Modern Slavery in Rural Areas

We speak with a nurse practitioner who has experience working with victims and survivors of modern slavery in the UK.   Episode summary: 00.45 Our speaker tells us about her professional background and how she developed an interses in modern slavery 04.15  What is modern slavery? 06.45  Where does modern slavery happen and does it affect rural communities? 09.00  Who is most at risk of human trafficking and modern slavery? 10.30  Who are the traffickers? 12.40  How would we identify modern slavery? 19.30  How do we approach consulting a patient who we suspect is a victim of modern slavery? 27.30  What happens after a person has been referred to adult safeguarding? 29.35  How could we support survivors of modern slavery? 33.15  Where can we learn more about trauma-informed care?         Key Messages: Modern slavery is a situation where individuals are exploited through coercion, force, and deception for various purposes.  The main purpose of the traffickers are benefits such as money. People would not always know they are being trafficked because of the deception and lies.  They would only suspect it once they find themselves in difficult situations. 50 million people globally have been trafficked. It is difficult to know the exact numbers due to the nature of trafficking.  In the UK,  in 2022, more than 10 000 people were identified by the Home Office as victims of trafficking.  The true numbers are suspected to be much higher than this.   Modern slavery can happen anywhere including rural communities.  It is much more hidden in rural communities, particularly in agriculture.  The main reason for human trafficking and modern slavery is poverty. People more at risk of being trafficked are those with less social support around them, people with people dependent on drugs or alcohol, people living in extreme poverty, and undocumented migrants - people who are part of vulnerable groups. Traffickers are clever and know who can be easily influenced into their businesses.   A victim of modern slavery might not know they are in that situation as they do not know what kind of conditions they should expect.  For this reason they may not know to ask for help. It is much more difficult for victims to be identified in rural areas.  Farmers and agricultural employers need to be on the lookout for unusual employment and recruitment practices.  Other signs can be unusual living conditions, limited freedom of movement, being closely monitored when they do move outside of their working or living areas, isolation, signs of abuse, malnutrition and untreated medical conditions, working long hours in hazardous conditions, little control over personal finances or possessions, fear and anxiety - may be very reluctant to talk to authorities or seek help.   Important for GP practices in rural areas to have training in identifying the victims of modern slavery, they have a crucial role in identifying these individuals.  Take special care when you are seeing someone who is accompanied by another who refuses an official interpreter and insists on being present in the consultation.  Trust your professional instinct and arrange a follow up appointment to explore further.   What to do if you suspect a patient is at risk of modern slavery? Make sure you are safe, stay calm, try to talk to them on their own and try to address their health needs. Alert your colleagues.  Ask for an interpreter.    If you are safe to do so, ask the accompanying person to leave, and try to examine the patient on their own. Try to make the person feel safe, build trust. Do not ask them about their immigration status, focus on their health needs and ask them what they want. Arrange a follow up appointment if requested or you assess it is needed. You must ask the person if you can refer them to the adult safeguarding team. If a child is involved then a referral is made immediately.  Once they have given you the permission then you can refer them to the adult safeguarding team. If you are unsure contact the national modern slavery helpline or police (anti slavery unit). Trauma-informed care is important for survivers of modern slavery and human trafficking. Culturally sensitive care is also vital as it is part of making the person feel safe.     Rural Health Compass - Navigating rural health and policy. Thank you for listening to the Rural Road to Health!