A Health Provider’s Role in Fighting Human Trafficking
August 19, 2021
Human trafficking, a form of modern slavery that exploits people for labor and sex, affects about 24.9 million victims worldwide, the U.S. State Department estimates. And the majority of victims will encounter the health care system during their time being trafficked.
Health care providers are uniquely positioned to identify and help human trafficking victims because of the likelihood they will come into contact with victims—particularly in urgent care settings, said forensic nurse Diana Faugno, MSN, RN, CPN.
“They’re coming into the emergency rooms, the urgent care [facilities] and the clinics,” said Faugno, past president of the Academy of Forensic Nursing. “To get health care providers on the same page, they need a lot of training on this. They know what it is … but they don’t know what to do, and that’s the big issue.”
Sex trafficking is a crime that “uses force, fraud or coercion to induce another individual to sell sex.” Sex trafficking may occur through escort services, pornography, illicit massage businesses, brothels or outdoor solicitation.
Labor trafficking is a crime that uses “force, fraud or coercion to induce another individual to work or provide service.” Labor trafficking may be found in industries including agriculture, domestic work, restaurants, cleaning services and carnivals.
Other industries and settings where human trafficking exists include bars and strip clubs, traveling sales, forced peddling, manufacturing construction, landscaping, forestry and illicit activities, according to a 2017 Polaris report (PDF, 4.9MB). Human trafficking victims may be involved in one or both types of trafficking.
Human trafficking is different from human smuggling. Although human trafficking and smuggling can be related, human trafficking and smuggling are different crimes. Human traffickers exploit people for work or sex, while human smugglers provide services to illegally move people across borders.
Although human trafficking and smuggling can be related, human trafficking and smuggling are different crimes.
Nurses and other health care providers are well-positioned to identify victims of human trafficking, as studies have shown that most trafficking victims encounter medical providers during their time being trafficked. Most encounters occur in the emergency room, according to research in Health and Human Rights Journal.
Although clinicians may detect warning signs of human trafficking among patients, training can help them more effectively respond to possible human trafficking situations.
“When they’re starting to get a history, it’s got to be in private,” said Faugno, who is also certified as a sexual assault nurse examiner for adult and pediatric populations. “No one is going to answer any of these questions if the person standing there is watching them. They fear for their lives. So, COVID-19 helped with that because we could keep them out if [victims] did happen to come in.”
IDENTIFYING HUMAN TRAFFICKING
As part of screening, health care providers can ask about:
Living and working conditions, such as:
Are you free to come and go in your home as you please?
Can you leave the place you work without threats to your safety?
Have you ever worked without receiving the payment you thought you would get?
Does anyone at your workplace make you feel scared or unsafe?
Do you live with your employer?
Risk factors for sex trafficking, such as:
Where do you sleep and eat?
Do you live there with other people?
Are you being forced to do anything you don’t want to do?
Have you been denied food, water or medical care?
How you can help the patient, such as:
What can I do for you?
What do you want to happen next?
Signs that may indicate a patient is a human trafficking victim:
Adult patients who are accompanied by another person who won’t leave the room and/or who speaks for the patient.
Patients without identification.
Patients who speak other languages.
Patients who spend a lot of time looking down at the floor.
Patients who return to the clinic or emergency room frequently for issues such as urinary tract infections, sexually transmitted infections or mental health issues.
When clinicians suspect a patient is a victim of human trafficking, they can take steps to help them.
Use “winning statements,” Faugno said, such as:
We’re here to help you.
Our priority is your safety.
We’ll give you the medical care you need.
We can find a safe place for you to stay.
You deserve the chance to become self-sufficient and independent.
Connect patients with community resources.
For patients who are minors and being trafficked for sex, call 911.
Call the National Human Trafficking Hotline, 1-888-373-7888.
If an adult patient is not ready to be removed from their situation, give the patient the hotline numbers so they can get help when they are ready. Trafficking victims and survivors can call 1-888-373-7888 or text “BeFREE” to 233733 to reach the hotline.
Health practitioners should keep in mind that for adult patients, the decision to seek help to leave a human trafficking situation is up to the patient, Faugno said.
“We’ve got to understand that it’s not, ‘I’m here to rescue you.’ That’s not what this is,” Faugno said. “When they’re ready, they’re going to say.”
How to Stop Human Trafficking and Support Survivors
In addition to health care providers, community members can also play a role in ending human trafficking. Some of the steps below may help people outside the medical community combat human trafficking and support survivors close to home.