Holly Smith, a 38-year-old blonde woman with a ready smile, stood before a group of nurses and medical personnel early last month in a basement conference room of St. Mary’s Medical Center.
She’d come to teach the small group about how to identify human trafficking victims who might come to the hospital, but are often not noticed as victims of human trafficking.
Smith’s seminar was part of Dignity Health’s systemwide program to help address human trafficking, since victims often first come into contact with people who can help them at hospital.
“Health care has not been at the table very much,” said Smith, pointing out the need for health professionals to step up.
When Smith was 14, a man lured her from a suburban New Jersey mall with promises of a modeling career in Los Angeles. Within hours, she was in an Atlantic City motel room, an older woman dolling her up. For the next two nights, she was sold to grown men in the gambling town’s glitzy hotels.
When she was finally rescued, authorities blamed her for choosing to be a prostitute instead of seeing her as a victim, she said.
“I was mentally and emotionally shut down by all the horrible things he was telling me,” Smith said about the officer. “Nobody saw me as, you know, a real victim.”
Smith’s experience, in the summer of 1992, is part of why she was teaching the early morning gathering on how to identify human trafficking victims who come into one of Dignity Health’s Bay Area hospitals.
The first step in that education, said Smith, is to dispel a series of myths most people hold to be true.
Those myths include false theories of who, how and where people are trafficked. Human trafficking does not only happen overseas, she said, and foreigners are not the only people trafficked in the U.S. In 2015, of the 5,500 cases of trafficking in the country, 1,660 involved U.S. citizens.
Human trafficking takes many forms, like sex work and indentured servitude, and includes people who are forced, coerced or manipulated into working against their will. It also includes child soldiers, child brides, organ trafficking and child domestic servants, of which there have been cases in California among other U.S. locations.
Victims of human trafficking can be in debt bondage and forced to work to pay off the debt. Sex trafficking perpetrators can be anyone from a boyfriend, friend, or parent to a gang.
Because of the variety of cases and the often reluctant victims, Smith pointed out a series of red flags for which medical personnel should be on the lookout.
Patients who are trafficking victims often have controlling partners who may refuse to leave the examination room. Often, the patient won’t speak for themselves and are fearful, submissive and uncooperative. They also often have signs of physical abuse.
If these signs are noticed, medical personnel are instructed to notify security and their superior so the patient can be separated from their companion and offered aid.
Although the hospital has yet to identify any cases of human trafficking, the program taught by Smith is meant to change that.
Sara Lentz, a 32-year-old nurse who attended the class, said knowing how to recognize the signs of someone who had been trafficked would have helped her with at least one past experience. “I wish I had known,” she said.
About five years ago, Lentz came into contact with a woman who, she now realizes, had all the red flags for being trafficked.
“She didn’t want help,” said Lentz, adding, “she was discharged.”
The magnitude of this hidden world was revealed in a recent report issued by The City covering human trafficking in 2015.
“Human trafficking is often hidden, and we can’t fix what we can’t or don’t see,” said Emily Murase, executive director of the San Francisco Department on the Status of Women. “This report shines a bright light on the dark recesses of modern day slavery that, unbeknownst to many, pervades San Francisco.”
The 2016 Human Trafficking Report found that there were 499 reported cases of human trafficking in San Francisco last year.
Still, it illustrates the varied nature of human trafficking. For instance, 77 percent of survivors were victims of sex trafficking and 18 percent were trafficked for labor.
Thirty percent of those who were trafficked were under 18 and another 60 percent ranged in age from 18 to 24. A whopping 76 percent were women, 7 percent were transgender women and 18 percent were men.
Dignity Health’s education program is just one of multiple in San Francisco attempting to address the issue.
The San Francisco Unified School District has adopted a policy to train staff on human trafficking and developed a curriculum for students. Additionally, The City has funded a 24-hour response team for sexually exploited youth in San Francisco and passed local legislation strengthening licensing of massage parlors.
The City has also funded bilingual outreach workers who are focused on industries vulnerable to trafficking such as massage establishments and restaurants, and passed a resolution leveraging San Francisco’s purchasing power to encourage hotels and restaurants to address human trafficking.