Healthcare for a hidden population

By Tom Tracy - Florida Catholic

FORT LAUDERDALE | With human and sex trafficking very much in the news, Broward County’s only Catholic hospital is exploring ways to fill a need for ongoing, long term healthcare services for victims of sex trafficking.

Working with at least three referral centers in the community, Holy Cross staff hope to establish a system for identifying and channeling local sex trafficking victims into a program of continuing primary healthcare services, with monitoring that goes beyond the emergency room.

“It will be to serve victims and survivors to make sure they get continued primary care, which is a component that they are lacking,” said Regina Paulose, an international rights lawyer working with Holy Cross who has experience in refugee, sex trafficking and exploitation issues globally.

The healthcare needs of trafficked persons routinely get ignored, Paulose noted.

Holy Cross’ Sexual Trafficking and Exploitation Program (STEP) will link hospital medical staff who wish to be part of the network with community resources. The goal is to offer a holistic response to human trafficking in South Florida.

“We are working with ICE victim advocates to ensure the success of the program,” Paulose said, referring to U.S. Immigration and Customs Enforcement’s Victim Assistance Program.

STEP will focus on sex trafficking for now, with the expectation of later expanding to other forms of human trafficking, she added.

Mercy Sister Rita Levasseur, vice president of sponsorship and mission effectiveness at Holy Cross, told the Florida Catholic that the hospital’s parent company, Trinity Health, has been involved in the human trafficking conversation for some time. It was part of a 2008 task force on the topic at the Tallahassee-based Florida Catholic Conference. That task force endeavored to promote statewide awareness of human trafficking issues among parishes and other entities.

 

Not just sex

“You have all these mafias that bring people from other places, take their passports. It is basically an enslavement, so we have to be on the lookout when you see all these people living together. It is not just sex trafficking but human trafficking,” Sister Rita said.

“California and Florida have the most (trafficking situations); the person next to you could be hosting a trafficked person,” she added. “I think it has always been there, but light now has been shed on it.”

Holy Cross has already offered special training for medical staff who might encounter trafficked persons, especially in the emergency room, which is often the place where trafficking victims first present themselves. The training aims to help doctors and nurses spot signs of trafficking and make an appropriate response.

But through STEP, Holy Cross is trying to move victims beyond that, into primary care. “It is a way of responding to a great need here, and (with the support of) the Sisters of Mercy,” Sister Rita said.

Kim Saiswick, a nurse who directs Holy Cross’ community outreach and has been involved in public health in Broward County for the last 30 years, said she is familiar with most of the dimensions of local sex trafficking and exploitation in south Florida. What she finds surprising is how much of it originates locally rather than across national boundaries.

“We often hear of truckloads and cargos of people shipped across (borders) but we are seeing people from the community and you don’t even know it,” Saiswick said. She cited an example at a local park where boys and girls have been trafficked while living at home “and their parents don't even know about it. It is not always kids from another country, it is our community, and so in that respect the scenario has really changed.”

“We are looking at individuals who are compromised against their will and exploited,” she said, adding, that the more digital the world becomes the more ways there are to access and find individuals to exploit.

 

Teenagers

The average age for sex trafficking victims is 14, but it can range from 12 to 17, Saiswick noted. There are also more females than males — only about 33 percent of victims are male.

She added that Holy Cross hopes to get victims into ongoing OBGYN and other primary care services, including mental health counseling, through partner agencies. A social worker “navigator” will help coordinate services in the STEP program.

“We want to make sure all their needs are taken care of,” she said. “Mental health is a big need so we will be working to make sure they are participating in relevant programs and referrals; dental issues also come up.”

Saiswick said that every year the area sees higher and higher numbers of trafficking cases, with some 1,600 hotline calls in 2016, including some 550 reported human trafficking cases in Broward County. Of those, 379 were adults 18 years of age and older, the rest were children; and more than 60 percent were U.S. citizens, she noted.

Skip Levitt, chief administrator of Holy Cross Medical Group, who is assisting in coordinating and training the medical staff in the STEP program, said that ongoing routine care is the missing outreach service that Holy Cross hopes to address through STEP.

“The training will evolve around how do we identify these individuals and to whom do we identify them,” Levitt said. “These same questions come up with various chronic behavior health problems or HIV or any social stigma —  there is obvious value for the physician to have that information.”

At least four Holy Cross physicians have already volunteered to provide primary care to sex trafficked individuals, Levitt added, and other staff will be invited to volunteer.

“I would think victims of human trafficking are likely to have higher incidence of things like sexually transmitted diseases, physical abuse, physical trauma — some of these populations in particular would benefit from establishing a routine, ongoing primary care relationship,” he said.

Holy Cross also believes it is uplifting and dignifying for trafficking victims to simply be given the opportunity to build long term relationships with healthcare providers and to be treated as other patients are treated, Levitt said.

“We want that to happen so that folks don't feel stigmatized in having basic healthcare services,” he added. “We feel as though it is part of Holy Cross’ mission to minister to those in need and this is a very needy population.”