Category Archives: Blog

Making that One Encounter Matter

Over the past 5 years whilst working with Snowdrop, Lara and I have had numerous people from other NGO’s to statutory and health organisations come to us and say – “I’ve never had training about trafficking.” People you would think would or should be informed: student doctors, social workers and NHS staff.

A 2015 survey of NHS staff reported[1]:

86.8% of 782 NHS professionals sampled reported lacking knowledge of what questions to ask to identify potentially trafficked people.

78.3% further identified that they had insufficient training to assist trafficked people.

This is a problem.

As a service provider, I know that NHS staff are very likely to be some of the first people and sometimes the only professionals to encounter trafficked people and most of them don’t know what to ask or how to help.  It is one of the most humbling and important aspects of my job to help change these statistics. To raise awareness, and to give professionals the information and tools they need to ensure that if they come across a potential victim, that they see the indicators and know what to do.

One of the ways The Snowdrop Project does this is through speaking and training groups, organisations and students.

In February, I had the privilege of guest lecturing 2nd Year Midwifery Students at Sheffield Hallam University about working with trafficked women, asylum seekers and refugees. The students I lectured were warm and engaged, passionate and knowledgeable. I was and am impressed by the calibre of these student midwives. They are going to be terrific.

I talked about how it is estimated that between 11,000 and 13,000 people are believed to be caught up in trafficking in the UK at any one time. We discussed the differences between refugees, asylum seekers and migrants – and the overlap between these groups and trafficking. I went through vulnerabilities of this diverse group – what makes someone vulnerable to trafficking? (lack of education, poverty, lack of opportunities, broken families, war, violence) What might keep someone in a trafficking situation? (fear, control, not knowing rights, inability to speak English).

We talked about how this issue is so complex and how survivors are still vulnerable even and especially after rescue.

We reflected about how it might feel to become pregnant as a result of trafficking. How important it is to trust your midwife.  How their treatment and compassion can make or break someone’s experience of the NHS. We talked about why as healthcare professionals they might be the first or only professionals trafficked women may encounter and what a privilege that is.  One female survivor, trafficked for forced marriage recalled:

“They were really nice and friendly and got me clothes, food and toiletries; one of the nurses even did my hair for me. They told me that I had to eat for my baby and they asked me what kind of food I liked so they could make sure I had the food I liked.” [2]

During this lecture, I talked about indicators of trafficking specific to midwifery and pertinent to healthcare:


Women who delay antenatal booking until their second or third trimester, or do not seek admission to a maternity unit until their labour is well established – especially those without English language skills.

Controlling person attending appointments with them, not allowing healthcare professionals to be alone with person can sometimes act as ‘unofficial translators’

Poor engagement with healthcare providers and attending with a controlling companion.

Signs of physical or sexual abuse such as broken bones, burns, chronic pelvic pain and STIs

Not having access to identity documents or proof of address.

Any of the above when paired with an inability to speak or understand English.

The students were quick to pick up that there is quite a bit of overlap between indicators of someone who has been trafficked and someone in a domestic violence situation. They drew from the statistic they already know – that a woman needs to be asked a minimum of three times about violence at home before she will disclose. How can they look for indicators of trafficking within the answers to questions about domestic violence?

Then the questions came –

We’ve had women attend hospital in advanced labour who said they were ‘on holiday’ – and she was assumed to be a health tourist. You’re saying this could be an indicator of trafficking?

If someone discloses something to me how do I make a note and flag it to my supervisors?

What if I identify a potential victim?

What do I do? What do I ask?

Who do I contact – how can I keep these women safe?

They were moved, compassionate, and informed.  They are going to be excellent midwives. And I am so pleased that I got to be a part of their education.

If you are concerned that an individual you meet may be a victim of modern slavery, call The Salvation Army’s confidential Referral Helpline on 0300 3038151 available 24 hours a day, seven days a week.

If you or your organisation are interested in training or speaking from Snowdrop please enquire here.

[1] (Sian et. al.  2015) “Provider Responses, Treatment and Care for Trafficked People: Optimising identification, referral and care of trafficked people within the NHS”  – Final Report for the Department of Health Policy Research Programme.

[2] Ibid.

This blog was written by Rachel Medina, the Snowdrop Project Local Coordinator.