The Silent Victims of Human Trafficking

Nurses are uniquely positioned on the front line between a victim's health and welfare or a life of despair. An injury or medical emergency may be the only opportunity a victim of human trafficking may have to make contact with a social system that can help rescue them. The situation is even worse for immigrants. This article focuses on the hidden signs to look for and what actions can be taken.

The Silent Victims of Human Trafficking

"Are you sure about how this happened?" asked the emergency room nurse, with a touch of impatience in her voice. "It looks like a gunshot wound." "Nah, yeah, it was a rock or something. I was mowing and a rock got spit out of the mower and it hit me in the leg. It's shrapnel from the lawnmower. I'm sure it was a rock." The nurse left the consultation room with an incredulous look, snapping the door shut behind her.

It was clear the young male patient was feeling an adrenaline rush as he fidgeted on the examination table, staring at his leg dressing. He couldn't help but prattle on erratically, as if the stranger on the examination table next to him were his best friend. "I know who it was. I know who did it. I recognized the car when it drove by. Ah man, I know why, too. I'm gonna make this right."

A few minutes later the nurse returned to inform the injured patient that both the doctor and a sheriff's deputy would soon be in to see him. "You have to realize we are required to report any suspicious activity," insisted the nurse. "If we don't report possible gunshot wounds, we get into trouble. Now let's look at that wound..."

This is a true story, and perhaps a familiar one in emergency rooms across the nation. Safety procedures and reporting systems are set up to protect victims of violence and crime once they engage with healthcare providers. A visit to the doctor or the emergency room may be the only chance a victim has for intervention.

The nurse in this instance recognized the signs of gun violence, but is she competent to recognize the hidden signs of human trafficking? Anyone can be vulnerable to this insidious crime, even in the United States, and especially among immigrant populations. Nurses are on the front line of intervention so it's important to understand how to interpret the seemingly harmless behavioral cues that hide a harsh reality that enslaves an estimated 21 million world-wide victims each year, according to the Polaris Project.

Hidden Signs

As a front line healthcare professional, would you recognize the hidden signs of human slavery? More specifically, could you identify these victims from among the non-English speaking immigrants seeking emergency treatment? The emergency room is the critical space where victims interact with the healthcare system, and may be their only chance of receiving assistance.

Look for the following indicators

  • Patients accompanied by someone unrelated to them who speaks on their behalf and/or controls their official documents, and whom the patients give unusual deference. Patients without money, valuables or in the case of hospital internment, any of the personal items that typically surround inpatients like cards, gifts, pictures or favorite objects from home
  • Physical signs of abuse, branding scars, or gang tattoos
  • The inability to converse with the patient in private

In these cases, verify your suspicions by asking the following questions yourself, or with the help of an interpreter:

  • Ask if they know how to get around the city or town where they live. If they are unfamiliar with the local areas, they may not be in control of their own movements.
  • Ask where they like to shop or dine out. They may not be allowed to handle money or shop anywhere but their company store.
  • Ask about their employer. Does he or she provide housing, food, clothes or uniforms? Do they have the freedom to seek employment elsewhere?
  • If appropriate, ask if they are engaging in dangerous sexual practices. If they are sex slaves, they may be following safe habits or they may be exposed to risky behaviors.

Take Action

If your suspicions are confirmed, contact the authorities to investigate your patient's situation. It's better not to ask if they are in the U.S. illegally; they may fear deportation more than they fear their abusers. Or their abusers may have threatened the safety of their family members left behind. Nor should you interrogate the patient's custodian and risk tipping your hand. Many local, county and state law enforcement agencies have been specially trained to handle cases of human slavery.

The Department of Health and Human Services offers concise recommendations in a flyer. To protect immigrant victims, a better solution is to merge human trafficking information with diversity training for the medical professions. For nurses working in areas with a significant Hispanic community, cultural competency training should address every aspect of healthcare affecting the 19 million foreign-born Latino immigrants in the U.S.

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lorimadden

About lorimadden

Dr. Lori Madden is a professor of foreign languages with a B.A. (Hood College), M.A. (University of Delaware) and PhD (University of Florida) in Spanish, Portuguese and Latin American Literature. She is on faculty at St. Petersburg College. Dr. Madden has resided in Spain, Brazil and Costa Rica. She has taught for many years educating adults in Spanish and Portuguese languages and Hispanic culture, in both academic and professional environments. She is owner of https://SLSPublications.com.

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Abortion clinic workers, especially, are in a vital and unique position to help these girls. Please know the signs and assist these desperate victims of abuse. Vital topic. Thanks for putting a spotlight on it.

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Specializes in Nephrology, Cardiology, ER, ICU.

I live in the midwest and migrant workers are another segment of the "invisible" traffick'd population as is prostitution.

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Specializes in Med-Surg, Rehab, Home Health.

Lori, thank you for this contribution. As someone with no familiarity with this subject matter, this was very informative.

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My daughter was recently a first hand witness at work and involved with stopping a girl from being trafficked. Poor thing ran away from home, all alone from across the country, pleaded for help and got it, from a min wage nice kid who took her seriously. Could have easily been chalked up to boyfriend drama in an area full of drama.

My daughter heard the father hysterical on the phone when they called him to let him know she was safe sitting in a patrol car. First line guy was arrested. It was the sort of thing you only read about.

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Specializes in Emergency, Trauma, Critical Care.

There was a case on my area, in a very upscale part of town a 15 y/o had been seduced at a mall, left with this guy. Im guessing because of her parents position the case got taken very seriously. They found her an hour away just before she was going to be on a van to who knows where. She was incredibly lucky because most girls aren't located. It can happen anywhere to anyone.

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Specializes in Psych.

Excellent article.

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Big events like the Super Bowl bring large numbers of prostitution/trafficking to a city. This year it's in the SF Bay area, so Santa Clara, Palo Alto, San Jose, Oakland and San Francisco and points in between medical personnel should be especially vigilant next month.

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Specializes in as above.

IF you have ever seen a gun shot wound, take the kid to task. If not, ask for advice, from a cop. OR ask a cop to escort you to the patient. Human traffic for people from overseas is alive and well, we are NOT to pass judgement.

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Thank you so much.. It is really helpful information. God bless..

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Specializes in Pediatrics, Emergency, Trauma.

My employer provides education about human trafficking; a few months ago, we had a teen come in who was a victim and needed serious medical attention-she was living on the streets and missing for months engaging in prostitution and drug use.

One of the major malls in my area has been targeted as a hub for human trafficking as well.

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Specializes in ER, Neuro, Trauma, Educator.

Thank you very much for this! I recently read another article and there is so much that we could miss during our assessment. Awareness and education is key! I'm seeing more and more publicity on the topic, do you guys know if any state BONs are requiring CEs for human trafficking (the way that Texas requires 2 hours of Forensic CEs for ER nurses)? Just curious! Thank you again for this information!

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