Victims may be reminded of previous traumatic experiences by apparently minor memory triggers which can provoke re-traumatization or panic responses. Sensory memory triggers in the form of sights, smells and sounds can also cause re-traumatization because they remind victims of their trafficking experiences. An East Asian woman trafficked for sexual exploitation Fei Yen is frightened if the telephone rings with a withheld number. If she sees people wearing football shirts, she feels panicky, because she is reminded of the occasion when customers of prostitutes in football shirts tied her to the bed when she was held in forced prostitution – this upsets her so much that she will alter her plans rather than remain anywhere in the vicinity of football supporters. Some victims go to great lengths to avoid re-traumatization triggers, for example by isolating themselves from any social situation where may they have to talk about themselves. They may completely avoid TV programmes and newspaper articles in case they are concerned with, for example, violence, prostitution or slavery. Some victims have an aversion to computers and the Internet due to experiences or fears of being exploited on websites while they were held in forced prostitution. Others may be reluctant to communicate in their first language or to have any contact with people who are from the same country or culture,58 or they may develop fears of groups of people who even vaguely resemble traffickers or their associates. Some victims have been known to panic or flee when hearing a name that is the same, or similar to, that of their trafficker. Questions about experiences of trafficking (particularly those involving sexual abuse/rape) in formal interviews, in court or just in the course of daily life, may also trigger retraumatization. All interviews of people who may have been trafficked should be conducted by professionals who are trained in working with victims of trafficking and understand how to work pro-actively and sensitively to minimize any re-traumatization. National Symposium on the Health Needs of Human Trafficking Victims: Post-Symposium Brief, “Children and adults can also experience re-victimization if their images have been posted online. Medical professionals serving victims of human trafficking cited online images as a major factor in computer aversion, which can significantly affect completing school or attaining gainful employment”. 78 Istanbul Protocol, Paragraph 149 Despite all precautions, physical and psychological examinations by their very nature may re-traumatize the patient by provoking or exacerbating symptoms of posttraumatic stress by reviving painful effects and memories. Questions about psychological distress and, especially, about sexual matters are considered taboo in most traditional societies, and the asking of such questions is regarded as irreverent or insulting. If sexual torture was part of the violations incurred, the claimant may feel irredeemably stigmatized and tainted in his or her moral, religious, social or psychological integrity. The expression of a respectful awareness of these conditions, as well as the clarification of confidentiality and its limits, are, therefore, of paramount importance for a well-conducted interview. A subjective assessment has to be made by the evaluator about the extent to which pressing for details is necessary for the effectiveness of the report in court, especially if the claimant demonstrates obvious signs of distress in the interview. 5.5 Low Self-esteem, Shame and Self-blame People who have been trafficked commonly suffer from low self-esteem as a result of their experiences of enslavement, psychological abuse, deprivation and/or violence. Clinicians find that this often inhibits victims from speaking with clarity, specificity or sufficient confidence, especially in response to direct questions. Young people trafficked for domestic servitude can suffer abuse which directly affects their self-esteem and self-image throughout their sensitive, developmental years. Examples of this include children being called “house girl/boy” and “slave”; being dressed in ill-fitting, cast off or ragged clothing, being denied essential sanitary/hygiene items or having their gender mocked, (for example a boy being called “maid”). One girl was called “stupid bitch”, “fool” and “prostitute” for perceived minor housework errors. Another had her hair cut off as a humiliating punishment and others have described younger children in the family being encouraged to mock them and/or treat them as a slave. A young victim of trafficking who was subjected to violence and domestic servitude throughout her childhood. “I felt like a commodity, worthless as a person.”