Between 14,500 and 17,500 human beings are trafficked into the United States annually, and about half of all those who have been trafficked have had some contact with a medical professional.
“Fifty percent of the time there was an opportunity to potentially help these women. These people are not able to go out to a restaurant or go shopping, but they do come to us in labor, they come in with vaginal bleeding, they come in acute pain. We are uniquely posed to help and identify these women,” said Erin E. Tracy, MD, MPH, Saturday morning during “Modern Day Slavery: A Look at Human Trafficking,” this year’s Anna D’Amico Lecture.
Dr. Tracy, obstetrician and gynecologist at the Massachusetts General Hospital Department of Obstetrics & Gynecology, gave the audience an understanding about the scope of the problem in the United States, discussed ways to identify patients at risk, and shared resources available to physicians to help trafficking survivors.
The problem is widespread across the United States, she said. The top 20 trafficking jurisdictions go from coast to coast, touching every corner, the deep South, and the heartland.
Sex trafficking often goes under the cover of massage parlors, escort services, adult bookstores, modeling studios, bars, and strip clubs. Labor trafficking can be found in sweatshops, commercial agriculture, domestic services such as maids and nannies, construction sites, and restaurants and custodial work.
During Saturday’s presentation, Dr. Tracy showed an algorithm from the National Human Trafficking Resource Center (NHTRC) that medical professionals can use to determine if a patient is a trafficking victim. It includes potential red flags and questions to ask a patient when the two are alone to help determine the patient’s situation.
Common patient presentations include STDs, unsafe ETPs, chronic pelvic pain, poor oral health, anxiety, depression, PTSD, suicide attempts, and HIV. Doctors should suspect trafficking if girls visit with an older non-relative, have unexpected material things, are overly familiar with sex or have a tattoo they are reluctant to discuss.
Dr. Tracy closed her presentation with a look at how to help survivors through trauma-informed care. Many survivors experience a lack of control in medical settings. Care providers should ask patients how to make them more comfortable in the clinical setting, such as setting up a verbal cue for distress, keeping the door ajar or including a support person in the room.
Information is available from the NHTRC, at https://traffickingresourcecenter.org/.
“I really believe this is a moral imperative,” she said. “I believe this is both an international and national crisis. I believe that this is a real phenomenon, and I shudder to think about the women I’ve missed. I started asking when residents present patients to me, ‘has she been trafficked?’ And they look at me like I’m insane because that’s just not something we’re comfortable with.”