Wednesday, February 19, 2014

The Role of Medical Responders in the Fight against Human Trafficking

The Role of Medical Responders in the Fight against Human Trafficking

As an emergency responder, chances are you have treated victims of human trafficking and child sex-trafficking and did not recognize it, or, if you did suspect something, you may not have known what to do.
During the EMS Today Conference and Exhibition in Washington, D.C. on February 7, Dr. Ramsey Tate, a fellow in Pediatric Emergency Medicine at the University of New Mexico, gave a riveting and inspiring talk about the critical role EMS responders have in the fight against human trafficking.
human-trafficking pic“Each of you is powerful against human trafficking,” she said. “It is an uncomfortable and challenging topic and it’s not easy to discuss,” but medical responders can do something about it by educating themselves about what to look for and how to respond.
First of all, this form of modern-day slavery is alive and well in our communities, according to Dr. Tate. It is happening all around the country. For example, in New Mexico where Dr. Tate lives and works, there are very high rates of child poverty, which is the most vulnerable population for sex trafficking (the average age of child sex victims is 12-14 years old). In addition, there are a lot of casinos in the area, which means there is a high demand for commercial sex.
EMS responders must first recognize that human trafficking and child sex-trafficking exists in their community and understand that they are on the frontlines.
What is Human Trafficking?Dr. Tate started the conversation by defining human trafficking, which is often referred to as modern-day slavery. First of all, trafficking is not smuggling—human trafficking is a crime against a person (whereas smuggling is a crime against a border). Second, trafficking is NOT voluntary sex work by adults—many adults choose to engage in sex work and they are not trafficking victims.
So what is considered human trafficking? Dr. Tate recommended following the A-M-P model to help identify human trafficking. In order to be considered human trafficking, there must be an action, a means, and a purpose:
  • Action: induces, recruits, harbors, transports, provides, obtains
  • Means: Force, fraud, coercion
  • Purpose: commercial sex acts, labor or service
The exception to this formula, which is critical for EMS responders to understand is:
ANY MINOR involved in commercial sex work is automatically considered to be a trafficked person.
How to Spot a Trafficked PersonDr. Tate discussed the unique position that EMS responders are in because they respond to the scene and can observe the location firsthand. Here are some things that first responders should look for as indicators of a trafficked person:
  • Any minor working in commercial sex
  • Presence of a companion who answers for a patient
  • They do not have their own ID documents
  • Companion who refuses an interpreter and seems controlling
  • Reluctance to explain tattoos/branding (many pimps will brand girls to signify their property)
  • Rectal/vaginal trauma
  • Battered and/or they are missing hair
  • Inadequately dressed for work or the location
  • There appears to be security measures at the residence that are meant to keep a patient in (i.e. locks on the outside of doors)
  • Degraded, unsuitable place for habitation
What Questions Should You Ask?If any of the indicators described above are present or you have a feeling in your gut telling you something with this situation is not right, Dr. Tate emphasized the importance of getting more information.
“This requires you to be a little nosey, and it can be uncomfortable, but it’s very important to ask questions of high-risk adolescents,” she said. Keep in mind that these youths have often been manipulated, they have been taught to be scared of authorities, and they are terrified of their pimps. You need to ask questions in order to help them. Here are some questions she recommends asking:
  • Who is with you?
  • Does anyone keep your ID, passport or visa?
  • Have ever had to trade sex for money or something else you needed?
  • What is your job like? Are you paid for your work? Could you leave your job if you wanted?
  • Has anyone threatened you with deportation or jail if you try to leave?
What to do When You Suspect TraffickingOnce you suspect someone might be a trafficking victim, the next steps are very important. First of all, transport the patient alone, do not allow their companion to come with them. Also, ask (and observe) the patient to turn off his/her cell phone so that no one can listen in during transport. Share your concerns privately with other emergency responders and the emergency department staff so they understand the sensitivity of the situation.
The Role of Law EnforcementDuring the presentation, Dr. Tate emphasized that EMS responders are a key piece in identifying victims of human trafficking, but the police must be notified.
“We don’t rescue people from human trafficking, the only ones who can do that is law enforcement,” she said. “Do whatever it takes to get law enforcement involved.”
If local law enforcement are unavailable or unresponsive, she recommended calling the National Human Trafficking Resource Center (Call: 1-888-373-7888 or Text: BeFree to 233733). This organization can provide resources and contacts.
When you suspect a victim, notify law enforcement from the scene (discretely) so police can meet a patient at the emergency department. This decreases the chances that a patient will run.
Also, when contacting police do not use the word “prostitution.” Instead say you are transporting a minor who you suspect is being trafficked for commercial sex. It is communicating the same information, but Dr. Tate said that in some states with Safe Harbor Laws, police are not able to hold child prostitutes because they are not considered perpetrators. While the intention of this law is good, in reality it is important for police to be able to hold victims for 72 hours to get them away from their pimps, she said. Also, by telling police you have a minor who is being trafficked often means that police will send their crimes against children unit who have experience dealing with this demographic.
The bottom line is that EMS responders are powerful in identifying and helping to stop human trafficking and child sex-trafficking. Now is the time to educate yourself by knowing the signs to look for and the best way to respond.

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