Some might look at an EMS run as just another ordinary call for service. However, in many cases, EMS providers have a more profound effect on a person’s life: Sometimes, we are the only first responders to have contact with patients who might be in distress or being held against their will.
There has been a rise in cases of human trafficking on a global scale. It can take multiple forms, most notably sex trafficking and labor trafficking. Victims come from all socioeconomic backgrounds and include all ages, races, genders and nationalities.
The Trafficking Victims Protection Act of 2000 defines human trafficking as either sex trafficking or labor trafficking.
Sex trafficking is the “recruitment, harboring, transportation, provision, obtaining, patronizing, or soliciting of a person for the purpose of a commercial sex act in which a commercial sex act is induced by force, fraud, or coercion, or in which the person induced to perform such act has not attained 18 years of age.”
Labor trafficking is the “recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud, or coercion, for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery.”
Many factors lead to people being lured into human trafficking, including an unstable home life, family abandonment, feelings of worthlessness and lack of affection. Common indicators that EMS providers as first responders should be on the lookout for can be identified by four basic categories: physical, behavioral, environmental and financial.
Physical indicators
One physical indicator is signs of abuse, such as bruises, cuts and burn marks. Victims also might show indications of being malnourished. They might exhibit symptoms of being sleep deprived, such as fatigue, irritability, difficulty concentrating and daytime sleepiness.
Other physical indicators are lack of proper and adequate medical care and tattoos of names, symbols or barcodes.
Behavioral indicators
Behavioral indicators include victims being fearful, anxious, submissive or timid. They often lack control over their documents, money and movement.
Victims also might exhibit symptoms consistent with post-traumatic stress disorder, which include anxiety, difficulty controlling emotions, avoidance, and being over aroused or sensitive. In many cases, victims’ ability to speak is restricted: Someone speaks on their behalf or the victim looks to a third party prior to answering any questions.
Environmental indicators
Environmental indicators include living in unsuitable conditions, lack of a stable environment and having their movement restricted. Many victims have limited ability to move freely or often have someone accompanying them without a valid reason.
Financial indicators
Financial indicators include a victim being either unpaid or underpaid. Victims might have large debts that they are unable to pay or are required to pay through pay deductions for their living expenses.
In some cases, they might have new and expensive clothing and objects, such as cellphones and jewelry, without an adequate income source to explain these expensive items.
Presence of multiple signs
EMS providers can tend to overlook the indicators or, in many cases, don’t tally the subtle signs. Numerous indicators alone can mimic other issues, such as domestic violence, mental health crisis and anxiety. However, when multiple indicators are present, we should be more diligent in our reporting—or at the very minimum, make sure our suspicions are known to hospital and law enforcement staff.
If you suspect that you encountered a victim of human trafficking, notify your local law enforcement agency or call the National Human Trafficking Hotline at 1-888-373-7888. Your call will be completely confidential.
Robert Olkowski
Robert Olkowski was appointed as assistant superintendent of the Detroit Fire Department’s Emergency Medical Services Division in 2022. In this role, he’s responsible for overseeing the operational aspects of Detroit’s EMS service and works closely with federal, state and local partners to plan for and execute special events in the city. Olkowski began his career at the Detroit Fire Department in 1999 as an EMT and then paramedic (a license he already earned). He rose through the ranks in the EMS Division and was working as a captain in EMS administration prior to his current position. Olkowski graduated from the Staff and Command in Executive Fire Leadership Program and is certified by the Michigan State Police as a Professional Emergency Manager. He also is a licensed EMS instructor-coordinator and teaches EMS licensure classes. Olkowski holds two associate degrees, one in business and one in business administration. He currently serves as the Detroit East Medical Control Authority’s Advisory Chair.
