Thank you, Chair.
Thank you to the House of Commons Standing Committee on Justice and Human Rights for inviting me here today. I am thrilled to see the committee is interested in hearing about the intersections of health care and human trafficking.
As mentioned, my name is Tara Leach. I am a Primary Health Care Nurse Practitioner. For the past 20 years I've worked with victims of violence within both primary care and emergency settings, both within Ontario and in many of the northern states of the U.S.A. I have worked with ages across the spectrum, spending time in facilities that focus on children, youth and adolescents, and adults. While I had already been exposed to patients who are experiencing human trafficking, I did not come to know the term until I was introduced approximately seven years ago through my husband's politics class. In truth, as a health care professional, I had never been taught about human trafficking: what it was, how to identify someone, or how to intervene or respond effectively. In fact, if I had waited for an opportunity from my professional organization or institutions I had worked for to teach me about human trafficking, I would still be waiting.
With this in mind, I present to you what I feel is a significant gap when I look at Canada's strategies to address human trafficking. Research tells us that a health care provider is one of the few professionals likely to interact with trafficked women and children while they are still in captivity. Studies have reported that upwards of 84% of trafficked individuals saw a health care professional while still in captivity. This represents a serious missed opportunity for intervention. Health care providers are in a unique position to identify victims of trafficking and provide important physical and psychological care to victims while in captivity and after.
The health care problems in victims of trafficking are largely as a result of several factors, including deprivation of food and sleep, extreme stress, hazards of travel, both physical and sexual violence, and hazardous work. Because most victims do not have timely access to health care, by the time they reach a clinician it is likely that health problems are well advanced. These women are at higher risk of acquiring multiple sexually transmitted infections and a sequelae of multiple forced and unsafe abortions. Physical abuse and torture often occur, resulting in broken bones, contusions, dental problems, and cigarette burns. From my experience, this population has a significant incidence of strangulation-type injuries.
Psychological violence results in high rates of post-traumatic stress disorder, depression, suicidal ideation, drug addiction, and a multitude of somatic symptoms. In my experience in working with victims of trafficking, victims are less stable, more isolated, have higher levels of fear, more severe trauma, and greater health needs, more than any other victims of crime I've previously served. In fact, one study even quoted that one trafficking victim can take the same amount of the provider's time as about 20 domestic violence victims.
Further to this, we now know through research that trauma has life-long effects and that it itself can be considered a chronic illness, one that will prove costly to our system if not properly managed. When I look at Ottawa, my home community, I reflect on how many primary health care providers are employed within hospitals and walk-in clinics, places where it is known that victims of human trafficking access care. How many do you think have taken a personal interest and continued with this interest, like I have, to evoke change and recognition to our health care system? How many do you think understand human trafficking, know how to recognize and respond to human trafficking, and work in environments that even support care of trafficking victims? As you may have guessed, not many have.