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Physicians Against the Trafficking of Humans (PATH) Toolkit

Toolkit: created by Michelle Lyman, Kashmira Chawla, and Carmen Hans

In 2014, AMWA founded Physicians Against the Trafficking of Humans (PATH) to help educate physicians, residents, and medical students about issues surrounding human sex trafficking.

Mission Statement

To help medical professionals better care for victims of human trafficking through

  • Enhancing awareness of the scope of the problem
  • Identifying at-risk patients by utilizing victim-centered interviewing techniques
  • Providing and promoting trauma-informed care
  • Equipping health professionals to intervene safely on behalf of patients
  • Connecting patients, providers, clinics, and hospitals to resources.

HISTORY 
In 2012, AMWA President, Dr. Gayatri Devi, identified human sex trafficking as an important issue for the organization to address. This led to the formation of the Human Trafficking Committee by Dr. Suzanne Harrison and Dr. Holly Atkinson (co-chairs). The committee authored AMWA’s position statement in this area. Dr. Kanani Titchen, then AMWA Resident Division President, conducted a survey to identify healthcare providers’ knowledge in this area and found that knowledge to be significantly lacking. These findings led to the creation of a series of educational videos and an interactive website to educate medical professionals about sex trafficking victims. PATH has also conducted webinars and supported local conferences on the issue of human sex trafficking. More about the history of PATH click here.

These videos are available for viewing and are accredited for 0.5 AMA PRA Category I credits.  Click here for the course Doctors: Learn How to Recognize Victims of Child Sex Trafficking.

Please join the PATH on-line community to learn more about what you can do to stop human sex trafficking in your community. To get involved, please e-mail path@amwa-doc.org for more information.

PATH IN THE MEDIA

  1. Read the article by Politico about the Summit here (September 21, 2015)
  2. Most trafficking victims see a doctor, but do doctors know how to help? (May 5, 2015)
  3. AMWA: Recognizing human-trafficking victims (April 27, 2015)
  4. Yahoo News: Most Doctors Couldn’t Spot A Human-Trafficking Victim If They Saw One. Could You? (March 18, 2015)

Co-Chairs:
Julia Geynisman-Tan, MD; Mollie Gordan, MD; Kanani Titchen, MD

Resident Co-Chairs:
Yaowaree Leavell (Noona), MD, Megan Reinders, MD

Student Co-Chairs:
Alyssa Davis – Secretary
Kathleen Till – Public Relations
Carmen Hans, Hilary Samuelson – Education
Michelle Lyman, Noona Leavell – Advocacy

Q: What is the PATH Toolkit?
A: This page is a comprehensive list of some of the growing resources for healthcare providers and student of all health professions on anti-human trafficking. The resources listed include both general information such as key definitions as well as links to additional websites, institutions, and literature. The page answers some common questions regarding human trafficking and healthcare with useful resources available to the healthcare community as well as organizing some additional resources commonly cited into categories based on factors such as education, advocacy, research articles, occupation, and others. Listed are the top three resources for quick access, with others listed below to provide additional information. If you have any suggestions for additional resources or a link you would like to share, please e-mail AMWAPathstudents@gmail.com

Q: What is human trafficking?
A: One of the most commonly cited definitions of human trafficking is from the United Nation’s Palermo Protocol and is as follows:
“The recruitment, transportation, transfer, harboring or receipt of persons, by means of the threat or use of force or other forms of coercion, of abduction, of fraud, of deception, of the abuse of power or of a position of vulnerability, or of the giving or receiving of payments or benefits to achieve the consent of a person having control over another person for the purpose of exploitation. Exploitation shall include, at a minimum, the exploitation of the prostitution of others or other forms of sexual exploitation, forced labor or services, slavery or practices similar to slavery, servitude or the removal of organs.”

Q: Who is trafficked? Where is this happening?
A: One of best resources for updated information on the number of people trafficked in the United States as reported through the National Human Trafficking Resources hotline is through the statistics published by the Polaris Project.

Q: Are my patients potentially trafficked persons? What should I do?
A: Below are some materials that are designed to provide more detailed description of vital skills for identifying and responding to human trafficking in a healthcare setting.

Future Events:

Stand Up to Sex Trafficking: Awareness, Implementation, and Networking (SUSTAIN)

Using criteria put forth by Dr. Jordan Greenbaum’s working group of the Helfer Society, we at PATH have created a training curriculum to give health care professionals more in-depth training about sex trafficking. The training, called “SUSTAIN” (Stand Up To Sex Trafficking: Awareness, Implementation, Networking,) uses a “train the trainer” model, and will be offered by AMWA-PATH experts across the country. The participant may opt for a didactic- and discussion-based half-day training or may choose to participate in the full day of training, which includes the didactic- and discussion-based morning session followed by an interactive and practice-based afternoon session that equips the participant to present his or her own talk on human sex trafficking. See below for training dates and locations. Up to $150 may be available for travel assistance. Please contact Ally Davis at ald11d@med.fsu.edu with questions or to register.

Philadelphia, PA: January 20th, 2018
Sidney Kimmel Medical College at Thomas Jefferson University
Full-Day: Time TBD, lunch provided
Half-Day: Time TBD
CME credit available

Honolulu, HI: February 10th, 2018
University of Hawaii John A. Burns School of Medicine
Full-Day: Time TBD, lunch provided
Half-Day: Time TBD
CME credit available

Houston, TX: Spring 2018 TBD
CME credit available

Past Events:

All trainings are FREE thanks to our generous donors.

  • TEDx Talk: How to Spot Human Trafficking, presented by Dr. Kanani Titchen (12 minutes)
  • Video with perspectives from a human trafficking survivor (23 minutes)
  • Watch PATH co-founder, Dr. Kanani Titchen, discuss sex trafficking here (1:46 minutes)
  • PATH Introduction to Human Sex Trafficking video (10:54 minutes)
  • Very Young Girls – Documentary expose on commercial sex exploitation of young girls and their treatment by police in NYC, available on Netflix, view trailer here  (1 hr 21 min)

See resources to learn more about trafficking and share information with other healthcare providers in your community here. Visit the links below for information on continuing education modules on the topic, pamphlets to distribute to other healthcare professionals, and more.

  1. PATH-AMWA: www.doc-path.org – video modules (CME Statement)
  2. Polaris/NHTRC: traffickingresourcecenter.org/nhtrc-hhs-online-trainings – online training and resources
  3. HEAL: Anti-Trafficking Education Initiatives – list of anti-trafficking educational resources
  4. SOAR: Health and Human Services pilot training on human trafficking for healthcare providers, coming in Fall 2016
  5. Catholic Health Initiatives: Human Trafficking and the Role of the Healthcare Provider – online modules
  6. Stanford University: humantraffickingmed.stanford.edu/ – online resources
  7. Mt. Sinai Hospital: Emergency Medicine Physician Trafficking Education – guide on caring for trafficked persons in the ED
  8. Christian Medical and Dental Association: Human Trafficking Continuing Education Module – CME accredited module
  9. Dignity Health Human Trafficking Response Program Shared Learnings Manual (May 2017)
  10. Protocol Toolkit for Developing a Response to Victims of Human Trafficking in Health Care Settings

If you suspect or confirm that your patient is a victim of human trafficking, call 1-888-373-7888You can also report cases on the National Human Trafficking Resources Center website.

Identification and Screening Tools. If you suspect that your patient might be trafficked, consider using one of the following screening tools to ask further questions and assess the situation.

  1. USDHHS Rescue and Restore Campaign – Trafficking Victims Identification and Screening Tools, 1 page pdf with screening tool questions available
  2. Polaris/NHTRC Trafficking Victim Identification Tool –  Links to various assessment tools and information for law enforcement and health providers.
  3. Ohio Human Trafficking Taskforce: Human Trafficking Screening Tool – manual with interview guidelines and questions as well as key definitions
  4. Vera Institute – Validated human trafficking screening tool (long version p. 13, short version p. 25)
  5. Loyola University Chicago Center for the Human Rights of Children – Screening tool for children on page 51 with accompanying red flags for clinical encounters provided on pages 47-48

 

Confronting Commercial Sexual Exploitation and Sex Trafficking of Minors in the United States: A Guide for the Health Care Sector by the Institute of Medicine: This guide from the Institute of Medicine/ National Research Council Report includes definitions of key terms and an overview of risk factors and consequences; barriers to identifying victims and survivors as well as opportunities for overcoming these barriers; examples of current practices in the health care sector; and recommendations aimed at identifying, preventing, and responding to these crimes.

Caring for Trafficked Persons: Guidance for Health Providers by the International Organization of Migration: The International Organization for Migration created this guide with support from the UN Global Initiative to Fight Human Trafficking. It provides advice for the healthcare professional seeking practical skills to understand, identify, and approach trafficking.

Human Trafficking: Guidebook on Identification, Assessment and Response in the Health Care Setting: Mass Gen and the Massachusetts Med Society published a manual for healthcare providers on human trafficking to describe the health effects of trafficking and guide practitioners in assessing at-risk and trafficked individuals. It is available for download.

Human Trafficking: Review of Educational Resources for Health Professionals: Review of current human trafficking educational resources by the American Journal of Preventative Medicine

The IOM Handbook on Direct Assistance for Victims of Human Trafficking: by the International Organization for Migration

The Mental Health Aspects of Trafficking in Human Beings: Set of Minimum Standards: Aimm to help the implementation of comprehensive and coordinated psychosocial care of trafficked persons from the time of their rescue to throughout their reintegration process.

National Institute of Justice: Needs assessment for service providers and trafficking victims. This report provides facts about sex trafficking in the United States and healthcare needs.

Trauma Informed Care Toolkit: document is a helpful list of websites and resources from various agencies relating to a number of specialties, types of trauma, and patient populations.

US Department of Health and Human Services: Report on medical treatment of victims of sexual assault and domestic violence and its applicability to victims of human trafficking.

WHO Guidelines for Interviewing Trafficked Women

Research Articles

National
Macy RJ and Graham LM. Identifying Domestic and International Sex-Trafficking Victims During Human Service Provision Trauma Violence Abuse. 2012 Apr;13(2):59-76.

Beck ME, Lineer MM, Melzer-Lange M, et al. Medical Providers’ Understanding of Sex Trafficking and Their Experience With At-Risk Patients. Pediatrics. 2015 Apr;135(4):895-902.

Grace AM, Lippert S, Collins K. Educating Health Care Professionals on Human Trafficking. Pediatr Emerg Care. 2014 Dec;30(12):856-61.

Dovydaitis T. Human Trafficking: The Role of the Health Care Provider. J Midwifery Womens Health. 2010 Sep-Oct; 55(5): 462–467.

Konstantopoulos WM, Ahn R, Alpert EJ, et al. An International Comparative Public Health Analysis of Sex Trafficking of Women and Girls in Eight Cities: Achieving a More Effective Health Sector Response. J Urban Health. 2013 Dec; 90(6): 1194–1204.

Beck ME, Lineer MM, Melzer-Lange M, et al. Medical providers’ understanding of sex trafficking and their experience with at-risk patients. Pediatrics. 2015 Apr;135(4):895-902.

Greenbaum J, Crawford-Jakubiak JE; Committee on Child Abuse and Neglect. Child sex trafficking and commercial sexual exploitation: health care needs of victims. Pediatrics. 2015 Mar;135(3):566-74.

Baldwin SB, Eisenman DP, Sayles JN, et al. Identification of human trafficking victims in health care settings. Health Hum Rights. 2011 Jul 14;13(1):36-49.

McNiel M, Held T, Busch-Armendariz N. Creating an interdisciplinary medical home for survivors of human trafficking. Obstet Gynecol. 2014 Sep;124(3):611-5.

International
Zimmerman C, Hossain M, Yun K, et al. The health of trafficked women: A survey of women entering posttrafficking services in Europe. Am J Public Health.2008;98:55–9.

Kiss L, Pocock NS, Naisanguansri V, et al. Health of men, women, and children in post-trafficking services in Cambodia, Thailand, and Vietnam: an observational cross-sectional study. Lancet Glob Health. 2015 Mar;3(3):e154-61.

Hossain M, Zimmerman C, Abas M, et al. The relationship of trauma to mental disorders among trafficked and sexually exploited girls and women. Am J Public Health. 2010 Dec;100(12):2442-9.

How do I connect with other healthcare providers and professionals to fight human trafficking?
There are many organizations from a variety of fields focused on the prevention of human trafficking and advocating for the rights of survivors. Below are some global, national, and local organizations and federal agencies and links to their specific Anti-Human Trafficking initiatives.

NATIONAL
U.S.A.:

  1. National Human Trafficking Resources Center
  2. Polaris Project – anti-trafficking organization
  3. HEAL Trafficking – expansive description and links to advocacy, education, and resources related to human trafficking
  4. Alliance to End Slavery and Trafficking
  5. ECPAT-USA – anti-trafficking policy organization
  6. Freedom Network USA – national coalition of anti-trafficking service providers
  7. Futures without Violence – advocacy, training and technical assistance for trafficking victims
  8. VS. – coalition builder to confront human-trafficking
  9. Physicians Against the Trafficking of Humans (PATH)– CME Credit available here, Search – Doctors:  Learn How to Recognize Victims of Trafficking
  10. American Medical Women’s Association (AMWA)
    1. AMWA Position on Sex Trafficking
    2. A Need to Talk About Domestic Violence – article by Suzanne Harrison, M.D., PATH founder
  11. American Medical Association (AMA): How Physicians Can Identify, Asssist Trafficking Victims
  12. American College of Emergency Physicians (ACEP): Policy Statement on Human Trafficking
  13. Mt. Sinai Hospital: www.humantraffickinged.com – Resources for EM physicians
  14. American Congress of Obstetricians and Gynecologists (ACOG)
    1. ACOG Policy Statement on Global Women’s Health and Rights
    2. Human Trafficking
  15. American Academy of Pediatrics: Child Sex Trafficking and Commercial Sexual Exploitation Clinical Report
  16. American Psychological Association: Resolution on Assisting Victims of Human Trafficking
  17. Christian Medical and Dental Association (CMDA): Commission on Human Trafficking
  18. UCLA: Anti-Trafficking and Human Rights Coalition
  19. National Center for Missing and Exploited Children
    1. Cybertipline – hotline/online report crimes against children
  20. U.S. Federal government: Federal Strategic Action Plan on Services for Victims of Human Trafficking in the United States
  21. U.S. Department of Health and Human Services: U.S. Office of Trafficking in Persons
    1. Main website
    2. Rescue and Restore Campaign
    3. Final Report
  22. U.S. Department of Homeland Security
    1. Human Trafficking
    2. Blue Campaign
  23. U.S. Department of State: Office to Monitor and Combat Trafficking in Persons
  24. U.S. Human Smuggling and Trafficking Center 
  25. U.S. Immigrations and Customs Enforcement
    1. Human Trafficking
    2. Child Exploitation and Investigation Unit
  26. U.S. Citizenship and Immigration Services (USCIS): Human Trafficking
  27. U.S. Department of Justice (DOJ)
    1. Anti-Human Trafficking Task Force Initiative 
    2. Human Trafficking Prosecutions Unit
    3. Office for Victims of Crime – Human Trafficking
    4. National Institute of Justice – Human Trafficking
  28. U.S. Department of Labor
    1. Bureau of International Labor Affairs – Child Labor, Forced Labor, and Human Trafficking
  29. National Criminal Justice Reference Service: www.ncjrs.gov/app/topics/topic.aspx?Topicid=82
  30. Human Trafficking Pro Bono Legal Center

BY STATE (U.S.A.):

  1. U.S. Office for Victims of Crime: Matrix of human trafficking services and task forced by state
  2. The VS. State Guide: State-by-state overview of human trafficking legislation, news, and resources
  3. California
    1. MISSSEY – survivor-led organizaiton to combat human trafficking of children throughout California
    2. West Coast Children’s Clinic – C-change clinic for sexually exploited minors 
    3. Los Angeles: Coalition to Abolish Slavery and Trafficking
    4. Oakland: Banteay Srei – organization to support Southeast Asian women at risk of or engaged in sex work
  4. Hawaii : Pacific Survivor Center
  5. Minnesota: Minnesota Indian Women’s Resource Center – Sexual Violence and Trafficking
  6. New York
    1. NYC: Girls Educational and Mentoring Services (GEMS) – services for female victims of sex trafficking
    2. NYC: Safe Horizon Anti-Trafficking Program

EUROPE

  1. European Commission: Together Against Trafficking in Human Beings

INTERNATIONAL

  1. World Health Organization: Human Trafficking Information Sheet
  2. Fair Girls – anti-trafficking programs worldwide
  3. Physicians for Human Rights

This is a new initiative from the PATH Student group — a monthly series in research and advocacy news summaries created by the PATH residents and medical students. Newsletters will feature brief breakdowns on some of the most recent scholarly publications as well as policy changes related to human trafficking.

2017

November 2017 Newsletter

August 2017 Newsletter

June 2017 Newsletter

May 2017 Newsletter

March 2017 Newsletter

February 2017 Newsletter

January 2017 Newsletter

2016

December 2016 Newsletter

November 2016 Newsletter

October 2016 Newsletter

September 2016 Newsletter

August 2016 Newsletter

July 2016 Newsletter

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