I had the opportunity to attend a conference on human trafficking recently. It was not something that I felt might directly apply to my practice, but as in any health care environment, you never know what might walk in the door and besides, there have been recent trafficking arrests in the county that I work in.
What I discovered shook me.
Did you know that there are more people enslaved now than any time in human history? Neither did I.
According to Article 3 of the UN Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children, Supplementing the UN Convention against Transnational Organized Crime human trafficking is defined as:
(T)he recruitment, transportation, transfer, harboring or receipt of persons, by means of threat, use of force or other means of coercion, of abduction, of fraud, of deception, of the abuse of power or of a position of vulnerability or of the receiving or giving of payment… to a person having control over another person, for the purpose of exploitation.
Human trafficking can take on many forms. Globally, child soldiering is occurring in warring countries to devastating effects. Baby trafficking, which may include women forced to give birth in order to sell their babies, is another form of trafficking. Organ harvesting, debt bondage, forced child labor, and domestic servitude are further forms of labor trafficking occurring around the world.
Globally and in the US, trafficking occurs in forms that we are more accustomed to. Sex trafficking and labor trafficking are the most common forms of human trafficking in the US. Sex trafficking occurs commonly in prostitution rings, pornography, massage parlors, and mining sites. Labor trafficking may be a little less familiar to you but is common in work camps, agriculture, construction, hospitality, and day laboring. No place is immune.
The evidence is jarring, but how does it affect healthcare providers? Well, the statistics show that 87% of people being trafficked will be seen at a hospital or health care facility without being identified. Yet, few of us have been trained to identify victims.
One victim described in the lecture could have been a child that many of us have seen in practice. This 17-year-old girl was cutting, doing drugs, and running away from home. It would be easy to brush that kid off as a troubled child. We see children similar to this all of the time, but because the provider was trained to look for signs of human trafficking, she began to ask questions. What she discovered was disturbing.
The child’s parents had divorced a few years earlier. The mother had blamed the child for the divorce and really did not want the responsibility of the teen, so she bounced back and forth between her mother and her father’s homes. The problems started when the teen, as a vulnerable and traumatized child, began to spend more time at her father’s home. Evidently, the father decided that she would be a good source of income and began to prostitute her.
It seems unconscionable to victimize a child, but victimizing children is common in human trafficking. There has been a huge upswing in trafficking cases of children in foster homes as traffickers discovered that foster children were easy targets not well accounted for. Of course, children are not the only victims. Globally, only 20% of trafficking victims are children. The majority of trafficking victims are women, but with the rise of labor trafficking, men are not far behind.
With 40 million victims of human trafficking, it is important to remember that these people are victims of a trafficker, not criminals. It is important to approach trafficking as a public health problem. People who are trafficked are victims. Today, The Polaris Group is working on passing The Visa Transparency Anti-Trafficking Act of 2018. This is an important step in minimizing the risks of being trafficked for those who come here legally to work. Globally, there are many organizations working against human trafficking.
And, as I began to reflect on these issues, I realized that when I was an NP in clinicals, I missed a clear and obvious case of child trafficking. As did my preceptor. Neither of us were trained to look for these signs. It will continue to haunt me for the rest of my career, but I’ve decided to make some changes in my practice as I hope you do.
So what can I do? You can educate yourself on the signs of trafficking. Know that a history of trauma and/or isolation, be it social, physical, or even language barriers makes people more vulnerable to being trafficked. Make sure that your organization has a protocol for how to handle a suspected victim of trafficking and if they don’t, start one. Get involved in helping to change laws to stop trafficking. And lastly, next time that patient who sets off red flags comes into your facility, mission clinic, or hospital, pay attention. Dig deeper. You may be saving someone’s life.