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BY: SR. ANNE VICTORY, HM, RN, MSN

As health care professionals, we daily have the sacred privilege of sharing in the suffering of those we serve. One danger is that, as we witness intense, traumatic, unimaginable grief and pain, we might unconsciously desensitize ourselves to prevent becoming swallowed up by it, even to the point of missing the reality of unjust and preventable suffering right before us. Such is often the danger with human trafficking.

A few years ago, my heart was broken as I watched a 23-minute film entitled "Fields of Mudan," the story of tiny children being sold into slavery as sex objects for wealthy businessmen.¹ This film brought me face to face with the tragic reality of modern day slavery — human trafficking — and filled me with questions: Slavery today? In our country? Our neighborhoods?

Like most people, I was shocked, alarmed, horrified by the reality of men, women and especially children being bought and sold in the present day for purposes of commercial sex or labor and services. How can this be happening? Why have we not heard about it? Why don't we see it? Who and where are the victims? Aren't there laws against it?

Since that time, I have learned that human trafficking is the second-largest criminal activity in the world and second only to drug dealing. More importantly, it is the fastest-growing.² The International Labour Organization, a United Nations specialized agency, estimates that profits from human trafficking run as high as $32 billion annually worldwide.³ So human trafficking is really about the money. Traffickers have little or no regard for those they enslave other than a desire to preserve their investment.

Among the most vulnerable victims of human trafficking are children, who make up about half of the estimated 600,000 to 800,000 persons trafficked across international borders each year.⁴

Since the crime of human trafficking tends to be hidden, numbers are difficult to pinpoint. The U.S. Department of State estimates between 14,500 and 17,500 trafficked persons are brought into the United States annually.⁵ However, Malika Saada Saar, founder of the Rebecca Project for Human Rights, stated on March 11, 2011, at the Women in the World Conference in New York, that "between 100,000 and 300,000 girls in the U.S. are subject to sexual trafficking every year, and few cases of child rape are ever prosecuted." She went on to say that "girls between ages 11 and 14 are particularly at risk, and more American-born than foreign-born children are being bought and sold for sex in this country."⁶

Human trafficking is about much more than numbers, though. It is primarily about people, often innocent children, who are forced, coerced or tricked into horrific circumstances, held against their will, deprived of the basics of food and water, often addicted to drugs, moved to unfamiliar locations, confined by physical or psychological chains and abused in often unspeakable ways. They are likely required to work long hours at dangerous jobs in sweatshops, factories or fields with little or no compensation. They might be sold as sex slaves, even at ages as young as 6 or 7. They may be crowded into unsanitary housing, hidden in locked rooms, kept isolated from others and often given only minimal food and water for sustenance.

Child victims — those under age 18 — are exploited for commercial sex, including prostitution, pornography and sex tourism. They may also be enslaved for labor, including domestic servitude as maids or nannies, agricultural workers, restaurant and hotel workers. They tend to be hidden "in plain sight," and not recognized as victims. They may come from any country in the world and, as noted above, could also be U.S. citizens.

In the United States, some children who live in abusive households run away, only to find themselves in dire circumstances without money to support themselves. Out of desperation, many will trade sex for food and shelter. These kids are easily enticed by a kind stranger, only to be trapped in a cycle of abuse and violence.

In foreign countries, parents may be lured by the American dream and its promises of an education, a good job and a great life in the "land of opportunity" for their children. Living in desperate poverty, they may sell their children to a trafficker with the promise that money will be sent home to support the family and the community. In a number of countries, the practice of human trafficking is an accepted, if generally hidden, part of the culture. Haiti, for example, has turned a blind eye to the practice of reste avec, French for "stay with." Impoverished parents send — or sell — so-called "restavek" children to work as servants for wealthier families. The recent earthquake brought to light the ease with which traffickers can take advantage of chaos and leaky borders to enslave children who suffered the loss of parents and family as well.

Children who are foreign-born may have been smuggled into a country and have no documents or have had them confiscated. Separated from family and familiar surroundings, they may not speak the language or know the customs. They may have learned not to trust law enforcement in their home country, and they may fear deportation. They may not realize that what is happening to them is a crime, or they may blame themselves for their plight. Some see no escape or may even come to identify with their captor as their friend or savior.

If children do escape their captors, they may be misidentified as juvenile delinquents, child prostitutes or illegal aliens. They are often too frightened or traumatized to tell what has happened to them. Or, when they have attempted to tell, no one believed them. They may act tough, deny any wrongdoing, lie about their circumstances or claim to be cared for by a loving uncle, sister, boyfriend, "husband."

Countries worldwide vary in their response to the crime of human trafficking. In 2000, the United Nations issued the Palermo Protocol to Prevent, Suppress, and Punish Trafficking in Persons, Especially Women and Children. So far, 117 of the UN's member states have ratified the treaty, though many lack domestic laws against human trafficking.

That same year, the United States issued the Trafficking Victims Protection Act, a federal law that defines human trafficking as "the recruitment, harboring, transportation, provision or obtaining of a person ... for commercial sex or labor or services through force, fraud or coercion." It also provides that, in cases when the victim is a minor, force, fraud or coercion do not have to be proved. The act makes human trafficking a felony with significant penalties for engaging in this activity with foreign-born individuals. At present, 45 states also have laws against human trafficking, although they vary in the scope and penalties for those who are indicted, for the training of law enforcement officers and for services provided to victims. Efforts continue to strengthen penalties for those who exploit domestic minors, particularly into sex trafficking.

As faith-based organizations committed to Gospel values, what might Catholic health care facilities do to counteract this horrific crime against some of the most vulnerable members of our human family? The following list offers some suggestions:

• Raise awareness of staff who can serve as "first responders" (emergency care technicians, physicians, nurses and others working in emergency departments, maternity and pediatrics clinics, home care departments, outreach programs and paramedics) about the issue of human trafficking and ways to recognize that a child may be being trafficked.
• Be alert to physical signs and symptoms common to trafficked children. They include malnutrition, stunted growth; poor dental hygiene; unusual marks, burns, scars, brands or tattoos; poorly healed fractures; evidence of sexual abuse; late presentation with diseases that are easily treated if diagnosed early, such as tuberculosis or other infections.
• Similarly, be alert to psychological signs and symptoms such as withdrawal, inability to make eye contact, depression, agitation and fright, phobias, panic attacks.
• First responders also need to know what questions to ask, how to ask them and what to do in case they encounter a victim. In order to keep the child safe, they especially need to learn methods for interacting safely and cautiously with anyone accompanying the child.
• Introduce policies and plans to be implemented when a potential victim is identified. Since suspected child abuse is reportable, potential victims of trafficking qualify for referrals to local law enforcement and children's services.
• Initiate solid working relationships and partnerships with law enforcement, children's services and area social service providers to create a safety net for victims. Services needed include safe and secure housing, food and clothing, medical and dental care, intensive psychological assessment and trauma care, legal aid, access to education and ongoing support.
• Advocate on the local, state and national levels for active enforcement of anti-trafficking legislation, for effective training of law enforcement professionals and for funding services for victims.
• Check on the corporate policies of companies with whom investments are made and partnership agreements are enacted to assure company compliance with worker rights, restriction of child labor, just wages and benefits, etc. and exercise the right to vote proxies to demand improvements. Coordinate these efforts with the Interfaith Center for Corporate Responsibility.
• When corporate meetings are held off-site, we can ascertain if airlines and hotels have policies in place against human trafficking and train employees to recognize it. Check out Airline Ambassadors International and the Code of Conduct for the Protection of Children from Sexual Exploitation in Travel and Tourism for details.
• As major employers and investors who support the principles of Catholic social teaching, stay informed about current efforts in combating human trafficking. Check with such trusted organizations as the United States Conference of Catholic Bishops, Polaris Project, Free the Slaves and Shared Hope International. We can subscribe to "Stop Trafficking," an online anti-human trafficking newsletter sponsored by the Sisters of the Divine Savior.

As Jesus cared for all, especially the most vulnerable, we are called to do no less in the face of these horrific crimes.

SR. ANNE VICTORY, HM, is education coordinator, Collaborative Initiative to End Human Trafficking, Rocky River, Ohio.

NOTES

1. "Fields of Mudan," written and directed by Stevo Chang, produced by Courtney T. Powell and Stevo Chang as a graduate thesis film at Florida State University. It premiered in 2004 and is distributed by Indieflix.com.
2. U.S. Dept. of Health and Human Services, Administration for Children and Families, "About Human Trafficking," www.acf.hhs.gov/ trafficking/about/index.html.
3. International Labour Organization, "ILO Action Against Trafficking in Human Beings 2008," (Geneva: ILO Publications), 1. Report can be downloaded at www.ilo.org/sapfl/Informationresources/ILOPublications/lang— en/docName—WCMS_090356/index.htm
4. U.S. Dept. of Health and Human Services, Administration for Children and Families, "Fact Sheet: Human Trafficking," www.acf.hhs.gov/trafficking/about/fact_human.html.
5. Liana Sun Wyler and Alison Siskin, "Trafficking in Persons: U.S. Policy and Issues for Congress," Congressional Research Service, Oct. 29, 2010, http://fpc.state.gov/documents/organization/152057.pdf.
6. Susanne Walker, "U.S. Girls Ages 1 to 14 at Risk for Sex Trafficking, Panel Says," Bloomberg News Service, March 11, 2011, www.bloomberg.com/news/2011-03-11/u-s-girls-ages-11-to-14-at-risk-for-sex-trafficking-panel-says.html.

Copyright © 2011 by the Catholic Health Association of the United States
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