AMWA's Physicians Against Trafficking of Humans
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PATH's webpage features an introduction to human trafficking and healthcare, click here to watch informative videos and learn more from the site.

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Welcome to the AMWA PATH Monthly Newsletter.

This is a monthly series in research and advocacy news summaries created by the PATH residents and medical students. Newsletters will feature brief breakdowns on recent scholarly publications and policy changes as well as highlighting PATH member efforts and upcoming events.

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E-mail your projects and events to the editors to be featured in upcoming newsletters.

October's Literature Feature is from:

 Human Trafficking: A Guide to Identification and Approach for the Emergency Physician

By Shandro, J. Chisolm-Straker, M, et al.

Background highlights: 
- Human trafficking is a 150$ billion-a year criminal industry with half of its victims coming from industrialized nations
- Globally Human Trafficking is estimated to include about 20.9 million victims of forced labor, 4.5 million of which are victims of forced sexual exploitation spanning at least 124 countries. 
- Background includes an overview of policy evolution including the removal of the requirement for physical transportation to be defined as a victim of trafficking. 
- Delves into some of the domestic features of human trafficking and the intimate methods of control 

Frontline Provider Role:
This section of the article outlines the pivotal role of health care providers in general, but particularly of ER providers as gateway agents of identification and assistance, a role which is at odds with the overall lack of available training and screening tools. (p 2-3)
- 28-88% of victims of human trafficking report a visit to a medical provider during exploitation. 
- 2/3's reported having interfaced with ED department
-notably victims are often reluctant to report, and providers are often not aware of signs of trafficking (4.9% or ER clinicians reported being confident in their ability to recognize a victim)

Tips and Pitfalls:
The guide provides insight into some methods of trauma conscious interviewing, including some tips and questions:
- Emphasizes that the additional goal besides treating illness is establishing the ED as sanctuary 
- Warns against the pitfall of attempting to identify victims as being from a particular racial, age, gender, SES, orientation
- Notes that victims are difficult to identify on the basis of history alone for several reasons including fear of disclosure, fear of law enforcement - suggests a very thorough physical in the context of other clues as a better screening method
-Reiterates that the National Human Trafficking Resource Center is a great resource; their number hotline is 1 (888) 373-7888

Interviewing tips 

  • Always separate the potential victim from accompanying persons
  • Foster trust and build rapport with the patient
  • Sit at eye level when asking questions
  • Maintain eye contact
  • Meet immediate physical needs (e.g., food, water)
  • Use a trained interpreter when needed
  • Ask specific questions about safety
Do not be afraid to ask:
  • Where do you live?
  • Who takes care of you?
  • Do you feel trapped in your situation?
  • Is anyone forcing you to do things you do not want to do?
  • Has anyone threatened your family?
  • Tell me about your tattoo?
  • Has anyone at home or work every physically harmed you?
  • Have you ever been denied food, water, sleep, or medical care?

For more on Emergency Medicine and Human Trafficking:
The American College of Emergency Physicians has shared some recommendations and support for further inquiring into the intersection of Emergency Medicine and human trafficking. Click here to read the article.

Additional Emergency Medicine specific training modules and resources have been compiled by Dr. Makini Chisolm-Straker and can be found here

Future Events:
Subscribe to the PATH newsletter for announcements about upcoming events near you and e-mail PATH for more information or questions.

PATH Member of the Month: Carmen Hans
Carmen Hans is a medical student at the University of Arizona College of Medicine. She started the AMWA-PATH chapter at her school in 2014, which hosts annual PATH Clothing Drives and Human Sex Trafficking Awareness events. Wanting to be involved with PATH on a national level, she began organizing national PATH webinars for students on topics related to trafficking. This year, she became the national PATH Education Co-Chair. She has created the PATH Welcome Kit and is working to develop a national curriculum that educate medical students across the country on how to become involved in ending sex trafficking.
Calling all interested volunteers! PATH is preparing for the Annual Clothing Drive in January to mark National Human Trafficking Awareness Month. Click Here for information on how to coordinate a drive at your school or institution.
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Copyright © 2016 American Medical Women's Association: Physicians Against Trafficking of Human, All rights reserved.

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