Researchers are urging New Zealand's healthcare workers to take a role in spotting victims of trafficking, labour exploitation and "modern-day slavery".
Writing in New Zealand Medical Journal, Dr Paula King and Dr Christina Stringer say modern forms of slavery—such as forced, underage and servile forms of marriage, and worker exploitation—are still largely hidden.
Stringer authored an influential report last year, examining the exploitation of migrant and New Zealand-born workers across industries including horticulture, hospitality and construction. New Zealand has previously had shocking cases of migrant worker exploitation in the offshore fishing industry, where migrant fishermen faced violence, sexual assault and non-payment of wages. Over the past two years there have been other reports on the exploitation of Filipino migrant workers in the construction and farming industries, or of hospitality workers in Auckland.
The report notes that "while there are no official figures specifically for New Zealand, our country was first described in the US State Department Trafficking in Persons Report in 2004 as a destination country for people trafficked for sexual exploitation.
King, a public health physician and clinical research fellow at the University of Otago, said in a release that "Victims are at increased risk of acute and chronic physical and mental health problems, injuries from dangerous living or working conditions, or physical or sexual abuse, so they are likely to come into contact with health workers.
"We know that health workers may have had contact with people in situations of slavery, but may not have had the knowledge, resources or skills to identify victims and offer effective help."
They say examples that should ring alarm bells for health workers include migrant workers with "workplace injuries" accompanied by a "superior" who insists on rushing treatment to get back to work; and an infectious outbreak where it is found that workers are living together in crowded conditions.
Victims may go to the doctor for routine care, but show tell-tale signs of exploitation such as unexplained injuries, contradictions in their stories and behaviour, not knowing their home address or lack of personal identification.
"Slavery has serious health consequences, but is a mostly neglected issue within the health system," King says. "Practitioners can, and should be leading advocates for change at government, health system and organisational levels."