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Human Trafficking, Exploitation, and Health: a new PLOS Collection

PLOS Medicine Associate Editor Colleen Crangle introduces the PLOS Collection on Human Trafficking, Exploitation and Health.

The exploitation of people for forced labor or forced marriage now affects over 40 million worldwide. Every nation is implicated in this human rights violation, subjecting people to exploitation so severe it is termed “modern slavery.”  A special Collection launched today at PLOS – Human Trafficking, Exploitation and Health – with Guest Editors Cathy Zimmerman and Ligia Kiss of the London School of Hygiene and Tropical Medicine – examines this global crisis. Five essays in PLOS Medicine and two research articles in PLOS ONE testify to the broad scope of the problem, while at the same time showing the many specific ways in which people are exploited. From unaccompanied migrant and refugee boys in Greece to fishing industry workers in South East Asia, from children trafficked for sex in the United States to adults laboring in dirty, dangerous and degrading jobs, people are entrapped in servitude that has grave consequences for their human rights and their health.

Several global organizations are involved in the fight against modern slavery, using overlapping vocabulary that can be confusing to the layperson. Human trafficking, according to the United Nations Office on Drugs and Crime, covers a range of activities such as recruiting, transporting, or harboring people with the aim of exploiting them, using threat or force or other forms of coercion and deceit. A person need not be transported from one place to another to be trafficked; a child can be trafficked for sex in her own home town. The International Labor Organization uses the term “forced labor” in its coverage of the many ways people are coerced into and retained in exploitative work, for the first time this year including forced marriage along with forced labor under the umbrella of “modern slavery.”

In an essay introducing the Collection, Zimmerman and Kiss argue that modern slavery is a global public health problem and, as such, should be treated as preventable. Recognizing the generational cycles of harm and disability that can accrue from extreme exploitation, they issue an urgent call to address the economic and social factors that sustain these abuses across the world.

In an essay on child sex trafficking in the United States, Jordan Greenbaum identifies opportunities for healthcare providers to detect at-risk youth, recognizing that training and resources are needed to provide developmentally appropriate care to traumatized children.

Elena Ronda-Perez and colleagues discuss the role of occupational health, noting that it is intrinsically related to labor trafficking yet has, to date, paid little attention to increasing awareness among health professionals of work-related health problems that can help identify trafficked individuals.

The exploitation and enslavement of sea workers in South East Asia is the topic of the policy forum essay by Rapeepong Suphanchaimat and colleagues, who point out that economic disparities between countries in the region have provided fertile ground for human trafficking syndicates to operate. Progress is being made towards universal health care in the region but migrant and trafficked seafarers present particular challenges.

Julie Freccero and colleagues address the plight of adolescent boys arriving unaccompanied on the shores of Europe as part of the refugee and migrant crisis. In light of few gender-specific approaches to preventing the sexual exploitation of boys, Greece has piloted programs that provide shelter, education and cash transfers, opening the way to rigorous evaluation urgently needed by policy makers and practitioners.

Research by Nicola Pocock and colleagues also highlights the experience of men and boys. Although women and girls are disproportionately affected by forced labor (99% in the commercial sex industry, 58% in other sectors, not counting forced marriage ), the experience of men and boys using post-trafficking support services in Thailand, Cambodia and Vietnam sheds light on this sometime ignored population.

In another research study, Debra Bick and colleagues offer further insight into survivor experiences, in this case trafficked woman receiving maternity care in the United Kingdom, with the perspective of National Health Service clinicians providing important context.

This Collection will grow as more articles are published. Given the magnitude of the problem – for every 1,000 people in the world between 5 and 6 people are enslaved, with 1 out of every 4 being a child  – research is sorely needed for evidence-based approaches to prevention and the provision of appropriate health care. See here for instructions on submitting to PLOS Medicine.


Feature Image credits (clockwise from top left): Lydur Skulason (Flickr), axelmellin (pixabay), rodrigoandrade3880 (pixabay), Oleg Afonin (Flickr), Scott Robinson (Flickr).

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