Asylum Seekers in a Time of Record Forced Global Displacement: the Role of Physicians

Abstract

In 2016, over 65 million individuals were displaced from their homes due to human rights abuses, and 262,000 people applied for asylum in the USA. Individuals who have experienced persecution are present in many primary and specialty clinics. A medical forensic evaluation can increase the likelihood of a successful asylum case. This paper reviews the legal framework for asylum and the contribution forensic evaluations can make to this vulnerable population. Physicians without asylum expertise can help these patients by recognizing their legal right to residential protection and referring them to lawyers and physicians with expert skills. Performing forensic examinations of asylum seekers offers physicians the opportunity to collaborate with attorneys, immigration officials, and human rights experts. Clinicians who do this work find it personally and professionally rewarding, especially when they impart their expert knowledge and skills to future clinicians by involving trainees in these evaluations. Physicians who encounter refugees or asylum seekers in their roles as providers or as preceptors should have familiarity with the field of asylum medicine to enhance the comprehensive care they deliver.

Patterns of torture among forcibly displaced Eritreans in California: A cross-sectional study

“…Finally, the high prevalence of significant physical and psychological findings observed in the reports examined underscores the essential role of healthcare providers in documenting evidence of torture on behalf of asylum seekers, in order to assist immigration officials in deciding when to grant the protection of asylum (Dyer, 2019;McKenzie, Bauer & Reynolds, 2019). Clinicians probing Eritrean patients about possible torture or abuse should be aware that persecution is often linked to the patient's tribal, religious or political identity (Abu Suhaiban, Grasser, & Javanbakht, 2019).…”

“…These evaluations document physical and psychological stigmata of torture and other forms of abuse in order to assist immigration officials and judges who are responsible for granting or denying asylum. Forensic evaluations make a substantial difference in the likelihood of an asylum claim being granted, and can be performed by any trained primary care or mental health clinician (McKenzie, Bauer, & Reynolds, 2019).…”

What Should Count as Best Practices of Forensic Medical and Psychological Evaluations for Children Seeking Asylum?

“…There is strong evidence that medical and psychological forensic evaluations aid in providing critical evidence of trauma, torture, or abuse that can significantly affect the outcome of unaccompanied children's asylum cases 10,11,12 and increase the likelihood of being granted asylum. 13,14 The evaluation can also serve to document and raise awareness of issues that necessitate specific resources and services to support the child (eg, mental health treatment and resources, educational supports, and medical care).…”

A gay Nigerian man’s journey to asylum in the USA

“…Unlike refugees, who are granted legal status before entering the USA, asylum seekers must apply to remain in the USA at the border, at which time they may be sent to a detention facility, or after entering the USA 2. Asylum seekers who have physical scars of persecution can benefit from a medical forensic evaluation when applying for asylum 3. While applying for asylum, which may take years,2 some asylum seekers may not be eligible for government-supported programmes, including healthcare services.…”