In a New Land

In a New Land

UM alumni are the paving the way, doing the urgent and even joyful work of helping immigrants and asylum-seekers find health and hope in new land.

The Challenges of Communication

WillacyMaybe it’s because she’s the daughter of immigrants that Erika Willacy, MPH ’04, feels such a connection to the people she serves—refugees and immigrants from places like Nigeria, Peru, Myanmar (Burma), and Iraq, people who for one reason or another have left their native countries and come to the United States in search of a dream.

“There is such a light about so many of them,” Willacy says. “There’s such a joy.” Their drive and ambition remind her of her own parents, Caribbean émigrés who came to the U.S. seeking an education and a better future. “I don’t think I’ve met any immigrants who seem to be taking anything for granted, in terms of what they’ve been given.”

As the lead health education specialist in the Immigrant, Refugee and Migrant Health Branch of the Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Willacy is in charge of communicating health information accurately and effectively to immigrant, refugee, and migrant populations throughout the U.S. and to the thousands of people at home and abroad who interact with these populations—including more than 600 physicians worldwide who conduct pre-immigration health screenings for the U.S. government.

Willacy conducts training summits throughout the world and helps design and disseminate communications materials about emerging diseases and changes in federal health policy. The challenges are vast. Bureaucracy, language, literacy, cultural attitudes about mental and other health issues—all these can impede the flow of information to people who desperately need it. “Certain refugee groups have a different concept of ‘germ theory,’” Willacy says. “The way I communicate about the flu may have to change if the audience believes that illness is caused by the souls of ancestors living in the body.”

Despite the challenges, she loves the work. “To me, hearing these stories and interacting with these people—this is really where the rubber meets the road in terms of vulnerable or disadvantaged populations. It reminds me of why I got into public health.”

And the immigrants themselves—people not unlike her own parents—inspire her. She’s met families who’ve spent 12 years in a camp waiting to emigrate, who’ve seen loved ones killed, and who have at last made it to the U.S. only to be given a few days of cultural orientation and then left to their own devices. “I don’t know how you take all that in,” Willacy says. “I’m continually impressed and in awe of these people.”

The Need for Documentation

RamanathanEach month, Vidya Ramanathan, MD, MPH ’98, sees four to five asylum seekers from every corner of the world and speaks on their behalf at the immigration courts. In her consulting room at Detroit’s Freedom House—a nonprofit that promotes democracy and human rights around the world—she documents improperly healed fractures and sprains and the aftermath of rapes and forced abortions. She sees headaches in people who have suffered severe penetrating head trauma, and vision loss in victims who, for example, were forced to stare at the sun for long periods of time. She also sees psychological trauma, post-traumatic stress disorder, anxiety disorders, depression, and memory loss.

Her work with asylum-seekers at Freedom House is strictly volunteer. Ramanathan is also a child advocacy consultant and adjunct assistant professor with the University of Minnesota Center for Global Pediatrics and a part-time pediatric emergency room physician at St. Joseph Mercy Hospital in Ann Arbor.

She wishes she had more time to dedicate to Freedom House, which she calls a “wonderful organization” that provides asylum-seekers with shelter as well as legal, educational, language, and medical services.

Ramanathan discovered her passion for this work while pursuing joint MPH/MD degrees at the University of Michigan. In those years she traveled to the Himalayas, where she worked for a rural development program and learned about displaced Tibetans, and to the Thai-Burma border, where she worked at a Burmese refugee clinic and visited refugee camps. Ever since then she has been committed to helping displaced peoples—particularly those like the ones she sees in Detroit, who come to the United States seeking political asylum.

According to the U.S. Immigration and Nationality Act, the U.S. government will not deport a foreign national to a country where his or her life or freedom could be threatened. Asylum-seekers, however, must clearly demonstrate a well-founded fear that, if returned home, they will be persecuted. Nationwide, an estimated 37.5 percent of asylum-seekers are granted asylum. That statistic increases to about 90 percent when they have a medical affidavit documenting their injuries from torture and abuse in their home country. Ramanathan’s job is to write those affidavits and testify when necessary.

So far, nearly 100 percent of her cases that have been adjudicated have received asylum [ed. note: text updated]. She says the act of providing medical care and documentation is not only essential to asylum-seekers but the most basic of human rights. “If you take away a person’s health, they have no fair shot at living in the world, and it’s not fair to say that some people deserve their health and others don’t. It’s not just.”

Article by Valentina Stackl