NURSE’S ROLE IN COMBATING HUMAN TRAFFICKING

One of the Global challenge in health care Delivery system is human

trafficking. Human trafficking is a major public health problem, both
domestically and internationally. Health care providers are often the only
professionals to interact with trafficking victims who are still in captivity. The
expert assessment and interview skills of providers contribute to their
readiness to identify victims of trafficking.

Human trafficking is modern-day slavery and involves the use of force,

fraud, or coercion to obtain some type of labour or commercial sex act. Article
3 paragraph (a) of Protocol to prevent, suppress and punishing trafficking
persons especially women and children, supplementing the United Nations
convention against transnational organised crime defines Trafficking in
Persons as the recruitment, transportation, transfer, harbouring or receipt of
persons, by means of the threat or use of force or other forms of coercion, of
abduction, of fraud, of deception, of the abuse of power or of a position of
vulnerability or of the giving or receiving of payments or benefits to achieve
the consent of a person having control over another person, for the purpose of
exploitation. Exploitation shall include, at a minimum, the exploitation of the
prostitution of others or other forms of sexual exploitation, forced labour or
services, slavery or practices similar to slavery, servitude or the removal of
organs.

Human trafficking is a hidden crime as victims rarely come forward to

seek help because of language barriers, fear of the traffickers, and/or fear of
law enforcement. Human trafficking has been broadly defined as “activities
involved when one person obtains or holds another person in compelled
service”; categories include sex trafficking, labor trafficking (including debt
bondage, forced labor, and indentured servitude), and trafficking in child
soldiers.

Where does human trafficking happen?

Human trafficking occurs everywhere. A country can be a source,

transit, or destination country, or any combination thereof. Human trafficking is
an extremely profitable endeavour; it’s believed to be the fastest growing
industry in the world and after drug dealing it is tied with illegal arms dealing
as the second-largest criminal industry.

Why does trafficking occur?

 The subordination of women in many societies, which leads to viewing
women and girls as economic burdens; a high worldwide demand for cheap
labor; and the disinterest of many governments in combating trafficking.

Who gets trafficked?

Although trafficking victims include people of all ages and both sexes, the
majority are women and girls.

Indicators of human trafficking

Recognizing key indicators of human trafficking is the first step in

identifying victims and can help save a life. Here are some common indicators
to help recognize human trafficking:

 Does the person appear disconnected from family, friends, community

organizations, or houses of worship?
 Has a child stopped attending school?
 Has the person had a sudden or dramatic change in behavior?
 Is a juvenile engaged in commercial sex acts?
 Is the person disoriented or confused, or showing signs of mental or
physical abuse?
 Does the person have bruises in various stages of healing?
 Is the person fearful, timid, or submissive?
 Does the person show signs of having been denied food, water, sleep,
or medical care?
 Is the person often in the company of someone to whom he or she
defers? Or someone who seems to be in control of the situation, e.g.,
where they go or who they talk to?
 Does the person appear to be coached on what to say?
 Is the person living in unsuitable conditions?
 Does the person lack personal possessions and appear not to have a
stable living situation?
 Does the person have freedom of movement? Can the person freely
leave where they live? Are there unreasonable security measures?

What does human trafficking look like?

Victims of human trafficking can be any age, gender, race, or
immigration status; they live in cities, suburbs, and rural areas. Human
traffickers relentlessly canvass ways to take advantage of people who find
themselves in circumstances of extreme adversity or violence, experience
discrimination, economic vulnerability, or dependence. Communities that
experience some of these hardships may be particularly vulnerable to human
trafficking.

Common health problems among trafficking victims

 Anxiety
 Chronic pain
 Cigarette burns
 Complications from unsafe abortion
 Contusions
 Depression
 Fractures
 Gastrointestinal problems
 Headaches
 Oral health problems
 Pelvic pain
 Posttraumatic stress disorder
 Sexually transmitted infections
 Suicidal ideation
 Unhealthy weight loss
 Unwanted pregnancy
 Vaginal pain

Human trafficking in India

Human trafficking is one of the major problems in India. Till date no
concrete study has been conducted so far to know the exact number of
trafficked kids in India. The New York Times has reported on the
widespread problem of human trafficking in India especially in Jharkhand.
According to the latest report on human trafficking by the United Nations
office on Drugs and Crime reveals that Tamil Nadu has 528 cases of
human trafficking in 2012. The number is next to West Bengal (549). As
per the data from home ministry, 1379 cases of human trafficking were
reported from Karnataka in the period of four years, in Tamil Nadu the
number is 2,244 whereas Andhra Pradesh has 2,157 cases of human
trafficking. Delhi is the hub of human trafficking trade in India and half of
the world’s slaves live in India (First spot). Delhi is the hotspot for illegal
trade of young girls for domestic labour, forced marriage and prostitution.
Delhi is also the transit point for human trafficking.
What is Blue Campaign?

The Department of Homeland Security (DHS)’s Blue Campaign

works to combat the heinous crime of human trafficking by raising
awareness around the country. Created in 2010, the Blue Campaign works
with law enforcement, government, non-government and private
organizations, to protect the basic right of freedom and bring those who
exploit human lives to justice. The Blue Campaign provides free resources
to educate and train professionals and the general public to recognize and
report human trafficking.

Nurse’s Role:
a. Identification of victim from behavioural characteristics-

• Accompanied by another person who exhibits controlling behaviour

• Has relocated frequently
• Is inconsistent in providing history or explanations of injuries
• Demonstrates submissive behaviour, anxious, fearful behaviour
• Is reluctant to give information
• Avoids eye contact

b. Identification of physical characteristics –

• Signs of battering/injuries
• Malnutrition/dehydration
• Poor personal hygiene
• Psychiatric/addiction disorders/suicide attempts
• Often do not have primary care providers
 Branding

Nurse as health care provider

• ALWAYS speak to your patient alone in private, remember how you
speak to your patient makes a difference
• Respect and understand cultural differences
• The health care provider role is NOT TO ‘RESCUE!’
Identification
• Thorough review of symptoms and physical assessment (including
mental health assessment)
• Treat immediate injuries
• Offer support, follow-up care
• Respect the right for self-determination
• Awareness of this issue and the health consequences are growing
but many nurses feel uncomfortable screening and responding to
victims

As a nurse educator

• Encourage future nurses to take an active role in combating all

forms of violence in our community
• Provide education to increase the comfort of all nurses to ask
appropriate questions in an effort to identify victims of violence
• Model compassion and respect
• Present a multidisciplinary model of care

Responsibilities as health care provider

• EDUCATION
• Collaboration with other providers and law enforcement
• Working to develop educational/training programs on identification
in your hospital
• Actively changing our beliefs and the language we use with regard
to victims
• Supporting our coworkers and our patients

Health Concerns

• Exposure to communicable diseases and risk for occupational

injuries(HIV, TB, other physical symptoms).
• STI’s
• Infertility/other reproductive problems-Related to long term effects of
violence
• Mental health: PSTD, anxiety, depression
• Substance abuse

Conclusion
 As nurses, we’re in a position to help make a difference in the lives of
trafficking victims at several points, from the initial encounter and
identification to their rescue and restoration to health.

References

1. U.S. Department of State, Office to Monitor and Combat Trafficking in

Persons. Trafficking in persons report 2004. Washington, DC; 2004.
2. U.S. Department of State, Office to Monitor and Combat Trafficking in
Persons. Trafficking in persons report 2006. Washington, DC; 2006 Jun.
http://www.state.gov/g/tip/ rls/tiprpt/2006.
3. U.S. Department of State, Office to Monitor and Combat Trafficking in
Persons. Trafficking in persons report 2010. Washington, DC; 2010 Jun.
http://www.state.gov/g/tip/rls/tiprpt/2010
4. Cole H. Human trafficking: implications for the role of the advanced
practice forensic nurse. J Am Psychiatr Nurses Assoc 2009;14(6):462-70.
5. Miller, C. L. (2013, September). Child sex trafficking in the emergency
department: Opportunities and challenges. Journal of Emergency Nursing,
39(5), 477-478. http://dx.doi.org/10.1016/j.jen.2013.06.004
6. Nursingworld.org
7. Tufts, K. A., Clements, P. T., & Karlowicz, K. A. (2009). Integrating intimate
partner violence content across curricula: Developing a new generation of
nurse educators. Nurse Education Today, 29(1), 40-47.
http://dx.doi.org/10.1016/j.nedt.2008.06.005