By Traci Kurtzer, MD
In honor of Human Trafficking Awareness month, I wanted to review the important work that AMWA’s Physicians Against the Trafficking of Humans (PATH) has done over these past 10 years in various anti-trafficking efforts in healthcare by speaking to some of the people who have been involved in the organization.
In 2012, AMWA President Gayatri Devi, identified sex trafficking as an important issue for AMWA to address. This led to the development of the Human Trafficking Committee by co-chairs Dr. Suzanne Harrison and Dr. Holly Atkinson, which authored AMWA’s initial position statement on human trafficking.
PATH’s mission is to educate health care professionals with accurate information to enhance awareness of human trafficking and help in identification of patients who are survivors of trafficking. Critical to this is dispelling the very common myths that so many, even in healthcare, hold about human trafficking. Dr Kanani Titchen, who served as the President of PATH from 2014 to 2019, recalls early on in her medical career thinking that human trafficking only happened in other countries, such as Eastern Europe and the Far East, but an experience with a patient in the OR having gynecologic surgery was her first awareness of trafficking in her own hospital. She wondered, “How many of these patients are we missing?” After doing research and reading in the NY Times about human trafficking in the U.S. and seeing a dearth of information on human trafficking in the medical journals, she recognized the need to educate health care professionals.
In 2013, Dr. Titchen as the AMWA Resident Division President, conducted a survey on the common knowledge about human trafficking and then upon realizing how limited the education and knowledge was in health care professionals, promoted awareness as part of her platform. With the support of Dr Eliza Chin, she co-created AMWA-PATH in 2014 and using the HEAL Trafficking guidelines for comprehensive human trafficking education, she along with others created the first train the trainer sex trafficking curriculum called “SUSTAIN” in 2017. With volunteer film/video producer, Stuart Culpepper, Titchen also created a series of educational videos on sex trafficking and an interactive website to educate medical professionals. Under her leadership, trainings evolved to be more inclusive of labor trafficking and were renamed “LIFT” for Learn, Identify, Fight Trafficking. One of PATH’s missions is to connect patients, providers, clinics and hospitals to local resources.
Dr. Titchen notes that the LIFT trainings were unique in that they incorporated panels with law enforcement and legal and social service agency representation as well as survivor experts local to the community in which the training was held to “provide healthcare professionals with practical information about how to partner with these stakeholders in the event that they encounter patients with experiences of exploitation.” PATH still provides these free continuing education comprehensive trainings to AMWA groups and medical organizations across the country. Dr. Titchen, now a pediatrician at UC San Diego Rady Children’s Hospital, credits her time as the co-creator and President of PATH with helping her learn how to “… identify strengths in others and build on these… as well as help others who were interested in being involved in how to make their interests more specific, and to help them find a place – or create a place – within PATH.” She also believes that her experiences with survivors of human trafficking made her aware that most walk around with trauma and learned how to relate to her patients with a greater sense of humility and kindness … she adds, “And I’m still learning all these things, too. I never stop learning.”
AMWA Past President, Dr Elizabeth Berdan who steered PATH successfully through the early years of the pandemic from 2019-2021 and continued the important education by transitioning the LIFT trainings to virtual platforms, agrees with her predecessor and states, “Participating in AMWA- PATH has been enriching in many ways – it has provided opportunities for meaningful advocacy work while bolstering my growth both personally and professionally.”
An example of the profound impact of the group, in 2015, AMWA-PATH partnered with the Department of Health and Human Services to host Human Trafficking: A Summit to Engage Healthcare Organizations, an event which convened over 50 organizations and institutions from various healthcare professions, including physicians, nurses, EMT’s social workers, technicians, psychologists, physician assistants, public health advocates, and more. The Summit provided an overview of human trafficking, highlighting the role of healthcare practitioners and organizations in addressing the issue. Speakers included leaders from federal agencies, academic institutions, and non-governmental organizations and survivors.
As mentioned, Dr Eliza Chin, AMWA Executive Director and a Past President (2010 to 2011) was an important mentor for PATH and major supporter from the beginning to present. “PATH has been one of the most impactful programs developed by AMWA, thanks to the vision and work of Dr. Titchen and so many others , the cadre of leaders who have continued to carry on the torch of PATH, the generosity of donors, and the students who champion and embrace this work”
One of the early members of PATH and contributors to the SUSTAIN and LIFT curricula was Dr Julia Geynisman-Tan who currently works as a Urogynecologist at Northwestern in Chicago and leads the ERASE Trafficking clinic. She became a Co-Chair for PATH in 2017, but started out in PATH as an OBGYN resident in NYC and already understanding the importance of providing good medical care for these patients from running a clinic for trafficking survivors. One of PATH’s missions is to provide and promote trauma informed care and to equip health professionals to safely intervene on behalf of patients. Dr. Geynisman-Tan says she was also a member of Health, Education, Advocacy, Linkage, or HEAL Trafficking, which was the only other group focused on medical professionals and providing a healthcare specific education and response.
At the time, most trainings on human trafficking across the country were otherwise being covered by social service, religious or community-based organizations and those other organizations did not readily recognize health care professionals as first responders. Dr Geynisman-Tan credits her work with PATH on the curricula as helping her understand how to spread her knowledge to other people who could then widen the impact farther and faster, whereas she “had previously assumed I would always have to be the one giving the lecture or being the source of expertise.” She further states, “Ultimately I would hope that an organization like PATH is not needed- that we put ourselves ‘out of business’ by lobbying for training enough providers who can continue to teach identification, trauma informed care and advocacy for these patients to their colleagues.”
As per Dr Geynisman-Tan’s wishes to make PATH irrelevant by training the future trainers, PATH is structured so that much of the education is geared to the next generation of health care professionals through a robust Student Interest Group (PATH-SIG). Many of the student leaders in PATH, have carried on in their careers after PATH to continue educating their peers and to become experts on human trafficking. Rachel Geiser, M.S. a medical student at the University of Arizona College of Medicine Class of 2026, served as SIG President from 2022- 2022 but started working with PATH-SIG in 2019. She credits her work in anti-trafficking as her number one motivation for going to medical school to become a healthcare professional. She came into her leadership position with a decent prior knowledge of trafficking from leading a student led non-profit in college called AllWalks and from a senior college course on it. She recalls Dr Juliana King, now Dean of the Mayo Clinic Alix School of Medicine, coming to her class to speak about physician involvement in anti-trafficking and Rachel reached out to her later to ask how she could get more involved and was introduced to Dr. Titchen and PATH. Her current goal as PATH Student Leader at her medical school, is to make the LIFT curriculum or some variation of it, mandatory training in medical education early on.
Ms. Geiser elaborates: “Everyone I’ve ever met who has attended a LIFT training has nothing but positive things to say, but it’s also self-selective for those who are motivated to attend. I think everyone would and should benefit from it, but they won’t know what a great resource is at their fingertips unless their institution requires it. It’s crazy to me that there isn’t some level of human trafficking education [for all].” She, as well as the others interviewed stressed how urgent it is to break through the stereotypes, myths and misconceptions about what trafficking victim-survivors look like and how they present in healthcare. The LIFT training emphasizes the importance of avoiding our biases, minimizing causing secondary trauma to survivors and also in banishing the “rescue fantasy“ – which is when professionals feel they can save a survivor from their trafficker when it is often very much more complex situation which requires a sensitive, trauma-informed, patient-centered approach. Rachel is current working on publishing an IRB approved survey-based study on attendees of a human trafficking and domestic violence in healthcare lunch training provided through her school’s research office of medical education.
Zara Siddiqui who is a MS4 at the Alabama College of Osteopathic Medicine going into OBGYN and the current PATH Student Interest Group President adds, “PATH gives me an avenue to use my knowledge as someone with experience working with survivors of sex trafficking and to continue advocating from within the medical field. I have been lucky to work with a group of highly talented and passionate students and physicians from around the country on many projects and educational presentations.”
In training the current and next generation of health care professionals, it is so critical to involve the experts with lived experience of trafficking, often referred to as survivor-experts. Hired survivor experts involved with PATH have co-led LIFT trainings, been content reviewers for educational curriculums and most recently, major contributors to our latest educational effort, videos highlighting the healthcare response to labor trafficking.
Integral to this project, was Mr. Suleman Masood, Subject Matter Expert, Human Trafficking and Male Victimization and former Council Chair of the United States Advisory Council on Human Trafficking from 2021-2023. Mr. Masood attended a training/panel event by PATH a few years ago and then started following the work being done by organizations, including PATH focused on healthcare education.
Regarding his recent involvement in the labor trafficking videos, Mr. Masood stresses: “Given the sheer lack of information on labor trafficking, this video series was an impactful concept to educate the public on understanding how labor trafficking occurs in the United States.” He hopes the videos will help healthcare professionals develop a better sense of how labor trafficking may differ from other trafficking due to cultural, linguistic, educational and societal barriers for survivors. “One key takeaway,” he says, “that I hope healthcare professionals understand is that survivors of labor trafficking may not be able to articulate their trauma/victimization due to the fact that they do not understand their basic workers’ rights afforded to them.” Having voices from those whose expertise is from lived experience is part of AMWA-PATH’s history and will continue to be a focus of PATH’s work in both education and advocacy going forward.
So, AMWA-PATH will continue to integrate up-to-date, evidence-based information on trafficking in our educational trainings. We will focus more, in the coming year, on national and state legislative advocacy for improved policies and government funding to support trafficking survivors and enhanced research and education for health care professionals. As Mr. Masood said: “Through continued awareness campaigns and intentional trainings, AMWA-PATH can truly help patients destigmatize the fear in reporting, as well as normalize the need for physical, emotional and mental healing from the “scars” they were forced to endure during their trauma. Through survivor-centered principles, AMWA-PATH can build a new ‘culture’ within the anti-trafficking movement that allow healthcare professionals to feel more confident in supporting their patients who may be victims of human trafficking.”
Congratulations and great work AMWA-PATH physician leaders and students! Learn more: AMWA-PATH
ABOUT THE AUTHOR
Dr. Traci Kurtzer is the Medical Director of Trauma Informed Care and Education in the Department of Obstetrics and Gynecology, Northwestern Medicine, Chicago IL. She is the current President of AMWA-PATH (2022-2024) and a founding member and the immediate past Co-Chair of the Cook County Human Trafficking Taskforce Healthcare Sub-committee.