What is Asylum
Asylum seekers are individuals who have fled their own country and seek sanctuary in another. In the United States, to be granted asylum these individuals must demonstrate evidence of a well-founded fear of persecution. Often, asylum seekers endure a multitude of psychological and physical trauma, including torture, resulting in complex health conditions including brain, spinal cord and musculoskeletal injuries. Providing evidence to a judge that an asylum seekers sequelae of physical or psychological trauma is a challenging feat and difficult to overcome.
My Experience
As a medical student I was a part of a medical student-run asylum clinic that worked directly with asylum seekers. We collaborated with physicians, often family medicine and psychiatry, providing pro bono forensic evaluations for survivors seeking asylum in the United States. Our day would consist of meeting with the asylum seeker, taking a thorough history and performing a detailed physical exam. I saw individuals with all types of blunt trauma, penetrating injuries, chemical injuries and burns. These injuries often led to significant impairments in mobility, strength, balance, etc. Now, as a physiatrist in training, I see tremendous opportunity for physiatry to contribute to this type of work.
The Role of a Physiatrist
Physiatrists have unique expertise to lend to this population because we understand the sequelae of both neurological and musculoskeletal injury. We are proficient in documenting tone, contractures, neuromuscular weakness and musculoskeletal injuries. We also understand the sequelae of neurological injuries such as neurogenic bowel and bladder. This in-depth understanding means the physiatrist is well positioned to accurately document forensic affidavits and can provide meaningful assistance to a vulnerable population.
How to Help
Because physiatrists are often working with patients with disabilities, if you know that your patient could benefit from services such as the one described above, please refer them to an asylum clinic. Not only can they potentially benefit from a medical affidavit, but they may also benefit from the other services that are often bundled in these clinics such as connections to social work, housing opportunities and community support. Keep in mind that whenever working with survivors of trauma, it is imperative to utilize trauma-informed care throughout those interactions. Lastly, if you feel that you have the extra time, asylum seekers could absolutely benefit from the physiatrist’s expertise in an asylum clinic. For those who would like to get more involved, Physicians for Human Rights holds regular training as well as a list of clinics throughout the country with contact information.