A critical summary of screening and intervention techniques all health professionals should be aware of.
Human trafficking is often thought of as an issue faced by other countries, but is estimated that between 100,000 and 300,000 children in the U.S. are affected. A 2014 study in the Annals of Health Law found that nearly 88% of survivors reported having some kind of contact with the healthcare system while they were trafficked.
While no other sector plays a more critical role in identify trafficking victims, the vast majority of physicians are unprepared. In a survey conducted by Physicians Against the Trafficking of Humans (PATH), more than 70% of physicians claimed they would not know what to do if they encountered a victim of sex trafficking.
Top 10 Screening Techniques
Physicians should be on the look for:
♦ Bruising, scars, burns, cuts, especially those in non-apparent places
♦ Multiple STD or pregnancy tests
♦ Fearful, anxious or depressed mood
♦ Cash payments, no insurance
♦ A third party may speak for the patient and not allow them to speak
♦ Substance addiction or the appearance of withdrawal symptoms
♦ Lying about age
♦ Patient transient or no address (or the patient doesn’t know what city he/she is in)
♦ Tattoo of a name or strange symbol
“Trafficking victims are frequently tattooed with the name of their trafficker, or the trafficker has some sort of tag that’s an identifying tag, so that if the victim tries to run away she can be readily identified by other pimps as the property of her trafficker,” says Lori Cohen, Director, Anti-Trafficking Initiative Sanctuary for Families in a PATH video. “If a healthcare provider asks the right questions in an environment that’s not judgmental and where a message is being communicated that this is being asked to help the individual, in many cases, a victim will be able to disclose what her experience has been.”
Critical Intervention Techniques
Do not react in the moment or act shocked if a young person decides to disclose their situation. This can be interpreted the wrong way, as a reaction or disgust toward the victim.
Protect the patient’s identity and privacy even before anyone else is called in: the moment the healthcare provider suspects the patient trafficking victim, change the patient’s name in the records, providing alias.
Write the patient a prescription for a follow up for some medical indication, otherwise you may never see that patient again.
Get the patient alone, especially if they are accompanied by a controlling companion who insists on answering providers’ questions.
Ask your patient if s/he’d like the police involved. Patients should be assured that what they are telling physicians will be kept confidential. They should also be aware that there are times when they are a mandatory reporter.
Avoid the rescue fantasy. This impulse is normal and harmful. Intervening prematurely or without patient consent compromises trust. Physicians can’t fix the situation but may be able to provide a stepping stone in a potentially long path.
“Intervening can be very complicated. Trust is key. If a doctor can continue to communicate that they are concerned about you—we want to help you, we’re not going to force you to do anything you don’t want to do—it gives the patient space to believe that this is someone who really cares about her,” says Cohen.
How to Report Human Trafficking
♦ National Human Trafficking Resource Center (888-3737-888)
♦ Text “BeFree” (233733)
♦ Childhelp (800-4-A-CHILD)
♦ National Center for Missing & Exploited Children (800-THE-LOST)