WOMEN IN EMERGENCY MEDICINE
Human Trafficking and Natural Disasters Myra Khushbakht, BS, Karin Brown, MS, Catherine Wertz, BA, Jennifer Reyes, DO FAAEM, Marianne Haughey, MD FAAEM, and Loice Swisher, MD MAAEM FAAEM
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ntroduction
Environmental stressors greatly impact vulnerable populations, resulting in an increased risk for human trafficking in situations where a natural disaster has occurred. As health care providers, it is imperative to recognize red flags to determine if a patient could be experiencing trafficking. In the event of a natural disaster, emergency providers have an increased chance to identify and support persons experiencing trafficking (PET). An estimated 24.9 million people worldwide are currently victims of human trafficking. A risk factor in becoming a person experiencing trafficking (PET) can include having a vulnerable background (i.e., foster care, homeless youth, migrant laborers, refugees).1 Trafficking does not necessarily need to happen across borders. According to the US Department of State, trafficking is the “act of recruiting, harboring, transporting, providing, or obtaining a person for compelled labor or commercial sex through the use of force, fraud, or coercion.”2 There are several forms of trafficking. Both sex trafficking and forced labor are covered as “severe forms of trafficking in persons” under the Trafficking Victims Protection Act (TVPA), a US federal law that was deemed one of the first comprehensive federal laws to address this issue.3 The US Department of Homeland Security (DHS) also runs the Blue Campaign, which is a “national public awareness campaign designed to educate the public, law enforcement and other industry partners to recognize the indicators of human trafficking, and how to appropriately respond to possible cases.”4 Under this campaign, the Federal Emergency Management Agency (FEMA) runs a mandatory course for employees on trafficking prevention.2 The agency even provides a six-minute course to recognize and report suspected trafficking during a disaster response.5
Trafficking and Natural Disasters Both natural and political disasters disrupt normal social, economic, and societal structures and lead to an increase in human trafficking.6 After the 2010 earthquake in Haiti, the US State Department noted the increased risk of sex and labor trafficking for survivors in internally displaced camps, especially children and women from low socioeconomic backgrounds.7 Understanding that displaced persons are vulnerable, traffickers will prey on those who lack basic needs (i.e., food, water, and shelter), social connections, and a stable income. Frequently, traffickers appear intentionally friendly or helpful to the intended victim. Because individuals in these situations are often in survival mode, experiencing acute trauma, and may be physically harmed as well, they may not be fully attuned to discern from whom they should accept help. They may not know to seek out specific organizations, such as the Red Cross,
International Rescue Committee, or FEMA, as safe places to accept aid and direction. Traffickers can take advantage of these turbulent situations to use force, fraud, or coercion to manipulate these at-risk individuals and sell them into trafficking situations. Not only do natural disasters destabilize already vulnerable populations due to a disruption of basic needs such as housing, food, and water, the aftermath can result in an influx of workers that are encouraged to take fraudulent jobs where wages are not what they seem, freedom of movement is restricted, and even mislead individuals into sex trafficking situations. After Hurricane Katrina, there was a huge need for laborers to help with the rebuilding and recovery in New Orleans and the surrounding regions. A number of subsequent civil cases have focused on the resulting labor exploitation in the region at the time, including instances of debt bondage at luxury hotels, labor trafficking through the H-2B guest worker program, and exploitation of manual laborers who were repairing residential properties. The temporary relaxation of regulations coupled with destabilized situations can lead traffickers to capitalize on their exploitative behavior.2
What You Can Do As a Health Care Provider Studies indicate that over 80% of PET come into contact with health care providers at some point during captivity and a majority of visits happen at the emergency department.8 General indicators that may indicate abuse include lack of proper identification, inappropriately dressed for the weather, and noticeable unexplained bruising. In addition, patients may be fearful, anxious, avoid eye contact, and limit their answers to
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COMMON SENSE MAY/JUNE 2022
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