CANCER inCYTES is a public health e-magazine that discusses the healthcare needs of disadvantaged populations. The uniqueness of Cancer InCytes is its focus on the link between cancer and social injustice, producing and discussing the latest research on this subject. Our articles become training material for law enforcement, advocates, clinicians, scientists, social workers, and your next-door neighbor. Connecting childhood trauma, disease risk, and social injustice.
Managing Editor: David H. Nguyen, Ph.D.
Volume 2, Issue 2, Winter 2013
TWICE AS STRONG
BY BARBARA AMAYA
Child abuse at home sent Barbara Amaya on her way to the streets of New York City, where she endured nine years as a trafficked child. Surviving the routine of rapes, beatings, and drugs she somehow found her way into a new life. But that past did not leave her alone, resurfacing as one medical problem after another, including endometrial cancer. Today, Barbara is a double survivor whose voice carries twice as far.
It Started When I was 12
It has been a little over a year since I broke my silence about having been a sex-trafficked child. I spent decades keeping all of my traumas deep inside. Keeping secrets can sometimes make you sick.
The summer I turned 12, I ran away from home after being abused under that roof. I ran away and was found on the streets of Washington D.C. by a couple that groomed me for prostitution and then sold me to a New York trafficker. I spent my youth growing up while being trafficked on the streets of New York. My pimp controlled every aspect of my life. As I grew older, I attempted to escape his control, but I was never successful.
Being raped, robbed, beaten and jailed became my daily routine. I saw no hope, and at age 15 I was introduced to heroin by another young girl on the streets. The drugs numbed me to the terrible reality of my existence. But because my pimp did not control the drugs, his violence became even more horrific. I would manage to escape from him and hide out for two or three days, only to be tracked down by him and beaten severely. This was my existence, unbeknownst to my clients or exacerbated by them.
At the age of 19, my pimp seemed to magically disappear. I found out only recently he was taken to prison on weapons and drug charges, although I did not know it at the time.
I believe in every person is a will to survive. For me, that spark still remained though I felt and looked like a walking zombie. One day, I walked into a drug clinic on Manhattan’s east side and my life changed. That day was really the day my life began because of a special counselor who took an interest in me. She located my family back in Virginia and I was reunited with them, never to return to the streets of New York. I slowly tried my best to put my life together with a 6th grade education and no job skills. The task was a daunting one.
One evening over a year ago, I watched a newscast about trafficked teens in my neighborhood and realized that I had to help make a difference. I had the classic epiphany moment. Thus began my advocacy work and public speaking. In the last several months, I have shared my story 26 times in various venues from Princeton to youth camps, and the Rotary Club to the Methodist church. I’ve been on a mission to educate the public about what human trafficking is and how they can make a difference against it.
Dealing With Uterine Cancer
I recently realized that I’ve been leaving out an important part of my story, which I’ve finally decided to tell. When I became aware of how the Adverse Childhood Experiences (ACE) studies applied to victims of human trafficking (1), I was inspired to tell my story of uterine cancer, which I’ve always believed was due to the sexual abuse that I endured.
I guess everything is relative, for me at least. After having survived the streets of New York for over 9 years, the news from my doctor that I had a severe form of uterine cancer was met by an atypical reaction: bring it on. I remember saying to that doctor, “I don’t want to die. And believe me, I will not.” Somehow, after surviving all the beatings, rapes, and incarcerations, I had been prepared for my battle with uterine cancer.
I had most likely been exposed to a number of risk factors that might have helped the cancer grow inside my uterus. While I am certainly not a doctor, I don’t think it’s far-fetched to think that I got the type of cancer that I did due to my history of sexual slavery. Because I was diagnosed with stage-two uterine cancer, I had to have three surgeries, a complete hysterectomy, and the removal of my cervix. I also barely escaped having radiation treatments. When I read the information on cancer.org and mayoclinic.org, I saw that I was not far off with my own thoughts and diagnoses. Research has shown that having more periods during a woman’s lifetime can raise her risk of endometrial (uterine) cancer (2). Young women who start their periods before age 12 have an increased risk of endometrial cancer compared to those who start later. I had my first menstrual cycle before I was ten years-old.
After I escaped from New York and began to piece my life together, I suffered from several medical conditions. People often don’t realize this, but I – like other trafficked children – did not receive medical or dental care the entire time I was growing up and being trafficked. I went from weighing 90 pounds to gaining massive amounts of weight. Research has shown that while the majority of a woman’s estrogen is made by her ovaries, fat tissue will change some other hormones into estrogens (3). Being overweight will increase a woman’s estrogen levels and increase her endometrial cancer risk.
After I was married and began to plan a family, I discovered that I was infertile due to the early trauma on my younger body. I went through surgery and was able to conceive. I develop diabetes while pregnant. Diabetes is common in women who are overweight. After the birth of my daughter, I began to experience very painful menstrual cycles. I was diagnosed with endometriosis, a painful condition where the lining of the uterus travels outside and bleeds monthly when a woman has her menstruation.
Would I have developed cancer if I had not been trafficked? Who knows? But I do know that my troubled health history is something that healthcare providers and researchers need to consider when they treat and study the needs of trafficking victims. I also know this: I believe that once a person has been through the fire of adversity and trauma, if they somehow manage to come through to the other side, if they make it, they are forged into something much stronger and even better than before.
So yes, I am a double survivor, if you will; a survivor of human trafficking and of cancer. The two of which I think are related, just like we know that certain forms of the human papilloma virus, a common sexually transmitted disease, causes cervical cancer (4). The risk factors for cancer throughout my story of trafficking are common among other children who are being trafficked today. I’ve lived through both of these horrific evils and I am stronger for having done so. I believe that I have gone through all I have in my life so that I can be here, now, educating and empowering others. And, I will continue doing my best to share my story of survival.
As for what the future brings, I say…bring it on! I am ready.
Barbara Amaya is an advocate against human trafficking. She tells her story through the first graphic novel written by a trafficking survivor, called “The Destiny of Zoe,” illustrated by John Mahomet. Learn more about her work at www.BarbaraAmaya.com.
References
1. Vincent J. Felitti. “Childhood trauma is linked to chronic diseases during adulthood.” Cancer InCytes. 2013, 2(1):e.
2. Veronica W. Setiawan et al. “Type I and II endometrial cancers: have they different risk factors?” Journal of Clinical Oncology. 2013, 31(20):2607-18.
3. Jongen VH, Hollema H, Van Der Zee AG, Heineman MJ. “Aromatase in the context of breast and endometrial cancer. A review.” Minvera Endocrinologica. 2006, 31(1):47-60.
Broken Until Spoken 