Immigration is in the news. Republican presidential candidates make crass statements about illegal immigrants. Political pundits make various unsupported claims about the dangers of immigration. Meanwhile, the Obama administration is asking a federal court to reconsider allowing it to continue detaining families caught seeking refuge along the southwestern border of the United States. The Obama administration’s request comes on the heels of a California district court judge’s order that the administration comply with existing legal standards for holding children in federal custody.
Immigration reform is an undoubtedly complicated issue. But, somewhere in the mix, we’ve lost sight of the children, women, and men at the heart of the debate. The failure to consider the people at the center of the debate is particularly puzzling since several of the presidential candidates and President Obama are children or spouses of immigrants.
For over a decade, as a physician and public health specialist, I’ve evaluated and cared for men, women, and children seeking asylum in the United States. Like hundreds of other health professionals across the United States, I provide objective forensic medical evaluations of asylum seekers to help determine if their claims of torture and ill treatment are supported by physical and psychological evidence.
Many of the people I’ve met fled from unsafe lands, seeking refuge in a country – “yearning to breathe free.” They are doctors, lawyers, teachers, journalists, mechanics, farmers, police officers, bankers, business owners…fathers, mothers, brothers, sisters, sons, and daughters. Many have been tortured. They have witnessed unimaginable atrocities. Some arrive legally. Others arrive illegally, often out of desperation. Some enter the United States legally and stay illegally after their visas expire. Regardless of how they arrive, once they reach the United States, many immigrants have a desire to contribute to society in ways that made them targets of human rights abuses in their home countries.
Our refusal to see the immigration debate for what it is – a health and human rights issue – is holding us back from identifying empathic, sustainable solutions.
Here’s why we can’t ignore the health and human rights issues embedded in the immigration debate.
Currently, there are approximately 500,000 torture survivors living in the United States. They have survived severe beatings, electric shocks, rape, mock executions, starvation, sleep deprivation, and other abuses. Their bodies and minds bear visible and invisible scars – including chronic pain, broken bones, traumatic brain injury, HIV, posttraumatic stress disorder (PTSD), depression, and anxiety disorders. If they can demonstrate a credible fear of torture, survivors of torture are eligible for protection in the United States under the United Nations Convention Against Torture.
Even after all they live through, many of these individuals rise to the challenge of establishing a new life in a foreign land.
Some asylum seekers who have not been tortured also have a credible fear of persecution or torture. In 1980, the Refugee Act was signed into law bringing the United States into compliance with the 1967 United Nations Protocol Relating to the Status of Refugees. In order to apply for asylum, an individual must be present in the United States and demonstrate a well-founded fear of persecution based on one of five grounds: race, religion, nationality, political opinion, or membership in a particular social group.
Many asylum requests from people fleeing Mexico and Central America meet a “credible fear” standard. Many of these immigrants have been targeted in their home countries because they refuse to participate in corruption, gang activity, and other illegal activities. They fear they will be targeted and killed if they are forced to return to the countries they escaped. However, changes to the law over the past 20 years have made it more difficult for people to apply for asylum.
Once immigrants arrive at the United States-Mexico border or other ports of entry, many are detained. Thousands of women and children caught entering the United States illegally remain in detention centers in the southwestern United States. In addition to the risk for sexual violence, tuberculosis, and other communicable diseases, these mothers and children face mental health obstacles. Studies have shown that the longer asylum seekers are detained, the greater their risk for PTSD and other psychiatric disorders.
Today, there are more displaced people living across the world than ever before. According to the United Nations High Commissioner for Refugees, the total number of people forcibly displaced by war, conflict, and persecution rose to more than 59 million by the end of 2014. Developing countries host more than 80 percent of displaced persons, creating an inequitable burden when many poor host countries also face growing epidemics of infectious and chronic, noncommunicable diseases.
We continue to strive for a generous, compassionate, and just society. At times, we’ve met that promise. Many people seeking refuge in the United States share our dream. But we are much more likely to live up to the dream through honest, respectful, and thoughtful discourse.