Human Trafficking

Having just given the IFM lecture on approach to a patient who's been assaulted, I mentioned that we didn't have time to cover elder abuse or human trafficking. Human trafficking is a growing problem. It is a problem throughout the U.S., not just in major cities with large immigrant populations. Here's a fact sheet with stats and information.

You can find trafficked people as street vendors (flowers, etc.) - all within the watchful eye of their captors. Some trafficked people don't even know that their situation is illegal - they come to the U.S. for a better life, for money for their family back home and how are they to know that they should not be locked in a house at night, have their wages taken and be abused.
Physicians and other health care providers may well be the first point of contact with trafficked people. They are brought in by their captors. Often their captors seem overly caring and speak for them (due to language barrier and because of  control) Physicians need to develop their antenna for trafficking. Here's fact sheets in different languages from DHHS. Children in prostitution and in trafficking mandate an automatic report. Helping adults is more complex.  The agency working on addressing human trafficking is the Dept of Labor. There is a national law preventing HT Trafficking Victims Protection Reauthorization Act of 2005. Getting people out of captivity and reporting the crime can occur if you report the finding. The downside is that it triggers an investigation in which the individual may or may not be deported. So they take a risk. But their life may be at risk in captivity.
Similar to IPV situations - separating oppressor from victim is key and getting a language translation service or individual can help.
Here's one example of a teaching unit on Trafficking from Mt Sinai/Osler/AMSA and Brown
Here's a nice powerpoint from the Floridian point of view:
Tips for the clinical exam:
At the very least - think about when you see dependent patients who are in low wage professions...they may be at risk. Knowing their options and sharing this with them can make a huge difference!

There is a Pennsylvania Lobbying Day to Prevent Trafficking on April 13th