King Paula, Blaiklock Alison, Stringer Christina, Amaranathan Jay, McLean Margot
Public Health Physician/Research Fellow, Department of Public Health, University of Otago, Wellington.
Public Health Physician/Honorary Senior Lecturer, Department of Public Health, University of Otago, Wellington.
N Z Med J. 2017 Oct 6;130(1463):63-69.
Contemporary forms of slavery and associated adverse health effects are a serious, complex and often neglected issue within the New Zealand health sector. Slavery in New Zealand has most recently been associated with the fishing and horticulture industries. However, victims may be found in a number of other industry sectors, including the health and aged-care sectors, or outside of the labour market such as in forced, early (underage) and servile forms of marriage. Victims of slavery are at increased risk of acute and chronic health problems, injuries from dangerous working and living conditions, and physical and sexual abuse. These issues are compounded by restricted access to high-quality healthcare. Slavery is a violation of many human rights, including the right to health. New Zealand has obligations under international law to ensure that all victims of slavery have access to adequate physical and psychological care. The health sector has opportunities to identify, intervene and protect victims. This requires doctors and other health practitioners to demonstrate their leadership, knowledge and commitment towards addressing slavery and its health consequences in ways that are effective and do not cause further harm. Key recommendations for a safe approach towards identifying and managing people in situations of slavery include building rapport, and culturally competent practice with an empathetic non-judgmental approach. We also recommend that health organisations and regulatory and professional bodies develop culturally competent guidelines to respond safely to those identified in situations of slavery. These responses should be based on the respect, promotion and protection of human rights, and occur within a robust person-centric coordinated government response to addressing slavery in New Zealand.
当代形式的奴隶制及其相关的不良健康影响是新西兰卫生部门内一个严重、复杂且常常被忽视的问题。新西兰的奴隶制最近与渔业和园艺业有关。然而,受害者可能出现在许多其他行业部门,包括卫生和老年护理部门,或者在劳动力市场之外,例如强迫、早婚(未成年)和奴役性婚姻等形式中。奴隶制受害者面临急性和慢性健康问题、危险工作和生活条件导致的伤害以及身体和性虐待的风险增加。获得高质量医疗保健的机会有限使这些问题更加复杂。奴隶制是对包括健康权在内的许多人权的侵犯。根据国际法,新西兰有义务确保所有奴隶制受害者都能获得适当的身心护理。卫生部门有机会识别、干预和保护受害者。这要求医生和其他卫生从业者以有效且不会造成进一步伤害的方式,展现出他们在应对奴隶制及其健康后果方面的领导力、知识和承诺。对于以安全方式识别和管理处于奴隶制状况的人员的关键建议包括建立融洽关系,以及采用具有文化能力且富有同理心、不评判的做法。我们还建议卫生组织以及监管和专业机构制定具有文化能力的指导方针,以安全应对那些被认定处于奴隶制状况的人员。这些应对措施应基于对人权的尊重、促进和保护,并在新西兰政府以个人为中心、强有力且协调一致地应对奴隶制的框架内进行。