The “Upstream” Work of Prevention

There is a disconnection between the intention to abolish slavery and most of the interventions being done that actually don’t apply to the prevention of slavery.

You have all heard this: “Join us in our effort to stop human trafficking by donating $$$ towards our efforts in rescuing girls!” Initially, that sounds like a great thing. It’s not a bad thing to do, don’t get me wrong. I don’t want anyone suffering any longer than necessary in the horrid circumstances of slavery. However, it is only partially true and only the tip of the iceberg when it comes to a success story regarding the rescued person.

First, regarding the bit to stop trafficking through rescue interventions, I have a couple of thoughts. By rescuing somebody, you are stopping the trafficking of that person. Hallelujah! But how grand would it be to actually prevent that person from being trafficked in the first place. Rescue interventions do nothing for prevention, although there may be the claim that they are “stopping trafficking”.

Furthermore, Human trafficking doesn’t start when someone enters a slavery situation, and it certainly doesn’t end with someone being rescued. There are myriad and complicated factors that contribute to someone’s vulnerability to being trafficked. Post-rescue, while the person may be physically free, the physical, mental, emotional, and sometimes legal burdens hinder a survivor’s true experience of freedom.

Most of the interventions being done to combat trafficking are targeted at victims, after the harm has been done. However, public health seeks to address the potential harms that exist and mitigate or remove them to prevent harm from occurring. Examples include seat belts, smoking, driving while intoxicated, etc.

Students of public health will recognize the “moving upstream” vignette: Someone on a river shore becomes aware that many people are drowning in a dangerous part of a river and she keeps saving as many as she can, but not everyone can be saved. After a while, she leaves that part and moves upstream to start to warn people of the downstream dangers, thereby saving many more lives than she could by rescuing them.

The US State Department’s tri-fold focus on human trafficking includes protection, prosecution, and prevention. Unfortunately, the latter has largely been forgotten and has very little “teeth”, is not well-applied to the countries under evaluation, and is usually addressed in the context of the other two. Unfortunately, a law-enforcement-centered approach is the model that that prevails in most other countries because the USA is seen as the leader and authority in dealing with trafficking in persons.

The United States government claims that progress is being made against human trafficking because they have increased their programs in victim services public education, employee training, as well as the use of technology and social media. It is worth celebrating that the number of victims identified has increased and the number of cases prosecuted has increased, but that is not the same thing as saying the incidence of human trafficking has gone down. In fact, we really have no idea what the incidence actually is, which is part of the problem.

Criminal law is not the mospreventiont effective tool for changing behavior, which is really what it is going to take to prevent trafficking. Regarding domestic violence and child abuse, increased awareness, “trainings”, and more robust laws in protection of child abuse victims and prosecution of abusers has increased in the last couple of decades [super!]. However, these efforts haven’t actually led to a decrease of the incidence of child abuse. The incidence of driving while intoxicated didn’t decrease until it became socially uncool, which is a change in societal behavior.

Societal… social… behavior? You mean I may have to change myself? I can’t just give money or attend a concert where everyone is against human trafficking? Yes, addressing the prevention of human trafficking must take us back to the roots of culture and society. This gets into morals, behavior, and a variety of things that seem ambiguous, variable, and personal. Issues such as violence against women, demand for sex, demand for cheap goods, pornography, and how we rear our boys and girls. Check out this article on the Girl Scouts of America. These aren’t things that are quick successes. They aren’t things that you can “like” on Facebook.

Speaking of Facebook, this article suggests that we, with the help of Google and Facebook, need to make human trafficking “uncool” in order to start doing something to prevent it. It could be a start, but these media moguls may have dubious and ultimately conflicting interests for it to go very far. I honestly hope that this IT project will work and I really hope that they have built in some monitoring and evaluation to determine whether or not they are actually preventing trafficking.

Of course public health prevention interventions need to be based on accurate information and there is a dearth of research on trafficking in persons, as I wrote about in this post. The process and implementation of prevention through behavior change and what that looks like in the context of human trafficking warrants another article.

Jonathan Todres(1) outlines a “model prevention program” which addresses these four components:

  1. Individual risk factors
  2. Relationships that increase risk
  3. The role of community in prevention (school, neighborhoods, worship centers, etc.)
  4. Societal factors (i.e. social and cultural norms)

What prevention IS:

  • Tightening the net (e.g. improving migration safety)
  • Decreasing risks and vulnerability (e.g. increasing awareness, decreasing push factors)
  • Decreasing demand

What prevention is NOT:

  • Identification
  • Prosecution
  • Improving law enforcement
  • Building more shelters
  • Improving survivor services
  • Safe Harbor laws

These are, of course all good and necessary things to do, but they are not enough.

Public health offers an approach that is uniquely suited to address prevention of human trafficking, but too few stakeholders, donors, and even public health practitioners themselves have been slow to realize this.

In this post, I’ve only raised issues and more questions that deserve much more attention but are beyond the scope of a mere blog post. I only hope to draw your attention to the fact that there is so much more to actually STOPPING  human trafficking than what we typically hear about in a tweet or a status update.

1. Todres, J. “Moving Upstream: The Merits of a Public Health Law Approach to Human Trafficking.” Georgia State university College of Law, Legal Studies Research Paper No. 2011-02.

2. Todres, J. “Taking Prevention Seriously: Developing a Comprehensive Response to Child Trafficking and Sexual Exploitation”. Vanderbilt Journal of Transnational Law. Vol 43:1. Jan 2010.


3 thoughts on “The “Upstream” Work of Prevention

  1. Yesterday I was thinking of you, Katherine.

    SO thankful for you and this great work that God has called you to. Thank you for making all of us aware on this… for prevention in this email and concrete ideas of what that means and what to do and look for to support.

    Prayers for you in this work, in life and for your dear heart. You rock!

    Date: Thu, 12 Sep 2013 09:46:35 +0000 To:

  2. Prevention is so important, and along with the public health perspective, there is also the importance of education, specifically providing for the education of young girls. Of course, like public health measures, this begins long before trafficking would take place, and it is very hard to measure the relationship in most cases. Thanks for your thoughts!

  3. Dear Britney, Thank you so much for your thoughts and encouragement! It means so much that we continue to be connected!

    Dear Deanne, I totally agree about education as well! Thank you for your comment!

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