Public Health

Righting human wrongs

In a career as a practicing physician or physician in training, have you encountered a victim of human trafficking?

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The answer to that question—considering that up to 88% of victims of human trafficking in the U.S. had contact with a physician during the period in which they were trafficked—is likely to be yes.

In spite of that daunting figure, the majority of physicians, nurses, social workers and other health care professionals—according to a 2015 survey—have received no training on trafficking. Without any instruction, physicians may struggle to treat or even identify victims.

Early on in medical school, Catherine Coughlin, MD, learned of the issue and then set out a plan to give physicians and medical students the know-how to change it.

“That [statistic] really shocked me and inspired me to pursue this disconnect,” she says. “We know that physicians are seeing victims of human trafficking, but we also know that these patients are falling through the cracks because providers don't have the awareness and training to be able to identify these folks and possibly connect them with resources.”

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A passion project

During her undergraduate studies at Tufts University, Dr. Coughlin learned of an organization called Love 146, an international human rights group working to end child trafficking and exploitation through survivor care and prevention. Her initial involvement with the group was more about listening and learning than acting.

“I was really struck by the egregious human rights violation that trafficking is,” she says. “The nature of human trafficking is so subversive, but so few people know about it and how to look for it. I didn't initially think that my interest in this human-rights violation was going to intersect with my interest in medicine.

“Physicians have an incredible privilege in being able to work with a broad proportion of the population, and we have the opportunity to be a voice for the people in that population that often are not heard,” Dr. Coughlin says.

Early on in Dr. Coughlin’s training at the Albert Einstein College of Medicine when she sat in on a lecture given by Kanani Titchen, MD, an assistant professor of pediatrics at the New York medical school who has been one of the leading voices in educating physicians and medical students on the issue for more than a decade.

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In meetings following that lecture, Dr. Titchen suggested that Dr. Coughlin work on creating a curriculum on the issue for medical students.

“Catherine liked the idea of teaching and creating something that would be lasting,” Dr. Titchen says.

“She took that idea and she ran with it. I directed her toward some of the increasing research that we've seen in the medical literature from some of the leaders in the field. And I told her, 'I'm not going to do it for you.' You do what you can and I'm happy to guide you. And she did. The next time we met, she had a full list of all the resources she had read and a PowerPoint that she had created.”

Read this story in its entirety as featured in the fall issue of AMA Moving Medicine.