Remember the person, not just the case of human trafficking
Human trafficking is a phenomenon that has been going on for ages. In today’s world, the chains used by the traffickers are invisible making the crime even harder to combat. Health care professionals have a role to play in fighting the vice. This is what they need to know.
On 23.08.2018, I attended a seminar organized by IOM Finland, the Embassy of the United States of America in Finland, and the National Institute for Health and Welfare (THL). The guest speaker, Hanni Stoklosa, a medical doctor from the USA and an expert on human trafficking, talked about her experience in identifying and caring for victims of trafficking. Being a professional nurse myself, it surprised me to hear that based on a U.S study 68% of trafficked persons had gone through the health services while being trafficked. It got me wondering, “how many times have I crossed paths with a victim without noticing?” Doctor Stoklosa went through how one can recognise a victim of trafficking, what health consequences the victims are exposed to, and how to approach the victims. She brought up some signs to pay attention to:
- Symptoms of trauma (physical or psychological);
- Simple symptoms that have not been treated, like small wounds which have become infected;
- Patient is accompanied by a minder who insists on being with the patient all the time;
- Patient is fearful and mistrustful;
- Patient may not know where he/she is.
Trauma re-wires the brain of trafficking victims
Traumatic events experienced by victims of trafficking may trigger a flight or fight mode or make them freeze when faced with situations that remind them of their experiences. This may be just a touch, a sound or a thing they are asked to do. The victims may be angry or difficult to deal with. How the victim reacts to health personnel should not be taken personally, it may be just a part of the brain wiring reacting to past trauma.
As a health care professional, what stood out for me was the concept of trauma-informed care. This was basic information on how to communicate with any patient but especially victims of trafficking. Trauma-informed care in a nut shell consists of:
Basic communication. Speak to the patients in a normal tone, maintain eye contact.
Be aware of reactions. All health professionals should be aware of their own reactions, body language and tone of voice. We should also pay attention to our patient’s reactions, body language and changes in tone. Be aware of the tone of the interpreter and if the patient’s behaviour changes with the presence of an interpreter.
Explain what is happening. We should always ensure that we explain to the patient what we are going to do in clear and simple language. If it is an x-ray, explain what will happen even before the patient gets to the x-ray room.
Give control back to the patient. Respecting the patient’s wishes even though you do not agree with their choices.
Ask for permission. Always ask the patient for permission before you do anything. Ask if it is ok to give details about their situation to the next person. By doing so, you give the patient control offer their own care.
Health professionals’ checklist in treating trafficking victims
In the afternoon session, there were different case studies and group discussions. The discussions brought to light how different professional groups observe things and react to trafficking victims. The beauty of it was that the different professional groups can all be of value in ending the trafficking chain.
By the end of the day the, I think the most important nuggets for healthcare professionals were:
- Cater for the needs presented
- Recognize the victim’s feelings
- Be aware of your own reactions
- Give the power back to the victim
- Create an environment of trust with the victim
- Do the records well. They may be used to help the patient get justice
- Keep the door is open for assistance, even if the victim at that moment is not be able to accept it
- REMEMBER THE PERSON, NOT JUST THE CASE.
The writer is a registered nurse working for IOM Finland in the area of health and migration
The views expressed by the authors in IOM Finland's blog are their own and do not necessarily reflect the official views of the International Organization for Migration.
- IOM Finland’s guideline for early identification and referral of victims of trafficking (HOIKU project) in Finnish
- Finnish National Assistance System for Victims of Trafficking