My first victim of Commercial Sexual Exploitation of Children (CSEC) was a 14 year old boy who was being sold to support his caregivers’ drug additions. He was admitted through the emergency room to our Pediatric unit when I was the Charge nurse. We did not even have the term human trafficking back then. But the idea that someone was selling a child in order to make money to purchase drugs was horrific. He was taken out of that situation because of the medical emergency that brought him to the Emergency Room.
When I started talking to healthcare providers about human trafficking, most felt that it was something that was happening far away in another country and none reported actually seeing a patient that was a trafficking victim. However, it turns out that in a recent research article, Dr. Laura Lederer reported that a majority of survivors (87.8%) indicated that they sought healthcare at some point during the time they were trafficked. Victims sought care at hospital emergency wards, urgent care clinics, neighborhood clinics, women's clinics, Planned Parenthood clinics, and primary care practitioners. Many providers were unaware of the fact that they were treating a trafficking victim, and unaware of the force, fraud, and coercion involved in trafficking. Most health care providers lack training in human trafficking and are ill-equipped to identify, assess and treat potential victims. This lack of training leads to missed opportunities for intervention, and may lead to inadvertent re-traumatization of victims through lack of trauma-informed care. (Full article http://www.globalcenturion.org/wp-content/uploads/2014/08/The-Health-Consequences-of-Sex-Trafficking.pdf)
Fast forward to 2015, I provided training for Emergency Room staff at an urban hospital last month. Within days we received a call that two victims had already been identified. Education gives nurses, doctors, and hospital social workers the eyes to see what has been in front of them over and over and to take action. Healthcare providers are trusted advocates for their patients. They may be the only professional to have direct contact with a possible victim of human trafficking and just need the tools to recognize and respond by calling local advocates or the National Human Trafficking Hotline 888.3737.888 who will help the caller assess and respond.
When I think of the trafficking victims who sought medical care from uninformed, unaware medical professionals, it makes me wonder how many of those kids looked tentatively into the eyes of those busy professionals hoping that someone would slow down long enough to make eye contact, and be intuitive enough to sense that something wasn't right.
Traffickers aren't caring, nurturing individuals, so we must consider that a visit to medical professionals must be prompted by a serious situation. Imagine how sick a kid has to be to finally get taken for medical care. They have no health insurance, and with traffickers paying cash for treatment, how is it that registration staff don't question the circumstances? And who are the doctors who write prescriptions for antibiotics without connecting the dots? And what about recommendations that the kid be admitted, but instead leave with only a prescription?
Imagine the pregnant twelve year old who is taken to Planned Parenthood by her thirty-something year old trafficker. Frightened, vulnerable, quietly doing as she's told, having been warned by her trafficker "boyfriend" not to say a word or raise any suspicion, she silently hopes that someone will notice and call the police. Imagine that child forced to go along with an abortion, and afterward sent back out to the trafficker who escorts her back into hell without rescue.
Consider that the average life expectancy of a trafficked kid is estimated to be seven years. When the "reusable human asset" is riddled with disease, and no longer responds to antibiotics, the most humane of the traffickers dump the girls off and call 9-1-1 with the address of where the girls can be found.
How many kids could be saved if all medical people were trained to notice, ask the right questions, and were required to report any suspicious circumstances?
There are lots of ways to promote training for healthcare providers in your community. You can start by listening to the Ending Human Trafficking Podcast on iTunes or Stitcher and download #36 and #59. You can also check out the Homeland Security Blue Campaign “Coffee Break” training for First Responders which includes Emergency health services https://www.dhs.gov/sites/default/files/publications/blue-campaign/bc-inf-fr101-first-responder-ht-coffee-break-training.pdf The National Human Trafficking Resource Center offers a suggested assessment protocol. http://www.traffickingresourcecenter.org/resources/human-trafficking-assessment-medical-professionals