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A patient encounter, unresolved.
In the late 1970s, I worked as a clinical nurse specialist in New Jersey. One day, a 15-year-old girl with fever and abdominal pain was admitted for possible appendicitis. Small, thin, and blond, she spoke only Russian. She was accompanied by two older adolescent girls and a surly middle-aged man. In halting English, he said that the girls lived with him, explaining that they were cousins and he was an uncle. None of the girls spoke English; all were here without other family members.
Figure. Maureen Shaw...Image Tools
The staff called me because they felt that something wasn't quite right. During the initial assessment and admission, the uncle answered all questions directed to the girl—even personal questions regarding her health—without consulting her. It seemed strange to the staff that he knew so much about her. The girl just sat in bed, her eyes downcast, showing no interest in the discussion. The other two girls sat mostly in silence. I agreed that something didn't seem right.
We consulted the hospital's security chief, a former police officer, who said that unless the girl filed a complaint that she was being held against her will, there was nothing he could do. We found a Russian translator and arranged for him to come after visiting hours, after the uncle and the other girls had left, but the girl said little to him, stating only that she was here visiting her uncle and cousins and that she was fine. She didn't know her current address; she said that her family in Russia had no telephone. Her test results were inconclusive; once her fever resolved, she was discharged to the man who said he was her uncle.
Knowing what I know now, it seems likely that the girls were trafficking victims. Several of the indicators described by Donna Sabella in her article, "The Role of the Nurse in Combating Human Trafficking," were present. But in the 1970s, trafficking just wasn't on the public's radar—at least not as something that was happening in the United States. Unfortunately, that misconception persists today.
Sabella provides a harrowing picture of human trafficking. She points out that thousands of people are brought into this country each year, and that "after Germany, the United States is reportedly the second-largest market for women and children trafficked into sex work." Labor trafficking in this country is also rampant. Some cases have made national headlines, as did an FBI case against a Milwaukee, Wisconsin-area couple—both physicians—who forced a Filipina woman to work as their servant for 19 years; they were convicted in May 2006. And last December in Florida, the FBI arrested the owners of a Boca Raton–based staffing agency for forcing 39 Filipinos to work in country clubs and hotels; the workers were recruited with false promises and then threatened if they complained about their assignments.
Contrary to what many Americans think, not all victims of trafficking here are foreign nationals. Domestic trafficking is also big business. Last November a three-day, 40-city operation by the FBI, the National Center for Missing and Exploited Children, and local law enforcement agencies led to the arrest of more than 800 people involved in child prostitution; 69 children were rescued. And in December, National Public Radio's Youth Radio reported on adolescents in Oakland, California, one of whom was kidnapped and forced into prostitution in another city.
I often wonder what became of that young Russian girl I encountered. There's no doubt that trafficking victims have passed through our health care system and have been seen by nurses who either didn't recognize the signs or, like me, didn't know how to pursue an investigation. I urge you to read Sabella's article and to learn more about human trafficking. If you find yourself with a patient whom you suspect is being trafficked, you'll know what to do.
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