“A”

I met “A” a couple weeks ago. I was visiting an outreach location where street boys can come and hangout in the afternoons. My friends who set it up were particularly concerned about A and when I met him, so was I. Although he still needs a confirmatory blood test, I have seen enough people with AIDS to have a high suspicion of his underlying problem. The problem, I suspect, by the blank and far-away look in his eyes, and the flat affect of his responses is that he is also concerned about this diagnosis and has so far refused to see a doctor. This is why I went to visit him that day. He still refused, and wouldn’t even let me examine him. He won’t even take a vitamin. He is severely depressed.

A is 16 years old, but already he has suffered way too much for a lifetime – let alone a childhood. He was sold at the age of seven, along with his two elder brothers, by the mafia to work as sex slaves. They were all rescued several years ago and the mafia boss responsible has been put away for a very long time, but A and his brothers continue to live with the physical and emotional consequences of the horror.

I will continue to go back and visit A, his brothers and the other guys that hang out there. By building relationships on their terms on their turf, I hope that A will at least agree to be tested, and at last receive some medical mercy. Perhaps more can be done for his brothers (both of whom are doing much better than A) and the other kids.

“N”

I never met “N”, but her story is so compelling I must share it. N is an African woman who was trafficked to Thailand for sex work and the toll on her body was high and profound. Sex work, being raped repeatedly without any means of protection sets victims up for reproductive tract trauma and sexually transmitted infections, most of which go untreated and can lead to cancer. This is what happened to N. She was able to visit a doctor, but although she was in extreme pain and bleeding heavily, her traffickers did not permit her to have the recommended surgery.

She was finally given the opportunity to escape sex slavery in Thailand but not before her body was wrecked. During her repatriation processing, another trip to the doctor re-confirmed the need for surgery and stressed her risk of cancer, but N was not willing to have surgery in Thailand by foreign doctors. When she finally reached home, cancer was indeed diagnosed but it is not clear if surgery will be enough to cure her. Certainly she suffers from many other physical, mental, and emotional problems as well. At least, however, she is home with her family and familiar surroundings. More of her story can be found here.

Not Hopeless

These stories are tragic, but they aren’t hopeless. If I gave up hope, I wouldn’t be doing this work. I want to make a difference in lives of people who have been trafficked, but more importantly before they even have to suffer. And it is never too late – not even for A or N. While they may not be able to be cured, the can still receive treatment and be shown mercy and compassion. The stories of others like them don’t have to be hopeless either. We (health care and non-health care people) can work to build a more compassionate and comprehensive health care component in the care of trafficked people.

In A’s case, where were the doctors, the nurses, who were involved in their care from the time they were rescued from their slavery? As a doctor, I want to know what were they thinking? Perhaps, their health care was overlooked altogether as others focused on their social and legal problems, forgetting about his health needs. Who was advocating for his comprehensive care?

As for N, how can we make it possible for her to feel more comfortable getting the care she needs at the time that she truly needs it? How can we as health care professionals be more available, more compassionate, more welcoming to people who feel more pain and shame than most of us can imagine?

The physical and mental health consequences of human trafficking are compounded in every person. From their vulnerable pre-trafficked situation through recovery, holistic care is a very real, yet unrealized need of victims. Let’s all work together for better protection, identification, and aftercare of trafficked people.

An increasing amount of resources are available for health care professionals to learn more about trafficking in persons and what we can do about it. Here is a short list of recommendations:

• Caring for Trafficked People: Guidelines for Health Care Professionals PDF download (click here for the Spanish version)
• A facilitator’s guide to the above handbook is available here.
• The Christian Medical and Dental Association has published an online curriculum for training health care providers on dealing with human trafficking available for CME credit ($15/ 1 hour AMA category 1 credit)
• Ahn R, et al. Human Trafficking: Review of Educational Resources for Health Professionals. Am J Prev Med 2013;44(3):283-289.
• You can visit my resource page for more links and information.