Healthcare visits

It is estimated between 28% to 88% of victims of trafficking, depending on their location and the type of forced labor, are seen in medical facilities during their forced servitude (Baldwin, et al, 2011; Ledere & Wetzel, 2014; Mumma et al, 2017). One victim in one study worked in a long-term care facility. When questioned by a family member who noticed she worked every day, the victim denied there was a problem.

Types of encounters

At small, private medical facilities or doctors’ offices, victims reported being seen for nonurgent care. These visits were prompted by conditions that prevented the victims from working such as respiratory illnesses, injuries or sexually transmittable diseases. Here’s one victim’s description of an injury from which she suffered for 10 days before being seen:

One time, I was cleaning the restroom. I was cleaning the wall, and I was on a chair. I slipped and fell to the floor. It was a hard fall; it’s a cement floor. I couldn’t get up. I was very dizzy ... For 10 days, I had some fluid coming from my left ear ... I couldn’t hear. I had a lot of pain (Baldwin et al, 2011, p. 40).

Emergency department visits were frequent for serious, urgent issues such as broken bones and concussions.

Hispanic traffickers are known to take victims to Las Curanderas, traditional Hispanic healers. Curanderismo is a healing approach based on faith and knowledge of the healing attributes of plants. Some of the victims did not believe in the validity of these approaches for their illnesses. Here was Teresa’s comment in her interview:

They used to take us to people who used to ... do cleansing, like witches, like curanderas (Baldwin, et al, p. 40).

Ledere and Wetzel (2014) studied 106 survivors of sex trafficking, 99% reported a minimum of one physical health issues. The most frequently reported physical problems were neurological (91.5%) which included memory and concentration issues (82%) and headaches (54%).

The subjects also reported the following contacts with various health care providers:

Red flags or signs the patient in the ED may be a victim of traffickers

Where they work

According to the hotline call in center of 4,460 cases, sex trafficking is the most common area of trafficking with 3,186 calls (71%) in the U.S. related to sex trafficking in 2017. Here are the most common venues for sex trafficking.

Types of health issues

The following are common health issues reported in a number of articles (deChesnay, 2013;Lederer & Wetzel, 2014; Becker & Bechtel, 2015; Shandro et al, 2016; Gibbons, & Stoklosa, 2016; Mumma et al, 2017) for which victims of trafficking can be seen in health care facilities, for which they should be screened:

Physical Injuries

Psychosocial distress

What to look for

Healthcare providers are some of the few groups that have frequent contact with victims of trafficking. They are in a unique position to provide support and assistance.

What to look for initially

Indicators of Human Trafficking

Trafficking victims are rarely seen in healthcare facilities.