Does human trafficking really happen here?
That is the most common question Mary Alice Phelan, community health director at St. Vincent's HealthCare of Jacksonville, Fla., hears when she discusses sex and labor trafficking.
The answer: It happens everywhere.
"In fact, most people probably have encountered a victim," said Phelan. "People are always shocked when they learn that it is an enormous problem."
Florida is considered a trafficking epicenter by the U.S. Department of Justice. Victims of labor trafficking are forced to work in the state's large agriculture and tourism industries, harvesting crops or cleaning hotel rooms without pay while sex trafficking victims are forced to work in mobile brothels, strip clubs and in the pornography industry. Frequently immigrants and teenage runaways, victims are isolated, threatened, beaten.
"It is an affront to human dignity that we in health care must address," said Phelan.
St. Vincent's is part of a statewide trafficking awareness campaign launched in January by the Florida Catholic Conference, the nonpartisan public policy voice of the state's Catholic bishops. The conference has turned its attention to this issue because law enforcement cannot stop trafficking alone, said Sheila Hopkins, the conference's associate director for social concerns/respect life. The campaign enlists the help of Mass-going Catholics and health care providers at Catholic hospitals.
Despite all of the best efforts of the federal government and the Trafficking Victims Protection Act of 2000, human trafficking has increased, said Hopkins. "There have been efforts here and there in Florida, but we wanted to raise awareness among people who may have contact with victims, and health care workers are among those people. Traffickers want to protect their investment. To them, human beings are just a commodity. They break them, and then fix them."
Emergency room staffers are thought to be the most likely to encounter victims because traffickers typically only seek care when a victim is in crisis. Ailments that may send up a red flag to health care providers range from rotting teeth from poor nutrition to tuberculosis acquired in cramped living quarters. Phelan said signs of abuse or health problems commonly experienced by trafficking victims include sexually transmitted diseases; chronic back pain, hearing, cardiovascular or respiratory problems related to farmwork or sweatshop employment; and weak eyes from working in dimly lit factories.
"These individuals suffer a great number of physical and psychological problems because they have living conditions with poor sanitation and nutrition and dangerous working conditions," said Phelan. "We don't want to fix them up just so they can be exposed to those conditions again. Our mission is clear — we must protect and care for the poor and the vulnerable, and there are few more vulnerable than these victims."
Runaway, throwaway children
Though the precise number of victims is unclear, the federal government reports that 18,000 to 20,000 people, half of them children, are trafficked annually into the United States. A recently released strategic plan researched by Florida State University and issued by the state of Florida recognizes labor trafficking, specifically debt servitude, as prevalent among farmworkers. Contractors cram 10 to 20 seasonal workers in a single house and then deduct any number of fees from the workers' paychecks, leaving them with little or no money. Contractors threaten victims with eviction, deportation or harm to family members.
Sex trafficking also is a growing problem, the report finds. Though, again, officials cannot know the precise number of victims, the report says it is estimated that at any given moment there are 30,000 to 40,000 preteen and teenage runaways or "throwaway children" who come to Florida for its warm weather and beaches. They are targets of pimps and at risk for exploitation in the sex industry.
Phelan said frontline clinicians can do more to stop the horror of trafficking. She is training St. Vincent's staff — both clinical and nonclinical personnel — about the signs of human trafficking, the health problems associated with victims and ways to help. The training includes a review of St. Vincent's policies regarding victims of abuse; such policies largely apply in trafficking cases. Next she will help train caregivers at Catholic facilities across Florida.
"We are training everyone, even our board members, because everyone needs to realize this exists," said Phelan, who uses information published by the U.S Department of Health and Human Services. "We also want them to know there is relief for these people." According to the U.S. Department of State, victims of human trafficking "may be eligible for benefits, services and immigration remedies under federal or state programs."
"The clinician or social worker should do their best to get the individual by him or herself so that they can talk to them," said Phelan. "We also want victims to know that we can help them, that there is assistance."
Phelan said that in clear cases of abuse, clinicians should call 911. Where the patient's circumstances are unclear, but something seems amiss, she encourages caregivers to call Health and Human Services' 24-hour National Human Trafficking Resource Center hotline at (888) 373-7888. Hotline personnel can help callers identify and coordinate with local service providers to aid victims.
CHA provides information and links to resources on human trafficking on its website.
How to identify trafficking victims
Men, women, young children and teens all may fall victim to human trafficking. Signs that someone may be a victim include:
Being accompanied by another person who appears controlling and insists on being the only one that provides information
Signs of physical or emotional abuse
Fearfulness or submission
Carrying no identification
Difficulty communicating because of language barriers
Probing questions to ask in a nonthreatening way include:
Can you leave your work or job situation if you want?
Have you been threatened with harm if you try to quit?
Do you have to ask permission to eat, sleep or go to the bathroom?
Is there a lock on your door or windows so you cannot get out?
Source: U.S. Department of Health and Human Services
Copyright © 2011 by the Catholic Health Association
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