August 24, 2016
To The Sacramento Bee:
As a physician heavily involved in the recognition and longitudinal care of adolescent victims of human trafficking I would like to provide a medical point of view in response to the recent article published in the Sacramento Bee concerning the challenges being faced by Courage Worldwide. I have had the opportunity to work with victims from several organizations providing care to human trafficking victims in the Sacramento region including adolescent patients from Courage Worldwide. Without a doubt the young women at Courage Worldwide are the most traumatized children I have ever encountered in my medical career. Some of the criticisms and insinuations posed in the article do not take into account the unique needs of this severely traumatized population.
In medicine we strive to optimize treatment plans to the individual needs of each patient. In society we must also strive to develop programs and treatment plans that meet the needs of human trafficking victims. The issues that minor victims of human trafficking face are monumental. To generalize the rules governing their treatment and care using set protocols, policies, and procedures (that may be reasonable in other settings) severely compromises the medical care these adolescent victims receive. It endangers their chance for recovery, their very lives, and the safety and lives of those providing their care.
For example, Courage Worldwide received a citation concerning victims being unable to access internet and cell phones. I have cared for victims that have been beaten, tortured, confined, raped, and coerced into irrational beliefs by their pimps and traffickers. This often occurs during years which formative brain development is being established. Many have never known a non-abusive relationship and have trauma-bonded with their abuser. I have seen unprecedented degrees of PTSD, anxiety, depression, suicidal ideation, and dissociation integration disorder (AKA: multiple personality disorder). During the distress that is an expected part of recovery healing victims will reach out to their abuser. Nationally, the average victim runs away seven times after being taken from their pimp or captor. I would not give a currently suicidal patient a gun and I would not give a child molester the key to my daughter’s room. Giving these patients the tools (AKA: cellphone or internet access) to contact their pimp is simply child abuse. Access to these would, in my opinion, severely compromise their chance at medical and psychological recovery. Minors that have been traumatized since an early age need psychological safety buffers in place to begin to rebuild their psyche and establish normal functioning biochemical pathways within the brain. This is common practice within addiction medicine and is part of the reason cell phone, internet, and television access is typically restricted for patients entering rehabilitation. The treatment of each victim is unique, and often requires months to years of treatment and medications to fully stabilize. This has to occur within a safe, protected environment. The implications of this access are inadequately appreciated by the state and the general population.
With regard to complaints concerning religious freedom, specifically concerning satanic worship, I would again encourage this topic be approached in context of this unique patient population. These minor victims have never been taught and thus never learned societal social norms. The right of religious freedom including satanic worship is protected in our society, however a child that has been raised in a setting where they have been tortured and sexually exploited as part of religious ceremonies will have a construct of normalcy inconsistent with basic human rights. They have never been given choice or perspective. They will be severely hampered from a psychological standpoint of recovery should extreme belief systems that they learned under duress be allowed to be continued. Restricting these practices until a child has an opportunity to heal and make a truly free choice is reasonable.
I cannot speak on the economics of Courage Worldwide nor the issue of publicity for personal gain insinuated in the article. What I can provide is a perspective based on direct observation of the character of Jenny Williamson and the work Courage Worldwide is doing for the medical welfare of their victims. Courage Worldwide has been extraordinarily proactive in seeking medical care for their victims. They typically care for extremely traumatized children that have failed numerous lower level facilities. I have personally seen Jenny bring victims to our office for follow up care after spending a sleepless night prior with them in an emergency room. As emotionally and physically exhausting as caring for these victims must be, she has only shown the greatest level of compassion and concern for their well-being. It is a dedication that I believe few of us can truly comprehend, and one I have otherwise only witnessed in the parents of very sick children.
I hope that we, as a community, can join together to advocate for changes in the rules governing the care of these special victims. I believe it is in their best interest from a medical stand-point that exceptions be made and alternative evidence-based policies and procedures be established. Morally it is the right thing to do and it makes common sense.
Minor sex trafficking in Sacramento and across the nation is a larger problem than many comprehend. In my experience the organizations in this community, including Courage Worldwide, do amazing work and create a true difference in the lives of the victims they serve. We should rise together to support these organizations and advocate for changes in the rules governing the care of these special victims. We should help them grow. Should the organizations and the people doing this incredibly difficult work fall victim themselves to insurmountable bureaucracy and criticism who then will be left to care for our most vulnerable?
Ron Chambers, MD, FAAFP