asylum
a·sy·lum /əˈsīləm/ noun; the protection granted by a nation to someone who has left their native country as a political refugee; a place of safety or shelter
photo by Kiran Naidu on Unsplash
Earlier this year, I began working with the Weill Cornell Center for Human Rights (WCCHR). WCCHR is a human rights clinic run by the medical students at Weill Cornell Medical College with the goal of providing forensic medical evaluations to survivors of torture seeking asylum in the United States.
The United States Immigration and Nationality Act defines a refugee as a person who has fled from his or her country of residence, and is unable or unwilling to return to that country because of past persecution or a well-founded fear of future persecution on account of race, religion, nationality, political opinion, or membership in a particular social group. An asylum seeker, in contrast, is someone who has fled from his or her country but has not yet been granted refugee status. As of December 31, 2024, there were almost 3 million asylum cases pending in US immigration courts.
WCCHR actively seeks qualified volunteers to perform physical, psychological, or gynecological examinations for asylum seekers and their respective attorneys in support of their applications. As a surgeon, I’m able to provide physical evaluations which consist of obtaining a brief history and performing a focused physical examination to document any injuries and scars which might support the claimant’s history of trauma. I prefer to volunteer for cases in which the claimant has specifically requested a woman physician - many of these histories are quite sensitive and repeating them to a man can potentially be triggering. As part of the evaluation, we’re asked to photograph our findings - an easy task for a plastic surgeon since we rely so heavily on images for documentation. The attorney requests an affidavit within a period of time, and if I’m lucky I even have a medical student who can assist me with this aspect. None of this is difficult and the evaluation requires a fixed but not extensive amount of time.
But here lies the challenging aspect - each claimant’s attorney sends a detailed affidavit prior to to the evaluation for our reference. These contain some of the most painful histories I’ve heard in my 28 years as a physician, and very commonly include reports of domestic abuse, gang violence, torture, and sexual assault, often all within one case. During my evaluations, which are only for the physical and not the psychological aspects of the claim, I try not to ask the claimant to describe these incidents again in detail as they’ve already done so in their personal affidavits - it’s frankly not necessary for my part of their case and would be intensely traumatic for them to relive these moments again.
The young women I meet during these evaluations have been through a lifetime of pain, often endured from childhood. But I’m most struck by their quiet resilience - they’ve left their homes, families, and possessions, often alone, with little more than the clothing on their backs, arriving with nothing more than a request for peace in which to begin their lives again. Their stories certainly serve to put our own lives into great perspective. As I told the two medical students who observed me during my last evaluation, I feel that I benefit more from the evaluations than the claimants do - I lend my credentials, clinical photographs, and a few hours of time for support of their claims for asylum, but they generously share their stories and allow me to find some balm for my soul.
Surprisingly, and regrettably, WCCHR often struggles to find enough clinical evaluators for their physical examinations. When the medical students recently with me asked me why I thought this was such a challenge, I had to look into their intelligent young eyes and break the news to them that most people of my generation just don’t seem to care any longer. I remember that everyone with whom I entered medical school had strong opinions about how we wanted to see medicine change, and particularly the need for greater equity within health care across gender and race. Perhaps the kaleidoscopes that reflect our lives simply shift in unpredictable ways as we age, changing what we believe in and whether or not we’re still willing to fight for our ideals.
While I prefer not to use this platform to expound upon my personal views on the changing face of asylum and immigration in this country, most would agree that this is a time of global upheaval. No single person can change an entire system, but as individuals it is still possible to make life better for one person as at a time. We each have our own version of what constitutes asylum, where we find our particular calm in the middle of an increasingly chaotic world. This small act has been mine.
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Weill Cornell Center for Human Rights (WCCHR) is a medical student-run human rights clinic dedicated to providing forensic medical evaluations to survivors of torture seeking asylum in the United States. Founded in 2010 through a partnership with Physicians for Human Rights (PHR), WCCHR is the first student-run asylum clinic at a US medical school and has been described as a "model for future asylum evaluation programs."
WCCHR is always looking for dedicated volunteers and collaborators. They collaborate with a range of professionals, including physicians, psychologists, social workers, advanced practice providers, medical students, lawyers, law students, and not-for-profits, among others. To learn more about WCCHR, donate, or volunteer, please visit https://humanrights.weill.cornell.edu/ or email wcchr@med.cornell.edu.
references:
8 U.S. Code 1101- Definitions. Legal Information Institute. Cornell University Law School.
United Nations High Commissioner for Refugees. 2013. UNHCR Asylum Trends 2012.
Hexom, B., Fernando, D., Manini, A. F., & Beattie, L. K. (2012). Survivors of Torture: Prevalence in an Urban Emergency Department. Academic Emergency Medicine, 19(10), 1158-1165.