Cathy Zimmerman, author of ‘Stolen Smiles’, will be presenting the report to MSPs at the Scottish Parliament on Thursday 29th June at 1pm in Committee Room 6. A report on Amnesty International’s recommendations on healthcare provision for trafficked women will be presented at the same meeting by its author, Dr Rachel Grenfell. A panel including police officers from Strathclyde Police’s Operation Pentameter will answer questions from the audience.

“Stolen Smiles: The physical and psychological health consequences of women and adolescents trafficked in Europe” provides some of the first ever comprehensive data on the health of and girls who have been trafficked and forced into prostitution or domestic work. It is a three year study, including interviews with more than 200 women and girls from 14 countries.

Key findings of the report are:

• Physical health damage: nearly three in five women (57%) report suffering more than 12 different physical symptoms when they enter care, including headaches, dizzy spells, back pain, stomach/abdominal pain, fatigue and memory problems. Nearly 7 in 10 still have headaches after more than 90 days in care.
• Mental health damage: 56% of women report symptom levels suggestive of Post Traumatic Stress Disorder (PTSD) on entering care. Trafficked women anxiety, depression and hostility levels are extremely high – within the top 10th percentile of the norm for the whole female population. 38% report suicidal thoughts, and 95% report feeling depressed.
• Sexual and reproductive health: over 60% of women report pelvic pain, vaginal discharge and gynaecological infections on entering care. Most women report that they were sometimes made to have sex without a condom. 17% report having at least one abortion during the trafficking. Many expressed concern about their fertility and future ability to have Children's rights.
• Violence during trafficking: physical or sexual violence while in the trafficking situation was reported by nearly all women (95%). Respondents described violence such as being kicked, burned with cigarettes, punched in the face, choked with wire, and having a gun held to their head. Power over women was asserted through violence and maintained by imposing unpredictable, unsafe and extremely restrictive environments. 77% of women report ‘never’ having freedom to do as they wished or go where they wanted.
• Women reported physical and/or sexual abuse before they were trafficked. This compares with some of the highest national prevalence levels in the world. Almost one in five said they had been ‘recruited’ by someone known to a family member. Most women are single (71%). 39% have Children's rights; more than four in five of these (82%) are single mothers. This suggests that women who are abused or single parenting may be particularly vulnerable to recruitment by traffickers.

Although it is difficult to obtain reliable statistics it is widely acknowledged that thousands of women are trafficked and forced into prostitution to and within the EU. It is also known that these women experience a whole series of human rights violations: kidnapping, beatings, rape, being kept prisoner. The damage to their health is profound and enduring yet no assessment has to date been made of their health needs.

“Stolen Smiles” is published as the debate about how the law and the authorities can tackle traffickers and protect their victims in the UK continues. Although there has been concerted and well resourced police action to tackle trafficking over the past few months, in particular through Operation Pentameter, victims of this crime are still not automatically entitled to any protection in the UK. There is very limited and irregular assistance available to them. In the eyes of the law they are most often simply considered illegal immigrants and there have been cases of trafficking victims, only recently escaped from the kind of trauma described above, being held in immigration detention centres and being deported back to their home countries without assessment of risk.

Report author and LSHTM Research Fellow Cathy Zimmerman said:

“This research shows that women who have been trafficked into sex work emerge with very severe pain and injuries, and they show psychological health problems that appear to be similar to those documented among victims of torture. Yet, with appropriate services, our findings suggest that for many women, their health does improve.

“Our conclusion is that women who are trafficked should be offered adequate and appropriate health care immediately upon release from a trafficking situation. They should be accorded a 90-day reflection period during which time they should receive the support they need to begin recovering from their injuries, pain and trauma and to make well-considered decisions about their future. We also believe that with this time and assistance, women will be able to provide more reliable evidence about the crimes committed against them.

“I hope this information will be used by policy makers and will contribute to improved practice and more resources for the many women who require assistance in rebuilding their health and their lives.”

Rosemary Burnett, Programme Director Scotland for Amnesty International UK, which is supporting the publication of this report, said:

“The continuing lack of automatic protection for victims of trafficking in the UK is shocking and unacceptable. This report gives us clear and hard facts about what trafficked women actually experience and need. The government must act on this information and grant protection to victims immediately. It should sign the European Convention Against Trafficking immediately and commit the UK to providing a very minimum level of support and care.”

Key recommendations of the report include that the UK government:

• Approve legislation that provides healthcare for all trafficked women, regardless of their legal status;
• Require police and immigration personnel to ensure that women suspected of being trafficked are asked about their health concerns at the first point of contact;
• Implement a recovery and reflection period of at least 90 days

Amnesty International’s recommendations to the Scottish Executive include:

• The provision of shelter, protection and specialist health care for trafficked women, including specialist psychiatric health care
• The establishment of guidelines on appropriate treatment for trafficked women for professionals working in the health service, police and social work
• The continuation of funding and support for the Inter Agency Working Group on Trafficking set up by Glasgow City Council.