LANSING — Criminals who sell victims for sex or labor leave marks that are rarely noticeable to the average person, but doctors and nurses have a unique advantage to spot these red flags and intervene — if they are properly trained.
This training requirement, to spot and properly respond to patients who show signs of human trafficking, was implemented by Michigan legislation that took effect in January.
Under the new law, the state Department of Community Health, with a consulting board, will establish standards to train healthcare professionals in identifying and reporting human trafficking. Within two years, this training will be added to requirements for anyone licensed or registered under the public health code.
This legislation comes from growing recognition that human trafficking is a problem throughout Michigan.
“It’s so deeply buried but yet so pervading within our society,” said Sen. Judy Emmons, a Republican from Sheridan who has centered her legislative agenda on human trafficking. “Every part of society has to know and has to be able to recognize it when they see it, and that’s what we don’t have right now.”
The numbers are difficult to tie down. Michigan-specific data showing the true extent of human trafficking is lacking, says the Michigan Attorney General’s 2013 Report on Human Trafficking, in part because trafficking operations are difficult to detect. The report indicates more than 300 known human trafficking cases in Michigan between 2011 and 2013.
People in many occupations could get better at spotting human trafficking with the right training, said Jane White, director and founder of the Michigan Human Trafficking Task Force, located at the School of Criminal Justice at Michigan State University.
Health professionals are able to see telltale medical conditions that are not obvious to lay people, such as sexually transmitted diseases and injuries that have been improperly treated. Health professionals also encounter both types of trafficking – human and labor – while it is still ongoing.
Emergency room nurses at Lansing’s Sparrow Hospital have been trained, largely through the International Association of Forensic Nurses, to recognize domestic violence, which often goes hand in hand with human trafficking.
They also look for certain types of injuries, patients who do not have a residence or can’t explain how they came to be at the hospital, and non-English speakers who come without an interpreter or with someone who won’t leave them alone with providers or a hospital interpreter, said Matthew Kasper, program director for the Sexual Assault Nurse Examiners Program at Lansing’s Sparrow Hospital.
The new training requirements will have a particular impact in smaller counties, Kasper said. Many larger hospitals, such as Sparrow, already offer training beyond existing requirements, so traffickers often take victims to smaller hospitals or urgent care clinics where they are less likely to be discovered.
Rural areas are also more likely to traffic in human labor, such as on apple orchards and farms, resulting in victims being taken to smaller hospitals or urgent care.
Kasper came face to face with human trafficking in rural central Michigan while working as a paramedic in the late 1990s. Responding to a call for an injured apple picker, Kasper saw the signs of human trafficking not only in the multiple sheds other workers were living in, but in the behavior of the immigrant victim.
When the victim was more worried about getting back to work than caring for his injury, Kasper became suspicious. Although he tried to explain to the man that he needed to be taken care of, the victim kept saying that he needed to get back to work so he could get his family to the United States. Kasper then contacted local law enforcement, but he does not know what happened after their investigation.
The new training standards are not only focused on spotting human trafficking, but also educating healthcare providers on what to do when they spot it. Nurses at Sparrow are trained to contact the National Human Trafficking hotline at 888-373-7888, or local law enforcement if they suspect a patient may be a victim of human trafficking.
“That’s the biggest thing,” Kasper said. “Some people recognize it and they don’t know what to do.”
But simply passing legislation isn’t enough, White said.
“Legislative change is not necessarily akin to implementation change,” she said in an email. “There [is] a need to deter the disconnect between policy and practice. There certainly is the beginning of progress and now we have to go from there.”