In Search of a Safe Haven
It is easy to become caught up in the political tensions involved with refugees and asylum seekers, and the social, psychological, and physical status of these individuals is often given little thought. Physicians, however, are obliged to look beyond such tensions and focus on the well-being and safety of all people.
In the fall of 2012, after becoming aware of a pro-bono clinic for asylum seekers at Cornell University, two medical students at the University of Michigan (UM) conceptualized the idea of a student-led organization on campus that aimed to help asylum seekers gain access to medical care and resources. By conducting a needs-based assessment of the mid-west region and establishing links with the UM Law School, Freedom House Detroit (a temporary home for survivors of persecution from around the world who are seeking asylum in the United States and Canada), and Physicians for Human Rights (PHR), and reaching out to students in their medical class cohort, they co-created the University of Michigan Asylum Collaborative (UMAC). Since 2013, UMAC has been mobilizing health professionals to provide forensic medical evaluations for victims and survivors of human rights violations and human trafficking.
Some of the ‘needs’ identified in the original assessments included conducting forensic medical evaluations, documenting physical and psychological evidence of torture and persecution, and providing medical affidavits that can help support asylum seekers’ cases to stay in the country.
In 2014 and 2015, the UMAC leadership board received (and completed) forty requests through PHR and legal clinics at UM and Wayne State University to conduct psychological and physical evaluations. Each evaluation consists of a small team, including one trained UM physician and two medical students who go through a long, detailed procedure of questioning.
Julie Blaszczak and Anne Phan-Huy, two UM medical students, and clinical professor Dr. Tipirneni in a debriefing after an evaluation.
According to Leah Bauer, former Co-Founder and Co-Executive Director of UMAC, “Psychiatrists have the client tell their story in their own words from beginning to end. Often times, they will have them talk about childhood experiences and their history to paint a picture of their life before the traumatic events that caused them to leave the country.” Because of the emotional distress on the victims and careful collection of details from healthcare professionals, it is common for these procedures to last more than four hours.
Following the evaluation, the pre-clinical and clinical medical students spend a maximum of two weeks writing a medical affidavit, a notarized piece of evidence that can be submitted as part of the application for asylum. “The physicians are very thorough in their work,” Elizabeth Scruggs, former Director of UMAC, claims. “They offer empathy through the interview process and write recommendations for care in a concluding statement at the end of the affidavit.”
Even though the clinic does not provide ongoing and sustainable care, UMAC has relationships with other non-profit organizations that have aligned viewpoints on individuals seeking asylum and provide resources for their clients.
“We work very closely with Freedom House, which provides housing, employment, access to medical resources and care, and legal representation for our clients,” says Bauer. UMAC continuously works on creating stronger bonds with their partner organizations and is exploring the idea of building relationships with other non-profit organizations on campus dedicated to helping refugees in asylum seeking.
“We are currently working with Freedom House in Detroit to complete a patient history program,” Genevieve Allen, Co-Director of UMAC says. “Having a medical record will reduce the number of times clients have to rehash their story to medical professionals and will make medical students feel connected to the patients.” In future years, UMAC hopes to expand the number of trained physicians that can perform evaluations and increase the involvement of faculty and students from surrounding schools (specifically Social Work and Public Health).
The UMAC leadership has doubled in size since its formation and has become devoted to seeing how the organization can develop. “It’s exciting to see how this organization has grown,” Bauer says, “especially when we have put a lot of time and energy into the process. You put your heart and soul into a project and you hope it will be a sustainable enterprise.” Both Bauer and Scruggs hope to stay involved with PHR after they graduate from medical school and will continue to help UMAC embody the values of medicine.
Footnote: The U-M Asylum Collaborative (UMAC) has been accepted as one of five presenters at the Transformative Student Initiated Innovations Showcase during the Association of American Medical Colleges annual meeting in Seattle, Washington in November, 2016. Their submission focused on a new Patient History Program, which was piloted in early 2016 with great success.
Read a related Medicine at Michigan article here.