January is Human Trafficking Awareness Month. The University of Vermont Medical Center Clinical Simulation Laboratory has programs that train healthcare professionals to identify and work with patients who are victims of human trafficking.
“Today, I want to discuss an issue that [. . .] ought to concern every person, because it is a debasement of our common humanity. It ought to concern every community, because it tears at our social fabric. It ought to concern every business, because it distorts markets. It ought to concern every nation, because it endangers public health and fuels violence and organized crime. I’m talking about the injustice, the outrage, of human trafficking, which must be called by its true name—modern slavery.” –Barack Obama
Human trafficking is not a problem confined to the developing world. This “debasement of our common humanity” occurs throughout the United States, and Vermont is no exception. I learned this first-hand when Rachel DiSanto, MD, highlighted the online advertisements for sex workers—often victims of human trafficking—here in the greater Burlington area at the Family Medicine continuing medical education event at the Sheraton Hotel Conference Center.
Dr. DiSanto’s presentation quickly relieved me of the naïve notion that human trafficking is not a rampant source of injustice in my community. Indeed, as the POTUS stresses in the epigraph above, human trafficking is an unconscionable feature of every corner and facet of our society, a disease that we can no longer continue to ignore.
Each year, second-year students at the Larner College of Medicine at UVM engage in public health projects designed to explore the interface between the role of a physician as a healer and as an advocate of community health. These projects allow medical students to work closely with community organizations and learn how—as future physicians—we will have the opportunity to help shape larger trends in health management, beyond the individual health of our patients. In collaboration with Give Way to Freedom—a local group dedicated to combating Human Trafficking in the state of Vermont—and Champlain College professor Duane Dunston, our group set out to tackle one of the most pressing issues facing this issue: effective identification of potential trafficking victims.
The healthcare setting would seem to be an ideal opportunity to identify victims of human trafficking. Indeed, according to the Annals of Health Law, estimates suggest that up to “87 percent of trafficking victims have had contact with a healthcare provider while being trafficked.” So then, what are the barriers to this group being identified by health care providers? While some of the problems facing the effort to screen for victims may be difficult to address, others represent concrete, modifiable dynamics that advances in healthcare practice and technology may serve to ameliorate.
Arguably, the greatest issue facing the appropriate identification of human trafficking victims in a healthcare setting involves the widespread lack of awareness and understanding of the issues pertaining to human trafficking and its key warning signs among healthcare providers, who may serve as a point of first contact for this vulnerable patient population.
One proposed solution to address this systemic problem is to standardize the process of screening for these patients by introducing an electronic screening tool that would reduce the immediate need for healthcare providers well-versed in this complex and often nuanced issue of social justice. While the imperative to educate healthcare workers on the issue of human trafficking is by no means diminished by standardizing the process of victim identification, a screening tool that would be available to anyone with access to an electronic device could serve as a valuable stop-gap measure until adequate competency in the healthcare setting can be achieved.
Given this need, the goal of our study was to assess healthcare worker receptivity to the implementation of an electronic screening tool. We conducted a survey of 27 Vermont healthcare providers across different specialties to gauge their opinions on the usability of an electronic screening tool based on an established method of risk-based screening for human trafficking. We found that 92 percent of healthcare providers reported that this too, or something similar, would be useful in a healthcare setting and would help them to identify trafficking victims.
Slavery still exists today, and one form is human trafficking. In the fall of 2015, the Obama Administration responded to the rising pleas to address the problem by committing to spend $44 million to help communities combat human trafficking.
Healthcare workers occupy a critical role at the forefront of this effort as people who are uniquely positioned to identify the risk factors of human trafficking. Support from the Obama Administration will go a long way toward education of healthcare workers, but it is also important to investigate alternative approaches to identifying victims.
A screening tool would enable healthcare providers with minimal training to ask highly sensitive questions of their patients, thus facilitating effective identification. With the overwhelmingly positive response we received from physicians here in Vermont regarding the potential use of this screening tool as a means of identifying human trafficking victims, we hope to see future work striving to implement standardized screening applications more broadly.
Stefan Wheat is a second-year medical student at the Larner College of Medicine at UVM where he is a member of the Class of 2018.