Abstract
Background
Human trafficking victims experience extreme exploitation and have unique health needs,
yet too often go undetected by physicians and providers in the Emergency Department
(ED). We report a clinical case of human trafficking of a white, English-speaking
United States citizen and discuss the features of presentation and treatment options
for human trafficking victims upon presentation to the ED.
Case Report
A 29-year-old woman with a past medical history significant for intravenous drug abuse
and recent relapse presented to the ED after a reported sexual assault. The patient
was discharged that evening and returned to the ED the following day acutely suicidal.
The patient divulged that she had been kidnapped and raped at gunpoint by numerous
individuals as a result of a debt owed to her drug dealers.
Why Should an Emergency Physician be Aware of This?
Many human trafficking victims present to an ED during the course of their exploitation.
To that end, EDs provide one of a limited set of opportunities to intervene in the
human trafficking cycle of exploitation, and physicians as well as other ED staff
should be equipped to respond.
Keywords
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References
U.S. Department of State: Diplomacy in Action. Washington, DC: U.S. Department of State. What is modern slavery? 2010. Available at: http://www.state.gov/j/tip/what/index.htm. Accessed July 18, 2015.
- H.R. 3244: Victims of Trafficking and Violence Protection Act of 2000.Library of Congress. United States Congress, 2000 (Available at:) (Accessed July 18, 2015)
- Recognizing victims of human trafficking in the pediatric emergency department.Pediatr Emerg Care. 2015; 31: 144-147
- Trafficking in persons: U.S. policy and issues for Congress.Congressional Research Service, Washington, DC2013
- Human trafficking in the emergency department: hiding in plain sight?.American Public Health Association, New Orleans, LA2014 (Available at:) (Accessed July 18, 2015)
U.S. Department of State: Diplomacy in Action. Trafficking in persons report 2015. Available at: http://www.state.gov/j/tip/rls/tiprpt/2015/. Accessed July 18, 2015.
- Turning pain into power: trafficking survivors' perspectives on early intervention strategies.Family Violence Prevention Fund, San Francisco2005 (Available at:) (Accessed July 18, 2015)
- Identification of human trafficking victims in health care settings.Health Hum Rights. 2011; 13: E36-E49
- The health consequences of sex trafficking and their implications for identifying victims in healthcare facilities.Ann Health Law. 2014; 23: 61-91
- Caring for Trafficked Persons: Guidance for Health Providers.International Organization for Migration, Geneva, Switzerland2009 (http://publications.iom.int/bookstore/free/CT_Handbook.pdf. Accessed July 28, 2015)
- Sex trafficking of women and girls.Rev Obstet Gynecol. 2013; 6: e22-e27
- Psychological coercion in human trafficking: an application of Biderman's Framework.Qual Health Res. 2015; 25: 1171-1181
- Prevalence and risk of violence and the physical, mental, and sexual health problems associated with human trafficking: systematic review.PLoS Med. 2012; 9: e1001224
- Health of men, women, and children in post-trafficking services in Cambodia, Thailand, and Vietnam: an observational cross-sectional study.Lancet Glob Health. 2015; 3: e154-e161
Banks D, Kyckelhahn T. Characteristics of suspected human trafficking incidents, 2008-2010. Special report, US Department of Justice. Available at: http://www.bjs.gov/content/pub/pdf/cshti0810.pdf. Accessed July 18, 2015.
- An international comparative public health analysis of sex trafficking of women and girls in eight cities: achieving a more effective health sector response.J Urban Health. 2013; 90: 1194-1204
- Human trafficking in the emergency department.West J Emerg Med. 2010; 11: 402-404
- Human trafficking health system protocol development: a tale of two coasts.Paper presented at the American Public Health Association, Chicago, IL2015
- Sexually transmitted coinfections among HIV-infected sex-trafficked women and girls, Nepal.Emerg Infect Dis. 2008; 14: 932-934
- The relationship of trauma to mental disorders among trafficked and sexually exploited girls and women.Am J Public Health. 2010; 100: 2442-2449
- Combating slavery in the 21st century: the role of emergency medicine.J Health Care Poor Underserved. 2012; 23: 980-987
- Domestic sex trafficking of minors: medical student and physician awareness.J Pediatr Adolesc Gynecol. 2015; ([Epub ahead of print])https://doi.org/10.1016/j.jpag.2015.05.006
- Medical providers' understanding of sex trafficking and their experience with at-risk patients.Pediatrics. 2015; 135: e895-e902
- Health care providers and human trafficking: what do they know, what do they need to know? Findings from the Middle East, the Caribbean, and Central America.Front Public Health. 2015; 3: 6
- Human trafficking education and assessment for medical students.Poster session presented at the American Public Health Association Annual Meeting and Exposition, Chicago, IL2015
Miller C. Toward evidence-based practice for sex trafficking survivors. Paper presented at the 25th International Nursing Research Congress, Hong Kong; 2014.
- Educating health care professionals on human trafficking.Pediatr Emerg Care. 2014; 30: 856-861
- Human trafficking: review of educational resources for health professionals.Am J Prev Med. 2013; 44: 283-289
- Medical education on human trafficking.AMA J Ethics. 2014; 17: 914-921
- Network of health professionals combatting human trafficking – HEAL Trafficking.Paper presented at the American Public Health Association, New Orleans, LA2014
Stoklosa H. HEAL trafficking: health professional education, advocacy & linkage. Available at: https://healtrafficking.wordpress.com/education. Accessed July 18, 2015.
Article info
Publication history
Published online: February 16, 2016
Accepted:
January 7,
2016
Received in revised form:
December 22,
2015
Received:
September 2,
2015
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
