First comprehensive study of trafficked men, women and children

The largest survey to date of the health of survivors finds high levels of abuse and serious harm associated with human trafficking. 

Findings reveal the severe mental and physical health problems experienced by men, women and children trafficked for forced labour and sexual exploitation in Southeast Asia. The study, published in The Lancet Global Health, also highlights frequent physical and psychological abuse and extremely hazardous living and working conditions.

Recent estimates suggest that more than 18 million people worldwide are in forced labour as a result of trafficking. However, trafficking is hidden by nature and hard to define so estimates are uncertain.

Researchers from the Gender Violence and Health Centre (GVHC) carried out the new study with the International Organization for Migration (IOM). It was commissioned and funded by the Anesvad Foundation with additional funding from the IOM Development Fund, and support from the Economic and Social Research Council (ESRC).

In this podcast, lead author Dr Ligia Kiss and co-author Brett Dickson discuss the study and its implications.

Kiss was also interviewed by Voice of America on the study. Listen and read the interview here.

El País published an article on the study. Read it here (in Spanish).


The researchers carried out face-to-face interviews with 1,015 people entering post-trafficking services in Cambodia, Thailand and Vietnam. They had been trafficked into sex work (32%), fishing (27%) and factories (13%), among other sectors.

Researchers asked participants about their living and working conditions, experiences of violence and health outcomes. They used the Hopkins Symptoms Checklist and Harvard Trauma Questionnaire to measure symptoms of anxiety, depression and post-traumatic stress disorder.

  • 48% had been physically or sexually abused (or both) and many suffered violence such as knife and dog attacks, burning and choking
  • 61.2% reported symptoms of depression
  • 42.8% reported symptoms of anxiety and/or post-traumatic stress disorder (38.9%)

Participants who experienced extremely excessive overtime at work, restricted freedom, bad living conditions, threats, or severe violence were more likely to report mental health issues.

Our findings highlight that survivors of trafficking urgently need access to health care to address a range of needs, and that mental health care should be an essential component of this. Research is needed to identify effective forms of psychological support that can be easily implemented in low-resource settings and in multilingual, multicultural populations.

Dr Ligia Kiss, study lead author

Key findings

Working and living conditions of participants

  • 48% experienced physical and/or sexual violence
  • 35% of women and girls reported sexual violence
  • 47% were threatened
  • 20% were locked in a room
  • 70% of participants with data available worked seven days per week
  • 30% of participants with data available worked at least 11 hours per day

Health outcomes among participants

  • 22% had sustained a serious injury at work, such as deep cuts, back or neck injury, eye injury or even losing a body part. Only 28% of these reported receiving medical care for the injury
  • 2% of participants reported symptoms of depression
  • 8% reported symptoms of anxiety
  • 9% reported symptoms of post-traumatic stress disorder
  • 2% had attempted suicide in the past month


The authors note some limitations to the study. In particular, the sample only included clients of post-trafficking services, rather than the general population of trafficked individuals. However, there was a large sample size across different settings (such as NGO or government shelters, and support centres for women and children across the three countries). This enabled the team to collect data from a diverse range of individuals. Caution must be used when comparing subgroups, as some had small sample sizes.


With abuse occuring across a wide range of labour sectors, there is need for:

  • greater government regulation
  • stringent health and safety standards
  • regular inspections of sectors that are susceptible to human trafficking

Exploitation of human beings is age-old. Although it is disheartening to see that human trafficking exists in such proportions in the 21st century, it is encouraging that various forms of these violations are increasingly recognised for what they are: modern-day slavery.

Dr Cathy Zimmerman, study co-lead


Ligia Kiss, Nicola S Pocock, Varaporn Naisanguansri, Soksreymom Suos, Brett Dickson, Doan Thuy, Jobst Koehler, Kittiphan Sirisup, Nisakorn Pongrungsee, Van Anh Nguyen, Rosilyne Borland, Poonam Dhavan, Cathy Zimmerman. Health of men, women, and children in post-trafficking services in Cambodia, Thailand, and Vietnam: an observational cross-sectional study
The Lancet Global Health. DOI: 10.1016/S2214-109X(15)70016-1
A detailed report on the findings, along with further recommendations, will be launched in Thailand on 27 February 2015.
The Study on Trafficking, Exploitation and Abuse in the Mekong Sub-region (STEAM) was launched in Phnom Penh, Cambodia on 18 November 2014. STEAM is a longitudinal survey of health consequences of human trafficking, and offers methodological guidance for the evaluation of a large NGO-funded intervention to prevent trafficking in seven Asian countries.

No comments yet.

Leave a comment