Human Trafficking: A Brief Guide for Physicians

Human trafficking. Like many things we hear about or read in the news, it seems like a problem of developing countries like Cambodia and Thailand. However, what we fail to realize is that human trafficking, also known as modern slavery, is alive and well within the United States and affects children and adults across all socioeconomic statuses. A harrowing fact is that up to 85% of people forced into human trafficking saw a physician at some point and more than 60% had at least one ER visit1. However, most physicians have not been trained on how to identify and help patients who are potential victims of human trafficking2. This article will hopefully provide more insight into what human trafficking is, how to identify a victim, and most importantly, how to help them.

The State Department of the United States indicates that human trafficking consists of domestic servitude, forced labor, debt bondage, as well as sexual exploitation3. While these are different types of human trafficking, warning signs that a potential patient is a victim to these crimes tend to be very similar. The U.S. Department of Education has provided some common identifiers for physicians in all states to be aware of, including a patient who:

  • Makes references to frequent travel to other cities or towns
  • Exhibits bruises or other signs of physical trauma, withdrawn behavior, depression, anxiety, or fear
  • Lacks control over her or his schedule and/or identification or travel documents
  • Is hungry, malnourished, or inappropriately dressed (based on weather conditions or surroundings)
  • Shows signs of drug addiction4

Victims are often in attendance with their abuser, whether this is a pimp or “employer”, so it is important to speak to the patient alone to elicit a thorough history and help the victim. An excellent resource for all health care professionals in the emergency room is a phone app called “Sex Traff”5. It is designed by two physicians with the intent of helping health care professionals identify potential victims of sex trafficking using a simple screening questionnaire.

As the awareness of human trafficking increases, there is also an increase in health professional training sessions available in several cities across the nation, as well as online training available through the national human trafficking hotline: https://humantraffickinghotline.org/material-type/online-trainings. It is important that healthcare providers of all ranks be informed of this pervasive problem, as well as how to respond. Please share this information with your staff and colleagues, so that we can do our part to combat human trafficking.

Source(s):

1https://wire.ama-assn.org/delivering-care/how-physicians-can-identify-assist-human-trafficking-victims

2https://www.reuters.com/article/us-sex-trafficking-recognition/doctors-not-trained-to-spot-sex-trafficking-victims-idUSKBN0MC1XE20150316

3 https://www.state.gov/j/tip/what/index.htm

4https://www2.ed.gov/about/offices/list/oese/oshs/factsheet.html

5 https://play.google.com/store/apps/details?id=com.ncpl.sextraff

Photo Credit: Thomas Wanhoff Source: Flickr

Manjit Bhandal

​Manjit Bhandal is a member of the Central Michigan University College of Medicine (CMU COM). She graduated with her bachelors degree from the University of California, Berkeley. Prior to entering medical school, she worked as a clinical research assistant at the Children's Hospital Oakland Research Institute, with the Berkeley Cardiovascular Medical Group, and at the Stanford Medical School. Her research interests include improving outcomes in cardiac transplantation as well as cardiac tumors. She is an avid reader, and loves food, animals, and traveling. ​

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