Global Health Care Experiences of Female Survivors Who Experienced Trafficking: A Meta-Ethnography.

INTRODUCTION: Most nurses and midwives do not feel adequately prepared to respond to the complex trauma and social and cultural needs of female clients who have experienced trafficking. There are data to support a lack of knowledge among health care providers about the types of human trafficking as well as poor structural supports within health care systems. The purpose of this review was to gain a more comprehensive understanding of the global health care experiences of females who have experienced trafficking. METHODS: Noblit and Hare's 7-step meta-ethnographic approach was used. We analyzed constructs, concepts, themes, and metaphors using reciprocal translations. The guidelines for preferred reporting the synthesis of qualitative research were adhered to enhancing transparency (Preferred Reporting Items for Systematic Reviews and Meta-Analyses). RESULTS: The collaborative search process in the PsycINFO, CINAHL, and Scopus databases resulted in 7 high-quality research studies published between January 2016 and January 2021. Most studies explored individuals' experiences of trafficking and views of health care services, challenges, and service use barriers. A total of 228 female survivors who experienced trafficking participated. They primarily experienced trafficking within different parts of North America, Eastern Europe, Africa, and South and Southeast Asia. Three main themes emerged: privacy, confidentiality, and identity problems; powerlessness; and clinician recognition and responsiveness. DISCUSSION: All participants reported being exposed to extremely high levels of physical and mental abuse before, during, and after exiting trafficking. Therefore, clinicians will require ongoing training and clearer guidance from clinical leadership to adequately care for the varying health needs of women and girls who have experienced trafficking or are currently in a trafficking situation. Adoption of a culturally sensitive, patient-centered, and trauma-informed approach is needed, as clients' reasons for staying in a trafficking situation vary. Relationships of trust should be formed in which rapport is cocreated and in which members of the health care team and client work hand in hand together to envision, identify, and pursue future-oriented and strength-based goals toward healing.

'Transgender Persons (Protection of Rights) Act' of India: An Analysis of Substantive Access to Rights of a Transgender Community.

The amendments to the Transgender Persons (Protection of Rights) Act of India in 2019 address non-binary persons' constitutional rights, recognition of their gender identity, and non-discrimination laws across institutional spaces (for example, family, workplace, education, and healthcare). The Act discusses legal rights in isolation of praxis, structural support and, more importantly, lacks guidelines needed to substantively access rights. Such a disconnection relegates human rights to merely legal changes with limited practice. In this article, we discuss the achievements and failures of the act from the perspective of a transgender community in India, and the impact it has had on their lives from its formulation in 2014. Although non-binary communities are recognized, they face severe abuse and discrimination. We analyse accounts of 15 transgender persons' lived experiences and challenges they faced in claiming their rights in Kolkata, a metropolis in eastern India. We used the framework of substantive access to rights, that is, the actual ability to practice and access documented rights, to critically discuss our findings across family, work, education, and healthcare spaces, often showing the gaps between achieved legal status, and the practical realities on the ground. We provide several recommendations to bridge these gaps-improving educational equity for non-binary people, including transgender specific training for healthcare providers and, more importantly, increasing the adequate representation of non-binary people in the positions of negotiation. The road to claiming social and economic rights following legal rights for non-binary gender communities cannot be achieved without overcoming their erasure within families and hypervisibility in public spaces.

Social world of organ transplantation, trafficking, and policies.

Although success of organ transplants reflects advances in medical procedures, the success has generated debates about the ethical standards and policies that govern transplants, especially the acquisition of organs for transplants. We focus on laws, policies, and organ trafficking to highlight the interdisciplinary perspectives that can shape our understanding of transplantation as a social phenomenon. We discuss international policies and country-specific legislation from Pakistan to point to gaps and their implications for protecting vulnerable people who are exploited for organ removal. International collaboration and the legal framework need to be strengthened to fight the menace globally and to deal with the cases of organ trafficking within the legal ambit of human trafficking so that the rights of victims are upheld by states, justice systems, and ultimately medical establishments and practitioners.