University of Louisville Magazine

SUM 2018

The University of Louisville Alumni Magazine: for alumni, faculty, staff, students and anyone that is a UofL Cardinal fan.

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Page 44 of 75

IF YOU SUSPECT SOMEONE MIGHT BE A VICTIM OF HUMAN TRAFFICKING, CALL THE NATIONAL HUMAN TRAFFICKING HOTLINE AT 1-888-373-7888. I was hallucinating on meth, and the emergency room discharged me after four hours. It was like I didn't matter. I was telling them I had a problem but they wouldn't help me." Although Cotie's negative experiences did not occur at Uof L, ensuring traffick- ing survivors receive proper care is some- thing the university is working to address. Nationally, as many as 88 percent of traf- ficking victims interact with health care professionals. However, the health care workers' ability to recognize the signs of trafficking often is severely lacking. The Uof L School of Medicine creat- ed a simulation-based medical educa- tion curriculum to prepare students to recognize victims and intervene on their behalf. The only such curriculum in the nation, the Medical Student Instruction in Global Human Trafficking, or M-SIGHT, uses online learning, medical documen- tation and standardized, patient-based simulation to prepare students to see the signs of human trafficking. The brainchild of Olivia Mittel, asso- ciate professor of pediatrics, M-SIGHT trains medical students in "trauma- informed care, which is health care delivered with an understanding of what patients experiencing trauma need," she said. "The training helps future physi- cians learn how to ensure confidentiali- ty, ask non-judgmental and open-ended questions to glean information and grad- ually progress from less invasive to more direct questions." M-SIGHT includes a standardized pa- tient simulation where an actor portrays an adolescent female with symptoms of a sexually transmitted disease, as well as the characteristics of victims of human trafficking: poor eye contact, reluctance to communicate with the physician, inconsistencies in what is communi- cated, tattoos that could suggest brand- ing and evidence of physical abuse. The goal of the simulation and its application is not to force intervention, but rather to build trust, said Carrie Bohnert, director of the standardized patient program at Uof L and Mittel's M-SIGHT colleague. Medical schools from Harvard, Uni- versity of South Florida and Universi- ty of Arkansas have expressed interest in Uof L's training. "There is a wide array of methods for creating human trafficking simulations, and we hope our process will inspire others to create similar interactive educational programs," Mittel said. Adds Bohnert: "The ultimate goal, of course, is to help human trafficking victims receive both the health care they need and inter- ventions that stop their exploitation." Uof L clinical care providers already are helping trafficked patients. Physician Jennifer Green is the only child abuse pe- diatric fellow in Kentucky and specializ- es in treating patients who are suspected of being physically abused. Emily Neal is a forensic nurse specialist and sexual as- sault nurse examiner who works with her. How they treat these patients can be as individualized as the experiences the pa- tients have. After reporting suspected sex trafficking cases to the Cabinet for Health and Family Services (CHFS) and law en- forcement, Green and Neal assess their acute medical state to determine if they need testing for sexually transmitted dis- eases, detox treatment to withdraw from drugs or alcohol, or psychiatric interven- tion for acute psychosis. "Once the acute conditions are ad- dressed, then we evaluate their chron- ic medical state," Green said. "We have a global, multidisciplinary approach to these patients, trying to address their complete medical and psychological needs." With law enforcement and CHFS taking the lead, health care providers stay involved with the patient as long as they can. "We know about 70 per- cent of sex-trafficked minors experience post-traumatic stress disorder," Neal said. "These kids need long-term care to fully recover from their experiences." C Cotie didn't have the help the School of Medicine provides, but for a while, she did benefit from Uof L's STAAR sessions at the Kristy Love Foundation. After one particularly intense group session in May, Cotie emerged from the group in tears. She initially agreed to be photographed for this story, but was in no shape to participate. She rescheduled for two days later. By that time, however, Cotie had disappeared. "It happens sometimes," Renfro said. "We pride ourselves on being a home, and people come to the home and people leave the home. But we always take them back. They always can come back home." The care providers and research- ers know the help they offer can be what finally makes a difference in the lives of survivors like Cotie. Unfortunately, victims often leave treatment programs or stop asking for assistance. But Middle- ton and her Uof L colleagues who have tak- en up the issue of human trafficking are committed to making a positive impact. "We're all really passionate about this issue and trying to combat it." Middleton and Hayden 43 SUMMER 2018

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