Thursday, January 28, 2016

Combating human trafficking through health system improvement

Mofor Samuel

Cameroonians are still to come to terms with hair splitting stories of victims of human trafficking enticed and deceived into believing that a brighter future awaits them in the Middle East and Kuwait in particular. Young Cameroonian girls, most of them graduates particularly in the health sector, were lured into believing that golden employment opportunities, comfortable financial packages and other non-financial incentives would characterize their working condition.  
    Messages like this one were often posted on poles and strategic points or ran like strips on television stations: If you are between 18 and 24 years old, like to work in the Middle East, and want to get between $6,000,000 and $20,000,000 in a year, pay attention. We are offering: A round-trip place ticket; A work visa to Kuwait, Dubai, UAE etc; Housing; Transport allowance; Advice on the law; Contract for 24 month’s work etc. Such messages often end with contact numbers for those interested to call for enquiries. Several families were forced to sell their only landed property to fulfill the financial conditions to enable their daughters to fly to the Middle East as they saw gold waiting for them at the end of the tunnel. Some even went for loans with the sure hope that once their children get settled down in their new destination, the loans will be taken care of. Not until CRTV’s prime time programme Cameroon Calling unleashed the bomb shell of the ordeals that victims went through once they touched down in their respective destinations. Victims come face to face with the grim reality that they were being trafficked and have to dance to the music of their owners. These young women were forced to work excruciating long hours with no money and no chance to rest.
    Victims of trafficking are often dumped in unsafe or illegal living and working conditions. Far from home, their personal identities, passports, birth certificates, identification cards, and address books are also being confiscated once they arrive at their destinations. Next, they endure physical abuse, ranging from punching, slapping, choking, pulling hair, body kicking, forced sex, and often involving the use of dangerous weapons such as guns or knives. The victims repeatedly suffer emotional and psychological abuse — i.e., their captors will threaten to hurt their families back home, threaten to turn them over to police or immigration officers, destroy their personal property, humiliate and demean them, or force them to commit illegal acts.
They are not allowed to have outside contact with family and friends. They are forbidden to go outside, to make phone calls, write letters, or see the light of day, except perhaps through a dimmed barred window. Many of them sleep on the floor, on the corridor sometimes with animals.
     The major reasons for the persistence of the ugly phenomenon of human trafficking in Cameroon include pervasive poverty in the society especially at the family level, the frightening problem of unemployment among the population particularly the youths, and ignorance of the prospective victims of human trafficking about their fate in foreign countries. Some other reasons include bad leadership that has failed to improve the welfare of the citizens thereby resulting in mass disillusionment and the urge by many citizens to leave the country in search for green pastures; the abuse of traditional method of fostering children and get-rich-quick syndrome in contemporary Cameroonian society.
     The escalation of the incidence of human trafficking in Cameroon began in 1990s as a result of decline in Cameroon’s economy which gave rise to pervasive poverty at family level; frightening unemployment; deterioration of social infrastructure; low wages, soaring prices of goods and consequent social misery among the population. This situation provoked the urge amongst many Cameroonians to immigrate to foreign countries to seek better life and favourable economic opportunities.
    Perhaps at this juncture, it is necessary to understand what human trafficking is all about before delving into its consequences.
    Simply put, it is the recruitment, transportation, transfer labour receipt of a person through deception, force, coercion to a strange place within or across borders for the purpose of retraining such a person in a situation of enslavement, servitude or debt bondage.   The effects of human trafficking paint a very negative image of Cameroon internationally. Some of the negative consequences of human trafficking on the country’s image are:
-          It creates the erroneous impression that the country is incapable of providing for her citizens especially in terms of employment and social welfare, hence the exodus of her able-bodied youths to foreign countries
-          It exposes some Cameroonians to all forms of inhuman treatment in foreign countries. These include physical assault, rape, detention and in some extreme cases execution. Many are also known to be languishing in prisons in some countries of the world due to the misadventure associated with human trafficking.
-          It gives rise to frequent deportation of Cameroonians from foreign countries.
-          It portrays Cameroon as a country in throes of political and economic crises.
-          Brain drain which is another dimension of ‘human trafficking’ deprives the country of the high-skilled manpower needed for rapid national development. Ibekwe (2010) summarized the negative effects of brain drain on developing countries, including Cameroon as follows: “Brain drain in developing countries has financial, institutional and social costs: little return from their investments in higher education; increasing dependency on foreign expertise due to dwindling professional sector; diminishing ability of several developing countries to offer basic health care services to their subjects; widening gap in science and technology between the richer and poor countries; crumbling middle class population; failing tax system and disappearance of jobs and society”.
    On the other hand, Cameroon’s health care and education sectors have been in deplorable state partly due to inadequate number of experts as a result of the effect of brain drain.” In the case of the health sector, Cameroon needs some 36,000 health workers to meet up her demand in human resources for health. In fact training and sustaining health workers in Cameroon just like many sub-Saharan African countries is a major problem begging for an immediate solution.     According to World Health Report (2006), a minimum of 2.3 health workers per 1000 population is required to meet the health needs of the MDGs.
    The inadequate funding of health systems in Africa (including Cameroon) has resulted in unsafe and unsupported working conditions for health professionals. Much of the current HRH crisis in Cameroon can be attributed to low government spending on health – a mere 4.6% and 5.1% of the gross domestic product in 2000 and 2012.
    The lack of basic equipments and regular drugs combined with many districts having less than $1 per person per year to spend on health care services reduces the ability of health workers to carry out their jobs effectively.
Inadequate retention, management and training characterized by low salaries, limited opportunities for career development and the lack of support and supervision are all contributory factors to brain drain in Cameroon as far as the health sector is concerned. On the other hand, most health workers are trained for individual performance and not for the team-based approach on the recognition that health is produced with others, whether they are professionals from different backgrounds or as members of the community. Team work with other sectors or communities are capabilities or skills developed during pre-graduate training. They are exceptionally addressed in most graduate health courses. The reductionist and wrong perspective that human resources for health are only those involved in curative, disease-centred and care institution still persists.
    Government should allocate sufficient internal resources to health in order to ensure the essentials and priorities established. Furthermore, since human resources require new capacities, the health work force needs to address new social, environmental and sanitary problems with an inter disciplinary approach and therefore, new competence and skills have to be developed to address situations encountered in the areas they serve.
    Policy decision makers and human resources training institutions must work hand in hand in planning for the health system’s needs. The training in health care that does take place in Cameroon is also seldom matched with employment needs.   
    In 2011, for example, severe staff shortages in the fields of mental health, ophthalmology and anesthesia–resuscitation were known to exist, but almost all health science students at training schools in Cameroon were intending to work as nursing aids, state registered nurses or laboratory technicians in other fields of medicine. The development of human resources for health, both at the undergraduate and post graduate levels needs to respond to the country’s health system’s needs and demand joint work between State and University. Health workers need to develop competence and skills for health promotion and prevention and the incentives for applying them as required.
    Continuing in-service education is crucial for ensuring quality response from the health work force, keeping pace with scientific advances as well as with changes and the complexity of the reality. Health workers with an enabling environment for their development and reflection on their own practices within an interdisciplinary team will be enriched in the interpretation of problems to be addressed and will be amenable to design more effective strategies for their solution.
    Last but not the least, leadership and accountability as well as decentralization within the health sector must not only be a slogan. Cameroonians from all walks of life should be able to hold the government and policy makers to account on health sector spending and ensuring that human resources are prioritized.
    The coordinated use of crime prevention and law enforcement resources to stamp out human trafficking and to liberate the vulnerable especially young female adults and adolescents, from exploitation, as well as to ensure their rehabilitation and effective reintegration into the society, the prosecution of barons or networks involved in this dehumanizing activity and collaboration with relevant national and international agencies is much welcomed at this point in time.  
    However additional measures such as improving the working environment in the health sector will enable Cameroon to stem the tide and protect its citizens particularly the youths from the scourge of human trafficking. These youths will then stay and contribute to development at home.

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