Human Trafficking Clinical Presentation and Treatment in the ED;

A Teaching Module:

The purpose of providing this information to ED providers is to improve the quality of healthcare that victims of human trafficking receive upon presentation. Emergency care practitioners are one of the few groups of people on the frontline, able to facilitate the escape of trafficked persons. Armed with the knowledge of how victims present and the proper treatment available for them, providers can save lives. Appropriately implemented, such education should increase the number of victims identified and create safe opportunities for trafficked persons to leave unsafe and unjust living conditions.

The following is a module, meant to guide the educator; it is offered as an effective and efficient means of educating busy but dedicated practitioners. It is by no means all inclusive or fixed. Education facilitators should feel free to liberally use this guide in an effort to best train ED providers.

Pre-Session Assessment (~a week before the Session)

Introduction/Salutation (≤60 sec):

• Name & position (eg: Makini Chisolm-Straker, MSIV at Brown Medical)
• “I’d like to take 20 min to talk to you about human trafficking.”

Present Case Study (~60 sec):

“Obtunded teenage ♀, GCS of 5, presents to LA E.D., w/her older bro. She is bleeding from her vaginal canal; old/new burns, scars, cuts visible on wrists, ankles, neck. Pt. unresponsive, but bro reports she is schizo. & suspects a ‘dangerous abortion attempt.’”

• Ask grp what their next steps would be (what tests do they want, what more information do they need?) (~2 min, depending on grp size; try not too get involved in helping the grp determine what they want to do; answer questions you can, based on info Jill’s story; the questions you don’t know the answers to, nod, and say, “Ok, and anything else?”)
• Provide brief synopsis of what happened (emergent medical issue treated, discharged into care of bro)

Read Jill’s Abbreviated Story (~4 min)

Short Transition/Pause to PowerPoint Presentation (~ “So. I imagine that was a lot for some of you, especially since I didn’t give you any warning. So. Let’s talk about our role, in the care of trafficking victims, as providers in the E.R.”)

PowerPoint Presentation (guiding notes included in powerpoint)

Post-Session Evaluation (immediately following presenation)

Before you give this presentation you should be familiar with the following resources:

1. www.polarisproject.org; read US testimonies
2. Trafficking Victims Protection Reauthorization Act of 2005
3. Jill Leighton, Ashek Hamid, and Ricardo Veisaga’s entire stories (included or visit: http://ex-oriente-lux.org/acc_usa_01.html (Leighton)

http://www.npr.org/templates/story/story.php?storyId=3282013 (Hamid;

audio version—transcript fee: $3.95)

http://chicagoreporter.com/2006/5-2006/trafficking/trafficking1.htm

(Veisaga))

4. “Hiding in Plain Sight” (included or visit: http://www.uri.edu/artsci/wms/hughes/hiding_in_plain_sight.pdf); note that this document is dated and refers to the TVPA of 2000; the Reauthorization 2005 does protect domestic victims, as well as international victims.
5. conceptual framework chart (included or visit: http://www.salvationarymusa.org/usn%5Cwww_usn.nsf/vw-sublinks/820384F6BA996E585256F25005D5274?openDocument)

More resources on human trafficking:

1. 1-888-373-7888
2. 1-888-428-7581 (voice and TTY)
3. local Polaris Project chapter
4. local anti-trafficking groups (important to find out about the healthcare needs and presentation of the victims in your area)
5. local US Attorney’s office