From the Guidelines
Healthcare providers should be vigilant in recognizing human trafficking in hospitals by identifying key warning signs, such as controlling companions, inconsistent stories, and signs of physical abuse, and respond with a trauma-informed approach to ensure patient safety and facilitate intervention. When interacting with patients who may be victims of human trafficking, it is essential to create a non-judgmental and supportive environment, as emphasized in the care of adolescent sexual assault victims 1. This approach is crucial in encouraging patients to disclose their situation and cooperate with healthcare providers.
Some key warning signs of human trafficking include patients being accompanied by controlling companions who speak for them, inconsistent stories about injuries, signs of physical abuse, lack of identification documents, and fearful or submissive behavior. Healthcare providers should be aware of these signs and take a proactive approach to identify potential victims. When suspecting trafficking, providers should separate the patient from companions to conduct a private assessment using trauma-informed approaches, similar to those used in sexual assault evaluations 1.
During the assessment, healthcare providers should ask direct but non-judgmental questions about the patient's living and working conditions, looking for indicators of exploitation or coercion. They should also be aware of potential physical signs of trafficking, such as tattoos or branding that may indicate ownership. Hospital staff should be familiar with their institution's protocol for responding to trafficking cases, which typically involves notifying social services and law enforcement when appropriate, while prioritizing patient safety 1.
Regular staff training on human trafficking indicators and response protocols is crucial for effective identification and intervention. By being aware of the warning signs and taking a proactive approach, healthcare providers can play a critical role in identifying and helping victims of human trafficking, ultimately improving their morbidity, mortality, and quality of life outcomes.
From the Research
Recognizing Human Trafficking in the Hospital
- Human trafficking is a significant human rights problem that is often associated with psychological and physical violence, and there is no demographic that is spared from it 2.
- Traffickers maintain control of victims through physical, sexual, and emotional violence and manipulation, and victims of trafficking seek medical attention for the medical and psychological consequences of assault and neglected health conditions 2.
- Evaluation of possible trafficking victims is challenging because patients who have been exploited rarely self-identify, and emergency clinicians are in a unique position to recognize victims and intervene 2.
Identifying Victims of Human Trafficking
- Healthcare professionals may be the initial contact that victims of human trafficking make outside the world of trafficking, and they are key agents in the identification of human trafficking 3.
- Skilled assessment made by a forensic nurse can alert the healthcare team to clear features of human trafficking associated with a person, and improvement of human trafficking educational programs is highlighted as a key adjunct to improving detection and facilitating the proper treatment of victims 3.
- Human trafficking education can equip healthcare professionals to recognize and assist trafficking victims and guide them to the specialized care they need, and trauma-informed human trafficking education for all healthcare professionals is recommended 4.
Barriers to Identifying Human Trafficking Victims
- Trafficking victims are prevented from disclosing their status to healthcare providers by fear, shame, language barriers, and limited interaction with medical personnel, among other obstacles 5.
- Increasing awareness of human trafficking, and modifying practice to facilitate disclosure, could improve victim identification, and healthcare professionals' self-efficacy in identifying and treating human trafficking victims can be improved through education and training 4, 6.
Impact of Human Trafficking Training on Healthcare Professionals
- Human trafficking training can lead to a short-term improvement in knowledge of human trafficking and a sustained improvement in awareness and attitudes about human trafficking among healthcare professionals 6.
- The training can increase healthcare professionals' self-efficacy in identifying and treating human trafficking victims, which can yield better patient and healthcare system outcomes 4.