distrust of authority, especially law enforcement. They fear legal repercussions for themselves, especially when involved in commercial sex exploitation and may worry about potential Security for both patient and healthcare professionals In some instances, angry individuals involved in trafficking may come to the establishment to which a trafficked individual has fled and attempt to use force or aggressive coercion to regain control and possession of the individual. Traffickers may use desperate and violent measures to obtain what they believe to be their property. Patient resources Having current patient resources available is a critical component to providing trauma-informed care. Taking a collaborative approach has several benefits, including increasing awareness of the toolkit throughout the workplace and developing a support team to help keep the resources up to date. Effective protocols are based on proactive coordination with a range of professionals, such as law enforcement and social services. This means creating and updating a list of national and local resources that will provide the highest quality of Conclusion Human trafficking occurs in countless ways. The law defines trafficking by the force, fraud, or coercion used to influence the trafficked person to meet the needs of the trafficker. Further examination of the process of trafficking reveals its elements of means, act, and purpose. A review of the means and purpose provide better insight into the atrocities that leave victims with serious health consequences. Traffickers are able to manipulate others by using psychological methods as well as recruitment, transit, and exploitation. Some of these exploitative measures involve techniques similar to those used in torture. Once a survivor is able to leave, the possibility of retrafficking remains, as does the possibility of detention and its related horrors. These experiences, along with Department of Health and Human Services (HHS) The Department of Health and Human Services has developed several initiatives and programs, including the Anti-Trafficking in Persons Program (ATIP) and the Stop, Observe, Ask, and Respond (SOAR) to Health and Wellness Training program. ATIP works to increase awareness of the issue through campaigns such as Rescue and Restore while aiding survivors in becoming eligible for public benefits and services, similar to those available for refugees. The SOAR to Health and Wellness Training program focuses on training healthcare providers on protocols and increased awareness, highlighting the need to provide patient-centered trauma- informed care. Department of Homeland Security (DHS) The Department of Homeland Security has created the Blue Campaign, a collaboration among law enforcement, government, nongovernment, and private organizations to protect the rights of trafficked persons. The Blue Campaign provides information and training for professionals across many fields to recognize and assist those who are trafficked. The Blue Campaign’s most recent task is to implement the Justice for Victims of Trafficking Act (2015), increasing training on deterring, detecting, and reporting potential trafficking. The Department of Homeland Security Hotline is available to report suspected trafficking cases: 1-866-347- 2423. Department of Justice A number of organizations within the Department of Justice advocate for and assist trafficking survivors in obtaining legal representation and prepare lawyers and Resources Government & Legal Resources
retribution when their traffickers find out they contacted the authorities. Being aware of these complexities and the existing laws will aid in selecting the appropriate course of action.
Healthcare institutions should have a protocol for aggressive persons. Common themes of safety protocols include fleeing from the aggressor when possible, hiding, and fighting only when absolutely necessary. The security protocol should establish which phone numbers to call in cases of emergency and the best escape routes from the building should an attacker become an active shooter. care and give trafficked individuals the best hope for recovery and integration. Organizations and themes mentioned in the Resources are a starting point for identifying what resources to incorporate in a protocol’s toolkit, including survivor network organizations. Once the toolkit is created, it is essential that it be regularly updated. New organizations can be created, and contact information for existing groups may change over time. Updated information is essential to providing good care and connecting victims with resources, existing risk factors, are what drive the cycle of trafficking and traumatization. Identifying and providing care for a trafficked individual can be challenging at times. Even before confirming that a patient is being trafficked, trauma-informed practices should be in place to prevent retraumatization of patients. Healthcare systems such as a hospital or group practice can adopt trauma-informed care, as can individual health professionals. As more is understood about human trafficking patterns and practices, resources can be refined, thus improving current infrastructure and developing new protocols. All healthcare professionals can take it upon themselves to stay informed about the issues surrounding human trafficking and the progress being made in supporting survivors. law enforcement officials to handle trafficking situations. These include the Human Trafficking Prosecution Unit, the Anti-Human Trafficking Task Force Initiative, and the Child Exploitation and Obscenity Section. The National Conference of State Legislatures This organization provides information on human trafficking laws related to mandatory reporting, available at http:// www.ncsl.org/research/human-services/redirect-mandatory- rprtg-of-child-abuse-and-neglect-2013.aspx https://www.ncsl.org/research/civil-and-criminal-justice/ human-trafficking.aspx The U.S. Citizenship and Immigration Services (USCIS) This organization helps trafficking survivors navigate the legal rights to which they are entitled, such as obtaining Continued Presence (CP) status, T visas, and U visas. Both the T visa and U visa give trafficking survivors the right to work within the United States if they are foreign nationals (USCIS, 2017). CP status is the short-term variation of the longer-term “T nonimmigrant status,” or T visa. The “U nonimmigrant status,” or U visa, is conferred to persons who committed certain crimes but are helpful in investigations or prosecutions. Survivors of human trafficking are eligible for both visas; the difference is in the level of cooperation required. The T visa may also eventually lead to eligibility for citizenship (USCIS, 2014). These visas and services from the DHS are important to empowering survivors, especially foreign nationals who were transported under fraudulent pretenses.
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