More doctors needed to assess asylum seekers’ claims of torture and violence

Widespread gang and domestic violence in places like Honduras and El Salvador assures demand for doctors to help enforce asylum law, according to a new study.
Silhouette of a refugees family with children, standing in front of chainlink fence at border


Violence in places like Central America has spurred an increase in people seeking asylum in the United States, and more doctors are needed to assess their claims of persecution and torture, authors from three universities argue in a new paper.

The practice of asylum medicine is crucial to carrying out laws designed to protect people fleeing persecution and torture, said Dr. Katherine McKenzie, director of the Yale Center of Asylum Medicine and corresponding author of the paper published in the Journal of General Internal Medicine.

We need doctors who perform these evaluations to tell their stories to the public, advocate to elected officials, and train young doctors in the practice of asylum medicine,” McKenzie said.

Dr. McKenzie and Dr. Shelli Farhadian examine a political asylum applicant at Yale.
McKenzie (right) and Dr. Shelli Farhadian examine a political asylum applicant.

Widespread gang and domestic violence in places like Honduras, El Salvador, and Guatemala assures demand for doctors to help enforce the law, despite new restrictions imposed recently by Attorney General Jeff Sessions. Asylum seekers continue to look to the United States for refuge as conflict and human rights abuses remain common in many parts of the world. Despite years of international treaties and domestic law supporting asylum for individuals suffering persecution in their home countries, the Trump administration has continued to introduce new executive branch restrictions on asylum seekers, the authors note.

The paper is co-authored by Jon Bauer, clinical professor of law and director of the Asylum and Human Rights Clinic at the University of Connecticut and Dr. P. Preston Reynolds, professor of medicine and nursing at the University of Virginia School of Medicine.

Globally, 65 million people were displaced from their homes due to human rights abuses in 2016 and 262,000 applied for asylum in the United States. Claims of persecution requires more than mere discrimination or harassment. Harms that have been found to constitute persecution include torture, rape, repeated physical abuse, prolonged imprisonment, severe mental or emotional abuse, imminent and menacing death threats, and extreme economic punishments.

A medical forensic exam is often crucial in deciding whether applicants will be granted asylum, the authors note.

Doctors who understand these issues will be better able to help applicants they are assessing navigate the process,’’ McKenzie said.

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