Volume 3, Issue 1, Summer 2014

 

HEAL TRAFFICKING: HEALTH PROFESSIONAL EDUCATION, ADVOCACY, LINKAGE
 

 

Because Human Trafficking is a Health Issue

 

 

By Susie Baldwin, M.D., M.P.H.

 

Managing Editor: Juliana Zhu, Esq.

 

 

Human trafficking is modern-day slavery, a global industry of exploitation that generates billions of dollars in international profits each year. Human trafficking involves a process through which a person is recruited, coerced, or defrauded into a situation in which they are controlled and manipulated to perform forced labor. People who are trafficked can be male, female or transgender; adults or children; documented or undocumented immigrants, visitors, or temporary workers; and US citizens or residents.

 

As a result of the complex trauma they experience, victims and survivors of trafficking sometimes suffer from both acute and chronic, short term and long term health effects. Health professionals play a critical role in meeting the needs of survivors, and helping them to recover and rebuild their lives. Health professionals also play a key role in identifying people who are currently being victimized by traffickers or who are at risk for trafficking. However, few private or public resources, and few policies or programs, have focused on the intersection of human trafficking and health.

 

HEAL Trafficking was founded to ensure that health professionals play a united, critical role in the national and global fight against human trafficking. We were founded by six physicians living and working in different corners of the United States, each discovering in isolation the profound challenges inherent to understanding and meeting the needs of survivors. We created HEAL Trafficking to face these challenges together. Since launching in October 2013, we have brought together over 300 physicians, advanced practice clinicians, nurses, psychologists, dentists, researchers, clinical social workers, public health workers, health educators, administrators, and other health professionals who work with and advocate for survivors of human trafficking.  Our growing network includes leaders in academia, government, clinical practice, and public health from geographically diverse areas, as well as survivors themselves. Together, we serve as a centralized resource on health for the broader anti-trafficking community. Those interested in joining the HEAL community can do so at www.HEALtrafficking.org.

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In our first collaborative project, HEAL Trafficking submitted comments to the U.S. House of Representatives Committee on Ways and Means regarding their draft legislation, “Preventing Sex Trafficking and Improving Opportunities for Youth in Foster Care.” Foster children, sadly, are among the people most at risk for trafficking. On behalf of our Prevention and Advocacy Collaborative Working Groups, and the Steering Committee, we advocated for the prevention of all child trafficking, including labor trafficking, trafficking of boys, and trafficking among LGBTQ youth. We requested the development of programs to better educate foster caregivers and foster youth themselves about human trafficking, to teach foster youth about their human and legal rights, and to help them develop healthy, long term relationships through mentorship. We encouraged the Committee to consider the mental health needs of foster children, and to promote the development of trauma informed health services for these youth as well as for other survivors of violence. We expressed our concern that child welfare services are not sufficiently funded or staffed to properly care for or protect the many children who are at risk for being trafficked.

 

In the coming months, HEAL Trafficking’s topically oriented working groups will synergize to improve the quality of our members’ existing work, and encourage collaboration. Our working groups have started meeting, bringing passion and great minds together on efforts regarding Education and Training; Research; Hospital and Clinic Protocols; Prevention; Advocacy; Direct Services; Legal Issues; Media and Technology; and International Linkages. We hope to impart to our colleagues, our communities, and our governments the importance of including health professionals in multi-system responses to human trafficking. We ask for support for our efforts to provide high quality, culturally sensitive, holistic, trauma-informed health care to people who have been trafficked and to those at risk.

 

BACKGROUND

  • Human trafficking is a health issue. Studies suggest that 28-50 percent of victims in the U.S. encounter health care professionals while being trafficked, but are not identified (1, 2). Health care providers who identify victims can connect them with vital services (3).

  • Trafficking survivors have physical and mental health needs that health care professionals can address (3, 4, 5, 6, 7).

  • Challenges in addressing the health needs of trafficking survivors for health professionals include:

    • Lack of access to health care for human trafficking victims, including lack of insurance or underinsurance, even under the Affordable Care Act;

    • Failure to identify and appropriately treat victims when they present for healthcare;

    • Lack of systematic training of all healthcare providers;

    • Limited resources to meet the acute and long-term medical and mental health care needs of this population;

    • Dearth of resources to address social and economic barriers that patients face in accessing and continuing care;

    • Scarcity of systems of trauma-informed care;

    • Decentralized and limited data on the numbers of trafficking survivors in the U.S. and their health issues; and

    • Inadequate/nonexistent data and research into best practices and outcomes;

  • County to county/state-to-state/country-to-country variation in local safety net structure and capacity.

  • Health professionals serving survivors of labor and sex trafficking in the United States have long worked in isolation to meet the extensive medical and mental health needs of their patients. These providers strive to improve the well-being of their patients, to better understand the broad and often profound health effects of trafficking, and to create new and improved systems of care to better meet the needs of survivors.

 

HEAL TRAFFICKING STEERING COMMITTEE MEMBERS

  • Susie Baldwin, MD, MPH, Los Angeles County Department of Public Health, Los Angeles, CA. healtraffickingnow [at] gmail.com

  • Kimberly Chang, MD, Asian Health Services, Oakland, CA. kchang [at] ahschc.org

  • Makini Chisolm-Straker, MD, Columbia - New York Presbyterian Hospital, The Mount Sinai Medical Center, New York, NY. makini.chisolm-straker [at] mssm.edu

  • Aimee Grace, MD, MPH, Children's National Medical Center, Washington, DC. aigrace [at] cnmc.org

  • Nicole Littenberg, MD, MPH, Pacific Survivor Center, Honolulu, HI. Nicole [at] PSChawaii.org

  • Hanni Stoklosa, MD, Brigham and Women's Hospital, Connors Center for Women's Health and Gender Biology, Harvard Medical School, Boston, MA. hstoklosa [at] partners.org

 

 

Susie Baldwin, M.D., M.P.H. is a Public Health/Preventive Medicine physician who specializes in women’s health and epidemiology. Since 2006, she has served as Chief of the Health Assessment Unit at the Los Angeles County Department of Public Health, where she oversees planning and analysis of the LA County Health Survey. In recent years, she has been honored with the Department’s Public Health Excellence Award and the Physician Recognition Award for Health Equity. Dr. Baldwin is the former medical director for the California Family Health Council and received their 2014 Family Planning Champion Award. Dr. Baldwin has served as an advocate for survivors of human trafficking since 2005, working as a researcher, educator, and volunteer clinician. For her work with survivors, she received the Paul and Sheila Wellstone Award from Freedom Network USA in 2011. She also received the June 2014 Advocate Spotlight Award from Cancer InCytes magazine.

 

 

References

  • Family Violence Prevention Fund. Turning Pain Into Power: Trafficking Survivors' Perspectives on Early Intervention Strategies. San Francisco: Family Violence Prevention Fund; 2005.

  • Baldwin SB, Eisenman DP, Sayles JN, Ryan G, Chuang KS. Identification of human trafficking victims in health care settings. Health and Human Rights: An International Journal. 2011;13(1):1-12.

  • Barrows J, Finger R. Human trafficking and the healthcare professional. South Med J. 2008;101(5):521-524.

  • Zimmerman C, Hossain M, Yun K, Roche B, Morison L, Watts C. Stolen smiles: a summary report on the physical and psychological health consequences of women and adolescents trafficked in Europe. London: London School of Hygiene and Tropical Medicine; 2006.

  • Zimmerman C, Hossain M, Yun K, Gajdadziev V,  Guzun N,   Tchomorova M, et al. The health of trafficked women: a survey of women entering posttrafficking services in Europe. American Journal of Public Health 2008;98:55-59.

  • Hossain M, Zimmerman C, Abas M, Light, M, Watts C. The relationship of trauma to mental disorders among trafficked and sexually exploited girls and women. American Journal of Public Health 2010;100:2442–2449.

  • Turner-Ross E, Zimmerman C, Howard, LM, Oram S. Labour exploitation and health: A case series of men and women seeking post-trafficking services. J Immigrant Minorty Health, 2013.

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