By: Sarah Thomas, Hanni Stoklosa, Laura Murphy
The scope of the issue
Child labor trafficking is a pervasive issue globally, affecting an estimated 5.5 million children worldwide.1 In the United States, the National Human Trafficking Hotline calculates that 16% of labor trafficking cases reported to them involved children.2 Children and youth are trafficked in agriculture, construction, domestic labor, commission-based sales, the drug trade, and other industries. Among the most vulnerable groups of children are the homeless, those in foster care, and unaccompanied migrants.2,3
The prevalence of child-labor trafficking is likely underestimated. Child labor trafficking is more difficult to identify than other forms of human trafficking; the line between exploitation and work is not always clear1. Furthermore, child labor trafficking’s scope is underestimated because of methodological limitations of data-gathering. Often, child sex trafficking and labor trafficking are often grouped into a single category in data collection systems. Finally, overall trafficking data-gathering tends to be focused on adults, with frequent failure to discriminate between adults and children.2,3
Health professionals have the Opportunity, Diagnostic Eye, and Patient Trust to help
Health professionals are uniquely positioned to identify and care for victims of trafficking. Many trafficked children report having seen a healthcare professional at some point during their victimization.3 Child victims often present with complaints related to their experience trafficking, including work-related injuries and exposure to toxins, or symptoms related to work-place abuses including bruises and scars, exhaustion, or malnutrition. Fortunately, health professionals can be trained to have increased vigilance and diagnostic acumen to identify child labor trafficking cases.4,5 Just as we have seen in training health professionals on other forms of abuse, employing a framework with a low index of suspicion is a critical starting point.5 Finally, health professionals are more likely than many other professionals to be trusted by victims, especially those who have had negative prior experiences with social workers or law enforcement.
What healthcare professionals can do to help child labor trafficking victims
On an individual level, all healthcare professionals must understand how to identify child labor trafficking victims and how to proceed when child labor trafficking is suspected.4,6 All trafficking education for health professionals should include child labor trafficking, as well as training on mandatory reporting of this particular form of child abuse and the potential harms associated with such reporting. Even in cases in which young people do not disclose, children and youth who are suspected victims or at risk of trafficking should be provided referrals and trauma-informed healthcare that reflects an awareness of the harms of trafficking and information that could help prevent potential or further victimization.
All health systems who care for children should include child labor trafficking responses in their trafficking policies and procedures. Resources available to healthcare workers seeking to improve their knowledge of (and sensitivity to) trafficking include: the HEAL Trafficking Toolkit,7 the National Human Trafficking Resource Center Assessment Tool,8 and the CDC’s guide to trauma-informed care.9
- Child Labor Trafficking in the United States. National Human Trafficking Resource Center; 2015.
- Kaufka Walts K. Child Labor Trafficking in the United States: A Hidden Crime. Social Inclusion. 2017;5(2):59.
- Fraley H, Aronowitz T, Stoklosa H. Systematic Review of Human Trafficking Educational Interventions for Health Care Providers. Western Journal of Nursing Research. 2019;42(2):131-142.
- Such E, Walton E, Bonvoisin T, Stoklosa H. Modern slavery: a global public health concern. British Medical Journal. 2019. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30808648
- Harlow A, Rothman E, Dyer S, Stoklosa H. EMS professionals: critical partners in human trafficking response. Emergency Medicine Journal. 2019;36(10):641-641.
- Anthony B, Crowe S, Benjamin C, Couture T, McCartin E, Gerrior E et al. On-Ramps, Intersections, and Exit Routes: A Roadmap for Systems and Industries to Prevent and Disrupt Human Trafficking. Polaris; 2018 p. 44-51. Available from: https://polarisproject.org/on-ramps-intersections-and-exit-routes/
- HEAL’s Protocol Toolkit. HEAL Trafficking: Health, Education, Advocacy, Linkage]. Available from: https://healtrafficking.org/heals-protocol-toolkit/
- Framework for a Human Trafficking Protocol in Healthcare Settings. National Human Trafficking Hotline; 2010. Available from: https://humantraffickinghotline.org/resources/framework-human-trafficking-protocol-healthcare-settings
- Infographic: 6 Guiding Principles To A Trauma-Informed Approach. Centers for Disease Control and Prevention. 2018. Available from: https://www.cdc.gov/cpr/infographics/6_principles_trauma_info.htm