How EMS can identify, help victims of human trafficking
By debunking human trafficking myths, EMS providers can assist the victims they encounter in their own communities
When Rodney Daniels’s daughter, Tiffany, went missing in August, 2013, it was several weeks before anyone considered the possibility that she’d disappeared into human trafficking. Daniels, assistant fire chief (ret.) at the Naval Air Station in Pensacola, Florida, said her car was found, undisturbed and unlocked, but not his 24-year-old daughter. She simply vanished. Seven years later, the family is still awaiting word of Tiffany’s whereabouts. One of the worst feelings to endure, he says, is not knowing.
Here’s a hard truth: human trafficking is happening at a location near you, wherever you are, right this minute. This robust industry (annual revenues $32 billion in the U.S. and $150 billion worldwide) is on target to surpass the profitability of the drug trade in 2020.  Human trafficking is not going away any time soon, and neither are the dimensions of heartache and tragedy.
We in EMS have a role to play in the battle against human trafficking. We can learn to notice possible victims, and thus potentially make a difference in tremendously troubled lives. Helping victims of human trafficking necessarily involves a multi-jurisdictional approach working with law enforcement, social workers and other healthcare providers.  Every minute of ignorance or apathy on the part of those who could curtail human trafficking is nothing but good news to those profiting from this crime.
Debunking human trafficking myths
Human trafficking is clouded by myths, prejudice and murky assumptions. It’s not true, for example, that only immigrants are trafficked, or that human trafficking always involves transport or physical force. Collectively, it’s time to shrug off typical sticking points and cultural attitudes, such as “they want it.” They don’t. Educational programs for EMS providers and others are an important and helpful start.
The U.S. Department of Homeland Security defines human trafficking as modern-day slavery. Most human trafficking involves sex or labor trafficking, but other forms include people trafficked for the illegal organ trade and to recruit child soldiers in some parts of the world.
The first comprehensive U.S. federal law to combat human trafficking and help victims was the Trafficking Victims Protection Act of 2000, which defines human trafficking as the recruitment, harboring, transportation, provision or obtaining of a person for one of three purposes:
- Labor or services, through the use of force, fraud or coercion for the purposes of subjection to involuntary servitude, peonage, debt bondage or slavery
- A commercial sex act through the use of force, fraud or coercion
- Any commercial sex act, if the person is under 18 years of age, regardless of whether any form of coercion is involved
The words “force, fraud or coercion” are key. Many people wonder why victims don’t simply leave, but traffickers are often sociopathically adept at building webs of psychological and logistical entrapment. Typical methods of control include physical and psychological violence, drug addiction, constant surveillance, shame and humiliation, threats against relatives or of deportation, confiscation of personal identification, debt bondage, even imprisonment. 
According to the U.S. Health & Human Services Office on Trafficking in Persons, “Traffickers prey on the vulnerable, often with promises of a better life. Risk factors for trafficking include: prior history of abuse or sexual violence, generational trauma, poverty, unemployment and unstable living situations or homelessness.” One in seven runaway children ends up as a trafficking victim, and in this modern era, according to Thorn.org (a non-profit dedicated to battling digital child sex trafficking), more than 70% of child victims are sold online.
Identifying human trafficking victims
Human trafficking victims are found in many settings. Victims of labor trafficking can be found in door-to-door sales crews, restaurants and bars, nail and beauty salons, domestic labor, food processing factories, agriculture, construction and landscaping. Sex trafficking victims can be found in bars and restaurants, spas and massage parlors (in commercial settings and private homes), hotels and resorts, escort services, strip clubs and adult film studios. Sex trafficking also happens at highway rest areas and truck stops.
Noticing and reporting suspected trafficking situations is important. “Since 2007, more than 49,000 cases of human trafficking in the U.S. have been reported to the National Human Trafficking Hotline, which receives an average of 150 calls per day,” according to journalist James Pasley. Another powerful, wide-reaching effort has been made by the trucking industry. The “Truckers Against Trafficking” program has so far educated 898,823 truckers, resulting in 2,496 calls from truckers to the national hotline, 663 cases identified, and 1,230 victims identified. 
Identifying victims of human trafficking begins with awareness of the possibilities, and is bolstered by your situational awareness and a high index of suspicion. Knowing these high-risk populations, and then assessing both the setting and the people involved may help you identify human trafficking victims. Look for situations in which things just don’t seem to add up. Certainly in cases where a person seems fearful in unusual ways (of you, of “the system,” of a person known to them who is insisting on answering for them) watch for other possible clues. If you think a situation warrants further investigation, notify the receiving facility or law enforcement of your concerns
EMS role in ending human trafficking
EMS personnel can do the same. We populate the same streets as victims of human trafficking, probably in every town and city. Once we know what to look for, we can report suspected trafficking. According to the U.S. Fire Administration, “EMS workers are well-suited to help counter human trafficking. They are often in contact with the most vulnerable members of the public and already have the needed interviewing skills to identify likely trafficking victims.” Programs are evolving, such as one in San Diego County that was set in earlier this year to train 3,000 firefighters at 40 local departments, along with EMS crews from AMR and Mercy Medical Transportation. To date, though, there is no coordinated national effort to raise awareness of this devastating issue.
While we are encountering opportunities to recognize victims of human trafficking, it’s not necessarily easy. Victims are often unable or unwilling to speak up out of fear. They may be silenced by shame or drugs or force. They might be brainwashed to see uniformed people as the enemy. A national survey of survivors showed that over 88% had come in contact with a healthcare provider or EMS provider and 67% had been seen in an emergency department, yet were not identified. 
No single agency or EMS crew can deal with this issue alone. Although human trafficking can seem sometimes to be invisible, this doesn’t mean it doesn’t exist. If you sense red flags in your gut that a case might involve possible human trafficking, bear in mind that the person you are helping is someone’s daughter, or sister, or son. Imagine what it would be like to be the one who could reunite Assistant Chief Daniels with his daughter, Tiffany.
- National Human Trafficking Hotline: 888-373-7888. Or text “Help” to BeFree (233733), or livechat at humantraffickinghotline.org. These resources are 24/7, confidential, and multilingual hotlines for victims, survivors, and individuals with human trafficking concerns.
- An online interactive training course on human trafficking for EMS workers: “What EMS Needs to Know About Human Trafficking” (This is a free course with a certificate of training from the Institute for Family Violence Studies at Florida State University)
- Truckers Against Trafficking
- Thorn.org, a non-profit to help combat childhood sex-trafficking that identified 5,791 child victims, and rescued 103 in 2017.
- U.S. Fire Administration, “Training helps EMS workers identify human trafficking signs,” posted Nov. 8, 2018.
- James Pasley, “20 staggering facts about human trafficking in the US,” in Business Insider (online, posted July 25, 2019).