Nurses like Michelle Markie, who have received Sexual Assault Forensic Examiner certification, are trained to record sexual assault victims' histories and collect evidence to help in the prosecution of their abusers. Markie, who works at St. Joseph Hospital in Bangor, estimated she personally encounters two to three cases of sex trafficking in her unit per year. She is pictured at a recent art auction to raise money for Hope Rising, a residential treatment program for survivors of the crime of human trafficking. Credit: Danielle McLean | BDN

Michelle Markie is one of about 35 people in Maine specifically trained to help victims of sexual assault, including those who have been trafficked. As an emergency department nurse at St. Joseph Hospital in Bangor, she sees the issue up close.

Over the past four years, she estimated she had personally encountered two to three cases of trafficking in her unit per year. Victims may seek medical assistance for unrelated-injuries, such as assault, sexually transmitted diseases, and injuries.

If victims are able to open up to nurses, the nurses “let them know that we are aware and that we can give them resources if they want them,” Markie said. “But we understand if they are not ready, and if they ever want to come back we are always there for them.”

Nurses like Markie, who have received Sexual Assault Forensic Examiner (SAFE) certification, are trained to record the victim’s history and collect evidence to help in the prosecution of their abusers.

SAFE nurses have been trained to watch out for certain red flags:

  • The patient looks like she or he is being controlled. Someone else may be holding the patient’s health insurance card or ID, or answering questions directed at the patient.
  • The patient doesn’t really know what city she or he is in.
  • Victims may have bruises around their bodies, pattern injuries around their neck from strangulation, or ligature marks around their wrists and ankles from being tied up.
  • They may show signs of post-traumatic stress disorder.
  • They are often scared, suffering from depression and anxiety, and having nightmares.

She’s seen some victims being sold by gang members, but most often it’s by significant others and spouses, or people they are close with. She recalled working with one young woman who was being trafficked by her parents.

But often victims being trafficked try to keep their situation hidden, so it can be difficult for nurses to identify them as victims.

“Most people don’t want to talk about it. They want to keep it hidden because they are ashamed, or they think it’s their fault, so they want to hide it,” Markie said. “They don’t see themselves as the victim, and they don’t see themselves as being trafficked.”

The response

When Markie suspects a patient may be a trafficking victim, she may try to get the person alone. Sometimes that requires assisting the patient to the bathroom to separate the patient from a handler.

Then she asks questions:

  • Is anyone making you do anything you don’t want to do?
  • Are you safe?
  • Where do you live?
  • Where do you sleep at night?
  • Are you able to leave the person you are with if you wanted to?

The nurses can’t force a potential adult trafficking victim to report to police. And if victims choose not to talk about the situation, the nurses simply let them know they are always there if they need them.

If they do open up about their situation, the nurses are trained to provide resources:

  • Sometimes they have to alert security and remove the patients from the hospital’s census, so others can’t find them.
  • Nurses try to find a safe place for patients to go when they do get discharged and help facilitate the means of getting there.
  • They try to find crisis counselors victims can talk to.
  • If victims are up for it, they put them in touch with police.

Many of the women being trafficked are given daily earning quotas by their pimps when they are being trafficked — sometimes as high as $800 per night, she said. Women who don’t make their quota are often punished, such as by being beaten, starved and deprived of sleep.

People can only sell so many drugs before they run out. But there are no limits on the number of times they can sell a person for sex.

“People are using women over and over and over, so the profit continues,” she said.

Markie and the St. Joseph nurses have found ways to use their knowledge and experience to support victims outside the emergency department as well.

Some nurses talk to teens residing at the Bangor-based youth homeless shelter Shaw House. She said traffickers and pimps typically target vulnerable homeless youth and young adults, and make them perform sex acts to receive basic essentials such as shelter.

“A gift is a gift,” she tells the teens. “If somebody offers you a place to stay, you do not owe them.”

Markie and another St. Joseph nurse are also employed at Hope Rising, a one-year-old, long-term sex trafficking victim recovery program located at an undisclosed location in Penobscot County.

At Hope Rising, the nurses teach victims about what medications they should take, teach them life skills, and help them process and cope with their traumas. Over the past year, she’s seen victims find new hidden talents, learn to live safer, healthier lifestyles, build-up their self-esteem and learn to live independently.

“I love, love, love working with these women. It’s my passion,” she said. “They’re all such beautiful people.”

If you or someone you know might be a victim of sex trafficking, call the National Human Trafficking Resource Center Hotline at 1-888-373-7888. To reach a sexual assault advocate, call the Statewide Sexual Assault Crisis and Support Line at 800-871-7741, TTY 888-458-5599. This free and confidential 24-hour service is accessible from anywhere in Maine.

Subscribe to the Maine Focus mailing list for updates on our projects