Healthcare Provider?  You’re a First Line of Defense

By Mitzi Perdue

 Suzanne Leonard Harrison

This blog post is specifically aimed at healthcare providers, but if that’s not you, chances are you’ll find it important anyway.

Our expert is Suzanne Leonard Harrison, MD, FAAFP, FAMWA, Director of Clinical Programs and Professor of Family Medicine & Rural Health, Florida State University College of Medicine

Interview with Suzanne Harrison

 Editor: How common is human trafficking?

 Harrison: According to the International Labor Organization (ILO), there are an estimated 40.3 million victims of human trafficking. These figures may be an underestimate because people who find themselves in these dire situations frequently have no ability to report what’s happening to them. Even so, a lot of important work is being done to get the information. The ILO in particular deserves credit for getting into the trenches and using many sources to uncover this data. 

 Editor: What role can health care providers play in dealing with human trafficking?  

Harrison:  Be sensitive to the problem of trafficking and slavery. In the same way that you look for signs of domestic abuse, be aware that trafficking and enslavement exist and that you can be a first line of defense by helping the individual get help. If you suspect trafficking or slavery, you are not called on to solve the problem.  Instead, you can play a critical role in dealing with trafficking by finding it and contacting the network of available resources. Be sure to check out the links to resources you’ll see at the end of this post. 

 Editor: Are signs of trafficking obvious?

 Harrison: A recent study showed that most of the women who had been trafficked and who were seen in the ER, had also been seen by a physician within the last year.  None of their health care providers picked up on the problem. The unfortunate fact is, if we’re not thinking about trafficking, we’re likely to miss it. Further, it often happens that the abuser insists on being with the patient during the examination. This effectively prevents victims from speaking up about their abuse.  For this reason, it’s a good rule to insist that you have time alone with your patient. For your patient’s safety, never ask about the abuse in front of the abuser. 

Editor: What should we be looking for? 

 Notice your patient’s demeanor and behavior. Is she unreasonably anxious and afraid? Is she accompanied by someone with whom she’s acting so subordinate that it makes you wonder?Does the person accompanying your patient keep answering for her instead of letting her answer for herself?

  • Is there an injury that doesn’t match your patient’s explanation? An example would be the patient who had burn marks all over her body, but she tried to explain this by saying she fell on the stove.
  • Are there an unusual number of sexual partners? If your patient tells you she’s had a couple of hundred partners in the last month, keep in mind that it’s likely that this may not be by choice.
  • Does she have suspicious tattoos or RFID implants? Traffickers sometimes brand people they’re trafficking the way a cattle rancher brands a cow. RFID implants can be scanned and the trafficker/pimp can be alerted, although this doesn’t necessarily mean the trafficked person gets returned. It is more about control than actual return of “property.”

 Editor: What to do if we learn a patient is being trafficked?

 Harrison: Start by validating what she’s told you. Let her know that it isn’t her fault and that no one deserves this.  Reassure her that help is available, and you are going to help her get the help she needs. Ask if there’s someone you can call on her behalf. Ask if she’d like to talk with a victim’s advocate.  And a very important point, make sure that your patient doesn’t use her own phone. Traffickers often track phone use, and this could put your patient at an increased risk for serious injury or even death.

Editor: What about resources for health care providers?

 Harrison: If you suspect abuse, contact people who are trained to deal with the issue of human trafficking. There are many resources available, including legal resources.

 Toolkit: https://www.amwa-doc.org/our-work/initiatives/human-trafficking/

AMWA position paper on sex trafficking (4 years old) https://www.amwa-doc.org/wp-content/uploads/2013/12/AMWA-Position-Paper-on-Human-Sex-Trafficking_May-20141.pdf

PATH website with videos (free, just create log-in) http://www.doc-path.org/

HEAL trafficking: https://healtrafficking.org/

Polaris Project https://polarisproject.org/human-trafficking