Part One Clinical Links Between Human Trafficking and Torture 2 Forms of Interpersonal Violence Suffered by Victims of Human Trafficking 2.1 Physical Violence Interpersonal violence is a term that is used to describe systematic, intentional and repeated acts of physical and/or psychological cruelty inflicted by a person or persons against individuals who are physically and/or psychologically entrapped 15. All clients in the care of HBF have suffered interpersonal violence whether from state torture, human trafficking, domestic violence, gender-based violence or collective violence. Some have suffered hazardous journeys under the control of dangerous people, during which they have been violently assaulted and/or raped and possibly witnessed attacks and the deaths of others on the way. This high level of violence and fear is effective “preparation” for the control of victims in exploitation. It is one of the reasons why traffickers can often relax their level of physical control and coercion as time passes, knowing that victims will continue to feel psychologically unable to escape their situation and are therefore unlikely to attempt to leave it. It is not unusual for clients to have suffered more than one of these violations. For example HBF clinicians work with victims of trafficking who have been tortured by the state in their country, or suffered collective violence in their community and have then been trafficked. Clients may also have suffered domestic violence in harmful relationships prior to their trafficking experience, or after their escape. Interpersonal violence in various physical and psychological forms may be exercised by traffickers for a very long time, sometimes years. It can span the stages of recruitment, the journey, transit, arrival in the destination country, and exploitation of the victim. The psychological bonds of this relationship, and the trauma that can result from it, often endure well beyond the point at which the victim leaves the control of the trafficker. From Birth to Death and Bench to Clinic: The Hastings Center Bioethics Briefing Book for Journalists, Policymakers, and Campaigns - Victims of trafficking for various forms of exploitation frequently describe experiences of prolonged interpersonal trauma during which the threat and the reality of extreme violence was ever present. Throughout the trafficking experience physical violence may be inflicted in many forms against victims. These are outlined in more detail at section 3.1. An East African woman trafficked for domestic servitude Tilay was beaten, kicked and punched by the wife and her children, and raped by the husband for the three years that she remained in the service of the family. The husband also beat her when she tried to resist his sexual attacks. She was threatened with being sent back to her own country if she revealed his actions. She was treated “like an animal. I slept on the floor. I had to clean, clean and clean. I was never given proper food, only leftovers. I was so hungry; always hungry. If the children saw me eating food they would tell their mother and she would punish me, beating me, telling the children to kick me.” 53