Kidnapped and forced into the sex trade at age 19, Bella Brown is now back in school and rebuilding her life with the help of Massachusetts General Hospital’s new Freedom Clinic.
The Freedom Clinic is the first medical clinic in the nation dedicated exclusively to caring for victims of human trafficking. Founded in 2015, it provides medical care, counseling and support services to people like Bella who have been exploited and abused.
“It’s our mission to care for the person as a whole; to treat their ailments, attend to their needs, help them recover from their trauma and support their healing so they can reengage safely with society,” says clinic founder, Wendy Macias-Konstantopoulos, MD, MPH. As director of the Human Trafficking Initiative in the Emergency Department’s Division of Global Health and Human Rights, she founded the clinic after conducting years of research and training hundreds of clinicians to recognize the signs of trafficking in their patients.
Regaining Normal Lives
Determined to spread the word about the often unseen problem of human trafficking and to help victims regain normal lives, Dr. Macias-Konstantopoulos designed a clinic to address their unique needs. “Labor and sex trafficking victims often have injuries or chronic diseases that have been left untreated,” she says, “yet they have also suffered psychological trauma so their needs are very complex.”
Human trafficking is a global problem whose victims include people enslaved for a wide variety of purposes including domestic or agricultural work. In Boston, many victims are girls and women trapped in the sex trade. Exploited daily by those who repeatedly sell and buy them, these young victims often self-medicate to ease their pain, becoming addicted to drugs in the process.
“This happens right here under our own noses,” says Ann Prestipino, Mass General’s senior vice president for Surgery, Anesthesia, Emergency Medicine, and Clinical Business Development. “The Freedom Clinic is important to the hospital’s community mission, which is to serve people in need.” The clinic’s location is secret to protect the privacy and ensure the safety of patients and clinicians.
Student Recalls Her Ordeal
With a backpack slung over a shoulder and a cascade of long, shiny hair, Bella looks like many other college students. But she pauses to take a deep breath before speaking of her harrowing escape from a Boston man who forced her into sex work at age 19.
She woke up in a strange apartment. He confiscated her identification, money and phone. He beat her, threatened her and told her she was “going to be an escort.”
“I was naïve. I just didn’t know up from down or good from bad,” she says, recalling the easy friendship she developed with an older man on her street in Boston’s Brighton neighborhood. Estranged from her troubled family, she was living in a halfway house for youth. The man offered her rides and bought alcohol for her and her underage friends. “I thought it was cool,” Bella says.
At the same time, he questioned her about her lack of family ties, low income and other details that made her vulnerable to exploitation.
One night, he made his move, pushing her to check out of the halfway house and get into his car. Her life changed terribly for the worse.
She woke up in a strange apartment. He confiscated her identification, money and phone. He beat her and threatened the safety of people she cared about. He told her she was “going to be an escort.”
He began selling her for sex several times a night. Moving her from state to state, he continued selling and abusing her for months until one night, after a particularly violent beating, she made her courageous escape. Eventually, she reported the man to the authorities and he was convicted and sentenced to prison.
Finding the Freedom Clinic
Bella came to the Freedom Clinic last year seeking a place where her experience would be understood and she would not be judged.
Bella came to the Freedom Clinic last year seeking a place where her experience would be understood and she would not be judged. Since then, the clinic has become her go-to place for medical care and for help navigating other aspects of her life.
“They’re kind of like my family, now” says Bella, who is attending the University of Massachusetts in Boston.
When a new patient arrives at the Freedom Clinic, the staff’s first priority is to start building trust. “Our patients are not used to receiving health care. Or they may have had a bad experience in another healthcare setting where they felt judged,” explains Dr. Macias-Konstantopoulos.
Patients often have no health records, so a nurse begins the visit with gentle questions about the patient’s medical history. The patient then visits with one of the clinics’ primary care doctors. Freedom Clinic physicians are dually trained in internal medicine and pediatrics, because Freedom Clinic patients are sometimes very young. The first primary care visit usually lasts a full hour or more, unlike a typical 15- to 20-minute primary care visit.
“It takes patience and time to build trust,” Dr. Macias-Konstantopoulos explains. Typical health topics come first, such as vaccinations and flu shots. More difficult topics, such as substance use and emotional health issues, are broached later in the visit. Staff members acknowledge the patient’s trauma and provide a safe space to talk about the painful details of the patient’s abuse or captivity when she or he is ready.
Help Victims of Human Trafficking
The knowledge and sensitivity of the MGH Freedom Clinic doctors, nurses and psychologists is crucial for human trafficking victims. For example, before touching a patient, even for a minor medical test like measuring blood pressure, they ask permission. Their understanding of the deep trauma suffered by their patients frees those patients from the need to explain it repeatedly or feel embarrassed when they react emotionally to seemingly benign practices.
The first visit ends with a plan in place for additional follow-up medical care or other services.
All services at the clinic are free to all patients—they need no health insurance and will not be billed. “It’s important for them to know that there is no charge,” Dr. Macias-Konstantopoulos says. Fear of being billed for medical services often keeps human trafficking victims from seeking care.
The Freedom Clinic began with funding from the Partnership for Freedom and receives support from Mass General. As more patients arrive, more help is needed.
A Need that Grows
The Freedom Clinic began with funding from the Partnership for Freedom and receives support from Mass General. As more patients arrive, more help is needed. For example, a dedicated social worker is needed to work with patients on housing, schooling and life skills. The clinic also needs an addiction specialist to treat patients who have substance use disorders.
For Bella, the Freedom Clinic is a backstop as she strives to build her future. Always a good student, she is studying pre-law at UMass Boston. Her face sets with determination as she describes her goal. “I want to be a federal prosecutor,” she says, to incarcerate people like the man who kidnapped her from her Boston neighborhood four years ago. “I’m a fighter,” she explains. “That’s just who I am.”
To learn more about the Freedom Clinic or to support its mission, contact us.