Medical community looks at issues surrounding human trafficking

Dr. Swati Shirali, left, who represented the Just Ask Prevention Project, is shown with Arlington County Medical Society president Dr. Don Saroff and executive director Michelle Saroff at a human-trafficking program on Jan. 15, 2020.

The medical community could – and perhaps should – be on the front lines in helping to combat sexual-based human trafficking, especially of young people, but few in the profession have the specific knowledge to ask the right questions and follow up appropriately.

A recent forum sponsored by the Arlington County Medical Society attempted to rectify that.

Only 3 percent of medical providers are properly trained to assess trafficking situations, said Dr. Swati Shirali, who represented the Just Ask Prevention Project, a McLean-based advocacy and training organization, at the Jan. 15 event, held at Washington Golf & Country Club.

“It’s happening in our area, in our back yard,” said Shirali, noting that human trafficking soon will exceed drug trafficking as the biggest worldwide criminal enterprise.

At first glance, medical professionals “may not recognize that [patients] are being trafficked,” said Shirali, an orthopedic surgeon with privileges at Virginia Hospital Center. And unlike stereotypes, the typical sex-trafficking victim lives at home and engages in forced-sexual activity when left unsupervised.

“A lot of these teens are manipulated – they don’t know they should go for help,” she said. “They feel trapped; they can’t get out. Some of them have no one to turn to, and just give up.”

The vast majority – 90 percent – of human-trafficking victims access health-care facilities and personnel at some point during their exploitation. Too often, victims find themselves feeling judged or discriminated against, in part because of a lack of understanding of the issues involved by those in the medical profession.

In her presentation, Shirali ran through a number of real-world incidents, where red flags popped up but were missed or ignored by health-care workers.

“You need to look one step beyond,” she said of the patient relationships. “We really need to talk to them on their level, be very non-judgmental. We’re all rushed . . . [but] take that extra moment.”

Despite advances in awareness, medical professionals still have a learning curve to address, and peppered Shirali with questions at the forum.

One physician recalled the story of a pregnant 14-year-old patient who she suspected might be at risk, but “I didn’t know what to do or who to talk to.”

(By coming to the seminar, “now, at least you know what to look for,” Shirali noted.)

Dr. Don Saroff, president of the Arlington County Medical Society, said one of the biggest challenges facing those in the medical profession is a lack of clarity about what information about patients can, and cannot, be released.

Medical professionals operate under federal-government rules on privacy – known as HIPAA – and slip-ups can be personally and professional costly, he noted.

“We’re all so used to being protective of ourselves,” Saroff said, calling it a “culture of self-protection.”

Medical professionals put their careers at risk if they take an ill-advised step on privacy issues. “All it takes is one bad thing to negate hundreds of good things,” Saroff said.

Shirali said that, under HIPAA, medical professionals cannot disclose specific medical information to law enforcement or the National Human Trafficking Hotline, but they can provide the name and address of those suspected of being victims.

In Maryland and the District of Columbia, it is mandatory for medical professionals to report suspected child trafficking, but no such rule is in place in Virginia. However, state Sen. Barbara Favola said the state government is taking steps to address exploitation issues.

Favola (D-Arlington-Fairfax-Loudoun) pointed to successful legislation she patroned last year to develop a school-based curriculum to educate young people on how to recognize and avoid situations that could lead to human trafficking. It is based on a program in Prince William County.

“As a result of the program [in Prince William], over 200 students came forward requesting a meeting with a social worker for triage,” said Favola, who chairs the Senate Committee on Rehabilitation and Social Services.

“The lessons have benefited not only students, but also school staff by training them to identify at-risk students,” Favola said. “Early identification is vital, because the longer individuals are in trafficking situations, the harder it is to get them out.”

Favola said she was hopeful the upcoming biennial state budget would add “even more resources” to promote training and support efforts to combat trafficking.

The Arlington County Medical Society hosts a number of educational forums for members each year. Shirali said the number of people who attended the Jan. 15 event was impressive.

“It was a great turnout,” she said.

• • •

The National Human Trafficking Hotline can be accessed at (888) 373-7888 or www.humantraffickinghotline.org. The Just Ask Prevention Project can be reached at (833) ASK2END or www.justaskprevention.org.

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