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Trafficking as a Problem for Public Health
August 10, 2017

This post is part of a series on intersectionality, or how child trafficking intersects with other industries and areas of concern. In this post, we discuss why reframing trafficking as a public health concern can help us see new ways–and other potential new advocates–to tackle the problem.

Why Legal Approaches Are Not Enough

When governments and international organizations turned their attention to the problem of human trafficking, their response has largely been a legal and criminal approach. These institutions introduce more and stricter laws to punish traffickers, and they also provided funding and support for victim services. These approaches are essential, of course, and have their role to play. However, trafficking is such a pervasive and insidious problem, we need more to combat it.

Estimates on the rate of human trafficking range per country from the tens of thousands to hundreds of thousands of victims annually. Globally, the estimates run in the millions. Arrest, prosecution, and incarceration rates in each country is often in the hundreds per year–or less. Traffickers get put behind bars at a rate that is just a tiny drop in the bucket compared to the number of victims.

This is not to impugn the efforts of law enforcement or legal systems–it is merely meant to show how difficult and comprehensive the problem is. We cannot arrest our way out of it.

We need to develop other complementary and innovative approaches.

Public health campaigns can be one such complement.

Why Trafficking is a Public Health Concern

The health implications of human trafficking are clear. The toll on victims should almost go without saying: the physical trauma, the psychological trauma/PTSD, the risk of infections, the exposure to contaminants in unsafe working environments, substance abuse and addictions, and the list goes on.

Because victims are often forced in unclean and unsafe working environments with little or no protection (like condoms), they risk catching infections from traffickers and johns, and then others risk catching infections from them. It can lead to the spread of disease not only within the communities in which they’re working or exploited, but also to victims’ home communities and to the home communities of the johns.

Combatting trafficking is not just about rescuing victims; it’s about understanding how it affects victims’ entire lives, their families, and entire communities–and hopefully finding a way to prevent it in the first place.

Ways Health Care Professionals Can Help

Public Health Campaigns to Reshape Societal Views & Behaviors

Public health campaigns have proven to be incredibly effective at changing behaviors on a societal level. From campaigns to help reduce cigarette smoking, to wearing seat belts, to raising awareness about domestic violence, campaigns have gotten extremely sophisticated about targeting the right audience and communicating clear messages.

Trafficking, in many ways, is still a bit of a taboo topic, or something that happens elsewhere, not at home. We need to raise awareness about how much of it happens close to home, and how much of it impacts us at home. Broad public health campaigns can help us do that.

They can also help us attract the attention of others who might be on the first line to identify victims: teachers, airline staff, hotel staff, first responders…and doctors.

Engaging Relevant Stakeholders

When people are held in captivity, they don’t often have much opportunity to interact with people outside the trafficker’s world. Sometimes, it is only when they become severely ill or injured that a trafficker might bring them in for medical care. The nurses and doctors who come in contact with the victim are the first line of response in helping to identify victims.

Moreover, because victims often suffer from complex and multiple traumas, it is essential to engage the medical community as a whole, to make sure doctors have a pathway and training and a network to ensure victims get comprehensive care for their physical and psychological needs. Many health care facilities aren’t set up to do this well, so raising awareness within the medical community becomes necessary to ensure we provide a better response to their immediate, medium term, and long term needs.

Examples Already in Place: Milwaukee

In various cities around the U.S., doctors are beginning to recognize the need for training and further education on this issue. One example is in Milwaukee,

“A team of medical researchers led by Dr. Angela Rabbitt, an assistant professor of pediatrics at the Medical College of Wisconsin and a child abuse prevention pediatrician at Children’s Hospital of Wisconsin, is bringing to light the doctor’s role when it comes to helping sex trafficking victims.

‘First of all, medical providers need to educate themselves on what a victim of trafficking looks like. We know from research that victims of trafficking, about 50% of them will see a medical provider at some point during their victimization. And we know from interviews with them that sometimes that is one of the only periods of time when they’re separated from their trafficker. So medical providers are in a unique position to take advantage of that and screen for trafficking and provide services to victims,’ Dr. Rabbitt said.”

….There are efforts underway at the Medical College of Wisconsin to teach aspiring doctors the best way to ask [trafficking related] questions, and how to recognize when these questions should be asked of their patients.”

One final note…

Engaging the medical community is not just about making sure victims get identified, it’s also about making sure medical professionals don’t invite further harm upon victims, whether knowingly or not. I have heard personally about a victim going to a doctor to seek help, and upon leaving the doctor’s office, went up to the top floor of the hospital and jumped out a window to their death. Victims suffer from incredible stigma and shame, and if the doctor had been more sensitive to the fragility of their state, perhaps the suicide might have been prevented.

We must do better.

Dr. Jade Keller is the Thailand Program Advisor and Editor for The Freedom Story (formerly The SOLD Project). After receiving a PhD in Political Science from UC Santa Barbara, she moved with her family to northern Thailand in 2010 to work in child trafficking prevention, education, and helping to raise awareness.

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