At St Vincent’s Health Australia (SVHA), a pioneering project is equipping nurses, midwives and other frontline clinicians with the tools to identify and respond to the often-hidden signs of modern slavery.
Funded through the Federal Attorney-General’s Department, The Anti-Modern Slavery and Human Trafficking Project developed a practical screening tool and online education modules, co-created with people with lived experience of modern slavery, to help clinicians recognise modern slavery through a public health lens and respond in a trauma-informed way.
Registered nurse and St Vincent’s Hospital Melbourne Emergency Department Care Coordinator Eve Wintergreen says nurses, midwives and other healthcare professionals are uniquely positioned to identify people experiencing modern slavery.
“As nurses and midwives, we are with people from the time that they are born until the time that they pass away in their most vulnerable moments,” she says.
“We know that people who are experiencing types of modern slavery exploitation in Australia are presenting to healthcare facilities not once, not twice, but our research with people with lived experience has demonstrated that 100%, so all of them, presented to healthcare during their periods of exploitation.”
More tellingly, 80% had attended healthcare services on more than five occasions while being exploited.
“We know that within healthcare, we have a precious opportunity to better identify and respond in a trauma-informed way,” says Eve.
“We may be the only professionals that people in these situations encounter and we’re best placed to identify and educate them about their options and support them to access specialist services in a way that is meaningful for them.”
The pilot project’s screening tool was introduced at St Vincent’s Melbourne last July.
Taking on board feedback from clinicians, rather than introducing another standalone screening tool, the team integrated a quick screening question into existing family and domestic violence screening processes, making it easier for clinicians to incorporate into routine practice.
The screening tool asks a simple question: “Do you feel forced, tricked or trapped for someone else’s gain or profit?”
Eve says modern slavery often intersects with other public health issues nurses and midwives encounter every day, such as homelessness, complex mental health issues, substance abuse, and family or domestic violence situations.
“We know that it takes many forms. Often, there can be an element of chemical coercion through forced substance dependence in situations of exploitation. People may not have to endure physical or sexual punishments or assaults to experience coercion. It can be more subtle, even in the form of online exploitation , or emotional and psychological coercion or threats to develop a fear of what the offender may do to them or their family members,” explains Eve.
“Overwhelmingly, we see that abuse of vulnerability. Whether the person has a disability, whether they may be on a temporary or dependent Visa situation, whether they may be in a situation of financial desperation; these vulnerabilities are used by perpetrators to coerce, to trick and to trap people for their own gain or profit.”
To further build the capacity of clinicians, the project team also developed Australia’s first online education modules on modern slavery that were co-created with people who have lived experience.
The modules draw on de-identified real cases from St Vincent’s Health services, recreated through clinical simulations, to help clinicians better identify people experiencing modern slavery when they present for care and offer a trauma-informed response and safe referral pathway.
Early results from the project have been significant.
Modern Slavery Liaison Officer Tarang Jain says the education modules have significantly increased clinicians’ confidence in recognising hidden indicators of modern slavery while strengthening their understanding of appropriate referral pathways.
“Before the introduction of these trainings, we were on an average seeing one case [of modern slavery] a month being identified,” he reveals.
“Since the introduction of these trainings, because of this increased understanding and confidence, we are seeing one case being identified a week, leading to a 400% increase to such an extent that it’s continually increasing. In the last 10 days we had one case identified every day.”
One recent case involving the conviction of a Melbourne man for possessing a woman as a slave underscored the ongoing reality of modern slavery in Australia and the project’s real-world impact.
Earlier this year, a County Court found the man guilty of slavery and assault offences following evidence of sustained exploitation, coercion and severe abuse of a vulnerable woman over several months in 2022. The victim, an older migrant woman, was subjected to forced labour, food and sleep deprivation, and physical violence while living in the offender’s home, denying her basic freedoms and dignity.
Tarang says the case, first identified at a St Vincent’s healthcare setting, demonstrates the critical role healthcare professionals can play in tackling modern slavery.
“Cases like this help us validate that, yes, the screening process is working because we were able to identify someone who may have been presenting disguised as a normal patient and may have presented multiple times to a facility,” he says.
“This unique process is helping clinicians learn about what may be hidden from plain sight, connecting the dots between what is visible on the surface – homelessness, substance dependence, family and domestic violence.”
According to Tarang, rather than focusing solely on a patient’s immediate presentation, the screening process helps clinicians understand “what is unfolding beneath the surface, what is the root cause, why are these patients continuing to present again and again and can we break that cycle”.
Beyond improving patient outcomes, Tarang suggests earlier identification also reduces repeated hospital presentations and pressure on the health system by helping people access the specialist support they need.
Despite growing awareness, Eve believes misconceptions about modern slavery remain widespread in Australia.
“Many people’s thoughts might go to situations of someone being kidnapped off the street or held in chains locked up in a basement,” she says.
“However, while that sometimes can occur, we know that the majority of cases in Australia are hidden absolutely in plain sight within any industry, whether it’s healthcare, agriculture, hospitality, beauty, you name it. It can happen to anyone, even nurses and midwives, and other healthcare workers.”
With the pilot Anti-Modern Slavery and Human Trafficking Project demonstrating clear benefits, the team is now working to share the education modules nationally so that more frontline healthcare workers can make a difference.
The modules can be uploaded onto other learning management systems, allowing health organisations and professional bodies to deliver them to their own workforce.
For Eve, the goal is simple: equip every nurse, midwife and health worker with the knowledge and confidence to recognise modern slavery and respond appropriately. Because a person cannot achieve a state of health or wellbeing if they remain in a situation where they’re feeling forced, tricked or trapped for someone else’s gain or profit.
“The pilot that we’ve conducted in Melbourne and the tools that we’ve developed, we want them in the hands of every nurse, midwife and health worker across Australia,” she says.
“We trust them to be able to build their capacity to educate themselves, as nurses and midwives have always done in communities forever, and start to understand this as a public health issue and challenge.
“None of us can do this alone, but collectively we can have a tremendous impact in turning the tide.”
