Human Trafficking

Human trafficking is a pressing public health concern that transcends all races, social classes, demographics, and gender. No population is exempt from the ever-present threat of traffickers. Human traffickers are motivated by greed, driven by quota, lack respect for human rights, prey upon the vulnerable, and damage their victims' psychological and physical well-being. The extent of the economic and social impacts on society are unknown and require further research to define and guide community-based care, protocols, and formal curriculum changes. Human trafficking is a $150 billion industry globally. The International Labour Organization's (ILO) 2016 estimate reveals that 40.3 million people were victimized worldwide through modern-day slavery, 5.4 victims per every thousand people worldwide. Of these 40.3 million victims in 2016, 29 million were women and girls (72% of the total). Almost 5 million in 2016 were victims of forced sexual exploitation globally, with children making up more than 20% of that number. According to new 2016 global estimates, data collected by the ILO and the Walk Free Foundation (WFF) in partnership with the International Organization for Migration (IOM) as part of their contribution to the Sustainable Development Goals (SDG), puts the number close to 25 million persons who have been subjected to forced labor worldwide and 15.4 million in forced marriages. Loss of freedom is the common thread that binds them together. The exact number of trafficking victims is difficult to quantitate due to the concealed nature of the rapidly progressing disease and public health emergency. Distinguishing between human trafficking and human smuggling is essential. According to the Trafficking Victims Protection Act (TVPA), an anti-trafficking federal law established in 2000 under President Clinton's administration, human trafficking is defined as the exploitation of a person or persons for sex or labor using "force, fraud, or coercion." Smuggling differs from trafficking because it involves the illegal crossing of borders and is usually consensual. Typically, the relationship between the smuggler and the person being trafficked terminates upon arrival to the destination country. Smuggling indebtedness can lead to trafficking as a means to resolve a fee owed to the smuggling entity.  Trafficking in persons (TIP), also known as modern-day slavery, is a crime in all 50 states under federal and international laws and does not require the physical transport of a person. TIP can and often does occur in local communities and schools as well as near popular sporting venues. Human trafficking involves three essential elements: action, means, and purpose. According to the National Human Trafficking Resource Center (NHTRC) and the TVPA, the Action-Means-Purpose, or A-M-P Model, helps determine whether force, fraud, or coercion was present, indicating the encounter was not consensual. A trafficker recruits, harbors, transports, provides, or obtains an individual. Force, fraud, or coercion is used to compel the victim to provide commercial sex acts, labor, or other services. Federal law defines sex trafficking as "the recruitment, harboring, transportation, provision, obtaining, patronizing, or soliciting of a person for the purposes of a commercial sex act, in which the commercial sex act is induced by force, fraud, or coercion, or in which the person induced to perform such an act has not attained 18 years of age." Force, fraud, or coercion do not need to be present for minors under 18 years involved in any commercial sex act because minors cannot consent to sex with an adult. Minors are easier to exploit and manipulate, thus vulnerable to trafficking. The TVPA's definition of labor trafficking is "the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage or slavery." The United States Department of Health and Human Services's (HHS) "Look Beneath the Surface" campaign and SOAR training in 2017 provided much-needed insight into TIPs based on the latest amendments to the TVPA. For example, force may involve rape, torture, beatings, or imprisonment and can be psychological or physical. Physical confinement is rare; however, "invisible chains" are often used to maintain power and control, similar to intimate partner violence. Fraud may include false claims of a job, marriage, promises of a better life, or a family. Coercion also involves threats, debt, or bondage that help foster a climate of fear and intimidation and may consist of abuse of the legal process. According to the TVPA, a commercial sex act is any sex act where anything of value is given to or received by any person, such as survival sex, drugs, transportation, food, or clothing.  Over the past 18 years, the US Congress has passed several comprehensive bills to bring this crime to light in domestic and international communities. This legislative process finds its basis in the 13th Amendment to the US Constitution, which banned involuntary servitude and slavery in 1865. One such law adopted in 2000 is the TVPA that combats TIPs using the "3 Ps" approach: protection, prosecution, and prevention. The TVPA established several necessary protective measures for trafficking victims in the United States. Regardless of immigration status, trafficked foreign persons are eligible for federally funded benefits, such as healthcare and immigration assistance. The T nonimmigrant status (T visa) is a protective measure that prohibits deportation or removal of a trafficked victim and sometimes offers a path to permanent residency. Human trafficking victims are especially vulnerable to re-trafficking within two years of first being trafficked and upon return to an originating country due to debt bondage or psychological, emotional, and economic conditions. Reintegration into society, coupled with functioning within societal pre-determined norms, can be traumatic for an already traumatized person who traffickers have exploited. Re-victimization must be avoided by enacting protective measures.  Under the TVPA Act, federal prosecutors were armed with additional tools to bring traffickers to justice for their crimes against humanity. The TVPA explored the existing statutes and broadened its conservative approach. The new legislation mandated financial restitution to the persons they had exploited through trafficking and offered more substantial penalties for those convicted of trafficking crimes. Revisions of the TVPA and subsequent enactments further defined human trafficking as "severe forms of trafficking in persons," including both sex trafficking and labor trafficking. The third "P," prevention, is perhaps the most important. The TVPA strengthens prevention efforts on behalf of the US government. International incentives were enacted to improve economic conditions around the world to deter TIPs. The Office to Monitor and Combat Trafficking in Persons was created within the State Department due to the TVPA. According to the US Department of State, annual TIP reporting was mandated and rated countries on their efforts to reduce TIPs. Furthermore, the TVPA required the creation of an Interagency Task Force to Monitor and Combat Trafficking, and TVPA reauthorizations were enacted in 2003, 2005, 2008, and 2013. In 2015, the adoption of the Justice for Victims of Trafficking Act allowed for additional tools to address this human rights issue and directed the Attorney General to create a National Strategy to Combat Human Trafficking and ensure its ongoing maintenance. These legislative directives, ensured by the passage of the TVPA and the Trafficking Victims Protection Reauthorization Act (TVPRA), bring human trafficking to the forefront of the conversation internationally. Prevention through education is paramount in efforts to curb the growth of this $150 billion industry, which is thought by some to surpass the drug trade in the market value of criminal enterprises. Healthcare providers are on the frontline of these efforts as the first point of contact for most victims.  The US Department of State also prosecutes human trafficking and smuggling cases. Diplomatic Security Service (DSS) agents and analysts often support foreign law enforcement agencies in an attempt to combat the global epidemic of TIP. On a domestic front, the US Department of State works with federal, state, local, and tribal leaders to investigate potential modern-day slavery cases for sex or labor exploitation.