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Sexual Trafficking: An Overview of the Practice and its Intersections with Public Health and Law. Rita-Marie A. Brady August 5, 2005 ORISE Fellow – CDC Public Health Law Program JD/MPH Candidate Emory University

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sexual trafficking an overview of the practice and its intersections with public health and law

Sexual Trafficking: An Overview of the Practice and its Intersections with Public Health and Law

Rita-Marie A. Brady

August 5, 2005

ORISE Fellow – CDC Public Health Law Program

JD/MPH Candidate Emory University

“This research was supported in part by an appointment to the Research Participation Program at the Centers for Disease Control and Prevention administered by the Oak Ridge Institute for Science and Education through an interagency agreement between the U.S. Department of Energy and CDC”

"The findings and conclusions in this presentation have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.”

presentation overview
Presentation Overview
  • Definitions, background, and figures
  • The health and human rights connection
  • Focus on women and sex trafficking
  • International laws and efforts to combat sex trafficking
  • US Laws and Efforts to combat trafficking
  • What’s next?
  • 2002 Interview with Senator Hillary Rodham Clinton
trafficking definitions international instruments
Trafficking Definitions – International Instruments

United Nations (UN):

“Trafficking in persons shall mean the recruitment, transportation, transfer, harboring or receipt of persons by means of the threat or use of force or other forms of coercion, of abduction, of fraud, of deception, of the abuse of power or of a position of vulnerability or of the giving or receiving of payments or benefits to achieve the consent of a person having control over another person, for the purpose of exploitation….”

Source: Article 3(a) UN Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children, Supplementing the UN Convention Against Organized Crime, 2000

trafficking definitions us law
Trafficking Definitions – US Law

“Severe forms of trafficking in persons means –

The recruitment, harboring, transportation, provision, or obtaining of a person for labors or services, through the use of force, fraud or coercion for the purposes of subjection to involuntary servitude, peonage, debt bondage, or slavery.”

Source: Victims of Violence and Trafficking Protection Act 2000 22 USC 7102 §103(8)(B)

trafficking definitions international organizations
Trafficking Definitions – International Organizations

International Organization for Migration (IOM):

“Trafficking occurs when a migrant is illicitly recruited and/or moved by means of deception or coercion for the purpose of economically or otherwise exploiting the migrant, under conditions that violate their fundamental human rights.”

(Gushlak & McPherson, 2000)

trafficking definitions trafficked individuals
Trafficking Definitions – Trafficked Individuals

Trafficked Women Defining Trafficking

“I know what it means, it just happened to me. I was being sold as though I was cattle. I was being captured and stripped of all my dignity and self-control”

“I remember my story. Police are combating it, but not very successfully.”

historical background
Historical Background
  • The International Labor Organization (ILO) notes that trafficking is a practice that dates back to the 16th century
  • In the 17th century trafficking evolved into “illicit trading”
  • 19th century trafficking contraband included human beings
  • In the late 20th century trafficking became a common term for movement across or within borders for exploited labor
global trafficking routes
Global Trafficking Routes
  • Caveat: Does not take into account “internal” or domestic travel
  • Map at right is from a USAID study released in 1999 which dealt with health and economic consequences of trafficking

Source: USAID

Global Trafficking in Women and Girls: Major Source Regions and Destinations (1999)

recent developments
Recent Developments
  • Recent conventions, laws, and protocols have sought to address the specific issue of trafficking and distinguish it from migration and smuggling
  • The UN addressed the issue in 1949 with the Convention for the Suppression of the Traffic in Persons and of the Exploitation of the Prostitution of Others
  • Two protocols emerged from the 2000 UN Convention Against Organized Crime in Palermo, Italy (a.k.a. Palermo Protocols)

1. Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children

2. Protocol Against the Smuggling of Migrants by Land, Sea, and Air

  • Recommended Principles and Guidelines on Human Rights and Human Trafficking established in 2002 by the HCHR
united nations estimates
United Nations Estimates

UN estimates on trafficking in 2000:

  • 4 million individuals per year are victims of trafficking
  • 700,000 victims of trafficking are women and children
  • 175,000 individuals are estimated to come from the former Soviet bloc countries
  • 45,000-50,000 individuals are estimated as being trafficked into the United States
united states estimates
United States Estimates
  • US Department of State trafficking estimates released in 2005:
    • 600,000-800,000 = number of estimated of individuals trafficked across international borders
    • 80% of estimated trafficked individuals are female
    • 50% of estimated trafficked individuals are children
    • 18,000-20,000 estimated individuals trafficked into the United States annually

Source: U.S. Department of State Trafficking in Persons Report June 2005

health and human rights
Health and Human Rights

Health Implications of Trafficking:

  • Substance abuse
  • Violence
  • Occupational illness
  • Sexual abuse
  • Psychosocial illness
  • Communicable/infectious disease (Gushalak & McPherson, IOM, 2000)
health and human rights1
Health and Human Rights

Human Rights and Trafficking

  • A human rights framework allows for empowerment of trafficked individuals
  • A human rights framework enables all trafficked individuals to be addressed
  • Concerns have been raised that the Palermo Protocols were created by the UN Commission on Crime Prevention and Criminal Justice in Vienna rather than a human rights body in Geneva

(Jordan, 2002)

health and human rights2
Health and Human Rights

Recommended Principles and Guidelines on Human Rights and Human Trafficking

“The human rights of trafficked persons shall be at the center of all efforts to prevent and combat trafficking and to protect, assist, and provide redress to victims”

  • Addresses the primacy of human rights, preventing trafficking, protection and assistance, criminalization, punishment, and redress

Source: (2002 Report of the UN High Commissioner for Human Rights to the UN Economic and Social Council)

women and trafficking
Women and Trafficking
  • According to a National Institute of Justice report the “shadow market” of sexual exploitation of women and girls is valued at $7-12 billion annually
  • US Department of State estimates that 50,000 -100,000 women and children are trafficked into the US for labor or sexual exploitation
  • International agencies such as the IOM and government reports estimate 1 million women are trafficked annually for sexual exploitation
women and trafficking1
Women and Trafficking

Trafficking Victims Reauthorization Act of 2003

- The act defines severe form of trafficking in persons as “sex trafficking in which a 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”

- Sex Trafficking is defined as “the recruitment, harboring, transportation, provision, or obtaining of a person for the purpose of a commercial sex act”

women and trafficking2
Women and Trafficking

Women’s Health Concerns as a result of sex trafficking:

- bodily injury and disability

- homicide

- suicide

- stress and psychological trauma

- STD’s, infectious disease, and non-infectious disease

- miscarriage, abortion, infertility, and unwanted


(Source: Committee on Women, Population, and the Environment)

international instruments to combat sex trafficking
International Instruments to Combat Sex Trafficking

Human Rights Arguments:

(In addition to HCHR 2002 Recommended Principles and Guidelines on Human Rights and Human Trafficking )

International Covenant on Civil and Political Rights (ICCPR)

- Article 21 extends rights to all individuals within a territory

- Article 8 prohibits slavery

- Article 9 guarantees liberty and security of persons

Convention on the Elimination of all forms of Discrimination Against Women

-Article 6 obligates state parties to suppress trafficking and prostitution

(Source: vonStrensee, 2000)

international laws and efforts to combat sex trafficking
International Laws and Efforts to Combat Sex Trafficking

Criminalization Arguments:

Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children 2000 = framework

- supplement to the UN Convention Against Transnational and Organized Crime

- fosters a global response and an international definition

- protects all victims and notes that consent is irrelevant

- victims do not bear the burden of proof

- key element = exploitation not movement across borders

- encourages countries to strengthen legislative policies

u s laws and efforts to combat trafficking
U.S. Laws and Efforts to Combat Trafficking
  • US is a signatory to both Palermo Protocols, but has not ratified either
  • US addresses the issue via the Trafficking Victims Protection Act of 2000 which was followed up with the Trafficking Victims Protection Reauthorization Act of 2003
  • President Bush addressed the issue in a 2003 address to the UN assembly, pledging $50 million to organizations that combat trafficking

(Sources: UN & US Dept of State)

u s case law
U.S. Case Law
  • U.S. v Cadena (1998)

Defendant Outcome: Sixteen men indicted in Florida charges ranged from involuntary servitude, visa fraud, conspiracy, and civil rights violations  sentences varied from two-six years and one ringleader was sentenced to fifteen years in prison

Victim Outcome: Living in Florida, either on their own or in shelters, trafficking ring was ordered to pay $1million, some of the money was received by victims using seized assets

  • U.S. v Kwon (1998)

Defendant Outcome: Pled guilty to conspiracy to violate the 13th Amendment, involuntary servitude, extortion, transportation for illegal sexual purposes

Victim Outcome: Currently living in Guam, Dept of Justice assisted them in procuring jobs

  • U.S. v Wattansari (1995)

Defendant Outcome: Eighteen defendants  indicated on charges of kidnapping, alien smuggling and “white slavery,” twelve prosecuted, two were extradited from Thailand, the remainder are currently in Thailand, sentences ranged from four to nine years

Victim Outcome: Unknown

  • U.S. v Manasurangkun (1995)

Defendant Outcome: Seven Defendants  convictions on alien smuggling, involuntary servitude, civil rights violations with sentences ranging from 7 months to 7 years

Victim Outcome: $4.5 million in restitution for all victims

Source: King, G. (2004). Woman, Child For Sale.

actions of u s states to combat trafficking
Actions of U.S. States to Combat Trafficking
  • 2003 = Texas (SB 1953) and Washington (SHB 1175) state passed anti-trafficking bills
  • 2004 = Hawaii legislature passed bill to make tourism for the purpose of prostitution a felony (penalty = revoking travel agent’s license)
  • 2004 = US Department of Justice released a Model State Trafficking Law (model for amendments to criminal codes)
  • 2004 = Arizona passed legislation requiring massage licenses and Maryland has similar legislation pending

Source: Stop Violence Against Women (2005) and The Protection Project (2005)

what s next
What’s Next?
  • NGO’s have taken the lead in providing resources such as counseling, shelter, legal assistance, and logistical resources to countries lacking the means to prosecute
  • Preventive campaign both in countries of origin and destination
  • Encouragement of success

Example: Ukraine’s increased criminalization

areas for improvement
Areas for Improvement
  • Recent IOM work has noted that there appears to be a “next step” missing in the investigative methodology
  • Research is lacking a quantitative element
  • Concern is that law enforcement and social workers can provide “deliverables” that researchers cannot (i.e., therapy, green card, etc.)
  • Focus has been on causes and victims, but not on consequences and perpetrators
questions raised and potential fall investigation issues
Questions Raised and Potential Fall Investigation Issues
  • How effective is comparative law analysis for trafficking research and policy proposals?
  • How has the Trafficking Victims Protection Act failed and succeeded as a legal tool, and what impact (if any) has it had on state actions?
  • What are specific areas where law and health intersect and how can legal interventions address health concerns associated with trafficking?
“Can people really buy and sell women and get away with it? Sometimes I sit here and ask myself if that really happened to me, if it can really happen at all.”

- A Ukrainian woman who was trafficked, beaten, raped, and used in the sex industry in Israel. After a police raid, she was put in prison awaiting deportation.

sources and recommended readings
Sources and Recommended Readings

Gushlak, B., McPherson, D. Health issues associated with the smuggling and trafficking of

migrants. Journal of Immigrant Health. 2000; 2 (2): 67- 78.

Hughes, D. The “Natasha” trade: the transnational shadow market of trafficking in women. Journal of International Affairs. 2005; 53 (2):625-651.

International Labor Organization (ILO). Trafficking in human beings: new approaches in combating the problem, 2003. PDF available at:

International Organization for Migration (IOM). Data and research on human trafficking: A global survey. (2005). PDF available at:

King, G. Woman, child for sale: the new slave trade in the 21st Century. (2004). New York: Chamberlain Brothers.

Protocol to Prevent, Suppress and Punish Trafficking in Persons,Especially Women and Children, Supplementing the United Nations Convention Against Transnational Organized Crime, G.A. res. 55/25, annex II, 55 UN GAOR Supp. (No. 49) at 60, UN Doc. A/45/49 (Vol. I) (2001).

Trafficking Victims Protection Reauthorization Act of 2003, H.R. 2620, 108th Cong, 1st Sess. (2003).

Victims of Trafficking and Violence Protection Act of 2000, Pub. L. No. 106-386 114 Stat.

1464 (October 28, 2000).

USAID: Office of Women in Development. Women as chattel: the emerging global market

in trafficking. Gender Matters Quarterly. 1999;1: 1-7. Available from: (April 13, 2004).

US Dept of Justice Model Anti-Trafficking Statute:

US Dept of State. Trafficking in Persons Report. Washington DC:USDS; 2005, June. PDF available at

United Nations Office on Drugs and Crime. Trafficking in Human Beings. 2005.

Web Resources:

Stop Violence Against Women

The Protection Project