Known as the ‘Rocket Man’ - because of his love for firing projectiles into the sky at family occasions - Chris became a volunteer straight out of medical college and, for over forty years, as the major issues of the 20th century unfolded – Civil Rights, wars in Africa and the Middle East, the AIDS epidemic and world poverty - he travelled around the globe bringing health care to children at risk. He was a larger than life character: bi-polar, a Quaker and a passionate believer in the power of medicine not only to heal children but also to free from them the cycle of poverty entrapping them.
Rocket Man tells the story of this extraordinary man’s life of service and its effect on those around him through rarely seen archive footage, interviews with family, friends and colleagues and film of Chris working in the field. At the heart of the film are two trips Chris makes to Haiti to set up and monitor a health program at an orphanage for 200 poor and abandoned children. The project takes Chris on a roller coaster ride of frustrations, guilt and recriminations and gives us a dramatic insight into the triumphs and challenges associated with being a volunteer in the developing world.
Rocket Man. Since my last post I have been putting together a 90 minute edit of my documentary about Dr. Chris Hansen, combining all the new footage I shot of Chris’s family and colleagues with the material I filmed of Chris in Haiti several years ago. After screening the film to other film makers I decided to create slightly more concise version of the film which would have a tighter storyline and be more suitable for television and other screenings. With some further funding, I was able to employ filmmaker Deborah Dickson as a script advisor to help re-edit and cut down the 90 minute version of the film. (The longer edit – which deals a little with Chris’s influence and legacy, will still be made available as will a more concise 10 minute version for schools).
Deborah is a visiting professor at the School of Visual Arts in New York and an award winning film maker best known for documentary features Ruthie and Connie: Every Room in the House, and Oscar nominated LaLee's Kin: The Legacy of Cotton. As well as helping make cuts and advising how to strengthen the story, Deborah suggested changing the title from Giving, to Rocket Man to open the film up to a wider audience with a more enigmatic title. His son Jona calls him the ‘rocket man’ and, in one of key scenes in the film, surrounded by his family, Chris talks about finding the "ultimate escape" away the stresses of his work by setting off rockets with his children. He describes the experience as a “magical wistfulness” and he feels he is, “going up with the rocket, and out into space,” away from it all.
Although I was fond of the title, Giving, I believe that Rocket Man is more original and fits with Chris’s anarchic sense of fun and reflects his peripatetic life as a doctor and volunteer. All the original themes of Chris’s fight for social justice, and lifelong service towards others, are still at the heart of the film. Of course the new title immediately brings to mind the Elton John song and I am investigating the possibility of getting permission to use a rerecording of the track for the rocket flying sequences in the documentary. For the soundtrack to the main body of the film I am in discussions with Canadian musician and composer Michael Brook (Affliction, Into the Wild, Brooklyn) about using some of his music - all of which is very exciting! I have posted a new 5 minute trailer of the latest version of film.
GIVING DOCUMENTARY UPDATE - New Trailer
With grants from the Obadiah Brown Fund and the Jonathan E. Rhoads Trust in 2013 and 2014 plus support from Friends, I have been completing the filming of interviews with Chris’s friends, family, and professional colleagues and editing the material into a feature length documentary (90 minutes).
I am getting very close to completing the documentary and if my current grant application is successful I will be able to license music, archive video footage, and then do the sound mix and final edit of the film. Meanwhile I have cut a new trailer to show how some of the recent material I have shot has been incorporated into the documentary.
This latest trailer focuses on Chris’s work in the Mississippi Delta in the 1960s -a time of great change for America and an emotionally challenging time for Chris, which was to severely affect his long-term health. It introduces two physicians he met there: Dr Jack Geiger, founding member and president of Physicians for Human Rights and Dr Robert (Bob) Smith, Executive Director Central Mississippi Health Services, Inc. who were to become hugely influential figures in his life and on his career.
DELTA HEALTH CENTER - A NEW WING OPENS, DEDICATED TO DR. H.JACK GEIGER
In August 2014 a new state of the art medical facility, the H.Jack Geiger Medical Center was completed in Mound Bayou and was dedicated to Dr.Geiger.
The new Health Center is part of the legacy of the work done in the 1960s by Jack Geiger, Chris Hansen, Bob Smith and others to create a new form of health care. Jack had spent time in South Africa, training in a revolutionary new healthcare system called Community Orientated Care, developed by a physician couple, Sydney and Emily Carr. Their idea was to create health centers in remote areas of the country, which would be responsible not only for the health of individual patients but also for the entire population. It was a merger of what then was called public health and clinical medicine and the centers would provide not only prescriptions for sick individuals but also food, sanitation and education for the whole population.
At the opening ceremony, Dr. Geiger said, "This was a collective effort involving so many. Looking back, I have been the one who has been enriched beyond measure. I made friendships for life with those who understood what was possible. They were charged to make change and had the courage to go on."
There are now effectively 9,000 health centers in the United States, talking care of 22 million people. Nothing that Jack and his fellow doctors dreamed of in the beginning. He said that for him the fact that young people would be inspired by his work to join the healthcare profession and help others, was the true legacy of his work at the first Delta Health Center in the 1960s.
"I am pleased to announce that next summer students in the medical profession will have an opportunity to train here through the National Medical Fellowship funded by the GE Foundation," said Geiger at the ceremony.
CHRIS HANSEN: CIVIL RIGHTS AND THE BIRTH OF THE HEALTH CENTER MOVEMENT
In the spring of 1966 Chris was working in Mississippi ensuring hospitals seeking federal funds were complying with civil rights act and not segregating patients into separate wards. He was guided in this work by a local doctor called Bob Smith who suggested to Chris that he help the movement by volunteering his medical services for a forthcoming march. The activist James Meredith had been shot while on a protest march from Memphis to Jackson, and Bob Smith was helping organize the March Against Fear, to continue the protest.
It was a fearful time to live in the South doing what Bob Smith and other doctors were doing for the cause of civil rights. Bob explains, “It was the only time in my life I registered a gun…My life was threatened more times than one. I was harassed, taken to jail just for practicing medicine, doing what I thought was the best to do in my life, and that was to serve people and practice medicine.”
In June 1966 the March Against Fear got underway, but in the town of Canton, where the marchers had decided to camp for the night, they were attacked. The Mississippi state police invaded the camp, firing tear gas into the crowd, and beating the marchers with baseball bates and rifle butts. All night Chris tended to people wounded by the police and was proud to say he had poured water in the eyes of activist Stokely Carmichael after he had been blinded by the tear gas attack.
With the march successfully reaching its destination in Jackson, Chris was scheduled to leave Mississippi, when Bob Smith told him about a group of doctors from the civil rights struggle who were now working on new form of health care, which would also be a force for social change. The place chosen for this new scheme was the all black town of Mound Bayou and the doctor running it was a young professor from Tufts Medical School in Boston, called Jack Geiger. Jack had spent time in South Africa, training in a revolutionary new healthcare system called Community Orientated Care, developed by a physician couple, Sydney and Emily Carr. Their idea was to create health centers in remote areas of the country, which would be responsible not only for the health of individual patients but also for the entire population. It was a merger of what then was called public health and clinical medicine and the centers would provide not only prescriptions for sick individuals but also food, sanitation and education for the whole population. Jack told Chris he was looking for pediatricians to come and help with the new project.
Chris was tremendously excited by the idea. He felt he had found the social justice project he felt had spent his life preparing for and he immediately signed up for the opportunity -impressing Jack Geiger with his commitment. “Chris was somebody who went looking for those opportunities and so it was amoral crusade for him an well as a medical crusade, and a crusade for social justice.”
Bob Smith saw Chris’ desire to join the project as reflecting his inner beliefs. “Besides being a physician, Chris had a deep abiding faith that all men are created equal, a deep abiding faith of empowering people, a deep abiding faith that all men deserve to get healthcare. So here he saw this combination of social human rights, civil rights, direct medical care all in one package. So that was a triumphal moment for Chris.”
Having decided that this was the job for him, Chris then had to go north and try to persuade his wife Alix to bring their three small children from New Hope, PA, to a ramshackle town in the heart of the Mississippi Delta to live.
Jack Geiger had recruited mostly pediatricians like Chris, because there were so many young children to take care of. “Able bodied people with the collapse of the sharecropper system and the mechanization of cotton agriculture had gone north to Chicago or St Louis or whatever in search of work. And there were Chris, a pediatrician named Roy Brown, another pediatrician named Leon Kruger that constituted the core of the staff, and Chris was the most dedicated and the funniest of all of them. And by funny I mean a wonderful sense of humor about the work, about the circumstances about his commitment to patients, and about living there.”
Chris and his family moved into a trailer in the center of town and Chris began work. He was immediately shocked by how the rural poor people were eking out a living in the Delta. Conditions were worse here than he had seen in the emerging world. Bob Smith gives a vivid and disturbing picture of what it was like, “The income of blacks was 600 to a thousand dollars per year. Most lived in substandard housing with outside privies. Conditions were just deplorable. Most of them squatting on plantations. Medical care was essentially non-existent. Chris would come in the clinic and I would work on one hall and he would work on another and it wasn’t unusual for us to have 40, 50, 70 patients waiting to see us in one day. And at that time we didn’t have the luxury as we have today of having a specialist down the hall but was overwhelmed sometimes by the level and complexity of these high level medical problems we would run into every day.”
Sometimes the doctors at the Health Center felt that no matter what they did, they weren’t really making a difference, and this feeling gradually began to overpower Chris. Jack Geiger was concerned about the impact of the conditions on his staff, “Fatigue and exhaustion and some depression could be a problem. The schools weren’t easy for Chris’s kids and think that was a concern when you’ve got worries about what you’re subjecting your family to. Chris and all of us started to develop some burn out.” Chris became depressed and eventually he felt he couldn’t work but had to go back up North with his family. This was also the beginning of a form of depression that was later diagnosed as bi- polar disease, which was to dog Chris throughout his career.
“One legacy very obviously is that there are effectively 9000 of these places in the United States now and they are talking care of 22 million people. Nothing we dreamed of in the beginning but something really important. A different part of the legacy is the fact that you discover young people who are inspired by it and aspire to do the same kind of thing – what more could you ask as a legacy?” Dr. Jack Geiger
In August 2014 a new state of the art medical facility, the H.Jack Geiger Medical Center will be opened in Mound Bayou, dedicated to Dr.Geiger.
CHRIS HANSEN IN MISSISSIPPI - A STORY FROM JACK GEIGER
In 2014 I filmed a interview with Dr Jack Geiger, Professor Emeritus of Community Medicine at the City University New York Medical School. Jack founded the 1st community health center in America, in Mound Bayou, Mississippi in 1965. I interviewed Jack for the documentary and he was able to tell me some wonderful stories about Chris. Unfortunately I am not able to include all of them in the documentary, so I am sharing them here. He told a story about how Chris used his talent as a comedian to send up the absurdity of life in the South at that time, just after the signing of the Civil rights Act.
”We had all of this opposition from the white power structure in the medical associations. But they were pretty predictable. We couldn’t be vetoed by the Governor because of a quirk in the law. They regarded this as probably a subterranean civil rights activity and certainly if not that, a brand of Soviet communism. Mississippi was certainly a dangerous place, in terms of white resistance on the ground level. We would go down to the nearest substantial town – 10 thousand 12 thousand people, Cleveland Mississippi, 10,12 miles away where they had real restaurants - every so often. And perforce, this is 1966 now, as an integrated group men and women black and white, for dinner. And a crowd of onlookers would form. They weren’t necessarily actively hostile but they had never seen this before in Cleveland Mississippi. The civil rights act had passed and so there was no question of people being turned away and I don’t think we ever had that kind of experience, at least in a large enough group – and so there we were men and women white and black at a table and there’s people kind of looking furtively and Chris would walk up to the cashier or somewhere else in the restaurant in the middle of the meal, just on his own, spontaneously, that was when I learned from him that he had made money while he was a medical student or a resident for imitating different neurological symptoms for the benefit of medical students. So he could do Syphilitic Foot Drop, Parkinsonian Gate, Verbal Salad Stroke Talk - whatever one wanted. So Chris would amble in front of this crowd up to the cashier, would Footdrop on the way up and Parkinsonian Symptoms on the way back. It was kinda his response to being observed in this way. It amused us. I don’t know if the crowd understood it but it was typical Chris response to an adverse circumstance.”
GIVING, FILMING OF INTERVIEWS STARTS
Michael has begun the next stage of filming for the documentary. Various of Chris' family members in Pennsylvania and New Jersey have now been interviewed, and most recently Anne Hansen, the director of the Neonatal Clinic at Boston Children's hospital was filmed working with the sick children in the Intensive Care ward there. She talked about her work at the Boston hospital and how it compared with her work with the organization Partners in Health in Rwanda, where she is treating children in rural areas and setting up a child health care protocol for the hospitals to adopt throughout the country. In the interview, she revealed how Chris Hansen's humanistic approach to pediatrics, influenced her and eventually helped persuade her to take up medicine. She discusses the concept of GIVING and tells us how the voluntary work in Rwanda, where she can focus on individual problems, albeit in a difficult and challenging environment, helps her to deal with the high tech world of intensive medical care in Boston Children's Hospital. Perhaps a distant echo of Chris Hansen's influence, and Anne's work in Africa, can be seen at the hospital's Neonatal ward which has a 'family friendly' policy, allowing parents to be with their sick children at all times - something that Dr. Chris Hansen's would certainly endorse.
GIVING DOCUMENTARY AWARDED GRANT
GIVING is a documentary feature film, directed and produced by Michael Coulson. Shot over 7 years, the film tells the moving story of pediatrician Dr. Chris Hansen and his desire, inspired by his Quaker beliefs, to help malnourished and sick children all over the world.
Michael is currently raising funds for the movie and has been awarded a grant from the Obadiah Brown Benevolent Fund and matched their grant with funds from private donors for more filming. The documentary shows how Chris Hansen lived and worked, to a moral code inspired by his Quaker faith. Michael has reached out to Society of Friends at Haverford meeting and Buckingham Friends meeting in New Hope. He shared his proposal with them and gave a presentation of an excerpt from the film. Michael has asked Friends to contribute to the film by being interviewed talking about Chris Hansen and his beliefs and how they motivated him in his life. Michael intends to meeting with them at intervals to discuss how the project is developing.
When the documentary is completed, as well as pursuing options for broadcasting to a wide audience via television and the internet. Michael feels there is strong educational component to the documentary and hopes to distribute the film to schools where it will hopefully inspire a new generation of ‘Chris Hansens’. Chris liked to visit schools and colleges in the Philadelphia area to speak with students and younger children about his work and Michael plans to continue this outreach. Michael recently gave a presentation about the film to friends at the Buckingham Friends Meeting, and has been invited to present the film as a work in progress at the William Penn Charter School.It is hoped he will be able to present many more such talks to young people.
Michael has set up a GIVING Facebook page: https://www.facebook.com/pages/Giving/344385402358607
click this link to go to the GIVING website: https://threehumansinc.com/Haiti_Giving/Haiti_Giving.html
GIVING. ABOUT THE DOCUMENTARY
'Giving' is a feature length documentary film directed by Michael Coulson about Quaker pediatrician, Chris Hansen who has spent his whole life trying to help sick children around the world. The film specifically investigates the problems he encounters in Haiti as he tries to help the children in an orphanage in Port au Prince, and also reveals the overall effect that his work has had on the many people who have been touched by him and his life of giving.
ABOUT THE PRODUCTION
Directed and produced by Michael Coulson, ‘Giving’ is currently in active production. Shot over the last 7 years, the film tells the moving story of pediatrician Dr Chris Hansen and his desire, inspired by his Quaker beliefs, to help malnourished and sick children all over the world.
The son of a clergyman, who converted to Quakerism, Chris Hansen, who died this year aged 77, followed his Quaker beliefs all his life in an effort to give back to the disadvantaged of the world. He was a volunteer for forty years, and during that time he worked with volunteer organizations at most major catastrophe sights in the world. He provided medical care to Apache Children in Arizona, worked with the Peace Corps in Turkey, at a rural health center in Mound Bayou Mississippi, where he became involved in the civil-rights movement, and helped treat abused children in Trenton Pennsylvania. From his home base in New Hope PA. he continued his travels around the world, taking trips to trouble spots in Nigeria, Vietnam, Iraq and Haiti.
The documentary follows Dr Chris Hansen on two of his trips to Haiti where he is providing ongoing support for an orphanage and school in Port-au-Prince called RENMEN, run by Haitian resident Florence Thybulle. At the time of filming, Chris is soon to retire from the medical profession, and is in failing health, but has nonetheless become the major donor for the project, which provides shelter and relief to homeless children in the capital of one of the poorest countries in the Developing World. This new responsibility means Chris, aged 70, must raise funds from the Quakers in the U.S. throughout the year and then travel to a center for poor, sick or homeless children in Port-au-Prince, Haiti.
Through weeks spent in close in contact with Chris, the film reveals the difficulties and stresses he faces as he tries to fulfill his obligations and make a difference to the lives of the young children there. Even before the recent earthquake which devastated Port-au-Prince, children were living there in conditions of extreme poverty. In the film Chris describes how the Haitian infant mortality rate is more than ten times higher than the infant mortality rate in the U.S.
The film presents a portrait of a deeply thoughtful man who struggles through a history of depression and ill health in order to stand up and follow his beliefs. In moments of extreme stress, Chris shows another side of his personality - as a funny unconventional man who uses humor as an antidote to the suffering he constantly faces. Chris loved children and loved toys and in footage shot of Chris with his family at their home in New Hope, Pennsylvania, we see his playful character on full display as he pursues his favorite pastime of ‘rocket flying’.
Chris, who sadly passed away this year, was concerned all his life, that he wasn't doing enough. But even after being diagnosed with a rare form of leukemia he still carried out his volunteer duties at a soup kitchen in Trenton – giving back to the end.
Preliminary editing of a rough cut of footage shot in Haiti and the United States has already begun. It is planned to film a series of interviews, in the style of a Quaker meeting, of people who have been touched by Chris during his lifetime of giving. Then post production will continue to a final cut of the documentary, which will be presented to film festivals in 2014.
It is hoped the film will be shown to young people as an example of what one man achieved in his lifetime and inspire them to choose a career path working for social justice – just like he did. Dr Chris Hansen was a role model – a man who made a difference to the lives of the people he came in contact with, and hopefully by watching him struggling to make a difference to others, we can’t help but reflect on what we are doing with our own lives.
FILMING IN HAITI
I had met Dr Chris Hansen, a Quaker pediatrician from New Hope Pennsylvania, and I knew he was involved in medical work with children in Port-au-Prince. I was interested to witness the situation in Haiti for myself. I talked to him and learned he was planning another trip to a school in Port-au-Price funded by the Quakers at the Philadelphia Yearly Meeting . I asked if I could come along and I suggested I could record his work and maybe make a film about him. I could see that he was not very happy about being the focus of attention. When I suggested that I would direct my camera away from him and towards the children, and that the resulting material might bring attention to their plight and help raise funds for the mission, he agreed to let me come along. This was to be the first of two trips with the intrepid doctor..
Dr. Christian Hansen: Pediatrician
With a long white, a "Quaker Oats" beard and khakis, Chris is a naturally photogenic character; I trailed this hymn singing, story-telling, lovable eccentric around Haiti on two trips to Haiti. The resulting footage shows the foreign doctor getting into difficulties, trying to reconcile his personal and religious beliefs about "right-sharing" or giving, with the frustrations and suspicions of the people he is trying to help, particularly with Florence Thybulle, a Haitian aid worker who is the recipient of his funds.
The son of a clergyman, who converted to Quakerism, Chris, 70, has followed his Quaker beliefs and helped the disadvantaged of the world most of his life. He has been a volunteer for forty years. During that time he has worked with volunteer organizations at most major world catastrophe sights. Now on the point of retiring from the medical profession, and in failing health, he has become the major donor for a project, which provides shelter and relief to homeless children in the capital of one of the poorest countries in the Third World. This new responsibility means Dr Chris Hansen, 69 must raise funds from the U.S. throughout the year and then travel several times a year to a center for poor, sick or homeless children in Port Au Prince, Haiti.
As I watched Chris navigate the moral twists and turns (hope, trust, guilt, disappointment) of his new role, I also began to understand the benefits and the pitfalls which befall the individual citizen should they decide to shoulder the burden of poverty relief and medical care in the Third World.
Chris is no longer a young man and he finds navigating the unpaved streets of Cite L'Eternal in Port-au- Prince in the blazing sun takes a toll on him. As he takes a break beneath a shady tree at his hotel, I asked him what motivates him. Is it really necessary for him to be making site visits in his seventieth year, or is he exorcising some personal guilt?
He says that he, "Just tries to share a little of what he has with others".
Florence Thybulle: Founder, RENMEN school and orphanage
Florence Thybulle is a divorcee from a large Haitian family. She started her program several years ago in a poor area of Port Au Prince, wanting to help children in need and to create a large family around her. She has been very successful and has created a well-run safe environment for poor and abandoned children, which is a combination of orphanage and day school. Called RENMEN, The children's center has more than 200 children aged from birth to ten years, and she provides them with schooling and one meal daily.
Florence's back yard is a place where mothers and children spend their time, sometimes waiting for a meal, where the nurse's aide teaches the mothers about basic nutritional needs, breast-feeding and proper hygiene. There is a basic playground with only a few toys available, so the children spend their time singing, playing, and participating in social games.
I talked to Florence Thybulle about what it's like to be on the other side of the "giving business".The children's basic needs are immense. Chris, with whom Florence has had a close and sometimes stormy five year working relationship, has tried to provide support for the clothing, bedding and food, but the money he provides arrives sporadically and Florence is frustrated and angry. I witnessed these frustrations boil over on my second trip to Haiti when Chris struggles to salvage the Quaker mission.
Chris has helped Marcel, a Haitian National who has worked in the USA, set up nutrition and a basic educational program for the children, with regular child health screening and treatment as well as a developmental component. Dr Sever provides immunizations when vaccines are available and affordable. Marcel does not receive any money for his work at RENMEN unless Chris sends it to Florence. I filmed an uncomfortable interaction between Marcel and Chris one day at the school. Marcel was voicing his frustration with the unpredictable nature of the Quaker funding and was telling Chris he is unable to keep working for nothing. Chris was pretty down after this altercation. I could tell the responsibility was getting to him. Later, at our hotel Chris spoke with me about how he sometimes finds it difficult to take the criticism after working to raise money for the project. It feels like he can never give enough.
The great question of this new century is whether the age of interdependence is going to be good or bad for humanity. The answer depends upon whether we in the wealthy nations spread the benefits and reduce the burdens of the modern world, on whether the poor nations enact the changes necessary to make progress possible, and on whether we all can develop a level of consciousness high enough to understand our obligations and responsibilities to each other. We are all going to have to change
Haiti's health statistics help illustrate what that overused word "poverty," actually means to the people living there. The average Haitian life expectancy is about fifty years, compared to seventy-seven in the U.S. The Haitian infant mortality rate is seventy five deaths per thousand live births, more than ten times higher than the infant mortality rate in the U.S. Only about half the Haitian households have access to wells or improved water sources and only about half the Haitian population can read and write. And yet - here is the grace - I saw children from homes without running water walking proudly to school, wearing immaculately clean, crisply-ironed uniforms. I couldn't figure out how the parents did it.
Haiti's that kind of place tragic and exasperating, but deeply spiritual and full of surprises.
Chris Hansen MD: In The Name Of The Children
In 2004 Haiti commemorated the bicentenary of its independence from Colonial rule. As the clock struck midnight, Haitians should have been dancing in the streets, celebrating the 200-year-old birth of the world's 1st nation of freed slaves, justly proud to be part of an island community with such a glorious history.
Unfortunately Haiti's spectacular achievement struck such fear into its former Colonial masters, who foresaw revolution spreading to other colonies in the area, that the new Black Nation was soon isolated from the western world. It's arguable that over the centuries since the revolution, Haiti has been systematically punished by French, British and American powers, for daring to break free from a system beneficial to their global economies.
Today, in a new age of global economics, Haiti's future is being decided by the same countries that once ruled and then abandoned it. After years of sanctions, which have been making one of the poorest countries in the world even poorer, America and the EEC are finally considering unfreezing multi-billion dollar loans promised to Haiti to help rebuild its crumbling infrastructure. Haiti has massive economic, environmental and health problems, particularly in the area of infant and maternal care with the highest mortality rates in the Western Hemisphere. With so many issues affecting its existence now hanging in the balance, it is timely to focus on Haiti as symbolic of many Third World countries trying to survive in the new global economy.
Because there is no official American or European aid for Haiti, a gold rush of well meaning folk, mostly from the United States, have made huge sacrifices at home, and descended upon the country to set up orphanages and medical facilities. Some facilities are excellent and have a world class reputation. But many organizations are set up by inexperienced people who have been led to Haiti by what they describe as a direct call from God. Because there is no real government regulation or supervision, the concern is that many of the organizations don't supply the care Haiti needs or in the worst circumstances are fronts for exploitation.