LANGUAGE ACADEMY

ANSWER KEY

SEMESTER II 2015/2016 SESSION

ULAB 2122 ADVANCED ACADEMIC ENGLISH SKILLS

ALL PROGRAMMES

2 HOURS

NAME:______

MATRIC NUMBER:______

FACULTY/SECTION NUMBER:______

NAME OF LECTURER:______

MARKS:30 MARKS

DO NOT OPEN THIS BOOKLET UNTIL YOU ARE TOLD TO DO SO

Instructions:

  1. This question paper consists of three (3) parts: Part I, Part II, and Part III.
  2. Answer all questions in the space provided in this question booklet.
  3. The marks allocated for each question are shown in brackets.
  4. Hand in this question paper at the end of the examination.

WARNING:Disciplinary action will be taken against students who are found cheating

during the examination.

This paper contains printed pages including cover page.

Part I (10 marks)

Instruction: Read the text below and answer the questions that follow.

Text 1

Human Trafficking and Health

IHuman trafficking has received considerable international recognition over the past decade. Initial anti-trafficking policies and programmes focused on women and girls trafficked for forced sex work, but, there is now growing attention to the many, if not more, men, women and children who are exploited in various forms of labour, such as agriculture, fishing, textile and other manufacturing industries, mining, construction, domestic servitude and cleaning services, forestry, soldiers, ‘wives’ and forced begging (ILO, 2005). To date, labour trafficking and men who are trafficked have been seriously under-represented in policy-making and service allocation. With increasing attention to labour trafficking, challenging definitional questions have emerged about the distinctions between ‘human trafficking’, ‘smuggling’, ‘exploitation’, ‘slavery’ and ‘bonded labour’ (Derks, 2010), which have added complexity to decisions about programmatic aims, individual eligibility for support and data collection. While precise statistics on human trafficking remain elusive, reports continually estimate that thousands of men, women and children are trafficked throughout the world, and that this trade reaps enormous profits for trafficking agents (Belser, 2005).

IIAlthough trafficking-related abuses have been well-documented, health is a subject that has been largely neglected in anti-trafficking work, particularly compared to activities in the fields of immigration and law enforcement (Salt, 2003). The health sector has had limited engagement in trafficking dialogues and published literature on health and trafficking in persons, particularly theory, remains scant (Hossain etal., 2010; Ostrovschi etal., 2011; Zimmerman etal., 2008). In addition, anti-trafficking policy discussion has been structured around prevention, protection and prosecution, which further minimizes the role of health sector. With no sign that human trafficking is abating, health and other policy-makers will imminently have to pose such questions as: “what is the range of health risks associated with trafficking” and “where and how can agencies intervene to protect the health of trafficked persons”. To help broach these questions, it is fundamental to understand the multiple forms of abuse or risks and health consequences associated with trafficking, which are not always so distinct but more often interlinked.

IIIMental health is perhaps the most dominant health dimension in trafficking cases because of the profound psychological damagecaused by (often chronic) traumatic events and the common somatic complaints that frequently translate into physical pain or dysfunction. An individual’s psychological responses are very often correlated with many – if not each – of the other risk categories. For example, depression is frequently detected among those who are sexually abused, drug addicted, socially marginalized or with insecure immigration status (Silove etal., 2006). Women trafficked for forced sex work show high levels of post-trauma reactions, including depression, anxiety and hostility which are associated with physical injury, trafficking conditions, (such as a longer time period and restricted freedom), and a short time period out of the trafficking situation (Hossain etal., 2010). Mental health symptoms found among these women are similar to those documented for individuals exposed to repetitive trauma or chronic abuse (Krakow etal., 2000).

IVPhysical violence is the most recognized and documented feature of human trafficking perhaps because this, along with sexual violence, is the most convincing evidence of a crime. For example, 57percent of women interviewed in post-trafficking service centres in Europe reported sustaining a physical injury associated with the trafficking experience.Women described physical violence that ranged from slaps, punches and beatings to more severe forms of torture, including cigarette burns and ice baths. While substantial data is available on female victims, less is known about the prevalence of physical violence experienced by labour migrants.

VSexual and reproductive health risks are among the most commonly reported health problems among women and individuals who are sexually abused and exploited (Garcia-Moreno etal., 2006;Leserman etal., 1998), whether or not they are forced into prostitution. Among the women in one European study, over half (58percent) reported a gynaecological infection diagnosis (Zimmerman etal., 2008).

VIAmong individuals trafficked for forced sex work, it is not uncommon for them to be forced or coerced into drugs and alcohol abused (Cwikel et al., 2003). Little is known about coerced drug use for other groups of trafficked persons. Drug or alcohol addiction can be used as a means of controlling individuals. Coerced alcohol use is a particular feature of women trafficked to Japan and Kosovo, where they are obliged to encourage men to buy them drinks (IOM, 2002). In some cases, drug and alcohol form negative coping behaviours during or following a trafficking experience. For example, women in the European study reported drinking to keep themselves warm on the streets in winter. Research in Eastern Africa noted that up to one-fifth of the participants reported substance abuse (Fleisher etal., 2008).

VIIVictims of trafficking also experience social restrictions and emotional manipulation, which proven to be powerful ways to isolate individuals (Johnson, 1995). Social restrictions in trafficking situations can sometimes be extreme. For example, in one European study, 76percent of women reported that they were “never” free to go where they wanted or to do as they wished (10percent said “seldom”) (Zimmerman etal., 2008). Several of the women who reported they were ‘sometimes’ free to do as they wished, stipulated that this was only if they were accompanied by minders. In cases of victims associated with labour exploitation, they also endure economic exploitation and debt bondage. Trafficked persons rarely have control over what they earn and are frequently subjected to deceptive accounting practices and repayment obligations, such as housing, food, clothing and inflated debts related to travel costs. The victims may often be financially penalised for perceived misdeeds, tardiness or non-compliance (Belser et al., 2005). To individuals trafficked internationally or those forced to undertake illegal activities, they may face legal insecurity especially when traffickers confiscate official documents (e.g., passport, tickets), leaving individuals unable to travel legally and fearing that they will be detained for immigration crimes (possessing false documents, illegal border crossing, etc.). The term legal insecurity may also pertain to the stress felt by those who are out of the trafficking situation and awaiting decisions on an asylum application.

VIIIFinally, high risk, abusive working and living conditions are widespread among migrants who are trafficked for low-skilled labour. Those who are trafficked for agricultural labour, for example, are likely to encounter hazards such as sun exposure, musculoskeletal disorders from repetitive stooping or heavy lifting and pesticide poisoning from prolonged exposure to treated crops or water (Ahonen etal., 2007andStellman, 1998). In manufacturing or factory settings, there are often risks of respiratory, bacterial and skin infections (IOM, 2009). These poor working conditions are also often accompanied by overcrowded or unhygienic living conditions (Anderson & Rogaly, 2005). Handling victims working and living in these difficult conditions, however, forms another challenge for anti-trafficking workas it is difficult to distinguish whether these victims are victims of trafficking or labour exploitation.

IXIt is clear that human trafficking is a form of violence that poses numerous and sometimes life-threatening health risks. The risks associated with human trafficking are frequently similar to those associated with other types of abuse, exploitation and situations of extreme vulnerability (Ahonen etal., 2007;Silove etal., 2006). While the crime is internationally objected because it harms people, health is an aspect of trafficking that has generally been neglected. Like victims of other forms of exploitation, trafficked persons may be socially marginalized, have unauthorized legal status or be unclear about their rights, and therefore have difficulty accessing health services and /or available protection measures. Solutions, therefore, must incorporate actions from various sectors, especially the health sector, immigration, labour and trade. Efforts must be coordinated through multi-lateral and bi-lateral actions, rather than operating as isolated national policies in order to make necessary advances in the protection and recovery of trafficked persons.

Adapted from:

Zimmerman, C., Hossain, M. and Watts, C. (2010). Human trafficking

and health: A conceptual model to inform policy,intervention and research.

Social Science & Medicine. 73. pp 327-335.

Instruction: Based on your understanding of the text, answer the following questions.

  1. Complete the table below on the factors that contribute to the neglect of health issues in relation to human trafficking. LOTS – (2 marks)

Sector / Factor
a. / Health / Limited engagement in health dialogues
Limited publication on health and trafficking theory
(1 m)
b. / Government (Policy makers) / More concerned on prevention, protection and prosecution
[“ neglect on health issue” is not acceptable]
(1 m)

(2 x 1m = 2 marks)

  1. Complete the table below on forms of abuse, risks and health consequences that individuals trafficked for sex exploitation may experience. LOTS – (2 marks)

Forms of abuse / Examples of health consequences
a. / Psychological / Post-trauma reactions
Or
Depression, anxiety and hostility
(1/2 m)
b. / Physical / Physical pain or injury or death
c. / Sexual / Sexual and reproductive health infections
Or
Gynaecological infection
(1/2 m)
Forms of risks / Examples of health consequences
a. / Forced drug and alcohol abuse / Drug and alcohol addiction (1/2 m)
b. / Social restriction and emotional manipulation
(1/2 m) / Feeling of helplessness and isolation

(4 x 1/2m = 2 marks)

  1. In paragraph I, the authors wrote “while precise statistics on human trafficking remain elusive, reports continually estimate that thousands of men, women and children are trafficked throughout the world, and that this trade reaps enormous profits for trafficking agents (Belser, 2005).” Why do you think the authors included this statement? HOTS

The authors want to show that human trafficking issue is a serious issue and thus give justification for their argument.

(1 mark)

  1. In paragraph II, the authors claim “physical violence is the most recognised and documented feature of human trafficking perhaps because this, along with sexual violence, is the most convincing evidence of a crime”. How do the authors support this claim? HOTS

The authors support their claim by giving evidence based on data found by interviewing trafficked women in Europe.

(1 mark)

  1. Complete the argument below by paraphrasing two challenges faced inanti-trafficking work focusing on labour trafficking cases. HOTS

Zimmerman et al. (2010) claimed that labour trafficking cases are challenging because 1)not much information / data is available and that2)it is difficult to identify whether a case is human trafficking or labour exploitation.

(2 x 1m = 2 marks)

  1. What is the authors’ stance regarding: HOTS

a)human trafficking:

Human trafficking is a form of violence that poses serious consequences

b)health issues in human trafficking:

Health issues in human trafficking are neglected

(2 x 1m = 2 marks)

Part II (10 marks)

Instruction: Read the text below and answer the questions that follow.

Text 2

Human Trafficking and Psychiatric Education

IHuman trafficking is a serious global health problem that involves severe forms of abuse and human rights violations. Human trafficking is defined as “the recruitment, transportation, transfer, harbouring or receipt of persons, by means of the threat or use of force or other forms of coercion, of the abuse of power ... for the purpose of exploitation” (UN, 2004 p. 42). Exploitation includes “the exploitation of the prostitution of others or other forms of sexual exploitation, forced labour or services, slavery or practices similar to slavery” (UN, 2004 p. 42). The illegal worldwide profits of trafficking activities are estimated at $150 billion per year. Although determining the numbers of victims is not simple, it is estimated that 35.8 million people have been victims. In the USA alone, an estimated 60,000 victims can be found in all areas in all fifty states.

IITrafficking of individuals occurs through the use of a combination of psychological tactics. Among the tactics are isolation, manipulation of perception, induced disability and exhaustion, threats and occasional indulgences. Although anyone can become a victim, about half of all detected trafficking victims are adult women. In fact, women make up the vast majority of detected victims who were trafficked for sexual exploitation (UN, 2013). In addition, globally, children now comprise nearly one third of all trafficking victims (UN, 2013), and runaway children are particularly vulnerable to becoming trafficked. The complex interplay of poverty, gender, education, age, and relevant policy deeply affect the vulnerability of women and children to trafficking.

III Common psychological effects of trafficking include anxiety, post-traumatic stress disorder, and depression. Psychiatrists, therefore, have an especially important opportunity to identify and help victims and to prevent others from becoming victims of trafficking. However, psychiatric training programmes have not included any topics related to human trafficking, suggesting that there are no formal requirements for psychiatrists to be educated on human trafficking. At the same time, emphasis is also not given on the need for medical students, residents, and health care providers across disciplines to be informed about human trafficking. Consequently, efforts must be put to identify a curriculum on human trafficking that might assist in educating psychiatric professionals and trainees as well as medical students, residents, and health care providers on issues related to human trafficking.

IVOne issue that should be addressed in the teaching on human trafficking is the ability to identify victims and understand steps that need to be taken when having encountered trafficked victims. Recognizing victims is challenging because many may not avail themselves of services due to fear, embarrassment or simply being prevented by traffickers.The ability to identify victims is, thus, critical to helping the victims release themselves from their circumstances, preventing re-victimization, and linking them with appropriate medical, psychiatric, social and legal services. Psychiatrists, as physicians with special responsibility for the care of vulnerable and victimized individuals, should have sophisticated and comprehensive understanding of the physical and mental health consequences of human trafficking in order to confidently identify victims.

VContext evaluation related to the process of victim identification has shown weaknesses of the process. One study of Canadian medical students found that the majority of them were not familiar with signs and symptoms of trafficked persons. Another study of medical students, residents, and physicians throughout the USA found that most respondents had never suspected a patient was trafficked. They were also inadequately informed about the scope of the problem, and did not know whom to report for such cases. Self-reported knowledge about human trafficking and whom to call for a potential victim was also found low among emergency department health care providers in the San Francisco area. These results highlight the potential value of focusing on the skills of victim identification and actions to be taken when coming into contact with victims.

VIPsychiatrists and other health care professionals will also benefit from learning about treatment strategies. The treatment of the psychologically distressing effects of trafficking shares common elements with the treatment of mood and anxiety disorders, such as post-traumatic stress disorder. Further, treatment must include additional psychosocial factors, for example, the consequences of previous sexual abuse, trauma, domestic violence, and/or poverty. Exploring potential social supports and evaluating sources of resilience are also essential to develop a true understanding of the patient and arrive at a therapeutic plan that is beneficial. In order to come up with an accurate diagnosis and care strategy, psychiatrists and health care professionals should also develop an appreciation of the narratives of victims.

VIIIn addition, teaching on trafficking should be integrated with teaching on sexuality and sexual history taking. This is especially essential in relationto diminishing discomfort and barriers to screening.Other than that, it should also be incorporated into histories of trauma, abuse and/or neglect, and domestic violence. Teaching on trafficking should acknowledge the sensitivity to uncovering trauma histories as it could potentially re-traumatize victims or generate secondary trauma among health personnel, especially for personnel who themselves have experienced trauma.An important dimension is that psychiatrists and health care professionals need to understand that the trauma of trafficking may involve multiple other interpersonal traumas. Treatment should, therefore, involve an understanding of the trauma and trauma-related issues, so that trauma-informed care which is long term in nature, comprehensive and competent could be given.

VIIIIn conclusion, since psychiatrists and members of health profession are likely to encounter victims of human trafficking, they have an important role in screening, treatment, and even preventive interventions.The lack of formal curriculum on human trafficking across health care provider groups including psychiatry clearly implies that little is being done in attending to the care of this highly vulnerable group of people. The potential role for health professionals in preventing human trafficking should not be underplayed as it is their initial encounter with victims that could actually provide valuable data for law enforcement officials, psychologists, social workers, and relevant political entities.