Fall 1998 Human Rights Magazine

In late 1997, Louise Umber, a twenty-seven-year-old Rwandan refugee, arrived in the United States, a shattered victim of her country’s devastating civil war. Detained, raped, and tortured as a result of her brother’s political affiliation, she languished for months in a Rwandan prison convinced that every day might be her last. Escaping detention, she walked for days to reach Kigali and finally fled her country using a falsified passport. Arriving at Philadelphia International Airport, Louise breathed a heavy sigh of relief believing that she had finally reached a safe haven. Yet, immediately upon arrival in the United States, Louise was once again detained and sent to a local jail where she now awaits an interview with an Immigration & Naturalization Service (INS) asylum officer who will determine her future.

Illegal Immigration Reform and Immigrant Responsibility Act

Like Louise, most torture survivors who arrive each day in the United States seeking asylum believe that their journey will end upon arrival at a United States port of entry. However, the 1996 passage of the Illegal Immigration Reform and Immigrant Responsibility Act (IIRIRA) means the flight from persecution and torture represents only the beginning of an even longer legal fight for refugees.

The IIRIRA imposes harsh penalties on the several thousand torture survivors seeking sanctuary in the United States each year. Under the IIRIRA, newly arrived immigrants seeking asylum have only one year to file for asylum. Those who arrive with no passport or falsified documents must demonstrate a credible fear of persecution during their INS interviews or face immediate deportation without right of appeal. If they pass their interviews, they must still remain in INS detention—often housed in cells in county jails—until their asylum claims are processed. On any given day, the INS holds more than 13,500 people in detention, thousands of whom are torture survivors. Immigration detention has become the fastest-growing incarceration program in the United States. Since 1996, the INS has expanded its bed capacity by 42 percent and aims to double its detention space by the year 2001.

Access to Legal and Medical Services

An asylum seeker’s access to competent legal and medical assistance during the asylum hearing process is imperative. However, isolated from family and friends, the incarceration of political asylum applicants makes access to this type of assistance very difficult. Thus, many torture survivors having just fled detention in their own countries now find themselves imprisoned in the United States. Reports of abuse at the hands of officers charged with the care of detainees are common, and in some cases disturbingly reminiscent of the abuse the asylum seekers experienced in the countries from which they fled. Some asylum seekers, after more than a year of waiting, have given up and sought voluntary departure rather than face further detention in a strange land.

In an effort to assist asylum applicants in overcoming these barriers, the medical and legal communities are working together. The medical community now lends its expertise to the legal profession in supplying expert medical testimony in the legal fight for asylum to victims of torture. Oftentimes, asylum seekers’ legal claims can be strengthened by such expert testimony. In 1989, recognizing the need for this type of assistance to torture survivors, the Boston-based health and human rights group, Physicians for Human Rights (PHR), founded the PHR Asylum Network. Today, the PHR Asylum Network includes more than 350 physicians and other health professionals throughout the United States who volunteer to conduct medical examinations of asylum applicants reporting torture and other persecution, and provide expert written testimony for their asylum hearings.

PHR Asylum Process

The PHR asylum process begins when PHR receives an inquiry from a lawyer requesting a physical or psychological evaluation of an asylum client. An appropriate volunteer health professional from the extensive PHR network of physicians and health professionals is then identified. Depending on the volunteer’s medical expertise, he or she examines the torture survivor, who may exhibit scars and wounds caused by gunshots, beatings, burns, rape, or other sexual violence. Not surprisingly, most torture survivors also suffer severe psychological trauma, including Post-Traumatic Stress Disorder (PTSD).

The role played by health professionals in providing expert testimony cannot be underestimated. A physician can objectively assess the degree to which the physical findings are consistent with the asylum seeker’s account of persecution and trauma. A psychiatrist or psychologist can conduct a psychological assessment, looking for the common sequelae of torture, including PTSD. Such written, medical expert testimony is extremely helpful to asylum adjudicators, who must determine whether the applicant demonstrates a well-founded fear of persecution. The importance of expert testimony is further underscored by the fact that in many cases, the torture survivor has no medical records of the injuries he or she has suffered, either because of having to flee without them, or because no medical treatment was ever given.

Other PHR Activities

PHR has also actively pursued support for victims of torture through a bill now before Congress: the Comprehensive Torture Victims Relief Act (CTVRA) (S. 1603 or S. 1606; H.R. 3161). The CTVRA authorizes the Agency for International Development (AID) to support torture treatment centers both in the United States and overseas through the United Nations Voluntary Fund for Victims of Torture. The CTVRA also provides some protection of torture survivors during the immigration process, as well as specialized training for resettlement and immigration officials who work with torture survivors. In February 1998, PHR wrote twenty-one key legislators urging them to cosponsor this bill, and issued an urgent call to action to members of PHR’s Asylum Network asking them to do likewise.

Working with a broad coalition of more than seventy human rights, religious, and immigration groups that comprise the Committee to Preserve Asylum, PHR submitted comments to the INS in January 1997, concerning proposed regulations to implement the new law. In those comments, PHR emphasized the difficulties facing torture survivors who must defend their claims of asylum upon arriving in the United States, lacking legal counsel, interpreters, due process, and possibly facing indefinite detention while their asylum claims are processed.

On March 31, 1998, PHR signed a joint letter that was sent to the United States Senate from dozens of organizations, expressing concern about the IIRIRA and its implementation. The letter was mailed on the eve of April 1, which marked the tolling of the one-year deadline to file applications for asylum.

Conclusion

There is still much work to be done to aid asylum applicants in their efforts to remain in the United States. The legal and medical professions have taken an important first step in working together to make this possible.

Caitriona Palmer is Media Relations Coordinator for Physicians for Human Rights.

Kerri Sherlock is Asylum Network Coordinator for Physicians for Human Rights.