Clinical update

Human trafficking and modern slavery: how nurses can support victims

What to look for, how to help – and what not to do if you if you suspect a patient is at risk

Nurses are a key point of contact for vulnerable adults and children who are being exploited by criminal gangs

Essential facts

Modern slavery is an umbrella term for all forms of slavery, human trafficking and exploitation, says the Office for National Statistics (ONS).

Men, women and children of any age can be affected and, while some may be trafficked from other countries, UK residents, some of the most vulnerable people in society, are also among the victims.

The hidden nature of the problem makes producing an accurate measure of prevalence difficult, says the ONS.

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    Nurses are a key point of contact for vulnerable adults and children who are being exploited by criminal gangs

    Nurses should be aware that victims of human trafficking and modern slavery may be men, women or children Picture: iStock

    Essential facts

    Modern slavery is an umbrella term for all forms of slavery, human trafficking and exploitation, says the Office for National Statistics (ONS).

    Men, women and children of any age can be affected and, while some may be trafficked from other countries, UK residents, some of the most vulnerable people in society, are also among the victims.

    The hidden nature of the problem makes producing an accurate measure of prevalence difficult, says the ONS.

    According to the charity Anti-slavery, more than 10,000 people in the UK were referred to the authorities in 2019, but the true figure for enslavement is believed to be much higher.

    People may be enslaved or trafficked for forced sexual exploitation; domestic slavery; forced labour on farms, in construction, retail, nail bars, car washes or manufacturing. They are used by criminal gangs in cannabis cultivation, street crime, forced begging, drug dealing and financial fraud, forced or sham marriages and organ harvesting.

    Individuals may be forced into farm labour, such as fruit picking Picture: Alamy

    What’s new

    The RCN has published updated guidance for nurses and midwives on modern slavery and human trafficking.

    The document examines the key signs of trafficking. These include a person who:

    • Is with someone who is controlling, for example, speaking for them.
    • Appears withdrawn or submissive.
    • Is vague or inconsistent in explaining where they live, work or go to school.
    • Has old or serious untreated injuries.
    • Is not registered with a GP, nursery or school.
    • Moves home frequently.
    • Struggles to speak English.
    • Lacks official identification or has suspicious-looking documents.

    The guidance document also details the kinds of health issues individuals may have.

    These include mental, physical and sexual trauma; self-harm; long-term multiple injuries; poor nutrition; dental pain; fatigue; psychological distress; vague symptoms such as back or stomach pain, skin problems, headaches and dizzy spells.

    The role of nurse or midwife is explored, with tips on what to do next if you suspect trafficking or slavery, including useful resources.

    How you can help your patients

    Suspecting someone is a victim of modern slavery or trafficking is a safeguarding issue, says the RCN.

    If you have concerns, the college advises asking questions and seeking extra information and support.

    One in five victims report having come into contact with healthcare services during the time they are trafficked, says the RCN, which means that nursing staff can play a pivotal role in securing professional help.

    If you have suspicions about enslavement, talk to the person in a safe, private situation Picture: iStock

    Remember that trafficked people may not self-identify as victims of modern slavery.

    It may also take time for a person to feel safe enough to open up to healthcare staff, with many feeling fearful, ashamed or grappling with language barriers.

    Try to speak to the person alone and in private, allowing time for them to share their experience, the guidance advises.

    Only ask relevant non-judgmental questions and don’t let concerns about challenging cultural beliefs stand in the way of making informed assessments about someone’s safety.

    For children, do not raise trafficking concerns with the person accompanying them.

    Seek advice from your manager, colleagues and local safeguarding leads.

    Expert comment

    Carmel Bagness, RCN professional lead for midwifery and women’s health: ‘Around 40 million people across the world are trapped in modern slavery and we know that people are forced into many different roles.

    ‘This updated RCN guidance is designed to help nurses and midwives identify victims of slavery and help people find the assistance and support they need.

    ‘What is important is that you trust and act on your professional instinct that something is not quite right.

    ‘It is usually a combination of an inconsistent story and a pattern of symptoms that may cause you to suspect trafficking or slavery.

    ‘Taking the first step can be the most important action in safeguarding those caught up against their will, and getting them the help and support they need.’

    Read the guidance

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