How emergency physicians can identify and recover human trafficking victims
80 percent. Every ZIP code.
Dr. Hope
They are two figures that shocked many emergency physicians in attendance at ACEP’s Leadership and Advocacy Conference this month, in a presentation by Jamie Hope, M.D., attending physician at Beaumont Hospital Royal Oak in Michigan.
80 percent of recovered human trafficking victims say they were seen in a medical setting while being trafficked. It wasn’t recognized — and they weren’t recovered.
Human trafficking occurs in every U.S. ZIP code.
According to Homeland Security, more than 300,000 children a year are lured into trafficking in the United States. Human trafficking— a form of modern-day slavery — involves the use of force, fraud, or coercion to obtain some type of labor or commercial sex act. Traffickers violence, manipulation, or false promises of well-paying jobs or romantic relationships to lure victims into trafficking situations.
When was the last time you saw a patient who was being trafficked?
How do you know it wasn’t your last shift?
If you don’t think about it, you won’t see it, Dr. Hope notes. It’s ubiquitous and largely unrecognized.
But we can work together to fight human trafficking.
Information, programs, and resources now exist that make a difference. You can educate your staff, provide assistance to your patients, and coordinate with community development programs.
Red Flags of Human Trafficking
Constantly supervised
Constantly on phone (forced to check in)
Appears younger than stated age
Doesn’t know where they are
Can’t answer typical questions (where did/do you go to school)
Branding tattoos
Scripted/memorized history, with difficulty providing more information
Fearful, lack of control, overly submissive
Defiant and untrusting
Not allowed to speak for themselves
Labor Trafficking signs and symptoms
Working excessively long or unusual hours
Excessive callouses
Unexplained injuries
Injuries that would have been preventable with proper protective equipment/situations
Not in control of money/not being paid
Untreated injuries
Bruises/injuries in multiple stages of healing
Hungry/dehydrated
Concern for jail/deportation
Untreated medical conditions
Sex Trafficking signs and symptoms
Clothing inappropriate for weather
Overly child-like or over-sexual
May have hair/nails done and look well-taken care of
Recurrent STIs
Multiple abortions
Pelvic/abdominal pain
Bruises/injuries in multiple stages of healing
Oral/rectal/genital trauma
Signs of strangulation
Hungry/dehydrated
Untreated medical conditions
If you become alert to red flags, there are questions you can ask the patient.
Can you leave your job if you want to?
Can you come and go as you please?
Have you been hurt or threatened if you tried to leave?
Do you have restricted access to food, water, shelter, medications/medical care, social support?
Has your family been threatened?
Do you live with your employer?
Where do you sleep and eat?
Have to been told by anyone that you have to “pay a debt”?
Do you have your identification? If not, who has it?
Are you ‘in the life’? (They may not use the word “trafficked.“
Have you been forced to work or do sexual acts?
Create an Action Plan for your ED
1. Teach staff how to recognize victims
2. Know which questions to ask, and how to ask them
Don’t simply use computer check-off lists as you would for common medical conditions
Sit, make eye contact, be empathetic
Avoid victim blaming
3. Know local and national resources
Find local shelters and safe-houses
Use hotlines and websites (see below)
4. If the victim wants help
Contact appropriate authorities, including the FBI for Human trafficking. Note: local law enforcement training varies, and many victims may have a record or are afraid of arrest.
Connect victims to resources
Keep them safe until they can access resources
Human Trafficking Hotlines
These services are available to victims and survivors, as well as others who need to report a tip or find resources.
Call: 1-888-373-7888
Text: “BeFree” to 233733
Live Chat: humantraffickinghotline.org
