As Katherine has already posted, Indiana governor Mitch Daniels signed the anti-trafficking bill into law on January 30, just days before the big game. This bill provides more robust penalties for criminals convicted of human trafficking. More importantly, it no longer requires proof that force or other forms of coercion was used in the commercial sexual exploitation of children.

After the first posting, we learned about a group of nuns who put together a tremendous awareness campaign, providing counter-trafficking training to the staff at over 200 hotels in the greater Indianapolis area, as well as taxi drivers and other key people with direct access to the public.

The first report of two rescued trafficking victims came on Friday, 3 February. There have been no arrests yet, because the trafficker appears to have fled the state, but apparently his identity is known.  Both victims, now adults, reported being trafficked at the age of 16.

Spending time researching this topic in cyberspace has taught me one thing:  when there is no data, people are more than happy to make up reasons for that lack. My favorite explanation is that so few people are arrested for trafficking during the Super Bowl because no one is being trafficked.  Wouldn’t it be nice to live in that world? It is being called the Super Bowl Sex Trafficking Hoax. And why not? When there aren’t laws on the books to arrest people who traffic in people, then no one is going to get arrested. If no one gets arrested, then it is easy to say that no one is trafficking people.  And for many people, believing that is convenient, but of course that doesn’t make it true. But it is equally difficult to prove that trafficking is a real problem when prosecuting traffickers, even when they are caught, is so challenging.

Of course, the new law can’t stand on its own; it needs to be enforced by a well-trained police force and the cases picked up by dedicated prosecutors. Although I applaud the Indiana legislature for passing this law quickly in an effort to curb or deal with trafficking at the Super Bowl, the problem won’t go away with the end of the Super Bowl, or the Indy 500, or any other major sporting event. Young victims in Indiana deserve protection from traffickers at all times, not just when the nation is watching.

I am hoping that with the new law, a more accurate picture of the current human trafficking situation in Indiana will come to light. Of course, no one would be happier than I would be if it turns out that Indiana has no such problem. But I am more of a realist than that. If we can provide evidence that human trafficking is a problem here, we will be one step closer to proving how necessary it is to have better services for victims of human trafficking in Indiana. And I can’t imagine anyone denying them that.

An unfortunate example happened recently: a girl (with multiple risk factors for HIV) in a shelter had a mental melt-down and started to cut herself with a mirror she had broken. In attempting to stabilize her a staff member got cut with a piece of the broken mirror that the girl had used to cut herself. The girl was stabilized but now the crises was addressing the risk of HIV transmission to the staff member. Without sharing details, the lack of a robust protocol for testing and protection raised the crisis of possible transmission to an unnecessary level.

Components of caring for survivors include such things as shelter facilities and staffing, child protection, educational and vocational services, case management, and health care. The Hands That Heal curriculum by the Faith Alliance Alliance Slavery and Trafficking is an excellent overview of these components that provides a sound foundation to their work.

There is a great need to take these basic minimum standards (if they exist) and solid principles and develop robust practical standards and protocols. This process involves engagement at the national level all the way down to working with the house parents of shelters.

Barriers to developing and adhering to a set of minimum standards of care include knowledge of what the standards are or should be, funds to implement them, and the technical resources to implement them. Many organizations lack basic protocols for how to manage preventive health care or dealing with medical problems – urgent or otherwise. many still do not understand the importance of and proper scheduling of blood tests for diseases such as HIV, Hepatitis B, and syphilis.

Relentless is currently working with nation-wide coalitions in Thailand and Cambodia to address these gaps by developing a set of minimum standards and protocols to ensure the best care and protection of the residents as well as the staff of these shelters.

As of this post, no arrests on human trafficking charges have been made, but Indiana law enforcement have been trained to look out for signs of trafficking and now have a stronger legal backing to their efforts. In past years, a spike of exploitation and trafficking has been reported surrounding the Superbowl events. With more law enforcement, media, and public awareness I hope to see more solid information regarding these reports come to light.

Relentless will post a follow up to the Superbowl and reports of exploitation and trafficking related to the event. Stay tuned!

The awareness about human trafficking, particularly regarding its presence in the USA and other developed countries, has increased exponentially in the last few years. Trafficking in persons is a very real, huge, and ubiquitous problem and the more people aware of the issues the better. We can talk about it, it is in our vocabulary, and there are books, websites and places to go to learn more about it. This is a good thing.

However, I wonder just how far this all this awareness will get us if we don’t start taking the next step beyond awareness. And of what exactly are we making people aware? Many people are already taking the next step, and want to do more. Even so, a lot of the awareness activities I see going on stop short. We can feel good about attending these events, possibly raising money for this or that activity, but then what? When we get home and our ears are buzzing from a great concert, are our hearts buzzing about the message behind the music? I wonder if the message was louder than the music or if it was even heard? And just how many movies about Asian girls locked up and raped every night until they are rescued by a white guy can we see until we are blinded to the problem as it fades into the background of our “trafficking fatigue”?

I’m not against concerts and movies. It is important to get as wide an audience as possible and the formats provide a variety of methods to tell the stories of those who are affected. But what exactly is the message and how has this awareness stimulated you to do something about the problem?

It seems that the focus of awareness tends to be about the problems, and even then, the problems presented tend to be narrow in focus. It would be good to see more awareness of solutions and how an everyday person can be an abolitionist. Instead of continually drawing our attention to the problems, and leaving us overwhelmed with the worldly weight of it, I hope that the awareness campaigns are also making you aware of a tangible way to help – and more than just putting money in the tin. Donating money is good – don’t get me wrong – this work depends on it. But I don’t want people making a gift to assuage guilt if you know you should do more. I  hope that awareness campaigns will stimulate a conversation about the things you are learning about human trafficking, and how will it change what you are doing or how you are thinking.

Trafficking doesn’t start when a girl enters a brothel and there are more ways to help trafficking victims than raiding a brothel and putting them in a shelter. Good activities for sure – but there is so much more to the issue. What I hope to make you aware is that human trafficking can be prevented and that you can do something about it.

• Have you ever thought about why American teens are at risk of being trafficked? Are you aware that you may be able to prevent American teens from being prostituted or caught up in pimp-hood? What about helping out at a homeless shelter or a drop-in center for teens?
• Are you aware that globally, labor trafficking is far more common than sex trafficking?
• Have you considered how to make migrant worker and immigration laws (in the US as well as other countries) fairer, yet without gaping loopholes for unscrupulous business people?
• What about integrated development of health, nutrition, sanitation in at-risk villages in developing countries? Traffickers prey on the poverty and ignorance of villagers in recruiting men, women, girls, and boys into whatever slave work they need.
• Consider working to strengthen families and communities to grow and serve each other – to protect each other – to look out for each other. All those “one-anothers” that we learned in Sunday School. It works.
• Have you had any thoughts about addressing demand? Why is it that trafficking is such a problem in our world – even in our own society? This evil is not relegated to seedy neighborhoods of cities but is insidiously present everywhere. Perhaps you have wondered whether pornography has anything to do with the problem of sex trafficking – perhaps you wondered that for only 30 seconds and then it was gone because you just didn’t want to go there. There is something you can do to shut down pornography – one of the roots of the flesh trade.
• Do you know how you might exert pressure on traffickers by buying products from companies that are transparent about their production and ensure that every worker has been paid a fair wage?
• How can you develop an index of suspicion so that you can tell if the person doing your nails has been 18 years old for the last three years, but looks only 15 years old? Not that you want to go looking for a zebra in every closet, but to know enough to keep your eyes and ears open.

This is a challenge, not a complaint. The issues I raise about awareness here are present around the world – not just in the States.

Please contact me for more challenges!

While most of the focus on human trafficking centers on countries far away, we are not without our problems here at home.  Every year around this time organizations like Shared Hope International focus on human trafficking, particularly sex trafficking, as related to the Super Bowl.  This year, as Indianapolis prepares to host Super Bowl XLVI on February 5, many Indiana lawmakers are preparing to deal with the potential influx of trafficked humans.

Unfortunately, real numbers are hard to come by.  During the last three Super Bowls, in Tampa, Miami and Dallas, there were mixed reports of the numbers of people trafficked to the event, and from what I could tell, most of those were guesses anyway.  For example, in 2010 in Miami, police estimated that about 10,000 women and girls were brought into the area Super Bowl weekend, but the number of women and girls who were trafficked is anyone’s guess.  Added to this, those cities, unlike Indianapolis, are “border” cities with historically bigger problems with human trafficking.

This is not to say Indiana has no problems.  Indiana was recently given a “D” in Shared Hope International’s Protected Innocence Initiative for Domestic Minor Sex Trafficking.  Indiana was criticized on many levels, including criminalizing the victim and having lax penalties for buyers, traffickers, and facilitators (those who make the traffickers’ jobs possible, or at least easier, such as taxi drivers, hotel staff, club owners, etc. and who benefit from trafficking through indirect involvement).  Indiana law also provides few options for prosecuting these crimes, punishing sellers only if force is used (unless children are trafficked by a parent or guardian).  In fact, Indiana only last year had its very first conviction for human trafficking despite having a law on the books since 2007.

To battle these inadequacies, Indiana Senator Randy Head proposed Senate Bill 4, which would close loopholes in Indiana legislation, making it easier to convict people of human trafficking by making it a crime to sell a child regardless of the relationship between the seller and the child and making human trafficking a Class A felony with a 20-50 year sentence instead of a Class B felony with a 5-20 year sentence.  The Bill passed unanimously through committee very quickly on Thursday, January 5.

Unfortunately, in Indiana the House Democrats have continued their absence from the floor in order to prevent quorum since the beginning of the 2012 legislative session due to differences over Right to Work legislation. If they don’t come back, the legislature is blocked from taking any action and Bill 4 is in danger of being unaddressed until after the Super Bowl.  This very important piece of legislation, which the Attorney General and the Governor have both enthusiastically supported, should certainly be given more priority by the House Democrats, who really need to put aside their differences over right to work in order to pass legislation that would more effectively protect women and children in Indiana.

I encourage any Hoosier whose Representative is currently absent from the floor (you can pretty much assume if they’re a Democrat, they’re absent) to contact them about this important bill. It is much too important to be overlooked as a result of a disagreement about an unrelated piece of legislation.

I intend to write a follow-up post after the legislation is passed, or after the Super Bowl, whichever comes first.  Certainly, if the bill isn’t passed prior to the Super Bowl, it is still an important piece of legislation, but it would be a shame not to seize the opportunity to pass the bill before the potential influx of trafficked people coming to Indianapolis Super Bowl weekend.

Editor’s note: I like Deanne’s point about the fact that we truly do not know how many men and women are involved as victims or traffickers. This is a difficult number to quantify and track. However, it is hard (or is it?) to imagine that the “entertainment” industry can find so many consenting women to prostitute themselves.

If you live in Indiana, getting in touch with your representative regarding this bill is a practical way you can advocate for justice. If you know of any preventative or outreach activities regarding prostituted or sex-trafficked women in Indianapolis, please write in and let us know. What about outreach to the johns to address demand – anybody doing anything there? There are others who would like know what is going on and get involved.

This news item out of Texas has “human trafficking” in the headline, but the situation they describe is clearly a case of smuggling. The dateline is in San Antonio and even is listed as coming from CNN. I don’t know how news items come through the wire, but I don’t think we can assume that the title also came from CNN. I hope not – CNN is supposed to know what human trafficking is. Perhaps someone at channel 14 didn’t know the difference between trafficking and smuggling, and/or thought that putting human trafficking in the title would get more traction than smuggling.

I don’t know what the editor was thinking, but it gives me a teaching moment so you won’t make the same mistake. What is the difference between smuggling and human trafficking?

The most widely accepted definition of trafficking in persons comes from the 2000 United Nations Palermo Protocol. Basically, the key features involve 1) movement or confinement of an individual; 2) removing of that individual’s personal agency; 3) coercion and exploitation of the individual for financial profit or gain of another; 4) the individual need not leave his/her town to be trafficked.

Smuggling is paying someone to take you illegally across a border (often international) and then technically you are free after that passage. People who employ smuggling are at risk for being trafficked, but it is not the same thing.

Now you know.

While these images may be true, they are far from telling the whole story of human trafficking in Cambodia. All forms of trafficking in persons exist in Cambodia with victims trafficked to, through, and from its borders involving both labor as well as sex trafficking. Issues such as child and domestic abuse, statelessness, child labor, and of course Pol Pot also have a role in the big picture of human trafficking there. Vietnamese women are trafficked to Cambodia to work as domestic slaves; Cambodian men are trapped on international fishing vessels for years; and boys are abused in a variety of ways from factories to massage parlors.

I spent the week before Christmas in Phnom Penh catching up on some work I’m doing with Chab Dai (“joining hands” in Kmer), a coalition organization of Christians working together against sexual abuse and trafficking. Chab Dai has a country-wide presence and is involved in prevention, research, and capacity building of counter-trafficking organizations. It also has a good relationship with the government to develop protocols and policies and even the development cross-border collaborative work.

Health care for the average Cambodian is abysmal. Add on the complex physical and mental health problems of abused and trafficked people, discrimination against the woman victim, lack of understanding of basic forensic medicine, and lack of basic health and sanitation knowledge of the average Cambodian, there is a great need for development of holistic health care there. I commend the medical teams already working on this issue in Cambodia and I am coming alongside Chab Dai to serve in the gaps of health and the specific needs of trafficked people.

Cambodia has a long way to go in its efforts to squelch human trafficking but in some respects, it may be ahead of many developed countries. For example, no coalition like Chab Dai exists in the United States or any other country. The power and synergy lies in its ethos of sharing knowledge, building up of local work, attention to research, and village-based integrated grassroots development. I am grateful for the opportunity to learn from the people at Chab Dai and honored to be a small part of their work.

There is, actually, quite a lot to read on this topic, and one can easily get bogged down and overwhelmed in the myriad websites, headlines, awareness campaigns, and the latest movie about a Southeast Asian girl trafficked into the flesh trade. Not that these are bad, but sometimes they don’t lead to the proper equipping of a budding abolitionist.

When starting out learning (or perhaps you’ve already been reading quite a bit about human trafficking) about the topic of human trafficking it is good to back up and take in a big picture perspective of injustice and what and how we can do something about it – or rather – how to become somebody who can do something about it. Reading the Bible, is of course a good idea, but it may help to read something else along with it. I highly recommend people start with Good News About Injustice by Gary Haugen (founder of International Justice Mission). Another good book to start thinking about the principles of development and serving the poor is When Helping Hurts by Corbett and Fikkert.

I’ve put together a short list (see below) of recommended reading material of books, manuals, articles, and websites for your perusal. This is not exclusive, and it leans a bit to the health care side of the issue, but I can help direct you to other reading here is, as I said, much more out there about justice, health care, and human trafficking. The US State Department annual Trafficking in Persons Report is published annually in June and can help you figure out what is going on in a particular country (from the US government’s point of view, anyway).

It is important to understand that trafficking in persons is a complicated topic weaving issues of poverty, migration, prostitution, gender, law enforcement culture, and others together in a mess of exploitation and evil. Welcome to the big picture!

Let me know when you are ready for more…

Books

Haugen, Gary (1999) Good News About Injustice. Downers Grove, IL: Intervarsity Press.

Corbett, S. and Fikkert, B. (2009) When Helping Hurts. Chicago, IL: Moody Publishers. www.whenhelpinghurts.org

Bales, Kevin (1999). Disposable People: New Slavery in the Global Economy. Los Angeles, CA: University of California Press.

Andrea Di Nicola, et al. 2009.  Prostitution and Human Trafficking; Focus on Clients. Springer Science, New York.

Malarek, Victor. The Johns, Sex for Sale and the Men Who Buy It. (2009) New York: Arcade Publishing.

Bales, Kevin ed. (2004) New Slavery Reference Handbook 2^nd Ed. ABC-CLIO, Santa Barbara.

Articles/Manuals/Reports

Caring for Trafficked Persons, Guidelines for Health Care Professionals. IOM. Geneva. 2009.  http://www.iom.int/jahia/Jahia/activities/by-theme/migration-health/caring-for-trafficked-persons/

Trafficking in Persons Report. US State Dept 2011. http://www.state.gov/g/tip/rls/tiprpt/2011/

Stolen Smiles: A summary report on the physical and psychological health consequences of women and adolescents trafficked in Europe. Zimmerman C. LSHTM, European Commission’s Daphne Programme, Int’l Organization for Migration 2006.

Turning Pain Into Power: Trafficking Survivor’s Perspectives on Early Intervention Strategies. Family Violence Prevention Fund in partnership with the World Childhood Foundation, March 2005. http://www.endabuse.org/userfiles/file/ImmigrantWomen/Turning%20Pain%20intoPower.pdf

Human Trafficking and the Healthcare Professional. Barrows, J., Finger, R. Southern Medical Journal. 2008; 101(5): 521-524.

Identification of human trafficking victims in health care settings. Susie B. Baldwin, David P. Eisenman, Jennifer N. Sayles, Gery Ryan, Kenneth S. Chuang © 2011 Baldwin, Eisenman, Sayles, Ryan, and Chuang. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License.

Websites/Online Resources

Faith Alliance Against Slavery and Trafficking www.faastinternational.org

Polaris Project: www.polarisproject.org

US Dept of Health and Human Services: www.acf.hhs.gov/trafficking/

Doctors At War www.doctorsatwar.org

Meeting people where they are: a consult from a car in rural Asia.

The intersection of health and justice

Physicians are trained to treat their patients with compassion as people, not diseases. However, those who have been enslaved tend to be more deeply wounded than others. A special understanding of the sensitivities and nuances of caring for chronically traumatized people is necessary.

The health care community has lagged behind first in identifying human trafficking as a health care issue, as well as effectively addressing the unique needs of trafficking victims. There is a great gap in trauma-informed, competent, and compassionate health care for most survivors of human trafficking today.  Katherine uses her experience and skills to advocate for survivors’ needs, as well as train health care professionals in holistic care of them. Health care professionals are also on the front lines of identification of trafficked people. A hospital or clinic may be the only interface with the general public a victim may have, and may present an opportunity for identification and release.

Health

To be healthy is, of course, to be free from disease. More than that, health means to be in a state of holistic wellbeing physically, mentally, and emotionally. Health is both public and private. It exists on an individual and community level, and it is generational.

Justice

Justice is much more than a legal term: it is an active and tangible work of making things in this world right and whole to bring about shalom: integrated wholeness. Justice is transformative, not only for the doer, but also for the receiver, bringing about integration in the midst of the action. To do justice with compassion means to work with empathy and extend mercy. Justice can be practical, but it can also be extravagant. Compassionate justice is the only way to be present to people such as these:

• To help lift the pain of that Chinese woman who, despite the urgings of her family, kept her child who is afflicted with cerebral palsy. Because there is no adequate welfare system for special needs children there, this woman prostitutes herself in order to pay for her child’s high-cost medical care.
• To be present to the stateless six year old abandoned by his father after his trafficked forced-bride mother disappeared, having been captured or arrested or worse.
• To give hope to the seventeen year old girl who has lost all hope in humanity, whose goal is to use as many people as possible before she kills herself.
• To approach research in this area with the vision that each man, woman and child is an individual loved by God, not simply a data point for publication.

John Perkins could not have said it better: “Resolve today that you are going to embrace the justice will of God; become someone he can use to transform your street, your neighborhood, your place of work, your school and, yes, your church.” (from Follow Me to Freedom, Claiborne and Perkins, Regal books 2009)

This woman and countless others like her were the beginning sparks of my interest and work in addressing injustice through health and medicine. As a senior medical student I spent two months working in a small mission hospital on the Thai-Burma border. Although at that time “Human Trafficking” was not a term commonly heard, it was still a reality for millions of people. During that time of caring for refugees, migrant workers, legal and illegal immigrants, probable trafficking victims, and prostituted women and children, the problem of the complete lack of human rights for so many people for seemingly no reason became very real and very personal. Just as astounding was the lack of awareness and attention by the West to such atrocities.

I became RELENTLESS. I am committed to addressing injustice by compassionately applying my skills as a physician to the needs that exist around me. For over a decade, I have touched the lives of refugees, abandoned children, people living with HIV/AIDS, and trafficked people. There is a unique niche for physicians, to work with this special population of trafficked people and sought out opportunities to serve people trapped in exploitation.