


The medical analysis of child pornography is an adjunct to the investigation process, although it is not an absolute requirement since most child sexual abuse images clearly depict children. At times, however, clarification becomes necessary, especially when teenagers are included in the evidence. The medical practitioner’s input can be helpful when the question arises as to whether the images are consistent with a child of a certain age or with a child who is younger than a certain age. For example, some statutes call for different penalties if an image is consistent with a child younger than 18 years or 12 years.
Proper Handling of EvidenceDuring the investigation process, a medical analysis is most often sought when the ages of subjects in pornographic images are questionable (ie, do the images depict adults or children?). Practitioners may find the recommendations for handling child pornography beneficial (Table 11-1). When handling these images, practitioners should proceed with caution for the following reasons:
Practitioners must ensure there is no risk of courtroom confusion or possible exclusion of evidence as a result of confusion. For example, when documenting the photographs of a child who has been physically abused and the bruises or injuries are pictured, if those images have not been properly labeled, then the evidence can be excluded since proof does not exist that the photographs were taken of that child. Similarly, if the investigation case number and computer-based image file number of an image are not indicated, it may be difficult to prove that the image pertains to a particular investigation. This attention to detail comes under the same consideration as chain of evidence.
The practitioner must also be able to verify that the images have been secured while in their possession to ensure that there has been no chance of mixing the images with those from other cases. Even if all images provided for analysis are copies of the original evidence, the onus rests on the medical expert to ensure that the review of these images is for a specific case and that images from another case have not been included.
The second important reason that images should be handled with care is to ensure that there is no risk of further exploitation of a child victim. The medical expert should be the most sensitive individual in respecting the child victim and protecting the child from further exploitation. When medical experts testify that they have made a significant effort to respect the privacy of the child victim, even if the identity of the child remains unknown to the examiner, a standard is created for the entire multidisciplinary team as well as the court with respect to the need to protect this victim. In a courtroom setting, the best scenario would be if the forensic medical analysis confirmed that pictured images were indeed consistent with children and that testimony could stand alone without the need for the jury to see the actual images. This scenario affords the least amount of further exploitation and allows a jury to understand that the dissemination of sexual abuse images is illegal.
Receipt of EvidenceWhen contacted to review images, the practitioner should use the original source in order to avoid further reproduction of the images. This rule is especially pertinent if the images have been found on a computer or by another electronic means of storage (eg, CD-ROMs, floppy disks). If the images have been published in magazines or stored as photographs in an album or otherwise, an on-site review of the data is best to avoid the risk of further exploitation of the children in the images. When the images have been stored as videos, the review usually requires personal access because the time needed to conduct a review is significant since there are often multiple images and subjects to be analyzed.
Receipt of Photographs and VideosIf the medical expert can not travel to review the images as a result of time or distance constraints, then the evidence must be delivered in a controlled manner. Within the law enforcement community, this delivery method is often described as “badge-tobadge” and involves coordination between law enforcement agencies. The Federal Bureau of Investigation (FBI), the US Customs and Border Protection, the Department of Homeland Security, and the US Postal Inspection Service frequently handle this form of contraband and are well versed in the appropriate manner of ensuring that the chain of custody is maintained within the United States. The International Criminal Police Organization (Interpol) and its affiliates throughout the world frequently facilitate these issues outside of the United States. The medical expert should be sure to document when and from whom the evidence is received (eg, certified mail, hand-delivered, commercial carrier), and this information should be included in the expert’s case file.
As with most contraband received for evaluation, safekeeping is in order. Child pornography should be kept in a secure place during analysis so there is no risk of a legal challenge that the images were altered in any manner during evaluation. The return of evidence should also be tracked so clear documentation exists. The report of such cases should not be transmitted via electronic mail; rather, the report should be an original document with the signature of the person who evaluated the evidence and the tracking ability of the report provided. This procedure ensures that discovery can be provided in a timely fashion, as deemed by the court system.
Receipt of Computer-Based EvidenceIf copies of images have already been made available for review, the evidence should be provided on CD-ROM so that the medical analysis of individual images can be conducted and the examiner has the ability to enlarge the images if necessary. Evidence should be reviewed in a manner that avoids copying images to the reviewer’s computer hard drive since storage of such contraband could constitute a violation of existing laws.
Sometimes copies of images are provided as printouts. At minimum, printouts should be made in color and should be larger than a typical thumbnail (ie, a file format used by imaging software, usually with a file extension of “.thn”). This enlargement is preferable so that analysis can be made with more ease. If this accommodation is not available, the reviewer may need access to magnification capabilities.
If possible, documentation of computer-based images should include the complete file name of each image. Information should be included regarding the investigation case number, the total number of images considered to have met the criteria of child pornography, and the total number of images provided for medical analysis. Frequently, the medical expert receives only a percentage of the total number of images since thousands or tens of thousands of images may have been discovered at the scene. In such instances, investigative agencies often select images that appear most like children.
Ashcroft v Free Speech Coalition (2002) placed the burden of proof on investigators to ensure that at least 1 image in a collection is of a known victim. Federal jurisdictions require that at least 1 image of child pornography be that of a known victim; state statutes vary, but there cannot be less than 1 known image. Although this ruling made prosecution of child pornography cases more difficult, because most images presently seen on the Internet show unknown children, it did provide a greater motivation to identify children who have been sexually abused in this manner. Consequently, although a medical examiner of pornography may be providing information for the courts, there must have already been at least 1 identified child in order for the case to proceed.
In 2003, the federal statutes of the United States changed when President George W. Bush signed the Prosecutorial Remedies and Other Tools to end the Exploitation of Children Today (PROTECT) Act. This new bill was sponsored by Senator Orrin Hatch and cosponsored by Senator Patrick Leahy. This legislation includes in its definition of child pornography images that, to an ordinary observer, appear to be of an actual minor. The bill also allows the option for the accused to escape prosecution if they can prove that the images were not produced using a real child. The provisions of the bill have 4 components with respect to defining child pornography:
At times, the medical expert may be asked whether digital modification of the images (a process often referred to as morphing) exists. This determination requires advanced computer skills and the ability for an analysis to be made by forensic computer experts who have access to significant image magnification tools and the ability to analyze pixel definition, color variations, and other factors. Forensic medical analysis is specifically for determining the content of the image and not the image’s quality. As a result, it is unwise for medical analysts to try to determine whether morphing was involved in production of the image unless they have received advanced training in the area of computer forensic analysis or have access to a prior report that addresses this issue at the time of medical analysis.
When morphing is obvious, it often includes the image of a well-known person’s face being placed on the body image of someone else. Such images are obvious and can be commented on by the medical practitioner; however, such an inclusion is somewhat frivolous and not necessary for analysis. The medical analyst can use such an image in a trial as a demonstrative aid to ensure that the analysis is serious and does not include nonsensical images.
Purposes of Medical Analysis of Child PornographySeveral purposes of a medical analysis of child pornography exist, including:
— Assessing the victim’s age to determine whether the evidence meets the criteria of the law regarding child pornographyMedical analysis is most often used to assess the victim’s age and determine whether the evidence meets the definition of the law, thereby constituting child pornography. According to US laws, the examiner assesses whether the images are consistent with a child younger than 12 years or between the ages of 13 and 18 years. Other countries may designate different age limits that determine whether images are illegal. It is important to note that a state’s or country’s age of consent may not necessarily be the same age as determined for pornographic production. For example, the age of consent in Canada is 14 years. However, if child sexual abuse images in Canada are consistent with youths less than 18 years of age, they are illegal and contraband.
In assessing the appearance of age consistency, the examination must be as objective as possible. The examiner must interpret the evidence only as it is presented. Speculation should be reserved only for victim identification and location so that all possibilities are considered. However, if the legal question is whether an image meets the definition of child pornography, one should not guess how a person came to appear as they did. One might speculate that a woman may have shaved her pubic hair, but unless the image is part of a video showing that action, an examiner must be objective and interpret only what is present in the image.
The provision of community and mental health support for child and adolescent victims of prostitution presents daunting and unique challenges. First, few providers or programs have the training and expertise to address all of the specific needs of these victims. Victims tend to be treated in a fragmented fashion that reflects the sequelae of their prostitution and victimization rather than the underlying causes. They may be treated for substance abuse, sexually transmitted diseases (STDs), or physical assault injuries, but their need for safety, education, social and trade skills, and protection are too often overlooked. Short-term therapy or treatment may be available but rarely addresses the sexual victimization. This problem is compounded by victims’ reluctance to disclose abuse and the tendency to avoid treatment until their physical health and mental health are severely affected.
The second challenge to providing community and mental health services for young victims of prostitution is that many victims do not want help or are too scared to seek and/or accept it. Many have been extensively groomed to accommodate their victimization while others have been frequently threatened, blackmailed, beaten, mutilated, and tortured by their pimps or perpetrators. Some victims avoid getting help out of fear of being reported to the juvenile justice system, getting placed into foster care, or having to return to the dysfunctional or abusive family from which they ran away and entered into prostitution in order to survive in the first place (Unger et al, 1998). To avoid disclosure and discovery of their victimization, children and adolescents typically and convincingly lie about their age and circumstances. Many victims even continue to deny their experiences of abuse even after service providers share eyewitness accounts, photographic evidence, or the perpetrator’s confession of their victimization.
Once victims of prostitution are identified, service providers face the challenge of gaining trust while complying with child abuse reporting laws and the need for safety plans. Many prostituted youth are generally knowledgeable about child protection and juvenile detention systems and tend to know what information is reportable and which activities are criminal. If service providers attempt to gather information that may result in police or child protective services (CPS) intervention, child or adolescent victims may recant the information they shared, refuse services, and leave quickly without returning.
Healthcare SettingsChild and adolescent victims of prostitution may present for treatment in any healthcare setting. They may enter the setting with medical or psychiatric problems related to their victimization, or they may disclose their abusive experiences after sustaining physical or sexual assault injuries. Other victims may be brought to a healthcare setting after the discovery of pornographic materials or a perpetrator’s confession. Once a child or adolescent is identified as a victim of abuse, protocols for physical and sexual abuse are employed, and the police and CPS agencies are immediately notified. CPS then becomes responsible for developing and enforcing an immediate safety plan as well as follow-up care and support services. Follow-up services commonly include visits to hospital emergency rooms, community child abuse centers, or specialized outpatient settings.
Due to a general reluctance to seek healthcare and fear of being reported, children and adolescent victims tend to seek services only after physical or psychological symptoms become extreme. They may present to emergency rooms, STD clinics, or detoxification units exhibiting symptoms of drug or alcohol intoxication, overdose or withdrawal, suicidal ideation, STDs, pelvic inflammatory disease, pregnancy, or physical assault injuries.
Ambulatory Care ClinicsVictims of juvenile prostitution who continue to reside with their families may present to ambulatory care clinics. In these circumstances, the family may or may not be aware of the child’s victimization. Family members that are aware of, or assist in, the child’s victimization will devise convincing but deceptive explanations for the child’s symptoms. Family members may make attempts to deflect health professionals’ concern and their need to report abuse to authorities by claiming that the child or adolescent is much older than he or she is or that he or she is consensually sexually active with other adolescents.
Emergency Care FacilitiesLaw enforcement officers may bring victims of juvenile prostitution into the emergency room if their victimization is witnessed or if they are found on the streets with significant health problems. A healthcare professional’s level of concern for victimization should increase whenever children and adolescents do not present themselves voluntarily for necessary medical care. This often indicates a need for a comprehensive assessment of risky behaviors that could affect victims’ physical and mental health.
Victims who present in emergency care facilities may exhibit an array of emotions that range from inconsolable crying and shaking to a controlled response. Clinicians may also notice victims exhibiting incongruent affects, such as laughing at inappropriate times. This is common and the victim can still be traumatized by an event. Combative or intoxicated victims may claim no memory or a “black-out” after they wake up with various injuries or find their clothes gone or in disarray. While intoxication may be a factor in lapsed memory, victims frequently deflect questions about abusive experiences they recall in order to avoid discovery and the necessity of someone filing a child abuse report with authorities.
Clinicians who practice in emergency settings need to be calm and reassuring, maintain control of their emotions, give choices to victims, and provide them with developmentally appropriate information. Providing information clearly and simply will serve to prevent victims from becoming further traumatized by their own ideas of what they think might happen and help them to make sense of their surroundings and current experiences (Perry, 1998).
Mental Health ClinicsProstituted youth are known to be at increased risk for depression, suicide, posttraumatic stress disorder (PTSD), and neuroses (Gibson-Ainyetteet et al, 1988; Seng, 1989; Yates et al, 1991). They may present to emergency rooms with acute overdoses or other signs of self-injurious behaviors. As with physical symptoms, children and adolescents are unlikely to present voluntarily for mental health services unless they are in an extreme state of crisis. Clinicians who respond need to recognize that this may be the only time this child or adolescent seeks help and that his or her response may be a decisive factor for further intervention and saving his or her life. Therefore, clinicians should be trained to respond appropriately and to be knowledgeable about their community resources to assist these victims effectively.
Juvenile Detention FacilitiesMany of the children and adolescent victims of prostitution are first identified in the juvenile justice system. About 60% of prostituted youth have had at least one justice system contact (Seng, 1989). They are often arrested for distribution or possession of an illegal substance, public intoxication, running away, prostitution, burglary, possession of an illegal weapon, aggravated assault, or aggravated robbery. While the detention facility presents an opportunity for mandated treatment, the trust and cooperation of detained children and adolescents are difficult to obtain. They are generally angry and uncooperative with the juvenile detention personnel. Many of the case studies presented in this chapter are based on the experiences of juveniles who were detained for extended periods of time. Their histories of victimization were, in many cases, revealed for the first time during their tenure in a juvenile detention facility.
Initial Assessment of VictimsWithin a healthcare setting, the clinician’s role is to identify medical and psychiatric emergencies and to facilitate referral for a more extensive developmental, behavioral, emotional, and family history assessment. The interview approach should initially be symptom-based, and an immediate referral to the clinical therapist or social worker is recommended for a more comprehensive initial assessment and recommendations for further management.
Prostituted youth who present to mental health clinics generally have severe psychiatric and emotional problems; therefore, initial assessments tend to focus primarily on acute symptoms. Compliance with follow-up appointments and assessment is generally poor. The assessment of high-risk health behavior and emotional status should evolve from the presenting complaint. Substance abuse or intoxication leads to questions about nonconsensual sexual contact when intoxicated, home life, support systems, and how the substances are acquired. Symptoms of STDs lead to questions of sexual partners, protection, human immunodeficiency virus (HIV) risk factors, and unwanted sexual experiences. Sexual or physical victimization should lead to questions about sexual perpetrators, access to weapons, and injury mechanisms.
Every effort should be made to interview the child or adolescent alone because the accompanying adult may be a perpetrator, pimp, or nonsupportive parent. The clinician and therapist should assume nothing and ask everything. If victims begin to make vague statements about their feelings or what happened to them, they should be asked to provide concrete expressions (Crisis Connection, 1994). One 14-year-old prostitution victim incarcerated for attacking her teacher said she disclosed her prostitution simply “because someone [at juvenile detention] asked.” Healthcare professionals need to inquire about the number of sexual partners, the genders of their sexual partners, prior STDs or pregnancies, and use of barrier methods. Inquiry into eating and sleeping habits, nightmares, trouble sleeping, and decreased appetite should also be conducted as these symptoms may be a result of PTSD or depression.
Establishing Communication and TrustMost victims of child prostitution do not present in clinical settings by choice. They have not chosen to go to a juvenile detention facility and may not be in the emergency room to escape their victimization. Their belief that nothing can change the destiny of their current lifestyle perpetuates a lack of desire to change their circumstances. This subsequently leads to feelings of cynicism, alienation, and non-
The exploitation of children has been a problem for countless years. Curiosity and trust—innate qualities of children—are normally considered positive character traits, but they can make children particularly vulnerable to sexual predators. Today, under the veil of secrecy provided by electronic technology, the number of exploited children is growing at an alarming rate. The Internet introduces unique and sometimes difficult challenges to the law enforcement community. Jurisdictional boundaries previously recognized by child protection services and police have become blurred. Child exploitation is a worldwide phenomenon. It takes communication and cooperation by those who protect children to bring the criminals to justice.
This chapter reviews the investigative process and the role of the first responder, the uniformed officer, and the investigators and detectives assigned to a case. In most jurisdictions, the first responder is the uniformed officer receiving a call for police. Many times the call coming in is vague, with little information. Therefore, the first officer on the scene is responsible for evaluating the situation and taking the first steps in the investigation. Specialized training and a great deal of experience are required to handle exploitation crimes. The information in this chapter is a culmination of more than 70 combined years of law enforcement experience in the field—experience that includes in-depth interviews with perpetrators. The suggestions contained in this chapter are the result of numerous cases handled personally by the authors and offer a unique perspective into the behavior of the sexual predator. The hope is that this information can help a first responder identify the traits and qualities of sexual predators, effectively elicit confessions, and successfully prosecute the perpetrators.
Preliminary Investigation by First RespondersThe criminal investigative process begins with and is based on a well-documented account of all observations, actions, parties present, and evidence relevant to the initial scene. This compilation of facts and ideas helps determine whether a crime has been committed. It is the responsibility of the law enforcement community to make the critical link between mere suspicion and a formal accusation.
Patrol officers responding to a child exploitation call should consider the following factors as an integral part of the preliminary investigative process:
— The investigation starts immediately on arrival at the scene. Visual observations and details about what is being said are important. In particular, anything said spontaneously that is relevant to the issue at hand should be noted and incor- porated into the initial report. The first responder’s responsibility is to ascertain whether a crime has been committed and if it has, who is responsible.The investigator or detective’s role is to obtain the pertinent information that will allow the case to be successfully adjudicated in court. Communication with the witnesses, suspects, victims, and complainants depends on the communication skill level of the investigator.
Information is the essential catalyst of criminal investigations. The predominant body of information is collected by investigators through verbal communication. It is the unique ability of the investigators that elicits appropriate, useful, and accurate information to allow the case to proceed successfully. Cases are made or lost by the effectiveness of the investigators.
A successful investigator of crimes against children has particular character traits, which include but are not limited to the following:
— An authoritative presence. Authority should be paired with calmness; overall, a confident demeanor is important.The first International Criminal Police Congress was held in Monaco in 1914. Legal experts and police officers from 14 countries gathered together to study the possibility of establishing an international criminal record office and coordinating extradition procedures. The outbreak of World War I halted progress until 1923, when the second International Criminal Police Congress met in Vienna, Austria, and set up the International Criminal Police Commission (ICPC), establishing its headquarters in Vienna. The ICPC, which was essentially a European organization, operated successfully until World War II.
In 1946, a conference was held in Brussels, Belgium, to revive the ICPC. New statutes were adopted, the commission’s headquarters was moved to France, and “INTERPOL” was chosen as the telegraphic address of the headquarters. Interpol, a contraction of “international police,” is the current name of what was formerly called the ICPC. In the year 2004, it had 182 member states.
The principles and procedures governing police cooperation in Interpol have been established over the years. According to Article 2 of the organization’s constitution, Interpol’s aims are as follows:
(1) To ensure and promote the widest possible mutual assistance between all criminal police authorities within the limits of the laws existing in the different countries and in the spirit of the ‘Universal Declaration of Human Rights’;The role of Interpol in the international community is of an educator and facilitator of crime investigations. Interpol is an international source of perhaps the most comprehensive array of information about child sexual exploitation, especially of crimes against children, trafficking of women, and human smuggling. As a gatekeeper of controlled information for the law enforcement agencies of its 182 member countries, Interpol plays a crucial role in the struggle against exploitation. For example, Interpol provides a complete list of international legislation regarding missing children, important information in human trafficking situations. If a child were taken from one country to another to be sexually exploited, the child’s home country would need assistance with performing an investigation in another country and managing the complex legal maneuvers needed to extradite the offenders and rescue the child. Interpol provides missing children posters to help investigators identify victims. In addition, Interpol maintains a Web site of legislation information (http://www.interpol.int/Public/Children/missing/NationalLaws/mcFirst Page.asp). Information regarding commonly used trafficking routes for the smuggling of people, drugs, and other contraband is available through the Web site.
Interpol makes a clear distinction between the smuggling of migrants and trafficking of people. According to Interpol, the smuggling of migrants “shall mean the procurement, in order to obtain, directly or indirectly, a financial or other material benefit, of the illegal entry of a person into a State Party of which the person is not a national or a permanent resident” (Children and human trafficking, 2004). In contrast, trafficking of persons shall mean the recruitment, transportation, transfer, harboring or receipt of persons, by means of the threat or use of force or other forms of coercion, of abduction, of fraud, of deception, of the abuse of power or of a position of vulnerability or of the giving or receiving of payments or benefits to achieve the consent of a person having control over another person, for the purpose of exploitation. Exploitation shall include, at a minimum, the exploitation of the prostitution of others or other forms of sexual exploitation, forced labour of services, slavery, or practices similar to slavery, servitude or the removal of organs (Children and human trafficking, 2004).
Interpol Structure and AdministrationInterpol has 2 governing bodies that meet periodically: the General Assembly and the Executive Committee. The General Assembly is composed of delegates from member countries and has the most authority as a governing body. The Executive Committee is a much smaller group that verifies the execution of the various decisions of the General Assembly. The organization’s General Secretariat, which comprises the secretary general and technical and administrative staff members, is headquartered in Lyon, France. The General Secretariat is responsible for implementing the decisions and recommendations adopted by the governing bodies, maintaining close contacts with the Interpol national central bureaus (NCBs) in the various member countries and for providing the framework for daily international police cooperation. Numerous Interpol subregional bureaus coordinate regional activity and are located in Harare, Zimbabwe; Abidjan, Ivory Coast; Nairobi, Kenya; and Buenos Aires, Argentina. In addition, a European liaison bureau is based within the General Secretariat. Interpol has created a number of expert working groups who specialize in various fields to establish best practices in criminology. These specialist groups provide training as well. The specialist group (the Interpol Specialist Group on Crimes Against Children) is coordinated by the Trafficking in Human Beings branch within the Criminal Intelligence Directorate of the General Secretariat.
National Central BureausExperience has shown that the following 3 factors tend to hamper international cooperation among police agencies:
Child prostitution and the sexual abuse of children by foreigners have existed since ancient times. Historically, soldiers, sailors, and traders have been known to sexually abuse children in the countries to which they traveled. Recorded examples of individuals traveling to exotic, tropical, and primitive locations to have sex with children dates back as far as the last century. While the sexual abuse of children by foreign travelers is not new, it has dramatically increased during the last 3 decades, coinciding with the explosive growth of international travel and tourism, particularly to third world countries. Tourism-related child prostitution has become such a significant problem globally that a term exists to describe this practice—child sex tourism.
Since the 1970s, child prostitution has become a lucrative industry in many thirdworld, tourist-receiving countries. This demand for children has come from locals and foreigners, including tourists, military, travelers, businessmen, and expatriates. The causal factors leading to this growth are multiple, interrelated, and complex. Poverty is undoubtedly the catalyst rendering children, their families, and their communities vulnerable to exploitation. However, child prostitution and child sex tourism could not exist if not for the exploiters—pimps, traffickers, corrupt authorities, lax law enforcement officers, and, most importantly, child sex abusers.
Although historical, cultural, social, and political factors contribute to the existence of child prostitution, globalization is considered the major force behind the rapid international increase and expansion of the child sex trade. The increasing interconnectedness of economies, technologies, and communities that characterize globalization has opened access to vulnerable children everywhere. In particular, the massive increase of international travel, growth of tourism to poor countries, and promotion of child sex tourism through media such as the Internet all contribute to the growth of the global child sex trade. Another contributor to the growth in child sex tourism is that many Western countries have recently begun to crack down against child sex offenders. These countries have done this by enacting stronger laws, increasing law enforcement efforts, tightening employment screening measures, conducting police checks, and compiling and maintaining sex offender databases to track offenders. This tighter scrutiny in some countries has “encouraged” many sex offenders to travel outside of their own country to destinations where they are unknown.
The exact number of children who become victims of child sex tourism is impossible to know. In the early 1990s, it was estimated that in Asia hundreds of thousands of children were exploited in prostitution, and a significant proportion of this demand was coming from sex tourism. During the last decade, child sex tourism has grown into a significant global problem that involves millions of children across Asia, Latin America, Eastern Europe, Africa, and the Pacific Rim Countries.
Concern Raised for Exploitation of Children through Sex TourismAlthough campaigns against sex tourism began in the 1970s when women’s groups vocally opposed the sexual exploitation of women by military personnel and tourists in Southeast Asian countries, it was not until the mid-1980s that the exploitation of children in sex tourism was raised as a concern. This acknowledgment resulted from the following factors:
— A visible increase in the numbers of children engaging in prostitution in Southeast AsiaOne factor that contributed to the concern about child exploitation was the visible increase in the number of children engaging in prostitution on the streets, in bars, on beaches, in brothels, and in tourist areas of Southeast Asia. Various forms of media were instrumental in exposing the growth of child prostitution and child sex tourism by working closely with child rights advocates to investigate the cases. In the late 1980s, several horrific incidents received international attention. In one case, 5 children were found dead and chained to beds after a brothel burned down in Thailand. In the Philippines, an 11-year-old girl was left to die in the street in plain view after an Austrian tourist sexually abused her and left a broken vibrator inside of her body. Also in Thailand, 3 Americans were discovered to be running a shelter for homeless children as a cover for sexual exploitation to visiting pedophiles. Despite this shocking media exposure, Southeast Asian government officials did not react immediately.
Minimization or Actual Denial of the Existence of Child ProstitutionAnother contributing factor that increased the concern about child exploitation was the worldwide minimization or actual denial of the existence of child prostitution. As stories about child prostitution became more publicized, some Asian government officials initially minimized or denied the existence in their countries. This was particularly true for those countries which feared the loss of tourism money. Minimal real data existed to validate that sex crimes, particularly against children, occurred in many countries. Therefore, western government officials denied the involvement of their nationals in child sex tourism because they had no reference database to prove its existence. As a result of the dramatic, worldwide exposure to the problem, combined with the persistent and strategic lobbying of nongovernmental organizations (NGOs) (especially ECPAT), governments and communities in rich and poor countries were forced to admit that child prostitution did exist, that local and foreign nationals were involved, and that governments everywhere had a responsibility to act locally and globally to protect the most vulnerable children in the world from sexual exploitation.