When I look at our very stressed health care system, I understand competing interests and needs. I understand that the patients I have described contradict the “treat and street” funding philosophy of our health care system, that the “one problem” that may get focused on is the most obvious and the one that health care providers may know how to treat.
Health care professionals are not aware of human trafficking, as there is no mandated education on human trafficking. There are no requirements for licensing that this be learned within professional reporting requirements. There is no developed standard education, within medical schools or nursing schools, to even open the awareness that this could be a potential patient. Health care providers are not aware and they do not have the tools, or even sometimes the permission, to spend the necessary time with patients to navigate their needs.
I would like to propose that health care providers be seen at more tables when issues like this are discussed. We need the opportunity to discuss how our current health care system is in fact inaccessible to victims of human trafficking. We need to discuss the stigma and shame that silences victims and prohibits disclosure, because our system is not trauma-informed and it should be. We need to discuss that care is not coordinated and often in keeping with often changing and very dynamic needs of those who have been trafficked.
For clients, previous experiences with stigma, judgmental attitudes, and punitive treatment by providers negatively influence health care engagement, especially among marginalized patient groups. Despite laws recognizing trafficked persons as victims of crime, the perception that survivors are complicit in criminality persists.
Research and practice indicate that human trafficking survivors experience stigma, discrimination, marginalization, institutional violence, and distrust of official systems, which includes health care professionals. Too often, I hear patients recognized as “being in the sex trade” and not identified as being trafficked. The change of language will change referral sources and the frame of mind when caring for somebody of this experience.
Because of the high rates of abuse and violence, human trafficking is associated with substantial trauma. Limited research exists to develop an effective model of health care delivery for human trafficking survivors, but practices that have been effective in other marginalized groups provide an initial road map. An example of this is actually based here in Ottawa. Voice Found, a survivor-led organization, has opened up Canada's first health care clinic focused on human trafficking. I happen to be the lead health care provider for this clinic. The HEALTH clinic is one example of a trauma-informed, survivor-centred, comprehensive health clinic that provides long-term primary and preventative health care as well as case management to survivors of human trafficking aged 13 years and older.
Innovative practices implemented at our clinic are derived from principles of trauma-informed care and psychological literature for a phase-based model of trauma treatment. A trauma-informed approach to treatment encourages therapeutic engagement with health care services and fosters health care access behaviours. While clinics like this can provide rich data to your committee, challenges related to financial sustainability need to be overcome. Our clinic has only three-year funding, provided by our province, and has the capacity to be open only two days a week, which already isn't enough for our demand.
As you gather your data, remember our clinic here in Ottawa and health care professionals like me. I took personal interest and continued to invest my own time to learn more because clients need me to. Oftentimes advocates are born from personal experience. I am not such an individual. Instead, I have been inspired by the strength of survivors, and have taken note of where health care has not been accessible because they did not have the right card or the right attitude. Health care providers cannot ignore human trafficking as an issue, and our government can no longer ignore the fact that health care is challenged and often inaccessible to persons who need it most.
Health care is an important partner to consider when looking at strategies and how to address human trafficking. No matter the moment, health care is generally part of a person's experience, and prevention efforts need to be framed to match a person's needs.
I thank you for your time and for offering me this opportunity. I look forward to your questions.