Fire and EMS Response to Human Trafficking: Awareness and Training

By Paul Kearns

According to the International Labor organization, there are an estimated 50 million people around the world who are victims of slavery. The represents an increase of 20% from a similar estimate from 2016. We may become aware of human trafficking prior to notable such as the Olympics, the Super Bowl, the World Series, the World Cup, and the NCAA Basketball Tournament. In addition to these, a significant incident occurred in 1993 when the Golden Venture ran aground off Coney Island, New York, when 250 people who originated from China came walked ashore. Less notable incidents but no less traumatic for those involved occur each day throughout the United States in many different forms: Sexual exploitation either in prostitution or forced marriage, and economic exploitation in the form of force labor.

The United States has prosecuted human trafficking for more than 100 years, beginning with the passage of the Mann Act in 1910. There are several notable individuals who have been charged or convicted of violating this act: Jack Johnson, a former heavyweight boxing champion who was ultimately posthumously pardoned by President Trump in 2018; Charles Manson for transporting prostitutes across state lines; the singer R. Kelly, who was convicted of sexual coercion and trafficking of young women; and Ghislaine Maxwell, who received a 20-year sentence for trafficking numerous girls.

The Polaris Project, the group that operates the National Human Trafficking Hotline, issues yearly reports. According to its most recent:

From 1/1/2021 – 12/31/2021, there were 10,359 trafficking situations reported to the National Human Trafficking Hotline. In those situations, a total of 16,554 likely victims of trafficking were identified. The top three types of trafficking reported in 2021 were Escort Services (10%), Pornography (8%), and Illicit Massage, Health & Beauty (8%).
Polaris Project

In the fire service, some events occurred so rarely that they would escape one’s memory; on the other hand, infrequent events could become forever seared in one’s mind, as in the case of a Mayday and rescue of a down firefighter. Other events occurred with a regularity that would cause an emotional numbness or acceptance of the event, such as the 0400 smoke from cooking on a Friday or Saturday night. Each of the events could have resulted in additional training or actions that would either eliminate the event from the future, such as the removal of hotplates or microwave ovens from university dormitories.

Some events, when reviewed from the perspective of time and evolving sensibilities, take on additional importance or meaning. Human trafficking cases are among these. Over the years, the term and topic had not received much notice, but is now of increasing concern to the public. Over the course of my career in a suburban/urban fire department in the shadows of New York City, I encountered several instances that could be classified as human trafficking. At the time, many were viewed as violations of the fire code or occupancy violations. Some were being sexually trafficked; others were being trafficked for their labor. None were reported by either print or broadcast journalism. Nowadays, there are reports from various news sources discussing a temporary increase in human trafficking as a result of various events.

Events Spotlight Increases in Human Trafficking

Human Trafficking and sporting events have become inextricably entwined, and there’s a growing awareness of the crime of human trafficking in the run-up to such events. Professional football, baseball, international sporting competitions, and NCAA basketball.

In 2014, the Super Bowl was hosted at MetLife Stadium in New Jersey. In the weeks leading up to the event, 16 juveniles were rescued in prostitution busts; 50 women who were forced into prostitution (sexual human trafficking) were rescued, and 45 pimps were arrested.

There are numerous reports of arrests of traffickers and those being trafficked. During the 2023 Super Bowl, 48 people were arrested; during the 2022 Super Bowl 500 people were arrested in the days/weeks leading up to the game, rescuing 50 victims of trafficking, per Reuters. Ahead of the 2021 Super Bowl, 71 people were arrested in a human trafficking sting.

In 2019, during the NCAA Men’s Basketball Final Four games, the Minnesota Department of Public Safety announce that 58 people were arrested: 47 people for felony solicitation of a minor and 11 for sex trafficking or promotion of prostitution.

During the 2023 NCAA College Baseball World Series, there were 50 investigations into Human Trafficking in the area surrounding Omaha, Nebraska, where the games were being held. These investigations looked into economic and sexual trafficking.

There were reports leading up to the 2022 World Cup Soccer in Qatar indicating exploitation of the workers who were building the facilities, according to the Guardian Newspaper, which suggested more than 15,000 non-Qataris died in the country between 2010-2019, and more than 6,500 migrant workers had died in the country since the awarding of the tournament.

In 2020, the International Labor Organizations reported that construction workers experienced 50 work-related deaths. The report said 500 were seriously injured, and 37,600 sustained mild to moderate injuries.

The next World Cup in 2026 is scheduled to occur in North America, in Canada, Mexico and the United States. Each of these nations has unique challenges with regards to human trafficking. For example, a report issued in 2020 notes that 50% of trafficking victims in Canada were indigenous peoples. The fire and EMS systems within Canada must therefore be aware of this information to adequately prepare for potential interactions. In Mexico, human trafficking takes two predominant forms: forced agricultural labor and sex trafficking, especially among the poor and indigenous peoples. Unaccompanied minors and indigenous peoples comprise the largest percentages, and this should not be a surprise.

Each of the emergency response agencies has specific capabilities, and this becomes especially complex due to the fact of the cross-jurisdictional impact that the events will have. For example, games being held in New Jersey will be held in a region with 104 municipalities within three counties that are contiguous to the Meadowlands Sports Complex. Multiple highways and rail lines will carry fans and supporters, each of them being brought to one of the 104 municipalities, staying in hotels and privately owned short-term rentals. This represents a potential challenge for emergency response personnel, especially when it comes to human trafficking. Canada has seen pimps using short-term rentals for prostitution. This problem is not uncommon within the industry and Airbnb has created a partnership with Polaris to lessen such occurrences. Response factors include the types of agencies within the regions, the training available, and the training that each member has received.

Definition of Human Trafficking

While the term “human trafficking” is commonly used, the U.S. Department of State also includes the term “modern slavery.”According to the International Labor Organization, there are 50 million people worldwide who endure some form of modern slavery, with an estimated 400,000 people living in modern slavery in the U.S. A large portion of these people are victims of debt bondage, working off debt incurred while being moved to the United States from their country of origin. This debt may be inherited by someone else if the victim does not survive.

During one visit to a location, this author observed multiple mattresses in the basement of a takeout restaurant. At the time of the observation, it was treated as a fire code violation, not as a potential human trafficking event.

There are two predominate types of human trafficking: sexual and economic. Within these types there may be different types of victimization.

Sexual: Forced prostitution/sexual abuse or forced marriage
Economic: Often forced labor.

Victims

Who are the victims of human trafficking? This can be a difficult question to answer, especially since there have been many times a failure to recognize them.

Perpetrators

Who are the perpetrators of human trafficking? Another difficult question, because there isn’t a set type of person who engages in the practice. Press releases from the law enforcement agencies announcing arrests and prosecutions of traffickers show a diverse population, including representatives from organized crime entities. One example of this unpredictability: The Bergen County (NJ) Prosecutor’s Office announced the arrest of a 50-year-old female was “indicted by a Bergen County, NJ Grand Jury and charged with second-degree racketeering, 2C:41-2(d); two counts of second-degree financial facilitation of criminal activity, 2C:21-25(c)(e); second-degree 1 promotion of organized street crime, 2C:33-30; and third-degree promoting prostitution, 2C:34-1(b)(2).” As a result of these actions, 50 women were rescued from being victims of prostitution.

There are three primary means of control that are used to control those who are being trafficked.

Force:

Physical assault
Sexual assault, rape
Physical confinement or isolation

Fraud:

Fraudulent employment opportunities
False promises about work and living conditions
Withholding wages

Coercion:

Threats to life, safety, family members, or others
Threats of deportation, arrest, or debt bondage
Withholding legal documents and psychological manipulation

Taking Action

As we become more aware of human trafficking, there are certain actions that firefighters and EMTS can take. These actions include training and development of relationships with the appropriate agencies and entities that will ultimately rescue the victims from the environment that they are currently in. As with many things in the fire and EMS world, language matters. The first step is to learn how to communicate properly with the victims of human trafficking. The Polaris Project has provided guidance for those involved in the response.

Language can harm victims by preventing them from recognizing they’re in a trafficking situation.
Language can shape public perception of how human trafficking happens.
Language can place blame on victims and survivors.
Language can perpetuate saviorism.
Language can neglect the inherent strength of survivors.

Each of these points requires the agency or responder involved to draft statements before the incident and to be edited as necessary, much like the statements created for the public information officer. All agencies should have a designated PIO and FEMA Emergency Management Institute offers a seven-hour independent study course titled “IS-29 A: Public Information Officer Awareness.”

“It Couldn’t Happen Here”

Training for fire and EMS personnel can take many forms. The initial and most important aspect of this issue is awareness-level training. Most people don’t believe that it could happen in their communities, becoming lulled into a false sense of security by manicured lawns, SUVS, fenced-in yards, and Main Streets straight from Norman Rockwell paintings. Initially, one of the most difficult things to overcome is the realization that human trafficking does not only occur somewhere else.

The sporting event examples provided earlier were obtained as a result of an Internet search. In Palmiotto’s Combating Human Trafficking: A Multidisciplinary Approach (1^st ed.), we find out that that many of the young trafficking victims have been victims of trickery, grooming, and/or an imbalanced power dynamic. Someone has groomed these victims, who have an average between 12-14. It is not uncommon to find that their victimization began via social media.

Anne Ellis, a social worker with the Wichita (KS) Police Department, offered a profoundly sad opinion when she said: “I wish someone listened the first time they ran away.” Although fire suppression forces may not have much exposure to runaways, EMS does. Both disciplines need to be prepared for the eventuality of assisting victims of human trafficking. The following points provide a baseline for anyone looking to prepare.

Get to know how and why things are done the way they are before suggesting a change. Idealism versus reality comes into play. A firehouse solution doesn’t always work.
Recognize the complexity of the problem. Human trafficking takes many forms and can impact the same community in multiple different ways.
Community organizations can be advocates for the good guys. Often, citizens don’t realize all that’s involved in decisions that are made.
Serving looks like work. There is going to be some effort expended to adequately address the needs of those who have been trafficked. That work won’t end when those who have been exploited are removed from the environment.

Young victims of sex trafficking in the United States—the average age of entry is 12 to 14 years of age—have most likely been tricked into believing that the person wielding the power truly cares about them, despite how they are treated. The pimp is an expert in exploiting vulnerabilities, so victims may be “groomed” by someone who leads them to believe he is a boyfriend or a father figure—someone the young person believes will take care of them, only to have the relationship become physically and emotionally abusive.
Palmiotto

Designing a Training Program

Within the fire service, much has been written about how to create and deliver training programs. It is universally accepted that effective training does not occur during an incident, rather it occurs prior to or after the incident. The stressors present during an incident create an environment where the focus is on the actions that are required to address the situation at hand and to address the priorities of life safety, incident stabilization, and property conservation. As a result of this focus, the ability to learn becomes severely impacted and constrained.

There are several ways to develop a training program. The process described in The Fire Chief’s Handbook, sixth edition, chapter 9, lists four items that need to be performed when creating a training program.

Assessing your needs
Develop your plan.
Implement your plan.
Evaluate and maintain the plan.

Numerous other sources can be used to develop the program, such as the National Fire Protection Association (NFPA) Standard 1201, Standard for Providing Fire and Emergency Services to the Public, 2020 ed. Another standard is also in the works: NFPA 1400, Standard on Fire Service Training. One acronym that I have found to be most useful in creating programs was shared by Michael Terpak and Frank Montagne in their book Assessment Center Management and Supervision, PLACO BRAT SAID ME:

Problem defined
Legal advice
Analyze information
Committees established
Objectives/goals defined
Budgets created
Resources needed
Action plan created
Time/schedule
Staff training needs identified and conducted
Approval of plan
Implementation of plan
Documentation of plan
Monitor plan for effectiveness
Evaluate and revise as needed

Human Trafficking Resources for Fire and EMS Training

The fire service has multiple ways of obtaining training on a variety of topics. At the federal level, this may mean the National Fire Academy, the Emergency Management Institute, the FEMA National Domestic Preparedness Consortium, in addition to funded programs from a variety of contract service providers. There are also state and local sources specific to the response areas of the Fire and EMS agencies, such as a traffic incident management course applicable to agencies that respond to incidents on limited-access roadways that may not be appropriate for agencies that do not have those responsibilities .

The federal government provides a variety of opportunities for the public and emergency response personnel to receive training via The Blue Campaign. Offered by the Department of Homeland Security, it provides awareness training to the fire service via the FEMA Emergency Management Institute Independent Study program. It offers a one-hour, self-paced course entitled IS-1152: Blue Campaign First Responder Training, that helps responders understand what human trafficking is, who can become a victim, and how you can play a role in identifying and responding to suspected victims.

The U.S. Fire Administration has a page titled Training Helps EMS Workers Identify Human Trafficking Signs that provides statistics and guidance on the topic of human trafficking.

The State of New Jersey via the Attorney General’s Office and its Human Trafficking Taskforce provides resources and information via its website and brochures. In September 2022, the governor of California signed a law that changed the training curriculum for EMTs and paramedics, which would require them to undergo training during initial licensure on human trafficking. This requirement takes effect beginning July 1, 2024.

An exceptional example of a local fire department offering training for it employees is the Baltimore City (MD) Fire Department, which created and delivered a one-of-a-kind program to its members to create an awareness about human trafficking. It focuses on identification and referral to the appropriate services.

Training is also provided by other public entities that aren’t usually deemed relevant sources of training for fire and EMS personnel. Florida State University has established The National Prevention Toolkit On Domestic Violence and Human Trafficking for Medical Professionals. The program offers training specific for EMS providers that, if taken and satisfactorily completed, results in a certificate of training from The Institute for Family Violence Studies at Florida State University.

The Aftermath: Victims and Responders

Victims of human trafficking may be profoundly impacted, both physically and emotionally, by their experiences, and it is common professional practice that they are offered counseling services. It’s also widely known that emergency response personnel experience emotional trauma at rates greater than that of the public. Members who discover victims of human trafficking can be profoundly impacted. They may experience emotional distress, moral conflict and injury, burnout, and secondary trauma. Such incidents may result in increased awareness and advocacy, resilience, empathy and compassion, and improved institutional response. Since its creation, in 2004, the Everyone Goes Home Program from the National Fallen Firefighters Foundation (NFFF) Program has included psychological support within its 16 Life Safety Initiatives. The 13^th initiative, psychological support, provides valuable guidance for firefighters and their departments, focusing on the fact that “firefighters and their families must have access to counseling and psychological support.”

According to the American Medical Association (AMA), stress injuries can cause behavioral changes, including:

Withdrawal from friends and family connections
Irritability
Decreased impulse control and other unprofessional behaviors, such as displays of anger in public or patient care areas
Impaired judgment, for example, when making clinical decisions
Working longer hours or becoming more rigid about following protocols
Decreased self-care

It is important for fellow firefighters and EMTs to be self-aware of these manifestations and to look at other responders for these signs. One NFFF brochure that may fit the immediate needs after a human trafficking response would probably be the brochure related to mass-violence responses. (PDF)

We should not be surprised by the impact finding vulnerable populations may have on our firefighters and EMTs. According to the U.S. Department of Veteran’s Affairs, incorporating spirituality into the recovery from post-traumatic stress disorder has the potential to complete the recovery process or to complicate the recovery. Having a trained chaplaincy that works in support of the trained mental health professionals is important. The International Association of Fire Chiefs provides resources for departments looking to create or strengthen their programs.

The problem of human trafficking—modern-day slavery—is, sad to say, not going away anytime soon. First responders, including firefighters and medics, are among those who are on the first line of defense against this evil. The most effective way to begin addressing the problem is to raise awareness among your troops, creating a viable training plan using reputable resources, and prepare to deal with the aftermath of human trafficking encounters among both the vulnerable population and your members.

Paul C. Kearns, Jr., is a lecturer in the Science in Emergency Management Department at John Jay College. He is a 27-year veteran of the career fire service and retired as battalion chief, having been assigned the duties of tour commander and incident commander of all incidents occurring while on duty. Previous fire department assignments include supervisor of the training bureau and safety officer, engine company lieutenant and captain, fire investigator, and fire inspector. He is currently a Level Two Fire Instructor and EMT and Hazardous Materials Technician. He lectures regionally on fire department operations and safety and he has attended courses nationally with a focus on risk identification and mitigation. He had been a member of NJTF-1- USAR, and the Health, Safety and Education Chair of the New Jersey Firefighters Mutual Benevolent Association. He is a graduate of John Jay College. He holds a master’s degree in environmental health and safety management.

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