A growing number of governments are creating “john schools” in the belief that providing men with information about prostitution will stop them from buying sex, which will in turn stop prostitution and trafficking. John schools typically offer men arrested for soliciting paid sex the opportunity (for a fee) to attend lectures by health experts, law enforcement and former sex workers in exchange for cleared arrest records if they are not re-arrested within a certain period of time. A 2008 examination of the San Francisco john school, “Final Report on the Evaluation of the First Offender Prostitution Program,” claims to be the first study to prove that attending a john school leads to a lower rate of recidivism or re-arrest (Shively et al.). Despite its claims, the report offers no reliable evidence that the john school classes reduce the rate of re-arrests. Read the article.

Neil Howard follows Issue Paper 5 on children and adolescents with an important story about the failures of the international child protection establishment to adequately protect the teenage labour migrants it defines as trafficked in Benin.

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Introduction and Research Context

Child trafficking began to emerge as a ‘problem issue’ in Benin at the start of the last decade. Though child labour had long been a focus of international and national attention within the country, two high-profile events saw trafficking displace it as the major child protection concern. The first was the interception of a Nigerian trawler smuggling Beninese adolescents to work in Gabon. The second was the ‘rescue’ of Beninese teenage labour migrants working in the artisanal mines of Abeokuta, Nigeria. Both events saw young workers identified as ‘slaves’, and both led to Benin being tarred as the new ‘epicentre’ of the international traffic in children.

The country’s government responded by ratifying the UN Trafficking Protocol, facilitating an influx of anti-trafficking funds and establishing various anti-trafficking initiatives. The bulk of these have focussed on pre-emptively protecting the young by preventing the work and migration seen as equivalent to trafficking. Crucially, following the ILO’s anti- child-labour framework, this work includes anything which ‘by its nature and/or the conditions in which it is exercised, may damage the health, safety or morals of the child’, for example:

‘mining and quarrying; manufacturing; construction; electricity, gas and water; sanitary services; transport, storage and communication; and plantations and other agricultural undertakings mainly producing for commercial purposes, but excluding family and small-scale holdings producing for local consumption and not regularly employing hired workers’.

This has led to the de facto criminalisation of most of the work performed by the country’s young poor. Importantly, no formal distinction is made between younger children and the working teenagers who, while still legally minors, are socially much closer to adulthood. As a result, even working teenagers who have consented to their employment are treated in the same fashion as small children forced into their work.

In order to examine the appropriateness of this policy, I conducted over 14 months of multi-sited fieldwork, during which I interviewed more than 300 people and observed and worked with individuals and institutions at every level of the anti-trafficking policy chain. At the ‘community’ level, I chose four case study villages from two districts in the Zou Region, where I interviewed community leaders, community members and current and former young migrants supposed by the authorities to be victims of trafficking.

I chose these villages for two reasons. First, they are from a region that has been institutionally identified as a ‘hub’ of child labour, trafficking and exploitation as a result of the fact that young males frequently migrate to Nigeria for quarry work.

Second, these villages are also at the heart of the Beninese ‘cotton belt’, which has seen household incomes plummet and remain low over the last 15 years as a result of international falls in the price of cotton.

I therefore wished to explore the hitherto un-examined link between declining income from cotton and adolescent movement to the mines (see my earlier Rightswork piece for details). Additionally, I conducted a follow-up field visit in February 2012 in order to examine more closely the socio-cultural and economic world of artisinal quarry-work in Abeokuta. During this visit, I interviewed representatives of all ‘classes’ involved in the quarry economy, including gang leaders, gravel purchasers, traders and transporters, landowners and Beninese adolescent migrant workers.

As will become clear below, my findings offer a strong challenge to the effectiveness of current policy.

Community Views on (Child) Work

In my case study, work, whether inside the home or for remuneration outside it, is not seen as a damaging ‘adult’ sphere from which under-18s are to be sheltered. In fact, it is seen as an eminently positive and necessary part of being young and growing up. In most households, children as young as three may be asked to perform basic tasks such as filling pots of water, at five or six to keeping an eye on their very smallest siblings, at eight or nine to washing those younger than themselves or sweeping the courtyard, and at 12 to cooking, cleaning and taking on the rest of the tasks performed by adult household members at home or within the context of their small-scale economic activities. Crucially, such realities are not viewed as a grave hardship. Even young children recognise the importance of their contributions and all are aware that these are necessary in what is a materially poor environment.

In line with this, where the anti-trafficking establishment sees the quarry work teenage boys do in Abeokuta as the kind of work that is necessarily unacceptable and exploitative, for the communities I researched do not agree. They say it is the nature of that work and its relation to an individual’s capacity that matters. Thus, in numerous interviews, villagers and former teenage migrants to the quarries complained about the official approach, as did my research assistant, who had formerly been an NGO employee sub-contracted by the state to ‘sensitise’ locals against such work and movement. One village elder told me that ‘The state, white people, NGOs, they all come here and say don’t let your kids leave for the quarries because what they experience there is slavery,’ Charley, a village head, continued, ‘NGOs call everything slavery…to stop kids leaving.’

My research shows that labour migration to the Abeokutan quarries – and the claims of ‘trafficking’ that have been associated with it – is consistently being translated by the authorities at ground-level as ‘kanoumon’ – the local word for ‘slavery’.

Such is the frustration with how far removed this designation remains from people’s lived experiences of quarry work, that when I asked one group of men how they themselves defined the work that teenage boys do in the quarries, I received a genuinely emotional round of applause as ‘the first person from outside to have ever come here and posed us this question’.

This reaction was not unique. A core component of all the interviews I conducted with former young migrant quarry workers and their communities was focussed on how they defined their work, how they understood exploitation, slavery, and trafficking and how they viewed the way others view them. Without fail, amid many expressions of frustration, I learned that none of them defined work in the quarries as ‘kanoumon’; rather, they see the work as predominantly an acceptable, if challenging, activity that can, at times, constitute ‘afoutame’, or ‘exploitation’ – but only if workers are asked to perform beyond their reasonable capacity.

Community Views on (Child) Migration

Work in, and migration to, the quarries of Nigeria is thus viewed in a broadly positive light by these communities. What my interviews revealed, however, is that this understanding of migration transcends the quarries. Indeed, the decision to migrate is generally viewed as a constructive one, in large part because it is the principle vehicle through which people can access paid work and the opportunity that this underpins for self, family, and wider village. This was expressed to me especially when discussing how people perceive the anti-trafficking, anti-migratory messages they hear from the authorities. Below is an example I have extracted from my notes:

 ‘Do you often hear the message at school that leaving is bad? Unanimously, like a chorus, they all said yes. Why? What do people say? It is their teachers. Some said occasionally also their parents. They say that you can’t be better off than in your community and that you shouldn’t leave. What do you think when they say this?

 - “We think its rubbish, because we see people coming back with motorbikes and other things and so we know it’s untrue”. Lots of nods and agreement.

 - Another boy added that dropping out of school to migrate isn’t great. But if you’re not at school or doing something else then there is absolutely nothing wrong with it.

 - The girls, through their elected spokesperson, said that as far as they are concerned, “if no-one helps parents to send their children to school, then it is absolutely fine for kids to leave and find work. They have to!”’

These views depend on the concentration of economic opportunity in locations outside of one’s home village. Indeed, and not without good reason, perceptions of migrant destination centres, (Cotonou, Nigeria or ‘yovotome’ – ‘the home of the white man’) consistently underline the notion that ‘elsewhere’ represents a land of opportunity, a place where life is materially richer than ‘here’, and where one can and must go if one seeks to advance.

Given such understandings, various of my interviewees repeatedly articulated that they believed the migration of both young and old served as a tool for local development. In one particularly telling example, two female elders railed passionately against the anti-trafficking policy establishment:

 ‘Neil: What do you think of the message that young people shouldn’t leave the village?

 Woman 1: Those who tell us this are those who hold back the development of this village!! It is a terrible message! And they give us nothing in return. The NGOs come here but they bring nothing with them!

Neil: Why do NGOs and the government do this and say these things?

Woman 2: They don’t want people to leave the village because they don’t want to see us go and develop elsewhere instead of here. Fair enough, but their words are useless, because they bring nothing’.

The Centrality of Cash

The above examples demonstrate the importance of cash and access to it in the decisions of young people, or those who decide on their behalf, to migrate for work. That cash should be so important was further underlined when I examined with the communities what was meant by the Fon word ‘ya’ – ‘poverty’. Though ‘poverty’ frequently featured as an answer to the question ‘why do young people leave here?’, further discussion revealed that – in contrast to the anti-trafficking notion of poverty as destitution – ‘poverty’ here simply means a lack of the cash necessary to ‘evolve’.

When I asked if ‘poverty’ meant ‘starvation’ and whether ‘poor’ people remaining in the village ‘would go without food’, most people therefore responded with an amused and resounding ‘no’. As one interviewee underlined, ‘poverty’ means that:

‘There is nothing in the village, there is no work. Parents are obliged to let their kids go and when kids decide themselves to leave, parents are obliged to accept. When they go, kids at least make some money; they at least send some back to us. We understand their “don’t leave” message, but we can’t eat their words can we?’

The Need for Alternatives

Village-level understanding of what policy-makers should be doing to protect the young from exploitation (or ‘trafficking’) consequently differs markedly from views within the policy-making system. When I asked young migrants and their communities the question, ‘what would you like to see the authorities do?’, two responses consistently made themselves heard:

1)      Provide us with economic alternatives to labour migration, and

2)      Ensure that those who do migrate can work in safe conditions.

Key for these communities is the ability to access the money that underpins their individual and collective life projects. If possible, they would like to have the option to do this ‘at home’, but where they cannot, they at least wish to be able to work in safety.

In the absence of policies that respond to these needs, communities both ignore and subvert the authorities and their attempt to control their work and migration. The following extracts from my interviews offer an indication of this fact:

‘Do you pretend to the NGOs and government, saying one thing to them and doing another?  There was lots of laughter amongst those that understood my question. Everybody said yes, they do…

So you just pretend to the authorities then? Yes, of course. We say “sure, we won’t leave” in the hope that they’ll bring us something’.

If policy-makers wish to see this situation change, greater participation and a greater focus on the politics of poverty are needed:

• At the macro-level, it is essential that they address the very real, very tangible political-economy underpinnings of the lack of money of that constitutes the main backdrop to the migration and work of the young in this part of the world.
• At the micro-level, they need to engage with communities in developing economically viable alternatives to labour migration and pathways to ensure that those who do migrate for labour are able to do so in safety.

If they fail to do this, little is likely to change at the level of the lived realities of young labour migrants and their communities. Indeed, it might be suggested that policy’s major accomplishment will be merely to entrench legally and institutionally dominant norms relating to ‘acceptable’ childhoods and to naturalise political-economic injustices.

Neil Howard is a PhD student finishing his thesis on anti-trafficking discourse and policy at the University of Oxford. From 2013, he will be Marie Curie Fellow at the European University Institute in Florence. He can be reached at neil.howard@qeh.ox.ac.uk. A longer version of this paper can be found here.

Gloria Steinem, founder of Ms Magazine and a veteran of the U.S. feminist movement, during her recent trip to India expressed her strong concern over the ‘global epidemic of trafficking’ and mentioned that Indian sex workers are the most exploited and underprivileged group in the country. She calls prostitution as “bodily invasion” and conflates prostitution and trafficking. Steinem is not the first to conflate prostitution and trafficking and to speak about the ‘fate’ of Indian sex workers; her remarks do fall under a radical feminist understanding of prostitution as violence against women. While Steinem’s remarks are received with considerable skepticism within India, her voice is still powerful and feeds into transnational discourses that all sex workers from non-west and particularly South Asia are always trafficked.

Steinem may have spoken with or observed Indian sex workers on her trip but her remarks are not based on any empirical evidence.  Yet, she speaks as an ‘expert’ on prostitution and trafficking in South Asia, which can have far reaching implications for policy reforms around sex work. In contrast, the book under review “Dangerous Sex, Invisible Labor” dispels this myth of sex workers as predominantly trafficked and as quintessential victims of violence.

Kotiswaran undertakes a rigorous empirical and theoretical analysis of sex markets in two cities in India based on ethnographic research conducted between 2004 and 2009. Her research reveals that, contrary to common myths, sex markets are not all the same. They are varied and diverse and, even within the same institutional set up (such as brothels), the relational and structural dynamics of the sex markets operate differently for different sex workers depending on the power relations. Another predominant myth that Kotiswaran’s work dispels is that sex work in India is primarily brothel based. In fact, brothels only cater to 9 to 10% of the sex workers in India.

Kotiswaran’s overall goal in this book is to offer a grounded analysis of the labor practices and institutional arrangements that prevail in the sex markets for a better understanding of the economic dimension of sex work. This focus is very critical and counters much of the debates on sex work currently that are only focused on violence and patriarchal exploitation of women. Kotiswaran, through her theoretical and empirical work, offers a different dimension of sex work and sex workers i.e. the economic activity and as economic actors.

In part I (1, 2, 3 chapters) of the book, Kotiswaran provides a historical and theoretical over view of various feminist positions (radical, socialist and materialist) with regard to prostitution and sex work. While doing so, she thoroughly reviews and revisits socialist feminist positions on women’s work under conditions of patriarchy and capitalism. In contrast to radical feminist positions that see prostitution as exceptional from marriage, socialist feminist (Alexandra Kollontai) place it in continuum with women’s economic exploitation that also includes marriage.

Kotiswaran draws on feminist insights that situate sex work in broader debates around women’s reproductive labor to move away from a narrow focus of radical feminist who see prostitution as nothing but sexual violence. The radical feminist argument that prostitution is essentially violence against women, as Kotiswaran emphatically argues, ignores broader forms of exploitation (such as capitalist labor relations which also gains from women’s unpaid reproductive labor) that women’s labor is embedded in. Kotiswaran thus brings back the discussion on women’s work and labor relations into productive dialogue with literature on sex work so as to better understand the conditions under which women undertake paid sexual labor.

It is only through understanding sex work as work, as Kotiswaran consistently demonstrates in her book, feminist analysts and policy makers can have more grounded and systematic analysis of specific forms of institutional arrangements, labor conditions (which may also include exploitative conditions) and market mediated practices that sex work and sex workers are embedded in. Lacking such understanding, as this section poignantly reveals, would only reinforces stereotypes of sex workers as quintessential victims of patriarchal violence and sex work as most degrading practice.

Part II of the book (chapters 4 & 5) is ethnography of the sex markets in two very different cities – Tirupati and Kolkata. In Tirupati (a major Hindu pilgrim center in South India), sex work takes place in diverse institutional settings ranging from street-based, home-based and hospitality-based settings with a high percentage of self-employed sex workers (82-83 %). There are no separately demarcated red light areas in Tirupati. Here, most street-based sex workers are self-employed, as are home-based and lodge-based sex workers.  In addition to surveying the institutional settings (street economy, household economy, and hospitality economy) and different contractual arrangements in which sex work takes place in Tirupati, Kotiswaran also maps the internal stakeholders (brokers, landlords, hotel owners and other) and external stakeholders (police) of the sex markets.

Kotiswaran also discusses various contractual arrangements women enter into within these settings for example, women who choose to work in the institutional setting of house based economy can contract their labor to a owner operator (who may also be a sex worker herself) or work independently if they have enough contacts and social capital to work on their own. For example, Rehana rents a space in a house and uses it during the working hours on weekdays to see her clients.  When she is not doing sex work Rehana lives in a one-room apartment with her husband and her son. To substitute her husband’s intermittent income as a painter she worked in a garment industry in the South Indian city of Chennai, but she returned back to Tirupati as she was subjected to constant sexual harassment at the garment factory. Upon returning, she is introduced to sex work by a friend. Her husband does not know that she is a sex worker and she feels that she would not have gone into sex work if her husband earned sufficient income. Rehana previously worked with several owner operators before she got her own room for rent.

Kotiswaran’s ethnographic data also reveals how notions such as dignity play out in interesting and contradictory ways in the lives of secret sex workers like Rehana who see their entry into sex work as the only way to uphold the ‘dignity’ of their families. Kotiswaran’s observations reveal sex workers striving to undertake sex work in a ‘dignified manner’.  These ethnographic observations help understand how notions such as respect, dignity and safety are constantly negotiated and reworked as sex workers’ make sense of the economic hardships and personal tragedies that they and their families face and live through.

According to the data gathered by WINS (Women’s Initiative) an NGO working with sex workers on HIV/AIDS prevention, sex workers’ in Tirupati reported very negligible amounts of violence from customers; 82.4 percent of street-based sex workers, 91.7 percent of family-based sex workers, and 89.2 percent of house-based sex workers reported that they had never been abused by a customer (p.114). It is also telling that much of the violence that sex workers’ reported in Tirupathi is the violence they face from police.

In contrast to Tirpuati’s sex market, Kolkata’s (Sonagachi red light area) sex market is brothel based with an estimated 7,091 brothel-based and 3,262 floating sex workers (also referred as flying sex workers) who travel throughout the city to work. Kotiswaran maps various relational dynamics of the sex market in this brothel setting in Sonagachi, for example, between the women, the brothel owners; brothel owners and landlords; women and clients. Her data shows diverse labor relationships in this sex market and that even within the brothel set up there are different forms of contractual arrangements that women enter into.

For example, roughly 29.3% or one-third of sex workers are self-employed or operating independently in Sonagachi. Kotiswaran demonstrates that the women calculate risk and economic gain in choosing their work, depending on the different kinds of labor, service and tenant relationships available. For example a self-employed sex worker (who is also referred to as flying sex worker) who rents a room when ever she visits red light area from a landlord or a brothel keeper may end up spending lot more money on renting a place on a hourly or daily basis than a sex worker who may contract her labor to a brothel owner but has more security from police harassment in Sonagachi than if she works as a street-based sex. Street-based sex workers face more vulnerability and risk arrest from the police.

Kotiswaran’s critical intervention as a legal scholar and legal ethnographer comes out starkly in this chapter as she engages with various criminal and civil laws that shape the institutional set up of a brothel based sex market. She demonstrates the impact of the tenancy laws on the supply and demand in the sex market because the laws impact the women’s ability to negotiate with the brothel owners and clients. In her ethnographic account, sex workers come alive as economic actors capable of strategizing against eviction, securing tenancy rights, and becoming property and land owners as they invest the income they earn from sex work to secure property for themselves and their families.

Kotiswaran’s research defies the myths that sex workers are always victims (as Steinem claims) and that brothels are primarily places of violence and oppression. She documents how women are able to move freely between various forms of contractual arrangements in this sex market and the collective actions that women undertake under the banner of DMSC (Durbar Mahila Samanya Committee) to protect themselves from regular police harassment and arrests in brothels.

Kotiswaran’s data also indicates that trafficking is not the primary mode through which women enter sex work in Sonagachi. Although instances of women being trafficked do exist – as when a brothel owner buys a sex worker by paying lump sum to her relatives or other intermediaries – this is not a widespread practice. Furthermore, DMSC’s data also indicates that sex workers collectivization has lead to high condom use in Sonagachi, which increased from 1.11 per cent in 1992 to 81.87 percent in 2001 (P: 202).

The final section of the book Part III (chapters 6 & 7) offers concrete suggestions for legal reform based on Kotiswaran’s mapping of the relational dynamics in the Sonagachi sex markets. She applies caution in recommending legal reforms and explains that partial or complete decriminalization could impact differently on street based or brothel based sex workers.  On the other hand, she describes how legalization, if framed from the perspective of sex workers empowerment, could protect them from damages from customers and brothel owners. This chapter then serves as a caution to policy makers and reformers who suggest reforms to prostitution laws without having an understanding of the relational dynamics of the sex markets.

Chapter 7 captures the redistributive and labor aspects of sex work by drawing on the sex workers’ own definition of their work. Kotiswaran shows how women driven into sex markets due to economic compulsions are very well aware of the constraints of the labor markets. It is telling that, in various narratives by the sex workers themselves, they primarily define sex work as an occupation or a business rather than a profession as some of their western counter parts do. For them, sex work can be a time bound and temporary occupation that they engage with while engaging with other means of livelihood. Furthermore, they assess themselves on par with domestic workers, scavengers, street vendors, and other workers of informal sector who also work under unequal bargaining conditions.

Kotiswaran emphatically refutes the assumptions of poverty and lack of choice that are found in the “outsider” narratives as being colonialist in nature. Through her empirical analysis and evidence, she show how an emphasis on poverty as a primary lens for examining the sex markets in a non-western context misses the concrete realities of the lives of women in the sex markets, and the specific modes and forms of exploitation that occur in the developing world.

The biggest strength of this book is the way in which Kotiswaran has made the voices of sex workers and their organizations visible and central. She carefully documents the strategies they employ as they negotiate for safer work conditions in these highly regulated sex markets. The book leaves readers with a greater appreciation of the diverse roles sex workers play in shaping their lives within the sex sector and in being active members of their larger communities.

Kotiswaran offers an important framework and a model in which to engage with sex work that is not caught in the polarities of victimhood and liberated sexual subjects. She turns our attention to a feminist analysis that seriously takes into consideration dimensions of work and labor practices in sex work for a better understanding of labor conditions, and unequal bargaining conditions that prevent sex workers from access economic rights and redistributive justice.

For rights and justice to happen, we cannot operate on myths and assumption that sex workers are only victims of patriarchal violence. It is important to have more of the type of robust empirical and theoretical work achieved by Kotiswaran in analyzing the ‘work’ aspect of sex work. Hence, in her postcolonial materialist feminist approach, Kotiswaran proposes that we recognize sex work as legitimate work.

This is a path-breaking book, which adds significantly to the emerging literature on ‘intimate labor’. Kotiswaran’s legal ethnography should also be of interest to lawyers, legal advocates, policy makes, and feminist scholars and activists who are interested in sex work and law.

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Chaitanya Lakkimsetti is an Andrew W. Mellon Postdoctoral Fellow at The Center for Feminist Research and the Gender Studies Program at the University of Southern California. Her areas of research include gender, sexuality, globalization and postcolonial studies. Her email is clakkimsetti@gmail.com.

This Issue Paper presents current knowledge about the scope and meaning of child trafficking. Although it might seem to be a simple subject to describe, it is not. First, there is the question of what a ‘child’ is. The international definition in the Convention on the Rights of the Child defines a ‘child’ as a person under the age of 18 but, at the same time, it recognizes the evolving capacity of adolescents to engage in certain activities and make certain decisions (UN Child Rights Convention, UN Committee on the Rights of the Child 2003).

Additionally, there is confusion about how to distinguish between child employment, which is permissible, and child labor, which is not. Also, there is a conflict between international law and local practices because, in many countries, children routinely start to work before reaching the minimum legal age for employment set by international law. Read the article.

In 1999, the Swedish government embarked on an experiment in social engineering to end men’s practice of purchasing commercial sexual services. The government enacted a new law criminalizing the purchase (but not the sale) of sex (Swedish Penal Code). It hoped that the fear of arrest and increased public stigma would convince men to change their sexual behavior. The government also hoped that the law would force the estimated 1,850 to 3,000 women who sold sex in Sweden at that time to find another line of work. Lastly, the government hoped that the law would eliminate trafficking into forced prostitution and the presence of migrant sex workers.

Not surprisingly, the experiment has failed. In the thirteen years since the law was enacted, the Swedish government has been unable to prove that the law has reduced the number of sex buyers or sellers or stopped trafficking. Read the article

Human trafficking for organ removal (HTOR) occurs across the globe and constitutes egregious human rights abuses. The crime is included in the UN Trafficking Protocol and is the subject of the 2008 Istanbul Declaration on Organ Trafficking and Transplant Tourism.  In a recent report, Sudanese Victims of Organ Trafficking in Egypt, the Coalition for Organ-Failure Solutions (COFS) presents an extraordinary set of preliminary findings about the hidden world of human trafficking for organ removal in Egypt. Through its on-the-ground investigation, COFS has uncovered compelling evidence that traffickers have exploited and are continuing to exploit Sudanese refugees and asylum-seekers for their organs in Egypt. These abuses include removing kidneys either by inducing consent, coercion, or outright theft. The victims include men, women and children. Many of the victims came to Egypt seeking refuge from the genocide and armed conflict in their homeland.

The report elaborates its findings of 57 Sudanese refugees and asylum seekers COFS-Egypt identified in Egypt who said they were victims of organ trafficking.  Each case involved the removal of a kidney.  COFS-Egypt conducted in-depth interviews with 12 of these victims who described their experiences in compelling detail.  It arranged ultrasounds and physical exams for five of the victims as part of its follow-up care outreach service. The medical exams confirmed that kidneys had been removed in all five cases.  Four victims also showed the COFS field researchers documents from the hospitals where their organs were removed and the transplants occurred that detail the date, surgeons and organ donor involved in the transplantation.

Of the 57 victims identified, 39 (68%) are from Darfur, 26 (46%) are female and 5 (9%) are children. The twelve victims COFS interviewed ranged in age from 11-36 years with an average of 23.5 years; four (33%) of the victims were 18 years old or younger; and five (42%) were female.  Three of the interviewed victims said people (who turned out to be traffickers) helped them to enter Egypt illegally. Those traffickers worked directly with other traffickers who arranged for the kidney removal.  Some of the victims indicated that some women and girls are simultaneously being trafficked for sex and organs (9 possible cases in the sample of 57), and that the actual number of females in general may far exceed that of males.  Thus, women and children are of special concern.

The case of Dawood illustrates some of the processes involved in targeting Sudanese asylum seekers for a kidney.  Dawood explained that he was smuggled through Egypt with the promise to go to Israel for employment. After being taken to Cairo, he was housed and fed by a friend of the smuggler and then told he had accumulated a debt he must pay in order to be smuggled the rest of the way to Israel. Dawood was told about the option to sell a kidney to clear these debts, was told he would receive 2,000USD, never told about the risks involved and knew no other way to get out of the situation while displaced in Cairo. Although recipients pay between 10-15,000USD for a transplant in Egypt, Dawood (like many other victims of HTOR) never received the full payment and was robbed of the payment he did receive.  Dawood and three other victims elaborate their testimonies in a video clip that COFS prepared of corroborated evidence of testimonies, ultrasounds and some documentation from transplant centers.

One victim told COFS researchers that he was imprisoned in an effort to prevent him from reporting his/ claim of organ theft; this victim escaped during the January 25, 2011 revolution.  COFS-Egypt has confronted other cases where victims were in situations where they were restrained to share their stories before reaching our field researchers.  For example, Abdul, an 11-year old boy whose mother was a victim of organ trafficking and eventually gave in to pressure to broker Abdul’s kidney, waited many months before he could reach a COFS-Egypt field researcher/victim advocate to share his story in the absence of his mother’s presence.  Another example involved a woman who was abducted for a kidney and expressed her suspicion of her husband’s involvement but has not been given sufficient opportunity to speak with our advocates without his presence.

Four of the victims said they met the patients who had received their kidneys. Seven of the victims knew the nationality of the recipients: three were from Sudan, one was from Jordan, one was from Libya, and two were from countries in the Persian Gulf.  Interviewed victims also reported that the broker stole the money they received for the organ.

All of the victims interviewed said they had experienced a deterioration of their health in addition to negative social, economic and psychological consequences as a result of the experience.  These consequences are elaborated in the Report but with regard to effects on health, all of the 12 victims interviewed expressed deterioration in their health. This is likely a result of factors such as insufficient donor medical screening and pre-existing compromised health conditions of this vulnerable population.

Three of the victims interviewed held official “refugee” status from the United Nations High Commissioner for Refugees (UNHCR). One victim’s application for refugee status was under review; another had filed an application; and seven others were illegal and had not yet applied to UNHCR at the time that they said organ traffickers victimized them.

Since the release of the report, COFS-Egypt field researchers have leads to 13 more recent cases of Sudanese victims and two of their stories have so far been confirmed by ultrasound.  COFS estimates that there are at least hundreds of Sudanese victims of organ trafficking in Egypt as well as numerous other victims from Jordan, Eritrea, Ethiopia, Somalia, Iraq and Syria.  The total number of victims of organ trafficking in Egypt is estimated to be in the thousands.[i]

The findings presented in the COFS report are based only on living victim-survivors of the organ trade that COFS was able to identify.  The report does not speak to claims that many other people have died as a result of an illegal commercial organ removal.  This has special significance considering recent reports about the kidnapping and abuse of sub-Saharan African migrants smuggled into the Sinai Peninsula en route to Israel.  The reports include claims of torture and removal of organs that have resulted in death. (Key reports can be accessed at: http://www.cofs.org/sinai.html )

In light of the extensive evidence uncovered in Egypt, COFS calls upon the medical professional community in Egypt, the transitional and future Government of Egypt, the United Nations, including the UN Human Rights Council, UN High Commission for Refugees, UNICEF, UNIFEM, and other organizations that provide assistance to refugees and asylum seekers in Egypt, as well as human rights organizations, to work together to bring an end to organ trafficking in Egypt and elsewhere.  The present instability in Egypt and the region presents conditions conducive to all forms human trafficking.  It is therefore critical that this matter receives urgent attention.

Significant progress has been made in recent years to strengthen laws intended to curb organ trafficking in key countries that host the organ trade such as India, China, Pakistan, the Philippines and Egypt. However, in these and many other countries, renal (kidney) failure is now reaching proportions similar to that of tuberculosis, in large part because the astounding growth in diabetes worldwide. With transplants as the preferred therapy for renal failure, demand for kidneys will continue to outpace supplies. Until nations can build transparent, reliable systems of organ donation through altruistic donations from healthy individuals and deceased donors, poor and vulnerable individuals are at risk for being targeted to supply organs to privileged patients.

Financial or material incentives for donation are inherently flawed as they necessarily target the poor by providing inducements for their organ “donation.” (Budiani and Golden 2009).  Legal frameworks must continue to be enhanced and enforced to combat organ trafficking/ HTOR.  Countries that have ratified the UN Protocol on Trafficking in Persons must also include HTOR in their trafficking laws.  This includes that the United States, which should add HTOR to the federal trafficking law.

Further, countries must make it illegal for citizens to purchase an organ abroad.  For example, it is not illegal in the United States for a patient from the United States to undergo transplantation in China even though transplants to foreigners are illegal in China. It is also illegal for a patient in the United States to participate in organ trade within the United States; however, neither China nor the United States is preventing the illegal activity in China.  The United States should extend the extraterritorial jurisdiction of the National Organ Transplantation Act (NOTA) to ban U.S. citizens or legal residents from engaging in organ tourism.  These and related recommendations are elaborated in a recent briefing on HTOR to the United States Senate Foreign Relations Committee as well as the Tom Lantos Human Rights Commission.

Debra Budiani-Saberi, Ph.D. is a Medical Anthropologist, the Executive Director and Founder of the Coalition for Organ-Failure Solutions (www.cofs.org) and a Visiting Research Associate at the Center for Bioethics at the University of Pennsylvania.   She has conducted extensive research related to organ trafficking beginning in 1999 as a part of her study on refugee health. Dr. Budiani-Saberi has also worked more broadly on health and human rights in various parts of the Middle East and Northeast Africa (Egypt, Eritrea, Morocco, Somalia, Qatar, United Arab Emirates) as well as in India.  Questions and inquires can be sent to Debra Budiani-Saberi at debra@cofs.org

References:

Budiani-Saberi, D. and Golden, D., Advancing Organ Donation Without Commercialization: Maintaining the Integrity of the National Organ Transplant Act -An Issue Brief, American Constitution Society June 10, 2009.

Budiani, D.,  Facilitating Organ Transplants in Egypt: An Analysis of Doctors’ Discourse, in Islam, Health, and the Body, edited by Diane Tober and Debra Budiani, London: Sage Publications Series in Body and Society, October 2007 13(3): 125-149.

Barsoum, R. and M.A. Bakr, The Egyptian Renal Transplant Experience. Clinical Transplants 2000; 359–60.

In her book Illicit Flirtations, Rhacel Parrenas provides us with cutting edge, systematic, and empirical research on Filipina migrant hostesses— the women the U.S. government called the largest group of “trafficked” persons in the world in its 2004 and 2005 Trafficking in Persons Reports. Illicit Flirtations challenges this simplistic long-distance assessment.  It presents the nuances, differences, struggles and hopes of Filipina women working in Japan as bar hostesses.  In 2005, Parrenas moved to Japan to conduct participant observations by working as a hostess in a bar for several months. She also conducted interviews with a diverse sample of female and transgender hostess workers in a wide range of areas in Tokyo from upscale to lower-classed venues.

Her on-the-ground research method is rarely seen in the world of human trafficking research even though it is crucial to understand the lives of migrant workers and trafficked persons. It allows the researcher to gain rapport and develop a relationship with women in order to unpack the nuanced and complex relations existing between the migrant worker, the club owners, the broker agencies, and talent managers in both the sending and receiving countries.

As a result of her extensive research, Parrenas cautions researchers and activists against sweeping generalizations of human trafficking. She acknowledges that there are two sides to the debate on human trafficking, with the anti-prostitution feminists and advocates on one side and the sex worker rights feminists and advocates on the other.  Parrenas dismantles this binary framework and calls for a more nuanced understanding of the complex dynamics of coercion and choice, based on her understanding of the lives of Filipina hostesses in Japan.

Parrenas asserts that not all women are trafficked or forced into sex work – yet the women are not completely free of labor exploitation either. Rather Filipina migrant hostesses inhabit a middle zone between human trafficking and migrant labor, where they are exploited but not held in forced labor.  They enter this zone that she describes as indentured mobility— a process of labor migration that results in both progress (improving their economic opportunities) and subjugation (submitting to exploitative working conditions). This highlights the tensions between the “financial gains afforded by labor migration that come at the expense of their freedoms” (pg. 7). For example, women may choose to enter into hostess work; however, they do so by submitting themselves to the structural conditions that bind them migrant brokers, employers, and possible criminalization.

Parrenas pushes us to think about the conscious decisions that women make as they willingly migrate and enter into hostess work while she simultaneously refuses to dismiss their vulnerability as migrants and women. The migrant Filipinas she worked with did not see themselves as trafficked women. That is, they were not kidnapped, sold, or forced into the sex industry. Rather, they willingly entered hostess work knowing that they would give up some basic freedoms because they felt that hostess work was less exploitative than domestic work.

This innovative approach pushes researchers, policy makers, and state officials to look beyond the sensationalized stories of the media and into the multi-layered set of morals in gendered and sexualized hierarchies that shape migrant experiences. Rather than looking at the moral views that society places on the act of selling one’s body for money, Parrenas examines the subjective moral dilemmas of hostess workers who do not always engage in sex work.

She argues that Filipina migrant hostesses can be placed into three groupings of moral conservatives, amoralists, and moral in-betweeners. Moral conservatives are women who believe that the direct purchase of sex for money is wrong and sinful. These women were rare and are also more likely to get sent back to the Phillipines. Amoralists do not believe that commercial sex in immoral and as such they engage in commercial sex work inside and outside of the club. The moral standards of what Parrenas calls in-betweeners are neither morally conservative nor amoralistic.

Hostess workers engage in relations with their clients that encompass a wide range of principles concerning the intersections of sex and money (p. 158). Some maintain strict moral boundaries around sex with their clients, while others accept the use of eroticism at work, as they flirt and engage in varying degrees of intimacy with their customers. However, in order to become a long-term legal resident in Japan, Filipina migrants must become sexual citizens. That is, in order to become a Japanese citizen they must engage in sexual relations with a Japanese citizen as a wife or bear the children of a Japanese citizen. This privileges heterosexual relations making legal citizenship virtually impossible for transgender hostess workers.

In the second half of the book, Parrenas does what no other scholar has been able to accomplish – to bring the literature on immigration, migration, and sex work into conversation with one another. Through her empirical data she brilliantly examines the circulatory migration patterns of temporary Filipina migrants and those who settle permanently in Japan. She examines how different patterns of migration lead to a range of vulnerabilities, as women have to negotiate their different relations with their Japanese husbands, brokers, and bar owners. For example, undocumented migrant workers who fear deportation live in fear of the police and immigration authorities. Moreover, Parrenas brilliantly sheds light on a group of women who live mostly isolated lives as visa over stayers. Bound between home and work these women are limited their geographic mobility, thereby, rendering them invisible in the legal sphere and thus vulnerable to exploitation and enslavement by their employers (p. 232).

As government organizations, NGO’s, and policy makers provide “solutions” to the problem of human trafficking, we need to find better ways to measure the problem and think through the complex layers involved around issues of labor and migration. Parrenas’ book is one of the first to provide us with a systematic analysis of the migrant hostess workers. Importantly, Parrenas asserts that “trafficked women” are not always victims who need to be saved. Nevertheless, as migrant workers they face severe structural constraints.

Rather than eliminating the women’s opportunity to earn a living as hostesses, Parrenas, along with other sex workers rights activists, urges policy makers as well as the US State Department to disentangle anti-trafficking ventures and anti-prostitution efforts in order to “ensure the independent migration of women.” Most importantly, she argues that we must acknowledge the will of migrant workers to choose to engage in sex work. In addition, she suggests that solutions to workers subjugation should be geared towards ensuring workers independent labor migration stating, “if migration is indeed liberating and empowering, then the near eradication of migration flow of hostesses from the Philippines to Japan threatens female empowerment” (p. 272). We must work towards improving their labor conditions as well as their ability to move freely across international borders by recognizing hostess workers as labor migrations rather than as “trafficked victims” in need of “rescue.”

This was a brilliant book and a must read for those interested in issues of human trafficking, gender, labor, migration, and citizenship.

Kimberly Kay Hoang is currently a Postdoctoral Fellow at Rice University in the Poverty, Justice, and Human Capabilities Program at the Center for Women, Gender, and Sexuality Studies and the Kinder Institute for Urban Research. She also serves on the advisory board for the Chao Center for Asian Studies at Rice University. She will join the faculty in the Department of Sociology at Boston College in 2013. Her areas of research include gender, migration, globalization, and political economy. She is most recently the author of, “She’s Not a Low Class Dirty Girl!: Sex Work in Ho Chi Minh City,” published by the Journal of Contemporary Ethnography. Her email is kayhoang@rice.edu.

Mahdavi’s book Gridlock offers a fascinating report of the negative consequences in the Middle-East, specifically in the United Arab Emirates (UAE) and Dubai as a result of the impact of the UN Trafficking Protocol[i] and the U.S. anti-trafficking law[ii]. Mahdavi focuses an invisible group of the Emirates’ inhabitants, namely, its migrant workers, ranging from domestic workers, cab-drivers and male construction workers to beauticians working in malls and sex workers. She undertakes an ethnographic study of these several groups of migrant workers to offer a powerful critique of the current paradigm of international anti-trafficking law and its implementation in Dubai arguing that they hurt the very people they seek to protect. Mahdavi claims that contemporary anti-trafficking discourse has been inordinately preoccupied with the increased criminalization of sex work. She instead successfully argues for reframing trafficking as an international migration and human rights issue.

In the introduction to Gridlock, Mahdavi asserts that the dialogue about trafficking itself has been trafficked (p. 11). In particular, the term trafficking is used in definitional and policy terms to primarily connote women, often young, who have been duped or forced into sex work (p. 13) —  even though the international legal definition in the UN Protocol refers to any worker who is recruited or transported through means such as force, fraud, or coercion for purposes of exploitation.

Consequently, the exploitative conditions under which a large percentage of Dubai’s migrant non-sex worker population labors is not considered seriously. All sex workers on the other hand are considered to be trafficked (p. 62). This has been reinforced by US influence on trafficking discourse, particularly, the US TIP Report for Dubai which certainly prior to 2009 focused on sex trafficking. This is compounded by the fact that political and social actors in the UAE experience the TIP report as an instance of US imperialism and hegemony and more generally as a tool of US trade and foreign policy. Their suspicion is justifiable considering that Dubai has occupied literally every place in the TIP report rankings from Tier 1 (2003) to Tier 3 (2001, 2002) and Tier Two and the Tier Two Watch List in other years (pp. 19, 21, 25).

In the ensuing chapters, Mahdavi is keen to show that there are women in the sex industry who have not been trafficked and that there are many instances of abuse inflicted on both men and women outside the sex industry. Thus chapters 3, 4 and 5 of her books are focused on specific labor markets in Dubai.

Chapter 3 on Sex work for instance demonstrates what global research on sex work typically reveals, namely, the diversity of the sex industry. The situation is even more complicated in a state like Dubai where 92% of its population consists of migrants and where the city is divided and constructed along the lines of gender, race and citizenship. Hence, Dubai’s sex industry is segmented into the high-end group of Iranian sex workers who operate collectively and without pimps in the plush newer condo developments of South Dubai, while South East Asian and South Asian sex workers are in the city’s bars and African sex workers are on the streets of North Dubai.

Mahdavi is at pains to show how these sex workers cannot be easily characterised solely as victims or agents and that for them both force and choice co-exist (p. 63) and lie along a continuum —  so the motivations to enter sex work are several and complex. Any attempt to ignore this reality and dictate that all sex workers are ‘victims’ translates into rescue operations, which go against sex workers’ wishes. More significantly, it leads to the provision of social services to sex workers in Dubai along racial lines as street-based sex workers have greater access to services when compared to sex workers working in relatively safer indoor environments.

Related to the chapter on sex work is Chapter 5 on female migrant workers engaged in domestic work. Here Mahdavi demonstrates that women who can legally enter the formal economy of domestic work often choose to enter the informal illegal space of sex work for the relative autonomy and higher pay that it offers. They prefer sex work to the highly exploitative working conditions and the absence of labor rights they face as domestic workers. When domestic workers are deceived about their hours of work, their visa status and their pay, which is not paid for months on end, they run away from their employers – this renders their immigration status illegal. Hence moving into sex work very quickly becomes a “deliberate well-reasoned act of income generation” (p. 141). The most significant insights here for those who advocate against sex trafficking according to Mahdavi is that many women enter sex work through legal migration channels and from jobs in the formal economy.

Having thus exploded certain myths around sex work and sex trafficking, Chapters 4 and 7 of Mahdavi’s book offer a poignant account of the appalling working and living conditions of migrant laborers in other sectors in Dubai.  They arrive on fake visas and pay exorbitant fees to recruitment agencies. They are tied to their employers by the kefala system, which prevents them from changing jobs.  This system undermines their bargaining power, forces them to live in squalid living conditions and work even when seriously injured. It often results in unpaid salaries and, even when paid, wages are well below what was agreed to. These serious abuses are further compounded by high penalties for living illegally in Dubai. So for some migrants, exit to their home country becomes practically impossible as the authorities would detect their illegal status upon departure. Thus Mahdavi points to the “discrepancy between imagined ideas about trafficking and the actual realities of forced labor and migration.”

Based on Mahdavi’s account so far, one might look to the space of civil society for addressing the serious rights infractions of migrant workers in Dubai. Except that the UAE formally prohibits the formation of labor unions. As a result, organisations that have been set up to support migrant workers lead a precarious legal existence. They are hampered by the inability to raise funds, scale up their operations or vocally advocate for workers’ rights.

It is this fragile space of civil society according to Mahdavi that has suffered the most from the politicisation of the trafficking issue and the mandate of the 2009 TIP report to the UAE to step up law enforcement efforts against trafficking, increase raids and arrests against sex trafficking and tighten borders (p. 213). These TIP recommendations according to Mahdavi led Dubai to import law enforcement personnel and dramatically increased the surveillance of female migrant workers. Further by reiterating the received US notion that countries in the Middle-East have no civil society, the efforts of existing groups amongst migrant workers were rendered invisible. Worse, of the four migrant workers’ organisations that Mahdavi chronicles, two were shut down by the government for harbouring illegal migrant women and ‘running a brothel’ while one other group decided to direct its efforts towards male migrants.

In conclusion, Mahdavi deploys her ethnography of migrant labor markets in Dubai to powerfully situate trafficking at the crossroads of complex macro-social forces operational in both sending and receiving countries – the structural realities of the migration process (such as the kefala system, the lack of the recognition of domestic work and sex work as forms of labor) and the powerful grip of the anti-trafficking discourse which renders abuse in non-sex work sectors invisible, while ‘fetishizing victimisation’ in the sex industry.

Despite the global moral panic that animates contemporary efforts against trafficking, Mahdavi is confident that the trafficking framework could potentially be used as a catalyst to improve migrant workers’ human rights. But for this to occur, the selective focus on sex work will need to be broadened to include all forms of labor and a greater emphasis will need to be placed on conditions that exist at the end of the migratory process rather than solely on consent to entry into a labor market. A systemic reform of the kefala system to allow for worker rights will be essential as well as better training of police personnel, an increase in the numbers of labor inspectors and the recognition of the legal status of NGOs supporting workers. Thus, it is by only by understanding trafficking as migration gone wrong (p. 12), can we address the ‘gridlock’ of contemporary anti-trafficking policy.

Prabha Kotiswaran is a Lecturer in Law at the School of Law, School of Oriental and African Studies. Her areas of research include feminist legal theory, law and society in South Asia and sociology of law, especially an economic sociology of law. She is most recently the author of Dangerous Sex, Invisible Labor: Sex Work and the Law in India, published by Princeton University Press (2011) and editor of a reader on Sex Work published by Women Unlimited (2011) for a Series on Issues in Contemporary Indian Feminism. Her email is pk5@soas.ac.uk

Labor migration schemes around the world are typically created to fit the needs of employers, and rarely support and protect the rights of the migrant workers. In my article, “Why Transparency in the Recruiter Supply Chain is Important in the Effort to Reduce Exploitation of H-2 Workers,” I propose one means to reduce worker vulnerability in the U.S. but the proposal could apply just as easily in other countries.

Over 100,000 workers a year obtain H-2 visas to come to the United States to labor in temporary, low wage jobs such as farm work, landscaping, and forestry.  H-2 visas allow workers to work only for one employer for less than one year.  Surprisingly, although they can work legally in the U.S., this foreign work force is at high risk of becoming human trafficking victims due, in part, to the lack of transparency in the recruitment process, a weak regulatory framework and weak enforcement of the few laws that do exist to protect them.

An important part of this trafficking story lays in in the recruitment of H-2 workers in foreign countries.  The H-2 recruitment system operates essentially in a clandestine manner leaving the workers in a guessing game if the person offering a job a charlatan, a trafficker, or an agent recruiting on behalf of U.S. employers who are certified by the US. to hire H-2 workers.  At present, there is no system for workers to find any information about the recruiter and, therefore, whether the job in the U.S. is real.

In the article, “Why Transparency in the Recruiter Supply Chain is Important in the Effort to Reduce Exploitation of H-2 Workers,” I lay out a means to bring more transparency to a specific source of exploitation during the recruitment process: the identity of the recruiter.  I argue that workers should be provided tools to verify the identity of the recruiter as a means to prevent their own possible victimization.

The core of the argument is disclosure of the “Recruiter Supply Chain”, which would require the U.S. employer at the beginning of the H-2 process to disclose details about the foreign recruiters and the sub contractors they may hire.

The information would be publicly available through multiple means, such as the U.S. Department of Labor and U.S. consular websites, as well as a U.S. consular hotline in the countries of recruitment.   Utilizing these sources, workers and their advocates could cross check the offer in the foreign country to determine whether the recruiter is legitimate and if the job is as promised.

The important point here is that the validity of a job offer could be investigated before the workers invest hundreds, if not thousands, of dollars on a job that may not exist.

Recruiter disclosure will also allow foreign governments to enforce their own laws, often crafted to protect workers in the recruitment process.   Without knowledge of who the recruiters are, the foreign governments are hard pressed to ensure their laws are being followed.

This type of pre-departure public information could help workers not only avoid becoming ensnared in a trafficking scheme, but lead to the prosecution of fraudulent recruiters and traffickers.

The economic desperation of so many workers – who are forced to depend upon unreliable sources for information about jobs overseas – presents challenges to creating meaningful, effectual mechanisms to reduce the chronic fraud, trafficking and other abuses committed in the name of the H-2 visa, but it is imperative that we try.

For more information, read Why Transparency in the Recruiter Supply Chain is Important in the Effort to Reduce Exploitation of H-2 Workers

Cathleen Caron is the Founder and Executive Director of Global Workers Justice Alliance.  Global Workers combats worker exploitation by promoting portable justice for transnational migrants through a cross-border network of advocates and resources.  Global Workers believes that portable justice, the right and ability of transnational migrants to access justice in the country of employment even after they have departed, is a key, under addressed element to achieving justice for today’s global migrants.  To learn more go to www.globalworkers.org or contact cathleen@globalworkers.org

This paper briefly raises some issues around the demand side of trafficking, initially focusing on demand relating to exploitative labour practices and then discussing issues around demand contributing to exploitation for sexual purposes. It is very much an opinion piece, intended to promote discussion.

The demand side of trafficking has started to attract more attention in recent times, perhaps due to the lack of evidence for success of prevention programmes that focus on what is often called the supply-side – reducing the number of people that are vulnerable to being trafficked. This lack of progress on the supply side is hardly surprising given the size of the potential supply pool, that is the number of potential migrants who, in the absence of effective protection, are vulnerable to being exploited. Read the article