Lecture 6 - HT & MMIWG



Understanding Human Trafficking

  • Definition: Recruitment, transportation, transfer, harboring, or receipt of persons through force, fraud, or coercion for exploitation

  • Exploitation forms include forced labor, sexual exploitation, involuntary servitude, and modern-day slavery

Importance of Human Trafficking in Health Care

  • Often viewed as a global issue, yet 94% of cases in Canada are domestic

  • First Nations, Inuit and Métis women account for 50% of human trafficking cases despite being 4% of Canada's population

  • Significant statistics: 25% of cases involve FNMI girls under 18, 88% of victims access healthcare while trafficked

Clinical Presentation of Trafficked Individuals

Physical Indicators

  • Signs of physical abuse; old fractures, bruises at various healing stages

  • Malnourishment and dehydration

  • Untreated medical conditions and STIs

  • Unplanned pregnancies and pelvic inflammatory disease

  • Signs of genital trauma

Psychological Indicators

  • Indicators of trauma: fearful, anxious, overly compliant

  • Possible substance abuse or addiction

  • Unsure of personal information and inconsistent histories

Social Indicators

  • Limited access to personal identification

  • Accompanied by controlling individuals during healthcare visits

  • Lack of freedom, inability to be alone with healthcare providers

Pathways to Trafficking

  • Rarely directly kidnapped; trafficking often results from:

    • Deceit

    • Coercion

    • Exploitation within social and family networks

    • Institutional exploitation

Local Context of Trafficking

  • Common areas include local hotels, casinos, and sites with high domestic violence rates

  • Notable events such as the North American Auto Show may serve as environments for trafficking

Provider Responses to Human Trafficking

  • Engage in human trafficking training

  • Encourage patient self-disclosure

  • Utilize screening tools for trafficking assessment

  • Recognize universal help hand signals

  • Provide trauma-informed care

  • Document all interactions thoroughly

Deborah's Story

  • Highlighting insights from a human trafficking survivor

Break

The Highway of Tears

  • Notable 725km stretch on Highway 16, British Columbia

  • Nine Indigenous women reported missing/murdered since 1989, with community insights suggesting over 40 cases

  • Law enforcement negligence complicates resolution

Background of the National Inquiry

  • Initiated due to the alarming over-representation of missing Indigenous women

  • Government began inquiry in 2016; involved community engagement and ceremonial practices

  • Final report published June 3, 2019, with testimonies from 1484 family members and survivors

Elder Laureen “Blu” Waters' Reflections

  • Emphasis on Indigeneity and ceremonial practices during the inquiry process

Final Report Insights

  • Reclaiming Power and Place emphasizes rights: culture, health, security, and justice

Chapter 6: Confronting Oppression – Right to Health

  • Health is considered a fundamental human right

  • Impacts of colonial violence on FNIM health identified:

    • Historical trauma

    • Social determinants of health

    • Systemic discrimination

    • Health system inequities

Calls for Justice

  • 231 calls addressing rights and obligations across multiple sectors including culture, healthcare, media, and law

  • Specific actions requested for Métis and Inuit communities

  • Importance of infrastructure development