Assessing and Treating Human Trafficking By Gregory Knapik
Nursing students and nurses have an enormous potential to influence healthcare in positive ways to help make our world a better place . At this crucial time in our healthcare system , a key obligation is to help vulnerable populations . Among the most vulnerable are victims of human trafficking . Second only to illegal drug trafficking , human trafficking is widespread throughout the world , including the United States of America . According to the Global Report on Trafficking in Persons ( UNODC , 2022 ), “ 50 % of detected victims in 2018 were trafficked for sexual exploitation , 38 % were exploited for forced labour , 6 % were subjected to forced criminal activity , while 1 % were coerced into begging and smaller numbers into forced marriages , organ removal , and other purposes .” Being a victim of trafficking is not a one-time event ; it is an ongoing daily oppressive servitude of deplorable working and living conditions .
What You Can Do Please do not underestimate the power and influence you can have , particularly in helping human trafficked victims . The following discussion will incorporate trauma informed care ( TIC ) basics , including adverse childhood experiences ( ACEs ), that every care provider should know and understand ( Menschner and Maul , 2016 ). A helpful resource is the Federally supported organization , Substance Abuse and Mental Health Services Administration ( SAMHSA ). We will discuss TIC and the recovery process in caring for victims of human trafficking ( HT ). We will focus mainly on adult victims , though many victims are children and adolescents . While we cannot adequately cover the child / adolescent HT victimization in this discussion , much of the discussion regarding adults is applicable to children / adolescents .
The initial challenges in helping HT victims are awareness and sensitivity . Keep in mind that you may be the “ window of opportunity ” to help deliver victims from their malignant life pathway . Victims of HT often are difficult patients . They tend to be withdrawn , quiet , detached , pre-occupied , show poor eye contact , and are evasive . They may not be easy to communicate with , though their non-verbal communication is very telling and should be a red flag for you .
Problems communicating is not surprising considering that HT victims typically live in ongoing fear , shame , deprivation , and abuses of all sorts , including threats of harm or death to the victim or the victim ’ s family members . The victim lacks autonomy , safety , and hope . Consider how not having any hope in your life would darken day to day living . Human trafficking has often been termed “ modern day slavery ” ( Willliams , 2013 ). The victims are deeply wounded and suffering in body , mind , and spirit .
The two most important care factors are your therapeutic presence and active listening . These are key to any patient interaction , but especially for HT victims to facilitate acceptance and security . This is a process that cannot be rushed and requires being comfortable with periods of silence . Silence can be one of the most effective communication techniques .
How you interpret your observations and perceptions of the patient are key to your assessment . Using open-ended questions can help support your ongoing assessment . Reassuring the patient of safety and your desire to help may open dialogue . This can be a slow process but is worth every minute .
Keep this in mind when you encounter a challenging patient who resists any engagement and presents a picture that seems out of sorts . If the patient is not alone , the escort will direct the encounter for the patient and be very selective in the disclosure of information . Often , your intuition or gut-level feelings will alarm you that something seems awry . Importantly , if you make a mistake , for example , say something nontherapeutic such as “ why don ’ t you answer me ,” you can kindly apologize . For example , you might say , “ I apologize for that insensitive comment . I want to help you as best I can .” Your openness will help build trust , often a slow , not so easy process , but essential .
A thorough physical exam is very helpful if the patient is comfortable with this . You must explain and request permission for each step , including vital signs . Keep in mind that this patient may have experienced physical and emotional trauma . If a female provider is not available to examine a female victim , include a female staff member in the exam room . Typically , the patient will not be forthcoming about traumatic experiences . As you build trust during this encounter , include gently inquiring about unusual physical findings . Consider any multiple bruising , scars , burn marks , and welts ; include examining soles of feet , inner lips , and scalp under hair on head . Likewise make note of unusual tattoos ( for example , bar codes , dollar signs , “ property of …”, “… girl ”). Often observed is a generally unhealthy appearance or
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