This ER Nurse Found a Way to Spot—and Stop—Human Trafficking

Human trafficking is rampant all over the globe, and that includes the United States. One ER nurse found a way to step in and help.

Henry Ford Hospital Clara Ford Award Winner - Danielle Bastien 2018Courtesy Danielle Bastien/Riva Sayegh-McCullenIt wasn’t one “aha!” moment that spurred nurse Danielle Bastien to start a program to help identify victims of human trafficking. It was several; among the worst were the lingering images of patients turning up in her emergency room bearing all the signs of being held in modern-day slavery.

“They’re most commonly accompanied by someone who’s controlling the conversation or speaking for them, who has control over money, identification, travel documents,” says Bastien, who holds her doctorate in nursing practice and works at Henry Ford Hospital in Detroit. If someone comes alone for care, they may show a fearful attachment to their cell phone (that’s how traffickers keep tabs on them). Bastien has also seen patients with GPS or listening devices on their phone.

Then there are injuries that don’t match the stories, and the injuries themselves. “They have things like sexual reproductive disorders, maybe frequent abortions, or infections from a poorly performed one, frequent urinary tract infections, drug overdoses,” she says. (Learn about tips to help a friend experiencing domestic abuse.)

As Bastien witnessed these signs of trafficking again and again, she began to wonder: Could she develop a screening tool that could help healthcare workers identify trafficked individuals and provide solutions for the women, men, and children in peril? Making it part of the doctoral degree she was pursuing at the time, Bastien created a program that is saving lives in the Henry Ford Health System.

Scope of the problem

There aren’t reliable statistics on the human-trafficking problem in the United States, says Terry FitzPatrick, communications and advocacy director at Free the Slaves in Washington, DC, but the number is likely “in the many thousands or many tens of thousands.” Internationally, there are 40 million people held in modern forms of slavery, including forced labor, sex slavery, and forced marriage.

Michigan, which hugs the border with Canada, has the seventh-highest number of reported human trafficking cases among U.S. states, according to the National Human Trafficking Hotline.

Human trafficking and healthcare

Although organizations such as FitzPatrick’s train labor inspectors, TSA agents, airline employees, law enforcement officers, and even UPS drivers to identify victims of human trafficking, the healthcare field is still playing catch up in identifying the problem. “We are seeing victims and survivors in our healthcare system, whether we’re identifying them or not, whether we’re prepared to respond appropriately or not,” says Holly Austin Gibbs, herself a survivor of child sex trafficking and now director of the Violence and Human Trafficking Response at CommonSpirit Health.

According to the human trafficking group Polaris Project, up to 88 percent of trafficking victims intersect with the healthcare system at some point in their ordeal. Few, however, report receiving information on victim services.

“The healthcare space is a space where a victim or survivor can potentially disclose and receive assistance in a space that might feel safer to them than a law enforcement setting,” says Gibbs, whose organization also trains physicians and others, including via online education modules. Some 50,000 professionals have completed the course called Human Trafficking 101, electronically or in person.

nurse writing on health papersLumiNola/Getty Images

A new way to identify trafficking victims

Bastien initially developed her human-trafficking protocol as part of her doctoral program, doing months of research into scientific and other literature before actually compiling the program simply called “Human Trafficking Screening.”

“It’s essentially like an electronic medical record, so it’s built into the system,” explains Bastien, who trained all of the staff at her hospital. “There are embedded questions that flag the staff members.”

The nurse first looks for outward signs of this type of abuse, such as suspicious bruises, as well as less obvious signs, like unwarranted anxiety, fear or submissive behavior

“If the person is flagged, then the primary nurse would automatically ask objective questions,” explains Bastien, 32, a native of Windsor, Ontario, Canada, just 10 minutes from Henry Ford in Detroit. Examples of questions might be, “What kind of work do you do?” “Are you being paid for the work?” “Are you free to come and go?”

Spreading the word

The protocol went live at Henry Ford Hospital’s emergency room on December 6, 2017, and has since expanded to all inpatient and outpatient divisions.

“The staff was super-willing to do everything then and now,” says Bastien. “As it took off around the hospital, more and more units wanted to do it. People are very receptive. I’ve had open doors throughout the hospital.” She notes that she has probably trained more than 1,000 medical professionals.

The response has been enthusiastic not just locally but nationwide as well. Bastien has been contacted by close to 50 hospitals around North America, she says, and has assisted them in preparing. At least a dozen have implemented protocols of their own, she says.

Help for victims and survivors

To date, Bastien’s protocol has identified more than 18 victims, four of them minors. Not all accepted help. The system has also helped staff identify domestic abuse they may not have picked up on previously, Bastien adds.

If the person is a minor, “you have to report to three if not four agencies,” Bastien says. “If they’re a foreign national, you have to call Customs,” she says, referring to U.S. Custom and Border Protection.

Adults are different. “You’re not a mandatory reporter for anyone over the age of 18,” she says. Instead, she gives information on the Human Trafficking Hotline (888-373-7888). If they accept help, the people are referred to social workers and others. The idea is to empower.

“You offer hope,” Bastien says.

If you or someone you know needs help, you can reach the National Human Trafficking Hotline at 1-888-373-7888.

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Amanda Gardner
Amanda Gardner is a freelance health reporter whose stories have appeared in,,, WebMD, HealthDay, Self Magazine, the New York Daily News, Teachers & Writers Magazine, the Foreign Service Journal, AmeriQuests (Vanderbilt University) and others. In 2009, she served as writer-in-residence at the University of Wisconsin School of Medicine and Public Health. She is also a community artist and recipient or partner in five National Endowment for the Arts grants.