Takeaway
Healthcare professionals have a unique opportunity to identify and help victims of human and labor trafficking. Read on for practical tips for how to recognize and support these patients.
Lifelong Learning in Clinical Excellence | April 28, 2025 | 3 min read
By Catherine Washburn, MD, Johns Hopkins Medicine
My patient was so thin and withdrawn. She looked far older than her 30 years. The man who never left her side jumped in to answer for her at times. She said he was her boyfriend. Was he?
Have you ever seen a patient you suspected was a victim of human or labor trafficking? When I saw one, I was immediately aware that I didn’t know how to help.
The crime occurs when a trafficker uses force, fraud, or coercion to make a person perform labor or sexual acts against their will. Victims may be any age, gender, and from any cultural or ethnic group. The trafficker might be a stranger, family member, or friend. Trafficking, a profitable criminal industry, generates billions of dollars worldwide and an estimated 12 million people, both children and adults, are enslaved in trafficking situations across the globe, according to the United Nations’ International Labor Organization. Lack of awareness means opportunities to identify victims go unnoticed and unreported.
Because of the tight control of movement and communication exerted by traffickers, victims are rarely at liberty to speak, call, or text unobserved. However, research has shown that a large majority of victims are seen by medical professionals during their time in captivity; these encounters are rare opportunities to access help. Therefore, as healthcare professionals, we’re in a unique position to identify and potentially help people who are trafficked.
We’re also mandatory reporters for underage trafficking victims, and laws regarding mandatory reporting of suspected adult victims vary by state. “We have a huge opportunity to make a difference in someone’s life,” said Dr. Suzanne Harrison, former American Medical Women’s Association president. Survivors who talk with a healthcare professional about their abuse are 2.6 times more likely to exit the abusive situation. We do have the power to help.
However, fewer than 10% of surveyed housestaff indicated they had seen a patient they suspected had been trafficked, and only 20% believed they knew what to do to help such a person. Similarly, I felt at a loss to know where to begin when I saw a patient whom I suspected was being trafficked.
The National Human Trafficking Resource Center provides some simple education about red flags: patients are unwilling or hesitant to answer questions about their illness, or who are accompanied by someone who refuses to allow them privacy or to speak for themselves. The PEARR Tool—Provide privacy, Educate, Ask, Respect, and Respond provides a framework for healthcare professionals to begin to assist them by building trust and creating a safe environment where disclosure can take place. For conversation to freely occur, speaking to the patient without the presence of others is key. One ideal opportunity can occur when they’re initially seen alone in the emergency department. Find a way to separate the patient from the people who brought them in so they may be more comfortable talking, says Dr. Harrison. Physicians should remember that patient privacy can be a life and death issue for trafficking victims.
Questions to open dialogue:
1. Are you comfortable? Are you hungry?
2. Where are you living? Who are you living with?
3. Do you feel safe?
4. Has anyone ever hit you or forced you to do something you didn’t want to do?
5. Do you live, work, and sleep in the same place?
6. Have you ever traded anything for sex?
Ensure the patient leaves the visit or hospital with a scheduled follow-up. Most trafficked individuals don’t immediately respond to efforts to connect and won’t be ready to leave their situation right away. Often, at the first encounter, a patient won’t disclose their situation or accept help but may be able to move forward at a later visit. It’s still important to attempt to build a bridge to safety, given what we know about contact with the healthcare system.
Access help:
Call the National Human Trafficking Hotline at 1-888-373-7888 or text 233733.
How healthcare professionals can extend a lifesaving hand to trafficking victims:
1. Notice
2. Question sensitively
3. Identify
4. Refer
5. Ensure follow-up appointment is made
6. Provide information and resources
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This piece expresses the views solely of the author. It does not represent the views of any organization, including Johns Hopkins Medicine.