Giving Voice to Asylum-Seekers' Scars

After a long day of treating diabetes, hypertension and high cholesterol, physician Randi Abramson shifted gears one evening last week to face a different litany of complaints: beatings with whips, burns with cigarettes, repeated rapes, mock drownings, sexual slavery.

"Man," Abramson said as she stepped from an exam room at Bread for the City's second-floor medical clinic on Seventh Street NW. "That was a really sad one."

Abramson drops onto a stool, composing her thoughts before entering on a laptop the horrifying story of her most recent patient at the District nonprofit organization's new monthly clinic for political asylum-seekers: a 24-year-old Kenyan woman who recently fled Mexico and is petitioning to stay in the United States. Raised by abusive grandparents who beat her and, at 10, subjected her to genital mutilation. Cast out by her family for choosing school over marriage, she was tricked into a prostitution ring couched as a scholarship opportunity. She ended up in a Mexican brothel, where she was held captive, beaten and knifed by a customer.

Such shocking tales of cruelty can take a toll, said Abramson, one of three doctors who have volunteered to lend expert medical credence to clients' allegations of torture and abuse. It has been difficult to find doctors willing to take on these cases. But those who have stepped forward say they find powerful satisfaction in the opportunity to boost wrecked lives onto a path toward salvation.

"The scars, everything I found in the physical exam completely support the history she related," Abramson said. "It's just very rewarding to know that I will document what I heard and saw this evening and that will have a huge impact on her life."

Doctors say they rarely see people trying to pass off other injuries as evidence of torture. Such cases are usually weeded out before they reach medical exams. Although doctors often cannot trace wounds to a particular incident, they can compare patients' accounts of their traumas to scars that tell their own stories.

Having a doctor certify that an asylum-seeker was tortured back in the home country enormously improves the chance that an immigration court will approve a claim, according to immigration lawyers. Typically, clients are refugees on the run, fleeing home without medical records, police reports or any other proof of their stories. A little expert testimony can turn a tale of woe into a legal victory.

"I've seen the impact an affidavit or testimony from a U.S.-educated physician has on the court, and it can be incredibly persuasive," said Laura Tuell Parcher, a lawyer at Jones Day in Washington who has handled pro bono asylum cases for 15 years. "I've seen a judge say after a doctor's testimony: 'That's it. We're done. I'm granting [asylum].' "

Like other immigration lawyers, Parcher has struggled for years to find doctors to examine her clients on a case-by-case basis. Bread for the City's new clinic, an outgrowth of a program pieced together by several physicians at George Washington University, seeks to make the service available more consistently.

Citing federal records, the nonpartisan Migration Policy Institute says about 30,000 people apply for asylum each year. Last year, 22,930 applications were granted, and about half of those required a hearing before an immigration judge.

The atmosphere at the clinic is surprisingly upbeat. As in any doctor's office, attendants sort charts and usher patients around. But when someone calls out "Child care!" from the waiting area, two young female staffers immediately drop what they are doing and go play with puzzles with two children of a woman who wants her story of torture vetted.

Kenyan-born Frida Ngwa had her allegation of torture assessed four years ago by Katalin Roth, a physician at George Washington who was seeing asylum-seekers at last week's clinic. Ngwa said she remembers Roth asking her to disrobe and reveal the scars from serial beatings by police who objected to her work with political prisoners. "They hit me with the butts of their guns and kicked me with their heavy boots," Ngwa said. "Dr. Roth examined me from the bottom of my feet to the top of my hair. I trusted her."