These three women are heroes. Every day, they deploy their considerable medical knowledge, skill, and compassion to treat patients whose life experiences are rarely seen in US clinic settings: torture, violence at the hands of the state in their countries of origin, psychological trauma, even forced abortions.
These medical professionals participate in the Northwest Health and Human Rights (NWHHR) program, delivering medical, psychological and legal assistance to torture survivors, the only program of its kind in Washington state. NWHHR is a partnership between Harborview Medical Center, Refugees Northwest, and Northwest Immigrant Rights Project.
You might be asking, how could this be a ‘feel good’ story? And you’re right, the problems seen in this clinic are often heartbreaking and scary. Yet what inspires us at Refugees Northwest is the resilience and courage of these patients, who are all survivors. The truly amazing professionals at NWHHR make it their life’s work to understand the delicate process of reaching and healing this population of people. Many patients are newly arrived in the US and already coping with language, employment, housing and other issues. But as we’ve learned, if their medical and psychological needs can be met, they will thrive. It is a genuine triumph of shared humanity.
Registered Nurse Heather Burkhalter is an experienced Emergency Department caregiver and has helped launch two federal grant-funded clinical services in refugee and immigrant care. At NWHHR, she now coordinates care for newly-arrived refugees and triages complex cases in the clinic. She serves the medical needs for survivors of torture, who have suffered unimaginably, both physically and psychologically.
“We might see depression or post traumatic syndrome. It can be traumatic brain injury, healed broken bones, joint or back injuries. It could something as common as urinary issues that tips us off to a deeper problem. I’ve come across cases of female genital mutilation, which I’d never seen before.” Seeing these patients only deepens her resolve. “For me, this work feels reparative. I can’t change what has happened to people, but we can listen and believe, we can take the time to understand the underlying issues and provide the right treatment medically and culturally,” explains Nurse Burkhalter. “We can help change their futures. We can help the person in front of us.”
We can help the person in front of us: it is a profound statement of purpose.
Dr. Mahri Haider, an attending physician in the International Medicine Clinic at Harborview, is relatively new to the NWHHR program (having been hand-picked by the Medical Director), but has a profoundly personal understanding of the human issues. She was a refugee at the age of 3, traveling through Pakistan from Afghanistan with her family to reach safety in the US. She’s worked on women’s health issues in Kabul, Afghanistan, and became deeply interested in global health and refugees even before earning her bachelor’s degree and M.D. at the University of Washington and her advanced degree in Public Health at Harvard.
“It doesn’t escape me, when I hear certain people’s stories, that that could have been me. Sometimes there are tears. But all of my interests and passions come together in this clinic, and we can make a difference when it counts most,” she says.
“I am so fortunate to work as a part of this team, to provide extra time and individualized care in a supportive environment for people who’ve been through so much. At the same time, what they can overcome amazes me and to be part of their lives and their recovery is really something.”
Knowing what to look for, what to ask and how to ask it, understanding cultural norms and political histories of the countries of origin–all of these are part of the equation. Allowing extra time for exams, identifying the forensics, listening carefully and thoughtfully, plus connecting patients to other services that can support their social stability are also crucial. Patients are aided in seeking health insurance, transportation, financial and legal aid. Sometimes, the first step is the simple act of listening and believing a patient’s life story.
“My very first patient here was a Chinese woman seeking asylum. She had endured multiple forced abortions, and I was pregnant at the time,” said attending physician Dr. Nicole Chow Ahrenholz, as her eyes welled. “You can’t help but relate and feel for your patients. It’s often pretty stunning stuff.”
Dr. Carey Jackson, Medical Director of the International Medicine Clinic with extensive experience in cross-cultural medicine, adds, “The more we understand about other cultures and experiences, the better we can deliver medical care. For example, I had a Cambodian patient with very painful memories about standing in line for scarce food in a refugee camp, so it was important to help her streamline her cancer care in such a way that did not bring that back with lots of waiting. Another patient, a man from Cambodia, had severe nightmares and stress once he was an empty-nester. He’d coped well up until then, but the solitude was difficult and caused suppressed feelings to well up. So, when we can truly understand our patients’ backgrounds and lived experiences, when we perpetually study the political happenings around the world and the cultural norms, we can be much more effective in addressing their needs. And everyone deserves that.”
Dr. Jackson is also a professor at the University of Washington, and deeply interested in anthropology and public health. Over the course of his work he has seen first-hand the results of beatings, forced feedings, electrocution, waterboarding, stress positioning, starvation, sleep deprivation, solitary confinement, and more. Amnesty International reports that, over the last five years, torture has been used in 141 countries, three-quarters of the world.
“But I believe in social justice,” he says with conviction, “and I know that medical institutions have proven there is a powerful approach to restoring people. We work each day to provide that. You see so much short-sightedness and meanness in the world and there’s nothing I can do about it. The mechanisms are limited. But this place, this program, allows us—one person at a time—to make a difference against brutal policies and people’s suffering. I am inspired by our patients.”
Refugees Northwest is inspired by these professionals who go far above and beyond the call of duty to care for people who so deeply deserve proper, respectful, knowledgeable support. We are proud to work alongside them. They are standout professionals who could work anywhere, do anything. But what they have chosen is health, justice, and hope.
Especially during this holiday season, we see in them the very meaning of being human. And we thought you should know them too.