Summer 2021 Update
Healthcare for Justice recently celebrated its second birthday, and we are so happy to report that we continue to grow and expand our mission of offering free primary healthcare to victims and survivors of human trafficking (HT)! During this time, we have occasionally been asked why the HFJ clinic is needed when there are so many government based public clinics that offer the same type of medical services with similar “free” care through public insurance pathways. This is not only a good question, but it’s important to understand that the answer is exactly why HFJ was established. In short, the public option wasn’t working for this patient population; we would know because prior to opening the doors of HFJ, we were attempting to serve this patient population through one such clinic. Let’s explore why.
Given the design of the US healthcare system, public clinics play a vital role for those in our community who otherwise would not be able to afford or access quality healthcare. Because of their top-down approach, they are able to allocate excellent resources to economically and socially marginalized populations. But it is also this top-down approach that ends up leading to barriers for some. Aside from our own experience, research has shown that some of the major barriers to healthcare for victims and survivors of HT stem from the fact that many of them have been traumatized (and often trafficked) via the mechanisms of existing top-down systems originally designed to help but re-purposed for tragic means. Additionally, traffickers come from all walks of life, and unfortunately there are instances where people with power in the system do the trafficking, such as medical doctors for example.
Despite these systems being in place to help marginalized populations, there still are many hoops and hurdles one must navigate before seeing an actual healthcare provider in a clinic. Once a person overcomes their fear about not having any financial ability to pay for the care, they need to call the clinic to set up an appointment, and then somehow make it to the clinic for the appointment. If they are not in a safe home recovering from their trauma, this alone can nearly be impossible as many traffickers will only have their victims seen by the medical system if there is an emergency. But even if they are in a safe home, the required paperwork and forms necessary to be seen at these clinics are typically daunting. One of our own patients has actually told us how forms and questionnaires remind him of the process by which he was traumatized and trafficked by a system and cause severe panic attacks. Also, while many in the healthcare industry are very empathetic, the reality is empathy isn’t present in 100% of the personnel and it definitely doesn’t exist in the process of forms and questionnaires. Thus, further trauma can be inflicted by the process or by unknowing or even at times judgmental staff who are not trained appropriately in trauma-informed care approaches.
It shouldn’t have been a surprise then when we experienced a no-show rate of about 65% of the HT victims referred from the local safe homes to be seen at the public clinic, but it was. So in response we surveyed survivors of HT and found the hesitancy of being seen was overwhelmingly about the fear of re-traumatization and stigma they carry from previous experience of healthcare systems.
That’s when we knew something needed to change. Our approach at HFJ would be from the bottom-up. We would design our clinic around the needs and capacities of the community we aimed to serve. With this, the mechanism in place for them to access care would be one that allows them to control the pace of care provided, the location of care received, and the topics of discussion. There is no cost for this care for them, no matter what. If there is something they need that is outside the capacity of our clinic to provide, we work with and advocate for them to get it one way or another. There’s no time limit on our appointments, they have direct communication to the providers via secure HIPAA compliant email and for many who desire, via text messaging as well. This bottom-up approach can react quickly and directly to the needs of the individual as well as the community being served and therefore is designed specifically to address and remove the barriers that the top-down system inherently creates. With our approach, after two years of operation, we are so elated to report that our no-show rate is now around 20%!
To be sure, despite the barriers of the top-down approach, the public clinics are necessary and amazing. In fact, we are grateful to the nation we are in as it allows HFJ and other grass roots organizations like it to exist and therefore meet the needs of many of our marginalized neighbors!
Finally, we want you to know that our dream has become a reality all because of you. When you subscribe to our updates and share our news and mission you are part of the bottom-up grass roots solution. And when you donate financially, especially as a recurring donor, you literally make this possible. As a non-profit and not a top-down public entity, HFJ can provide the aftercare services our patients need in order to fight for their liberty, and you are fighting alongside them with us.
The HFJ Team