Modern slavery is the illegal trade of human beings for the purpose of commercial sexual exploitation or reproductive slavery, forced labour, or a modern-day form of slavery.
British and foreign nationals can be trafficked into, around and out of the UK. Children, women and men can all be victims of modern slavery. Reasons for trafficking of individuals include sexual exploitation, domestic servitude, forced labour including in the agricultural, construction, food processing, hospitality industries and in factories, criminal activity including cannabis cultivation, street crime, forced begging and benefit fraud, and organ harvesting. It distinguishes human trafficking as a crime against an individual, and smuggling as a crime against the state where there are illegal border crossings.
There are an estimated 13,000 modern slaves in the UK. To tackle modern slavery in the UK, the Modern Slavery Act 2015 has been introduced. This is the second piece of anti-slavery legislation in 200 years. The Act gives law enforcement the tools to fight modern slavery, ensure perpetrators receive suitably severe punishments for these crimes, and enhances support and protection for victims. The UK government has a scheme of assessment and support for trafficked people, but currently only a small proportion are getting this support; approximately 20-25% of victims.
Those who present in healthcare settings may have little or no engagement with any other services. Health professionals therefore have an important role to play in identifying and caring for trafficked people and in referring them for further support and by being able to support them to report to the appropriate authorities.
As part of this, Public Health England is rolling out training to the PHE workforce on identifying and supporting victims of modern slavery, of which some of the lessons are here to further raise awareness.
The relevance to public health is multitude and includes long term multiple injuries, mental health, physical health, sexual trauma, sexually transmitted infections, late access to maternity care, unplanned pregnancies, disordered eating or poor nutrition, self-harm, dental pain, fatigue, post-traumatic stress disorder, psychiatric or psychological distress, back pain, stomach pain, skin problems, headaches, and dizzy spells.
As public health professionals and as citizens in our countries we all have a responsibility to look for the signs of modern slavery and to seek support for these vulnerable people. It is usually a combination of triggers, an inconsistent story and a pattern of symptoms that may cause you to suspect trafficking. Signs to look for in an individual include being accompanied by someone who is controlling, being withdrawn, submissive, vague, inconsistent, old and untreated injuries, no registration with a GP, nursery, or school, frequent movements of location, neglect, or poor English. Importantly, trafficked people may not self-identify as victims of modern slavery, can feel fear or shame in revealing their experiences or may be limited through language barriers. Support and advice is offered by the Salvation Army for adults and local safeguarding leads for children in the UK.
As public health professionals we have a responsibility to know the signs of modern slavery, and know where to go, and to share and inform our wider workforce and colleagues who work directly with the public.
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References
- Modern Slavery Act 2015. Accessed on 11/10/2017 http://www.legislation.gov.uk/ukpga/2015/30/contents/enacted
- Department of Health, 2015. Supporting victims of modern slavery through healthcare services. Accessed on 11/10/2017 https://www.gov.uk/government/news/supporting-victims-of-modern-slavery-through-healthcare-services
- Public Health England. 2017. Human trafficking: migrant health guide. Accessed on 11/10/2017 https://www.gov.uk/guidance/human-trafficking-migrant-health-guide
- department of Health. 2015. Identifying and supporting victims of modern slavery: guidance for health staff. Accessed on 11/10/2017 https://www.gov.uk/government/publications/identifying-and-supporting-victims-of-human-trafficking-guidance-for-health-staff/identifying-and-supporting-victims-of-modern-slavery-guidance-for-health-staff
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Karen Buckley
Public Health Specialty Registrar, UK
(As published in EuroNews #13)