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HUMANTRAFFICKINGHIVANDExploring vulnerabilitiesand responses in South Asia2007

HUMANTRAFFICKINGHIVANDExploring vulnerabilitiesand responses in South Asia2007

AC K N O W L E D G E M E N TShis publication was put together by Javita Narang, an independent consultant fromNew Delhi, India, under the supervision and guidance of Caitlin Wiesen, UNDPRegional HIV/AIDS Team Leader & Regional Programme Coordinator for Asia & thePacific. We are grateful to Javita for her depth of knowledge, unwavering dedication tothe issue and strong commitment to quality.TWe would also like to express our gratitude to the authors of the country studies thatconstitute the basis and backbone of this publication: Hangama Anwari (Afghanistan);Ishrat Shamim (Bangladesh); Balaji Pandey, Bharti Ali, Sunitha Krishnan, Shamla Natrajan,Shobhita Rajgopal, Priti Patkar, Manebendra Mandal, Frank Krishner, Geetha Menon,Dharmendra Rai, and Abhijit Das (India); John Frederick (Nepal); Arshed Bhatti (Pakistan);and Bhavani Fonseka and Shalindra Mylvaganam (Sri Lanka).In addition, this publication contains substantial contributions from Kazuyuki Uji, KristjanaSigurbjornsdottir, Angela Ison, Pramod Kumar and B. Bhamathi. Additional inputs wereprovided by Ivana Lohar, Ian Macleod, Mini John, Nashida Sattar and Yusei Uji. We are alsograteful for quality editing provided by Richard Simon.Lastly, we would like to extend our appreciation to the Government of Japan, whichfunded our three-year regional project on human trafficking and HIV under the UnitedNations Trust Fund for Human Security. This publication is one of the many results of thatproject.Published by UNDP Regional HIV and Development Programme for Asia Pacific UNDP Regional Centre in Colombo, 2007Layout and design by Harish BhardwajCover photo by Aman MahajanPhotographs by Agnimirh Basu and Samrat MukherjeeThe opinions expressed in this publication are those of the authors and do notnecessarily represent the opinions of UNDP.2

A B B R E V I AT I O N S & AC R O NYM IVPPPRASSAARCSTIU.A.EUNUNAIDSUNDP RCCUNICEFWHOAcquired immunodeficiency syndromeAnti-retroviral medicineConvention on the Elimination of All Forms of Discrimination against WomenConvention on the Rights of the ChildFemale sex workerFree trade zoneHuman immunodeficiency virusInternally displaced personInjecting drug userInformation, education and communicationLiberation Tigers of Tamil EelamMen who have sex with menMale sex workerNon-governmental organizationPeople living with HIVPurchasing-power parityRapid assessment studySouth Asian Association for Regional CooperationSexually-transmitted infectionsUnited Arab EmiratesUnited NationsJoint United Nations Programme on HIV/AIDSUnited Nations Development Programme – Regional Centre in ColomboUnited Nations Children’s FundWorld Health Organization3

FFOREWORDFOREWORDHIV/AIDS and human trafficking threaten human security andhuman development. Millions of women and girls have beentrafficked across borders and within countries in recent years,making human trafficking a global industry that generates anestimated five to seven billion U.S. dollars each year. It is estimated that300,000 to 450,000 people are trafficked within Asia each year, of whichmore than half take place in South Asia. Women and children,particularly girls, are trafficked within country boundaries, to othercountries within the region and across regions and continents beyondSouth Asia. The growing trafficking problem in South Asia has beenrecognised and has become a serious concern over the last decade.However, the links between human trafficking and HIV/AIDS have only been identified fairly recently. Neither HIV/AIDS norhuman trafficking have been integrated or mainstreamed adequately, either at policy or programmatic level. This is despitethe fact that HIV and human trafficking share many causal and consequential factors, including gender inequalities,poverty, lack of economic opportunities for women, stigma and discrimination, rights violations and a life without dignity.The dual vulnerabilities of women and girls in the region to trafficking and HIV demand urgent attention.One of the fundamental weaknesses in explaining and exploring the linkages between trafficking and HIV is a lack ofadequate data. This is attributable to the historical absence of a systematic approach to examining dual vulnerabilities, thehighly sensitive nature of both issues and the strong stigma attached both to survivors of trafficking and to people livingwith HIV. The mixture of these intricate and delicate factors has deterred efforts to examine critically and act proactively onthese two closely-intertwined issues in the region.In an effort to reduce the dual vulnerabilities of trafficking and HIV among women and girls through greaterunderstanding of the issues and the current state of play in the region, the UNDP RCC convened a Rapid AssessmentStudies (RAS) in six South Asian countries: Afghanistan, Bangladesh, India, Nepal, Pakistan and Sri Lanka. The RAShighlights the magnitude, dimensions, causes, consequences and key interventions on HIV/AIDS and human trafficking.The emphasis was on exploring the linkage of the two issues and mainstreaming at different levels of interventions –policy, legislation and programming. A compilation of findings from the RAS is presented in this publication, whichhighlights the critical links between the two issues and the paucity of data and concerted efforts to address the twotogether. A number of areas of convergence and joint initiatives have also been identified and recommended.We hope this publication will inspire policymakers and key stakeholders to explore further the links between humantrafficking and HIV/AIDS and of initiatives addressing the two in a coherent, integrated and sensitive manner at local,national and regional levels.Caitlin Wiesen-AntinRegional HIV/AIDS Team Leader& Programme Coordinator for Asia & the PacificUNDP Regional Centre in Colombo, Sri LankaHUMAN TRAFFICKING AND HIV5

CCO N T E N TSAcknowledgements [2]Abbreviations & acronyms [3]Foreword [5]1Introduction [9]1.1 Human trafficking in South Asia [10]1.2 Migration and human trafficking: the nexus in South Asia [13]1.3 HIV/AIDS in South Asia [14]2A rapid assessment in the region [17]2.1 Human trafficking and HIV/AIDS: a brief summary of country situations [19]Afghanistan [19]Bangladesh [22]India [26]Nepal [30]Pakistan [34]Sri Lanka [37]A common factor [42]2.2 Vulnerability factors: human trafficking and HIV in South Asia [42]2.3 Current programming: approaches, gaps and needs in South Asia [55]3Conclusions and recommendations [61]Annexure: Rapid Assessment Study on Human Trafficking and HIV in South Asia [68]

““HIV/AIDS AND HUMAN TRAFFICKINGTHREATEN HUMAN SECURITYAND HUMAN DEVELOPMENT

1CHAPTER ONEINTRODUCTION

1CHAPTER ONEINTRODUCTION“Trafficking is a complex development issue. It is aneconomic problem, as the vast majority of womenseeking to escape poverty are lured into traffickingby the false promise of economic gain. Trafficking isa health problem, as trafficked women and childrenare most at risk from HIV infection. It is a genderproblem, as unequal power relations reinforcewomen’s secondary status in society. Lastly, it is alegal problem, as its victims are stripped of theirhuman rights and lack any access to redress for thecrimes committed against them.1”1.1 Human trafficking in South Asia2uman trafficking generates billions ofdollars for organized crime. It isconsidered the third largest source offunding, preceded only by drugs and guns.3 InSouth Asian countries, trafficking has increaseddrastically over the past several decades.HDue to its clandestine nature, there are no precisestatistics on the extent of the problem. However,it is reported that South Asia has the secondlargest number of internationally traffickedpersons in the world. It is assumed that millionsof women, in particular, have been traffickedacross borders and within countries. Overall, it isestimated that 150,000- 200,000 people fromSouth Asia are trafficked annually.Among countries in the region, Bangladesh,Nepal and Sri Lanka are the major centres oforigin. India and Pakistan are destinations ortransit countries to other regions, in particularthe Middle East.4Activists and governments are increasingly1 ‘USAID Strategic Treatment for the Asia Regional Anti-TraffickingInitiative.’ May 25, 1999 (draft). Washington, D.C., 1999, USAID.2 This document is based on results from a regional rapid assessmentstudy (RAS) conducted in Afghanistan, Bangladesh, India, Nepal, Pakistanand Sri Lanka between 2004 and 2006 and is compiled by Javita Narang,Consultant, India.3 Miko, F.T. & G. Park, ‘Trafficking in Women and Children: The U.S. andInternational Response’. Congressional Research Service Report 98-649C.Washington, D. C., 2000: United States Department of State.4 Ibid10HUMAN TRAFFICKING AND HIV

CHAPTER ONEacknowledging that human trafficking takesplace both within the borders of a country andacross regions and continents beyond South Asia.For instance, India is a source, transit anddestination. Receiving children from Bangladeshand Nepal and sending women and children tocountries in the Middle East is a commonoccurrence. India and Pakistan are the maindestinations for children under 16 who aretrafficked in South Asia.young girls and women from poor, illiteratefamilies. The clandestine nature of the trademakes it impossible to obtain accurate data, butconservative estimates available from NGOs andother international sources make grim reading.For example, thousands of Nepalese women andgirls are trafficked into India every year. The AsianDevelopment Bank estimates that between oneand two hundred thousand Nepalese womenand girls, roughly a quarter of whom are less thaneighteen years old, are held against their will inAccording to the 2002 SAARC (South AsianIndian brothels.5 An estimated 9,000 girls aretrafficked annually within South Asia from NepalAssociation for Regional Cooperation)to India and from Bangladesh to Pakistan; a littleConvention on Preventing and Combatingover half of all girl sex workers in India are fromTrafficking in Women and Children, “Trafficking isNepal or Bangladesh.6 Thethe illegal moving andchildren of these sexselling of human beings“Overall, it is estimated thatworkers, especially girls,across and within150,000 - 200,000 people fromare often either pushedcountries and continentsinto the trade or is takenin exchange for monetarySouth Asia are traffickedas a substitute for theirand/or otherannually.”mothers.compensation.” While theConvention focuses onSri Lanka has a growing sex tourist industry,trafficking for sex work, there are many otherespecially along its coastal belt, where thereasons for human trafficking in South Asia:demand from European tourists for young maleforced marriage, forced labour, domestic service,organized begging, camel jockeying, circus work, sex workers or ‘beach boys’ is high. Such workerscomprise a large proportion of children whoseillicit adoption, pornography production andsexual exploitation leaves them vulnerable to HIVorgan trafficking for the transplant market. Asinfection.noted, most of those trafficked are women andgirls, but boys are also trafficked, in particular asOther countries in the region are similarlycamel jockeys or forced labour, for adoption andaffected: UNICEF reports that 40,000 childrenin some areas as sex workers.from Bangladesh are involved in sex work inPakistan.7 Generally in South Asia, childThough women and girls in South Asia aretrafficking is of particular concern as “antrafficked for other purposes besides sexualextension of a serious child labour problem”,exploitation, this remains the single largestwhich includes the exploitation of girls forcategory of exploitative trafficking crimethroughout the world. The majority of victims are domestic work.85 State of World Population 2006, A Passage to Hope: Women and International Migration; UNFPA6 'Combating Trafficking of Women and Children in South Asia', Regional Synthesis Paper for Bangladesh, India, and Nepal. 2003: Asian DevelopmentBank.7 'Combating Trafficking of Women and Children in South Asia', Regional Synthesis Paper for Bangladesh, India, and Nepal; 2003: Asian DevelopmentBank8 Unbearable to the Human Heart: Child Trafficking and Action to Eliminate It, p. 17. Geneva, 2002: ILO.HUMAN TRAFFICKING AND HIV11

CHAPTER ONEAnother source of demand driving the traffickingin young women arises from the prevailinggender inequalities in densely populatedcountries like India: namely, the perception that agirl child is an economic liability. Sources in Indiareport an emerging pattern of trafficking in girlsfrom West Bengal and Assam to the moreprosperous states of Punjab and Haryana, where‘gender gaps’ are most acute. The traffickedwomen and girls are sexually exploited andforced to give birth to a male child. The woman iseither abandoned or passed on to another manafter the birth of the child.to work for many years, well beyond what mightbe considered a reasonable repayment period,before their debts are regarded as settled.In South Asia, the phenomenon of traditionalbonded labour is common and widespread.Millions of people are enslaved from generationto generation. They seldom know the amount orterms of their debt, a fact that increases thecoercive power of their employers – orslavemasters – and ensures their continuedservitude. Cultural practices, illiteracy andunequal power relationships make this traditionalform of slavery for low-skilled work particularlyhard to eliminate.The trafficking and exploitation of African andSouth Asian children as camel jockeys hasburgeoned in the Gulf States. Here, the discovery Conflicts, crises and natural calamities have led toof oil and the associated surge in wealth hasa rise in unsafe mobility and human trafficking.transformed camel racing from a traditionalFor example, the aftermath of the DecemberBedouin sport into a multi-million dollar2004 tsunami saw sporadic reports from affectedcommercial activity. Today, thousands of children countries of rape, sexual abuse, kidnapping andfrom Bangladesh, Pakistan and eastern Africa,trafficking in persons. Thousands of orphanedsome no more than twochildren becameyears old, are traffickedvulnerable to exploitation“Trafficking is the illegalinto slavery to serve asby criminal elementsmoving and selling of humancamel jockeys.seeking to profit from theirbeings across and withinmisery. In response,A form of coercion populargovernments,countries and continents inwith traffickers is the useinternational organizationsexchange for monetaryof a bond or debt to keepand NGOs made thevictims in subjugation. Thisprevention of humanand/or other compensation.”is referred to in law andtrafficking, particularlypolicy as ‘bonded labour’ or ‘debt bondage’ and is child trafficking, an integral component ofidentified in the UN Protocol on Trafficking indisaster-relief planning.Persons as a form of human trafficking. Manyworkers around the world fall victim to debtIn South Asia, trafficking routes are fluid. Newbondage by assuming an initial debt as part ofroutes replace old ones as traffickers seek totheir terms of employment – or ‘inherent debt’ inavoid detection. Many traffickers operate withmore traditional systems of bonded labour. Theypolice connivance. Their networks are numerous,are then compelled to remain in service ‘until the spanning countries and crossing borders. Thedebt is worked off’, but meanwhile the terms oftrafficking chain connects a variety of criminalservice mutate, the debt grows and thetypes: small-time hoodlums, local crime lords oremployer-employee relationship becomes‘godfathers’, national and international gangs,exploitative. Bonded workers are generally forced corrupt police and border security officers,12HUMAN TRAFFICKING AND HIV

CHAPTER ONEdebauched members of local elites, procurers,pimps and other agents, together with brothelkeepers and other employers who obtain director indirect financial benefits from the trade.connection between migration and humantrafficking is therefore critical to the developmentof counter-trafficking strategies.Migration and human trafficking are oftenPorous borders aid traffickers. Betweendistinguished from one another by the notionBangladesh and India,that migration ischeckpoints and securitycharacterized by choice“It is essential that HIV andpersonnel are widelyand trafficking byanti-trafficking prevention and coercion, deception ordispersed and few inintervention strategies benumber, while Nepal andforce. In practice, theIndia share an opendistinction is not so clear.directed at reducing theborder. Such factors makePeople often migrate invulnerability of migrants, notit difficult to maintainexpectation of a well-paidstrict vigilance againstjob, only to findat restricting migration itself.”human trafficking, thoughthemselves forced to workborder forces are usually knowledgeable aboutunder exploitative conditions in a plantation, in aillegal crossings by traffickers and their victims.sweatshop, in domestic service or in sex work. Alack of available information on safe migration1.2 Migration and human trafficking: practices, coupled with socio-cultural conditionsthat discourage many South Asian women fromthe nexus in South Asiaactively seeking such information, results in manyCountries in the South Asian region arewomen being duped into coercive situations.experiencing rapid economic, political andThose involved in their recruitment anddemographic changes. These often contribute totransportation may or may not be involved in thewidening economic disparities. The resultingfinal stages of exploitation.diversity of labour and population profilesencourages migration, both legal and illegal, inIt is no coincidence that the growth in traffickingresponse to the dynamics of supply and demand. has taken place during a period of increasingnational and international demand for migrantMigration and human trafficking, thoughworkers that has not been adequatelyseparate and distinct processes, are connected.acknowledged or facilitated. The process ofThe pressing need for work and life opportunities migration involves particular risks for women andhas turned migration into a common livelihoodchildren, who may end up being trafficked intostrategy in South Asia, creating a fertile field foran exploitative situation (often but nottraffickers and unscrupulous ‘employmentnecessarily in the sex trade) and at risk from HIVagents’.and other health problems. Short of preventingmigration altogether, the primary issue is how toToday, trafficking can no longer be viewedmake the process safe for women and childrenoutside the context of labour migration. The lineand how to protect their rights before, duringbetween the two is fluid, shifting easily betweenand after migration.what might be seen as voluntary migration forlegitimate work and what can clearly beThe links between migration and trafficking arerecognized as exploitation. Understanding thecomplex and disputed. Migration itself does notHUMAN TRAFFICKING AND HIV13

CHAPTER ONEmake a person more vulnerable to trafficking.Neither is trafficking simply ‘forced migration’, aterm that also covers flight from armed conflict,natural disasters, poverty or domestic violence.Even so, there are several relevant points ofintersection between trafficking and migration.‘Willingness to migrate’ is an important potentialvulnerability factor in trafficking. Whatever itscause – family problems, poverty or flight fromarmed conflict – uninformed and unconsideredwillingness to migrate can result in a personaccepting a situation that can result in atrafficking outcome.Another factor making migrants vulnerable totraffick

Studies (RAS) in six South Asian countries: Afghanistan, Bangladesh, India, Nepal, Pakistan and Sri Lanka. The RAS highlights the magnitude, dimensions, causes, consequences and key interventions on HIV/AIDS and human trafficking. The emphasis was on exploring the linkage of the two issues

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