Human Trafficking: Do You Really See Me?

Theresa Flores is a human trafficking survivor.¹ If you have not watched her TED Talk², I urge you to do so now.  

As I listened to her heartbreaking story, I was overcome by three terrifying realities:

1)      at some point in my life, and without knowing it, it’s possible that I lived next to, went to school with, or worked with someone who was being trafficked.
2)      many of us are clueless about domestic trafficking within our own communities.
3)      human trafficking does not just affect its victims. From a health perspective, it has the potential to harm whole communities.

The International Labor Organization (ILO) estimates that globally, about 21 million children, women, and men are victims of human trafficking (2012).³ These ILO statistics show the most vulnerable populations, business sectors where exploitation is most prevalent, and the illegal profits annually earned by traffickers.⁴

The Institute for Trafficked, Exploited & Missing Persons (ITEMP) states that 100,000 children in the U.S. are trafficked each year, and 1,000 between the ages of 13 and 17 are trafficked internationally.⁵

Let’s look at trafficking from a health perspective using a fictional victim named Anna. While being trafficked across state lines to a brothel for sex work, Anna contracts TB disease that becomes active, but goes undiagnosed and untreated.

She is in contact with other workers, 10-20 clients daily, and periodically frequents public venues, all the while talking, coughing, and sneezing.  She is also likely having occasional unprotected sex.

Anna’s clients could be single, married, with children, and have jobs. How many people will eventually be infected with, and spread, TB disease and STDs? What happens when those with active TB disease travel (via cars, trains, planes, buses) to other cities and states without a proper diagnosis and treatment? How much would it cost each community to test and treat patients, and trace the origin and spread of the disease?

Theresa’s story made me ask myself these questions:

- Why are so many of us ill-informed about domestic human trafficking?

- Would I know where to find the resources to help them?

- Would I recognize the less obvious signs of a trafficking victim?

The Ohio Human Trafficking Task Force’s June 27, 2012 report highlighted something crucial -  domestic human trafficking has flown under the radar for a long time, because much of the data (especially at the federal level) has, for years, been more focused on international human trafficking.⁶ As such, many of us may associate human trafficking with foreign nationals being shipped against their will across borders and state lines, without considering the possibility of our neighbors, family, and friends becoming victims of this illegal trade. In addition, as seen in Theresa’s case, many believe that these young women choose to become prostitutes, and as such, they cannot be trafficking victims.

The Ohio Department of Health⁷ states that, “Ohio has ranked as high as fifth among all states in total reported human trafficking cases with Toledo being identified as the fourth highest ranking city in the nation for recruiting victims into the illegal trade (2016).” Fortunately, Ohio now has various organizations that: (i) research the prevalence of domestic trafficking, (ii) provide resources to raise awareness, and (iii) provide services for victims and survivors.

To name a few, organizations like the Central Ohio Rescue and Restore Coalition⁸ and the Ohio National Human Trafficking Resource Center⁹ work with service providers and other professionals, law enforcement, and volunteers, etc by offering education, training, advocacy, and legal representation. Nonprofits like The Daughter Project¹⁰ and Grace Haven¹¹ offer rehabilitative group homes for trafficking victims (girls). Others like Freedom A La Carte¹² give survivors training and jobs, which is critical for their integration back into society.

Local citizens can get access to these resources at their local library, online, or from departments that offer human services, and be a part of the process in raising awareness, while providing support for victims and survivors.

There is one absolute truth that we cannot ignore – anyone can be a victim of human trafficking. Anna could be you or me. It just takes the wrong person to see the right circumstances and opportunity to destroy your life.

References

1.      TraffickFree – About TraffickFree (2016). Retrieved February 16, 2016: https://www.traffickfree.com/about.php 

2.      TEDx Columbus – Theresa Flores – Find a Voice with Soap (2011). Retrieved February 16, 2016: https://www.youtube.com/watch?v=5QW_nsAjweE

3.      Forced Labor, Human Trafficking, and Slavery. (2012). Retrieved February 16, 2016: http://www.ilo.org/global/topics/forced-labour/lang--en/index.htm

4.      Statistics and Indicators on Forced Labor and Trafficking. (2012). Retrieved February 17, 2016: http://www.ilo.org/global/topics/forced-labour/policy-areas/statistics/lang--en/index.htm

5.      Institute for Trafficked, Exploited & Missing Persons (ITEMP) (2016). Retrieved February 19, 2016: http://www.itemp.org/humantrafficking101/humantraffickingfacts.html

6.      The Ohio Human Trafficking Task Force (2012). Retrieved February 18, 2016: http://humantrafficking.ohio.gov/OhioHumanTraffickingTaskforce.aspx

7.      Ohio Department of Health – Human Trafficking Resources (2016). Retrieved February 18, 2016: http://www.healthy.ohio.gov/sadv/htraffick.aspx

8.      Central Ohio Rescue and Restore Coalition (2016). Retrieved February 18, 2016: http://www.centralohiorescueandrestore.org/

9.      Ohio National Human Trafficking Resource Center (2016). Retrieved February 18, 2016: https://traffickingresourcecenter.org/state/ohio

10.  The Daughter Project (2016). Retrieved February 18, 2016: http://thedaughterproject.org/#/welcome

11.  Grace Haven (2016). Retrieved February 18, 2016: http://gracehaven.me/

12.  Freedom A La Carte (2016). Retrieved February 13, 2016: http://freedomalacart.org/news/

Image

The Medina County Coalition Against Human Trafficking. (2015). Human Trafficking By The Numbers [Image], Retrieved February 19, 2016: https://traffickjamming.wordpress.com/2015/06/24/june-2015-meeting-agenda/

The case of OJ vs. the Orange; The jury trial

Your honor... Today this glass of orange juice or OJ you see before you is on trial for causing several humans to become overweight. Take this boy, Tommy for example. He’s 12 years old and doctors have prescribed more physical exertion to bring his body weight to a healthier level. Tommy would consume about 2 glasses of orange juice every morning. Generally, juices are full of free sugar (glucose, fructose, sucrose etc.) which are often added by the manufacturer to enhance flavor. According to a Press Release dated 4^th March 2015, the World Health Organization outlined a guideline recommending adults and children to reduce their daily intake of free sugar to less than 10% of their total energy intake (1).

Consider Tommy’s breakfast table...On one end is an orange and on the other is a glass of orange juice.

Constituents	OJ/Orange Juice (100ml)	The Orange (Fruit diameter: 8 inches)
Calories	47	62
Sugar	8.81 grams	12.25 grams
Dietary Fibre	0.2 grams	3.1 grams
% of Recommended Daily Intake	4%	3%

The Orange is roughly 8 inches in diameter, a proportionate fruit carrying 62 calories, 3.1g of fiber and 12.25g of sugar (2). The glass holds 100ml of Orange juice carrying 8.81g of sugar, 0.2g of dietary fiber and 47 calories (3). Now the brand of the juice has a direct impact on the exact caloric constituents. Given the above stated values, one could assume that after consuming one orange you are more likely to feel fuller. On the other hand after one 100ml glass of orange juice, you are more likely to seek out the fridge for a second serving.

So it’s like that at breakfast Tommy could have just one orange which makes up for 3% of his Recommended Daily Intake (RDI) (2). Or he could have about two 100ml glasses of orange juice which accumulates to 4% of his RDI (3). It is important to note that we are still referring to his breakfast table and that additional juice may be consumed at lunch and dinner. However the juice is more accessible and easy to consume. The orange on the other hand requires peeling and additional preparation.

The director of the World Health Organization’s Department of Nutrition for Health and Development had this to say about free sugars...

“We have solid evidence that keeping intake of free sugars to less than 10% of total energy intake reduces the risk of overweight, obesity and tooth decay,” (4)

As human beings we have a tendency to assume that “more” is always better. This is not always the case. Too much of anything is not great for your body. In fact your mantra should be “everything in moderation”. Take sugar for example, too much of sugar in your diet can increase your risk of becoming overweight. This in turn may result in chain reactions that could lead to Type II Diabetes, Atherosclerotic heart disease or a predilection for cancerous outcomes. The orange in its natural state harbors additional constituents such as fiber etc that aid your digestive system’s motility while facilitating a gradual absorption of sugar.

This case is a bit murky, that I am aware of. The choice remains among individuals like Tommy who may go for the healthier fruit option or go for the more accessible glass of OJ. Statistics even show that with increasing age, the consumption of sweetened drinks increases among children and young adults (4). Given this trend and all this information, the question remains... Is there enough evidence to find this glass of OJ guilty?

References

(1) World Health Organization. (2015, November 26). Media Centre; WHO calls on countries to reduce sugars intake among adults and children. Retrieved from World Health Organization : http://www.who.int/mediacentre/news/releases/2015/sugar-guideline/en/

(2) Fatsecret . (2015, November 26). 1 Fruit Orange. Retrieved from Fatsecret: http://www.fatsecret.com/calories-nutrition/usda/oranges%3Fportionid%3D33208

(3) Fatsecret. (2015, November 26). 100ml Orange Juice . Retrieved from Fatsecret: http://www.fatsecret.com/calories-nutrition/usda/orange-juice?portionid=1137131&portionamount=100.000

(4) Home - Health Reports - Beverage consumption of children and teens. (2015, November 27). Retrieved from Statistics Canada: http://www.statcan.gc.ca/pub/82-003-x/2008004/article/10715/6500232-eng.htm

Public Health 007

Let's talk about the “three coughs” or three major problems that threaten global health from the perspective of a U.S. Scientist.

He believes the first problem is the emergence of new diseases such as; Middle Eastern Respiratory Syndrome (identified last year), H7N9 avian influenza flu and SARS (which swept the world in 2003). He goes on to express his appreciation of the efforts made by Chinese health authorities in relating all the information about the H7N9 strain and thereby allowing the disease to be considerably contained worldwide. These new infectious diseases pose 2 problems; Health care professionals have no knowledge about them when they develop and we don’t have any natural immunity against them. We can only assume their devastation...

The 2nd “cough” is the ever growing risk of multidrug resistant tuberculosis. And the 3rd global health issue he addressed was the threat of Bioterrorism in today’s world and the need for wide spread surveillance in order to prevent mass disasters. The growing dangers of measles and HIV infection was also cited in the article and ended on a happier note; how the efforts of PEPFAR (the President’s Emergency Plan for AIDS Relief) had saved millions of people from AIDS.

The scientist quoted throughout the article was the director for the Centre for Disease Control, Dr Thomas Frieden from a few years ago...

Infectious disease! Whether it was vector borne dengue or manmade biological weapons, microorganisms continue to rule our microscopic world. On reading the article, the 1st “cough” and the 3rd “cough” caught my attention. With our growing population and the effects of global warming, I would not be surprised if I hear about the emergence of a new avian flu in the months/years to come. It is critical that we pay more attention to the way we interact with our environment and there by aid in the emergence of deadly organisms. As a health care professional it would be ideal to create a upstream solution to this problem. With the current data at hand, one could assume 2 things; that, by invading the natural human free ecosystems, we expose ourselves to organisms that lay dormant and there by disturb the sleeping horrors that lay in the forests. The second possibility is that we create ideal environments in our communities for disease progression and evolution. Either way, it is time to create a vaccine for our arrogance.

If we didn’t have enough problems to start with, we now must protect us from ourselves. Bioterrorism has been the arena for much debate over the years. It started with the study of deadly organisms like Small pox and has now become the reason that nations go to war. As a public health professional, I would ponder on the relevance of bioterrorism to my field. I could argue that it is not my fight, that it is a fight at the macro level. But I believe it is also a major problem that public health would have to face in the future. The world just became more like a James Bond movie.

Cleanliness and Godliness: Sanitation in the Community

It is my honour to introduce my friend Austin Otieno. He lives in Mtongwe Village, located in Mombasa, Kenya, and works as an administrator at New Mtongwe Medical Clinic. He is an ambitious young man who's full of dreams as seen during our work together in projects concerning hospital matters. I applaud his efforts in the community.

Austin Otieno can be found on LinkedIn and and his Twitter handle is AustinOtty.

Background information

New Mtongwe Medical Clinic is a 24 hour private hospital in Mtongwe village. It is built in a low income earning neighbourhood and provides services that include outpatient, in-patient, maternity, family planning and antenatal. According to Austin, the common disease in the region is Malaria which impacts both children and adults, and Diarrhoea that affects children.

Maulid:  What is it that you do?

Austin:  I facilitate the availability of the right personnel, drugs, and a conducive treatment environment for patients.

Maulid:  Let us know about yourself?

Austin:  I'm a 26 year old environmentalist. I graduated from Kenyatta University with a BSc Environmental Science, and I've worked as an administrator with the New Mtongwe Medical clinic for three years.

Maulid:  What are you passionate about?

Austin:  I'm passionate about the environment, health, politics and football. I'm a super fan of Arsenal football club.

Maulid:  What makes what you do important?

Austin:  As a youth, an environmentalist, and now a hospital administrator, getting people and children to stand on their feet; working, doing their duties and daily chores in building the country is important to me.

Maulid:  Tell us about your profession?

Austin:  To emphasize and educate the sustainable use of available resources and environmental conservation including development projects in the society.

Maulid:  Tell us about proper sanitation in the community?

Austin:  I work in a low income earning neighbourhood. In this area, Malaria and Diarrhoea are major concerns; simply, this means there is no proper sanitation in this neighbourhood and parents are not concerned about it.

Maulid:  What is the direct relation to an inequity or inequality in the area of public health or global health that the individuals are combating collaboratively? 
Austin:  There is a lot of ignorance in the society. That’s why the cases of Malaria and Diarrhoea are there. I did a collaborative project with parents to offer free medicine to children. I thought I was helping, but no, in this area, treatment appears to be the second option. I did not empower them on the issues of proper sanitation so after one to two months there was a long queue at the hospital.

Maulid:  Why is proper sanitation in the community important?

Austin:  Proper sanitation in the community is very important because there will be no cases of health issues. We will avoid Malaria and Diarrhoea cases. First we have to deal with proper sanitation for health purposes and then treatment.

Maulid:  If you had a message to share with the world what would that be?

Austin:  “let’s leave the world better than we found it.”

Cleanliness is next to Godliness

I give thanks to the Almighty God for giving me the opportunity to meet with Austin Otieno. Thank you Austin Otieno for inviting me to New Mtongwe Medical Clinic for a productive interview. Your participation will make a great impact in the society. You are a charismatic person and I like your ideas and efforts.

#YearInReview... Lessons for putting on a scientific/health event...

The nature of an opportunity is defined individually as they are determined by every individual’s perspective on their life and their careers. My passion for public health practice was founded on my journey in clinical medicine. As my interests range from research appraisal, knowledge mobilization and community outreach, I found that every opportunity should be considered for its potential to showcase one’s professional skills. Recently this year, I co-lead a professional development event titled the Personal and Professional Pursuit of Excellence 2015 Symposium. At that point, a lot of individuals asked me why I wavered from my path in public health. The truth was that I never did.

In early January, I was actively seeking employment in health promotion, protection and knowledge creation. When a colleague suggested an opportunity to collaborate, I jumped on it. I was only aware of one impact at the time. That impact was the enhancement of my communications, leadership and stakeholder engagement skills. Reflecting on the planning, implementation and evaluation of this event, I had effectively developed my project management skills. Walking in to situations with a scientist’s perspective, I began to refine the lens by which I looked at community and stakeholder engagement. It had more to do with the appreciation of patience and an awareness of clear concise objectives. We often outline the scope of projects, but I began to outline what was no longer within the scope of projects as well.

This symposium showcased over 13 collaborations and our objective was to have the conversation about personal and professional development. My objective to look at the social and economic factors surrounding the professional’s health; this I observed in myself, our volunteers, our collaborators and participants as well. The event was about providing a platform for professionals in transition to engage with subject matter experts. We wanted to give everyone an opportunity to collaborate and a chance to be better informed. With 8 workshop facilitators and 3 event sponsors; the event was an opportunity for all of us to come together and contribute to the discussion about personal brands in the professional climate.

My application of these project management competencies allows me to now effectively manage future projects, especially the 2 global health ventures that I am now a part of.

My 3 lessons learned are as follows;

1) Training is required on all fronts

It doesn’t matter if you’re a volunteer, a speaker or a sponsor, one requires a clear outline of what they are expected to deliver on. These individuals will facilitate your event from start to finish, so it is vital that you instruct them on the agenda and the nature of the activities with precision detail. Moving forward with regard to knowledge mobilization events, I produce detailed manuals and documents (such as a memorandum of understanding) for all associated parties. Securing dates for rehearsals and training in advance will essentially produce fluid events.

2) Emails are often lost in translation

Forget about emailing your project stakeholders about every detail, the majority will not respond or respond competently. Keep communications simple and few in numbers; you must also remember that these are fellow professionals with work who may not have time to read through your bulky emails. Also try to hammer out your communications plan in advance and get to know your stakeholders; not everyone will prefer email.

3) Be Specific

Events require marketing plans and must be promoted on multiple means. This means that you need all the information in front of you. Plan out what you require from each involved party, this will allow you to secure your data in advance. The more specific you are the better. For example; don’t request a picture from a keynote speaker with a short bio, request a high resolution picture in formal attire with a 75 to 100 worded bio.

The moral of this blog post is that opportunities can further so many of your skill sets without you even planning on it. This opportunity now allows me to cater to highly effective productions of events. So when opportunities knock on your imaginary door, consider the outcomes and impacts it can have on your career. Don’t forget to let your imagination run wild, because I did. This blog was initially created to house a few thoughts by a few creative public health professionals. However, reviewing this year has taught me to dream BIG! So this blog will now house a number of global health professionals with diverse perspectives on health. This is an opportunity and it is most worthy of building anyone's application of global health knowledge and experience. I ask you to share your thoughts and perspectives in order to inform our approach in healthcare and health promotion activities. 

Change begins with YOU!

Building Teams from the Bottom UP!?

The role of multidisciplinary teams in healthcare  is to ensure that clients or patients receive personalized healthcare services that utilizes a holistic health lens. During my attendance at the 2015 ASAC (Administrative Sciences Association of Canada) conference, a talk regarding team work in the healthcare context was delivered. One specific image caught my attention! Although I was unable to capture the image on time, I drew up a similar cartoon (above)... 

The visual prompts the following questions...
" if they don't learn together, how can one expect them to work together..." 

The way we view multidisciplinary care is often colored by our experiences. Personally, I value the opportunities that were offered to me. Working and learning with professionals from such diverse backgrounds gave me an amazing opportunity to further mold my team competencies. 

Do you believe that learning together cultivates an environment of mutual respect and importance for each other's profession? I think so! What do you think?

Communicating human HEALTH

My experience in global healthcare and public health colors my perspective of life at times and reminds me to not take my life for granted, at times. The photograph accompanying this post was captured by Kevin Carter, a South African photojournalist. The visuals tell a tale of famine in Sudan, prior to the conflict and division of the nation. The tale is complex; poverty in a climate that is detrimental to human existence yields low survival potential. Simplistically, a child is brought to his knees by the famine within a country while a vulture waits in prey for an unfortunate circumstance. The photograph dominates the headlines and media gaining much philanthropic attention for a country in crisis. Months later, the photographer wins a Pulitzer and later takes his own life.  

Source: https://iconicphotos.wordpress.com/2009/08/12/vulture-stalking-a-child/

How do we communicate the importance of public health and global health? One could employ sound methodologies or frameworks to ensure that the communication of health promotion or protection is evidence based. At times we utilize visuals to communicate the urgency of a health issue. Advocating for vulnerable populations and worthy causes will definitely earn you a gold star, but what will the message eventually become? Is it a story that we will never speak of because of the negative connotation associated with it? Or will it be a story of human resilience that will echo across our communities. As an advocate of health equity, I believe that it is important to convey messages and human reality as it is. However, I believe it is of utmost importance to consider your audience and what message they will receive...

When you see this picture, how do you feel? As a public health or global health professional how would you communicate this situation or crisis differently? Or would you leave such a communication as it is... Why..?