Arun Kumar Acharya - Universidad Autónoma de Nuevo León, Maria Luisa Martinez Sanchez - Universidad Autónoma de Nuevo León
Julia Planitzer, Nora Katona, Barbara Linder, Karin Lukas - Ludwig Boltzmann Institute of Human Rights, Vienna
Human trafficking is a modern day form of slavery that involves many forms of forced or coerced sexual exploitation. In the last seventeen years since the adoption of the Palermo protocols several research studies have been conducted to understand the dimension, causes and consequences of human trafficking, especially sex trafficking. The Global Slavery Index 2016 estimates nearly 45.8 million people subject to some form of modern slavery in the world today and in Mexico this figure comes out to nearly 376,800 victims. Sex slavery and trafficking leads to adverse impacts on the physical and mental health of victims due to sexual and physical exploitation and violence. Trafficking victims are often forced to live in cruel and inhumane conditions. Thus, the main objective of this study is to analyse the physical and mental health disorders suffered by trafficked women in two US-Mexican border cities, Monterrey and Reynosa. For the present study 100 trafficking victims (N=100) were interviewed using a snowball method (80 in Monterrey and 20 in Reynosa) during 2007-2016 in Monterrey, and 2014-2016 in Reynosa.
‘Human trafficking’, also known as modern day slavery, is the second largest illegal international trade, surpassed only by arms trafficking.US Department of State (USDOS), The Trafficking in Persons Report 2016 (Washington, DC, 2016). The United Nations defines human trafficking as ‘the recruitment, transportation, transfer, harboring or receipt of people, by means of threat or use of force or other forms of coercion or abduction, fraud, deception, through the abuse of power or of a position of vulnerability, or by giving or receiving payments or benefits to achieve the consent of a person having control over another person for the purpose of exploitation’. Exploitation further described to ‘include at a minimum the exploitation of the prostitution of others or other forms of exploitation, forced labor or services, slavery or practices similar to slavery, servitude or the removal of organs”.United Nations, Protocol Against the Smuggling of Migrants by Land, Sea and Air, supplementing the United Nations Convention Against Transnational Organized Crime (New York, 2000). Victims include adults and children of all genders and citizenship statuses.
Trafficking women is by no means a recent phenomenon. In the nineteenth century for example, feminist activists and scholars brought international attention to ‘white slave trade’ of European and American women who were forced into prostitution, and this issue resulted in the enactment of the International Agreement for the Suppression of the White Slave Traffic in 1904, 1910, 1921, and 1933, and its successor, the 1949 United Nations Convention for the Suppression of the Traffic in Persons and of the Exploitation of the Prostitution of Others.A. Derks, ‘From White Slaves to Trafficking Survivors: Notes on the Trafficking Debate’, working paper no. 00-02m (Working Paper Series, The Center for Migration and Development, Princeton University, May 2000). During the last three decades, various anti-trafficking efforts have engaged in different parts of the world, and much research and policy interventions have targeted trafficking for female sexual exploitation.F. Laczko & E. Goździak, ‘Data and Research on Human Trafficking: A Global Survey’, International Migration, Special issue, vol. 43, no. 1/2 (2005). The US Department of State (USDOS) recently highlighted that in addition to sex trafficking, other forms of trafficking such as labor trafficking, forced marriage and child marriage are increasing in Asian, African and Latin American countries.Ibid., 1. Current global estimates suggest that approximately 21 million to 27 million people are trafficked at any given time.International Labour Organization, ILO Global Estimate of Forced Labour: Results and Methodology, Special Action Program to Combat Forced Labour (SAP-FL), (Geneva, 2012).,K. Bales, Disposable People: New Slavery in the Global Economy (Berkeley: University of California Press, 3rd ed., 2012). According to UNODC data,United Nations Office on Drugs and Crime (UNODC), Global Report on Trafficking in Persons 2014 (Vienna, 2014). nearly 70 to 80 percent of trafficking victims are women and girls, and 97 percent of those are trafficked for sexual exploitation.
In the case of Mexico, the 2016 Trafficking in Persons Report provided by the US Department of State indicates that Mexico is a source, transit and destination country for women, children and men subjected to sex trafficking and forced labor. According to this report, Mexican women, children, as well as men are exploited and are doing forced labor in agriculture, domestic service, food processing factories, construction, the informal economy, begging, and vending in both the United States and Mexico. The most vulnerable groups to human trafficking in Mexico include women, children, indigenous people, individuals with mental or physical disabilities, migrants and LGBT Mexicans.Ibid., 1.
Human trafficking for the purpose of sexual exploitation in Mexico has become a public concern in the last few years, especially with respect to the prostitution of children.R. Esteinou, ‘Selling Bodies and Sexual Exploitation: Prostitution in Mexico’, in Global Perspectives on Prostitution and Sex Trafficking: Europe, Latin America, North America, and Global, Dalla, Rochelle et al. (eds.), (Lanham: Lexington Books, 2011). Mexico ranks second in the world in terms of prostitution of underage persons.P. Monroy, ‘México: pasividad ante explotación sexual infantil’, Contralínea, 5 September 2010. Available evidence suggests that children are commonly trafficked from poor areas of the country and are often exploited by American tourists.COHA (Council on Hemispheric Affairs), Modern Day Slavery in Mexico and the United States, 21 December (Washington, DC, 2009); M.A. Ruíz Torres, ‘La explotación sexual de niños en dos ciudades turísticas: Cancún y Acapulco’, in La infancia como mercancía sexual: Mexico, Canada, Estados Unidos, E. Azaola & J.R. Estes (eds.) (Mexico, DF: Siglo XXI, 2003). Prostitution has been practiced in the country since the Pre-Hispanic period, and is still commonplace throughout the country.R. Franco, La prostitucióni (Mexico: Diana, 1973); G. Ríos de la Torre, La prostitución femenina en la ciudad de México durante el porfirismo (Mexico: UNAM, Master Thesis, 1991). According to Azaolathe rapid increase in the number of children for commercial sexual exploitation is due to the following factors: (1) The deterioration of living conditions of poor families, (2) the promotion of child prostitution by close family members, (3) the use of sexual activities as means of survival by street children who escaped an abusive home, (4) the recruitment of children as sex workers by an organized crime network and, (5) the illegal transfer of children as sex workers from developing countries to developed countries.E. Azaola & J.R. Estes, La infancia como mercancía sexual: México, Canada y Estados Unidos (Mexico, DF: Siglo XXI, 2003).
According to the ECPAT report, Mexico has long been regarded as a popular sex tourism location and it is estimated that more than 16,000 Mexican children are trafficked and forced to work in the sex industry in the country’s popular tourist destinations, such as Acapulco, Cancun, Guadalajara, Puerto Vallarta and the border towns of Juarez and Tijuana.Ibid.
In the last few years, some significant effort has been made to understand the problem of trafficking persons in Mexico. There is also evidence that both domestic and international trafficking of persons, especially of women and children, has increased.US Department of State (USDOS), The Trafficking in Persons Report – 2015, (Washington, DC, 2015); T.L. Montalvo, ‘Víctimas de trata en México se duplican en el último año: la mayoría son mujeres y niñas’, Animal Politico, 26 November 2014; CNDH (Comisión Nacional de los Derechos Humanos), ‘La trata de personas’ (Mexico, DF, 2012). Our previous research indicates that every year approximately 10,000 people are being trafficked within Mexico, particularly to the following six cities: Cancun, Acapulco, Mexico City, Tijuana, Juarez, and Monterrey, and approximately 5,000 people are trafficked into the United States.A.K. Acharya & J.C. Bryson, ‘Trafficking of Women and Vulnerability to HIV/STI Infection in Urban Mexico’, Genus, vol. LXX, no. 2-3, (2014). This study also found that in Mexico 7 out of 10 trafficked women are being trafficked within the country and 3 out of 10 are taken abroad.A.K. Acharya, ‘Trafficking of Women in Mexico and Their Health Risk: Issues and Problems’, Journal of Social Inclusion, vol. 3 (1), (2015), DOI: 10.17645/SI.V3I1.179. In addition, every day an estimated 400 women enter prostitution (this figure includes trafficked and non-trafficked women) in Mexico City; 80 percent of them do so against their will.R. González, Violencia contra las mujeres deja un millón de víctimas anuales en México (Mexico, DF: CIMAC, 2003). The study of Acharya and Bryson showed that there are four factors that are responsible for women being trafficked in Mexico:Ibid., 21. (1) Family factors (including domestic violence, physical abuse by stepfather), (2) economic factors (including poverty, unemployment and household economic problems), (3) social factors (including gender discrimination and sexual abuse) and, (4) personal factors (including marriage to boyfriend or to earn more money).
In 2014, the Observatorio Nacional Ciudadano de Seguridad, Justicia y Legalidad [National Citizen Observatory] conducted a four-year analysis (January 2010 through July 2013) on human trafficking in Mexico including 31 states, the Federal District, and the federal government. The present study found persistently high levels of impunity for the crime, demonstrating how incomplete and contradictory official information contributes to bury the true scope of the problem. In the period mentioned above, 16 states reported a total of 846 victims, while the rest failed to provide information.ONCSJL (Observatorio Nacional Ciudadano de Seguridad, Justicia y Legalidad), Estadística sobre la eficiencia en el combate a la trata de personas en México: un ejercicio de acceso a la información 2010-2013 (Mexico, DF: ONCSJL, 2014). Around 87 percent of the reported victims were women and approximately the same percent were victims of sex trafficking, and nearly 90 percent of the victims were single, Mexican citizens and under the age of eighteen.Ibid.
In the case of Mexico trafficking of women is a complex phenomenon as it has many consequences on the health of victims. Female victims of trafficking suffer a wide range of physical and mental violence, which has direct impact on their health. For example, the study of Zimmerman et al.,C. Zimmerman, M. Hossain & C. Watts, ‘Human Trafficking and Health: A Conceptual Model to Inform Policy, Intervention and Research’, Social Science & Medicine, 73 (2011). DOI:10.1016/j.socscimed.2011.05.028. Greenbaum and Crawford-Jakubiak,J. Greenbaum, J.E. Crawford et al., ‘Child Sex Trafficking and Commercial Sexual Exploitation: Health Care Needs of Victims’, Pediatrics, vol. 135, no. 3 (2015), 566-574. DOI: 10.1542/peds.2014-4138. Goldenberg et al.,S.M. Goldenberg et al., ‘Exploring the Impact of Underage Sex Work Among Female Sex Workers in Two Mexico-US Border Cities’, AIDS and Behavior, 16(4), (2012), 969-981. DOI:10.1007/s10461-011-0063-3. identified that physical mental health disorders are directly associated with sexually transmitted diseases, forced abortions, hepatitis, self-hatred, suicide, and depression. Some other studies such as Oram, Stöckl, Busza, Howard, and Zimmerman,S. Oram et al., ‘Prevalence and Risk of Violence and the Physical, Mental, and Sexual Health Problems Associated with Human Trafficking: Systematic Review’, PLoS Medicine, vol. 9, no. 5 (2012), 1-13. DOI:10.1371/journal.pmed.1001224. Kiss et al.,L. Kiss et al., ‘Exploitation, Violence, and Suicide Risk Among Child and Adolescent Survivors of Human Trafficking in the Greater Mekong Subregion’, JAMA Paediatrics, vol. 169, no. 9 (2015). DOI:10.1001/jamapediatrics.2015.2278. indicate that trafficked women suffer various types of violence which have harmful consequences on the physical and mental health of the victims, which in a lot of cases leads to drugs and alcohol addiction, sterility, diseases like TB, mind/body separation, fear, distrust, and suicidal thoughts. Despite the ongoing increased research on human trafficking in many parts of the world including Mexico, there has been very limited research on the physical and mental health of the victims of trafficking, particularly in the case of Mexico. Thus, taking the aforementioned into account, the authors questioned: What kind of physical and mental health disorders do victims of human trafficking in Mexico suffer from? Taking this question into consideration, the objective of this paper is to explore the physical and mental health disorders suffered by trafficked women in two US-Mexican border cities, Monterrey and Reynosa. For this study, we interviewed 100 women (N=100) (80 in Monterrey during 2007-2016 and 20 in Reynosa 2014-2016).
For the present study, we used a snowball sampling technique during our fieldwork. Interviews of trafficked women were carried out in two steps: The first step involved establishing contact with key informants, and the second step was to interview women who were victims of trafficking. Once we received information from our key informant, we visited the designated brothel and contacted the woman. We paid the solicited amount the victim asked for and conducted the interview in a private room in the brothel where we could talk more freely. We acted as a client to hide our identity from the brothel owner and the traffickers. Only the woman concerned knew we were researchers. After concluding the interview, we asked her to help us find more victims of trafficking who were working in the same or other brothels nearby. The woman whom we interviewed first declined to help, but after a while she agreed to cooperate to locate other victims. In return we also offered to pay her 100 pesos per woman. Every time she located a woman, she arranged an interview and called us. Therefore, by applying the snowball sampling or chain-referral sampling technique, we were able to get in touch with victims of sex trafficking in Monterrey and Reynosa and interview them.
Sex trafficking victims experience an extreme level of sexual and physical violence in their day-to-day life.C. Zimmerman et al., ‘Trafficking in persons: a health concern?’, Ciência and Saúde Coletiva, vol. 14 (2009). The research conducted by Zimmerman et al. on the health status of post-trafficked women in Europe indicates that the majority of trafficking victims reported various kinds of physical health problems such as back pain, stomach pain, headaches, memory problems and gynecological problems during and after trafficking.Ibid. Similarly, the study of Deshpande and Nour on sex trafficking of women and girls reflects that sex trafficking victims often suffer different kinds of physical abuse and torture that causes severe physical injuries.N.A. Deshpande & N.M. Nour, ‘Sex Trafficking of Women and Girls’, Reviews in Obstetrics and Gynecology, vol. 6, no. 1 (2013), e22-e27. According to their study, trafficking victims often suffer injuries such as broken bones, burns, broken teeth, headaches, memory loss, brain injury, weight loss, and breathing problems.
On mental health status, the studies of Oram et al. and Zimmerman et al. state that due to their high physical, sexual and psychological abuse, trafficked victims experience various mental health problems such as anxiety, phobias, disbelief, depression, and posttraumatic stress disorder (PTSD).S. Oram, ‘Human Trafficking and Health: A Survey of Male and Female Survivors in England’, American Journal of Public Health, vol. 106, no. 6 (2016), 1073-1078.
DOI:10.2105/AJPH.2016.303095.,Ibid., 27. Additionally, some trafficked women also reported being forced or coerced into drugs and alcohol consumption.C. Zimmerman & C. Watts, WHO Ethical and Safety Recommendations for Interviewing Trafficked Women (Geneva, Switzerland: World Health Organization, 2003). The study Stolen Smiles: A Summary Report on the Physical and Psychological Health Consequences of Women and Adolescents Trafficked in Europe published by Zimmerman et al. researched 207 trafficked women from 14 countries and found that upon release from trafficking, many women suffered severe physical and mental health problems such as headaches, fatigue, dizzy spells, back pain, stomach/abdominal pain, memory problems, PTSD, and depression.C. Zimmerman et al., Stolen Smiles: The Physical and Psychological Health Consequences of Women and Adolescents Trafficked in Europe (London: London School of Hygiene and Tropical Medicine, 2006).
Ulibarri et al.’s research on the history of abuse and psychological distress symptoms among female sex workers in two Mexico-US border cities indicates that female sex workers suffer a higher level of depression.M. Ulibarri et al., ‘History of Abuse and Psychological Distress Symptoms among Female Sex Workers in Two Mexico-US Border Cities’, Violence and Victims, vol. 24, no. 3 (2009), 399-413. In 2012, the World Health Organization published their report Human Trafficking: Understanding and Addressing Violence against Women. This report underlines that the psychological impact of victimization may be more severe than the physical violence.Human Trafficking: Understanding and Addressing Violence against Women (Geneva, Switzerland: World Health Organization, 2012). Victims, who have been rescued from sexual slavery, typically present with various psychological symptoms and mental illnesses, such as PTSD, depression, anxiety, panic disorder, suicidal ideation, Stockholm syndrome, and substance abuse. The study of Rimal and Papadopouloson mental health of 66 female sex trafficking survivors found that among the victims,R. Rimal & C. Papadopoulos, ‘The Mental Health of Sexually Trafficked Female Survivors in Nepal’, International Journal of Social Psychiatry, vol. 62, no. 5 (2016).
DOI:10.1177/0020764016651457. respectively more than 80 percent present with symptoms of anxiety, depression and PTSD thresholds. This study is further evidence of how damaging sex trafficking can be to victims, particularly in terms of being at risk of clinical depression and/or anxiety.
Williamson, Dutch and Clawson indicate that there are a number of mental disorders,E. Williamson, N.M. Dutch & H.J. Clawson, Evidence-based Mental Health Treatment for Victims of Human Trafficking (Washington, DC: Office of the Assistant Secretary for Planning and Evaluation, US Department of Health and Human Services, 2008). which can develop because of exploitation associated with human trafficking. These include mood and anxiety disorders, dissociative disorders such as PTSD in which feelings, thoughts, sensations, perceptions and memories become disconnected from each other, in addition to drug or alcohol related disorders. According to Levine the mental health condition of sex trafficking victims demonstrates that they are immersed in a social ecology that is linked to various social factors like family violence,J.A. Levine, ‘Mental Health Issues in Survivors of Sex Trafficking’, Cogent Medicine, vol. 4 (2017), 1278841. DOI:10.1080/2331205X.2017.1278841. coercion, sexual exploitation, drugs use, poverty, crime, corruption, and gender inequality.
The demographic information of trafficked women obtained from the cities of Monterrey and Reynosa in Mexico, indicates that victims are getting younger and younger. Participants ranged in age from eleven to twenty-six years old; the largest group was between thirteen and seventeen years old (78%). Moreover, when we asked them at which age they were trafficked, the response from the majority of them (90%) was that it happened before they turnedfifteen, and only three girls responded they were trafficked aged ten and eleven. The data collected from the two US-Mexican border cities highlight that traffickers use different tactics to attract young girls and women to enter their network. Traffickers frequently prey on the vulnerabilities of the woman to trap the victims. The recruitment tactics by sex traffickers indicates that 64% of the girls and women get trapped through marriage proposals and intimate partner relations, 27% of the girls and women are lured in through false promises, such as employment with certain companies near the US-Mexican border and migration to the US. However, in some cases, the trafficker promises them domestic employment with higher remuneration (nearly 30 dollars per day) including food, shelter and two days off per week, as well as modeling jobs in New York and Los Angeles. Once traffickers entice them with these promises, they don’t take them to the US, but just transfer them to border cities and force them to work in prostitution.
On the other hand, we found that women accept offers from traffickers for various reasons. By analyzing the factors behind trafficking in Monterrey and Reynosa, we conclude that there are several factors associated with the phenomenon. For example, women have cited various factors such as domestic violence, physical abuse by their stepfather, poverty, unemployment, household economic problems, marriage to their boyfriend, and migration to the US. However, we perceive from interviews with victims in Monterrey and Reynosa that family disintegration is one of the main fueling factors behind trafficking women in Mexico, as in the case of Jennifer, a fourteen-year-old girl, currently working as a table dancer in Reynosa. She narrates: ‘I was born in the state of Veracruz, Mexico. I have one sister and two brothers. My father was working in Puerto de Veracruz and my mother was working as a housemaid in town. Since I was a child, I have seen my parents fight for many reasons; my family environment was always tense and unhealthy. When my younger brother was born in 2009, my parents separated. After that we never saw our father. My mother remarried in 2013, and my stepfather was very cruel to us. When he started living with us, he advised my mother not to let us go to school, and asked us (my older sister and I) to work with him in a bar. However, we were not interested in working there. We asked our mother to say something about it to him, but she also insisted we should go work there. She said that my stepfather would take care of us and that nothing bad would happen. Since we could not convince our mother, one day my older sister contacted the capataz,Agent who hires workers. who usually offered jobs at the northern border. After a few weeks he offered us a job in Reynosa in a restaurant. I would earn nearly 100 to 150 dollars per day including food and shelter. He suggested us to leave Veracruz as soon as possible, or he would offer this job to someone else… We immediately accepted his offer. The next day we traveled with him to the border, and once we got there, he brought us to this place and forced us to do this work.
The Global Report on Trafficking in Persons categorized human trafficking as one of the worst forms of violence against women. According to the report, trafficking victims suffer a wide range of physical, sexual as well as emotional violence at different stages while being trafficked. Once recruited, the women usually find themselves in situations in which their freedom is severely curtailed. Many times they also experience imprisonment, forced abortions and physical brutality at the hands of their so-called ‘owners’.United Nations Office on Drugs and Crime (UNODC), Global Report on Trafficking in Persons 2012 (Vienna: Research and Trend Analysis Branch Division for Policy Analysis and Public Affairs, UNODC, 2012), 98. In this study women reported that they had been hit, kicked, punched, struck with objects, burned, cut with knives, raped, and experienced others kinds of violence by their madrina/padrino. Similarly, in our study, 100% (N=100) trafficked women from Monterrey and Reynosa responded that during the last week they had suffered and observed violence against themselves or against their friends. When asked about the kind of violence they personally suffered, we found a wide range of violence such as verbal abuse, locked inside a room without food for days, death threats by their madrina/padrino, being hit, kicked, and punched by their madrina/padrino as well as by clients, struck with objects, and burned with cigarettes.
Figure 1: Violence experienced by trafficking victims during a week in US-Mexican border cities
However, when inquired about observing violence against their friends, trafficking victims responded that their madrina/padrino forced their friends to have sex with more than one client at a time and that chili powder was put in their eyes and vagina by the madrina/padrino. Analysis indicates that trafficking victims face an extreme level of violence and aggression, which causes severe physical and psychological injuries. In this regard, a trafficking victim from Monterrey stated: ‘One day I was feeling very sick, I had a severe fever and my whole body was trembling. I asked the madrina if it was possible not to take any client because I wanted to take a rest… Without listening to me, she got furious and said: “I do not care whether you are sick or not, just go and sit with clients and ask for a drink… If you do not obey, I will put you in an infierno.Hell. But at the end of the night, she saw that I had not accepted any clients, she sent a guy to me. He pulled my hair, put a knife on my neck and started to beat me on my back, and said: “If you do such thing again, you won’t get out alive from this place. We will not hesitate to kill you.”’ (Lupita, sixteen years old).The information obtained from these two border cities indicates that victims of trafficking experienced a higher degree of violence by people they were surrounded by,Here we define ‘people they were surrounded by’ as clients, other trafficked victims, and brothel owners. which has a direct impact on physical and mental health disorders.
Physical, sexual and psychological abuse against victims of trafficking has multiple physical health consequences. In this regard, our analysis of the physical health conditions of human trafficking victims in Monterrey and Reynosa indicates that women experienced different kinds of problems. We asked women to report physical injuries or illnesses they have suffered over the past month, and most women (N=93) reported sixteen symptoms during this period. Seven of the hundred victims did not answer this question.
In Table 1 we have analyzed the physical health problems such as gastrointestinal, respiratory, neurological, musculoskeletal, and constitutional. Results indicate that nearly 66% of the victims suffered from back pain, 41% said they suffered fractures in their hands and feet, 25% reported facial injuries, 100% reported joint and muscle pain, 94% mentioned stomach pain, vomiting, and diarrhea, 99% felt tired and fainted, 100% had a loss of appetite, 76% mentioned tooth pain, 100% reported cold, fever, and coughing, 97% had eye and ear pain, and 100% of the victims said they had severe headaches during the last few weeks. Respondents explained that violence and punishment inflicts heavy physical as well as mental damages among the victims.
Most of the time the injuries are extremely severe, but nobody, not even friends console them or ask them about their health, as Cindy, a nineteen-year-old woman experienced. ‘It is common for the madrina to exercise her power and abuse us physically, sexually, and mentally. You do not know when and how she will react from time to time. She always wants us to take lots of clients and generate money for her, even if you are not feeling well, physically or mentally. That is not important… If we do not fulfill her orders, then things will get worse for us. She beats us, locks us in a room and tells her bodyguard to have sex with us against our will. Once I had a severe injury on my head, because she beat me with a beer bottle since I refused to have sex with an adolescent. My head was bleeding heavily, but none of my friends came to me and helped me. I told the madrina that I was in a lot of pain. But instead of helping me, she said: “Burra te merece eso o tambien mucho más.” [You donkey, you deserve that and much more.] And she hit me again on my back… I collapsed and was crying in pain… But no one came to help me... and like me, there are so many cases here… I am not the first person it happened to. Every day we have many girls who go through this. We are forced to work here in all conditions… There is no room for how we feel.’
As we mentioned earlier, women who are forced into trafficking suffer many gynecological complications. Over two thirds of our subjects responded having one or more symptoms associated with sexually transmitted diseases.
Symptoms | Percentage | Number (N= 93) |
Back pain Fracture in hand and feet Facial injuries Joint and muscle pain Stomach pain, vomiting, diarrhea Tired and fainted Loss of appetite Tooth pain Cold, fever, and coughing Eye and ear pain Continuous headache | 66 41 25 100 94 99 100 76 100 97 100 | 61 38 23 93 87 92 93 71 93 90 93 |
Source: fieldwork
Table 1: Physical Health Disorder Among Trafficking Victims in US-Mexican Border Cities
Our analysis on urogenital symptoms indicates that nearly 97% of the victims reported vaginal pain, 82% mentioned itching and irritation in the vagina,57% reported pain and bleeding during sexual intercourse, 15% of the victims experienced vaginal discharge and 90% of the victims said they felt pain during urination (see Table 2). Moreover, these kinds of problems have long-term consequences and it may lead to severe sexual, physical, and mental illnesses as well as the death of the victims. According to responses from trafficked women, they are forced to have unsafe sex, as well as sex with multiple partners. In most cases this causes tearing of the vaginal tract and genitals, which leads to infection as in the case of Luisa, a fourteen-year-old girl from Reynosa. She said: ‘On my first day the patron asked me to have sex with two persons… When I said “no”, he forced me to do it… even though I resisted for a few minutes. I could not keep that up, because he threatened to kill me… After a few minutes the patron and the two clients took me upstairs and removed my clothes forcefully. They had both anal and vaginal sex. I felt a lot of pain and asked them to leave… But none of them listened to me… I was bleeding heavily and since then I’m always in pain during sex, or even when urinating. I have asked the patron if I could go to the clinic, but he said no and that if I insisted, he would send me to hell. I am in a lot of pain… Sometimes it is intolerable, but my friends have said to me to take cocaine and every day, once or twice, I use it and to some extent I feel better.
Symptoms | Percentage | Number (N= 93) |
Vaginal pain Itching and irritation in vagina Pain and bleeding during sexual intercourse Vaginal discharge Pain when urinating | 97 82 57 15 90 | 90 76 53 14 84 |
Source: fieldwork
Table 2: Physical Health Disorder Main Urogenital Symptoms Among Trafficking Victims in US-Mexican Border Cities
As observed, physical disorders of human trafficking victims may lead to long-term health issues. Research on sex trafficking suggests that the more physical illnesses victims have, the more mental health problems they will develop.
Evidence of psychological and mental health conditions of human trafficking victims indicates that coercion and abuse suffered at different stages of trafficking results in mental health problems. Thus, to obtain an overview of the range of mental health conditions of trafficking victims, we asked the women some questions on their present mental status. For example: Do you sleep poorly? Do you cry more than usual? Do you feel tired all the time? Do you have a lack of appetite? Have you ever thought of ending your life? Do you lack interest in things? Do you feel tense, anxious or worried all the time? Do you frighten easily?
During the interviews with 93 victims, 89 of the women responded positively. From Table 3, it is observed that out of the 89 women, 82 (92%) of them reported that they feel easily tired or are tired all the time. This was followed by sleeping poorly (91%). Also nearly 86% of the trafficked victims said they cry more than usual and have a lack of appetite. Similarly, among the other mental disorder symptoms we found that of the 89 victims of trafficking, 71 (80%) said that in the past month they entertained the idea of committing suicide many times. On our question about their lack of interest in things or feelings of depression, nearly 90% of the victims responded positively and 100% of the women said that they constantly feel tense, stressed, anxious, worried, irritated, and angry. It is true that in addition to the violence and abuse, the nature of the work and their living environment also cause the victims to often experience stress, panic and anxiousness. In this regard, Fanny, an eighteen-year-old girl from Reynosa, narrated: ‘Every day I start working at around one or two in the afternoon until the next morning… Our patron hardly gives us four to five hours to rest… Every day around ten in the morning he comes to our rooms and forces us to wake up… For the last five years I have not rested for even a single day… I am very tired and I also feel very dizzy… Last year I got pregnant and the patron forced me to have an abortion. Since then I feel sick all the time… I don’t have any interest in working or talking to others… Most of the time, clients complain to the patron that I am not cooperating with them… Although I don’t want to be here, I don’t see a way to escape. The only way out is suicide… A few days back I thought about cutting my veins... but I couldn’t… I don’t know what to do... Last year, a girl from Michoacán committed suicide and even though I have similar thoughts, I do not have that much courage… Right now I am taking too much alcohol and cocaine. It relaxes me to some extent… I feel it is the only way for me to deal with this painful life…
Symptoms | Percentage | Number (N= 89) |
Feels tired easily or is tired all the time Sleeps badly Cries more than usual Lack of appetite Feels depressed and has no interest in things Thoughts of committing suicide Feels tense, stressed, anxious, worried Feels irritated by everything Feels angry | 92 91 86 86 90 80 100 100 100 | 82 81 77 77 80 71 89 89 89 |
Source: fieldwork
Table 3: Symptoms of Mental Health Disorder Among Trafficking Victims in US-Mexican Border Cities
As several studies indicate, for instance Zimmerman et al. and Reid,C. Zimmerman et al., ‘The Health of Trafficked Women: A Survey of Women Entering Post-trafficking Services in Europe’, American Journal of Public Health, vol. 98 (2008), 1.,J. Reid & S. Jones, ‘Exploited Vulnerability: Legal and Psychological Perspectives on Child Sex Trafficking Victims’, Victims and Offenders, vol. 6, no. 2 (2011), 207-231.
DOI:10.1080/15564886.2011.557327. mental health disorders often provoke substance abuse such as alcohol and drugs consumption among the victims. From the victim’s point of view it can be said that the working and living environment is so stressful that women seek refuge in drugs and alcohol. Therefore, it is clear from this study that human trafficking victims are dealing with complex mental health disorders.
In 2012, the Government of Mexico introduced and approved a new anti-trafficking law, replacing the one from 2007. This national law to prevent, punish, and eradicate crimes on human trafficking and to protect and assist victims of these crimes, defines trafficking as an organized crime activity, and therefore its prosecution is a task exclusively for the federal agencies, leaving the protection of the victims in hands of the local governments. Both local and federal governments are responsible for preventive action. The law also prohibits all forms of human trafficking, prescribing penalties of five to sixty years imprisonment depending on the form of trafficking; these penalties are sufficiently stringent and equal to those prescribed for other serious crimes, such as rape.Cámara de Diputados del H. Congreso de la Unión, Ley General Para Prevenir, Sancionar y Erradicar los Delitos en Materia de Trata de Personas y Para la Protección y Asistencia a las Víctimas de estos Delitos. Nueva Ley (Government of Mexico, 14 June 2012). However, two years later in 2014, Congress reformed the anti-trafficking law, though this reformed law remained more or less the same as the 2012 anti-trafficking law since very few changes were made.Cámara de Diputados del H. Congreso de la Unión, Ley General Para Prevenir, Sancionar y Erradicar los Delitos en Materia de Trata de Personas y Para la Protección y Asistencia a las Víctimas de estos Delitos. Última Reforma (Government of Mexico, 19 March 2014).
One of the objectives of the government through this law is to provide dignified and enduring attention, and safety to all victims. Attention for the victims of trafficking can include a wide range of services, ranging from housing assistance; medical care; psychological, social, and legal counseling; enrollment in school; and professional training. In Section 6, Article 2 of the anti-trafficking law it states that it is necessary to establish an integral, adequate, efficient and effective mechanism to repair the damage already suffered by the victims. Similarly, the law indicates that it is also the responsibility of the government to implement measures to ensure the total physical, mental/psychological, and social healing of victims of human trafficking. For example, Article 89, Section VII assigns the Secretariat of Health (SALUD) the physical and psychological attention for the victim in the appropriate shelters; section VIII demands the Secretariat of Labor and Social Welfare to promote agreements with the private sector aimed to provide labor guidance and job opportunities for the victims; section XI appoints the National System for Integral Family Development (DIF) the care of minors; in sections XIII the National Institute of Migration (INM) is responsible of guaranteeing the permanence of foreign victims and provide voluntary repatriation; according to section XIV the National Institute of Women is in charge of assisting female victims of trafficking. Similarly, Article 90 assigns the federal government the design and management of victims’ assistance and protection models that should provide at least legal counsel, physical and psychological attention, schooling, labor training and job opportunities.
Our present study analysis on physical and mental health conditions of sex trafficking victims indicates that trafficked women suffer physical, sexual, and psychological abuse and violence, deprivation, and torture. They are also forced to use a variety of substances. Unlike most other violent crimes, trafficking usually evokes prolonged physical and mental health problems and therefore these victims need special integral attention for their well-being. However, in the case of Mexico until thus far no adequate steps have been taken to address the health issues of trafficked victims. Currently, there are fifty-nine short- and long-term shelters in Mexico, that provide counseling, family reintegration, medical assistance, family support grants, legal assistance, education, vocational training and a safe place to stay, among other services. Even though these shelters provide some basic medical assistance and psychological treatment, they are not adequate. For example, the psychological or mental health care must be aimed at preventing women from committing suicide and managing depression, helping to stop the violence cycle and empowering women to achieve their autonomy. Similarly, the medical care, although comprehensive, should be focused on the reproductive and sexual health issues of the victims.
Our results on physical and mental health conditions of human trafficking victims of two US-Mexico border cities reveal that those women are living in a very painful and challenging situation. They are being exploited, abused and maltreated by their pimps, clients, bar boys as well as their friends. In addition to beatings and rape, victims also suffer malnutrition and unhealthy weight loss due to food deprivation and poor nutrition. They are treated as animals, as we have evidenced from our discussion, if they do not obey their pimp. They often are locked inside a room for days without food or water. The dimensions of coercion, violence and abuse aggravate long-term physical and mental disorders. Although most victims are aware of the deterioration of their physical and mental health, it is impossible for them to do something about it since they are not allowed to visit a doctor. Our analysis, as well as other research, also indicates that pimps in Mexico treat trafficked victims as their ‘property’ and use them the way they want. For example, one victim said: ‘In this place neither our emotion nor our sentiment has value...’
Finally, despite the limitations of the study such as representative sample, we believe that the present research provides urgently needed information of a sub-population which is completely invisible in the Mexican society. As documented earlier, there is a higher growth in the number of people infected by sexually transmitted diseases. In most of these cases female victims of trafficking are seen as the source of these diseases. Therefore, it is important that policymakers as well as practitioners are aware of these issues and include it in an anti-trafficking program. In 2014, Mexico’s Government implemented a national program to prevent, punish and eradicate crimes in matter of trafficking in persons and for the protection and assistance of those victims. In Objective 2 of the program it specifies that the State must provide comprehensive care, protection and assistance to victims of trafficking. The model of care, protection and assistance should be an institutional framework that includes health, education and employment sectors. Although the national program specifies the comprehensive care for victims of human trafficking, it does not mention the mental and physical care for these categories of people. Therefore, it is necessary that the government creates instruments in the national program to address the unmet health needs for trafficked victims.