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'We have a critical role in identifying and treating victims of modern slavery'

Diana De
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In the last five years, there has been a 10-fold increase in the number of victims of modern slavery in Britain. Yet, last week, another student nurse told me they did not know that slavery was still happening.

Previously overlooked by society, modern slavery is still a highly lucrative business. Men, women and children of all ages and backgrounds can fall victim to human trafficking.

The International Labour Organization estimates that more than 40 million people worldwide could be affected and that increased homelessness is fuelling this trade. According to the Global Slavery Index, the number of suspected victims in the UK has risen from 13,000 in 2013 to 136,000 in 2018. Yet, most victims remain hidden within everyday society.

Oppressive psychological control, including threats of violence against victims or their loved ones, is often used to maintain servitude. Some victims will incur physical injuries such as bruising, broken teeth and fractures. Often victims will be denied access to healthcare services.

However, half the victims of modern slavery do report contact with health professionals during their exploitation, and one in eight of us will, at some point, treat someone involved in it.

“Finding a discreet moment to chat informally with the patient alone can sometimes offer a much-needed life-line”

This ratio is even higher in maternity services where the 2015 Department of Health-funded PROTECT Report found that 25% to 50% of human trafficking victims in the UK were either pregnant or already had children.

Nurses often have the opportunity to observe patients and their visitors. Finding a discreet moment to chat informally with the patient alone can sometimes offer a much-needed life-line.

Nurses should incorporate curiosity and vigilance into everyday practices, particularly, in situations that seem unusual or inconsistent. At the same time, we need to be mindful that normal personal and cultural differences can trigger a sense of ‘strangeness’ within us.

Even when separated from their oppressors, victims may choose to keep their circumstances secret. Attracting attention or attempting to escape could also lead to dangerous repercussions. Being sensitive and tactful is therefore key.

Nurses have ethical, legal and professional duties to uphold, so we need to be aware that any person can be at risk of exploitation. So, wherever you are based, please try to consider the following during encounters with a patient:

  • Do they appear overly anxious, look depressed, or say very little?
  • Do they provide inconsistent information about their age or history?
  • Are there any unexplained signs of physical neglect, injuries, or abuse?
  • Do they have an unclear relationship with an accompanying, perhaps controlling, adult?
  • Are there different languages spoken or religious practices within the same family unit?
  • Does your patient go missing or do they not return for further scheduled appointments?

Things are improving slowly: according to recent figures published by the National Crime Agency, nearly 7,000 potential victims of modern slavery and human trafficking were identified in 2018. That number increased by more than 80% over the last two years. We have a way to go still.

All members of the public — health professionals in particular — can play a critical role in identifying, responding to and treating victims of modern slavery across every clinical and community setting.

Diana De is senior lecturer, School of Healthcare Sciences, Cardiff University

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