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Reassembling smashed lives
Refugee center helps survivors of atrocities worldwide

By Hope Green

No psychiatrist sees tougher cases than Michael Grodin does.

	Michael Grodin Photo by Vernon Doucette

One of his current patients is a Hutu woman who fled ethnic strife in Burundi, where civil war has claimed 200,000 lives. Last spring, Tutsi police raped her in front of her 10-year-old son after arresting her husband, a fisherman and former schoolteacher who had been involved with human rights work. She fled to the bush to hide, leaving her son with a neighbor. When she returned to the village, the Tutsis had burned it down, and she found only dead bodies.

The woman escaped to Toronto with help from a group of priests and then came to Massachusetts. She still doesn't know the fate of her husband and child.

Another patient is a Tibetan monk the Chinese imprisoned and tortured for 10 years. Among other forms of punishment, he endured electric shocks, beatings, psychological abuse, and mock executions. Buddhists, he tells Grodin, are taught to acknowledge suffering as part of the process of spiritual growth. But now he cannot sit quietly and meditate, an essential ritual of his faith, because he is constantly plagued by flashbacks.

A steady stream of traumatized people seek counseling at the Boston Center for Refugee Health and Human Rights, where Grodin directs human rights advocacy and education. It is one of the few such facilities in the United States. Last year the outpatient program, based at the Boston Medical Center, provided health care and legal and social services to 140 people from 25 countries. It helped many of these patients obtain political asylum in the United States, as refugees often are ill-equipped to navigate the courts by themselves.

"We're involved in trying to put their lives back together," says Grodin, a codirector of the refugee center. "Their minds have been broken, their bodies have been broken, and unfortunately, their souls have been broken as well."

Grodin draws on multiple disciplines for his work: he is a professor of health law at BU's School of Public Health and a professor of psychiatry and sociomedical sciences and community medicine at the School of Medicine. On the liberal arts side, he teaches philosophy at the College of Arts and Sciences. A noted speaker and author, he is working on a book entitled Mad, Bad or Evil: How Physician Healers Turn to Torture and Murder, From Nazi Germany to the Former Yugoslavia.

He also teaches bioethics and lectures widely, so most of his time is not spent with distraught patients. A majority of his associates at the center also work there on a limited schedule. Even so, at weekly meetings, they make a point of discussing their own mental state as well as their clients'. "There are well-known cases where care providers of torture survivors have had nightmares and flashbacks," Grodin says. "We're very sensitive to that and monitor it closely."

The patients are lucky in one respect: they managed to escape to America. According to data from the United Nations, there were an estimated 11.4 million refugees living throughout the world in 1999, not counting millions of citizens who were displaced within the borders of their own countries.

A beating in Pakistan. A physician in the background monitors the punishment to decide whether the man can survive more blows or whether the beating should stop before it kills him.

Up to one-third of all refugees are thought to be survivors of torture, and in the United States, by some estimates, 5 to 10 percent of all foreign-born patients in inner-city hospitals are torture survivors. "Doctors don't always find this out," Grodin says, "because just as it used to be with spousal abuse, if they don't ask, they don't know." The psychological scars of torture include depression, post-traumatic stress disorder, intrusive thoughts and flashbacks, inability to concentrate, and hypervigilance. Grodin has seen it all, as he has treated victims of the world's atrocities for more than two decades. In 1996 he and George Annas, another SPH professor of health law, established Global Lawyers and Physicians, a nonprofit human rights organization. And four years ago he cofounded the refugee center at BMC with a group of other University colleagues, who provide pro bono legal and medical services.

BU faculty, social workers, and vocational rehabilitation counselors work at the refugee center, along with interpreters from BMC who speak 30 different languages. Apart from guiding clients through the court system, Grodin and the staff attempt to track down missing family members, such as the Hutu woman's husband and son.

Education and lobbying are other important components. Grodin and his colleagues hold sensitivity training sessions for health and social service professionals, and remind judges and immigration officers not to interrogate refugees. At the legislative level, the center is advocating changes in a law that limits the period for filing a political asylum application to one year after the refugee sets foot in the United States.

"It's just ludicrous," Grodin says. "People come to this country, they don't speak the language, and they're frightened. There are many people who need longer than a year to file a claim."

He acknowledges that this is not the best time to be lobbying for a change. Since the September 11 terrorist attacks, Congress has not been all that sympathetic toward refugees and immigrants, particularly those from Africa and the Middle East.

The center has a very small operating budget, although it has received support from the U.S. Office of Refugee Resettlement and the United Nations Voluntary Fund, as well as a recent $20,000 grant from the Reebok Human Rights Foundation. Fundraising is a constant concern, and there's a pressing need for donations of warm clothing: half the patients come from countries where temperatures never dip below 40 degrees.

As a result of violent upheavals throughout Africa, 40 percent of the patients attending the refugee center last year came from that continent. Another large group were women raped in Kosovo and the former Yugoslavia. The Buddhist monk is one of several Tibetans whom the center has helped, along with oppressed Kurds from Turkey and Iraq, political refugees from Latin and South America, and survivors of the Cambodian genocide. On average, three to four new cases are referred to the center every week.

"We're inundated," Grodin says. "Where our patients come from depends on where there's a crisis, and increasingly, there are crises going on all over the world."

For more information, visit www.glphr.org/refugee. To donate clothing, call 617-414-4794.

18 January 2002
Boston University
Office of University Relations