Hackensack Meridian CEO: Healthcare is the true front-line to fight human trafficking

If you are a physician or nurse working in a hospital or clinic, you likely have treated a victim of human trafficking - but you may not have known it. Nearly 9 in 10 victims seek medical care at some point during their exploitation and almost 70 percent have gone through an emergency department. 

Our industry is in an optimal position to help the estimated 50 million victims who are trafficked each year in the U.S. and globally. We are the frontline in this fight and we need to act with a sense of urgency: human trafficking is growing and is now the second largest criminal industry worldwide, after drug trafficking.

That’s why I am calling on health system and hospital CEOs to join me in fighting this global crisis. There’s no question these efforts align perfectly with the healthcare mission, but how do we get there?

First, by educating our teams. They must learn how to identify victims of human trafficking, including sex trafficking and labor trafficking, and carry out appropriate responses once they are identified. There are multiple examples of the effectiveness of training: one study in the San Francisco Bay Area Emergency Departments determined that staff’s ability to recognize victims more than doubled after training and their understanding of the right officials to call increased from 7 percent to nearly 60 percent. The American College of Emergency Physicians’ training intervention yielded notable improvement as well. Prior to training, fewer than 8 percent of clinicians felt some degree of confidence in their ability to identify victims and treat them. After the training, more than half reported more confidence to aid victims.

Teams are taught to identify red flags: does the patient seem overly fearful, submissive, tense or paranoid? Is the person deferring to another person before giving information? Does that person refuse to leave the victim alone? Is the patient’s ID held by someone else who accompanies the victim for treatment? I recall one nurse executive saying that after training, she looked at patients differently. Could that woman who is struggling with addiction actually be a trafficking victim? Is the patient with repeat UTIs being trafficked?

While many more healthcare organizations are taking this on, we also need standardized global protocols to ensure physicians from Bangladesh to Beijing can have effective, easy-to-implement standards to help identify and treat patients and intervene with law enforcement. I was fortunate to serve on a UN panel recently with global experts to develop these protocols, including Deb O’Hara Rusckowski, founder of Global Strategic Operatives, which launched an evidence-based, world-wide training protocol for health care providers to address this crisis. Equally important, the group establishes and builds relationships with key partners in these efforts including local community resources, law enforcement, State Attorney General Offices and Homeland Security Investigations. Global Strategic Operatives has facilitated training and research with our health network and others and is leading efforts to request that the World Health Organization adopt these global protocols.

Second, remember that this is a problem that occurs in every state in the U.S., in rural and suburban areas and wealthy and struggling communities. California, Texas, Florida and New York report the most number of cases respectively, according to the Human Trafficking Hotline, but none of us can turn our head and say this is someone else’s problem. 

One of the members of the UN panel I served with illustrates how anyone can become a victim, anywhere. Jasmine Grace-Marino of Massaschussetts had a challenging childhood, but obtained a high school degree, a hairdressing license and was attending community college. A young man expressed interest in her at a bar and she ended up being trafficked for five years, in several states and cities, including Maine. Her remarkable recovery and advocacy continues to inspire. 

Third, consider the fight against human trafficking as an expansion of your health network’s social determinants of health strategies. Research tells us that up to 80 percent of the factors that impact health are non-medical. Our health network, Hackensack Meridian Health, launched a program in 2021 that uses two separate digital platforms and electronic medical records to screen patients for food and housing insecurity, transportation, mental health and caregiver stress. All the information from the screening goes directly into the patient’s medical record. So far we have screened more than 500,000 patients and have provided 1.5 million referrals to social service agencies our patients may not have even known existed. In 2023, we will include screening for human trafficking to expand our reach.

Fourth, remember that if we really intend to make a difference, we must start educating future physicians about this global crisis in medical school. Many institutions are focusing on the social determinants of health in their programs. At Hackensack Meridian, it is foundational to our curriculum. Next year, we will begin teaching future physicians to identify potential victims, to treat them appropriately and make a difference. Future health care professionals must understand that they are truly on the frontline in this global crisis.

Robert C. Garrett is CEO of Hackensack Meridian Health, New Jersey's largest health network with 18 hospitals, more than 500 patient care locations and the Hackensack Meridian School of Medicine.

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