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.