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Human Trafficking: Clinical Presentation & Treatment. How to Care for Trafficked Persons in the E.D. Makini Chisolm-Straker, MSIV Brown Medical School, Mt. Sinai School of Medicine 2008. Instructional Goals:.

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human trafficking clinical presentation treatment

Human Trafficking:Clinical Presentation & Treatment

How to Care for

Trafficked Persons in the E.D.

Makini Chisolm-Straker, MSIV

Brown Medical School, Mt. Sinai School of Medicine

2008

instructional goals
Instructional Goals:
  • You will be familiar with the clinical presentation of human trafficking victims in the E.D. in the U.S.
  • You will be familiar with the appropriate treatment of human trafficking victims.
  • You will appreciate the role of emergency healthcare practitioners in facilitating the escape of trafficked persons.
instructional learning objective what you will do by the end of this session

Instructional Learning Objective(what you will do by the end of this session):

You will know the hotline to call when a suspected trafficking victim presents to the emergency department.

slide4
Case
  • obtunded teenage♀, GCS 5
  • extensive bleeding from vaginal canal
  • visible burns, cuts, scars on wrists, ankles, neck
  • h/o schizophrenia?
  • bro. concerned about a dangerous abortion attempt
human trafficking is
Human Trafficking is:
  • the recruitment, transportation, transfer, harboring or receipt of persons:
    • by the threat or use of kidnapping, force, fraud, deception or coercion, or by the giving or receiving of unlawful payments or benefits
    • to achieve the consent of a person having control over another person, and
    • for the purpose of sexual exploitation or forced labor.
human trafficking is1
Human Trafficking is:
  • the illegal use of a variety of means
  • to force an individual (the trafficked)
  • to relinquish his/her personal freedom
  • for the profit of another person (the trafficker).
  • often, simply considered “involuntary servitude” or “modern-day slavery.”
types of trafficking
Sexual Exploitation

prostitution

pornography

bride trafficking

commercial abuse of children

massage parlors, hostess clubs, brothels, escort services, commercial phone sex & internet dating

exotic dancing/stripping

Types of Trafficking
types of trafficking1
Forced Labor

domestic servitude (domestic work & child care)

manual labor

-small-scale factory work

-construction work

-sweatshops & farms of multinational corps

-agricultural & landscape work

restaurants

nail salons

hotel housekeeping

false adoption

drug trade

street begging

camel jockeys

child soldiers

organ harvesting

Types of Trafficking
slide9
Trafficking Affects

(Populations at Risk):

  • 15,000 – 60,000 people are trafficked into the
  • U.S. annually
  • 80% of trafficked persons are ♀& children
  • U.S. citizens
  • U.S. residents
  • documented immigrants
  • undocumented immigrants
  • youth (esp. runaways)
  • urban pop.
  • suburban pop.
role of healthcare practitioners in the e d
Role of Healthcare Practitioners in the E.D.
  • Identify human trafficking victims
  • Treat the chief complaint/illness and/or the emergent issue
  • Offer (& provide, if patient-desired) appropriate treatment for the unsafe environment
difficulty identifying trafficking victims
Difficulty Identifying Trafficking Victims
  • distrust of service providers
  • lies & false stories
  • untrustworthy interpreters
  • “one shot”
  • difference between intimate partner violence & human trafficking
signs sx
lack of knowledge of a given community/whereabouts

not in control of personal ID

few  no personal possessions

does not speak

3rd party insists on being present or interpreting

injuries (multiple, old & new)

signs of malnourishment

branding

Signs & Sx
signs sx1
no healthcare

under 18 & in sex industry – DE FACTO

claim of “just visiting”

inconsistent story

behavior change when “law enforcement” is mentioned

STIs

bacterial &/or yeast infxns

demeanor (e.g.: fearful, anxious, submissive, flat affect)

Signs & Sx
what to do
What to do

What to do

  • building trust is the number one priority
  • reassure the potential victim
  • one-on-one interactions are ideal
  • specifically ask about the patient’s safety
  • offer reworded stories
  • stay calm & even-keel
  • ALWAYS document your suspicion in your notes, at the very least
8 call a help hotline

8. Call a Help Hotline:

English: 1-888-373-7888

Korean: 1-888-976-5274

Spanish: 1-888-80-AYUDA

slide16
The folks working at the hotlines are trained to know how to help you, but you are their eyes & ears. Trust their knowledge, your experience & your gut. If the patient is an adult, they have the last say, but give them every opportunity to receive help.Even if a potential victim doesn’t want help, call: 1 - 8 8 8 - 3 7 3 - 7 8 8 8,to report suspected trafficking;the tip can save lives.
clinical recommendations
Clinical Recommendations*

Presumptive Treatment for:

  • gonorrhea
  • chlamydia
  • trichomoniasis
  • syphilis
  • UTI

*for sexually exploited victims

slide18
Special thanks to Polaris Project

for the images & information.

Clinical Recommendations courtesy of

Doctors of the World.

slide19
For more information on trafficking in the U.S. you can:email: [email protected]: www.polarisproject.orgor www.humantraffickingED.com
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