A Quick Look at the Public Health Approach to Human Trafficking

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heal traffickingA human trafficking conversation with Hanni Stoklosa from HEAL Trafficking, Freedom Network USA Individual member.  

As an emergency department doctor, how did you find yourself working in the anti-trafficking field?

The majority of human trafficking survivors in the US access health care while being trafficked. And most of them end up in emergency departments. When I learned those facts I was stunned and realized how many opportunities to intervene I had missed during my career. And, if I, as a Harvard-trained emergency physician, was not trained on trafficking, how many nurses, doctors or physician assistants across the globe were in the same boat of ignorance? For me, there was no choice but to act and help create the solutions for health care’s response to trafficking.

HEAL Trafficking’s tag line is “Because Human Trafficking Is a Public Health Issue.” Can you briefly describe the public health approach?

We believe that the current approaches to human trafficking – largely grounded in a criminal justice framework – will not allow us to end trafficking. We cannot arrest or prosecute our way out of trafficking. Rather, we believe a public health approach that looks upstream in tackling the underlying vulnerabilities to trafficking is necessary. A public health approach is also one that is survivor-centered, trauma-informed and evidence-based. So, as a movement, we must also examine other movements to understand and learn from the unintended consequences of interventions which had faced validity, but failed to account for the complex interplay of structural inequities, racism, and all intersectional stakeholder communities.

You talk about human connection here. How can medical professionals establish this when working with at-risk populations?

A survivor of trafficking once told me, “Trauma survivors have excellent bullshit detectors. It is how we survive.” So, how can we as medical professionals connect with at-risk populations?

It starts with the basics. Getting at eye level, making eye contact, showing that you care by attending to simple comforts. Are they thirsty? Are they cold? Get them something to drink or a warm blanket. Look for opportunities to give control back to the patient by asking permission before doing things. The fancy name for that is “trauma-informed care.”

We also have to be aware of our own unconscious biases and judgments – and mitigate them at every turn. Finally, if we are not taking care of ourselves and the trauma we experience as medical professionals, we will not be able to bring our full selves to our clinical encounters.  

This session was about the relationship between law enforcement and medical professionals. What would you say are the most important elements of building a productive relationship?

Start before you have even have a human trafficking case. When building your health system protocol, involve law enforcement in conversation and walk through lots of hypothetical situations. Finally, build a regular communication space for dialogue about what went well and what did not go well for cases. There is always opportunity to grow and learn from each other.

Where should people go to learn more?

Join us in ending human trafficking! You can find us at HEALtrafficking.org.

Hanni Stoklosa, MD, MPH, is the Executive Director of HEAL Trafficking and an emergency physician at Brigham and Women’s Hospital (BWH) with appointments at Harvard Medical School and the Harvard Humanitarian Initiative.