In Human Trafficking Cases, Doctors Lack Confidence to Intervene

Victims of human trafficking are ripped from the familiarity of home and deluded into a numbing isolation. Hidden in plain sight, they are often bullied and tricked into believing their situation is normal, yet it’s inescapable. They suffer in silence, enslaved for forced labor or sex.

When the abuse results in a pregnancy or an injury that can’t be ignored, a rare instance arises: Victims directly interact with health care providers. Clinicians have the power to connect these vulnerable individuals to the resources they desperately need but are too afraid to seek independently.

Yet a vast majority of health care workers—almost 80 percent—don’t feel they have adequate knowledge to assist those victims, according to new research in the U.K.

The study, published in BMJ on Thursday, reveals the findings of almost 900 interviews with professionals in the National Health Service, the U.K.’s nationalized health care system.

While 13 percent of respondents—about one in eight—reported having encountered a victim of trafficking in their practice, most said they had insufficient training to identify, help, and make referrals for victims.

“People scored highly on questions about the definition of trafficking, and they seemed to be comfortable about what trafficking was,” said author Siân Oram, a doctor and lecturer at King’s College of London. “Where they lacked confidence was what they should do if they suspected it.”

More than 78 percent of hospital-based professionals surveyed said they didn’t have enough training to help trafficked individuals.

Human trafficking is a global problem, and it’s believed an estimated 21 million victims are being exploited in every country, according to the International Labour Organization.

American pediatrician Kanani Titchen knows all too well what it’s like to see signs of trafficking but not feel confident enough to assist the victim. She’s still haunted by a time when she recognized a new mother as a potential victim but did not act. The woman was manicured and made up but smelled as if she hadn’t bathed in days. She was accompanied by a man.

“Something felt very off to me…. I wanted to find a way to talk privately with the patient, but I felt intimidated too,” she said. “I told one of the nurses that the whole situation made me uncomfortable, and she agreed, and she told me that social work had already been called. I had two other deliveries to go to, an NICU full of babies awaiting me, and paperwork to do. So I left.”

That experience inspired Titchen to found Physicians Against the Trafficking of Humans, a website that gives doctors screening questions and resources for suspected human trafficking victims.

“Whether we see these patients in the [operating room], the E.R., or the clinic, if we fail to notice the signs of trafficking, demonstrate empathy, ask pertinent questions, and schedule close follow-up, we fail these patients,” Titchen said.

While some training packages that teach National Health Service professionals these skills are available—there’s one prominent e-learning module through the U.K. Department of Health—they aren’t widely used, according to Oram.

This is a concern, because clinicians have a unique chance to intervene in instances of human trafficking—and the National Health Service is one of the largest employers of health care workers in the world.

While 75 percent of National Health Service professionals in Oram’s study reported wanting to be educated about human trafficking, training still focuses on the rather complex work of medicine, according to Anthony Steen, chairman of the Human Trafficking Foundation and former member of parliament.

“All the doctors I know…I can’t fault them,” Steen told TakePart. “But they’re very narrowly trained in medical care. They’re not trained to look out for the telltale signs: Was the girl nervous? Was she looking over her shoulder? Did she come with a girlfriend? Did she come with a very authoritarian woman? Was it a young man? Did he look bruised or beaten?”

Since this study is one of the first in the U.K. to consider the interaction of human trafficking victims and health care professionals, Oram hopes it will lead to further research and a change in the way health care providers are trained.

“I think what health care professionals need to be thinking about is that any opportunity to interact with a victim of trafficking is an opportunity to provide help,” she said.