Online Education/Enduring Material

Trafficking in Persons: A Primer for the Health Care Professional

Planning Committee: The Planning Committee Members of: Jeffrey Barrows, DO MA (bioethics); Gloria Halverson, MD; Clydette Powell MD, MPH; Barbara Snapp; Katherine Welch, MD; Sharon Whitmer, EdD, DENTAL Planning Committee Members: Grace Ahn, DDS; Alan Carr, DDS; Michael O'Callaghan, DDS; Richard Topazian, DDS do not have any relevant financial relationships with any commercial interests.

CE Committee: The CMDA CE Review Committee of: Bruce MacFadyen, Chair; Jeff Amstutz, DDS; Lindsey Clarke, MD; Stan Cobb, DDS; Gary Goforth, MD; Elizabeth Heredia, MD; Curtis High, DDS; Dale Michels, MD; Shawn Morehead, MD; John Pierce, MD; Gene Rudd, MD; David Stevens, MD; and Richard Voet, MD do not have any relevant financial relationships with any commercial interests.

Medium Used:
Educational materials are provided by PDF document links. Download Adobe free software.

Method of Participation:
Medical/Dental participant will view the PDF documents and will complete a post-test evaluation for credit which will measure the potential effect of this educational material on their competence, performance, and/or patient outcomes.

Estimated time to complete the educational activity:
Each session should take 1 hour in length to complete

Review Date: December 1, 2015

Release Date: January 1, 2013

Expiration Date: December 31, 2018

Accreditation Statement
The Christian Medical & Dental Associations is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The AMA Designation Statement
The Christian Medical & Dental Associations designates this enduring material for a maximum of 11 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Dental Continuing Education (11 hours available)
The Christian Medical & Dental Associations is designated as an Approved PACE Program Provider by the Academy of General Dentistry. The formal continuing education programs of this program provider are accepted by AGD for Fellowship, Mastership and membership Maintenance credit. Approval does not imply acceptance by a state or provincial board of dentistry or AGD endorsement. The current term of approval extends from 1/1/2015 to 12/31/2018. Provider ID# 218742

11 hours of self-instruction/online education hours – No prior level of skill, knowledge, or experience is required (or suggested). Intended audience: General Dentist, Dental specialist, Dental Assistant, Dental Hygienist, and other healthcare professionals


Human trafficking, otherwise known as modern day slavery is thought to have more than 27 million victims today. There has been a resurgence in awareness and counter trafficking interventions in the last few years both domestically in the US as well as globally. However, the health care community as a whole has been slow in recognizing this as a health care issue and there remains a scarcity of data informing the identification of and services provided to survivors of human trafficking.

Human trafficking is an important global health issue of our time and there have been many calls for more involvement by health professionals in services and research.

Several gaps exist in our ability to care for trafficked persons including:

  1. Improving our ability to identify victims
  2. Developing holistic approaches and sensitization to their specific needs
  3. Developing protocols for care and follow-up
  4. Improving working relationships across disciplines (law enforcement, social work, etc.).

These issues will be addressed through this continuing education online course.

Educational Objectives:

  1. Discuss the widespread extent of human trafficking.
  2. Identify people who have been trafficked.
  3. Screen for common health concerns of this group of people and provide appropriate treatment.
  4. Identify how and where to find resources to safely intervene in a victim’s situation.
  5. Recognize the need for a holistic approach and develop sensitivity to their specific needs.
  6. Review appropriate language that conveys compassion and concern when treating patients.
  7. Observe patients for signs of human trafficking.
  8. Identify the needs of orphans, aliens and those who appear to be oppressed.
  9. Describe a holistic approach (physical, emotional, spiritual) to healthcare when treating a patient.
  10. Examine scriptural references to human trafficking and oppression and how these aid in holistic healthcare.


  • Jeffrey Barrows, DO MA (bioethics); Health Consultant on Human Trafficking, Christian Medical & Dental Associations; Vice President of Education and Advocacy for Abolition International
  • Ruth Downing, MSN RN CNP SANE-A; Founder and President Forensic Healthcare Consulting
  • Gloria Halverson, MD; Adjunct Professor Obstetrics and Gynecology, Medical College of Wisconsin; Team Leader, Global Health Outreach Human Trafficking Division
  • Clydette Powell MD, MPH; Medical Officer, Bureau for Global Health, USAID; Associate Professor of Neurology, George Washington University School of Medicine
  • Katherine Welch, MD; Founder and Director of Relentless; International Human Trafficking Consultant

The Trafficking In Persons (TIP) Faculty do not have any relevant financial relationships with any commercial interests nor do their presentations present unlabeled or investigational use(s) of a drug(s) or devices(s) in the educational modules.

Contact button for CMDA Human Trafficking Commission
CMDA Department of Continuing Education

P.O. Box 7500
Bristol, TN 37621
Fax: 423-844-1017

Continuing Education Modules:

Instructions to Receive Credit
There is absolutely no charge to view the material. However, there are requirements to receive AMA PRA Category 1TM or AGD Pace Credit. Please complete the Trafficking in Persons CE Payment Form. There is no cost for CMDA members.  If you are NOT a CMDA member, there is a $20 per credit hour charge.  For example; completion of 5 of the 11 modules totals a $100 fee to obtain the above types of credit.

Once membership is verified or payment is processed, you will be sent your CE certificate/attendance verification via e-mail.  You should receive the e-mail within 5 business days.  If questions or comments, e-mail

Continuing Education is AMA PRA Category 1 Credit(s)™ and AGD PACE Credit(s). To provide general feedback on the material and for questions, please email CMDA's Trafficking In Persons.

Download the Trafficking In Persons CE Payment Form

Trafficking in Persons: A Primer for the Health Care Professional. THERE IS NO COMMERCIAL SUPPORT FOR THIS ACTIVITY.


Intro to Domestic Trafficking in the U.S.  [1 hour]

Jeff Barrows, DO, MA

Module 1 will provide an introduction to the topic of domestic minor sex trafficking (DMST) within the United States specifically geared to the healthcare professional. It will discuss the known statistics regarding DMST, predisposing factors, recruiting techniques used by traffickers, as well as briefly describe the demand side of sex trafficking. Finally, the module will briefly give an overview of indicators within the healthcare setting that might suggest that the person is a victim of sex trafficking and specific steps the healthcare professional should take if they suspect a patient is a victim of DMST.

Learning Objectives:

  • Realize the extent of the phenomenon of domestic minor sex trafficking (DMST)
  • Identify the signs that a patient may be a potential victim of DMST
  • Take concrete steps if a patient is suspected of being a human trafficking victim.

Trafficking in Persons: An Introduction to the Global Situation  [1 hour]

Katherine Welch, MD

Module 2 will give an introduction to Trafficking in Persons on the global front, that is, outside of the United States. Information will be broad, but will also highlight areas pertinent to the healthcare professional. An overview of the definition, the stages, and the forms of trafficking will be given. Current trends and issues will be discussed. Specific health issues and ways health care professionals can get involved in the efforts against human trafficking will be outlined.

Learning Objectives:

  • Understand definitions, stages, and forms of trafficking in persons (TIP)
  • Discuss perspectives of migration, prostitution, legal, and health issues of international TIP
  • Discuss current trends and issues in the global trafficking situation

Physical Health Consequences of Human Trafficking  [1 hour]

Katherine Welch, MD and Gloria Halverson, MD

Module 3 Health problems of trafficked people encompass the whole spectrum of diseases, but there are unique challenges to addressing these problems. This module will 1) briefly describe the physical health consequences of trafficking in persons; 2) provide practical measures health practitioners can take to address health issues of trafficked people; and 3) address unique opportunities and challenges that health care professionals have in addressing these issues.

Learning Objectives:

  • Describe the health risks and the physical health consequences of trafficking in persons (TIP)
  • Take practical measures to address health problems of trafficked people
  • Discuss the public health impact of trafficking in persons

Mental Health Consequences of Human Trafficking  [1 hour]

Katherine Welch, MD

Module 4 Mental health issues are among the most important problems suffered by victims of human trafficking. However, mental health is also one of the more difficult problems to deal with in this population. This module will outline the more common problems presenting as well as some of the unique challenges to helping the survivors in their mental health.

Learning Objectives:

  • Describe the various mental health problems suffered by survivors of human trafficking
  • Outline the basic principles of mental health care and follow up in this population
  • Discuss the difficulties and barriers to providing adequate mental health care for survivors of human trafficking

Identification and Medical Evaluation of Labor Trafficking Victims  [1 hour]

Katherine Welch, MD and Ruth Downing, MSN RN CNP SANE-A

Module 5 will address the particular needs (acute and chronic) of survivors of labor trafficking. Health problems may differ depending on the place and nature of the work being done and these will be outlined. The steps health professionals should take to address the various health problems in various settings will be discussed.

Learning Objectives:

  • Recognize the forms of trafficking in persons (TIP), in adults and children, for labor purposes
  • Recognize signs and symptoms that may indicate a patient is a victim of labor trafficking
  • Take appropriate steps in the assessment and management of a labor trafficking victim

Identification and Medical Evaluation of Sex Trafficking Victims [1 hour]

Jeff Barrows, DO, MA and Ruth Downing, MSN RN CNP SANE-A

Module 6 will focus on training the healthcare professional to identify victims of sex trafficking within several healthcare settings by discussing the various identifiers of sex trafficking as well as the types of medical problems victims of sex trafficking tend to present with. The module will also discuss the medical evaluation, screening and triage of a victim of sex trafficking brought into a healthcare setting after being found by law enforcement, or some other agency.

Learning Objectives:

  • Recognize the indicators that a patient may be a victim of sex trafficking
  • Take the necessary steps to identify whether the patient is, in fact, a victim
  • Perform an adequate medical evaluation of a sex trafficking victim

Identification and Treatment of Long-Term Health Consequences  [1 hour]

Gloria Halverson, MD and Clydette Powell, MD, MPH

Module 7 will identify the long-term health consequences of HT and classify them into various medical and public health categories, thereby allowing the health care professional (HCP) to develop and implement diagnostic and treatment responses, appropriate in either low- or high- resourced settings. The session will also guide the HCP towards selecting primary, secondary, or tertiary prevention measures with an eye to both individualized and community-based approach to health care provision. While pointing out the research gaps about various parameters surrounding long-term health consequences of HT, the session will suggest some avenues for needed research to quantitate and track these issues on both a local and global basis.

Learning Objectives:

  • Name the major long-term health consequences of human trafficking
  • Describe the key reproductive health, nervous system, and infectious disease conditions which can be chronic conditions in trafficked persons
  • Explain initial approaches to mental health conditions, substance abuse issues and chronic pain management
  • Describe some preventive health interventions that should be considered for trafficked persons

Multi-disciplinary Care of the Trafficked Person [1 hour]

Clydette Powell, MD, MPH

Module 8 Working within a team is the most effective means of responding to the needs of a trafficked person or a trafficked suspect. The health care professional will need to understand his/her role in relation to other health professionals whose specialties can contribute to the health evaluation of the trafficked person. Moreover, he/she will need to know how to interface most effectively with law enforcement, child protective services, shelter staff, substance abuse and addiction services, and forensic examiners. He/she will also need to know how to develop a plan for an appropriate transition of care.

Learning Objectives:

  • Identify the key personnel with whom healthcare professionals (HCP) will interface in the process of care for a TIP victim - including law enforcement.
  • Develop an approach to referral services and the short- and long-term needs of trafficked victims.
  • List the key forms of immigration relief available to victims, including T and U visas.
  • Apply key lessons as an expert witness (as a healthcare professional) and how to use affidavits.

The Healthcare Professional's Role Beyond the Clinic Setting [1 hour]

Clydette Powell, MD, MPH

Module 9 Responses to trafficking in persons are often categorized as the three P’s: prevention, protection, and prosecution. The health care professional has an opportunity to participate in prevention through advocacy and awareness raising; protection for TIP victims by working with shelters and aftercare facilities; and to some extent, prosecution of their traffickers through such means as expert witness. Many other channels for engagement are also covered in this module, and describe resources and tools for becoming an abolitionist of modern day slavery.

Learning Objectives:

  • Identify ways to get TIP training, tell others, serve victims, and advocate against human trafficking
  • Describe how to get engaged in the 4 P’s
  • Explain the role of media, the internet and mobile technology in trafficking
  • Identify print, web and other media resources on TIP
  • Design strategies to fight TIP

The Spiritual Basis for a Response to Human Trafficking [1 hour]

Jeff Barrows, DO, MA

Module 10 will discuss the scriptural references that relate to the issue of human trafficking and how they communicate compassion and concern for those who are oppressed. The session will discuss how these scriptures come together to address the needs of orphans, aliens, and those experiencing oppression. Finally, the session will discuss options for healthcare professionals to approach suffering from a physical, emotional and spiritual perspective.

Learning Objectives:

  • Compile Scripture verses that deal with the issue of human trafficking
  • Use these Scripture verses to answer questions from victims of human trafficking
  • Evaluate the spiritual needs of victims of human trafficking
  • Describe ways to support victims of human trafficking

Caring for Victims in Low Resource Settings [1 hour]

Katherine Welch, MD and Gloria Halverson, MD

Module 11 will address some of the challenges that health professionals face when serving trafficked persons in low-resource settings. Health care practitioners can be prepared to meet a variety of situations without the standard facilities and equipment with some anticipatory guidance. Appropriate protocols may vary depending on whether this is a short term trip or the development of a sustainable long term program. Protocols and procedures developed for effectiveness in low resourced countries will also be presented.

Learning Objectives:

  • Identify the myriad resources that may be lacking in the care of trafficked people
  • Employ techniques for assessing and treating health problems in low-resource areas
  • Identify ways in which a health care professional can help bridge resource gaps
  • Identify necessary steps for short term teams to be effective