Aug31 A1-Human trafficking

Question 1

risk factors for human trafficking (who’s at risk)

Answer 1

marginalized populations (vulnerable and easy to isole from the community)

• First Nations, Metis, Inuit
• women, children, youth, especially LGBTQ
• homeless youth
• migrant works, new migrants, refugees
• low SES (but all SESs are victims)
• can still have a victim that is not part of a marginalized group*

Question 2

times where you’re obliged to report human trafficking

Answer 2

security, physical integrity, life or development of a child is in danger
-includes abused children

Question 3

most common types of trafficking in Canada

Answer 3

• sexual exploitation
• forced labour
• forced begging

Question 4

ethnicity, origin of the population that has the most victims of human trafficking

Answer 4

Canadians (Canadian born)

Question 5

most common way of human trafficking in Montreal

Answer 5

sexual exploitation

Question 6

trafficked vs reported in numbers

Answer 6

• millions of people trafficked

- only hundreds are reported (law enforcement data)

Question 7

% of physicians that come into contact with human trafficking victims in their life

Answer 7

100%

Question 8

(important) most important thing to know as a physician about human trafficking

Answer 8

• will come into contact with victims of human trafficking

- this interaction may be their only chance to receive help

Question 9

red flags for human trafficking in the Hx

Answer 9

• changes in behavior (truancy from school, aggression, withdrawal)
• visible expensive gifts
• new use of drugs
• Hx of self harm, sexual abuse, STIs, living outside home, gaps in schooling
• debt or no access to own money
• always moving
• sexually suggestive situations (hotel, naked, etc.)
• delay to seek care

Question 10

red flags for human trafficking in PE, signs and symptoms

Answer 10

• signs inconsistent with the Hx*
• weird bruises
• multiple fractures, broken arm
• circular burns (cigarette)
• tattoos
• bad teeth
• dyspareunia
• fatigue
• head trauma
• self harm
• depression, PTSD, anxiety
• anything relating to sexual activity (early sexual activity, STIs, UTIs, pyelonephritis, unsanitary abortion consequences, etc.)
• inappropriate work conditions

Question 11

red flags for human trafficking specific to children

Answer 11

• unusually high lvl of maturity and self-confidence
• sexual language
• unusually high levels of awareness of sexual issues
• access to money and goods inconsistent with child’s age
• not living with parents or relatives
• not attending school

Question 12

red flags of human trafficking in the interaction in the clinic

Answer 12

• always accompanied and monitered
• accompanying person speeds up the interview, refuses to leave
• pt with no ID or documents
• pt gives inconsistent explanation of where they live, employment, schooling
• pt unaware of their location

Question 13

5 screening questions for human trafficking (only ones approved)

Answer 13

• Did anyone arrange your travel to here?
• did anyone where you work ever make you feel scared or unsafe?
• did you ever feel like you couldn’t leave the place where you worked?
• did anyone where you worked ever trick you into doing something forcefully?
• were you allowed to take breaks, eat, use phone, etc.?

Question 14

important rule about offering resources

Answer 14

can’t offer things you can’t provide

Question 15

when to contact law enforcement

Answer 15

if patient approves doing so

Question 16

what to do in interview if red flags present

Answer 16

• control environment, separate from accomapniment
• patient centered approach, trauma, etc
• ask screening Qs
• provide advice (validation of problems, reassurance, list of resources
• set next appointments
• refer to Forensic Nurse, social worker, available resources (with pt consent)
• contact law enforcement (with pt consent, unless obliged to)