Human trafficking: Health care workers can be the first line of defense

Human trafficking cases have continued to rise in Texas since 2007. In 2020, a statewide survey by the Texas human trafficking council recorded the highest number of arrests related to human trafficking, with the Dallas-Fort Worth metropolitan area accounting for 35% of the state's commercial sexual exploitation cases. And these numbers only continue to rise.

The International Labor Organization estimates that there are currently 25 million victims of human trafficking around the world, which accounts for $150 billion in illegal profits per year.

Victims of human trafficking are mainly from socioeconomically vulnerable populations and broken families.

Even more sickening, human trafficking rings often seek out and recruit their victims from drug rehabilitation centers, in addition to behavioral and mental health centers.

Human trafficking frequently exposes victims to forms of physical and psychological torture. Victims often suffer from malnutrition, physical trauma and sexually transmitted diseases. They face sleep deprivation, drug use and abuse — often forced upon them by their captors — and mental health issues such as post-traumatic stress disorder, anxiety and depression.

Moreover, human trafficking allows the potential for the unchecked spread of infectious disease, such as the human immunodeficiency virus. Trafficked individuals, moving frequently, can unintentionally become vectors for diseases, adding stress to local health care systems.

One report conducted by Polaris, a survivor-centered movement to end human trafficking, estimates that up to 88% of human trafficking victims access health care services.

The frequent use of healthcare facilities by victims presents a clear opportunity for health care individuals to spot and report potential human trafficking situations; however, the Polaris report claims that only 6% of health care professionals have reported treating a victim of human trafficking, and over half of survivors reported never being asked trafficking or abuse assessment questions during their health care visits.

The inability of health care personnel at every level to screen for, and identify, potential human trafficking cases is inexcusable and needs to be improved both individually and systemically.

Combating human trafficking isn't just a moral obligation; it's a pragmatic one. It's about protecting human rights and dignity and ensuring the sustainability of our healthcare systems.

So, what can be done? International collaboration and border control are key to preventing the unchecked influx of human trafficking victims. In addition, more efforts need to be spent on infiltrating and surveilling human trafficking rings.

Health care workers must be educated about the signs of trafficking, and there must be safe and easy ways to report their suspicions.

When a captive comes into a health care facility with a controller, some common controlling behaviors and signs to look for include: the controller insisting on being present at all times, holding the patient's identification or documents, filling out paperwork without consulting the patient, and claiming to have a familial relation to the patient, but not knowing details about medical history or identity.

The U.S. Department of Health and Human Services has been designing an online training course for health care workers to learn how to spot these characteristic signs of human trafficking, and how to respond appropriately.

Most important, after human trafficking victims have been identified and separated from their controllers, it is critical the survivors be provided with adequate support to reintegrate into society to reduce long-term health issues and be protected from future human trafficking scenarios.

The issue of human trafficking cannot be solved with governmental and institutional policy alone. Hospitals and health care systems can do their part to create a culture, from the ground up, that encourages their employees to learn to recognize the signs and screen for human trafficking scenarios. Even more, schools of health professions need to educate future providers on the importance of this issue and how they can make a difference. Until then, human trafficking victims will continue to fall through the cracks in our health care system.

Brian Rezel Carr, M.D., D.M.D., is an oral and maxillofacial surgery resident in Dallas. He wrote this article for The Dallas Morning News.

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