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Child Trafficking Meets Healthcare: A Touchpoint for Change

Jordan Greenbaum, MD
November 27, 2017

A 14-year-old girl was brought by police to our child protection center for medical evaluation after being identified as a sex trafficking victim in a sting operation. Authorities told us the child was a long-time runaway who “lives on the streets, and every once in a while hooks up with a pimp.”

I walked into the room and began a casual conversation that gradually focused on why she thought she was brought to our clinic. She scoffed at the police, saying she worked the streets but never had a pimp and never would. She needed nothing from me or anyone else, she insisted. She took care of herself.

As legally defined in the United States, child sex trafficking involves any person engaging a minor under age 18 in a commercial sex act (sexual activity in exchange for something of perceived value), while labor trafficking involves a person using force, fraud, or coercion to engage a child in involuntary servitude or similar practices. 

If, in reality, our patient had no one controlling her--no pimp--would she be a victim of child trafficking? What if she were a teen male “hustling” the streets on his own? Would we or anyone else view him as trafficked, or would his victimization be overlooked? Would these youth be treated by health care providers and authorities simply as “troubled” kids,” juvenile offenders who made bad decisions?

In the mid-1980’s, the vaccine for HIB was released and thirty years later we no longer see this disease. Because of the effectiveness of this vaccine my younger partners only know of HIB meningitis through textbooks (and some of my anecdotes).

This is the recurring story of vaccine preventable diseases.

- See more at: https://www.aap.org/en-us/aap-voices/Pages/We-Can%27t-Let-Our-Guard-Down-Against-Vaccine-Preventable-Diseases.aspx#sthash.196pj2e8.dpuf

"Human rights advocates have estimated there are more than 20 million victims of human trafficking globally, with hundreds of thousands in the United States. Many are children."

As physicians who care for children, the vast majority of us learned nothing about human trafficking in our professional training. We’ve only recently come to realize the alarming extent to which children are exploited in sex and labor trades throughout the world. Human rights advocates have estimated there are more than 20 million victims of human trafficking globally, with hundreds of thousands in the United States. Many are children.

Health care professionals are beginning to recognize their important role in preventing and intervening in child labor and sex trafficking. There is a growing movement to frame human trafficking as a global public health issue, rather than simply a legal or a social problem. However, much work remains to better recognize exploitation when we see it, understand its many health consequences, and learn how to effectively help these patients.

We lack sufficient knowledge on the various risk factors, health consequences, medical and psychological needs, and effective treatment practices for trafficked children, especially those experiencing labor trafficking. Worse yet, we have almost no evidence-based strategies for primary prevention to guide health care professionals in their treatment of high-risk youth. That’s why a new policy statement from the American Academy of Pediatrics (AAP), “Global Human Trafficking and Child Victimization,” is so important.


"Unfortunately, re-exploitation of trafficked persons is very common, which further highlights the need to identify resilience factors, determine better ways of engaging victims and building trust, and design effective treatment strategies"

The AAP policy statement calls on health care providers around the world to take an active, multi-dimensional role in helping to protect children from exploitation. It highlights the need for rigorous, empirical research to build a solid evidence base to train providers about prevention practices, possible indicators of trafficking, and culturally appropriate, trauma-informed ways to respond to suspected exploitation.

The AAP statement also articulates the role of health care providers in advocating for child rights and protecting children across the globe from sexual and labor exploitation. The AAP offers recommendations regarding state, federal and international policy, medical education, research, and multi-disciplinary collaboration. But much of our efforts will begin in, and return to, the exam room.

Our 14-year-old patient brought in after a trafficking sting was treated for a sexually transmitted infection, taken into custody by child protective services, and admitted to a shelter for trafficked girls. But before she could undergo her mental health assessment and begin trauma-focused therapy, she ran away from the shelter. She was picked up by law enforcement six months later in the company of a known trafficker. Unfortunately, re-exploitation of trafficked persons is very common, which further highlights the need to identify resilience factors, determine better ways of engaging victims and building trust, and design effective treatment strategies.

Now is the time for us to take the initiative, learn what we can do to help these children, and commit to creating effective, sustainable change. 

The views expressed in this article are those of the authors, and not necessarily those of the American Academy of Pediatrics. ​​​


​​​Ab​out the ​​Author

​​Jordan Greenbaum, MD, is a member of the American Academy of Pediatrics Council on Child Abuse and Neglect and an author of the American Academy of Pediatrics policy statement, "Global Human Trafficking and Child Victimization," published in the December 2017 issue of Pediatrics. Dr. Greenbaum works with victims of suspected physical/sexual abuse, neglect and sex trafficking at the Stephanie Blank Center for Safe and Healthy Children at Children's Healthcare of Atlanta. In addition, she is the director of the Global Health and Wellbeing Initiative with the International Centre for Missing and Exploited Children.

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