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FMR 64
   42                          Trafficking and smuggling
        www.fmreview.org/issue64                                       June 2020

       Joshua Youle joshua.youle@gmail.com    1. The Walk Free Foundation (2013) Global Slavery Index
       Abigail Long aelong361@gmail.com     bit.ly/Global-Slavery-Index
       Program Advisors, Everwatch Solutions Corporation   2. ILO (2012) ‘Hard to see, harder to count’
                                            bit.ly/ILO-HardtoSee-2012
       and Cherokee Nation Mission Solutions,   3. ILO (2018) ‘Guidelines concerning the measurement of forced
       Contractors, the US State Department, Office to   labour’, 20th International Conference of Labour Statisticians.
       Monitor and Combat Trafficking in Persons   Geneva, 10–19 October 2018 bit.ly/ILO-ICLS20-Oct18
                                            4. UN General Assembly (2000) ‘Protocol to Prevent, Suppress
       The views expressed in this paper are those of the   and Punish Trafficking in Persons Especially Women and
       authors and are not an official policy nor position of   Children, supplementing the United Nations Convention against
                                            Transnational Organized Crime’ (known as the Palermo Protocol)
       the US Department of State or the US government.  bit.ly/UN-Palermo-Protocol
       www.state.gov/bureaus-offices/under-secretary-  5. Johansen R (2019) ‘UNODC’s use of Multiple Systems
       for-civilian-security-democracy-and-human-rights/  Estimation (MSE) to assist countries in measuring human
                                            trafficking and reporting on SDG indicator 16.2.2’
       office-to-monitor-and-combat-trafficking-in-persons  bit.ly/Johansen-UNODC-MSE-2019
       Understanding the psychological effects of sex
       trafficking to inform service delivery

       Jennifer McQuaid
       Those providing assistance to survivors of trafficking should focus not only on the delivery of
       services but also on building survivors’ capacity to engage in treatment and support.
       When trafficked for sexual exploitation,   This severe rupturing of attachment
       women are subjected to extraordinary   relationships can have a significant impact
       physical, sexual and psychological   on survivors – disrupting their sense of self
       violence which puts them acutely at risk   and affecting their ability to leave exploitative
       for developing not just short-term physical   situations, rebuild themselves emotionally
       ailments but also lasting mental illness   and engage with services. After periods
       that can profoundly alter their ability to   of imposed isolation, a loss of autonomy
       navigate effectively in the social world.   and forced servitude, survivors report
       Survivors may be dealing with HIV    feeling helpless and hopeless, struggling
       infections, experience gynaecological issues,   to feel competent with life skills, ashamed
       succumb to substance and alcohol abuse,   about their past victimisation, and angry
       and suffer the prolonged effects of physical   about missed education and job training.
       injury. The impacts on their mental health   Many feel lost in their personal search for
       include anxiety, depression, self-harm and   identity and meaning. Regulating difficult
       post-traumatic stress disorder (PTSD).    emotions and interpersonal relationships
          Violent exploitation may also result in   can be challenging. All told, the effects
       survivors developing a mistrust of care-  of sex trafficking are wide-reaching,
       giving individuals and systems, which   profound and often not well understood.
       can severely hinder service delivery. Sex   Signs and symptoms of psychological
       trafficking disrupts caregiving by hijacking   distress may also fall outside diagnostic
       the victim’s relationship with trust and   categories and manifest in cultural
       security. Victims rely on their traffickers to   idioms of distress. Systems of care that
       provide them with food and shelter but to   adequately account for these experiences
       obtain these victims must work, and that   have a far greater chance of success. 1
       work involves sexual violence and coercion.
       The hand that feeds and gives shelter and   The road map of complex PTSD
       promises a path to safety is therefore also the   The traditional reliance on PTSD as a
       hand that leads to injury and persecution.   diagnostic means of describing distress and
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