Women’s Health

Open journal

ISSN 2380-3940

Human Trafficking – A Global Perspective

Susan Scott Ricci*

Susan Scoot Ricci, ARNP, MSN, MEd, CNE UCF,  Nursing Faculty, Concurrent Program ,Altamonte Springs campus, Site Coordinator, University of Central Florida, College of Nursing, Orlando, Florida, USA, Tel. (407) 404-6088, E-mail: Susan.Ricci@ucf.edu

Most people think that slavery ended with the signing of the Emancipation Proclamation…. not so! Human trafficking is a worldwide crime that ruthlessly exploits women and children into forced labor and sex. It is the modern form of slavery and a violation of human rights. It is the fastest growing criminal activity in the world, which generates over $150 billion annually, with >70% of the dollars spent are from the United States.1 The hidden nature of this crime makes it a huge problem today, but one in which no one wants to think about or address. This topic is designed to raise your awareness, enrage you, and inspire you – enraged that human trafficking exists today as the fastest growing and most lucrative crimes, and to inspire you to reach out to help one of the most vulnerable populations trapped in slavery.

Human trafficking is a form of modern day slavery in which traffickers use force, fraud, and coercion to control victims for the purpose of engaging victims in commercial sex acts or labor services against his/her will. Sex trafficking has been found in a wide variety of venues within the sex industry, including residential brothels, escort services, fake massage parlors, strip clubs, and street prostitution. Labor trafficking has been found in diverse labor settings including domestic work, small businesses, large farms, and factories.

The International Labor Organization [ILO] estimates that there are 27 million victims of human trafficking globally, with hundreds of thousands in the United States. The victims of this crime in the United States are men, women, children, and foreign nationals. The Asia-Pacific region accounts for the largest number of forced laborers in the world, followed by Africa and Latin America.2 It is hard to combat this problem because victims are often afraid to go to authorities for help.

Human trafficking is a market-driven criminal industry that is based on the principles of supply and demand, like drugs or fire arms trafficking. It does not exist solely because many people are vulnerable to exploitation, but instead it is fueled by a demand for cheap labor and for commercial sex. Human trafficking thrives for several reasons:

Ø Low risk – traffickers perceive there to be little risk or deterrence to affect their criminal operations due to lack of government and law enforcement training, low community awareness, ineffective laws, lack of law enforcement investigation, scarce resources for victim recovery, and social blaming of victims. Ø High profits – When individuals are willing and able to pay for commercial sex and forced labor, they create a market and make it profitable for traffickers to sexually exploit children and adults in the sex trade and labor industry.3

Traffickers exploit others for the profit they gain from commercial sex and from forced labor. They lure people into forced labor and sex trafficking by manipulating and exploiting their vulnerabilities. The majority of victims are women and girls, though men and boys are also impacted. Traffickers prey on people who are hoping for a better life, lack job skills or opportunities, have unstable home lives, run away children, homelessness, or have a history of sexual or physical abuse.4 Traffickers promise a high paying job, a loving relationship, or new and exciting opportunities and then use physical or psychological violence to control them.

Traffickers can be lone individuals or part of an extensive criminal networks, all which have the same mission – exploiting vulnerable people for profit.

Although human trafficking victims are thought to be a problem affecting women, men are also victims; in some parts of the world, they’re victimized more often than women. It is estimated that 98% of sex trafficking victims are female and 2% are male.5 Identification may be difficult due to lack of awareness of the part of health care workers and, most victims won’t speak up due to shame and humiliation.

A misconception of the public is that victims of human trafficking will immediately ask for help and will self-identify as a victim of crime. The reality is that victims of human trafficking often do not seek help or self-identify themselves due to a variety of reasons, such as lack of trust, self-blame, or specific instructions by the traffickers on how to behavior in public. There is frequently a negative consequence for the victim if they reach out to the police or medical personnel. Trust building is often needed to uncover the victim’s whole experience.

Health care workers need to be able to recognize the potential ‘red flags’ and indicators of human trafficking and report them so intervention can take place. The following indicators may identify a potential victim of human trafficking:

ü Is not free to leave or come and go at will

ü Is unpaid, paid very little or only through tips

ü Works excessively long and unusual hours

ü Is fearful, anxious, depressed or tense

ü Avoids eye contact

ü Appearance that doesn’t match stated age

ü Is not allowed breaks or unusual restrictions at work

ü Owes a large debt and is unable to pay it off

ü Lacks medical care or is denied medical services when needed

ü Appears malnourished and shows signs of physical abuse

ü Is not in control of their own money or possessions

ü Has several inconsistencies in their story when asked

ü Loss of sense of time.

If any health care provider recognizes any of these indicators, they should contact the National Human Trafficking Resource Center hotline at 1-888-373-7888 to make a referral and report their observations immediately.

Human trafficking is a form of modern day slavery and is considered a crime under federal and international law; it is also a crime in every state in the United States. The Trafficking Victims Protection Act of 2000 was the first comprehensive federal law to address trafficking in individuals. The law addressed prevention, protection, and prosecution. According to federal law, any minor under the age of 18 engaging in commercial sex is a victim of sex trafficking, regardless of the presence of force, fraud, or coercion.3

To address this global problem, it is essential that all health care workers take on the responsibility to educate themselves about human trafficking, be acquainted with screening questions to ask to identify victims, and know what resources are available to help victims. As frontline health experts, we are in a unique position to help stop human trafficking. We may be the only outside person that the victim comes in contact with who is able or willing to help them attain their safety and freedom. As we go forward in our practice settings, be diligent to make sure that any opportunities to assist victims are not missed.


1. De Chesnay M. Sex trafficking: a clinical guide for nurses. New York, NY: Springer Publishing Company, 2013.

2. International Labor Organization [ILO] 21 million people are now victims of forced labor. Website: http://www.ilo.org/global/ about-the-ilo/newsroom/news/WCMS_181961/lang–en/index.htm 2012; Accessed 2015.

3. National Human Trafficking Resource Center [NHTRC[. Human trafficking. Website: http://www.traffickingresourcecenter.org/ type-trafficking/human-trafficking 2015; Accessed 2015.

4. Centers for Disease Control [CDC]. Understanding sex trafficking. Website: http://www.cdc.gov/violenceprevention/sexualviolence/trafficking.html 2015; Accessed 2015.

5. Perkins A. The truth about human trafficking. Nursing made incredibly easy. 2015; 13(6): 32-40. doi: 10.1097/01. NME.0000471841.37883.f5


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