Human trafficking is considered a form of modern-day slavery that is widespread throughout the United States and worldwide. According to the International Labor Organization (ILO), forced labor alone (one component of human trafficking) generates an estimated $150 billion in profits per annum as of 2014. In 2012, the ILO estimated that 21 million victims are trapped in modern-day slavery. Of these, 14.2 million (68%) were exploited for labor, 4.5 million (22%) were sexually exploited, and 2.2 million (10%) were exploited in state-imposed forced labor. Human trafficking is thought to be one of the fastest-growing activities of transnational criminal organizations.
According to the US Department of Health & Human Services, human trafficking is not limited to forced prostitution but can also encompass forced-labor situations such as domestic servants (maids or servants), sweatshop workers, restaurant workers, janitors, and so on. Healthcare workers may be the only outside communication these victims have. One report finds that as many as 88% of sex trafficking victims end up in emergency departments and clinics at some point while being held. Health care providers are in a pivotal position to identify these victims and help provide resources such as housing, health, and legal services.
At the end of this course, you will be able to:
- Explain human trafficking and differentiate the different types
- Identify factors that place a person at risk of becoming a victim of human trafficking.
- Identifying possible trafficking victims in a clinical setting by warning signs and knowledge of key questions to ask during patient visits
- Use screenings tools and knowledge to appropriately report victims of trafficking
- Relate available resources for victims of human trafficking
What is Human Trafficking?
Human trafficking is a global issue that affects every country around the world and all ages, races, genders, and cultures. Human trafficking is not a new issue. It has been occurring and will continue to occur unless it is spotlighted by increased education and identification of the victims. Human trafficking is about profit. After drug dealing, human trafficking is tied with illegal arms trade as the second largest criminal enterprise in the world. Because human trafficking has been largely a hidden crime, the public has never been aroused to fight it; a lack of identification with the vicas impeded moves to intervention and to make governmental resources available to them. Healthcare providers, with the proper tools and training, can act as a critical resource in identifying and implementing escape from the victims’ abusers.
Human trafficking is a crime involving the exploitation of someone for the purposes of compelled labor or a commercial sex act through the use of force, fraud, or coercion. Human trafficking has no boundaries and affects individuals across the world and across gender, age, ethnicity and socio-economic backgrounds.
Types of Human Trafficking
Human trafficking falls into three main categories: Sex trafficking, Labor trafficking, and Domestic servitude
Sex trafficking is the recruitment, harboring, transportation, provision, obtaining, patronizing or soliciting of a person for a commercial sex act, in which the commercial sex act is induced by force,
fraud or coercion has been found in a variety of venues within sex industries, including brothels, escort service, fake message business, strip clubs and street prostitution.
Sex trafficking is the most prevalent form of human trafficking in the United States. Sex trafficking is a high profit and low-risk business where the commodity; the human being’s body; can repeatedly be sold. Unfortunately, sex trafficking is a problem in the United States because there is a high demand for child pornography and prostitution. Commercial sexual exploitation includes prostitution, pornography, live sex shows, stripping, personal sexual servitude, escort services, mail order brides, military prostitution, and sex tourism. Children and teenagers are at a higher risk for any sex trafficking.
Labor trafficking is another type of human trafficking. In the United States, the Trafficking Victims Protection Act of 2000 (TVPA) defines labor trafficking as “the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage or slavery”. Peonage is the act of paying off debt through work. Debt bondage is where the victim is forced into bonded labor to work to pay off a debt, loan, or other obligation. Areas most prone to forced labor include domestic work, agriculture, construction, manufacturing, and hospitality. Forced labor is often difficult to detect. Forced labor in the private economy generates $150 billion in illegal profits per year, with migrant workers and indigenous people being particularly vulnerable. Illegal immigrants can become confined to forced labor if the abuser confiscates their passport or identification documents and uses the threat of their exposure as an illegal to the authorities.
Traffickers target those with low literacy and education levels and those living at or below the poverty line According to the ILO, nearly 21 million people are victims of forced labor, with 11.4 million women and girls and 9.5 million men and boys Women and children are highly trafficked in labor arenas because of their relative lack of power, social marginalization, and overall status as compared to men.
Domestic servitude is a special category of labor trafficking: the plight of domestic workers such as maids, servants, housekeepers, child-care givers, those caring for the elderly, the ill, and the infirm. In many instances, some of these duties may overlap. It constitutes the second highest incidence of forced labor in this country. Every year U.S. citizens and foreign nationals living in the U.S. bring thousands of domestic workers into the country. Many of them suffer abuse, ending up essentially held in bondage. Frequently these are young women who have been promised an education in America but rarely get what they bargained for. Visas normally require that domestic service workers remain with their original employer or face deportation. This tends to discourage workers from reporting abuse. Additionally, monitoring is impossible as the work takes place hidden in private homes. Violence and sexual abuse are common. Even American citizens employed as domestics find they are excluded from almost all the fair labor practice laws that normally apply in other fields.
WHY DOES HUMAN TRAFFICKING EXIST?
Because human trafficking is a market-driven criminal industry, it is based on the principle of supply and demand, like drugs, or arms trafficking. Human trafficking does is not mutually exclusive, many factors contribute to this crime. Human trafficking is fueled by a demand for cheap labor, services, and for commercial sex exploitation. To solve the problem of human trafficking, it is necessary to address the demand-driven market as well as alter the overall market incentives of high profit and low risk that traffickers currently exploit for a huge profit.
Low Risks: Human traffickers perceive that there are little to no risk or deterrence to affect their criminal operations. While law enforcement and penalties have increased over the years, many traffickers still believe the high-profit margin to be worth the risk of detection.
High Profit: When individuals are willing to buy commercial sex, they create a market and make it profitable for the traffickers to exploit children and adults alike. Also, when consumers are willing to purchase goods and services from industries that rely on forced labor, they are also creating a profit incentive for labor traffickers to maximize revenue with minimal production costs.
MODERN HUMAN SLAVERY- STATISTICS
Human trafficking is a concern of all hospitals in the country. Many states are now requiring nursing staff to have training in identifying possible victims of trafficking. Most important, we must have the proper training to identify when it is safe to communicate with the possible victim while keeping both the staff and the victim safe from retaliation. Also, resources must be identified for the victim in advance then provided once desired.
The priority is to protect victims from potentially increased harm. Human traffickers are known to be very manipulative, and they do not hesitate to use violence on their victims. As healthcare providers, our goal is to keep the victim safe and if possible, assist victims in escaping their abusers. This must be done with finesse and skill. There are several large hospital organizations across the country that are now dedicating clinics to victims of human trafficking.
- Nearly 21 million people worldwide are trapped in a trafficking situation each year according to the ILO; during 2016, the National Human Trafficking Hotline (NHTH) received 1,623 calls and 550 case reports related to human trafficking in Florida. This is the third highest call volume in the country. Of the 550 cases reported, 73% were related to sex trafficking while 17% were for labor trafficking. Besides, nearly 85% of reports involved trafficking in women.
- Nearly 70% of reports involved adults.
- About 30% of reports involved minors.
- Venues for sex trafficking included hotel/motel based, brothels, escort services, online ads, and street-based.
- Venues for labor trafficking included domestic work, agriculture, traveling sales crews, restaurant/food service, and hospitality. (NHTH, 2017)
- Victims can be any age, race, or culture, and found in any country. The abusers prey on the weak and vulnerable. Youth especially at risk of being trafficked as are those from a lower socioeconomic status or privilege. These young people are at greater risk because they are looking for an escape from poverty or an abusive situation. The trafficker is precise and methodical in cultivating a friendship and what appears as a loving environment with the future victim.
- Human trafficking has been reported in all 50 states with both U.S. citizens and foreign victims. The types of human trafficking can vary from community to community, and happens just about every, from suburbs to rural towns to cities.
Human trafficking will continue as long as there is demand for its victims. Healthcare providers may be one of the only channels through which a victim is identified. Proper staff training can lead to potential identification and intervention. Your ability to assess a victim and knowledge of the resources to assist a victim can turn a very bad situation into a positive outcome. Victims who are in a clinic or emergency department (ED) may rely on you to ask the right questions at the right time. It is possible a healthcare provider is the only other human contact they may experience in months or years, depending on their situation.
With the abuser pretending to act protective and caring, it can be easy for you to overlook a victim if you are not trained in what to look for, or if the abuser does not allow adequate time or conversation with the victim. Healthcare providers must be sensitive and methodical in approaching a victim if they suspect something is “off” about the situation. Having a screening tool, or training on appropriate questions to ask the victim and abuser, can open dialogue and uncover possible victimization.
RECRUITING: WHERE DO VICTIMS COME FROM?
Recruitment of victims in the United States can come from anywhere common places are like shopping malls, junior high and high schools, foster homes, group homes, courthouses, restaurants and bars, bus stations, concerts, parks, libraries, and social networking websites. Parents should be aware that one of the most common ways that traffickers access children is now through the use of social media sites like Facebook
Once the victims are found, they may be transported to where the trafficker has a high demand, or they may stay close to the area where they were targeted. The use of internet advertising has taken the sex industry to a global operation.
The Trafficking Victims Protection Act (TVPA) defines the crime of sex trafficking as the “recruitment, harboring, transportation, provision, or obtaining of a person for the purpose of a commercial sex act where such an act is induced by force, fraud, or coercion, or in which the person induced to perform such act has not attained 18 years of age” Many people would not be able to recognize a sex slave even if living in the same community. For this reason, proper training of healthcare workers is essential in reducing this crime.
GROOMING: GETTING VICTIMS COMFORTABLE
Victims of sex trafficking will be “groomed” in stages by the abuser (see below). Traffickers look for victims who are vulnerable by using acts of kindness to groom them into submission. (source DOH)
RECOGNIZING VULNERABLE VICTIMS
Those at highest risk of any form of human trafficking are the vulnerable populations. As noted earlier, human trafficking is more common in people of low socioeconomic status or with children who experience abuse at home. While these are the most common, human trafficking does not discriminate. Red flags in spotting trafficking victims should be taught to all staff from the receptionist to the attending physicians to all ancillary departments. Everyone must be taught the signs of a potential victim the same way facilities train staff members to spot the child and elder abuse.
Abuse can be emotional, physical, or sexual, and it can arise from emotional neglect, physical neglect, and family violence. All are prevalent among trafficked youths. Sexual abuse is the strongest predictor of human trafficking for both boys and girls. Those who have experienced sexual abuse in the home may be looking for a way to escape to a better life, only to find themselves manipulated into a trafficking situation.
Lack of caregiver protection from abuse in the home increases the likelihood of a child’s seeking protection from someone outside the home. Exposure to family violence is also an increased risk of human trafficking. Abusers will cultivate relationships with these young children or teens and they soon become victims. Trafficking of boys more commonly relies on emotional and sexual abuse.
According to the Department of Justice (2016), youth at risk for human trafficking include:
- Youth in the foster care system
- Young people who identify as LGBTQ
- Homeless or runaway youths
- Those with disabilities
- Youth with mental health or substance abuse disorders
- Youth with a history of sexual abuse
- Those with a history of being involved in the welfare system
- Those who identify as native or aboriginal
- Youth with family dysfunction
Traffickers will specifically target runaway or “throwaway” teens who are having trouble at home. They are seen as easy targets because they are looking for shelter and may not be old enough to get a job legally. It is common for these teens to trade sex to meet basic survival needs of food, shelter, and clothes.
SCREENING FOR HEALTH CARE CLINICIANS
Because medical professionals are on the front lines for these victims, proper training is the most important thing we can do to prepare for these patients. There is nothing more valuable to the rescue of our trafficking victims than prompt screening. Being able to screen them in private, when safe and away from their abuser or “family member,” is the priority. Safety of the staff, facility, and victim is essential before intervention can begin.
WARNING SIGNS TO LOOK FOR
The Department of Justice suggests basic warning signs that we must be trained to identify:
- A youth that has been verified to be under 18 and is in the commercial sex industry, or has a record of prior arrest for prostitution or related charges.
- Having an explicitly sexual online profile.
- Excessive frequenting of internet chat rooms or classified site.
- Depicting elements of sexual exploitation in the drawing, poetry, or other modes of creative expression.
- Frequent multiple sexually transmitted diseases or pregnancies.
- Lying about or not being aware of their true age.
- Having no knowledge of personal data, such as age, name, and/or date of birth.
- Not having control of own finances.
- Being in a controlling or dominating relationship.
- Having no identification.
- Wearing sexually provocative clothing.
- Wearing new clothes of any style, getting hair and/or nails done with no financial means.
- Having secrecy about whereabouts.
- Having late nights or unusual hours.
- Having a tattoo that he or she is reluctant to explain.
- Being in a controlling or dominating relationship.
- Not having control of own finances.
- Exhibiting hyper-vigilance or paranoid behaviors.
- Expressing interest in, or in relationships with, much older men or women (DOJ, 2016).
SIGNS OF ABUSE
In a medical clinic, you may be confronted with multiple signs of abuse. These include but are not limited to:
Evidence of sexual trauma
bruises or contusions,
tattoos on the body that may serve as a “brand” of their trafficker
respiratory infections, dental issues, drug-related issues (hepatitis, skin infections)
Malnutrition and dehydration
injuries to head and mouth,
temporal mandibular joint problems from oral sex
bite marks, stab, or gunshot wounds
hearing loss from head trauma
bald patches from having hair pulled
traumatic brain injury
bladder damage and other injury or infection.
The most common healthcare areas that attract trafficking victims are EDs, urgent care, primary care clinics, obstetrician/gynecologist clinics, school nurses’ offices, community health centers, mobile clinics, planned parenthood clinics, and dental clinics. When encountering a potential victim, it is important for clinicians to remember that victims may not be comfortable coming forward.
Healthcare providers must be trained in identifying possible trafficking victims by knowledge of key questions to ask during patient visits. Multiple characteristics can be assessed when clinicians screen to determine if an intervention for a potential victim is necessary and safe. Practitioners must be careful in assessment and identification not to lead the victim into future harm.
It is important for any organization to become a resource for human trafficking victims when staff is trained to recognize that it is possible for victims to be right in front of them without their knowledge. If you believe you have identified a trafficking victim, but any intervention may place the victim or facility at risk of the abuser, you may need to step back to avoid violence.
Facilities need to ensure that they have the appropriate resources to make assistance available to the victims. Ideally, they will assist in their rehabilitation back into society after the traumatic experiences that may have occurred.
Most victims are in need of immediate medical care. They may present to a clinic for the first time when giving birth, or with a child who is in need of medical care. Nursing staff must be trained with the screening tools and interventions beginning with increased knowledge about asking the right questions to avoid further exploitation and abuse.
The best question to ask a possible victim would be “What has happened to you?” Not “What’s wrong with you” or “Why are you doing this?”. Open-ended questions encourage discussion and allow the victim to disclose as much information as they are comfortable sharing. Victims need to feel safe with you before they will begin to open up about their situation and their needs.
Are you free to come and go as you please?
have you or your family been threatened if you try to leave?
Have you been physically harmed in any way?
What are your working and living conditions like?
Where do you eat and sleep?
Do you sleep in a bed, on a cot, or on the floor?
Have you ever been deprived of food, water, sleep, or medical care?
Do you have to ask permission to eat, sleep, or go to the bathroom?
Are there locks on your doors and windows so you cannot get out?
Has your identification or documentation been taking from you?
Is anyone forcing you to do anything that you do not want to do?
It has been found that questions asked about migration, work, and living conditions are good predictors of trafficking after taking demographics into account. Practitioners who are culturally competent may have an easier time building a trusting environment with victims who do not speak English or are unfamiliar with American customs It is best to utilize a professional hospital translator during the assessment when there is a language barrier. If the abuser is present, the value of questions is doubtful.
THE TRAFFICKING VICTIM IDENTIFICATION TOOL
The Trafficking Victim Identification Tool (TVIT) provides a guideline and interview questions that have been proven to identify victims of human trafficking. These questions should be asked by a trained healthcare professional and in a secure environment. For best results, the screening tool should not be used until there is trust between the victim and the interviewer; also, it is best to keep the number of people to a minimum when working with these patients to avoid overwhelming them.
During the interview process, it is important to take the time to get the full story. Pay attention to the words the victim uses throughout the conversation. The TVIT inquiries about “work or other activities” performed during the capture. This is to solicit information about sexual services and other types of informal work. Victims may not think of rape, forced prostitution, forced shoplifting, or forced drug smuggling as “work”. Screeners should use the same terminology as the victim. The tool can be downloaded at https://www.ncjrs.gov/pdffiles1/nij/grants/246713.pdf
OTHER BEHAVIORAL CHARACTERISTICS
When assessing a patient in a medical setting, look for other behavioral characteristics such an inconsistent past medical history; patient making no eye contact; an unwillingness to share answers; resistance to gynecologic exams; being accompanied by an individual who does not let the patient speak; whether the patient is unable to provide an address or is unaware of location or date/time.
Victims can often act fearful and nervous, especially if the abuser is present Psychological effects of torture include helplessness, shame and humiliation, shock, denial and disbelief, disorientation and confusion, phobias, and panic attacks. Victims of labor trafficking can present with chronic back and visual or respiratory problems from working in agriculture, construction, or manufacturing under dangerous conditions.
When patients find they trust you enough to speak about their situation and risk possible consequences from their abuser, the process of exiting trafficking can begin. They are moving from “victims” to “survivors.” Once a survivor is comfortable with you and in a safe environment, you can begin asking questions. The World Health Organization (WHO) has a guideline for interviewing potential trafficking victims.
First, and most important, do no harm. Assess the risk associated with each case before beginning the interview. This is for the safety of the patient as well as yourself and the staff. Next prepare referral information in the survivor’s language about appropriate legal, health, shelter, and security services. Select interpreters, if needed, and enlist coworkers who have the proper training in screening methods.
Protect patient identity and confidentiality at all times during the interview process. Ensure that patients understand how the interview information will be used and that they have given informed consent. Provide a non-judgmental environment to listen and respect the patient’s concerns.
Avoid asking questions that might provoke an emotional response or re-traumatize the survivor. Always have an emergency plan if survivors say they are in imminent danger. Finally, use the information in a way that will benefit the patient and help develop policies and procedures in the future to assist and identify other trafficking victims.
RESOURCES FOR VICTIMS OF HUMAN TRAFFICKING
Survivors need a great deal of support, beginning with the most basic needs, once they are able to escape their captive. Nurses are one of the few professional groups that interact with victims while they are still under the control of their abuser. Resources that are available depend on the degree to which the facility’s approach is proactive for appropriate interventions and proper staff training. If an organization has not trained the staff or identified the necessary resources to assist with trafficking victims, it greatly limits the possibility for assisting them safely.
NATIONAL HUMAN TRAFFICKING RESOURCE CENTER
The National Human Trafficking Resource Center (NHTRC) offers a database of service providers who deal with human trafficking throughout the United States. They help healthcare agencies to connect with existing resources in their area as they begin developing a response protocol for victims of human trafficking. The NHTRC has a referral network for anti-trafficking organizations, legal service providers, shelters, law enforcement, and local social service agencies to assist victims of human trafficking. Facilities can also turn to the NHTRC for extensive training on a variety of topics related to trafficking.
HOSPITALS AND OTHER HEALTHCARE AGENCIES
Many healthcare organizations are also beginning to collaborate with outside resources to assist in recovery and healing for human trafficking survivors. Hospital organizations can form partnerships with resources in their area such as police departments, schools, shelters, and clinics
USDHS BLUE CAMPAIGN
The U.S. Department of Homeland Security (USDHS) offers a website resource under its Blue Campaign to work toward ending human trafficking (DHS, 2017). The website recognizes the key indicators of victims of human trafficking as the first step in identifying victims. This site contains lots of general information for the public as well as tips and resources for contacting law enforcement and assistance if there is a suspected victim of human trafficking. Many of the graphics in this course are taken from the Blue Campaign website.
To report suspected human trafficking:
866 347 2423
To get help from the National Human Trafficking Hotline:
888 373 7888
The U.S. Department of Health and Human Services offers training to clinicians through the SOAR to Health and Wellness Program:
S = Stop
O = Observe
A = Ask
R = Respond
This program uses a public health approach by building communities that can identify and respond to the complex needs of victims and survivors of human trafficking. The program understands the root causes that make individuals, families, and communities vulnerable. able to trafficking and educates healthcare providers and the public vulnerable to trafficking and educates healthcare providers and the public.
NATIONAL HUMAN TRAFFICKING RESOURCE CENTER(NHTRC)
If your agency has a possible trafficking victim and is unsure what to do, the hotline of the National Human Trafficking Resource Center (800 373 7888) can be called to help conduct an assessment. The hotline can be called anonymously if staff are nervous about identifying themselves.
In 2016 there were 7,572 cases of trafficking reported in the United States: 73% as sex trafficking, 14% as labor trafficking, and 3.5% reported as both. The NHTRC provides an assessment tool on its website to assist potential victims of trafficking.
National Human Trafficking Resource Center Hotline
888 373 7888
(24/7) and access to 170 languages
Ask for assistance with assessment questions, resources, and next steps.
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
Another valuable resource is the U.S. Department of Health and Human Services (DHHS). The DHHS lists multiple resources, including legal rights information, on their website.Their motto is “Rescue and Restore.” The DHHS has built a task force and training services to inform the public about identifying victims and how to contact organizations that provide help. Clinicians or the general public can email firstname.lastname@example.org or call 844 648 8822 to speak with a specialist. Services are free and delivered as needed.
Nursing Plan of Care and Nursing Responsibilities
Plan of Care
- Alteration in self esteem related being victimized.
- Potential for injury and harm related to physical and mental abuse
- Nurses are in a position to help make a difference in the lives of trafficking victims at several points, from the initial encounter and identification to their rescue and restoration to health. Studies shows that often such opportunities are missed, one study confirms that in the San Francisco, Los Angeles, and Atlanta areas, researchers found that although 28% had come into contact with health care providers during their captivity, the providers didn’t realize their patients were being trafficked.
- It is also worth noting that clinicians in a variety of setting, not just hospital ED, could potentially encounter people who are being trafficked. For example, in the aforementioned study, some of the victims were brought to dentists’ or physicians’ offices. Regardless of the setting and the suspected victim’s place of birth, much of what we need to know in order to approach and intervene effectively is the same.
- Nurses’ primary concerns must be to prioritize and treat the person’s health problems and to ensure her or his safety. Once these needs have been met, if trafficking is suspected, the nurse and others on the health care team can then proceed to assess the situation. It is never too soon to start thinking about how to handle a potential trafficking situation.
- Encourage your facility’s administration to address the issue of human trafficking by providing education and training to nursing and medical staff and establishing policies and procedures for cases in which trafficking is suspected or known
- Stay informed by reading about human trafficking and learning more about local and national efforts to address the issue. Provide trafficking literature to others on staff.
- Explore the sites listed in Resources. A good starting point: the toolkits created by the U.S. Department of Health and Human Services’ Campaign to Rescue and Restore Victims of Human Trafficking.
- Don’t be afraid to ask questions if your patient has one or more indicators of trafficking or if something doesn’t seem quite right to you. Remember to speak with the person alone; if a translator is needed, make sure she or he has no connection to the traffickers.
- Post the NHTRC’s toll-free hotline number: 1-888 3737-888. They answer calls around the clock, 365 days a year.
- Prepare small palm-sized cards with instructions in several languages for calling the NHTRC hotline number and local law enforcement that you can give to suspected victims.
- Hang posters with such information in places victims might see them, such as outpatient clinics, EDs, and facility bathrooms. • Think beyond the clinical setting; notice what’s going on in your community. Are there children who never seem to go to school? Are there men coming and going at all hours at a nearby residence?
- For your safety, never confront a suspected trafficker directly. Instead, contact local authorities and call the NHTRC hotline number. • Reach out to professionals in other disciplines at your facility. Talk with people involved in antitrafficking efforts in your community, as well as with local law enforcement personnel.
- The primary goal is to secure the safet of trafficking victims and ensure they have access to resourses that can assist them through rehabilation.
Human trafficking does occur in the United States. It is a global problem that does not discriminate against any age, gender, or race. The United States is the second largest sex trafficking market in the world (Lake, 2017). Healthcare providers are important figures in this battle as advocates for victims. If left unchecked, human trafficking will continue to flourish and traffickers will continue to reap substantial monetary gains with relatively low risks of getting caught or losing money. As such communities can help to reduce sex trafficking in their communities by not buying sex and not participating in the commercial sex industry. Community members can use available tools online to see how human trafficking exists in the services and products they consume.
Through the services and efforts of healthcare providers, criminal prosecutors, and law enforcement, society, and the communities can help to reduce the demands for sex and labor trafficking. Training for all healthcare workers on signs of trafficking is imperative to change these victims into survivors with a chance for recovery. The fight does not end when they are removed from their abuser. Support will need to continue as they begin the healing process. Healthcare providers at all levels can make a positive impact as they help in the recovery process and re-acclimate the survivors to a new and healthy life.
Setbacks are common as many suffer from post-traumatic stress issues, anxiety, and depression. Physical or mental scars must be dealt with once they are free from their captures. Support and encouragement from healthcare professionals may be all the assistance a victim has. Even when no physical abuse is evident, mental abuse can be hidden and even more damaging. Survivors likely will have to deal with the memories and trauma for the remainder of their life.
A public health approach to target anti-trafficking efforts can help to reduce the risk of the most vulnerable populations. Local organizations should work collaboratively to provide the best possible resources for the victims of human trafficking. Collaboration and training of all healthcare workers is only the beginning. A great deal of work must continue to support survivors; to expose trafficking victims without a plan to address their complex situations can endanger them. We must do our best to turn victims into survivors, directing them to the resources designed to rehabilitate them back to freedom.