Migrant women escaping exploitative work conditions are delivering babies prematurely then being slugged with hefty medical bills, while male counterparts are sleeping in tents in parks in regional NSW.
A landmark report from independent NSW Anti-slavery Commissioner James Cockayne found there are an estimated 16,400 people trapped in modern slavery in NSW.
The commissioner called for an urgent inquiry on Wednesday after the report - Be Our Guests: Addressing urgent modern slavery risks for temporary migrant workers in rural and regional NSW - was tabled in state parliament by the attorney-general.
The study looked at modern slavery risks temporary migrant workers face in agriculture, horticulture and meat processing in more than 15 rural and regional NSW towns, talking with 80 Pacific Australia Labour Mobility (PALM) scheme workers.
Modern slavery includes everything from debt bondage, deceptive recruiting and forced labour to extreme cases such as sexual servitude and human trafficking.
"We heard this morning about someone who showed up, gave birth to a child prematurely and (was) then hit with a $25,000 bill so she disconnected the child and left the hospital because she knew there was no way she'd ever pay it," Dr Cockayne told reporters.
"We need systems in place ... so you don't end up with this kind of emerging humanitarian crisis."
The report found in Griffith, in NSW's Riverina region, there were some early warning indicators that suggested the possibility organised labour trafficking may be emerging on a small scale.
PALM workers can stay for about six months for seasonal work or up to four years tied to one employer without the ability to change workplaces.
The number of workers has grown substantially over the past five years from about 6000 to almost 32,000 workers nationwide, with the largest numbers coming from Fiji and Vanuatu.
In NSW, there are 6135 PALM workers (about a fifth of the national total) with the majority in long-term work mostly in meat processing (77 per cent).
"Rather than being treated as valued guests, too many vulnerable migrant workers in rural and regional NSW are taken advantage of by unscrupulous employers and labour hire companies," the report states.
"This frequently leaves them destitute, and more vulnerable to exploitation."
Moe Turaga, a Fijian survivor-advocate who was enslaved at 17 on a grape farm in Victoria, had his passport confiscated and his wages stolen by trusting in his older cousin.
His employers at the fruit farm were complicit but had no idea.
"People like me come to Australia hoping for better job opportunities and a better future for our families, but many are confronted by harsh realities once they arrive," he said.
"Right now, too many people are being denied their basic rights."
Sophia Kagan, principal policy adviser on labour migration at the commissioner's office and report co-author, said women were particularly vulnerable to modern slavery.
"Shortcomings in the current schemes have led to an increase in disengaged female PALM (Pacific Australia Labour Mobility) workers reporting violence, coercive control, and sexual exploitation," she said.
Independent MP Joe McGirr, who heads parliament's modern slavery committee, is calling for an inquiry with investigative powers.
"When you mention the word modern slavery, most people say in Australia it's not possible, but when you dig into it you realise we have instances of people ... living slave-like conditions in labour," he told reporters.
"As Australians we don't want this happening on our soil ... we need to get to the bottom of this."
