By Laura Freeman
Next time you are Atlanta-bound on I-20, you'll probably notice the busy truck traffic. But you may not realize that other travelers on the road can include underage teens from Mississippi or New Orleans. There could be little girls and boys from Birmingham's poorest neighborhoods or runaways from an affluent home with secrets. They aren't on their way to a fun time at an amusement park. They are the entertainment, headed to Atlanta and points along the east coast to meet the demand for sex workers at high profile events.
If you're surprised that Birmingham is on the crossroads of a sex trafficking trade that includes an appalling number of children, you're not alone. However, local police are not surprised, and neither are the physicians, psychologists and social workers of Sunrise Clinic at Children's of Alabama.
"We had assumed most of the traffic was passthrough on the way to big metropolitan areas. But it turns out that 40 percent of domestic trafficking happens in the south," Debra Schneider, LICSW, PIP said. Schneider is Executive Director of Children's Hospital Intervention and Prevention Services (CHIPS) and the Sunrise Clinic, which opened last year to meet the needs of children who have been trafficked.
"Each child's story is different," Schneider said. "Runaway teens are the primary target of traffickers. Kids who leave home, often because of abuse, end up on the street without food or shelter and do what they have to do to survive. Some are trafficked by boyfriends who persuade them to have sex with friends for money or they might take pictures and use them to threaten the girl into complying. Others are children from desperately poor homes. They may feel they are helping to bring in money to help the family survive. In particularly sad cases, parents who are addicted may be desperate enough to exchange access to their child for drugs.
"Some trafficked children live at home, and others are shuttled from city to city to work big events when big sports or entertainment attractions come to town," Schneider said. "We were meeting with police and organizers of the World Games months in advance to make sure we had health care and mental health resources in place to care for the influx of trafficked children we expected to be here during the event. It's the same story for football games, concerts and other events that attract large crowds."
How do 'customers' connect with underaged children for sex?
"It's a well oiled machine using social media, phones and ads with coded phrasing offering 'merchandise,'" Schneider said. "Through websites, people shopping for sex can specify age, gender and appearance to find exactly what they like. Some are pedophiles and others don't ask about age as long as other preferences are met."
In addition to providing medical and mental health services for children who have been trafficked, the Sunrise clinic works to teach hospital staff and the medical community what to look for in order to recognize a child who is being trafficked.
Kara Huls, MD is the Medical Director of the Sunrise Clinic.
"If you see a tattoo, especially on a child younger than the usual age for body art, ask them to tell you about their tattoo. It may be a bar code or a name that isn't the child's name. Some gangs use tattoos to signify ownership," Huls said. "Most of the underage children involved in sex trafficking here were born in the U.S. Although they may be transported across state lines, we aren't seeing many transported across international borders in this area.
"When adults who accompany a child to the doctor's office don't seem to want to let the child talk and try to do all the talking for them, or when they don't know much about the child's medical history, that is suspicious behavior. Try to separate the child from that adult so it is safe for them to speak freely. Ask them about things like school and home and any signs of previous injuries.
"Children trafficked involuntarily may not have been getting regular medical and dental care. My first case was a girl who came to me with terrible heartburn that had been untreated for years. The person trafficking her didn't care that she was suffering and didn't take her to seek care.
"Some of our patients at the Sunrise Center were identified when they came into our ER or the mental health center. They may have the same injuries as victims of sex abuse, or came in after attempting suicide. People who have been trafficked are at much higher risk for suicide. The emotional trauma can exacerbate other conditions like depression that were already there."
Sunrise Clinic patients are given a comprehensive health evaluation including screenings for sexually transmitted diseases, pregnancy and mental health. They are treated for illnesses or injuries, and the Department of Human Resources is called in to evaluate their home to determine whether it is safe for the child to return. If not, alternative housing arrangements are made. The goal is to free them from trafficking and start them back on the road to recovering a normal life with the help of follow up medical and mental health care at the Sunrise Clinic.
"Globally, the biggest market for trafficking is labor," Huls said. "We haven't identified much of that in Birmingham, but it does happen. If children show up with injuries you'd expect to see in factories, processing plants or agriculture, ask questions about the injury, school and activities. It's a dangerous situation for both children and adults who are essentially slave labor. We hope to be expanding our expertise in the future to offer help to children involved in labor trafficking."
If you have a patient under 18 that you strongly suspect is being trafficked, you can refer them to the Sunrise Clinic at Children's Hospitals' CHIPS Center.