Nurses Play Critical Role in Identifying Victims of Human Trafficking

In the same way health care personnel have been educated to look for and report suspected cases of child abuse and domestic abuse, attention is now being focused on recognizing signs that a patient may be a victim of human trafficking.

A rather obscure problem, you say? No. A rarely talked about situation, perhaps, but not rare. Worldwide, human trafficking ranks as the third largest business behind illegal drug sales and gunrunning. But, surely not much of a problem in the United States? Wrong again. It is estimated that 15,000 to 20,000 human trafficking victims enter the U.S. every year. Those numbers are not firm and may, in fact, be low estimates due to the secretive, dangerous and criminal nature of the business.

While most people associate trafficking with sex-related businesses, such as massage parlors, victims may also be working in other low-level positions such as housekeepers, nannies, nail salon workers or janitors.

Most trafficking victims are women and children who are lured by false promises of money and jobs. Before long their passports are taken, they are forced to work long hours, given little to eat and often threatened, beaten and/or sexually abused on a daily basis.

In 2008 the American Nurses Association passed a resolution to educate nurses as to how to identify trafficking victims and refer them to support and legal services.

Detection is not easy. Traffickers usually prevent their victims from seeking medical care but if they do present, nurses can play a key role in identifying the victims. Assessment skills can enable nurses to pick up on clues that indicate a patient is being trafficked.

As an example, an Eastern European woman presents in the ED in late-term pregnancy, having received no prenatal care and showing signs of physical abuse. She is accompanied by a much older male who speaks for her. These are red flags that could indicate a trafficking situation.

Victims of labor trafficking may present with repetitive motion injuries as a result of excessive hours of forced labor. Trafficked farm laborers may have skin damaged by long hours of exposure to the sun. Couple those indicators with signs of physical abuse—a broken jaw, evidence of old untreated fractures—and trafficking should be considered a possibility.

It is incumbent upon the nurse to provide to victims the advocacy, support and care they need. If a nurse believes he/she has identified a victim of trafficking, a safe environment must be secured for that victim, the staff and him/herself. Notify hospital security to be on scene, or call 911 for local law enforcement support. The victim should be placed in a shelter or other safe environment as soon as possible. When that has been accomplished, various social services agencies should be called in to handle the myriad aspects of the situation.

Human trafficking is a disturbing reality that was nowhere on our radar screens a decade ago. While the problem seems to be most prevalent on the East Coast, particularly on Long Island and in the Atlantic City area, there have been documented cases across the country. This is yet another situation where nurses can be considered first responders in a way that can end suffering on a level most of us can’t fathom. I urge you to become informed and keep your antenna up.

If you have had an experience with victims of this heinous criminal practice, please share your story. To learn more about how you can recognize and deal with this problem, go to the link below.

A tool kit for healthcare providers is available at www.acf.hhs.gov/trafficking.