Advocacy and Education

• Host a discussion: Case studies of asylum seekers [1]
• The Refugee Protection Act of 2010 [2]

Host a discussion: Case studies of asylum seekers The Refugee Protection Act of 2010

Creating an Asylum Clinic at Your School!

Physicians for Human Rights’ Asylum Network is a community of hundreds of health professionals who offer pro bono physical and psychological evaluations to document evidence of torture and persecution for men and women fleeing danger in their home countries. Survivors of human rights abuses are entitled to seek safe haven in the United States, but often find themselves immersed in lengthy and complex legal procedures that could ultimately result in deportation— resulting in further abuse, torture, and even death.

The Asylum Network at Physicians for Human Rights conducted 317 evaluations during academic year 2010-11. These evaluations aided survivors of female genital mutilation, LGBT persecution, gang violence, government sponsored torture, and a number of other forms of persecution. 10% of these evaluations were shadowed by medical students and residents through student run asylum clinics.

PHR has partnered with clinics at Mount Sinai, Cornell, UCSF, and University of Miami, and is now working with students to establish a new clinic at Tufts School of Medicine.  These clinics offer not only direct medical training for students and residents, but provide much-needed forensic evaluations to survivors of egregious human rights abuses. Medical affidavits provide clear evidence of persecution, helping to secure legal status for survivors who deserve the chance to start their lives anew in the US.

PHR forensic evaluations are conducted by licensed physicians and residents, psychologists, and clinical social workers.  However, medical students can play a very active role in conducting forensic evaluations. Asylum clinics run by students are a valuable resource, and PHR is always looking to expand to more medical schools.

Steps for medical students to establish an asylum clinic:

1. If your school has a free clinic, see if it can be reserved for a few hours a week [or month] for forensic evaluations.

2. Locate interested physicians who would be willing to conduct evaluations while teaching medical students. Professors, clinicians, mentors, and residents are all great resources for building a team for your clinic. Once identified, have the physicians join the PHR network [1] directly.

3. Identify a PHR-Student clinic point person. This student representative will be responsible for in-taking clients referred by PHR. When the clinic has openings for client evaluations, the point person will notify PHR, who will then send a list of pending clients.

Throughout the process, PHR will be available to answer any questions, provide training materials and example affidavits, and place you in touch with students and mentors from the already operating student clinics.  Please see the example of the clinic at the University of Miami here. [2]

Student clinics are a wonderful way to gain valuable medical training, while directly helping clients in critical need of medical evaluations.  Students who are involved in their asylum clinics can arrange training sessions for students and residents, host meetings to present their asylum work, and continue to get more students and licensed practitioners alike passionate and motivated about helping this vulnerable population.

If you are interested in establishing an asylum clinic at your school, please contact Kelly Holz, the Asylum Network Coordinator, at [email protected] [3].  She will be available to answer any questions, and to provide all of the available resources.

The Asylum Network needs more forensic evaluators— and you can recruit them for us through establishing a student-run asylum clinic. Contact the Asylum Network today!

Creating an Asylum Clinic at Your School! Physicians for Human Rights’ Asylum Network is a community of hundreds of health professionals who offer pro bono physical and psychological evaluations to document evidence of torture and persecution for men and women … Continue reading →

US Immigration Detention and Alternatives: An Overview

Why are Noncitizens in Immigration Detention?

Those without US citizenship, even green card holders, may be deported from the US under certain circumstances.  In most cases, deportation requires a judge’s order.  Deportation hearings take place in immigration courts, where immigrants do not have the same protections afforded to criminal defendants. A lawyer is not provided by the government, even if a person is unable to understand or participate in legal proceedings, and impartial determinations of mental capacity are unavailable.

Immigration detention was formerly used only for those with the most serious criminal convictions or those who posed national security concerns. However, strict immigration laws passed in 1996 drastically expanded the list of crimes that warrant detention, and also implemented mandatory detention for most people caught arriving in the US without valid permission to enter. Any noncitizen accused of being deportable or under a deportation order may be held in a prison, jail, or jail-like detention center until the case is decided.

As a result, immigration detainees are today the fastest growing segment of the incarcerated population in the US.

Detention of Asylum Seekers in the US

Asylum seekers very often flee their homes in acute danger and try to avoid official detection until they reach a country where they hope to find refuge. Because many asylum seekers escape from their countries hastily, many arrive in the US with without adequate identification and are therefore particularly likely to find themselves subject to mandatory immigration detention while awaiting resolution of their cases.

Detention is severely damaging to the health and well-being of Asylum Seekers

United Nations treaties and international laws strongly advise against detaining asylum seekers because detention damages the physical and mental well being of asylees who may have experienced severe persecution or torture. The US government’s plan for health care of detainees has historically focused on “mak[ing] sure [detainees] are medically able to travel and medically able to return to their country,”[1] [1] as opposed to maintaining or improving health.

In a landmark 2003 survey by PHR and the Bellevue/NYU Program for Survivors of Torture, many respondents reported that they had significant difficulty in accessing care while in detention, and nearly half reported that their physical health had declined while in detention. The survey also found that 90% percent of asylum seekers in detention suffered one or more of the conditions of anxiety, depression, and PTSD, and more than 90% of these individuals reported that detention had substantially contributed to worsening their mental health. There is significant variation between different detention facilities, and a lack of comprehensive oversight. Although conditions in some detention facilities have improved since 2003, poor conditions and human rights violations continue in many others due to the lack of standardization and oversight of detention facilities. Between October 2003 and January 2010, a shocking 107 detainees died in immigration detention, many due to documented substandard care or severe neglect of their medical conditions.

Alternatives to Detention

Programs that offer alternatives to detention have proven successful both in ensuring that asylum seekers appear for immigration hearings, and in avoiding incarceration of innocent individuals. In the late 1990’s the Vera Institute of Justice created a pilot program called the Appearance Assistance Program (AAP). Immigrants selected by the government were diverted from detention, received help with establishing community ties and finding “sponsors,” and were required to meet regularly with program staff about their rights and duties in the legal process.  Ninety three percent of formerly detained asylum seekers in AAP appeared for all of their hearings, compared to 78% of a control group who received no special services. Detention is justified only when an individual is determined through individualized review to pose a danger to the community.  Otherwise, asylum seekers should be released into effective alternative community supervision plans.

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[1] [2] Caitlin Weber, “ICE Officials’ Testimony on Detainee Medical Care Called into Question,” [3]CQ Politics [4], June 16, 2008,  (accessed February 25, 2009).

US Immigration Detention and Alternatives: An Overview Why are Noncitizens in Immigration Detention? Those without US citizenship, even green card holders, may be deported from the US under certain circumstances.  In most cases, deportation requires a judge’s order.  Deportation hearings … Continue reading →

How asylum and detention affect health and human rights.

• An Introduction To Asylum [1]
• An Introduction To Immigration Detention [2]
• Dual Loyalty: Should Physicians Always Prioritize The Patient? [3]
• Conditions Of Detention: The Use Of Isolation And Segregation [4]
• Respect Medical Neutrality [5]

How asylum and detention affect health and human rights. An Introduction To Asylum An Introduction To Immigration Detention Dual Loyalty: Should Physicians Always Prioritize The Patient? Conditions Of Detention: The Use Of Isolation And Segregation Respect Medical Neutrality

• How To Contribute To The Asylum Network [1]
• The University of Miami Human Rights Clinic: A Model [2]

How To Contribute To The Asylum Network The University of Miami Human Rights Clinic: A Model

The Immigration Oversight and Fairness Act

The Immigration Oversight and Fairness Act (H.R. 933) is a bill that would stop the worst abuses that occur in the immigration detention system. Each night, the Department of Homeland Security (DHS) holds tens of thousands of immigrants in a patchwork network of jails, prisons, and detention centers around the country. Inmates include asylum seekers, survivors of domestic violence and torture, and people with severe physical and mental illnesses. The health and well-being of these vulnerable immigrants suffers due to inadequate resources to address their needs and inappropriately harsh, punitive treatment in detention centers.

Improvements in Medical Care

The Immigration Oversight and Fairness Act would protect the health of detained immigrants by ensuring that the care they receive meets high quality and ethical standards, and is subject to rigorous, independent oversight. It would require all facilities to maintain accreditation by the National Commission on Correctional Health Care and the Joint Commission on the Accreditation of Health Care Organizations. Common-sense procedures to guarantee good medical decision-making would become standard practice in the detention system: for example, the medical and mental health screenings which are, at present, sometimes performed by immigration enforcement officers would become the exclusive domain of trained health professionals. Strong informed consent protections in the Act would safeguard against troubling incidents that have occurred in the past, like administration of involuntary psychotropic medication to non-dangerous detainees with no history of mental illness.

Prevention of Sexual Assault

Because of fear of deportation, linguistic and cultural barriers, and personal histories of victimization, immigrants are at heightened risk for sexual abuse in detention, and are less likely than other incarcerated persons to report incidents of abuse to facility staff. In spite of this, the Department of Justice recently indicated that the preventive and responsive measures set forth in the Prison Rape Elimination Act (PREA) of 2003 are not required of immigration detention centers. The Immigration Oversight and Fairness Act would step into this void and direct detention facilities to follow PREA, and to provide comprehensive counseling and medical services to immigrant victims of abuse.

Recognition of Immigrants’ Humanity and Dignity

The Immigration Oversight and Fairness Act would make a strong statement in support of the right of detainees to be treated with basic dignity. It would require DHS to write new laws preventing cruel and degrading treatment of detainees, and placing strict limitations on the use of shackling and handcuffing, tasers, restraint chairs, solitary confinement, and similar control techniques.

The Act would also

• Guarantee that detainees can effectively file grievances and are not retaliated against for expressing their concerns;
• Protect detainees’ access to the people and resources they need to manage their immigration cases; and
• Create a strong preference for releasing particularly vulnerable immigrants into community monitoring programs rather than incarcerating them in prison-like detention centers.

The Immigration Oversight and Fairness Act amassed 66 co-sponsors during the Congressional session that ended in December 2010 but has only been endorsed by three lawmakers thus far in the current session: Rep. Lucille Roybal-Allard of California, Rep. Jared Polis of Colorado, and Rep. Barney Frank of Massachusetts.  Please ask your Representative to join these three in standing up for basic fairness and decent conditions in immigration detention!

The Immigration Oversight and Fairness Act The Immigration Oversight and Fairness Act (H.R. 933) is a bill that would stop the worst abuses that occur in the immigration detention system. Each night, the Department of Homeland Security (DHS) holds tens … Continue reading →