6th October 2017, Volume 130 Number 1463

Paula King, Alison Blaiklock, Christina Stringer, Jay Amaranathan, Margot McLean

Contemporary forms of slavery and accompanying serious health consequences exist in New Zealand today.1–5 The International Labour Organization estimates there are 40.3 million victims of slavery worldwide.6 While there are…

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Summary

Slavery and its adverse health consequences is a serious, complex, and often hidden problem in New Zealand. We have endeavored to raise awareness about this neglected issue and highlight the numerous opportunities for doctors and other health practitioners to be leading advocates for change at government, health system and organisational levels. Responses should be based on the respect, promotion and protection of human rights, and occur within a robust person-centric coordinated government response to addressing slavery in New Zealand.

Abstract

Contemporary forms of slavery and associated adverse health effects are a serious, complex and often neglected issue within the New Zealand health sector. Slavery in New Zealand has most recently been associated with the fishing and horticulture industries. However, victims may be found in a number of other industry sectors, including the health and aged-care sectors, or outside of the labour market such as in forced, early (underage) and servile forms of marriage. Victims of slavery are at increased risk of acute and chronic health problems, injuries from dangerous working and living conditions, and physical and sexual abuse. These issues are compounded by restricted access to high-quality healthcare. Slavery is a violation of many human rights, including the right to health. New Zealand has obligations under international law to ensure that all victims of slavery have access to adequate physical and psychological care. The health sector has opportunities to identify, intervene and protect victims. This requires doctors and other health practitioners to demonstrate their leadership, knowledge and commitment towards addressing slavery and its health consequences in ways that are effective and do not cause further harm. Key recommendations for a safe approach towards identifying and managing people in situations of slavery include building rapport, and culturally competent practice with an empathetic non-judgmental approach. We also recommend that health organisations and regulatory and professional bodies develop culturally competent guidelines to respond safely to those identified in situations of slavery. These responses should be based on the respect, promotion and protection of human rights, and occur within a robust person-centric coordinated government response to addressing slavery in New Zealand.

Author Information

Paula King, Public Health Physician/Research Fellow, Department of Public Health, University of Otago, Wellington; Alison Blaiklock, Public Health Physician/Honorary Senior Lecturer, Department of Public Health, University of Otago, Wellington; Christina Stringer, Associate Professor, Department of Management and International Business, The University of Auckland, Auckland;
Jay Amaranathan, Emergency Medicine Physician, Capital & Coast District Health Board, Wellington; Margot McLean, Clinical Director Women, Child and Youth Services, Hauora Tairāwhiti, Gisborne.

Acknowledgements

The authors would like to acknowledge Rebekah Armstrong, Shila Nair, Catherine Healy, Dr Graeme Lear and Dr Doug Lush for their valuable comments on an earlier draft of this article. We would also like to thank the NZMJ reviewers for their helpful peer-review comments.

Correspondence

Paula King, Department of Public Health, University of Otago, Wellington, 23A Mein Street, Newtown, Wellington 6021.

Correspondence Email

paula.king@otago.ac.nz

Competing Interests

Nil.

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