Clinicians Raise Voices, Signs to 'Restore Asylum' for Migrants

Kathleen Doheny

February 28, 2020

The 13 volunteers lined up single file on the overpass of Interstate 5 at Camino de la Plaza in San Diego, the last freeway exit in the United States before the Mexican border. As it got darker, each hoisted a battery-operated light board so the steady stream of southbound cars could see their message: Restore Asylum.

The hour-long light vigil on February 26, hosted by the newly formed San Diego chapter of Doctors for Camp Closure (D4CC) — a national "nonpartisan activist group of physicians who oppose inhumane detention of migrants and refugees who are attempting to enter the USA," according to their Twitter page — capped off a day of activist messaging for immigrant rights nationwide.

Members of Doctors for Camp Closure hold a protest banner over a freeway in San Diego.

Earlier, members of D4CC and other groups had displayed banners at several other San Diego area overpasses, with the same message. Nationwide, D4CC, along with Never Again Action, Overpass Light Brigade, Gente Unida, and other groups also put up banners in Houston, Texas; Los Angeles, California; Minneapolis, Minnesota; Plymouth, Massachusetts; Newton, Massachusetts; New York City; and Washington, DC.

At Wednesday's light vigil, some healthcare professionals arrived in casual clothes, while others, including the chapter founder Tari Gilbert, FNP-BC, MSN, a nurse practitioner at Owen Clinic of the University of California, San Diego, were still in their white coats, fresh from seeing patients.

Whatever their attire, each echoed the same message: Doing nothing is no longer an option as detained immigrants are being denied basic healthcare.

Members of Doctors for Camp Closure hold lighted protest signs.

"What the US is doing at the border is torture," Gilbert told Medscape Medical News. "Asylum is an important first step."

She began organizing the San Diego group after clinician activists who went to the border with flu vaccine for immigrant children got turned away and arrested in December 2019. "Flu has killed children," Gilbert said. After that incident, D4CC tweeted: "We came with free vaccines. We left in handcuffs. We cannot let this continue."

The San Diego chapter's first meeting was in January, and already 15 healthcare professionals are actively participating, Gilbert said, including physicians, nurses, nurse-practitioners, a physician's assistant, and ''a couple activists."

On a national level, the group's Facebook page lists over 2300 members. They don't work solo, realizing strength in numbers. "We are building coalitions," Gilbert said. "We know healthcare. We know human suffering." She admits readily that they have a lot to learn about negotiating activism. "So there's a lot of coalition-building."

The D4CC group, along with their allies, are protesting not just the refusal to allow vaccinations, but the Trump administration's toughened asylum and immigration policies that began in 2017. Gilbert explained that the group wants asylum not just for those in camps but for others detained, too.

On February 28, the US Court of Appeals for the Ninth Circuit blocked the Trump administration-backed policy requiring those applying for asylum to remain in Mexico while awaiting the decision. Known technically as Migrant Protection Protocols, those challenging the policy contend it does the opposite by placing people in danger.

Still, according to a report published February 27 by the Migration Policy Institute, the Trump administration's ''interlocking policies" have greatly reduced the number of people receiving asylum. The report cites the February 27 testimonial of Customs and Border Protection (CBP) Acting Commissioner Mark Morgan before a House Appropriations subcommittee, saying these policies mean officials can offer a consequence or alternative pathway to 95% of those apprehended, ''rather than releasing them into the interior of the United States."

In a statement, a spokesperson for the CBP told Medscape Medical News that the organization ''is increasing efforts with partner countries to stem the tide of illegal immigration."

Officials from the US and partner countries (Honduras, Guatemala, El Salvador) hope to discourage people ''from making the dangerous journey north to the United States" and not to place their lives in the hands of human smugglers, the spokesperson said.

In 2019, according to the CBP's website, nearly 1,150,000 people were denied admission at the border. The CBP detained or "controlled," according to the agency, more than 859,000 people and turned away more than 288,000 others.

In just the first month of 2020, over 94,000 people have been denied admission, with over 133,000 apprehended, according to the CBP.

During the hour-long vigil in San Diego, many drivers of the southbound cars honked — "We're going to assume that's in solidarity," said one of the light-holding volunteers, Karolyn Mauro, MD, a family practice physician in San Diego.

Some passersby walking on the overpass stopped to ask what the vigil was about, while some drivers on the overpass waved and smiled. One man walking by muttered: ''F­­--- asylum."

What Lit the Activist Fire?

For many of Wednesday's volunteers, just as with Gilbert, the December 2019 refusal to allow clinicians to administer flu shots to immigrants detained at the border was the beginning or revival of their activism. "If you have the vaccine [available], why not?" asked Elena Johns, RN, a nurse at the Scripps Cardiology Clinic.

After a long day at the clinic, Johns volunteers with the D4CC group and others. Sometimes she flies out of state for immigrant rights protests and activities, paying out of pocket.

Some of her fellow nurses, she told Medscape Medical News, have asked why she doesn't ''just take care of what's on her plate." And she said that for her, ''it brings me back to why did I become a nurse? We are in it to help all people. It's a humanitarian crisis and it's not going to get better unless we step in and help."

Mauro describes herself as a life-long activist, but she, too, was moved to action by the flu vaccine refusal. "I can't not do something." She said the ''last straw'' in recent years was the separation of children from their parents.

"That is not something people get over quickly," Mauro told Medscape Medical News.

And a new study backs up the belief that there are lingering effects. On Tuesday, the nonprofit group Physicians for Human Rights (PHR) issued a report concluding that the trauma experienced by the 26 parents and children they studied, all separated as a result of 2018 US policy, is technically torture.

The executive summary of the report states: "The U.S. government's treatment of asylum seekers through its policy of family separation constitutes cruel, inhuman, and degrading treatment and, in all cases evaluated by PHR experts, constitutes torture."

"As doctors, we spend our time trying to alleviate disease and suffering," said Sarah Stone, MD, a hospitalist with the Sharp Rees-Stealy Medical Group. "What we are doing at the border is causing suffering." And that, she said, ''is opposed to everything that I do."

Her activism to help immigrant rights, she told Medscape Medical News, has grown in the last 4 years, and she cited the election as playing a major role. She mentioned the federal attempt for a Muslim ban and what she views as the further marginalizing of groups already marginalized. To colleagues, she says: "Use your voice. People are suffering."

"We have a lot of power, we have a lot of privilege," Gilbert said. By that, she means the privilege of an education and of having skills. That privilege must be used, she said. "I couldn't live with myself if I didn't."

Beyond the Light Vigil

Gilbert is already planning the next D4CC project — a ''chain fast" to raise awareness of detained immigrants, some of whom have staged hunger strikes. It will be set up, she said, as a website event. Participants sign up for a day of fasting, and fast according to their religious, dietary, or other needs, she said, whether it's for a few hours or a day.

"The idea came from the hunger strikes in the detention camps," Gilbert said. "They're trying to force feed them, which is illegal."

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