‘Modern day slavery’
Sex trafficking summit warns of epidemic
STATE COLLEGE — When Kendra Aucker, CEO of Lewisburg’s Evangelical Community Hospital, first learned about the pervasiveness of sex trafficking along the Route 15 corridor where her hospital is located, she was shocked enough to order all 2,000 hospital employees to undergo training so they could recognize trafficking victims when they encountered them and deal with them properly.
Aucker’s response to the problem is what’s needed throughout the health care industry, whose employees encounter 88% of people held in sex trafficking bondage at some point during that captivity, according to officials at a human trafficking summit here.
Fewer such victims are getting the help they need from health care facilities than are showing up at those facilities, which means there’s an opportunity for providers to make a difference in what Aucker calls an “abominable” situation, according to summit presenter Jenny Sell, service provider partnership manager for the National Human Trafficking Hotline, Polaris, in Washington, D.C.
A health care patient’s victimhood isn’t necessarily obvious.
One victim in a hospital got a call from a “regular” client, unhooked her IVs, visited the client, collected the money and returned to her hospital room without being questioned, Sell said.
But even when victimhood may be obvious, there’s frequently bias that leads to contemptuous and dismissive attitudes among health care workers, officials said at the summit, sponsored by the Pennsylvania Office of Rural Health.
“They treated me like I was dirty,” said one woman in a video shown at the event. “To them I was a prostitute.”
Another woman in the video spoke of being abused by an X-ray tech.
Another spoke of admitting she was a prostitute and scared, which resulted in her being told she “obviously” had a sexually transmitted disease and being sent on her way — after which she found out that she didn’t have an STD after all, but some other malady.
Such prejudice and such treatment needs to end, according to Aucker.
She has ordered that Evangelical become a “no judgment zone,” where substance abuse disorders, family issues and fraught sexual histories do not influence the way hospital employees treat victims, but where the standard is an offer of help to get victims out of their situation or, if they’re not ready, a signal that such help will always be available.
“(Employees) have to put personal biases, beliefs and value systems to the side,” Aucker said.
Leave door open
It’s important for providers to deal with possible victims in a way that will inspire trust, so even if victims are not ready to come forward, the incentive to do so eventually will grow, according to Sell.
The video showed victims who had been treated well by providers.
“The nurses showed kindness,” one woman said.
Another recalled a doctor asking, “‘Are you under a lot of stress?'” — a recognition for which she was grateful and from which she took reassurance.
“Traffickers tell victims that no one will believe or care for them,” stated Sell’s PowerPoint presentation. “Don’t make traffickers truth tellers.”
“Leave the door open,” stated Sell’s PowerPoint. “If they don’t want to walk through today, it’s always there when they’re ready.”
Because of patient privacy laws, employees need permission from patients to call social agencies or law enforcement, or victims themselves need to contact authorities, who then take control, Aucker said.
Providers need to watch for signs that a patient may be a trafficking victim.
Those can include identification documents being held by someone else, a male companion whose claimed relationship with the victim seems suspect, a hair trigger startle reflex, hypervigilance — especially in the presence of such a male, followed by a deflated, exhausted affect when the male is out of sight, officials indicated.
At Evangelical, where eight trafficking victims have been identified in the past year, one woman’s alleged boyfriend wanted to be present during a gynecological exam, while another woman had the name of her alleged boyfriend tattooed inside her mouth, according to Aucker.
The training encourages staffers to trust their gut when they suspect something is wrong, when something “raises your hinkie flag,” Aucker said.
Victims often are prone to panic attacks, paranoia, fatigue, depression, a fatalistic attitude and suicidal thoughts, said Krista Hoffman, Homeland Security exercise officer with the Governor’s Office of Homeland Security, who spoke largely about police interaction with victims. Head trauma is common, along with drug use, so they may speak slowly, mumble and be confused, Hoffman said. They often give the impression they’re “running on empty,” she said.
“Don’t assume they’re being shady,” she said.
It can be tricky, as pimps try to monitor their victims closely, sometimes in person, sometimes through an associate who comes into the facility, sometimes from a car in the parking lot, officials said.
Separate pimps, victim
Providers need to become adept at separating the traffickers from the victims, so they can speak with them confidentially about the victims’ situations and offer help, Aucker indicated.
Providers leery of violating patient privacy law can always call the hotline, Sell said. Callers are in control, and can say as much or as little as they want, while keeping information general or specific, she said.
When police encounter victims, they need to watch body language and treat potential victims with respect, aware of their need for privacy and reassurance, Hoffman said. That may require police to recognize that a victim may not be comfortable discussing her situation in settings such as the waiting room of a hospital, Hoffman said.
It also requires police to recognize that there may be timeline confusion, omission of details and a sense of disconnection from the victims’ experiences, according to Hoffman.
“(But) they’re going to remember what’s important to them,” Hoffman said.
When victims encounter police, they are often hungry, tired, cold and in need of both medical attention and safety, she said.
At those times, it helps to have blankets, potato chips and the “sugariest” soda you can find, along with wipes to clean the sweat and grime off victims’ faces and flip flops and Band-Aids to relieve blistered feet, Hoffman said.
One officer kept SpongeBob SquarePants Band-Aids, which could get victims laughing, she said.
Tampons and pads are also needed, because even when victims aren’t having their periods, they’re often bleeding, she said.
“You need to be able to talk about these things,” she added. Officers also need to be cognizant of their tone of voice and body language.
Victims’ concerns include the possibility of legal punishment, the safety of other victims, what’s going to happen next, the potential for reunification with their families and possibly immigration documents.
It’s also important that police reports designate sex acts performed by victims in language that reflects their involuntary nature: not “make love,” but rather “sexually abused,” Hoffman said.
The scourge of sex trafficking requires police to be re-educated, according to James Sortman, retired magisterial district judge in Williamsport.
“I know the old-school thinking, but we have to break that,” he said. The blame can’t be on the victims.
The average age of entry into trafficking for victims is 14, said Susan Mathias, chairwoman of the Pennsylvania Association of Sexual Assault Centers.
Traffickers use vulnerabilities
Traffickers have an amazing ability to find ways to identify individuals who are vulnerable, Mathias said.
Such individuals often include foster children and runaways, she said.
Traffickers may stand outside methadone centers to recruit, offering potential victims drugs, or they may bail a potential victim out of jail, so that person feels indebted, said Patricia Danner, regional outreach specialist with the Philadelphia office of the U.S. Department of Health and Human Services.
Traffickers often use their “bottom girl” — the one among their victims with the lowest status — to recruit, said Shea Rhodes, director of The Villanova Law Institute to Address Commercial Sexual Exploitation. They also use messages on social media, false promises and the lure of “pseudo-family dynamics,” Rhodes said.
To maintain control of their victims, in addition to holding victims’ identification documents, traffickers often control the flow of drugs, using the threat of dope sickness as leverage, Rhodes said.
They sometimes threaten to separate victims from their children, saying they’ll call children’s service agencies to report abuse or neglect or saying they’ll take children to the traffickers’ mothers, Rhodes said.
They also may threaten to reveal what the victim has been doing to the victims’ families or the schools their children attend, Rhodes said.
Victims may have sex with 10 to 20 men a night, Mathias said.
It can lead them to “lose all sense of reality,” she said.
Only a tiny percentage of those who provide services in the sex trade are doing so in a truly voluntary fashion — those who have their own businesses, Mathias said.
It happens all over, not just in the cities, according to Rhodes.
When she hears representatives of rural counties blame the problem on traffickers from big cities, she replies with sarcasm –suggesting they keep all their runaways within their own counties and all their sex buyers out of the big city, she said.
Human trafficking, including labor trafficking, generates $32 billion a year in profits, said Martha Okafor, regional administrator in the Philadelphia office of HHS.
Jane Guerino, 59, founder of Glory House in Allentown, a transitional home for women, was a trafficking victim herself, she said.
Victims can be sold
Guerino, who was adopted, grew up in a loving home in Allentown but was molested by her grandfather and her father’s best friend, who said if she told what he did to her, her parents would give her back, she said.
She was kidnapped at
age 30 by a corrections officer, and sold to someone in New York, where she was tortured, then sold to someone in Washington, D.C., then to someone in Los Angeles, she said. The sales were conducted like slave auctions, she stated.
She was actually chained up at times, she said.
She has been in situations where the doctors who checked on her and others being held captive had sex with them as payment for their services, she said. Police came in, too, and did the same, presumably as payment for overlooking the crimes, she said.
She escaped from captivity in Los Angeles and ran in front of a truck, whose driver stopped and helped her get away, she said.
Society — including organizations that are well-meaning and aware of the problem — needs to realize that when the identity of a trafficking victim becomes known, emergency measures should be taken immediately, Guerino said.
“If there’s a red flag, talk to somebody,” she said.
Asked whether there’s a concern that a new alertness to signs of trafficking could lead to frequent profiling of innocent people, Mathias said she hasn’t heard of any profiling complaints.
Currently, the problem in society is lack of vigilance, not over-vigilance, Mathias said.
Sex trafficking nowadays is largely internet-based, tied in with drugs, with runaways and with girls and women who are “scared and beaten,” said Robert Schopf, deputy district attorney in Lehigh County.
The pimps that control them are intelligent, sophisticated and manipulative, typically in their 30s or 40s — not “teen gangbangers,” Schopf said.
Sex trafficking creates less criminal “exposure” for them than drug dealing, he indicated.
There’s easy deniability, as pimps may sit in a car outside a hotel while their victim is inside with a john.
“‘What do you want out of me?'” they’ll say to an officer who confronts them. “‘I didn’t have sex with anybody. Are you going to believe the hooker?'”
Pimps can be “incredibly persuasive” to potential victims they’re trying to recruit, Schopf said.
Among the ways they engage is to offer drugs, he said.
They also offer companionship.
Many victims come from households in which “some emotional component is missing,” he said.
They also offer allure and glamour of sorts.
The typical pimp’s message is “We’re in the life, and the guys outside are squares,” Schopf said.
And they offer support. They let victims know that when they’re arrested, the pimps will be there to post bail, he said.
They flatter their victims, compare them to other girls in their group, create a competitive status system within the group, with symbols that include seating position in the pimp’s car — top place being the front with him vs. the rear with the “the back seat bitches,” Schopf said.
“That’s a big deal,” he said.
Being the girlfriend is better than just an employee, Schopf said.
Pimps sometimes even talk of marriage and getting a house together, and of eventually getting out of the life, he said. But that gets postponed indefinitely.
It’s always, “we’ll do it a little while longer,” he said.
Violence often used
Meanwhile, he’ll add, “I don’t want to hear your excuses — if you don’t want to work, you know what happens,” Schopf said.
Violence is part of the formula, he said.
The victim doesn’t necessarily need to be the direct recipient of that violence. When she sees someone else getting beaten, she gets the message, he said.
Pimps don’t like being told what to do, Schopf said.
They’re always intent on calling the shots, even after they’re arrested and charged, he said.
One he prosecuted tried to run his ring from prison, he said.
He ended up being thrown out of his own trial, according to Schopf.
They thrive because there’s a huge supply and a huge demand, Schopf said.
One victim’s phone showed 739 propositions from prospective johns in Allentown, Schopf said.
“This is a big business,” he said. “Incredibly lucrative.”
A woman who goes on duty can get “hit up” immediately, he said.
A victim from Allentown often had sex with seven to 10 johns per night, earning $4,000 for her pimp.
A pimp with a group of three or four victims could generate $12,000 a night, Schopf said.
In one of his successful cases, the jury came back with a guilty verdict in less than an hour, having had no problem understanding the nature of the pimp’s exploitation, despite the victim’s having been drug-addicted, with mental health issues, Schopf said.
That verdict tells such victims, “You were seen, you were heard,” he said.
Schopf prosecuted the cases under a 2014 state law, Act 105, Pennsylvania’s comprehensive anti-human trafficking laws, which mirror the federal Trafficking Victims Protection Act of 2000.
There have only been 44 convictions on the 2014 law so far, so there’s no case law to refine legal understanding yet, according to Rhodes.
The state law was supplemented in 2018 with the Safe Harbor Act, which protects minors against charges of prostitution and other crimes that they committed because they were trafficked, according to Mathias.
A proposed Buyer Beware Act in Pennsylvania would raise penalties against the purchasers of sex, Matthias said.
Most of those purchasers are white men, she said.
That proposed law recognizes that the old idea that patronizing a prostitute was essentially harmless, a transaction with someone providing a voluntary service, needs to give way to the reality that the demand is what sustains a corrupt industry in which only a tiny percentage of those service providers are doing so in a truly voluntary fashion, Mathias indicated.
“This is modern day slavery,” said PORH director Lisa Davis.
Mirror Staff Writer William Kibler is at 949-7038.