I met this afternoon with U.S. Department of Homeland Security (DHS) Secretary Janet Napolitano and others to discuss strategies to address the scourge of human trafficking, or modern-day slavery. (Sec. Napolitano is pictured at the bottom left in the photo, next to Alejandro Mayorkas, Director, U.S. Citizenship and Immigration Services. Standing next to me in the upper right is Shamere McKenzie, a trafficking victim turned activist.)
I outlined the plan below to Sec. Napolitano, who had been summoned by President Obama to a cabinet meeting within the hour.
She responded positively to the plan and noted, "I'll be meeting with [U.S. Secretary of Health and Human Services, Kathleen] Sebilius in about 20 minutes and I'll ask her to be involved." Alice Hill, Senior Counselor to Sec. Napolitano, noted that DHS had been working on the idea of outreach to the medical community since I had suggested the plan a year ago at the launch of the
DHS Blue Campaign. DHS staff have devoted significant time and resources to fighting human trafficking, and have reached out to nongovernmental organizations as partners in that effort.
Medical - Law Enforcement Partnerships to
Enhance TIP Victim Rescues, Health and Cooperation
Problems and opportunities
1. Increasing victim recognition and reporting
by educating medical professionals
Victims taken to medical professionals
during their captivity often are not recognized and reported,
[i]
because most medical professionals do not know the signs of trafficking victims
or how and where to report suspected cases.
[ii]
Healthcare professionals--especially
those who work in emergency rooms, clinics in low-income areas and Obstetrics
and Gynecology--need training to learn how to help recognize, report, rescue
and restore victims of trafficking in persons (TIP) brought to hospitals and
clinics for health needs.
[iii]
Knowing how to identify and work with
law enforcement officials plays a key role in this effort to increase the
number of victims reported, rescued and rehabilitated. To conform to the continuing
medical education (CME) requirements and expectations of medical professionals,
the training should be developed and overseen by medical professionals.
2. Gaining the trust and cooperation of
victims by meeting their health needs
Because victims often evidence the
Stockholm syndrome and have been conditioned to view law enforcement officials
as enemies rather than allies, a lack of trust can impede initial interviews,
cooperation in prosecutions and attempts to persuade victims not to return to
traffickers.
Law enforcement officials need to be
able to enlist the help of healthcare professionals to initially interface with
and medically examine victims immediately following raids and rescues, and also
to provide ongoing medical care for victims.
By assisting in initial interviews of
rescued victims, medical professionals can provide a readily trusted contact
for victims who have been conditioned to mistrust law enforcement officials and
even men in general. If one of the first persons a victim encounters is a
caring medical professional who helps meet her health needs--for example, a
female health professional caring for a female victim--that victim will much
more likely cooperate with questioning and prosecution efforts.
3. Diagnosing diseases to treat victims and
protect agents and caregivers
Absent medical protocols for interfacing
with trafficking victims during intake interviews, victims may not receive
immediately needed medical help, and law enforcement officials and caregivers
unknowingly risk exposure to infectious diseases such as tuberculosis and
typhus.
[iv]
Developing protocols to immediately identify
and address health problems, including infectious diseases, will help victims
receive potentially lifesaving help while also protecting law enforcement
officials and caregivers from potentially life-threatening exposure.
Solution
SUMMIT: Medical and Law Enforcement
Partnerships to Stop Human Trafficking
Goal:
Engage medical specialty
group leaders and other healthcare leaders to educate and motivate healthcare
professionals to partner with law enforcement officials in recognizing,
reporting, treating and earning the cooperation of victims of human
trafficking.
Invite:
1.
Leaders of medical specialty organizations whose
members are most likely to see victims of human trafficking (e.g., American
College of Emergency Physicians, American Congress of Obstetricians and Gynecologists,
American Association of Public Health Physicians, etc.). Medical specialty groups
reach hundreds of thousands of professionals.
2.
Leaders of community and faith-based organizations that
work with victims and/or are likely to have contact with victims.
3.
Leaders of influential medical educational
institutions.
4.
Top officials representing public health agencies.
5.
Healthcare specialists serving in crisis relief
agencies, community health and faith-based programs and others working with
vulnerable populations.
Speakers:
·
Secretary of the Department of Homeland Security
·
U.S. Surgeon General
·
Member of Congress who sponsored TVPRA
Panels
1.
Medical-law
enforcement partnering to identify, report, treat and engage victims
·
Outline steps to recognizing victims in healthcare
settings.
·
Explain methods and considerations for reporting
victims to law enforcement authorities.
·
Discuss the process of rescuing, interviewing,
treating and earning the cooperation of victims in prosecutions, and how
medical professionals can participate.
2.
Federal TIP
resources and how to customize them for specific medical audiences
·
Overview medically related TIP education
materials developed by federal agencies.
·
Encourage attendees to customize the agency
materials and develop their own national awareness education resources, adapted
for the various medical specialty groups (e.g., Ob-Gyn, emergency medicine,
public health) and types of medical professionals (e.g., physicians, nurses,
support staff).
3.
TIP medical
working groups: Needs and opportunities
Solicit
volunteers for two TIP medical working groups to develop:
·
a formal medical
protocol for use nationwide with victims immediately following raids and
rescues; and
·
a plan for a registry
of medical professionals who will interface with victims immediately
following raids and rescues.
Endnotes
[i]One
study noted, "In all, 28 percent of the trafficking victims that we
interviewed came into contact with the health care system during their time in
captivity—each one of those visits represents a missed opportunity for
potential intervention or education about trafficking." Turning Pain into Power: Trafficking Survivors’ Perspectives
on Early Intervention Strategies. San Francisco, CA,
2005. Available at http://www.childhood-usa.org/upl/files/4109.pdf
Accessed 8/1/2011.
[ii] A
recent study examining the experience of emergency room personnel regarding
trafficking victims found that although 29% thought it was a problem in their
emergency department population, only 13% felt confident or very confident that
they could identify a TIP victim, and less than 3% had ever had any training on
recognizing TIP victims. Chisolm-Strike M, Richardson L. Assessment of
emergency department provider knowledge about human trafficking victims in the
ED.
Acad Emerg Med 2007;14(suppl1):134.
[iii] The United Nations Declaration of Basic Principles of
Justice for Victims of Crime and Abuse of Power (1985) 62 states that persons
who are likely to be in contact with victims (such as staff from health and
social services, and other personnel) should receive training in order to
enable them to identify victims and to be sensitive to their needs (United
Nations Office on Drugs and Crime, Trafficking in Persons Global Patterns,
April 2006, p. 75).
[iv] The
Salvation Army Anti-trafficking training manual prepared for the Office for
Victims of Crime,
U.S. Department of Justice notes, "Another safety
consideration is whether the victim has been exposed to infectious diseases
such as tuberculosis, HIV, and typhus (Salvation Army, 2006) and the risk of
exposure to others. This should be determined as part of an initial assessment
or screening of the victim."
