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Home » Vision » March-April 2019 » Human trafficking has become a healthcare issue

Human trafficking has become a healthcare issue

By Kelly Herron

Millions of people around the world are subjected to imprisonment and human trafficking. Many of them are in the United States and present to healthcare ministry sites for care. Some people refer to it as modern-day slavery, and many people who are trafficked do indeed become enslaved. However, it is important to distinguish human trafficking as its own abhorrent activity with its own barriers and remedies.

“Trafficking in persons,” “human trafficking,” and “modern slavery” are used as umbrella terms to refer to both sex trafficking and compelled labor. The Trafficking Victims Protection Act of 2000 defines “severe forms of trafficking in persons” as:

  • Sex trafficking: the recruitment, harboring, transportation, provision, obtaining, patronizing, or soliciting of a person for the purpose of a commercial sex act, in which the commercial sex act is induced by force, fraud, or coercion, or in which the person induced to perform such act has not attained 18 years of age; (and)
  • Labor trafficking: the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery.

The key to this definition is force, fraud, or coercion. When these elements are present, human trafficking is a reasonable red flag to assess. Trafficking objectifies another human being and robs them of their dignity. It commodifies and abuses a whole person – physically, emotionally, mentally, and spiritually. Prior to the enactment of the TVPA in 2000, no comprehensive federal law existed to protect victims of trafficking or to prosecute their traffickers. The TVPA and its subsequent reauthorizations have worked to prevent human trafficking both in the U.S. and abroad.

The annual Trafficking in Persons Report outlines the progress made to eradicate this horrific crime from the U.S. and the world. The 2018 report “focuses on effective ways local communities can address human trafficking proactively and on how national governments can support and empower them. Local communities are the most affected by this abhorrent crime and are also the first line of defense against human trafficking. By engaging and training law enforcement, religious leaders, teachers, tribal elders, business executives, and communities, we become more vigilant and learn to identify and address vulnerabilities swiftly.” The report assigns a tier status to each country.

Tier 3: Countries that are the most egregious participants in human trafficking.
Tier 2: Countries that take part in human trafficking, but, according to the State Department, are making significant efforts to combat the problem.
Tier 1: Countries that are not significantly engaged with human trafficking.

The United States is a Tier 1 country, meeting the requirements to eradicate trafficking. As awareness of the problem grows, there are many calls in the U.S. for efforts beyond those requirements, and a cry for collaboration and interdisciplinary work.

To answer this call, we must identify our areas for improvement. For example, acknowledging how trafficking differs from domestic violence or child abuse is critical. Or, as a country, we need to look at how the lack of adequate laws lead to much variation from state to state, re-victimization of people who escape trafficking, and lack of adequate partnerships. A final example, law in all states does not require training in human trafficking before renewing a professional license or for certification. But in spite of variation, the landscape of human trafficking is changing for the better.

Statistics are difficult but not absent. The National Human Trafficking Hotline and Polaris’s BeFree Textline provide people affected by human trafficking with vital support and a variety of options to get help and stay safe. The 30,000-plus cases identified on these hotlines over eight years comprise the largest available data set on human trafficking in the U.S., although it has limitations. Question any statistic that shows a “count of victims” or “worst state” for trafficking. It is still hard to know the scope of the crime due to lack of reporting and stigmatization of victims.

Healthcare professionals were included late in the conversation on human trafficking. But the most common point of contact with people who are trafficked is in a healthcare setting.

Healthcare professionals were included late in the conversation on human trafficking, which has been a law enforcement issue until recently. But the most common point of contact with people who are trafficked is in a healthcare setting. Human trafficking is a public health issue. Through a public health lens, human trafficking is a communal issue and it is preventable. It will require multidisciplinary teams across many human service organizations, working together to end human trafficking and support survivors. This shifts the solution from only enforcing laws or treating presenting health issues to inclusion of a whole community and fostering systemic change.

For the spiritual care provider, understanding the demands on the healthcare team and the breadth of the problem increases the likelihood for quality, interdisciplinary care of victims. Healthcare professionals are both providing care in the current landscape and increasing their capacity — quickly — to care for people who are trafficked or at risk of it. It has helped to learn some basic facts about trafficking. For example, people are vulnerable for many social reasons, such as physical or sexual abuse, neglect, homelessness, poverty, or another type of marginalization in their community. We already have some solutions to respond to these social determinants. However, we need a renewal of what it means to cherish our fellow human being. We also need trauma-informed care training that includes a response protocol or decision tree.

A trafficker will seek healthcare in the most episodic setting. This may be a free clinic, urgent care, or emergency department. Any place where a person can receive care and be asked the fewest questions, that is where the trafficker will go. Healthcare professionals, including spiritual care providers, have a moral imperative to become aware and respond accordingly. This includes tempering the desire to rescue adults, which could put a person in more danger. Instead, supporting the person and connecting them to resources when it is safe to do so is the best first step. Commitment to awareness, quality, and comprehensive care protects human dignity and ensures for care of the whole person.

Kelly Herron is the chief mission officer at St. Joseph Mercy Oakland in Pontiac, MI.


About Vision
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Human Trafficking: What can chaplains do?

Trafficking is wide-ranging, but resources are available – by David Lichter,
Executive Director

The many faces of trafficking: A survivor’s story – by David Lewellen, Vision editor

Printed protocols help staff screen for trafficking victims – by Jodi Pahl

ICD-10 codes will raise awareness, gather data on trafficking – by Laura Krausa

Human trafficking has become a healthcare issue – by Kelly Herron

Caring for the caregivers on the front lines of trafficking – by Kimberly Williams and Hilary Chala

Medical advocate role helps trafficking survivors – by David Lewellen, Vision editor

Research Update

Human trafficking: Implications for Chaplains – by Sr. Nkechi Lilian Iwuoha, PHJC

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