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WCCHR May 2019 Newsletter

WCCHR April 2019 Newsletter

WCCHR Networking Luncheon

The Border and Beyond: Health and Hardship of Families Migrating to the US Amidst Evolving Federal Policy

The event will feature a panel discussion and a Q&A session with:

Anand Balakrishnan J.D., Staff Attorney, Immigrants’ Rights Project, ACLU 
Dr. Neeraj Kaushal, PhD, Professor of Social Policy & chair of doctoral program at Columbia School of Social Work
Dr. Spyros Orfanos, PhD, ABPP, Clinic Director of NYU Postdoctoral Program in Psychotherapy and Psychoanalysis

The event is free and open to the public. 

Please register at: https://tinyurl.com/wcchrluncheon2019 

WCCHR Februrary 2019 Newsletter

WCCHR January 2019 Newsletter

Spring Asylum Evaluation Training with the Weill Cornell Center for Human Rights

Spring Asylum Evaluation Training with the Weill Cornell Center for Human Rights

Saturday March 16th 2019 - 8:45am to 3:30pm

Weill Auditorium 1300 York Ave, New York, NY 10065

https://goo.gl/forms/YQqLSQl879TK8LSA3

Safe & Sound

Growing up in Azerbaijan, Yusif was frequently attacked for being gay. Over the years, he was beaten up at school, punched and kicked by neighbors, and pelted with rocks and had homophobic slurs written on the door of his family’s home. The violence escalated when he was 18: Three men dragged Yusif to a schoolyard one night in 2012 and put a knife to his throat. Two took turns raping him, while the third filmed it on his phone and threatened to show the video to others. Yusif went to the police, but an officer refused to file a report even though he could identify his assailants. “Everything changed after that,” says Yusif [not his real name, which he asked be withheld to protect his privacy]. “I said to myself, ‘You have to get out of here. Your life is going to end soon.’ I felt it.”

A year later, Yusif’s mother borrowed money so he could buy a plane ticket and enroll at a language school in the New York area, which allowed him to enter the United States on a student visa—although upon arriving, he discovered that the school didn’t exist and they’d been swindled. With nowhere to go, Yusif lived hand-to-mouth for months, working at places that only paid him in fast food, and for a time, sharing a room with seven other people. He eventually connected with family friends in New Jersey, who gave him a temporary home and referred him to an asylum attorney. That brought him to the Weill Cornell Center for Human Rights, a medical student-run clinic that provides pro-bono physical and mental health evaluations for immigrants seeking asylum in the United States, based on abuses due to race, gender, sexual orientation and other grounds. Though Azerbaijan decriminalized homosexuality in 2001, the country has done little to protect its LGBT community from discrimination, violence, hate crimes and police harassment. “I don’t consider my life before as a life,” says Yusif, who was diagnosed with post-traumatic stress disorder (PTSD) and depression. “I considered it survival.”

Yusif—who was granted asylum last year—is one of 318 clients from 63 countries who have been evaluated by the center since 2010, when Weill Cornell Medicine students founded it with Physicians for Human Rights (PHR). It was the first clinic of its kind in the United States, serving as a model for similar programs at more than a dozen schools including Columbia, Brown and the University of Pennsylvania. With a roster of 65 volunteer clinicians—many of whom are Weill Cornell Medicine faculty—and more than 150 trained student evaluators, the center examines asylum seekers and prepares medical legal affidavits that can be used at court hearings. Its high success rate underscores the value of such evidence in helping applicants prove their claims: of the clients whose cases have been adjudicated, about 94 percent have been granted asylum—nearly three times as many as those without this type of documentation, according to figures from a study led by researchers at the University of California, San Francisco  that was published in The Journal of Immigrant and Minority Health in 2008. “Because they’re fleeing persecution, the only evidence they can bring with them is, quite literally, the physical and psychological scars that they carry on their bodies,” says the center’s co-executive director, Andrew Milewski, a sixth-year MD-PhD student. “So our affidavits are crucial pieces of evidence in their immigration court proceedings.”

The center connects with clients through referrals from PHR, private immigration attorneys and local law schools. Exams are done at Weill Cornell Medicine’s Margaret and Ian Smith Clinical Skills Center or at a clinician’s office, led by a physician or mental health professional. Student volunteers take detailed notes of the interview and carefully document signs of abuse, then help write the affidavit; the clinician finalizes it and, if necessary, testifies in court. The center has seen Syrian refugees suffering from extreme PTSD, women who’ve endured genital mutilation—common in certain African and Middle Eastern countries like Egypt, Somalia, Guinea and Burkina Faso—as well as victims of torture and other brutalities from places in Central America where gang violence has skyrocketed in recent years. Other clients seek asylum because of domestic violence, escaping homelands that don’t offer legal protections. One evaluation that Milewski assisted with in 2014 involved three siblings who fled Honduras because of their father’s mistreatment. Milewski says that the father would often whip one of the daughters and had broken the son’s nose; when they moved in with relatives in an effort to escape the abuse, one of the sisters was sexually assaulted by a cousin. “That was a really hard case,” says Milewski, who notes that the siblings were granted asylum a few months after the evaluation. “The trauma was still very fresh with those kids.”

The center doesn’t just provide a valuable service for asylum seekers. It trains the next generation of evaluators—who are desperately needed, given the current backlog of more than 620,000 asylum cases in U.S. courts. It also gives students hands-on clinical experience early in their medical training. “They get to contribute in a meaningful way to securing our clients’ access to a future free of fear and danger,” says Dr. Joanne Ahola, the clinic’s medical director emeritus and a former adjunct assistant clinical professor of psychiatry at Weill Cornell Medicine, who helped found the center and still works as a volunteer evaluator. “Plus, they get to help a woefully underserved population.”

Even if the students don’t continue to help with asylum cases later in their careers, their involvement with the clinic teaches them how to sensitively treat patients who have endured physical and emotional trauma. Dr. Thomas Kalman, a clinical professor of psychiatry and the center’s medical co-director, sees such experience as a vital part of any medical student’s education. “This exposes students to human cruelty—which is an ugly sounding term, but it’s very real and it exists,” says Dr. Kalman, a psychiatrist at NewYork-Presbyterian/Weill Cornell Medical Center. “Here in the United States, we have gun violence, natural disasters—terrible things that leave people traumatized. This clinic is an opportunity to introduce students to some of these things and to show them that people can overcome them.” Milewski agrees, noting that he’s thankful for the chance to observe how resilient many of the center’s clients are. “Knowing that some of our clients, despite what they’ve experienced, still have hope for a better future—that’s incredibly heartwarming and inspiring,” he says.

Indeed, for Yusif, the future looks brighter. Now in his 20s, he’s studying to become a nurse. He volunteers at an LGBT center near his New York area home, wanting to give back to a community that has offered him invaluable support since he came to America. “To any LGBT individuals that for any reason are afraid, possibly under pressure or threat by homophobic people, I would like to say that you are not alone,” he says. “There are resources and people who will support you.” Ever since he learned he’d been granted asylum, he adds, his chronic nightmares and anxiety attacks have abated considerably. “All my life I never felt safe,” he says. “That day was the first time I felt like, ‘OK, I can sleep well tonight.’”

— Heather Salerno

This story first appeared in Weill Cornell Medicine, Vol. 16. No. 4

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Human Rights Education Impacts Medical Student Views of Torture

Integrating human rights education into the medical school curriculum may strengthen medical ethics with regards to physician participation in and acceptance of torture, according to the results of a new study from students and faculty from the Weill Cornell Center for Human Rights. The center is a Weill Cornell Medicine student-run organization that provides clinical assessments for people seeking political asylum in the United States.

Despite clearly stated ethical guidelines, some medical professionals continue to participate in or condone torture. To assess how Weill Cornell Medicine’s medical and MD-PhD students view such practices, the student and faculty leadership of the Weill Cornell Center for Human Rights (WCCHR) developed a 28-item survey that was circulated among the student body in November 2016. It queried students’ opinions related to specific torture activities, justifications for torture and ways physicians might participate in torture (for example, qualifying their agreement or disagreement with statements such as “The use of torture is an effective means of obtaining important information”).

The results, published Nov. 21 in the Health and Human Rights Journal, showed that the majority of respondents were opposed to torture, disagreed that torture is an effective way to obtain information, and supported professional and legal consequences for physicians who participate in torture. The survey also revealed that voluntary engagement in Weill Cornell’s human rights program was associated with significantly stronger opposition to torture.

“This study demonstrates how much impact participation in a voluntary, human rights program can have on participants’ attitudes toward a sensitive and important topic that’s not usually covered in a standard curriculum,” said senior author Dr. Thomas Kalman, a clinical professor of psychiatry at Weill Cornell Medicine and WCCHR co-medical director.

The Weill Cornell Medicine survey was inspired by a 2008 University of Illinois College of Medicine-Chicago (UIC) study of medical student attitudes toward torture – the only previous survey on this topic at an American medical school. In the current study, the questionnaire was sent to 483 Weill Cornell Medical College and Tri-Institutional MD-PhD students, with 121 recipients responding with completed surveys.

“We looked at this study from UIC and thought it would be important to not only replicate it but also expand on it,” said first author Krista Dubin, an MD-PhD student at Weill Cornell Medicine and WCCHR senior student advisor. “We wanted to see what people thought about torture, and how their demographics and experiences, such as if they have been harassed in the past, affect their view on it.”

In comparison to UIC survey respondents, a larger proportion of Weill Cornell Medicine students opposed torture. For example, when asked if it was permissible for interrogators to use psychological intimidation, 93 percent of Weill Cornell Medicine respondents disagreed, compared with only 30 percent of UIC respondents.

“That was an interesting finding, but it’s possible the phrasing of the questions had an impact on the results,” said study author Andrew Milewski, an MD-PhD student at Weill Cornell Medicine and WCCHR co-executive director. “We included examples of what psychological intimidation could look like, while the UIC study didn’t. Geographic and demographic differences also make it difficult to draw comparisons between our two institutions nearly a decade later.”

Respondents who had experienced discrimination or harassment answered the survey in ways that reflected stronger pro-torture attitudes, but the trend did not reach statistical significance.

It’s also possible that current events may have shaped the students’ responses. Study authors sent out the survey shortly after the conclusion of last year’s national election. “This added an interesting component, considering all of the talk around torture that happened during the election cycle,” Milewski said.

When it comes to human rights education, the authors found that students trained by the WCCHR were significantly more opposed to torture than those who had not participated. They also were less likely to agree that obtaining life-saving information justifies the use of torture or that it’s permissible for physicians to treat individuals so that torture can begin or continue.

Founded upon the tenets of service and education, the WCCHR aims to expose students to the idea of human rights abuses and the role physicians can play in documenting signs of torture. Students learn about the different forms of torture and provide service by participating in pro bono evaluations of asylum seekers. As part of their research, the study authors surveyed the incoming class of 2017 to learn how many of them had heard of the WHCCR. They found that more than one-third of them had, and that the center was one of the reasons why they chose to attend Weill Cornell Medicine, Milewski said.

“We are the first student-run asylum clinic in the nation,” Milewski said. “Our hope is that the results of our survey will inspire students at other institutions to create similar organizations.”

While medical schools often handle issues of professionalism and ethics in a standard curriculum, the specific issues around torture or other human rights issues “are addressed in a more variable fashion,” said study author Dr. Joseph Shin, an assistant professor of medicine and WCCHR co-medical director. He hopes these results lead to the implementation of human rights education into the medical school curricula, both at Weill Cornell and beyond.

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"Medical Students' Attitudes towards Torture, Revisited," written by members of the WCCHR

The article "Medical Students' Attitudes towards Torture, Revisited," written by members of the WCCHR, was published on November 21, 2017 by the Health and Human Rights Journal as a Paper-in-Press. The article will officially appear in the journal's December issue and can be accessed at the following link:

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Event: Asylum Evaluation Training with the Weill Cornell Center for Human Rights

What: Asylum Evaluation Training with the Weill Cornell Center for Human Rights
When: Saturday September 16, 2017. Check-in/breakfast beginning at 8:00 am. The event will run from 9:00 am until 3:30 pm and includes lunch
Where: Weill Auditorium, 1300 York Ave.

On September 16, 2017 from 9:00 am – 3:30 pm we will hold a training session, led by our volunteer evaluators, where you can learn more about the role of clinicians and students in the asylum evaluation process. The training will comprise lectures that provide an introduction to asylum law and affidavit writing and cover the three types of evaluations: gynecological, physical, and psychological. Additionally, during the last part of the training, attendees will break out into small groups led by experienced evaluators to discuss redacted, example affidavits drawn from the leaders' work.

The training is REQUIRED for any student or clinician who wishes to volunteer with the WCCHR and has yet to attend a previous training. The event is free of charge and no prior experience is necessary. To learn more about forensic evaluations, please visit our website at http://wcchr.com or contact us at wcchr@med.cornell.edu.

This training is open to any clinician (MD, PsyD, PA, LCSW, NP) or student interested in performing forensic evaluations of asylum seekers.

Lunch and a light breakfast will be served. Kindly RSVP at the following link if you plan to attend.
https://goo.gl/forms/mzlBmCofvo9Xt0Uo1

Any question can be directed to Latha Panchap, WCCHR Education Coordinator, at lap2020@med.cornell.edu.

Date: 
September 16, 2017 9:00am -3:30 pm

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Weill Cornell Medical College Center for Human Rights 1300 York Avenue, Box #2 New York, NY 10065