An examination of the services provided to international victims of human trafficking (adults and children) reveals emergency, short-term, and long-term needs (Caliber Associates, 2007; Clawson, Small, Go, & Myles, 2004). Some victims initially may present to a service provider with basic needs for safety, housing, food, and clothing. In fact, the need for safe and secure housing and overall support and advocacy are primary needs for virtually all victims of trafficking.
These basic needs often are accompanied by an immediate need for legal assistance/representation to handle issues related to immigration status, provide legal representation that may be required in an ongoing investigation and prosecution of the trafficking case, or provide counsel in a civil lawsuit against the trafficker or in a potential custody case (Caliber Associates, 2007; Florida University Center for Advancement of Human Rights, 2003). Interviews with service providers and NGOs reveal that beyond these common immediate needs, the needs of victims are as diverse as the countries from which the victims originate. Additionally, during the course of working with victims, their needs are likely to change (Caliber Associates, 2007).
A needs assessment conducted with service providers working with victims of human trafficking identified a broad range of victims needs, including emergency, transitional, and permanent housing; food/clothing; medical services (including dental care); advocacy (moral/emotional support), legal services; transportation; and information/referral services (e.g., rights as a victim of human trafficking, available services) (Clawson et al., 2004). For international victims, more often than not, there is a need for language assistance, often requiring an interpreter/translator to help the victim communicate with first responders and those trying to provide assistance. Only after these immediate needs have been met can a victim benefit from treatment for depression, trauma, re-traumatization, and other issues (Misra, Connolly, Klynman, & Majeed, 2006).
Addressing the symptoms exhibited by victims of human trafficking is critical to their long-term recovery. Victims of human trafficking have been described as exhibiting symptoms and needs for service similar to torture victims, victims of domestic violence/sexual assault, battered immigrant women, migrant workers, refugees, and asylum seekers (Clawson et al., 2004). Like torture victims, victims of human trafficking (both sex and labor trafficking) often experience post-traumatic stress disorder (PTSD), depressive disorder, other anxiety disorders, and substance abuse (De Jong, et al, 2001; Shrestha, Sharma, Van Ommeren, Regmi, Makaju, et al., 1998). Specific symptoms exhibited by victims can include nightmares, difficulty concentrating, becoming easily upset, and having difficulty relaxing. Victims can frequently feel sad or angry, have difficulty thinking, experience feelings of hopelessness, and demonstrate sleep disorders. The trauma itself also may manifest as physical symptoms, such as headaches, chest pain, shaking, sweating, and dizziness (Center for Victims of Torture).
Beyond trauma-recovery services, long-term service needs include permanent housing, legal assistance, job training, job placement, education, family reunification (within the United States), and repatriation (in some cases). For some victims, in particular victims of labor trafficking, the victim may have a need for long-term medical care to address physical disabilities resulting from the abuse and/or harsh labor conditions under which the person was forced to work (Bales, 2004; Caliber Associates, 2007). Based on research on the needs of unaccompanied refugee minors, minor international trafficking victims may experience depression and feelings of isolation, but given their culture, they may not know how to express or describe what they are feeling. They may display psychosomatic symptoms; experience high levels of anxiety (especially if language obstacles and cultural differences exist between the minor and the caregiver); experience survivor guilt (victims feel they do not deserve to be alive and in a safe place when friends, siblings, or other family members are suffering); exhibit behavioral problems, including aggression; and question their ethnic identity (Ryan, 1997).
Intensive case management and medical, mental health, and social services are important for responding to the needs of these children. Additionally, educating and training foster care families about the dynamics of human trafficking, the needs of victims, and the symptoms of trauma are also needed to ensure appropriate placement for children in need of homes. Given the complex needs of international victims of human trafficking, it is not surprising that providers report working with clients for more than a year and often for several years, frequently on an intermittent basis. This makes sustained progress challenging (Caliber Associates, 2007; Clawson et al., 2004).