Universal Education About Human Trafficking for Health Professionals

26 February 2019
Research Innovation

Hanni Stoklosa  | Executive Director of HEAL Trafficking
Terri Davis  | Emergency Medicine Physician, UF Health Shands Hospital

Many trafficked persons have contact with health professionals at some point during their exploitation. Globally, then, how do we equip the healthcare workforce with the knowledge and skills to care for trafficked persons? We need to employ cutting-edge medical education principles, scale existing training models, build structural capacities to respond to trafficking, and create governmental and international agency policies that prioritize systematic comprehensive, trauma-informed, survivor-informed human trafficking trainings for health professionals.

Educating healthcare professionals

Clinical responses to human trafficking are complex and nuanced. Therefore, it is not enough for all health professionals to be simply aware of trafficking, but rather they must be empowered with skills to assess for trafficking and to care for trafficked persons. Educating clinicians about trafficking is about training them to translate knowledge into practice with the ultimate goal of improving the health and well-being of trafficked persons.

Adapted by Wendy Pilcher from “Training US healthcare professionals on human trafficking: where do we go from here?”

Therefore, education for health professionals must incorporate cutting-edge, adult-learning education principles that have shown efficacy for training health professionals in other forms of interpersonal violence.

Adapted by Wendy Pilcher from “Applying educational theory in practice”. 

 Adopted by Wendy Pilcher from “Applying educational theory in practice”.

Adapted by Wendy Pilcher from “Applying educational theory in practice”. 

Utilizing simulation and e-learning

One such instructional methodology, simulation, incorporates adult learning principles and is being used to teach clinician trainees to identify, treat and refer victims of human trafficking in the United States and Canada. Simulation is the “artificial representation of a complex real-world process with sufficient fidelity with the aim to facilitate learning through immersion, reflection, feedback, and practice minus the risks inherent in a similar real-life experience.” Essentially, simulation gives learners an opportunity to put skills into practice and cement learning, while also making mistakes without any risks to their patients.

E-learning and online modules are another avenue for educating health professionals, incorporating adult learning principles and reaching a large number of individuals in a cost-effective way. Using e-learning modules in medical schools produced better comprehension than traditional learning in an Egyptian study evaluating reproductive health education. Online learning is useful for healthcare workers, for example, who cannot travel to meetings, allowing them to access the information at their convenience from their phones, home or work, decreasing costs and increasing reproducibility. E-learning can also be shared among countries, with thoughtful adaptations according to cultural differences, language, laws, local resources and typologies of trafficking.

Both the United Kingdom and the United States Department of Health and Human Services have developed free, online, interactive learning platforms to assist healthcare and social service professionals in identifying and helping trafficked persons. Use of simulation and e-learning should be further evaluated and considered for scaling to reach broad swaths of health professionals with effective training.

Standards for training

There is the potential for harm if health professionals are given incorrect information about human trafficking. For e xample, because corruption abounds and many trafficked persons are forced to commit crimes as part of their exploitation, calling law enforcement may put a potential victim at further risk, resulting in arrest or deportation. Moreover, trainings that focus exclusively on sex trafficking, neglecting other forms of trafficking, may result in a workforce that builds an entire response to one form of exploitation to the exclusion of other forms of exploitation. It is important that content of training is standardized, comprehensive, trauma-informed and survivor-informed.

HEAL Trafficking has created an assessment tool that allows those developing curriculums to determine gaps in their training. The United States Department of Health and Human services is currently in the process of creating core competencies for health provider education on trafficking. And the International Organization for Migration (IOM) manual “Caring for Trafficked Persons: Guidance for Health Providers” covers topics including ethics, physical exam, data storage, interactions with law enforcement and self-care.

The need for protocol and training development

At the moment a trafficked person is identified, the health professional needs to know the next steps to take. The development of health provider trainings must be done in parallel with creation of policies, procedures and protocols that link health systems to community partners. One such resource to assess health systems in building these protocols is the HEAL Protocol toolkit.

Numerous professional medical societies and governments, including the United Kingdom, United States and Canadian governments have recognized the need to train health professionals on trafficking. Yet, international agencies, including the World Health Organization, and most national governments have yet to recognize the critical role that health professionals play in addressing trafficking.

Implementation of national policies could also include mandated education on trafficking for healthcare professionals. Multiple states in the United States, including Michigan, Illinois and New Jersey, have adopted policies that mandate that healthcare professionals receive training in human trafficking awareness as part of maintaining their professional licenses.

Future Work in Human Trafficking Education

In order to make progress toward Sustainable Development Goal 8.7, involvement of the health sector can no longer be an afterthought. Health professionals are on the frontlines of victim assessment and care. International agencies, including the World Health Organization, and national governments, including ministries of health, must take a leadership role in facilitating universal education of health professionals across the globe on trafficking.

Terri Davis, MD is an emergency medicine physician at UF Health Shands Hospital in Gainesville, Florida.

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

This article has been prepared by Terri Davis and Hanni Stoklosa as contributors to Delta 8.7. As provided for in the Terms and Conditions of Use of Delta 8.7, the opinions expressed in this article are those of the authors and do not necessarily reflect those of UNU or its partners.

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