Table 5

Example potential indicators of MSHT—physical injury and torture (non-exhaustive)

Presenting concernPossible MSHT-related cause
Musculoskeletal pain, abnormal bone healing, abnormal posture or movement45 61Secondary to enforced poor or prolonged posture, repetitive movements, manual labour with insufficient support or safety systems.
Violent injury to limbs (includes deliberate amputations, punishment for theft)
Stress positions of torture.
Head injury, headaches, facial, ocular and/or hearing damage45 61 63 64Secondary to accidental or non-accidental head injury including single or repetitive beating around the head.
Skin wounds, tattoos and scarring45 70 73 74May be secondary to deliberate injury infliction that is, cigarette burns, whipping, ropes, skin markings in association with witchcraft or juju control rituals.
Environmental skin injury secondary to unprotected chemical, temperature or sun exposure.
Skin tattoos, gang-markings or ‘slave branding’ (may include images of money symbols, trafficker initials, ‘daddy’, hex symbols, sexualised words and placements).
Pulling of nails or violent nail injury.
Genital, anal, internal and oral injury71 75Damage to external and/or internal organs secondary to rape and sexual abuse, including with objects or forced plugging of cavities with drug packets.
Violent or unsafe abortion.
Female genital mutilation.
Dental injury71Forced pulling of teeth or dental damage.
Direct eye injury65 72Secondary to violent injury or deliberate rubbing of irritants into the eye.
Other sequalae of physical and psychological violence.Physical and psychological violence including stabbing, burning, beating, drowning, hanging and mock executions which may lead to severe damage, disability or death.
Children may be forced to harm or kill children, adults or animals and to watch the degradation, injury and assault of others.76
  • MSHT, modern slavery and human trafficking.