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Changing Lives Through Advocacy: The University of Michigan Asylum Collaborative

by | Mar 28, 2023

As the wheels of their plane hit the runway, my parents were greeted with the announcement, “Welcome to JFK International airport.” My mother, five months pregnant at the time, was flying from their then third-world country: Trinidad and Tobago. Like countless other immigrants, my family came under the promise of “the American Dream,” but what does that really look like? For us, it meant the opportunity to access the best education possible. 

We settled in the bustling metropolis of New York City, a place that’s home to over 700,000 unauthorized immigrants. Imagine arriving to a foreign country with only a few hundred dollars in your pocket, ineligible for food stamps or Medicaid. You take over-the-counter supplements, daily turmeric and excessive amounts of tea, hoping to stave off any illness. Finding a job becomes a daunting task when you’re suddenly asked to disclose your citizenship status on page eight of the job application. Then, a global pandemic hits, and you’re left jobless without any access to unemployment benefits or stimulus checks. But that’s not all – the mere sound of a police siren or the sight of a law enforcement officer fills you with paralyzing fear. You become accustomed to feeling this way, with a racing heart and sleeping with one eye open becoming a normal part of daily life.

When it comes to discussing the topic of immigration, the mainstream media frequently overlooks a crucial aspect: the 10-year ban that immigrants face if they attempt to visit their home country to see their loved ones. The heartbreaking reality of missing important life events like funerals, weddings and the births of nieces and nephews often goes unmentioned. Yet, despite all these struggles, the opportunity for a better life in America is worth it, and immigrants endure decades of hardship, instability and emotional turmoil to create that better life for their families. This is the story of my parents, two of the many immigrants who came to America.

Medical students, residents, and physicians actively listening to Dr. Jessica Pierce describing how to conduct the psychological evaluation for asylum seekers and refugees.

My journey brought me to the University of Michigan Asylum Collaborative (UMAC), a non-profit, medical student-run human rights clinic. UMAC offers free physical and psychological evaluations to survivors of human rights abuses who are seeking asylum in the United States. As the training coordinator, I recently had the opportunity to invite influential individuals in the field of asylum medicine to present to a room full of medical students, residents and physicians.

One of our speakers was Dr. Vidya Ramanathan, a pediatrician, human rights advocate and medical director of our organization. She trained our attendees on how to conduct the forensic medical exam and write the medical affidavit. Using the Physicians for Human Rights Istanbul Principles, she demonstrated the gold standard of effective investigation and documentation of torture.

Another speaker was Dr. Jessica Pierce, a child and adolescent psychiatrist who is passionate about civil rights and social action. She guided the crowd on how to conscientiously conduct a psychiatric/psychological asylum evaluation. Dr. Pierce defined psychological torture, explained the psychiatric review of systems and challenged us to strengthen our cultural understanding, especially when working with this population.

We closed with Teresa Duhl, the fund development and engagement manager at Freedom House Detroit. She informed us on asylum law through a unique case study following a family’s journey to the United States. Freedom House is a non-profit organization in Detroit devoted to helping asylum seekers rebuild a safe life through providing shelter, community and legal assistance. Many of the cases we receive are referred to us from Freedom House. Our training program is designed to equip our volunteers with the skills needed to provide free forensic medical evaluations to those escaping persecution and seeking refuge in America. After successfully completing the training program, our attendees can volunteer and make a meaningful difference in the lives of those who need it the most.

As medical students, we may not have the power to change immigration laws or provide direct medical care for all who needs it, but I believe that we can still make a meaningful contribution to the lives of immigrants by giving our time, kindness and commitment to learning more about the challenges they face.  Recently, I had the privilege of sitting in on an evaluation case as part of UMAC. This experience opened my eyes to the immense transformative power of medicine and helped me understand that the role of a physician goes beyond clinical presentations and medical diagnoses. A physician must truly grasp a person’s life experiences, strengths, traumas and culture to provide the best possible care. This requires building a deep human connection that forms through empathy, understanding and compassion, ultimately leading to the establishment of trust. What I witnessed on that call was the cultivation of hope and strength through storytelling and advocacy. To be trusted by this person to convey their story and experiences in a medical affidavit left me feeling humbled and grateful. It is a privilege to be part of an organization that challenges me to constantly reflect on my privilege and use it to drive change. By advocating for immigrants seeking to rebuild a safe, secure and beautiful life for themselves and their future generations, I have found a sense of purpose that is truly fulfilling.

To me, the power of humanity lies in our ability to form deep connections and support each other through adversity. While we may not be able to solve all the world’s problems, we can make a lasting impact by lifting each other up in times of need. This is a lesson I learned from my parents, who made selfless sacrifices to bring me to this country and instilled in me a passion for uplifting marginalized populations through service and advocacy. UMAC has provided me with a platform to turn that passion into meaningful action. As I reflect on my journey as a first-year medical student at the University of Michigan Medical School, I feel grateful for the opportunity to contribute to a cause that is bigger than myself and to work towards creating a more just and equitable society for all.

Advocating for Asylum-Seekers through Connections between the University of Michigan and Physicians for Human Rights

by | Nov 12, 2021

Dr. Hannah Janeway, ED physician and founder of Refugee Health Alliance (https://www.refugeehealthalliance.org/), provides medical care to a patient in the El Chaparral asylum-seeker camp in Tijuana, Mexico. Photo by Lisbeth Chavez (https://www.lisbethchavez.com/).

Thousands of tents lined the crowded streets. The sun was rising slowly on the horizon. At the end of the street stood a large white tent, hovering above the others. A physician and nurse sat in the shade that the tent provided. Quickly, hundreds of people began to line up in front of the tent, waiting to be seen by the health care providers. The doctor handed the coughing children honey, a rare treat that trickled down their lips and stuck to their hands. The children ran around the tent that we had set up, clinging onto my stethoscope and Physicians for Human Rights (PHR) badge. As I worked closely with Dr. Janeway to provide care to those seeking asylum at the border, I felt truly grateful to be a medical student at the University of Michigan.

Tents line the streets at the El Chaparral asylum-seeker camp in Tijuana, Mexico.

As a medical school applicant, I was drawn to the University of Michigan Medical School due to the wide array of opportunities for students to participate in volunteer activities and advocacy efforts. At Michigan, students are given many opportunities to explore advocacy both within the confines of Michigan Medicine and beyond. The school truly understands the importance of training the future generation of physician advocates.

Given my interest in advocating for immigrants, refugees, and asylum-seekers, I dove into advocacy opportunities my first year as a medical student by joining the Physicians for Human Rights student chapter, also known as the University of Michigan Asylum Collaborative. Specifically, I served as the Co-Executive Director of the Asylum Collaborative during my first year of medical school. During my first and second year of medical school, I also collaborated with attendings and other students in providing forensic evaluations for asylum-seekers; such evaluations document the physical and mental health effects of trauma endured by asylum-seekers and are subsequently used as an informative document in their asylum claims. During my first year, I also served a student leader in other student organizations, such as the Co-Community Engagement Director for the Health Equity Scholar’s Program (HESP).

Members of the 2018-2019 University of Michigan Asylum Collaborative (UMAC) Executive Board hosts a forensic evaluation training session for faculty and students at the University of Michigan

During my third year of medical school, I wanted to further explore the role of advocacy at the intersection of clinical care and research. I applied for an internship position with Physicians for Human Rights. As a Medical Student Intern, I helped develop and implement a research project to evaluate the mental health impact of family separation and expulsion among asylum-seekers in Mexico. The experience, particularly interviewing asylum-seekers in Tijuana and Ciudad Juarez, Mexico, granted a holistic picture of how the asylum process intersects with mental health. Our team then used these findings to generate a report for Physicians for Human Rights, titled “Neither Safety Nor Health: How Title 42 Expulsions Harm Health and Violate Rights.” This report was used to guide key advocacy efforts, such as in the creation of a letter to the CDC – signed by 1,383 medical professionals – requesting that the CDC reverse the Title 42 expulsions order at the US-Mexico Border. Our research was also referenced in recent media coverage by organizations such as Amnesty International, Mother Jones, and more. This opportunity was made possible through Michigan Medicine’s unwavering support, ranging from the support of amazing faculty, such as Dr. Michelle Heisler, to funding for the project via the Capstone For Impact Project grant.

PHR representative Cynthia Pompa (right) and I interview a 22-year-old mother from Guatemala who was seeking asylum for herself and her children. Photograph by Lisbeth Chavez (https://www.lisbethchavez.com/).

Now, I am a fourth-year medical student applying to psychiatry residency. In the future, I hope to serve as a psychiatrist who advocates on behalf of immigrants, refugees, and asylum-seekers. Pursuing training at Michigan Medicine fostered my interest in pursuing justice in the field of mental health. The opportunity to pursue such a diverse array of electives during my M3 and M4 year was critical in allowing me to get “on the ground” experience. Furthermore, having incredible mentors who supported my vision for advocacy – such as Dr. Michele Heisler — was critical in my success. I truly believe that pursuing my medical education at the University of Michigan granted me the skills and vision to serve as an effective advocate.