● Domestic work, including cooking, cleaning, other household work, and care giving. ● Restaurants and small businesses, including waitstaff, kitchen staff, bussers, or dishwashers. ● Traveling sales crews, and peddling and begging rings, including selling candy, magazine subscriptions, and other goods or soliciting money. ● Health and beauty services, including nail salons, hair salons, spas, or massage parlors. ● Escort services through agencies and online sex sites. ● Brothels, which can be home-based, lodge-based, or road (truck stop)-based. (National Human Trafficking Resource Center [NHTRC], 2015a; Polaris s, n.d.b) In some cases, the trafficked person may not understand that he or she is being trafficked according to the law (International Organization for Migration [IOM], 2009). 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 intervention for those being trafficked, including individuals who may be unaware of the full consequences of their current situation. ● American Indians and Alaska Natives. ● Migrant laborers. ● Foreign national domestic workers in diplomatic households. ● Employees of businesses in ethnic communities. ● Populations with limited English proficiency. ● Persons with disabilities. ● Rural populations. ● Lesbian, gay, bisexual, and transgender (LGBT) individuals. (U.S. Department of State, 2015) Certain factors, such as previous abuse or homelessness, make individuals more vulnerable to trafficking. Traffickers target marginalized persons, often those with a weaker social support system, as well as those who have limited financial support. Traffickers seek individuals with limited communication abilities, such as limited knowledge of the indigenous language, because this vulnerability makes it more difficult for trafficked persons to leave the trafficker or report the abuse. Living in rural areas increases vulnerability to human trafficking, because sparsely populated regions make the act of trafficking easier to hide.
years of age. For adults, sex trafficking occurs when there is an element of force, fraud, or coercion along with commercial sex acts, which differentiates it from consensual commercial sex. Labor trafficking encompasses those individuals actively manipulated into situations of labor exploitation through involuntary servitude or slavery. A person does not need to be transported physically from one location to another for the crime to fall within the trafficking definitions stated here (U.S. Department of State, 2000). There are various ways to exploit individuals within sex and labor trafficking. One form of exploitation is bonded labor, or debt bondage. In this type of trafficking, a trafficker uses financial indebtedness to prevent an individual’s freedom (U.S. Department of State, 2000). Coercion is another way trafficked persons are exploited and can include blackmailing, social marginalization, physical threat, and fear of being criminalized or deported. Sex and labor trafficking can occur in a variety of licit and illicit settings. Formal industries and ways in which sex and labor trafficking occurs in the United States include: ● Agriculture, including seasonal harvesting work or caring for animals. Who is trafficked? Although human trafficking is rampant, the data on numbers of victims are limited. No international database for the number of victims exists. Victims are often reluctant to report their plight for fear of retribution by the traffickers or of deportation. The Polaris Project, an organization working against human trafficking, coordinates the National Human Trafficking Resource Center (NHTRC) hotline [(1-888-373-7888, Text BeFree (233733)] and provides vital services to trafficked individuals. Since 2007, Polaris has collected data from the hotline to document where human trafficking is taking place in the United States (NHTRC, 2016). In 2019, 22,326 victims and survivors were identified (NHTRC, 2019). The 2015 Trafficking in Persons (TIP) Report identifies a list of populations that have increased vulnerabilities to trafficking in the United States. These groups may seem to have little in common, but they are all at a greater risk for trafficking. These populations include ● Children in the child welfare and juvenile justice systems.
● Runaway and homeless youth. ● Children working in agriculture.
RECOGNIZING HUMAN TRAFFICKING
Trafficking is often a cyclical process, with several stages and reiterations of a similar chain of events. Individuals who are trafficked may return to this cycle multiple times for a multitude of reasons. Understanding the process allows healthcare Elements of human trafficking Healthcare professionals can use the elements of human trafficking – the act, the means, and the purpose – to recognize human trafficking (UNODC, 2014). This knowledge enables healthcare professionals to identify scenarios in which screening for trafficking is appropriate and gives them a better understanding of what trafficked persons may have experienced. The act The act refers to the traffickers’ actions. These actions, which may include recruiting, transporting, transferring, and harboring, are common among traffickers who seek to profit from the lives of others. A complex dynamic exists between traffickers and those they are exploiting; the means and purpose that drive the acts provide a deeper perspective into the crime. The means The means used by traffickers are integral to the definition of this element of human trafficking. Use of threats or force, coercion,
professionals to better aid and recognize potential trafficked persons. Additionally, recognizing the means by which traffickers manipulate and use coercion is a first step toward prevention.
and fraud define human trafficking. A common misconception of trafficking is that it always involves physical force; that is, a weaker individual is physically forced to live with and provide services for the trafficker. However, not all traffickers use physical force to exert control. Instead, traffickers use a myriad of powerful coercive techniques, such as deception and legal threats, to groom and exploit others (UNODC, 2014). Traffickers may use deception to insert themselves into the lives of those they are controlling. False promises and offers evolve into a more sinister reality of abuse and exploitation. Threats of legal or social repercussions may control the individual; many traffickers prey upon the person’s fear of being deported or arrested. Conversely, traffickers may show intimacy and affection toward the person, who may have been deprived of both before and during trafficking (Zimmerman, Hossain, & Watts, 2011), and
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