Human Trafficking: When you Suspect your Patient is a Victim
Kim Maryniak, PhD, RNC-NIC, NEA-BC
Human trafficking is when a victim is forced or coerced into performing actions against his or her will, including labor or sexual acts. It is a problem worldwide, and is a form of slavery. There are three forms of human trafficking- sex trafficking, labor trafficking, and organ harvesting.
Globally, it is estimated that there are 20.9 million human trafficking victims. Of those, 68% are in forced labor, 55% are female, and 26% are children (Polaris, 2018a). Victims can be adults, adolescents, or children, and male or female. There are different methods that are used by offenders to subject victims to trafficking. Traffickers use force, fraud, and coercion to compel their victims to engage in activities.
Victims of human trafficking come from diverse backgrounds and all locations. All age groups and male, female, and transgender are represented in victims. However, there are some risk factors which may make individuals more vulnerable to becoming victims of human trafficking. These factors may include runaways and homeless youths, foreign nationals (either documented or undocumented), individuals with a past history of violence, trauma, discrimination, neglect, or abuse, and other social, personal, and environmental factors.
Many victims of human trafficking require some form of health care. It is often difficult for victims of trafficking to discuss their situation in healthcare settings, so it is vital that healthcare professionals approach this carefully. Developing rapport and engaging patients is essential in a safe, therapeutic environment. Assessment of potential safety risks that may occur with sensitive questions and inquiry is needed prior to discussion. The goal of this interaction is not to force disclosure of information or necessitate rescue of the patient, but rather to establish a secure and non-judgmental environment which will assist in the identification of trafficking indicators and support the patient (National Human Trafficking Resource Center (NHTRC) Polaris Project, 2011; NHTRC, n.d.).
Some general indicators of a trafficking victim include if a person verbalizes a history which sounds scripted or is inconsistent, or if he or she is hesitant or not willing to answer questions about an injury or illness. If a person is unable to give his or her address, or is not oriented to date, time, or place, these might be other indicators. If the person is accompanied by someone who does not let the patient speak for him or herself, is not willing to leave the patient’s side, or who interprets for him or her. If there is evidence of controlling or dominating relationships, such as expressing many concerns about pleasing another person, this could be a general indicator. Other indicators could be if a person does not have his or her identification documents, is not in control of his or her money, or indicates that he or she is not being paid or has withheld wages. Additional signs may be if the individual appears fearful or nervous, avoids eye contact, resists assistance, or demonstrates hostile behavior (National Human Trafficking Resource Center [NHTRC], n.d.; Polaris, 2018b).
There are specific legal requirements for each state regarding mandatory reporting of human trafficking. There may be situations which require mandatory reporting under related statutes, such as child abuse or domestic violence. Cases of human trafficking may fall into mandatory requirements based on those state statutes. It is important to know what your local and state laws are, as well as your facility policies (NHTRC, n.d.). Contacting the National Human Trafficking Resource Center (NHTRC) can facilitate a report to specialized law enforcement trained to handle human trafficking cases. When contacting the NHTRC or other local resources, HIPAA must be upheld (NHTRC, n.d.; NHTRC, 2016a).
• National Human Trafficking Hotline (from the National Human Trafficking Resource Center)
• Website: https://humantraffickinghotline.org/
• Available 24 hours per day, seven days a week. Can provide assistance in more than 200 languages.
For more information, refer to the RN.com course Human Trafficking: Implications for Healthcare Professionals.
National Human Trafficking Resource Center (NHTRC). (n.d.). Identifying victims of human trafficking: What to look for in a healthcare setting. Retrieved from https://traffickingresourcecenter.org/sites/default/files/What%20to%20Look%20for%20during%20a%20Medical%20Exam%20-%20FINAL%20-%202-16-16.docx.pdf
National Human Trafficking Resource Center (NHTRC). (2016a). Framework for a human trafficking protocol in healthcare settings. Retrieved from https://humantraffickinghotline.org/sites/default/files/Framework%20for%20a%20Human%20Trafficking%20Protocol%20in%20Healthcare%20Settings.pdf
National Human Trafficking Resource Center (NHTRC). (2016b). Recognizing and responding to human trafficking in a healthcare context. Retrieved from https://humantraffickinghotline.org/resources/recognizing-and-responding-human-trafficking-healthcare-context
National Human Trafficking Resource Center (NHTRC) Polaris Project. (2011). Comprehensive human trafficking assessment. Retrieved from https://humantraffickinghotline.org/sites/default/files/Comprehensive%20Trafficking%20Assessment.pdf
Polaris. (2018a). Human trafficking: The facts. Retrieved from https://polarisproject.org/human-trafficking/facts
Polaris. (2018b). Recognizing the signs. Retrieved from https://polarisproject.org/human-trafficking/recognize-signs
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