6
Recognizing and Responding to Human Trafficking in Texas: Summary
opportunities to interview the patient alone, as traffickers may accompany patients to their visits and insist on staying with them throughout the encounter. Requesting that the patient leave the room for specific tests, such as x-rays, or urine testing, even when not necessary, may provide time away from the escort to ask questions in a confidential environment. Examples of probing questions: • Has your identification or documentation been taken from you? • What are your working or living conditions like? • Where do you sleep and eat? • Can you leave your job or situation if you want? • Do you sleep in a bed, on a cot, or on the floor? • Do you have to ask permission to eat, sleep, or go to the bathroom? • Can you come and go as you please? • Have you ever been deprived of food, water, sleep, or medical care? • Are there locks on your doors and windows? Do you lock them or does someone else (e.g., so you cannot get out)? • Have you been threatened if you try to leave? • Have you been physically harmed in any way? • Is anyone forcing you to do anything that you do not want to do? • Has anyone threatened your family? Physical Examination A physical examination should be performed carefully and sensitively, guided by the clinical presentation and by information gleaned from the history. In cases involving sexual violence and other forms of trauma, forensic evaluation and evidence collection should be offered when appropriate (e.g., if the most recent sexual assault has occurred within 120 hours of presentation, and with the patient’s consent or in conjunction with mandated reporter responsibilities; Alpert et al., 2014).
Abuse and violence, including that resulting from human trafficking, should be suspected when any of these physical findings are noted. • Bilateral or multiple injuries • Evidence consistent with rape or sexual assault • Evidence of acute or chronic trauma, especially to the face, torso, breasts, or genitals • Pregnant woman with any injury, particularly to the abdomen or breasts; vaginal bleeding; or decreased fetal movement • Body tattoos that are the mark of a pimp or trafficker • Occupational injuries not clearly linked to legitimate employment Documentation Clinicians should carefully and accurately document all injuries and findings in the medical record, not only because this is standard care for all patients but because such data may be valuable if the patient seeks legal redress . Photographic documentation of physical findings may be appropriate, with the patient’s permission. Images should contain the patient’s face and the injury or lesion measured with a ruler or other common object (such as a coin). Patients should be informed that they have a right to refuse photographic documentation altogether or to restrict photographic documentation to certain specific areas if they so choose. The words suspected human trafficking as a finding, diagnosis, or problem should be included in the chart when appropriate. The Clinical Goal The healthcare provider should work to create a climate that allows every patient to feel safe, secure, cared for, validated, and empowered to disclose if they choose to. Disclosure might occur later if the patient does not feel ready to disclose in the immediate clinical setting. Therefore, each individual clinical encounter should be viewed as a step on a pathway to safety for at-risk patients.
Powered by FlippingBook