FOCUS GROUP ON HEALTH

1. FOCUS GROUP ON HEALTH

2. SEX TRAFFICKING AND HEALTH • DECEPTION • COERCION • TORTURE • PAIN • EXPLOITATION • SLAVERY • EXTERNAL-STIGMA/REJECTION

3. THE CONCERN • SUBTLE • COMPLEX • SUSTAINED OVER A LONG PERIOD

4. HEALTH IMPACT • PHYSICAL • SEXUAL • EMOTIONAL/PSYCHOLOGICAL • BEHAVIORAL • SOCIAL • PSYCHIATRIC

5. Health/Physical • Fractures • Cuts, bruises, injuries • Chronic illness from poor hygiene • T.B./Respiratory infections • S.T.D.s, H.I.V. • Repeated Abortions • Malnourishment • Unwanted Pregnancy • Aches and pains

6. Chronic Fatigue • Head injury and TBI • Facial trauma including broken teeth • Malaria • Hepatitis B, Hepatitis C • Pelvic Inflammatory Disease • Cervical Cancer • Untreated illness • Over treatment with antibiotics leading to drug resistant infections

7. Sexual • Sexual misconceptions • Sexual aversion • Hypersexual behaviors-Promiscuity, Seductive behaviors • Sexual manipulation • Confusing love and sex

8. Emotional/Psychological • Guilt and shame • Fear • Low Self Esteem • Lack of confidence – overconfidence • Unworthiness/Self disgust • Feeling degraded • Hopelessness, powerless/vulnerable • Sad/depressed • Lack of trust, betrayal • Hostile

9. Sexual Trauma / Shame • Fear / Loss of safety • Moody • Intrusive memories • Suicidal • Dissociation • Stockholm’s Syndrome( identifying with the abuser) • Normalization of exploitation • Substance abuse • Alcohol • Amphetamines • Other substance abuse

10. Behavioral • Numbness, Shock • Disoriented /confused • Low concentration • Helplessness • Aggressive, violent, abusive • Risky behaviors, impulsiveness • Self harm (suicidal, attempts, slashing,cutting)

11. Rebellious, defiant • Interpersonal difficulty • Truancy, Stealing, Lying • Suspiciousness • Develop running away tendencies • Physical tortures of others (other inmates, friends made at the shelter etc)

12. SOCIAL • Isolation • Difficulty in forming relationships • Difficulty to conform to societal norms • Anti social behavior • Loss of earlier achievements

13. PSYCHIATRIC • Depression/Suicide • Phobia • Post Traumatic Stress Disorder (Anxiety, Nightmares, Flashbacks, Sensitivity to trauma triggers, Numbing, Irritability, Hyper vigilance, Startle reaction, Poor concentration, Loss of sense of future) • Anxiety and Panic • Eating Disorders • Sleep Disorder • Substance Abuse

14. HEALTH CARE • IMMEDIATE ASSISTANCE • MENTAL HEALTH INTERVENTIONS • LIFE SKILLS/EDUCATION/ LIVELIHOOD

15. Immediate Assistance • There should be provisions in every shelter government or non-government for immediate medical care. As soon as a victim is brought to the home she should be taken to a hospital at the earliest. The purpose of the hospital visit should be clearly explained. • A complete medical examination should be done to identify any physical damages. General physicians and gynecologist should examine the victim and put her on immediate treatment. • On specific tests such as HIV/AIDS,RTI and STI pre-test counseling should be done and only on informed consent tests should be conducted. • Special priority care should be given to pregnant and lactating mothers. • Each home should have facilities for weekly health check-ups by a registered medical practitioner, gynecologist, referral to external medical experts, hospitals, and facilities for hospitalization.

16. Home should have trained care takers to provide appropriate care and support for HIV positive inmates for early management of opportunistic symptoms. • Each home should have a first aid box and trained staff and girls with basic medicines and equipments such as thermometer and updated medical record of each inmate. • Home should have arrangement for care takers who will escort inmates during hospitalization. • Balanced diet which is age sensitive and also caters to the specific needs of individual • ( pregnant /lactating mothers, HIV positive , sick persons) victims should be provided. • There should be provisions for fun food at times.

17. Mental Health Care • There should be both professional and barefoot counselors in a home who would provide immediate trauma care and long term counseling for the inmate. • There should be trained staff that can provide individual, group and peer counseling. • There should be a regular psychiatrist and psycho-therapist to provide immediate care for major or minor psychological disorders. • Home should have referral networks with mental health institutions for immediate and timely support in terms of hospitalization of psychologically disturbed inmates. • Home should have referral network with de-addiction centers for those inmates who have a problem of substance abuse /alcohol addiction. • The homes also should have a consultant physician specialized in psycho-sexual variations.

18. Life Skills, Education and Livelihood Training • There should be daily classes for inmates on life skills such as grooming, social skills, personality development, communication skills, anger management, conflict management, stress management and leadership to overcome negative socialization and sense of rejection. • All victims should be provided basic literacy and scope for education as a means of developing positive self image. • In collaboration with reputed technical training institutes viable, sustainable and job oriented trades should be taught to the inmates who should ensure job placement after the stay in the home. This will ensure development of a positive self identity.

19. HEALTH BUDGET • VICTIM- RS 2500/ • DE-ADDICTION- RS 3000/ • PREGNANT AND LACTATING MOTHERS-RS 3500/ • HIV POSITIVE -RS 4000/ CORPUS FUND FOR EMERGENCY MEDICAL CARE.

20. HEALTH- STATE OF COMPLETE PHYSICAL,MENTAL,SOCIAL WELL BEING NOT MERELY THE ABSENCE OF DISEASE OR INFIRMITY • HEALTH CARE FOR SURVIVORS SHOULD RESTORE DIGNITY OF THE PERSON.