Young people's experiences of trafficking in the UK: health impacts

Young people’s experiences of trafficking in the UK: health impacts

Joanne Westwood, Nicky Stanley, Sian Oram, Sharon Jakobowitz, Cathy Zimmerman and Louise Howard

Human trafficking

• Human trafficking is the recruitment or movement of people by force, fraud, or deception, for the purposes of exploitation.

• People are exploited in a variety of settings, including: • Sex work

• Domestic servitude

• Agriculture, factories, restaurants, hotels, nail salons, car washes

• Forced criminality (e.g. begging, theft, cannabis cultivation)

• Evidence on the health needs of trafficked children and young people is extremely lacking (Oram et al 2012)

• Cross sectional survey of survivors of human trafficking: 29/160 participants aged between 16-21.

• Participants recruited with assistance from support services

• Quantitative data collected on socio-demographic and trafficking characteristics, physical and mental health, sexual and reproductive health (incl. pregnancy).

• Qualitative data collected on healthcare experiences.

Study of health issues affecting young people who have experienced trafficking

Sample characteristics (young people)

N=29 (%)

Age range• 16-17• 18-21

7 (24.1)22 (75.9)

Gender• Female• Male

24 (17.2) 5 (82.8)

Type of trafficking*• Sexual exploitation• Domestic servitude• Labour exploitation

18 (62.1) 7 (24.1) 3 (10.3)

Duration of trafficking (months)*• 0-6• 7-12• 13-24• 24+

9 (31.0)5 (17.2)3 (10.3)9 (31.0)

* Missing data, does not equal 29

Nationality

Albania Cameroon Afghanistan

Lithuania Malawi Bangladesh

Poland New Guinea

Slovakia Nigeria

Sierra Leone

Uganda

Nationalities of trafficked young people

Health problem N=29 (%)

Headaches 16 (55.2)

Memory problems 9 (31.0)

Back pain 7 (24.0)

Stomach pain 7 (24.0)

Dental pain 6 (20.7)

Diagnosed STI 4 (13.8)

Trafficked young people and health Page 6

Trafficked young people and pregnancy

• Sample included 24 women aged between 16 and 21• 5 (20.8%) reported pregnancy during trafficking

• 1 reported an abortion while trafficked• 0 reported having seen a midwife while trafficked

• These women were exploited through:• Sexual exploitation • Domestic servitude • Labour exploitation

• The women who became pregnant while trafficked were from • Albania• Nigeria• Lithuania

• Participants were asked about:

• Access for health/medical treatment during and after the trafficking episode

• Type of health provision accessed during and after trafficking episode

• Health provider seeking information about the victim and their experience of trafficking

• If they accessed health during the trafficking episode how was this arranged?

• What are victims’ views of their experiences of health provisions?

Qualitative interviews with trafficked young people

“Interviewer: Have any of the GP’s that you’ve been to so far, have they ever asked what happened to you? Did they ask you about trafficking?

Young person: No.

Interviewer: Would you have felt comfortable talking to them if they’d asked?

Young person Yes. If they asked, I would tell them.”

(Bangladeshi female, (15-17 years) trafficked for forced marriage).

“The way she was talking to me made me comfortable, able to open up and explain. She asked me about what had happened.”

(Sierra Leone female (15-17 years) trafficked for sex work)

Health professionals asking about experiences of trafficking

“I don’t want everybody to know my story at the end of the day….{I would} tell them, as long as they will, they will not contact that woman.”

(Nigerian female (15-17 years) trafficked for sex work)

“The first time I went, I was upset and went out of the room and my foster carer stayed in and talked a while. So I think maybe she explained. But I have a different GP now.”


Health professionals asking about experiences of trafficking

“They were very kind, … felt pity for me you know. So they would cry for me they understand everything… when I went there I was a bit worried but when, after meeting them and everything my mind calmed down”

(Nigerian female 15-17) trafficked into sex work for 4-5 years)

“The most important thing is to ask, and to give you time to explain how you are feeling instead of just assuming what is wrong, giving you the chance to explain, and listening to your opinion about why you feel like that.”


Talking to health professionals about the experience of trafficking: compassion and empathy

“Interviewer: Did they explain to you what the injections are for?

Young person: No they didn’t explain, but I thought it was to prevent me from falling pregnant.”

(Slovakian, female (18 years) trafficked for sex work)

“Yeah, they explained it to me because when we get there they just said …they just want to check me, to do a check up to know if I need any help in medication or any health needs…. they did so many tests on me”

(Nigerian female (18 years) trafficked for sex work)

Understanding the health intervention

“When I found out [that I had HIV]…I wanted to, I wanted to take my life because …I can’t live with it and I don’t even know who is going to accept me with it…let me just die’”

Counselling was offered as additional support:

“They referred me…the same day because I wasn’t ok at all… I wasn’t listening, I don’t even want to listen, yeah, they saw my mood”

(Nigerian female (18 years) trafficked for sex work)

“He say I can only take paracetamol… the next day, I looked in my mouth, then, I see something again, my mouth white…The man doesn’t like to give people medicine.”

(Nigerian female (18) trafficked for sex work)

Being diagnosed

“It’s like they weren’t present at all times, not present at times to find out how she’s doing after birth, they came to ask later on only once”.

(Albanian female (18) trafficked for sex work)

“ …but when I went ….the way she was asking me questions it was like it was my fault, like I was responsible for the problems. The way she asked me, it brought sad memories back”


Experience of health provisions

• Importance of access to independent and qualified interpreters, preferably face to face;

• Health professionals need clear guidance about how to deal with potential trafficked situations where young people are accompanied to health appointment by adults;

• Need for training for staff on how to ask about trafficking experiences and to recognise the impact of their questions;

• Trafficked young people lack familiarity with the NHS and need explanations of appointment & referral systems;

• Staff need to try and create conditions that support the sharing of trafficking-related health problems, including explaining about confidentiality;

• Clear protocols for information sharing should be communicated to trafficked young people themselves;

• Analysis which examines the experiences of health professionals who have worked with trafficked victims is currently underway

Implications for health providers

Funders: This report is independent research commissioned and funded by the Department of Health Policy Research Programme (Optimising Identification, Referral and Care of Trafficked People within the NHS 115/0006). The views expressed in this publication are those of the author(s) and not necessarily those of the Department of Health.

Participating Organisations: City Hearts, ECPAT UK, Helen Bamber Foundation, Medaille Trust, Migrant Helpline, NSPCC, Poppy Project.

Project Steering Group: Melanie Abas, Debra Bick, Adrian Boyle, Rebecca French, Clare Gerada, Louise Howard, Sian Oram, Nicky Stanley, Cathy Zimmerman.

Fieldworkers: Sharon Jakobowitz, Laura Nellums, Sian Oram, Kylee Trevillion, Joanne Westwood

Data entry: Jack Ogden

Acknowledgements Page 16

Government & Nonprofit

Young people's experiences of trafficking in the UK: health impacts