Faculty: 

Jane Kurz, PhD, RN

Bet Key Wong, MSN, RN, CNORe

This learning  activity uses different education modalities to address the complex issues intersecting domestic violence,  human trafficking and addiction.

The learning activity consists of 2 parts:

•  This online activity utilizing resources from nurses and subject experts on domestic violence, human trafficking, and addiction. 
• The second part of the education program utilizes a trauma-informed approach to learning. It will be held on 4/28/24 in Lewes, Delaware with a live show, community resource fair, and a panel discussion with representatives from local social agencies.  The show is performed by one woman, Mary Goggin. Mary Goggin was a drug and alcohol addict who was a victim of domestic violence and prostitution. The show is written and produced by Mary Goggin. A panel discussion will follow the show.  The panelists are Mary Goggin, Yolanda Montgomery (former NICU nurse) of Zoe Ministries, and a representative from the Delaware Human Trafficking Court, to name a few.

I. Background

According to the CDC, human trafficking is a public health issue that involves at-risk populations like runaways and homeless youths. The Polaris Report states that traffickers use their victims’ vulnerabilities to create dependency.  Many victims of human trafficking have unmet or urgent needs such as substance use.

The state of Delaware is experiencing an increase in human trafficking due to its location along the Interstate-95 corridor. Along with human trafficking, Delaware is also seeing an increase in drug trafficking and deaths due to drug overdose. From 2011 to 2020, the number of suspected drug overdose deaths increased by 170%. That number dropped for the first time in a decade  in 2023  by 1.8% compared to 2022.

Action: Watch Sex Trafficking in the U.S.: Young Lives, Insane Profit | Yolanda Schlabach | TEDxWilmington - this TedTalk by Yolanda Montgomery, Ed.D. (former NICU nurse), Executive Director, Zoe Ministries of Delaware, was given in  2016. Some Internet sites in her talk may not exist but the state of human trafficking continues to be a growing problem in Delaware.  Listen to Yolanda’s talk on the definition of human trafficking, how it relates to domestic violence and abuse, why Delaware is a safe haven for human trafficking, and her call to action.

II. Why should healthcare workers be involved? 

The first call to action from Yolanda Montgomery’s Ted Talk is to educate ourselves.  Human trafficking happens right under our nose and we don’t even know it.  In fact, health care workers especially nurses interact with victims of domestic violence and human trafficking but they often do not know how to screen and care for these victims. 

In 2023, the American Hospital Association, in collaboration with Jones Day and HEAL Trafficking, created the Hospital Against Violence Initiative, to provide resources for health care providers on human trafficking. Speakers are Jones Day’s Alexis Gilroy, Curt Kirschner, and Taylor Goodspeed, along with Hanni Stoklosa, MD of HEAL Trafficking, and Claire Zangerle, DNP, MBA, RN, NEA-BC, FAONL, FAAN, former Chief Nurse Executive at Allegheny Health Network.

Action:  Listen to podcast by Jones Day Talks: Health care provider education and reporting.  

From the Jones Day podcast, mandated reporting  and education requirements vary from state to state. While a state may not have reporting and education obligations related to DV/HT, an employer may have policies and required  competencies related to domestic violence and human trafficking.  

For the state of Delaware,  the Delaware Courts, the Office of the Child Advocate and Children Protection Accountability Commission, and the Domestic Violence Coordinating Council have useful resources on reporting requirements for health care providers.

In 2023,  HB223 was introduced to the Delaware legislature to amend Title 24 of the Delaware Code relating to continuing education for nursing professionals.  If passed, HB223 will mandate all nursing professionals to receive at least one hour of continuing education on sexual or physical abuse and domestic violence upon license renewal. 

III. Screening tools

Mercy Medical Center in Baltimore has one of the earliest nurse-led anti-human trafficking training programs in the country. The Blue Dot Initiative was started in 2007  by forensic nurses working in Mercy’s emergency room. The goal is to teach staff members to recognize and flag victims of human trafficking. Listen to the podcast by the American Hospital Association and their interview with Debra Holbrook, MSN, RN, FNE-A/P, SANE-A, DF-AFN, FAAN, Director of Forensic Nursing at Mercy.

Action:  Hearing the Voices of Human Trafficking victims; Mercy Medical Center’s Blue Dot Human Trafficking Project 

It is important to note from the AHA  podcast that healthcare workers are not here to rescue but to be a lifeline. It’s also important to know resources that you can go to when a patient tells you that he/she is a victim of domestic violence/human trafficking.

Be familiarized with the following screening strategies

• 10 Red Flags that Your Patient Could Be a Victim of Human Trafficking by the American Hospital Association
• Child Sex trafficking Myths by the Polaris Project
• The PEARR Tool - an evidence-based framework for assessment for trafficking and interpersonal violence. The PEARR tool is created by CommonSpirit Health, HEAL Trafficking, and Pacific Survivor Center
  • Provide privacy
  • Educate
  • Ask
  • Respect & Respond

IV. National Resources

• National human trafficking hotline: 1-888-373-7888
  • https://humantraffickinghotline.org/
• National domestic violence hotline: 1-800-799-SAFE (7233) 
• National Sexual Assault Hotline: 1-800-656-HOPE (4673)
• Blue Campaign - https://www.dhs.gov/blue-campaign
• Polaris Project - https://polarisproject.org/
• HEAL Trafficking - https://healtrafficking.org

V. Delaware Resources

• Delaware Coalition Against Domestic Violence
• Domestic Violence Coordinating Council
  • Victim Service Resources
  • Domestic Violence Resource Manual for HealthCare Professionals
• What’s Your Voice
• Zoe Ministries of Delaware

VI. References

1. Basile, K.C., DeGue, S., Jones, K., Freire, K., Dills, J., Smith, S.G., Raiford, J.L. (2016). Sexual Violence Prevention Resource for Action: A Compilation of the Best Available Evidence.  Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention 

2.  https://polarisproject.org 

3.  Drug Overdose Deaths in Delaware Residents (2024). My Healthy Community: Delaware Environmental Public Health Tracking Network. Report retrieved from  https://myhealthycommunity.dhss.delaware.gov/topics/drug-overdose-deaths/locations/state 

4. Byrne M, Parsh S, Parsh B. (2019). Human trafficking: Impact, identification, and intervention. Nursing Management, Wolters Kluwer Health. 

 5. Delaware domestic violence resources for mandatory reporters. Accessible at resource_guide_mandatory_reporting_child_abuse_and_neglect.pdf Delaware Coalition Against Domestic Violence. Accessible at https://dcadv.org 

6.  House Bill 223. Delaware General Assembly. An Act to Amend Title 24 of the Delaware Code Relating to Continuing Education for Nursing Professionals. Accessible at https://legis.delaware.gov/BillDetail?LegislationId=140574.

 7.  Corrigan, P. (2021). Mercy Medical Center aids in Baltimore's fight against human trafficking, Catholic Health World. Accessible at https://www.chausa.org/publications/catholic-health-world/archive/article/august-15-2021/mercymedical-center-aids-in-baltimores-against-human-trafficking. 

8.    10 Red Flags that YourPatient Could Be a Victim of Human Trafficking by the American Hospital Association. Accessible at https://www.aha.org/system/files/2018-07/human-trafficking-infographic.pdf.

9. Child Sex trafficking Myths by the Polaris Project. Accessible at https://polarisproject.org/child-sex-trafficking.

10. PEARR Tool, Accessible at https://healtrafficking.org/wp-content/uploads/2018/08/CSH-PEARR-Tool_June-2021-Protected.pdf

11. Domestic Violence Coordinating Council. Victim Services Resources. Accessible at https://dvcc.delaware.gov.

 12.  Domestic Violence Coordinating Council (2021). Domestic Violence Resource Manual for Healthcare Professionals. Accessible at https://dvcc.delaware.gov