Integration/reintegration When a person is able to leave a trafficker’s exploitation (and is no longer detained or never 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 his or her new country or returning in those same domains to his or her country of origin (Zimmerman et al., 2011). 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). Unfortunately, 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 et al., 2011). Additionally, many new obstacles can prevent (re)integration; stigmas and the continuation of preceding factors make retrafficking prevalent among survivors. 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 et al., 2011). Retrafficking Previously trafficked persons may find themselves exiting and re-entering the trafficking system at various stages of the cycle (Zimmerman et al., 2011). This can occur for a number of reasons. In some cases, the trafficker may still be nearby and may track the survivor in his or her daily movements (Jobe, 2010). 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. and occasionally providing indulgences. Table 1 connects these methods to their purpose. Other tactics traffickers use to control others psychologically include threats, degradation, and enforcement of trivial demands.
natural disaster, stops them. Upon leaving the exploitation, the trafficked person becomes a survivor – an empowering term used to describe trafficked persons who have escaped trafficking, either temporarily or permanently. Survivors may or may not enter the next state of the human trafficking process: detention. Detention is the stage during which trafficking survivors are in custody or engaged in closely guarded collaboration with state authorities, such as law enforcement (Zimmerman et al., 2011). Not everyone who is trafficked is detained, however. For those who are, detention plays an integral part in shaping survivors’ experiences and influencing their outcomes (Zimmerman et al., 2011). A person might be held on charges of illegal immigration, prostitution, or other crimes and be unable to implicate his or her trafficker for fear of safety, because of the person’s legal status, or for fear of other negative outcomes. Some trafficking survivors are deported by authorities, returned to their original country only to be retrafficked by traffickers, repeating the trafficking cycle (Jobe, 2010). 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. When cooperating with authorities in prosecuting traffickers, survivors may risk retaliation and retraumatization as they recall harmful events that occurred during their trafficking. These stressors may contribute to existing health conditions from the trafficking, making (re)integration 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 (Jobe, 2010). Psychological methods used in human trafficking Traffickers use numerous psychological methods to manipulate individuals and maintain their compliance (Baldwin et al., 2014). Such methods of coercion include isolating the person, monopolizing perception, inducing debility and exhaustion, Table 1: Human Trafficking Health Risks and Consequences Health Risks
Potential Consequences
Physical abuse, deprivation.
Physical health problems, including death, contusions, cuts, burns, broken bones. Mental health problems, including suicidal ideation and attempts, depression, anxiety, hostility, flashbacks, and re-experiencing of symptoms. Sexually transmitted infections (including HIV), pelvic inflammatory disease, infertility, vaginal fistula, unwanted pregnancy, unsafe abortion, and poor reproductive health.
Threats, intimidation, abuse.
Sexual abuse.
Substance misuse: drugs (legal and illegal), alcohol. Social restrictions and manipulation and emotional abuse. Economic exploitation: debt bondage, deceptive accounting. Legal insecurity: forced illegal activities, confiscation of documents. Occupational hazards: dangerous working conditions, poor training or equipment, exposure to chemicals, bacterial or physical dangers. Marginalization: structural and social barriers, including isolation, discrimination, linguistic and cultural barriers, difficult logistics.
Overdose, drug and alcohol addiction. Psychological distress, inability to access care.
Insufficient food or liquid, climate control, poor hygiene, risk-taking to repay debts, insufficient funds to pay for care. Restriction from or hesitancy to access services, resulting in deterioration of health and exacerbation of conditions. Dehydration, physical injury, bacterial infections, heat or cold overexposure, cut or amputated limbs.
Unattended injuries or infections, debilitating conditions, psychosocial health problems.
Note . Adapted from Zimmerman, C., Hossain, M., & Watts, C. (2011). Human trafficking and health: A conceptual model to inform policy, intervention and research. Social Science and Medicine , 73(2), 327-335.
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