Healthcare Workers: Understand Human Trafficking

Human trafficking is a form of modern slavery that occurs in every state, including Indiana and Illinois, and it is believed to be on the rise. Human trafficking takes many forms, and healthcare workers should be aware of the signs and red flags of trafficking.

What Is Human Trafficking?

According to the Department of Homeland Security, human trafficking is the use of force, fraud or coercion to obtain labor or commercial sex. Trafficking can happen in any community, and victims of human trafficking can be any age, race, gender or nationality. Human trafficking is a multi-billion dollar criminal industry that denies freedom to 24.9 million people around the world.

The National Human Trafficking Hotline defines human trafficking types: sex trafficking and labor trafficking.

Sex Trafficking

Sex trafficking is when a commercial sex act is induced by force, threat of force, fraud or coercion or in which the person induced to perform such an act is under the age of 18 years.

Labor Trafficking

Labor trafficking is the recruitment, harboring, transportation, provision or obtaining of a person for labor or services, using force, fraud or coercion for the purposes of subjection to involuntary servitude, peonage, debt bondage or slavery.

Cases that are considered human trafficking involve three elements:

• Action: What is done. Recruiting, harboring, transporting, providing or obtaining of a person.
• Means: How it is done. Force, fraud or coercion.
• Purpose: Why it is done. Compelled labor or services or commercial sex acts.

At the least, one element from each category must be present to establish a potential situation of human trafficking.

The Critical Role Of Healthcare Providers

According to one study, 87.8% of trafficking victims encounter a healthcare professional while captive, and few, if any, of these encounters result in the victim being freed because of lack of training to recognize victims of human trafficking.

"Human trafficking is not just a social issue, but also a healthcare issue," says Lori Bridegroom, RN, SANE nurse coordinator and ER nurse at Franciscan Health Michigan City.

Lack of training results in misconceptions among healthcare providers, hindering identification of and service provision to human trafficking victims.

Healthcare providers are in a unique position to recognize and respond to victims of human trafficking. Some of the hot spots are emergency rooms, urgent cares and walk-in clinics.

"We ask minimal questions at these locations and focus on the primary complaint," Bridegroom said.

Challenges in Healthcare

Some of the challenges that providers can face are that the patient doesn’t disclose information or the facility lacks screening tools and a lack of objective to recognize.

Most times pimps and traffickers have complete control over the human trafficking victim, so this means there are rare opportunities for victim identification and intervention.

Indicators And Signs Of Human Trafficking

It is important to recognize indicators and warning signs of human trafficking. According to the National Human Trafficking Resource Center there are general indicators that people should be aware of, especially healthcare providers.

General Indicators a Person May Be a Victim of Human Trafficking

• Shares a scripted or inconsistent history
• Unwilling or hesitant to answer questions about the injury or illness
• Accompanied by an individual who does not let the patient speak for themselves, refuses to let the patient have privacy or who interprets for them
• Evidence of controlling or dominating relationships (excessive concerns about pleasing a family member, romantic partner or employer)
• Demonstrates fearful or nervous behavior
• Avoids eye contact
• Resistant to assistance
• Demonstrates hostile behavior
• Unable to provide his or her address
• Not aware of his or her location, the current date or time
• Not in possession of his/her identification documents
• Not in control of his or her own money
• Not being paid or wages are withheld
• May have hotel room keys in possession
• May be a chronic runaway or homeless youth
• May have signs of branding, such as tattoos or jewelry
• May carry backpack with “work” clothes and street clothes

Social Indicators a Person May Be a Victim of Human Trafficking

Underlying Conditions

Victims of human trafficking suffer from a host of physical and psychological problems stemming from:

• Inhumane living conditions
• Poor sanitation
• Inadequate nutrition
• Poor personal hygiene
• Brutal physical and emotional abuse
• Dangerous workplace conditions
• General lack of medical care

What Should You Do If You Suspect Human Trafficking?

The National Human Trafficking Resource Center stated that it is critical for medical practitioners to be thoughtful about engaging patients, employing trauma-informed practices and creating a space that is conducive for discussing human trafficking. Recognize that the goal of your interaction is not disclosure or rescue, but rather to create a safe, non-judgmental place that will help you identify trafficking indicators and assist the patient.

Mandated Reporting

According to the AMA Journal of Ethics, in the United States, various laws might require a healthcare professional to make a report either to law enforcement or child protection agencies as a result of an interaction with a victim or survivor of human trafficking.

"If you have a suspicion, go ahead and report it," Bridegroom said.

If you believe you may have information about a trafficking situation:

• Call the National Human Trafficking Hotline toll-free hotline at 888-373-7888. Anti-Trafficking Hotline Advocates are available 24/7 to take reports of potential human trafficking.
• Text the National Human Trafficking Hotline at 233733. Message and data rates may apply.
• Chat the National Human Trafficking Hotline via www.humantraffickinghotline.org/chat
• Submit a tip online through the anonymous online reporting form. However, please note that if the situation is urgent or occurred within the last 24 hours, it is encouraged that you call, text or chat.
• DCS must be called for any individual under 18 that is suspected to be a victim of human trafficking. IC 35-42-3.5

Human Trafficking Laws

Every state has their own laws for human trafficking.

Illinois Human Trafficking Laws

A new law in Illinois, which took effect January 1, 2019, makes it easier for human trafficking victims to sue their perpetrators. The law is called the Trafficking Victims Protection Act. It helps victims deal with real-life obstacles they face in seeking justice.

Victims have 25 years from the date they find out about the act and that the perpetrator caused it. In other words, the clock doesn't start ticking until the victim knows about the abuse and knows the perpetrator’s identity.

Indiana Human Trafficking Laws

In 2006, the first state law dedicated to human trafficking offenses was passed in Indiana. IC 35-42-3.5-1 details the state provisions regarding human trafficking. Different sections of this law describe the various offenses and level of felonies the offences hold. Indiana’s anti-trafficking statute provides human trafficking offenses and details the rights that trafficked persons have as victims.

The statue also provides restitution for victims and provides a civil cause of action to victims after the perpetrator is convicted of a human trafficking offense. In a civil case the victim may recover actual damages, court costs, punitive damages, and attorney’s fees.

How Can You Help Stop Human Trafficking?

Human trafficking is happening everywhere and is occurring every day. According to the National Human Trafficking Hotline, in 2019 there were 127 cases of human trafficking reported in Illinois and 97 reported cases in Indiana. So, what can we do to help prevent and stop it?

"90% of the time victims know their trafficker," said Amie Rainfish, from the Indiana Trafficking Victims Assistance Program (ITVAP), which is part of the Youth Services Bureau, who presented recently at a program at Franciscan Health Michigan City.

The U.S. Department of Health and Human Services recommends ways to help end human trafficking.

• Know the signs
• Spread the word
• Think before you shop
• Volunteer locally
• Stay informed
• Register for training
• Raise your voice