Dr. Carli Richie-Zavaleta
After her first Intro to Sociology class, Dr. Richie-Zavaleta was drawn to the field and inspired to pursue research by her Sociology professors. She learned from her professors and mentors showed her that research has the power to redirect attention and shape society. Dr. Richie-Zavaleta said, “I really liked that concept of using research one to bring out the voices of the vulnerable and using that knowledge to make changes in society.” After completing her Masters in Sociology, Dr. Richie-Zavaleta was introduced to a program in Costa Rica where she studied International Peace Studies and Conflict management. It was on that trip where she felt divine intervention call her attention to human trafficking. “I did not want to study this topic, especially at the beginning, it brought a lot of sadness to my heart, and I felt very hopeless.” After reading Dr. Kevin Bales’s book, Disposable People: New Slavery in the Global Economy, given to her by a friend, Dr. Richie-Zavaleta felt that God showed her that she needed to work with vulnerable populations like survivors and victims of human trafficking. Continuing on her journey to find the work she felt called to do, Dr. Richie-Zavaleta became interested in public health. She recalls translating for families on mission trips being a very impactful moment. After experiencing the lack of healthcare access in Nicaragua and Mexico in her travels, Dr. Richie-Zavaleta pursued her Doctorate of Public Health.
Since then, Dr. Richie-Zalvaleta has published her work, taught at colleges and universities, and mentored students, all while balancing being a mom to her two children. Dr. Richie-Zavaleta’s studies on the intersection of public health and human trafficking such as “Compassionate Care—Going the Extra Mile: Sex Trafficking Survivors’ Recommendations for Healthcare Best Practices” has helped inform healthcare facilities’ best practices to notice the signs of human trafficking. Today, she is passionate about access to health care, the vulnerabilities of the homeless population, and bringing the voices of survivors to the table in order to influence training creating more “Evidence-based practices”. Her work is currently focused on getting a few manuscripts published this year and mentoring students. She is also looking forward to a potential grant for a research fellowship. In the future, she wants to continue to mentor students and develop her vision for expanding healthcare access across the world. Her inspiring story reminds one to listen to their calling to and work with passion. She continues to pursue her work as she inspires and mentors the future generations of interdisciplinary change makers.
A Scoping Review of Resilience in Survivors of Human Trafficking
Logan Knight, Yitong Xin, & Cecilia Mengo
Resilience is critical among survivors of trafficking as they are mostly vulnerable populations who face multiple adversities before, during, and after trafficking. However, resilience in survivors of trafficking is understudied. This scoping review aims to clarify the current state of knowledge, focusing on definitions of resilience, how resilience has been studied, and factors associated with resilience among survivors. Five databases were searched using key words related to trafficking and resilience. Studies were included if they were published in English between 2000 and 2019 and focused on resilience with the study design including at least one of these four features: (a) use of standardized measures of resilience, (b) qualitative descriptions of resilience, (c) participants were survivors or professionals serving survivors, and (d) data sources such as case files or program manuals directly pertained to survivors. Eighteen studies were identified. Findings indicated that resilience was primarily described as emergent from interactions between the survivor and the environment. Resilience in trafficking appeared largely similar to resilience in other kinds of victimization. Nonetheless, trafficking survivors also may display resilience in alternative ways such as refusing treatment. Positive interpersonal relationships were the most commonly mentioned resilience factor. In addition, current research lacks studies featuring longitudinal designs, interventions, participatory methods, types of trafficking other than sexual trafficking, and demographic characteristics such as age, gender, and national origin. Future research needs to establish definitions and measures of resilience that are culturally and contextually relevant to survivors and build knowledge necessary for designing and evaluating resilience-enhancing interventions.
Knight L, Xin Y, Mengo C. A Scoping Review of Resilience in Survivors of Human Trafficking. Trauma Violence Abuse. 2021 Jan 20:1524838020985561. doi: 10.1177/1524838020985561. Epub ahead of print. PMID: 33468034.
Going the Extra Mile: Sex Trafficking Survivors’ Recommendations for Healthcare Best Practices
Arduizur C. Richie-Zavaleta, Augusta M. Villanueva, Lauren M. Homicile OrcID and Lianne A. Urada
Human Trafficking (HT) persists in the US, despite multi-level measures designed to mitigate its societal costs. HT instruction for healthcare providers is growing, but there is a dearth of resources and training presenting obstacles for victims accessing suitable healthcare services. Voices of survivors are also scant in the literature, despite the fact that their recommendations would appear essential when designing best practices. This study aimed to methodically gather recommendations from sex trafficking (ST) survivors who sought medical care during their victimization. An exploratory concurrent mixed-methods design was used, and semi-structured interviews (N = 22) were conducted between March 2016 and March 2017, in San Diego, CA, and Philadelphia, PA. Data were analyzed through a coding system to identify meaningful analytical themes. Study participants were recruited through survivor-centered organizations, and their identification was kept anonymous and confidential. Findings included three main themes: (A) Red Flags; (B) supportive healthcare practices; and (C) resources for ST-patient study participants’ recommendations aimed to improve healthcare practice in response to their medical needs in a compassionate and caring manner, with trust building, rapport, and an opportunity to instill hope among ST-patients. Implementing Compassionate Care approaches when caring for ST-patients could positively impact patient–provider interactions, while creating opportunities for intervention.
Richie-Zavaleta, A.C.; Villanueva, A.M.; Homicile, L.M.; Urada, L.A. Compassionate Care—Going the Extra Mile: Sex Trafficking Survivors’ Recommendations for Healthcare Best Practices. Sexes 2021, 2, 26-49. https://doi.org/10.3390/
A Survivor-Derived Approach to Addressing Trafficking in the Pediatric ED
Carmelle Wallace, Yvette Schein, Gina Carabelli, Heta Patel, Needhi Mehta, Nadia Dowshen, Nancy Kassam-Adams, Kenneth Ginsburg, and Cynthia Mollen
OBJECTIVES: Our objective was to elicit the perspectives of survivors of child trafficking on addressing trafficking in the pediatric emergency department (ED) and, secondarily, to provide a survivor-derived framework to help pediatric emergency medicine (PEM) providers discuss trafficking with their patients.
METHODS: We conducted in-depth, semistructured interviews with young adults who experienced trafficking as children and/or as adolescents. In the interviews, we employed a novel video-elicitation method designed by the research team to elicit detailed participant feedback and recommendations on the pediatric ED through an interactive, immersive discussion with the interviewer. A grounded theory approach was employed.
RESULTS: Seventeen interviews were conducted revealing the following themes, which we present in an integrated framework for PEM providers: (1) fear is a significant barrier; (2) participants do want PEM providers to ask about trafficking, and it is not harmful to do so; (3) PEM providers should address fear through emphasizing confidentiality and privacy and encouraging agency; (4) PEM providers should approach the patient in a direct, sensitive, and nonjudgmental manner; and (5) changes to the ED environment may facilitate the conversation. Suggested wordings and tips from survivors were compiled.
CONCLUSIONS: Trafficking survivors feel that the pediatric ED can be a place where they can be asked about trafficking, and that when done in private, it is not harmful or retraumatizing. Fear is a major barrier to disclosure in the pediatric ED setting, and PEM providers can mitigate this by emphasizing privacy and confidentiality and increasing agency by providing choices. PEM providers should be direct, sensitive, and nonjudgmental in their approach to discussing trafficking.
Carmelle Wallace, Yvette Schein, Gina Carabelli, Heta Patel, Needhi Mehta, Nadia Dowshen, Nancy Kassam-Adams, Kenneth Ginsburg, Cynthia Mollen Pediatrics Jan 2021, 147 (1) e20200772; DOI: 10.1542/peds.2020-0772
At the Intersection of Method and Empowerment: Reflections from a Pilot Photovoice Study with Survivors of Human Trafficking
Sue Lockyer and Christopher J Koenig
As human trafficking research increases, attention to ethical research methods with trafficking survivors is important to ensure equitable processes and reliable results for policy and social services. This article first describes Photovoice, a participatory research method that asks individuals to take photos and then to narrate the significance of those photos to develop critical consciousness, and second reflects on the Photovoice method for use with survivors of human trafficking. We outline a pilot Photovoice research project with survivors of human trafficking (n = 4) to consider the strengths, challenges, and opportunities that Photovoice offers for basic and applied research. When implemented as part of a trauma-informed and resilience-oriented framework, Photovoice promotes participants’ sense of empowerment, self-competence, and self-esteem. We discuss how Photovoice can support vulnerable populations, including survivors of human trafficking, while also generating rich and nuanced research data. Our reflections on the lessons learned conducting Photovoice research will support others to implement the method to empower individuals who have survived human trafficking and will promote researchcontributing to a more just, peaceful, and inclusive society.
Sue Lockyer & Christopher J. Koenig (2020) At the Intersection of Method and empowerment: Reflections from a Pilot Photovoice Study with Survivors of Human Trafficking, Journal of Human Trafficking, DOI: 10.1080/23322705.2020.1809300
Multiplicity of Stigma: Cultural Barriers in Anti-Trafficking Response
Annie Isabel Fukushima, Kwynn Gonzalez-Pons, Lindsay Gezinski, and Lauren Clark
Purpose: The purpose of this study is to contribute to the social understanding of stigma as a societal and cultural barrier in the life of a survivor of human trafficking. The findings illustrate several ways where stigma is internal, interpersonal and societal and impacts survivors’ lives, including the care they receive.
Findings: The research team found that a multiplicity of stigma occurred for the survivors of human trafficking, where stigma occurred across three levels from micro to meso to macro contexts. Using interpretive analysis, the researchersconceptualized how stigma is not singular; rather, it comprises the following: bias in access to care; barriers of shaming, shunning and othering; misidentification and mislabeling; multiple levels of furthering how survivors are deeply misunderstood and a culture of mistrust.
Practical Implications: There are clinical responses to the narratives of stigma that impact survivors’ lives, but anti-trafficking response must move beyond individualized expectations to include macro responses that diminish multiple stigmas. The multiplicity in stigmas has meant that, in practice, survivors are invisible at all levels of response from micro, meso to macro contexts. Therefore, this study offers recommendations for how anti-trafficking responders may move beyond a culture of stigma towards a response that addresses how stigma occurs in micro, meso and macro contexts.
Social Implications: The social implications of examining stigma as a multiplicity is central to addressing how stigma continues to be an unresolved issue in anti-trafficking response. Advancing the dynamic needs of survivors both in policy and practice necessitates responding to the multiple and overlapping forms of stigma they face in enduring and exiting exploitative conditions, accessing services and integrating back into the community.
Originality/Value: This study offers original analysis of how stigma manifested for the survivors of human trafficking. Building on this dynamic genealogy of scholarship on stigma, this study offers a theory to conceptualize how survivors of human trafficking experience stigma: a multiplicity of stigma. A multiplicity of stigma extends existing research on stigma and human trafficking as occurring across three levels from micro, meso to macro contexts and creating a system of oppression. Stigma cannot be reduced to a singular form; therefore, this study argues that survivors cannot be understood as experiencing a singular form of stigma.
Fukushima, A.I., Gonzalez-Pons, K., Gezinski, L. and Clark, L. (2020), “Multiplicity of stigma: cultural barriers in anti-trafficking response”, International Journal of Human Rights in Healthcare, Vol. 13 No. 2, pp. 125-142. https://doi.org/10.1108/IJHRH-