Harris County Forensic Nurse Examiners
Center of Forensic Excellence

Human Trafficking


Rachel Fischer, BSN, RN, CFN, SANE-A SANE-P

HCFNE Forensic Nurse & Human Trafficking Expert

The Importance of the Medical Forensic Exam in Human Trafficking Cases

How Does HCFNE Help Victims of Trafficking?

HCFNE closes the gap in medical forensic services for victims of trafficking. The medical forensic management of this population is crucial on two levels, first, they have immediate needs from an evidentiary standpoint and an exam by a trained and certified forensic nurse is essential. These immediate needs also include sexually transmitted infection, HIV and pregnancy prophylaxis as well as an overall physical assessment for their well being, looking for any other injuries and trauma.

The HCFNE forensic nurse is vital to connecting victims with services provided by our other community partners and NGOs, including Rescue Houston and Houston Area Women's Center (HAWC), among others. Secondly, victims of trafficking are at high risk for many long term medical issues, including gastrointestinal issues from poor nutrition, reproductive concerns, psychological issues, among many others. Connection to medical services and organizations we partner with can prevent long term implications from these ailments. 

Impacting the Demand

The medical forensic exam provides the District Attorney's Office (DAO) with additional avenues to aid in prosecution.  The history obtained during the medical forensic exam, becomes a useful piece of evidence for the DAO as it is an exception to the hearsay rule because it is taken for the purpose of medical diagnosis and treatment. HCFNE has specially trained forensic nurses to diagnose and treat this vulnerable population. 

The medical forensic exam provided by HCFNE is both best practice for the patient and for prosecutorial efforts that benefit the patient and community. Currently, in Houston, medical forensic exams are only offered at specified area hospitals, which puts the victim in an uncomfortable emergency room environment. Oftentimes, victims and families have to wait in the ER for hours to be seen. And even after waiting, they are not guaranteed to be seen by a seasoned trauma informed nurse that has been specially trained to take care of the trafficking population. These victims are not the usual victims of sexual assault. They need specialty, individualized care. HCFNE aims to be a mobile solution and will launch in  February, 2019. HCFNE will also provide services in designated clinic spaces inside HAWC and The Bridge Over Troubled Waters. HCFNE is securing contracts with areas hospitals and other organizations to be able to go into their locations to provide this service as well. We have been in communication with HPD Vice, DPS and the HCSO HT Division to be a part of their organized stings, which will create an ease of access to the medical forensic exam and prevent the chaos of the emergency room environment for the patient and Law Enforcement Officers LEO.