The Trafficking Victims Protection Act was passed in 2000, officially making human trafficking a federal offense. The act also created the Office to Monitor and Combat Trafficking in Persons, which, along with the Department of State, publishes the TIP Report annually (U.S. Department of State, 2015). The act, which is enforced by the Interagency Task Force to Monitor and Combat Trafficking, also established the T visa, allowing eligible trafficked individuals and their families to become temporary U.S. residents, with eligibility to become permanent residents after 3 years. Law enforcement officials should be contacted with discretion and when needed. Law enforcement is often crucial in creating a multidisciplinary team. However, calling law enforcement at the wrong time could cause the trafficked person to worry about the risk of arrest and other legal developments. Building trust is vital, and this trust may include telling the trafficked person when and whether law enforcement will be called. With
pediatric cases, however, there are more challenging aspects to involving law enforcement. Some communities have a human trafficking task force as part of their law enforcement services. Task force members are often trained in trauma-informed approaches and the need to gather a thorough account of the trafficking details. Task forces can help provide a wide range of services such as case management and safety plans to help victims escape their trafficker over time. Social services Social work professionals should be included in the care of trafficked individuals whenever possible. These members provide invaluable insight into many of these areas of recovery for trafficking survivors and have previous experience working with organizations such as Child Protective Services and the Department of Justice.
BARRIERS TO INTERVENTION
A number of limitations may create obstacles to providing ideal interventions for patients. Some of these are due to the complicated relationship and social dynamics between trafficked individuals and their traffickers .Others may be a consequence of difficulties in communicating; for example, a translator may not be available for those who are not fluent in the language, or the patient may be unable to read the written literature or other resources provided. Communication is vital, both between providers and patients and between organizations. Therefore, it is important to have a variety of resources available, such as written literature for those who are literate and an alternative message for those who are not. Without clear lines of communication, it is difficult to determine what resources are needed and what partners are available to aid in patient care. Institutional protocols for human trafficking cases require flexibility to accommodate the wide variety of cases and a robust collection of resources to address trafficked individuals’ needs adequately. The level and type of response may vary by person, but all protocols need coordination between disciplines Documentation requirements Documenting interactions with patients is standard in many healthcare settings and for all levels of professionals. These records are especially important and sensitive in cases of human trafficking, because documentation may be vital in tracking the health of a trafficked individual and future legal redress (Alpert et al., 2014). Keeping secure, accurate, and unbiased records of quotes, oral disclosures, and written descriptions provides invaluable information. When creating a protocol, healthcare providers should consider standardized procedures for documenting and securing privacy for all records. Specific considerations in documentation include written descriptions, sketches, and photographic evidence of injuries, with patient permission (Alpert et al., 2014). Initial and serial follow-up documentation may be useful in following the progression of injuries. Protocols should incorporate trauma- informed care practices by respecting and informing patients of their right to refuse details or not allow photographic evidence. (These practices may inflict retraumatization.) Forensic evidence Documentation of forensic evidence is extremely important in cases that involve sexual assault. Medical personnel with specific forensic training – such as sexual assault nurse examiners or forensic nurse examiners– are ideal team members to collect forensic evidence. They specialize in
One subjective barrier is the healthcare provider’s expectations for the case. Healthcare professionals must remember that trafficking cases do not always resolve quickly, and must refrain from making choices for the trafficked person. Each trafficked individual has a unique set of concerns to address that may affect his or her ability to escape from trafficking. Being aware of these common needs of trafficked individuals can help providers circumnavigate these obstacles. Furthermore, although interventions may seem ineffective in the case of delayed escape from trafficking, the healthcare provider’s efforts, as well as empathy toward trafficked individuals, can empower a person to leave during the right circumstances.
BUILDING A PROTOCOL
and fields and a comprehensive approach (Alpert et al., 2014). Both immediate (nutrition and physical protection) and long- term (Legal services and permanent housing) needs should be considered. The general principles to help guide the creation of a protocol are discussed here. collecting methods, facilitating postassault health care, and obtaining detailed and compassionate histories (Alpert et al., 2014). Protocols should include procedures for what agencies and collection processes will be used in cases of sexual assault. Mandatory reporting The awareness of trafficking has risen greatly over the past decade, and new laws address this crime. Some states mandate that professionals, including those in health care, report cases of child trafficking. Nearly all states require healthcare professionals to report child abuse and neglect (Child Welfare Information Gateway, 2019); however, whether human trafficking falls under the legal definition of these categories is determined at the state level. The National Conference of State Legislatures provides a list of human trafficking laws specific to each state (see Resources; National Conference of State Legislatures, 2020). At present, most states do not have a mandatory reporting requisite for human trafficking cases. As the public gains human trafficking awareness, more states are adopting legislation and mandates for reporting. Healthcare professionals must know the legal requirements of reporting within the state of practice and to proceed accordingly. Reasons for not wishing to report cases of human trafficking are complex and largely center on the need to maintain the patient’s trust. Trafficked individuals often have a powerful
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