PTSD – UAB Institute for Human Rights Blog

The Sex Trafficking Industry Right In Alabama

by Dianna Bai

a picture of hands in chains — Source: Public Domain

You may have heard of the tragic situation straddling the I-20 corridor, the stretch of highway that runs between Birmingham and Atlanta.

Known as the “sex trafficking super highway,” the I-20 corridor is a hotbed for human trafficking.

The intimate settings of this illegal trade? Familiar places in our backyard: the hotels on Oxmoor Road, Woodlawn, Bessemer, and establishments all over the city of Birmingham.

Yet sex trafficking is not just confined to the I-20 corridor, as many media reports would suggest. It’s spread throughout the state of Alabama, in large cities and rural areas alike, appearing in myriad variations. The Global Slavery Index estimates that there are over 6000 victims of human trafficking each day in Alabama, which includes labor and sex trafficking.

As a $32 billion industry, human trafficking is the second-largest criminal industry in the world after the illicit drug trade—and it’s the fastest-growing. It’s the modern-day slave trade flourishing under the radar.

In the idyllic foothills of Alabama, we are touched by dark and complex operations with global reverberations.

Who are the victims of sex trafficking in Alabama?

Sex traffickers prey on the vulnerable, such as people who come from poverty or broken families.

According to The WellHouse, a non-profit organization that shelters young women in Alabama who have been victims of sex trafficking, there is a common “model” of a victim human traffickers prey on.

She is often a 12-14-year-old girl who has already been a victim of sexual abuse by a family member. An emotionally vulnerable young woman, she is lured in by the promises of comfort, love, and acceptance that an older man offers her.

He will later become her captor.

One example provided by Carolyn Potter, the executive director of The WellHouse, offers us a glimpse into the world of the girls who become victims of traffickers:

“There was a victim who had been abused by her stepfather—and her mother blamed her. Her captor started luring her in and buying her Hello Kitty items. She loved this. Nobody who was supposed to protect her protected her.”

Sex traffickers often prey on girls who have been abused by the people who love them. The accumulated trauma and experiences of abuse that these girls have been subjected to in their young lives gives rise to a sense of apathy and hopelessness.

So when their captors, who had been lavishing them with gifts and attention, start asking them to sell their bodies, their reaction is often, “Why not? This has been happening to me all my life.”

To numb the pain of repeated abuse, they may turn to drugs provided by the captors and become addicted. Traffickers then have a way to keep them from leaving.

A few might escape this life by her own efforts, but more often than not they escape through rescue operations carried out by law enforcement. In January of this year, the Well House participated in a sting operation led by the FBI during the Atlanta Super Bowl that rescued 18 girls and led to 169 arrests.

Once rescued, one of the most important steps to helping victims is simply the process of gaining their trust, as most victims who have been trapped in this life suffer from complex trauma. “Their level of PTSD is equal to someone who’s been in war,” Potter said.

What does the sex trafficking industry look like in Alabama?

As a criminal activity, sex trafficking in Alabama can take on many forms.

“Alabama is a microcosm of human trafficking around the world,” said Christian Lim, a professor of social work at the University of Alabama who is heading up a federally funded project on the subject. “There is just about every type of human trafficking in Alabama.”

On one end of the spectrum, there are individual pimps conducting a small-time business. They might even be family members who are pimping out their children for rent or drug money—and these cases often go unreported because of the family connection. On the other end, there are the massage parlors that are the fronts for international criminal networks, laundering money and trafficking women from places as far as China and Korea. These massage parlors routinely bring in $500,000-$800,000 a year, operating late into the night and advertising online at dozens of websites selling sex.

Sex trafficking has also risen in recent years among street gangs in Alabama with ties to Georgia, Florida, and even the West Coast, according to Teresa Collier at the Alabama Law Enforcement Agency. Street gangs such as the Bloods, Simon City Royals, Latin Kings, and Surenos are known to be engaging in sex trafficking to make a profit alongside the illegal drug trade. Recruiting mostly young victims, traffickers use “bottom girls” – prostitutes who are trusted by the pimps – to identify and recruit new girls, as well as a bevy of popular social media sites including Facebook, Twitter, Instagram, Snapchat, KIK, Meet Me, Badoo, and Seeking Arrangement. Gangs like the Surenos, which have a powerful reach back to El Salvador, can even coerce the women by threatening their families back home.

In many cases, other criminal activities such as drug dealing, money laundering, and murder also surround sex trafficking operations.

What’s being done about sex trafficking in Alabama?

One reason Alabama attracts traffickers of all stripes is because it is easier to get away with the crime than other states like Georgia that have a tactical task force dedicated to combating sex trafficking, according to Collier at the Alabama Law Enforcement Agency.

Also playing to the trafficker’s advantage is the fact that Alabama is mostly a rural state with greater distances between police stations and fewer resources for law enforcement, said Lim, the professor of social work at the University of Alabama. He also said there’s needs to be more awareness raised about this issue as many misconceptions exist about sex trafficking due to the popular media’s portrayal of sex trafficking in movies like “Taken.”

The Department of Homeland Security is investigating an array of cases in Alabama and prosecuting cases at both the state and federal level. “We have made human trafficking arrests at every socioeconomic level in Birmingham, from Mountain Brook to $35-a-night hotel rooms,” said Doug Gilmer, the agent in charge of the Department of Homeland Security’s Birmingham office. “Trafficking victims also run the spectrum, with girls ranging from age 12 to the 50s.”

DHS has also provided training to 1500 Alabama law enforcement officers to combat sex trafficking in the state and offers education to any community group that’s interested. These trainings focus on how to how to recognize the signs of sex trafficking, how to respond to a call, and how to support the victims.

Meanwhile, local law enforcement agencies such as the Tuscaloosa Police have jumpstarted special initiatives to combat sex trafficking in Alabama. The Tuscaloosa Police worked with Illinois’ Cooke County police three years ago in a “National Day of Johns” sting, specifically targeting the “demand” side of the industry. Officers placed fictitious ads for sex services on various sites, which led to the arrest of 135 Johns over 16 days.

But it’s a cat-and-mouse game as traffickers find new ways to advertise sex services, moving from online ads to alternatives like secret Facebook groups. Undercover agents are seeking out these secret online groups to find traffickers and victims as traffickers learn from past mistakes and become savvier at using the digital tools at their disposal. A popular website hosted in the United States, backpage.com, was shut down by the FBI several years ago, yet has created new challenges for law enforcement as dozens of newer and smaller sites have now popped up hosted by foreign servers that are outside the jurisdiction of U.S. law enforcement agencies.

Alabama’s state legislature is also moving on this issue. They have recently passed three resolutions that would require training for truckers and healthcare workers to spot the signs of human trafficking and make it easier for the trucker to identify victims. Two other bills moving through the legislature are intended to fine and “shame” johns for soliciting sex services.

“There should be no politics when it comes to protecting our children,” State Representative Merika Coleman told AL.com.

Right in Our Backyard

It is revealing and disheartening to see the extent of the modern-day slave trade right here in our backyard in Alabama. Without the right consciousness, it may be invisible to the average person. You may see a scantily dressed young woman walking through a gas station, a Sonic, or a Walmart. She is always accompanied by someone. She looks depressed or hopeless… You may have just run into a victim of human trafficking.

Vulnerable women (and men) and children are being exploited over and over again for the profit of more powerful and unscrupulous individuals and criminal organizations. The traffickers could be anyone, but what they have in common is a disturbing disregard for human life and human dignity. In Alabama, there are many dedicated agencies fighting for the human rights of these victims, including The WellHouse, Alabama Human Trafficking Task Force, Alabama Fusion Center, and the Department of Homeland Security.

For DHS agent Doug Gilmer, there is a sense of urgency to his mission because it is a crime that’s “unspeakable.”

“When you get into the nitty-gritty of sex trafficking at the street level and you are interacting with the victims, seeing what they go through, seeing what the traffickers do…. It’s horrible,” Gilmer said. “Seeing a 14-year-old girl with eight different STDs and the 35-year-old man who purchases this girl for sex?”

“It shocks the conscience.”

Important Links

The WellHouse – A 24-hour shelter offering immediate assistance to trafficked women who are rescued from anywhere in the United States.

EnditAlabama.org – A project of the Alabama Human Trafficking Task Force, which brings together public and private agencies to address the issue in Alabama.

Alabama Fusion Center – An information-sharing organization within the Alabama Law Enforcement Agency designed to combine or “fuse” information between federal, state and local government, private sector entities, and the intelligence community

Department of Homeland Security “Blue Campaign” – A national public awareness campaign, designed to educate the public, law enforcement and other industry partners to recognize the indicators of human trafficking, and how to appropriately respond to possible cases

Dianna Bai is a Birmingham-based writer who currently writes for AL.com. Her writing has been featured on Forbes, TechCrunch, and Medium. You can find her portfolio here.

PTSD is Not Just for Veterans; It’s A Trauma Disorder

by Marie Miguel

Some people believe that PTSD is only a mental health condition that affects those who have come back from war, but this isn’t the case. People who have Post Traumatic Stress Disorder aren’t just veterans. Individuals with PTSD have experienced severe trauma. It’s not only people that come back from combat, but that’s how many of us associate the disorder. PTSD can happen to anybody who experiences trauma such as a sexual assault, a natural disaster, or many things that would prompt someone to have a traumatic reaction, so let’s stop talking about PTSD as though it’s something that only war veterans experience. Anyone who has been through a traumatic experience can develop PTSD. According to the National Alliance on Mental Illness (NAMI), PTSD affects 3.5% of the U.S. adult population. That works out to eight million American people living with the condition. Approximately 37% of people diagnosed with PTSD display serious symptoms. Women have higher rates than men. Later in this article, we’ll discuss the gender divide.

What is Post Traumatic Stress Syndrome?

Post Traumatic Stress Syndrome happens after a person experiences trauma, and it’s something that sticks with a person. Symptoms can include flashbacks, night sweats, insomnia, panic attacks, and isolating from friends and family. We need to understand that people with PTSD aren’t dramatic; they’re traumatized. When you experience trauma first-hand it changes your brain. According to the U.S. National Library of Medicine – National Institutes of Health, Several areas of the brain are involved when a person experiences PTSD. A stress response includes the amygdala, hippocampus, as well as the prefrontal cortex. PTSD and trauma can cause lasting changes in those areas of the brain.

What causes PTSD?

The cause of PTSD is that a person experiences trauma and never adequately deals with the issues because it sticks with them. People think that PTSD is caused by being in combat because combat can be a traumatic experience, especially if you see someone die in front of you. The cause of PTSD is when an individual has difficulty adjusting after a traumatic event; their brain changes and the memory of the traumatic event gets stuck in their brain. These intrusive memories make it difficult for an individual to function. The root cause of PTSD is a traumatic event, but the symptoms are what overwhelm people to the point where it’s diagnosable. People with PTSD often have recurring distressing and upsetting memories of the trauma, and when you continually have upsetting memories and can’t stop them, it makes you want to shut down, which is a problem that many people face when living with PTSD, and it can seriously impact your relationships.

Causes of PTSD

A stressful experience
Trauma
Mental Illness
Predisposition to mental illness or family history of mental illness

Risk factors for PTSD:

Long lasting trauma
Childhood sexual abuse
Other childhood trauma
A job where you’re exposed to trauma such as a military position
If you don’t have a sound support system
Seeing someone get hurt
A history of substance abuse

Types of trauma

When we think of PTSD, we might think of combat, but it’s not just that. Anyone who has experienced trauma is at risk of developing PTSD. Whether you witnessed a violent act or you were physically attacked yourself, you’re at risk for PTSD. In addition to combat, types of trauma that can induce PTSD include but aren’t limited to:

Childhood sexual abuse
Other childhood trauma
Sexual assault or violence
Physical assault
Natural disaster
Being attacked with a weapon

Symptoms of PTSD

Symptoms of PTSD can range from mood symptoms to physical symptoms. These symptoms can include but aren’t limited to nightmares, irritability, being easily startled or frightened, trouble sleeping or concentrating, or even feeling completely emotionally numb. These symptoms occur after a traumatic event and are only some of the possible signs that an individual could experience. Everyone reacts to trauma differently. And it’s understandable that someone may shut down, lash out, or break down crying. These are all responses that could happen.

How intense are your symptoms?

Depending on the person, the intensity and type of PTSD symptoms will differ. If you have suicidal thoughts or ideation, it’s incredibly crucial to reach out to a friend, loved one, or to contact the national suicide prevention hotline (1-800-273-8255 or 1-800-273-TALK in the United States.) It’s essential that you talk to your doctor if you’re experiencing difficulty functioning.

Complications of PTSD

PTSD can impair someone’s function to the point where they’re unable to engage in normal life activities. Someone might develop substance abuse issues, an eating disorder, or other comorbid mental health conditions. PTSD can be debilitating. It can lead people into a state where they can’t work. It can make it so that they’re unable to attend social functions, and it can severely impact a person’s life. If you’re diagnosed with PTSD, you need to have the following symptoms:

One avoidance symptom – Avoidance is where you’ll stay away from things that remind you of the trauma. Avoidance symptoms include avoiding places and situations that remind you of the trauma, and avoiding thinking about upsetting thoughts connected to the event

At least two arousal symptoms– Arousal symptoms of PTSD make a person extremely anxious. Arousal symptoms include:

Getting startled easily
Feeling tense
Having problems sleeping
Angry outbursts

At least two cognition/mood symptoms – Cognitive symptoms of PTSD can rob people of things they once enjoyed. Cognitive symptoms include difficulty remembering the trauma, distorted emotions including guilt, and loss of interest things you once enjoyed

One re-experiencing symptom – Re-experiencing a key marker of PTSD, and it sounds exactly like what it is; re-experiencing. Re-experiencing symptoms include flashbacks or reliving the trauma, nightmares, or scary thoughts.

a lone little boy sitting on a platform — Source: John Smith, Creative Commons

Children vs. Adults With PTSD

Children can have different responses to trauma in comparison to adults. They might wet the bed or have selective mutism, they might start acting out during play time, or they might begin experiencing separation anxiety. According to the National PTSD center, seven or eight out of every 100 people experience PTSD at some point during their life. Not every person who has PTSD has been through a dangerous incident; some people experience it after a loved one has suffered harm.

According to The U.S Department of Veteran Affairs Studies, approximately 15% to 43% of girls and 14% to 43% of boys experience significant trauma. Of the children and teens that experience trauma, 3% to 15% of girls and 1% to 6% of boys go on to develop Post Traumatic Stress Syndrome.

We can see that females seem to develop PTSD more than men do. What is the reason for this? Many women are survivors are sexual assault, try to speak up and aren’t believed. According to the National Sexual Assault Resource Center, one in five women and one in 71 men will be raped at any given point during their lives. Yet, we as a society do not believe survivors as we should. We need to start believing women when they come forward. When we do they can get treated for what happened to them appropriately.

Why do some people get PTSD and others don’t?

You may be wondering why some people develop PTSD while others do not. Part of it has to do with having the risk factors listed above, but there’s nothing wrong with you if you have PTSD and someone else in the same situation did not. There are other disorders that can go along with PTSD. An individual with PTSD can have additional mental health conditions. They may also struggle with suicidal ideation and may attempt to take their life. Here are some mental health conditions that people with PTSD also manage:

Generalized Anxiety Disorder
OCD
Depression
Borderline Personality Disorder
Substance Abuse

How to prevent PTSD

PTSD isn’t necessarily preventable because you can’t control when trauma happens, but you can deal with the trauma after it happens. After experiencing a traumatic event, it’s vital to seek mental health treatment in the form of therapy and, if you need to, a psychiatrist. You can reach out to people in your network and find someone to treat your symptoms. Whether you see someone online or in your local area, PTSD is treatable and even preventable if you address trauma right away. If you develop PTSD, it’s okay, and there’s no need to feel shame. It’s a treatable mental illness, and you’re not alone. Many people live with PTSD, and with support, you will get through this. It starts with getting help from a mental health professional, whether that’s working with someone in your local area or finding the help of an online counselor, like one at BetterHelp, you can find a treatment plan and get the help that you need to health from PTSD. You’re not alone, and remember that millions of Americans live with the condition. By going to therapy, you’re doing something incredibly brave, which is taking charge of your mental health. You will get better, but it’s going to take time. Be patient with yourself. Healing from trauma can be difficult, but it’s worth it.

Marie Miguel has been a writing and research expert for nearly a decade, covering a variety of health-related topics. Currently, she is contributing to the expansion and growth of a free online mental health resource with BetterHelp.com. With an interest and dedication to addressing stigmas associated with mental health, she continues to specifically target subjects related to anxiety and depression.

Refugees: Peace of Mind

The Storm Refugees – Tribute To The Victims Of The Harvey Storm. Source: Daniel Arrhakis. Creative Commons.

“Armed conflict kills and maims more children than soldiers,”

-Garca Machel, UNICEF

Global unrest and armed conflict are becoming more common, intense, and destructive. Today, wars are fought from apartment windows, in the streets of villages and suburbs, and where differences between soldiers and civilians immediately vanish. Present day warfare is frequently less a matter of war between opposing armies and soldiers than bloodshed between military and civilians in the same country.

In 2014, there were 42 armed conflict, resulting in 180,000 deaths worldwide. Civilian death tolls in wartime increased from 5 per cent at the turn of the century to more than 90 per cent in the wars of the 1990s. War and armed conflict is one of the most traumatic experiences any human can endure, and the brunt of this trauma is felt by civilians- most especially children. In 2015 alone, some 75 million children were born into zones of active conflict. As of May 2016, one in every nine children is raised in an active zone of conflict. Two hundred and fifty million young people live in war zones, with the number refugees at its most prominent since World War II. Currently, there are 21.3 million refugees worldwide, and half of them children.

For refugees, the events leading up to relocation (notably war and persecution), the long and unsafe process of relocation, settlements in refugee camps, and overall disregard for human rights, takes a major emotional and mental toll. PTSD, depression, anxiety, and sleeping disorders are just few of many problems refugee children experience. Respecting human rights is essential to society’s overall mental health. Equally, a society’s mental health is essential for the enjoyment of basic human rights. Addressing the psychological needs of victims of armed conflict is essential for the prosperity of war-battered children’s future.

The Relationship between Mental Health and Human Rights
Armed conflict affects all aspects of childhood development – physical, mental, and emotional. Armed conflict destroys homes, fragments communities, and breaks down trust among people, thereby undermining the very foundations of most children’s lives. The psychological effects of loss, grief, violence, and fear a child experiences due to violence and human right violations must also be considered.

Throughout the process of becoming a refugees, the three main stages in which people experience traumatic and violent experiences include: 1) the country of origin, 2) the journey to safety, and 3) settlement in a host country. The interrelationship between human rights and mental health are recognized in various universal human right conventions and resolutions. Numerous legislative measures exists for mental health, but two main conventions that address the situations refugees experience include: 1) Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment and 2) The Convention on the Rights of a Child. These two conventions specially address mental health pertaining to violence.

Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment: 1987
This Convention is significant towards the promotion of mental health as a human right because “torture,” any act that creates severe pain or suffering, can be both physical and mental. This convention is particularly relevant to refugees because they are more vulnerable and susceptible to mental and physical torture. The short video documentary released by the UNHCR provided refugees and migrants to tell their own stories of kidnap and torture during their journeys to Europe. The stories told by survivors are emotionally distressing but highlights the realities refugees continuously experience.

The Convention on the Rights of a Child: 1990
The Convention on the Rights of a Child is the first legally binding international instrument to integrate the full array of human rights. This convention is also an important document for mental health. The CRC explicitly highlights the significance of both the physical and psychological wellbeing of a child. This convention is particularly important because it addresses the relationship of affect armed conflict on mental health. First, Article 38 of the Convention highlights state parties’ obligation under international humanitarian law to protect the civilian population in armed conflicts, and shall “take all feasible measures to ensure protection and care of children who are affected by an armed conflict.” International humanitarian law is a set of rules which aim, for humanitarian purposes, to minimize and protect persons from the effects of armed conflict. Second, Article 39 of the Convention states “States Parties shall take all appropriate measures to promote physical and psychological recovery and social reintegration of a child victim of: any form of neglect,… torture or any other form of cruel, inhuman or degrading treatment or punishment; or armed conflicts.” For children refugees, the Convention on the Rights of a Child is an imperative document for the security of their right to mental health, and mental health services.

Barriers to Accessing Health Care Services
The process of becoming a refugee takes a tremendous emotional and mental toll on all refugees. PTSD, depression, anxiety, and sleeping disorders are just few psychological diagnoses given to refugee children. The fundamental right to mental health care is addressed in various international standards, such as the Convention of the Rights of the Child, however, there continues to be numerous barriers preventing access to these services. There has been an unparalleled surge in the number of refugees worldwide, the majority of which are placed in low‐income countries with restricted assets in mental health care. Currently, responsibility for mental health support to refugees is divided between a network of agencies, including the United Nations High Commissioner for Refugees (UNHCR), the World Health Organization (WHO), government, and nonprofit organizations. Yet, the reality is that most refugees with mental health problems will never receive appropriate services. Cultural barriers, such as language, persistently affect a refugee’s capability to utilize mental health series. A study examining health care barriers of post-settlement refugees reveals language is the most impeding cultural barrier to accessing healthcare. Refugees and mental health service providers often do not speak the same language, making successful communication during healthcare visits less effective. Language barriers affect every level of the healthcare system, from making an appointment to filling a prescription. A lack of multilingual interpreters for refugees and health care providers weakens the healthcare system, making miscommunication about diagnoses and treatments possibilities common. Lastly, stigma surrounding mental health is another barrier to health services. Refugees often feel the words “mental health issues” should be reserved for individuals with extreme learning disabilities, and do not understand mental health problems can be conditions like depression and anxiety.

Psychopathologies due to trauma are very powerful, however, recovery is possible. In Judith Herman’s book Trauma and Recovery, she discusses her theory of recovery. She states recovery happens in three stages: 1) establishment of safety, 2) remembrance and mourning, 3) re-connection with ordinary life.

Stage 1: Safety
Trauma diminishes the victims’ sense of control, power, and overall feeling of safety. The first stage of treatment focuses establishing a survivor’s sense of safety in their own bodies, with their relations with other people, in their environment, and even their emotions. Self-care is also an important focus point during this stage. The purpose of this stage is to get victims to believe they can take protect and take care of themselves, and they deserve to recover.

Stage 2: Remembrance and Mourning
The second stage of Herman’s recovery theory highlights the choice to confront trauma of the past rests within the trauma survivor. It’s important for victims to talk about their goals and dreams before the trauma happened so they can reestablish a sense of connection with the past. That second stage begins by reconstructing the trauma beginning with a review of the victim’s life before the horrors and situations leading up to the trauma. This second step is to reconstruct the traumatic event as a recitation of fact. The goal of this step is to put the traumatic event into words, and come to terms with it. Testimonies are ways for survivors to get justice, feel acknowledged, and find their voice.

Stage 3: Reconnecting
In the final stage, the victim focuses on reconnecting with oneself and the recreation of an ideal self that visits old hopes and dreams. The third stage also focuses on emotionally and mentally reconnecting with other people and social reintergration. By this stage the victim should have the capacity to feel trust in others. A small but influential minority of individuals revolutionize the meaning of their trauma and tragedy, and make it the foundation for social change.

Peace. Source: John Flannery. Creative Commons.

A Peaceful Future
Even though human rights activists are not psychological clinicians, we can still contribute to the success of these stages. At present, more than half of the refugee children population are children. Despite the violence these children have experienced, refugee children are the foundation and hope for a peaceful future. However, for that to happen, refugee children need to find peace in themselves. Respecting human rights is essential to society’s overall mental health. As activists we need to advocate for refuges and children who don’t have a voice. Activists for human and mental health rights should start focusing their goals on ensuring their communities and hospitals contain mental health care provisions. As activists, we can lobby for more accessible mental health services throughout our health care system, join and volunteer at non-profit organizations, and advocate for the rights of refugees. As Herman Melville states, “we cannot live only for ourselves. A thousand fibers connect us with our fellow men.”