 million girls and 97 million boys) [38]. This accounts for nearly one in ten of all children worldwide [38]. Between 2000 and 2020 there was a nearly 35% decrease in the number of children in child labor. The reduction was greater for girls than for boys . The number of children in child labor has increased from 2008 to 2020 in sub-Saharan Africa (from 65.1 million to 86.6 million), while it has declined in other parts of the world (e.g., Asia/the Pacific, Latin America/the Caribbean) [38]. The definition of child labor is controversial because the defi- nitions for “work” and “childhood” are ambiguous and often culturally defined [39]. On a conceptual level, work may be beneficial for the socialization and educational processes of children [39; 40]. So, it is important to differentiate between child work and child labor. Child work has been defined as activities that are supervised by an adult and that promote the development and growth of the child, while child labor does not benefit the child [37]. Many definitions of child labor cre- ate a dichotomy whereby child work is considered not harmful while child labor has negative emotional, intellectual, and

FACTORS THAT CONTRIBUTE TO VULNERABILITY TO HUMAN TRAFFICKING

INDIVIDUAL A variety of individual level factors may predispose an indi- vidual to human trafficking victimization. A history of physical, sexual, or emotional abuse and/or of witnessing violence in the home has been identified at increased rates among traf- ficking victims. Other possible risk factors include adherence to rigid gender roles, acceptance of norms supporting sexual exploitation of women and children, overestimation of prob- lem behavior in peers/others, lack of trafficking awareness, and substance abuse [51]. Adverse Childhood Experiences In more recent years, research has focused on the impact of adverse childhood experiences (ACEs) in general. ACEs are defined as potentially traumatic experiences that affect an individual during childhood (before 18 years of age) and increase the risk for future health and mental health problems (including increased engagement in risky behaviors) as adults

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MDTX1625

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