The horrors experienced by victims of human trafficking in Egypt’s Sinai Peninsula are almost unimaginable. Held in ‘torture camps’ run by gang leaders, they are systematically subjected to physical abuse and sexual violence by their captors in a bid to exhort money from family at home and abroad. Many die or are killed. Others escape, only to be detained by Egyptian security forces, held in detention facilities and subsequently deported. A lucky few reach Cairo. It is rarely the sanctuary one might expect.

The lawless nature of the restive peninsular region makes the scale of the problem hard to gauge, but by most estimates the numbers are huge. A draft report entitled “The Human Trafficking Cycle: Sinai and Beyond” (PDF) and co-authored by human-rights activist MeronEstefanos, Tilburg University’s Professor Mirjam van Reisen, and Dr. Conny Rijken—which was presented to the European Parliament last week—suggests that 25,000 to 30,000 victims were trafficked in Sinai between 2009 and 2013.

Many of the victims are Eritreans snatched either from their home country, after fleeing to neighbouring Sudan and Ethiopia to escape its authoritarian regime, or while making their way through the Sinai in an attempt to reach Israel. They are typically held for months while their kidnappers attempt to collect ransoms, often upwards of $30,000. Survivors describe having burning plastic melted on to their bodies, being hung from ceilings, brutally beatenand raped. Relatives are often phoned while this torture takes place—an aid worker dealing with trafficking survivors describes a case in which a father killed himself after hearing his daughter’s screams.

Many victims die in transit or as a result of injuries sustained at the hands of their torturers. Others are killed when ransoms are not forthcoming, according to the report’s authors. An Eritreansurvivor, who now lives in Cairo, describes in testimony how two of his friends succumbed to the wounds inflicted on them in a torture house. Captors, he says, then fed their bodies to dogs.

Some hostages escape or are released in Sinai. If Egyptian security forces catch them, however, they are considered illegal immigrants andheld indefinitely in detention facilities with no possibility of access by, and assistance from, the UN High Commissioner for Refugees (UNHCR). Their only chance of leaving is to pay for their own deportation, despite the fact that that Eritreans may be accused of leaving the country illegally by authorities should they return home and could be detained or persecuted as a result.

Egypt’s legal framework provides adequate protection for victims of trafficking, but its implementation, according to the report’s authors, is “gravely lacking.”

The few who make it to Cairo, usually do so after having their ransoms paid in full or with the help of sympathetic Bedouin leaders and aid organisations. Sarah Wahby, a project manager with the International Organisation for Migration’s (IOM) Cairo office, says there are currently 329 victims of trafficking registered in the city, of which 32 percent are minors.

It is the best possible outcome for victims, but Egypt’s capital offers little respite. Elizabeth Tan, Deputy Regional Representative at UNHCR’s Cairo Office describes the position of this population as one of “extreme vulnerability.”

The most pressing issue, rights groups say, is protection. Traffickers often continue to harass and stalk their former captives via phone and in person. Sometimes the goal is pure intimidation, but attempts are also made to obtain yet more money or force victims into working for them. There have also been documented cases of further abductions. “We often hear reports of people being threatened, that traffickers have their phone numbers. There’s also a risk of re-trafficking,” says Wahby.

Gangs often have links with the communities in which victims live and even target them outside the various agencies and organisations they visit to receive assistance, say aid workers.

Survivors of trafficking also face discrimination and violence from Egyptians; a problem shared by many other groups of refugees and migrants, particularly those from sub-Saharan Africa. “We are seeing increasing levels of xenophobic attacks and abuse in general,” says a human rights activist who asked that he be referred to only with the initials “HI”. “This is not new for refugees, especially those who are non-Arabic speakers, such as Ethiopians, Eritreans and Somalians.”

Female survivors are particularly vulnerable. More than 99 percent of women and girls in Egypt have experienced some form of sexual harassment, according to UN research released earlier this year and trafficking victims are particularly exposed to abuse. Rights groups have documented cases in which they have been abducted, then raped or taken, held for days and gang raped in their local neighbourhoods.

Because trafficking survivors are located in urban settlements rather than designated areas or camps, providing meaningful protection is difficult. There are some facilities—the National Council for Children and Motherhood, for example, operates a shelter in which victims of trafficking can stay for as long as six months. However, it has a maximum capacity of 12 and is only for women and children. “We’re aware there’s a gap for men, but we are hoping to address that in future work, together with the government of Egypt,” IOM’s Wahby says.

Law enforcement authorities are little help, says a member of an organisation providing assistance to trafficking survivors, who spoke on the condition of anonymity. “Our representatives are happy to accompany victims of violence to police stations to help them file police reports… [but] there is not enough cooperation or understanding from police or prosecution.” Rights groups say that police sometimes refuse to even issue a report or say they will not act unless the perpetrator is brought to the station.

The psychological effects of living in this environment can be crippling, especially given that many of those who have escaped trafficking operationssuffer fromposttraumatic stress disorder and experience suicidal thoughts and survivor guilt. “They don’t want to go outside to take advantage of educational opportunities such as language courses, for example,” says Stefanie Rühl, a human rights advocate. “Many stay at home all day and all night and just stare.”

Trafficking victims are a small population in comparison with the total number of refugees in Cairo, but their needs are complex. To meet them, UNHCR, along with partners including IOM and others, provide a specific support package lasting a year. This includes financial assistance, emergency medical care, specialised treatment for sexual and gender-based violence, psychological services and housing, says Tan.

However, the‘Human Trafficking Cycle’ report authors describe medical treatment as inadequate for victims’ requirements and financial assistance as completely insufficient to cover even basic necessities, especially given that they arrive in Cairo with nothing. “I receive 400 Egyptian pounds of financial assistance per month,” says the Eritrean survivor in his testimony. “Once I pay my part of the rent I don’t have much left and sometimes I can’t even buy food. Sometimes we don’t have any food for days. When that happens, we just sleep. It’s the only thing we can do.”

After UNHCR’s initial 12 months of assistance have passed, trafficking victims are re-assessed and if found still vulnerable included in its normal assistance programme for asylum seekers and refugees, Tan says. They may, however, not have fully recovered from their ordeal in that period but still find they are no longer able to access the type of specialized services they require. “It comes down to a question of help in Cairo,” says Gerry Simpson, a senior refugee researcher and advocate with Human Rights Watch.“They get certain amount of assistance, which lasts for a certain period of time and is then discontinued. Then they fall through the cracks and can’t access certain types of care that they need.”

Reduced aid means that many must find a different way to support themselves. Work permits, however, are incredibly difficult for refugees of any kind to obtain and trafficking victims often must—like many others—eke out a living through working in the informal sector.

Many are in no psychological shape to do so. “There are a lot of victims who are too traumatised to work—too scared to even leave the house,” Rühlsays.

For those that can, a domestic jobis the most commonrecourse. It is not a safe one. Workers have no rights and are, again, extremely vulnerable. Many women are taken advantage of, raped, beaten and underpaid or not paid at all, Rühlnotes. “They are completely marginalised and vulnerable to being abused. The government tells these people that they have to be responsible for their own livelihood, then denies them the right to work. They are consigned to the shadow economy and forced to work in abusive situations.”

For many survivors, the main goal is resettlement in a third country and some geographical distance from the incredibly traumatic experiences they have suffered through. This tends to be a lengthy and convoluted process, taking at least two years even under ideal circumstances. Each potential destination country has its own quota and requirements regarding resettlement cases they choose to accept and priority tends to be given to families or women at risk. Most trafficking survivors are single and many are male says HI, therefore resettlement is, at least in the short term, unlikely.

In the meantime, he adds, survivors remain trapped, neither able nor willing to integrate or envision life in a country where they endured horrific abuse and exploitation and continue to live in fear of harassment and violence. “I was released from Sinai, but still I am not free,” the survivor’s testimony continues. “Because I remain in the land of those who tortured me.”