The Social Medicine Portal

Human Trafficking

Girls are not for sale

On Tuesday, December 9th, 2008 Ms. Lori Cohen, a lawyer from Sanctuary for Families spoke at Social Medicine Rounds on “Understanding Human Trafficking.”

Sanctuary for Families is the largest New York State non-profit “dedicated exclusively to serving domestic violence victims and their children.”  However, over the past 20 years Sanctuary’s work in domestic violence has led the organization to become  increasingly involved in issues of trafficking.  DV victims are not uncommonly also victims of trafficking.

And, as Ms. Cohen pointed out, they often first come to the notice of health professionals who see them for the sequelae of their abuse.  Clinicians, therefore, can play an important role in identifying and referring victims.  A website (http://www.humantraffickinged.com/) has been set up to alert Emergency physicians to the problems of trafficking.  This very simple, but quite useful site, is a joint effort by the (NY) Mount Sinai Department of Emergency Medicine, the American Osler Society, AMSA and Brown Medical School.

Much Ms. Cohen’s talk was devoted to sex trafficking, and particularly sex trafficking among minors.  About 450,000 children run away from home each year.  One out of three are estimated to be lured into prostitution within 48 hours.  This may explain why the average age at which prostitution begins is 13.  Ms. Cohen showed the beginning of a film (which is currently being aired on Showtime) entitled “Very Young Girls” about tween and teenage prostitutes.  This was not a very easy film to watch.   However – in a section of the movie we did not see – it traced how Rachel Lloyd, “a survivor of commercial sexual exploitation and trafficking” established GEMS – Girls Education & Mentoring Services – to help young women who are victims of trafficking and to end commercial sexual exploitation of children.  The bracelet pictured in this post is sold by GEMS to raise money.

Whereas most human trafficking is within the United States (state to state and within states) New York City has a large population of immigrant victims of trafficking.  Trafficking into the United States comes from Southeast Asia (China, Thailand, Vietnam), followed by Eastern  Europe (Russia, Ukraine, Czech Republic), and finally Latin America.  As Ms. Cohen noted, whenever there is an important military conflict affecting civilian populations, trafficking from that area increases.   She discussed clients of hers from Russia, Venezuela, the Ukraine, Korea and Sri Lanka, as well as locally trafficked victims of abuse.  Sometimes women are brought in by organized crime rings, other times by “Mom and Pop” or family operations, such as the infamous Carreto family in New York.

Ms. Cohen emphasized that recognizing that a woman was a victim of trafficking is often difficult.  Women are distrustful of government agencies. They often times do not have identification papers and believe that they have committed crimes.  Their stories are programmed by the trafficker.  Denial or minimization is common, as is shame.  Language poses a barrier with abusers often serving as “interpreters.”  The Human Trafficking ED site offers recommendations for providers seeing patients who they suspect are victims of trafficking.

The take home message is that clinicians should be aware of this problem, maintain an index of suspicion for abuse and trafficking, know how to sensitively interview a patient and have access to referral sources, such as Sanctuary for Families.

Posted by Matt Anderson, MD