Human Trafficking - An Overview

The purpose of this article is two-fold. It is intended to bring awareness to the growing social concern of human trafficking, affecting the lives of numerous individuals receiving healthcare in the State of Texas. Secondarily, it offers an opportunity for emerging leaders to share information in the community of nursing administrators. The article is written by two students in the MSN Nursing Administration Program at the University of Texas at Arlington.  Included in the article is an overview of the issue of Human Trafficking as well as an exemplar of an actual situation occurring in the work place.

Human trafficking is a global trend impacting healthcare.  Although human trafficking has been occurring for centuries, it continues to be a serious problem in today’s society (Edmonson, McCarthy, Trent-Adams, McCain, & Marshall, 2017).   Human trafficking is the act of controlling individuals against their will for purposes such as labor or sex (Edmonson, McCarthy, Trent-Adams, McCain, & Marshall, 2017).  In the world, approximately 21 to 30 million people are victims of human trafficking (CdeBaca & Sigmon, 2014).  Sadly, this crisis is occurring in our backyard.  In Texas, an estimated 300,000 individuals are victims of human trafficking (Busch-Armendariz  et al, 2016).  Victims of human trafficking are subject to physical and emotional injuries that can have life-long effects (CdeBaca & Sigmon, 2014).  Some of the characteristics that victims of human trafficking may exhibit are fractures, bruising, urinary tract infections (UTIs) and sexually transmitted diseases (STDs) (Alpert, Ahn, Albright, Purcell, Burke, & Macias-Konstantopoulos, 2014).  Victims of human trafficking tend to display behaviors such as avoidance of eye contact, inability to answer questions, seeking of approval or reassurance prior to answering questions, and inconsistency in regard to the nature of injuries (Alpert et al., 2014).  Since these injuries can cause the victims to seek medical attention, it is imperative that nurses are attentive of the warning signs.  According to studies, healthcare workers in the United States missed the signs of victims who presented to healthcare facilities (CdeBaca & Sigmon, 2014).  Nurse leaders need to be aware of the prevalence of human trafficking and implement education for healthcare workers.  Healthcare organizations should have screening tools and protocol to identify victims of human trafficking.  Nurses are in an optimal position for identification and assistance.   Nurses are seen as a trusted profession (American, 2016).  This concept lends to the opportunity that victims may be more forthcoming regarding their situation.  Since nurses perform health assessments, they have the opportunity to recognize specific signs or other indicators characteristic of victims.  Nurses need to be attuned to responses or findings that require further inquiry.  Nurse leaders have the ability to provide nurses with the tools necessary to discover and assist victims of human trafficking.

Case Study

On the inpatient oncology unit, an Indonesian, middle aged female patient was admitted to possibly start chemotherapy after completion of a lymphoma workup. The patient was accompanied by a timid, young woman. Both women were non-English speaking. During the patient’s stay, the nurses began to notice an unhealthy relationship between the two. For instance, the patient would often yell and throw items at the young woman. The young woman never ordered food and was caught eating the patient’s leftovers from the trash. Neighboring patients began to complain about the disruptive noises coming from the patient’s room in the evening. The nurses suspected the actual patient was physically and verbally abusing the young woman. Despite such suspicions, lack of training left the nurses unequipped to promptly and properly address the situation. The cultural and language barriers presented additional challenges. Although nursing leaders were notified, they too were at a loss on how to best manage the problem. Several days went by before law enforcement was contacted and the young woman was discovered to a victim of forced labor.

The global public health issue of human trafficking (HT) is described as a modern form of slavery affecting the lives of approximately 20 million victims (Polaris, 2017b). With an array of physical and psychological problems requiring medical attention, healthcare professionals are in the frontline of advocating, treating, and protecting this vulnerable population (Grace et al., 2014). Unfortunately up to 50% of trafficking victims are unrecognized and unidentified in the United Stated by the healthcare worker (Grace et al., 2014). Nurses must uphold their social duty to the public and not be bystanders to injustices as described in the case study above. The inpatient nurses felt torn between an allegiance to care for the patient and advocate for the young woman. According to the American Nurses Association (2015), a nurse must practice ethically with compassion and respect for the dignity and worth of all people. An ethical practice environment is inclusive of everyone not solely the patient. Honoring such a responsibility requires proactive measures be made to assist nurses protect and defend the human rights of HT victims (Edmonson, McCarthy, Trent-Adams, McCain, & Marshall, 2017).

References:

Alpert, E. J., Ahn, R., Albright, E., Purcell, G., Burke, T. F., Macias-Konstantopoulos, W. L. (2014).  Human Trafficking: Guidebook on Identification, Assessment, and Response in the Health Care Setting.  Boston and Waltham, MA:  MGH Human Trafficking Initiative, Division of Global Health and Human Rights, Department of Emergency Medicine, Massachusetts General Hospital, & Committee on Violence Intervention and Prevention, Massachusetts Medical Society.

American Nurses Association. (2016). Nurses rank #1 most trusted profession for 15th year in a row.  Retrieved from www.nursing world.org

Busch-Armendariz, N. B., Nale, N. L., Kammer-Kerwick, M., Kellsion, B., Torres, M. I. M., Cook-Heffron, L. Nehme, J. (2016).  Human Trafficking by the Numbers: Initial Benchmarks of Prevalence & Economic Impact in Texas.  Austin, TX: Institute on Domestic Violence & Sexual Assault, The University of Texas at Austin.  Retrieved from http://sites.utexas.edy

CdeBaca, L., & Sigmon, J. (2014). Combating trafficking in persons: A call to action for global health professionals.  Global Health: Science and Practice,2(3).  Retrieved from www.ghsjournal.org

Edmonson, C., McCarthy, C., Trent-Adams, S., McCain, C., & Marshall, J. (2017).  Emerging global health issues: A nurse’s role.  OJIN: The Online Journal of Issues in Nursing, 22(1). doi 10.3912/OJIN.Vol22No01Man02

Grace, A. M., Lippert, S., Collins, K., Pineda, N., Tolani, A., Walker, R., Horwitz, S. M.

(2014). Educating Health Care Professionals on Human Trafficking. Pediatric

Emergency Care, 30(12), 856–861. doi.org/10.1097/PEC.0000000000000287

Polaris. (2017a). Service providers. Retrieved from https://humantraffickinghotline.org/audience/service-providers