______________________________________ Human Trafficking and Exploitation: The Texas Requirement
SCREENING QUESTIONS Examples of questions to screen for human trafficking include [105; 106; 107]: • Can you tell me about your living situation? • Has anyone ever threatened you with violence if you attempted to leave? • Does anyone force/require you to have sexual inter- course for your work? • Has anyone ever threatened your family if you attempted to leave? • Does anyone make you feel scared at work? • Are you free to come and go as you wish? • Does your home have bars on windows, blocked win- dows/doors, or security cameras? • How many hours do you work? • Have you ever worked without receiving payment you thought you would get? • Do you owe your employer money? • Do you have to ask permission to eat, sleep, use the bathroom, or go to the doctor? The Polaris Project has developed a flow chart for the assess- ment of potential trafficking victims, available at https:// www.traffickingresourcecenter.org/sites/default/files/Assess- ment%20Tool%20-%20Medical%20Professionals.pdf. Again, if a person is thought to be a victim, healthcare providers should follow workplace protocols and/or contact the National Human Trafficking Hotline at 1-888-373-7888 for next steps. INTERVIEWING TRAFFICKED VICTIMS: BEST PRACTICE GUIDELINES Service providers should repeatedly weigh the risks and benefits of various actions when interviewing human trafficking victims [70; 108; 109]. Survivor safety is of utmost importance, and a private conversation should be sought, if at all possible. It may be necessary to be discrete or nonchalant when requesting to speak with the victim alone, as angering the trafficker may result in negative consequences for the victim. If the agency has a policy to always speak to patients alone, this may be easier to explain. Other strategies to separate a possible victim from a companion include stating the need for a private exam or testing (e.g., radiology, urine test). A companion’s assistance with paperwork may also be requested in an outside office or lobby. If the potential victim does not want to be alone or is reluctant to go to a private location, it is vital to respect her/ his wishes. In addition, the following interviewing recommendations were published by the World Health Organization to encourage service providers to continually and ethically promote human trafficking victims’ safety during every phase of the interview- ing process [102; 110]:
• Each victim and trafficking situation should be treated as unique; there are no standard templates of experi- ences. Listen carefully to the victim’s story. Each story told is unique, and each patient will voice distinctive concerns. Believe each story, no matter how incredible it may seem. As rapport and trust build (perhaps very slowly), accounts may become more extensive. • Always be safe and assume the victim is at risk of physi- cal, psychological, social, and legal harm. • Evaluate the risks and benefits of interviewing before starting the interviewing process. The interviewing process should not invoke more distress. In other words, the interviewing process should not end up re- traumatizing the victim. • Provide referrals for services where necessary; however, it is necessary to be realistic and not make promises that cannot be kept. Trust is vital because it has been severed on so many levels for trafficking victims. • Victims’ readiness to change will not be based on what society defines as “ready” or on social expectations. Some victims will eagerly grasp new opportunities, while others may be fearful of potential traffickers’ threats and be less receptive to help. • Determine the need for interpreters and if other service providers should be present during the interviewing phase. Ensure that everyone involved is adequately prepared in their knowledge about human trafficking, how perpetrators control their victims, and how to ask questions in a culturally sensitive manner. Keep in mind that often times, traffickers will offer to help with the interpreting. Using interpreters from the same community of the victim should be avoided to prevent breaches in confidentiality. • All involved should be prepared with an emergency plan. For example, is there a set plan for a victim who indicates he/she is suicidal or in danger of being hurt? • Always be sure to obtain informed consent. Remember that the informed consent process is going to be unfa- miliar to many victims. In addition, self-determination and autonomy have been compromised by continual threats and being forced to commit dehumanizing acts. Avoid using legal and technical jargon. Providers should assume that human trafficking victims are describing their reality to the best of their ability, given the trauma they have experienced. Responses and behaviors (e.g., being guarded, defensive, belligerent) may be coping mecha- nisms [99].
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MDTX1625
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