MUSC students try to help asylum seekers

Thirty students at the Medical University of South Carolina are involved with an asylum evaluation clinic for people fleeing their home countries. The goal is to document evidence of physical and emotional trauma to bolster their cases when they go to court to try to prove they qualify for asylum in the U.S.

Brian Elmore, a student in the College of Medicine and former Peace Corps volunteer, started the clinic through the nonprofit organization Physicians for Human Rights. Other medical schools working with the PHR to run asylum clinics include the Columbia University College of Physicians and Surgeons, the Georgetown University School of Medicine and Harvard Medical School.

“Asylum seekers are one of the most marginalized and demonized populations,” Elmore said. “But they’re fleeing real danger. I think it’s important that we do our best to use the medical skills we’re learning to try to support their asylum cases.”

Donna Kern, M.D., senior associate dean for Medical Education in the College of Medicine, called the clinic valuable for the students. “They hone their clinical forensic evaluation skills while gaining tremendous insight and perspective. They practice empathy and compassion and learn about important human rights issues.”

Students in MUSC’s colleges of medicine, dental medicine and health professions are involved with the clinic, serving as assistant evaluators and interpreters. “A clinician is paired with a student and performs the forensic medical and psychological evaluations of asylum seekers, documenting signs of torture, trauma and abuse,” Elmore said.

 

The clinicians he’s referring to are doctors who also serve as assistant professors in the College of Medicine, Sean Haley, M.D., and Cristin Adams, D.O. They, along with another medical doctor and a psychologist, work with the students and asylum seekers on their own time in an off-campus location.

After each exam, Elmore said the student writes the first draft of an affidavit documenting their findings. “The student and the clinician then collaborate to come up with the final draft of the affidavit that we give to the asylum seeker’s immigration lawyer.”

So far, the student-run clinic has done more than 20 evaluations with asylum seekers from Guatemala, Honduras, Mexico and Nicaragua. Most are women, Elmore said.

He knows that asylum is controversial. “You talk to people in the community, and they say the asylum seekers are making stuff up so they can stay here. But it’s obvious from performing these evaluations that they have been seriously abused in the past - traumatized in their home country, often traumatized on the journey to America and traumatized at the border.”

Haley and Adams described what they’ve heard from the asylum seekers. “Stories of severe physical abuse. Sexual abuse. Harassment. Threats of violence. Actions of violence against family members. Threats of violence against families. Murders of siblings,” Haley said.

“Murders of family members,” Adams continued. “And threats of, if people were to come back to their home country, they would kill them and their children. And definitely a lot of threats to children. A lot of emotional abuse in general.

“A lot of times, our exam is literally the first time they’ve really talked about it openly, been asked about their feelings and symptoms related to what happened. They’ve been forced to be stoic until now. They’ll start crying and saying, ‘I’m sorry this is the first time anyone’s ever asked me these questions about my experience.’ No one we’ve seen so far has been in treatment for anything, even though they have really severe psychiatric issues as a result of these traumatic experiences.”

The asylum seekers are living in South Carolina, Georgia and Louisiana, waiting for their time in court. So far, two have qualified for asylum under the Violence Against Women Act. “According to the lawyer, the evidence of abuse we presented was crucial to their approvals,” Elmore said.

A judge denied asylum for three other people seen by the MUSC clinic. The asylum seekers are appealing those decisions. “Our district immigration court is one of the harshest in the country, approving only 7.4% of asylum cases in fiscal year 2019 versus 32.3% nationally,” Elmore said.

While the odds are not great, Elmore said the asylum clinic is one way to try to help. “Often, they’re fleeing their country, carrying nothing with them. So they go to court with no documentation. This evidence we provide sometimes can be the only thing they have that documents that abuse.”