Human trafficking is a modern form of slavery, second only to drugs as the world’s largest criminal activity. The United Nations defines trafficking in human beings as the recruitment, transportation, transfer, harboring, or receipt of persons by means of the threat or use of force or other forms of coercion, abduction, fraud, detection, abuse of power or position of vulnerability, or the giving or receiving of payments or benefits to achieve the consent of a person having control over another person for the purpose of exploitation.2 Healthcare providers, like dental hygienists, are some of the few professionals who may be allowed contact with victims while they are being trafficked. Due to this fact, dental hygienists should be aware of how to identify behavioral indicators of potential trafficking and be prepared to offer resources for assistance to victims.
It is estimated by the U.S. Department of State that 26 million individuals worldwide are trafficked annually; this includes 1.2 million children. In the United States, 11% are victims of labor trafficking lured by promises of employment, and 82% were subjected to sex trafficking.4 Those perpetuating human trafficking could be anyone including family members, intimate partners, gang and network members, business owners, and government officials. They are men and women from diverse racial, ethnic, and socio-economic backgrounds.
Those at risk of human trafficking are often involved in the child welfare system, homeless youths, runaways, have mental health concerns, or substance abuse issues.1 Lack of access to social integration, opportunities for employment, and poor access to education make victims more exploitable.3 Traffickers work to identify their victim’s vulnerabilities and use them to create dependency in many cases.
The Polaris Project, an anti-trafficking organization, lists access to health services as one of the top five points of access to help for victims. A U.S. based survey found that 26.5% of survivors had been seen by a dentist or other healthcare professional while being trafficked, but very few were identified. Human trafficking victims may present for dental care as a result of being restricted access to oral health products or negative effects on oral health due to forced labor or sex work. In addition, traffickers may bring victims for cosmetic purposes to make them more attractive to clients.4
Patients who are being trafficked may show signs of victimization such as injuries from violence, head and neck trauma, sexually transmitted infections, dental orofacial conditions, and malnutrition. Tattoos or brandings are common, marking the trafficked person as property. The lists below, adapted from the Polaris Project, are important follow-up questions and red flags for dental hygienists who may be concerned a patient is being trafficked.1,4
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Human Trafficking Assessment Questions
HUMAN TRAFFICKING – MEDICAL PROFESSIONAL CERTIFICATION (free)
Resources for Help or Reporting Human Trafficking
• National Human Trafficking Hotline – 888-373-7888
• Local Police Department – Local contact number or 911
• Department of Homeland Security Blue Campaign to End Human Trafficking – https://www.dhs.gov/blue-campaign
• Polaris Project Website – https://polarisproject.org/
• U.S. Immigration and Customs Enforcement (ICE) & Homeland Security Investigations (HSI) – 866-347-2423 – https://www.ice.gov/features/human-trafficking
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