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Several years ago a young man
came to see me in my clinic.

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He told me he was running for his life.

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He said that he fled his home

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because there, homosexuality
wasn't just illegal,

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in some cases it was punishable by death.

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So when his sexual
orientation was exposed,

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his family rejected him,

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his boss fired him

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and angry mobs repeatedly
attacked him in the streets.

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And each time the police arrived
only to arrest him,

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detain

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and torture him further.

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And he knew that if he couldn't escape
the cycle of violence,

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he would surely be killed.

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So he had to do what he needed
to do to survive.

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He left everything behind.

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All of his friends,
his family, his career.

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He fled his home,

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he escaped to the United States

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and here he applied for asylum.

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But like many people fleeing
this kind of persecution,

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he couldn't carry much.

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He had some basic ID,

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barely any money

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and a few other belongings.

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He certainly didn't bring
official documents

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from the police who tortured him.

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No videos from the mob
that tried to kill him.

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He didn't have this kind of evidence
to help support his claims,

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yet here he was,

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sitting in my clinic,

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showing me some of the most powerful
evidence of his persecution.

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That was the physical and psychological
scars that he brought with him.

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You see, he suffered from chronic,
debilitating pain.

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He had severe scars
scattered over his body,

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poorly healing wounds
that got infected over and over again.

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He suffered from severe depression

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and continued to regular, paralyzing
nightmares and flashbacks from PTSD.

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So we continued our work.

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We met regularly for months,

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documenting each of these pieces
of medical evidence.

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We went over the details of every attack,

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photographed his scars,

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documented his injuries and wounds,

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and we were even able to start
chronicling his slow but steady recovery

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while under our care.

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Working closely with his lawyers,

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I submitted a detailed affidavit,

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including the findings of this forensic
medical evaluation,

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and we included it as part
of his asylum application.

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And then we waited

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for several long years
while he navigated the courts.

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And then one day I got an email from him.

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It said that he was granted asylum.

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And everyone in the clinic was overjoyed.

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He said in his email that this was
the first time in years

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that he didn't fear deportation and death.

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It was the first time in years
that he truly felt safe,

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that he had the security
to rebuild his life all over again.

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And it was only through this medical
and legal advocacy

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that we were able to help restore
his legal status and his rights

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that he could do that,

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all through asylum.

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Now for many people fleeing persecution,

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they come to programs
and clinics like this

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telling unimaginable tales of violence

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and different reasons
they were persecuted.

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But one this is always the same.

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The violence meted against them
was met with complete impunity.

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Sometimes by the hands of the state
directly through police

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of military officials.

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In other cases,

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the state just turns a blind eye

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and condones the acts
of paramilitary groups

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or even violent domestic partners.

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In other cases,

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state is completely powerless

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to protect the vulnerable
from powerful gangs.

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Now we know that social determinants
of health play a huge role

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in determining the health
and well-being of our patients:

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housing,

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income,

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education,

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race,

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social inclusion.

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But the same can be true
for equal protection in the law.

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Due process.

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Especially in societies
for the most vulnerable,

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the marginalized

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and even those who are actively targeted,

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their access to these human
rights protections,

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that can mean the difference
between sickness and in health,

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and often it's the difference
between life and death.

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And for millions of people
who endure persecution and torture,

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the only way to heal

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is to acknowledge the human
rights abuses that have occurred,

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and to help restore the rights
and protections that were so violated.

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After the atrocities of World War II,

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the asylum system was set up
as one pathway to that kind of relief.

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But these days it seems like that pathway
has turned into an obstacle course,

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setting people up to fail.

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Asylum seekers oftentimes
don't know how to start

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let alone complete the process
that can drag on for years.

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They're not entitled to lawyers,

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so they don't know their rights.

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Increasingly, they're even being barred

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from setting foot in places
of potential refuge.

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They're arrested or prosecuted,

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even deported before they ever
get to see an asylum officer.

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And even if they do
make through the process,

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asylum grant rates
can be as low as 20 percent,

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and far worse for some.

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It's almost like the system was designed

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to keep people from
exercising their right.

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But there is something that many
of these people can do.

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Something that can potentially
increase their chances of success

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to 90 percent or more.

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So what makes the difference?

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Getting a lawyer and having
a medical evaluation.

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It's as simple as that.

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The man who came to my clinic
and won his asylum case.

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Doctors and lawyers working together
to present all of the evidence,

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including the medical evidence,

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to the courts

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allows judges to make informed
and just decisions.

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And it's this kind
of medical-legal partnership

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that's now more important than ever.

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Because we live in a time
of epic forced migration

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due to violence and conflict.

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In 2018 there were 70 million
people worldwide forcible displaced

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due to war, conflict and persecution.

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It includes 40 million
internally displaced,

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25 million refugees

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and three million asylum seekers.

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Here in the United States,

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we see the impact of escalating violence
in places like El Salvador,

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Guatemala and Honduras,

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where murder rates can be high
as those in Syria and Afghanistan.