Exploring the role of health sector in prevention of human trafficking.

Sir,

Over the past decade, human trafficking has become a global public health concern, which encompasses a serious violation of basic human rights on an international platform.[1] United Nations has defined human trafficking as the recruitment, transportation, transfer, harboring or receipt of persons, by means of the threat or use of force or other forms of coercion, of abduction, of fraud, of deception, of the abuse of power or of a position of vulnerability or of the giving or receiving of payments or benefits to achieve the consent of a person having control over another person, for the purpose of exploitation.[2]

Human trafficking is often difficult to quantify because of its illegal nature; range of trafficking activities and adoption of variable definitions by countries, but approximately 21 million people are trafficked and in forced labor world-wide, the majority are from Asia with women and girls most affected.[3] Victims of human trafficking are vulnerable to a wide range of physical (viz. headache, backpain, stomach pain and memory problems), psychological (viz. anxiety, depression, post-traumatic stress disorder) and health hazards mainly because of deprivation of food and sleep; extreme stress; hazards of travel; violence (physical and sexual) and occupational health risks.[145] As most of them do not have timely access to health-care, by the time they reach the health-care facility their health condition is often deteriorated.[6]

For individuals who are trafficked, health hazards and adverse consequences usually begin before they are included in the trafficking process, continue throughout the period of exploitation and the aftermaths persist for long-term. The health sector can play a substantial role toward the prevention of trafficking and in the management of health-care needs of the trafficked people.[47] The health-care professionals working in government/private sector and the public authorities should be proactive regarding the provision of the necessary information about the consequences of physical, psychological and sexual exploitation. Health sector can develop mechanisms within the limit of available resources for extending information-education-counseling to the trafficked victims so that any long-term sequel of exploitation can be averted.[8] Nevertheless, the reverse has been observed in most of the scenarios owing to language and cultural differences; lack of training and knowledge on human trafficking and care; limited resources; poor involvement of victims in the decision-making process.[457] Different strategies and approaches have been proposed to counter the hazard of trafficking at different levels-for policy makers (viz. stringent punishment for the offenders; initiatives to increase awareness about human trafficking among the general masses; provision of health-care services to trafficked persons by international collaboration and establishing the framework for rehabilitation/re-integration/repatriation of victims);[9] for health-care providers by conduction of the sensitization sessions to increase their capacity to identify and provide sensitive/safe services to victims[1011] and promoting research on potentially representative samples of trafficked people with an aim to assess their health needs, accessibility to health-care services and assessing the impact of the implemented strategies.[19] Furthermore, different non-governmental organizations working in the field of welfare of the vulnerable sections of the society can be roped-in to assist the initiatives of the government. Infact, a conceptual model has been developed based on multi-country research to explore the migratory and exploitative nature of a multi-staged trafficking process, to promote the protection and recovery of people who are trafficked.[12]

To conclude, human trafficking is a global concern that requires active inputs from all national and international stakeholders, well-supported with a comprehensive legal framework. To meet international obligations, government and health-care providers should be prepared to identify, treat and assist victims of trafficking for maximizing the benefit to the victims.