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Public Health Response

Healthcare Interventions

There are many public health initiatives that are being implemented to identify victims of sex trafficking. There are few professionals that are likely to encounter victims of sex trafficking, but healthcare providers are a unique group because they are more likely to come into contact with individuals that are still in captivity. The National Human Trafficking Resource Center provides guidelines to aid healthcare providers in identifying victims of sex trafficking. They provide general guidelines to indicate human trafficking (i.e. inconsistent/scripted history, unwillingness to answer questions about illness or injury, etc.), but also includes indicators to hone in on sex trafficking. Those indicators in In addition, this network has created a framework for sex trafficking protocols in healthcare settings once a victim is suspected or identified. The goal of the protocol is to provider those interacting with the patient stepwise instructions on how to proceed once a potential trafficking victim has been identified. Additionally, an initiative known as the HEAL Trafficking and Hope for Justice Protocol Toolkit is being made accessible to healthcare providers. The goal of the toolkit is to provide a uniform medical response to trafficking. The toolkit combines known policies and procedures with tenets of trauma informed care. The toolkit is intended for the use of different healthcare providers such as community health workers, social workers, mental health counselors, nurses, and many others. A second initiative was taken on by the Centers for Disease Control. They have started to implement new fields of data collection through International Classification of Diseases (ICD) in order to better identify and categorize cases of sex trafficking. The new fields are ICD-10-CM codes. These are further categorized into T codes and Z codes. The T codes are further subcategorized into specific diagnoses that are used to indicate suspected and confirmed cases of trafficking. In addition, Z codes are also further categorized, but will be used for examination or observation of trafficking victims for other reasons.

Approximately 87.8% of trafficking victims have come in contact with a healthcare professional either during of after their time of exploitation and labor. On February 26, 2018, the Office on Trafficking in Persons (OTIP) under the U.S. Department of Health & Human Services passed the SOAR to Health and Wellness Act of 2018. SOAR which is an acronym which stands for Stop, Observe, Ask, and Respond is a training program which aims to properly equip professionals with the the necessary resources and methods to identify victims of human trafficking. Approximately 87.8% of trafficking victims have come in contact with a healthcare professional either during of after their time of exploitation and labor. On February 26, 2018, the Office on Trafficking in Persons (OTIP) under the U.S. Department of Health & Human Services passed the SOAR to Health and Wellness Act of 2018.[1] SOAR which is an acronym which stands for Stop, Observe, Ask, and Respond is a training program which aims to properly equip professionals with the the necessary resources and methods to identify victims of human trafficking. The training aids to help others recognize key indicators and characteristics of human trafficking as well as aid in key communication techniques that are effective for everyone involved. Response tactics can be key to identifying victims without causing harm and putting them in increased danger. The trainings also provide key communities with the support and resources they may need to bring attention to a crime which may be heavily impacting that area. The training can either be taken online or in person and can be personalized based the role of the professional. SOAR is available to anyone who who may be interested in learning how to identify victims or situations of human trafficking in a healthcare setting. Trainings are available for social workers, medical and public health professionals, and even educators. The training can either be taken online or in person and can be personalized based the role of the professional. SOAR is available to anyone who who may be interested in learning how to identify victims or situations of human trafficking in a healthcare setting. Trainings are available for social workers, medical and public health professionals, and even educators.

Physicians against the trafficking of humans (PATH) is a program of the American Medical Women's Association (AMWA) that was started in 2014 with efforts to encourage medical professionals including physicians, residents, and medical students to become more aware of human trafficking.. The initiative was initially brought into discussion by Dr. Gayatri Devi in 2012 who was the president of AMWA at the time. She identified human sex trafficking as a key issue to be addressed. This discussion then progressed into forming a Human Trafficking Committee to handle the issue. PATH has since been creating content for hospitals and other medical facilities to use in order to educate professionals and students on the identification and advocacy for human trafficking. PATH has also been featured in many media outlets such as Politico and TEDx.

Understanding Control Tactics to Facilitate Intervention

There are many control tactics used by sex traffickers in order to control their victims such as: threats, physical and sexual assault, confiscating legitimate travel and immigration documents, and verbalizing threats against the victims family. The University of Minnesota Duluth published the power and control wheel to help target domestic abuse intervention. The wheel identifies eight different mechanisms of power and control used on victims including: intimidation, emotional abuse, isolation, denying, blaming, and minimizing, sexual abuse, physical abuse, using privilege, economic abuse, as well as coercion and threats. The wheel was developed to be used in counseling and education groups for victims of sex trafficking. The wheel breaks down the tactics used against victims so the cycle of violence may become visible and stopped. A second mechanism used to understand control is the BITE Model created by Steven Hassan. The BITE Model describes four categories of coercion used on sex trafficking victims: behavior control, information control, thought control, and emotional control. He describes that it is essential to understand the loss of identity victims experience in order to help them get out or recover from sex trafficking.