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t m c » p u l s e | j u ly 2 0 1 7 31 "You have to earn their trust," Mari explained. "Offer little things, just little things to help. Because then they realize that somebody cares about them and doesn't want anything back. It seems like such a little thing to buy them shampoo or give them a sandwich, but it means the world to girls like me that are out there." A safe place If trafficking is suspected and the patient is under 18 years of age, indi- viduals are required by Texas law to report it immediately—just like any other case of child abuse or neglect. Reports should be made to law enforce- ment or the Department of Family and Protective Services (DFPS) at 1-800- 252-5400 or at txabusehotline.org. The National Human Trafficking Hotline number is 1-888-373-7888. If the patient is over 18, clinicians and other individuals are not legally bound to file an official report. Experts suggest that health care providers attempt to separate adult patients from any individuals accompanying them and ask screening questions to assess the situation, but to recognize that some adult victims may not feel comfortable or safe exposing their per- sonal situation to law enforcement at the time of medical treatment. The one exception to this rule: suspected abuse of an elderly or disabled person, which requires reporting in the same manner as minors. Notably, clinicians may always make anonymous tips without reveal- ing protected patient information to local law enforcement, the DFPS hotline, or the Department of Public Safety, accessible via iWatchTX.org. Clinicians should also refer patients to community resources, even if they are not ready and willing to utilize them at the time of their encounter. "Even if they don't allow you to report their situation while they're there, it's important to give them a safe place to come and talk if they ever want to get out of that situation," Jain said. Experts encourage all health care facilities to implement a standard response protocol for suspected human trafficking cases. Ideally, guidelines would include patient assessment and screening tools geared specifically toward trafficking victims, the develop- ment of safety protocols, patient separa- tion and reporting procedures, and an easily accessible list of local resources. Increasing general education and awareness surrounding the issue is also recommended. Doctors for Change has developed a one-hour curriculum approved for Continuing Medical Education credits that is available to local hospitals and health systems. It focuses on identifying potential victims, best practices for helping victims in the health care setting, and available resources in Houston. HEAL Trafficking, a national organization that tackles the issue through a public Create and foster a climate and culture of innovation in the health care industry through the C. T. Bauer College of Business Executive Education's Creating Innovation in Health Care seminar. CREATING INNOVATION IN HEALTH CARE August 8-9, 2017 Register now at bauer.uh.edu/exec The University of Houston is an EEO/AA institution. C. T. Bauer College of Business is an AACSB accredited business school. COMMON SIGNS of SEX TR A FFICK ING: TIPS for the MEDICA L COMMUNIT Y » Patient is accompanied by another person who is controlling » Patient shares a scripted or inconsistent story » Patient has visible signs of abuse or physical injuries in various stages of healing » Patient acts unusually fearful or submissive and avoids eye contact » Patient is unable to adequately explain where he/she lives or works » Patient has branding-type tattoos » Patient reports an unusually high number of sexual partners and/or unwanted pregnancies » Patient is not in possession of his/her identification documents, especially if international » Patient does not have appropriate clothing » Clinical signs include malnutrition, dehydration, damage to the reproductive system or genital trauma, urinary tract infections, drug abuse, skin infections, HIV and other STDs » Mental health issues include depression, acute anxiety, stress and paranoia, self- destructive behaviors, suicidal ideation, dissociative disorder, eating disorders and PTSD health perspective, also released an extensive protocol toolkit for health care settings. "It's important, especially for us physicians, to be aware of this issue and to have it at the back of our minds when we're seeing patients," Jain said. "If it's there in your mind, you may be able to catch someone who is in that situation and help them. Any small contribution you can do is going to help." For Mari, incarceration was the way out. But others may be able to escape through the help of a thoughtful clinician—someone who took the time to learn the signs of trafficking and had the courage to ask the right questions. Source: doctorsforchange.org

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