Taking History of Torture

Political Violence as Health Disparity

Among the health disparities prevalent among asylum seekers, refugees and immigrants is a history of political violence in the form of imprisonment, war fare, interrogation, threats and torture.  You will find that this experience is shared by Vietnamese survivors of the re-education camps, Egyptian students, gay men from Pakistan, Ethiopian shopkeepers, Angolan obstetricians, and the political opposition from Congo. In the diversity of occupation, gender and ethnicity is a shared experience of a violent suppression of democracy that plays itself out in their lives through dislocation, chronic pain and disease, sometimes for decades. 

Continue reading
Coronavirus

Covid-19 in Immigrant Communities

Being poor can be like treading water with the waterline right under your nose. The slightest ripple and you choke, a wave will submerge you. The novel coronavirus pandemic is a tsunami for those living in poverty. As a recent New York Times article illustrates, communities living in crowded conditions, with uncontrolled chronic diseases like diabetes and hypertension, marginalized by the lack of comprehensible health information, and mistrusting the current systems to treat them fairly will be disproportionately ravaged by Covid-19. We have seen this in the past with tuberculosis, HIV, and hepatitis B. But the novel coronavirus acts faster and in some cases more aggressively and so reveals disparities even more dramatically.

Continue reading
The Planet Earth

Environmental Justice, Global Warming and Global Conflict

Migrants exist in two worlds simultaneously: one in the country of asylum and the other through their calls, connections, and visits, to the people back home. Global warming is changing both worlds; in fact it is why many have been forced to migrate. Recently, world representatives met in Poland to coordinate efforts to address climate change. As they acknowledge it is almost too late, many realize the stakes are far too high to trust politicians alone to handle the broad cultural changes needed to address environmental collapse.

Continue reading
Immigrants Protesting

Patient Trust Threatened by U.S. Immigration & Customs Enforcement (ICE)

With co-authors Maggie Cheng, Staff Attorney, Northwest Immigrant Rights Project and Elizabeth E. Dawson-Hahn, MD MPH Attending Physician, Harborview Medical Center and Seattle Children’s Hospital.

The trust between physician and patient is a core tenant of the medical profession. By extension, trusting relationships with nurses,technicians, hospitals and clinics are where this relationship plays out. This trust is now threatened by U.S. Immigration and Customs Enforcement (ICE). In a startling breach of precedent, ICE agents have begun to target clinics and hospitals to enforceimmigration policy. It is our opinion that these enforcement actions actively jeopardize patient care.

Continue reading

Race, Ethnicity and Language Data

Fourteen years ago the Institutes of Medicine published Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Among their recommendations was the observation that to find disparities in care, health systems must first collect Race, Ethnicity, and Language (REAL) data at registration. Many health systems across the country began to make this effort. But then in 2008 the economy collapsed and health systems found themselves launching a rearguard effort to shore up their IT and EMR departments as budgets were cut and IT work forces downsized.Since then, the Affordable Care Act was passed and equity became a pillar of care. Electronic medical records were enhanced and since have evolved to facilitate the sharing of medical information.

Continue reading
Sign saying immigrants and refugees welcome

Anti-immigrant Sentiments Affect Immigrant Health

The rhetoric around immigration has again reached a fever pitch. It did after 9/11, it has repeatedly, and it has again. Migrant children fleeing intolerable gang and domestic violence in Central America have crowded the Southern border. Refugees fleeing Syria are swarming over Eastern Europe and a chronic flow of migrants from East Africa stream north and cross the Mediterranean in precarious flotillas. The West feels under siege and frightened. There are many with distinct political agendas that capitalize on this fear and propagate unwarranted anxiety for their own ends. We see this in national political debates and we see it daily in local politics.

Continue reading