The UCSF Pediatric Human Rights Collaborative-East Bay provides individuals seeking asylum with forensic documentation of the physical and psychological manifestations of torture and ill-treatment experienced in order to apply for asylum in the United States. The clinic trains clinicians on how to perform forensic evaluations and help build a network of providers in the Bay Area, advocate for asylum seekers and provide referrals to health and social services for the clients we serve.
GENERAL INQUIRIES & TO SUBMIT A REFERRAL
ADDITIONAL INFORMATION ABOUT THE UCSF HUMAN RIGHTS COLLABORATIVE
2024 HRC Leadership Board
HRC holds a monthly adult, pediatrics and psych clinic. The clinic coordinators manage the
UCSF HRC clinic's operations and handle clinic-related email/phone correspondence with our
legal, community, and clinical partners. These coordinators interface directly with clients and
evaluators. These roles are especially great for students interested in clinic or program
operations and leadership.
Adult Clinic Coordinators: Ivy Tran & Shivany Y. Condor Montes
Peds Clinic Coordinators: Kaitlyn Crowley & Sapna Ramappa
Adult & pediatric clinic support attend monthly clinics to support clinic coordinators and in-clinic
operation. They work closely with clinic coordinators to facilitate clinic organization and
implementation, including: setting up cases in REDCap; requesting interpreters; requesting
shadowers; requesting care team referral sheets.
Adult Clinic Support: Daniel Luis Zager
Peds Clinic Support: Riya Master
After a client is seen in HRC, the care team provides 3 follow up phone calls within 6 months
during which they screen for social needs and provide referrals to community resources using a
survey in REDCap. The care team coordinators will lead this program.
Adult Care Team Coordinator: Samar Shaqour
Peds Care Team Coordinator: Austine Peng
This role is responsible for operating as the liaison between the HRC and law offices/community
organizations representing HRC clients. The referral coordinator manages referrals and select
cases with the support of HRC faculty, and then connect closely with clinic coordinators to hand
off cases for scheduling in the HRC. This coordinator will read and review client declarations
which can require significant exposure to trauma.
Referral Coordinator: Mahika Nayak
Affidavit coordinators ensure that affidavits are completed and submitted to attorney before
deadlines and track outcomes of cases that have been seen by HRC.
Affidavit Coordinators: Melat Birbo & Mandy Quan
Research coordinator maintains and updates IRB training and amendments to current IRB
ensuring study personnel are added and up-to-date with training and modifying application to
include new study aims.
Research Coordinator: Nebyou Mergia
The Training Coordinator serves as the liaison between the HRC and the clinicians who perform
asylum forensic evaluations, and the students who attend the elective. Overall, this role involves
recruitment, training, support and consultation for our HRC evaluators, and to catalyze long term
engagement for all students in the elective.
Training Coordinator: Ifechukwu Okeke
UCSF Benioff Children’s Hospitals monthly town hall on April 5, 2022 focused on BCH’s health equity initiatives, including the Center of Excellence for Immigrant Child Health and Wellbeing and it's Pediatric Asylum Clinic, the Center for Child and Community Health and the Center of Community Engagement, and how BCH and UCSF collaborate with community groups to further our work of serving every child in need.
[CoE & Pediatric Asylum Clinic presentation starts at: 39:18]
In the News: Pediatric Asylum Clinic Launches In Oakland
On August 28th 2021, the Center of Excellence for Immigrant Child Health and Wellbeing (CoE) at UCSF Benioff Children’s Hospitals, in partnership with UCSF Health and Human Rights Initiative’s Human Rights Collaborative launched its Oakland-based Pediatric Asylum Clinic. A first of its kind, this clinic was created in response to an emerging global call for pediatric asylum medical and psychological practitioners who can provide the necessary documentation of human rights violations specifically affecting young children and adolescents.
Each year, children and families from all over the world flee violence and persecution in their home countries and seek asylum in the U.S. According to Customs and Border Control, more than 18,000 unaccompanied children came across the border in March 2021 (twice the number from the previous month). Alameda County is the second largest county in California receiving unaccompanied minors. During the 2020-2021 school year, Oakland Unified School District (OUSD) had close to 3,000 newcomer students enrolled. Of these students, 267 were asylees and close to 650 were unaccompanied minors.
With the number of unaccompanied migrant children and families on our border at an all-time high, there is a pressing and growing need for forensic evaluation and documentation of human rights violations. When a physician conducts a forensic exam, they are providing compelling evidence to be used during the child’s interview with the asylum officer or immigration judge. A forensic exam corroborates the testimony detailing why their home is too dangerous to return to. A study completed in 2018 found that asylum seekers with a medical evaluation performed by a health professional were granted asylum 89% of the time, in contrast with a national average rate of 37.5% for those that did not receive an evaluation.
Given the highly sensitive screening of the child’s mental, emotional, and physical health, a forensic exam can take three to four hours or more to perform. Using forensic medicine, the examiner is identifying and documenting signals of traumas such as torture, isolation, persecution, and abuse. Each evaluation is followed by a detailed report written by the examiner submitted for use in legal proceedings. From start to finish, it can take approximately two days to complete one forensic exam. Signs of trauma at times can be easily missed, therefore, exams can only be done by medical and psychological professionals trained in forensic evaluations. Currently, there is a tremendous shortage of qualified forensic examiners in Alameda County, particularly those trained in pediatric forensic exams.
For this reason, the CoE established this specialized clinic at UCSF Benioff Children’s Hospital Oakland for trained practitioners to train other providers to conduct these exams that take into consideration the unique needs of children and adolescents with respect to age, development and the effects of trauma.
The clinic counts on a cross-bay team of dedicated volunteers including pediatricians, psychologists, pediatric nurse practitioners, social workers and interpreters from various UCSF campuses. The first Saturday clinic saw four Central American adolescents, providing 2 medical exams and 2 psychological exams. The CoE extends its deepest gratitude to our partners at HHRI-HRC and our first team of volunteers: Arielle Balbus, PsyD; Lisa Fortuna, PsyD; Arthur Lande, MD; Naomi A. Schapiro, RN, PhD, CPNP-PC; Martha Rea, LCSW; Patty Mundera, LCSW; and the CoE team: Raul Gutierrez, MD; Zarin Noor, MD; Lourdes Juarez, CPNP, MSN; Peggy O’Grady, LCSW; Griselda Marie Chavez, MA, Infant Development Specialist; Aura Aparicio, MA, Project Coordinator.
For more information about the Center of Excellence for Immigrant Child Health and Wellbeing: https://immigrantchild.ucsf.edu/
Currently, the Pediatric Asylum Clinic is held on the 4th Saturday of each month. If you are a community-based organization with pediatric asylum cases that can benefit from these services, contact: [email protected] or submit a referral directly to: https://humanrights.ucsf.edu/referrals.
L-R (top): Zarin Noor, MD; Naomi A. Schapiro, RN, PhD, CPNP-PC; Raul Gutierrez, MD; Martha Rea, LCSW;
Patty Mundera, LCSW; Lisa Fortuna, PsyD; Arthur Lande, MD; Peggy O’Grady, LCSW
L-R (bottom): Lourdes Juarez, CPNP; Arielle Balbus, PsyD
From the UCSF Department of Pediatrics blog
Providing Free Medical Exams for Children and Youth Seeking Asylum
A forensic medical exam can improve the success rate for people applying for asylum in the United States from 30% to nearly 90%, but access is limited by a shortage of qualified healthcare professionals that can document human rights violations.
“Even established medical and psychological professions require special training for these exams, as they involve asking highly sensitive questions and detecting subtle signs of previous trauma,” says Zarin Noor, MD, MPH, an expert in immigrant health and UCSF Associate Professor of Pediatrics in the Division of General Pediatrics.
To corroborate the testimony from someone seeking asylum that their home is too dangerous to return to, forensic medical exams identify signals of torture, isolation, persecution and abuse. Exams can take up to 4 hours and are followed by a written report for use in legal proceedings.
Free Exams for Children
Noor and fellow immigrant health expert Raul Gutierrez, MD, MPH, UCSF Associate Professor of Pediatrics, successfully launched the UCSF Pediatric Human Rights Collaborative-East Bay in 2021, a pediatric asylum clinic in Oakland, where they offer free forensic medical exams and train healthcare professionals on the nuances of caring for immigrant children and youths. It is the one of the first clinic of its kind in the United States and has seen patients from Mexico and Central America, South Asia and the Middle East.
“We saw great value in a specialized pediatric clinic that takes into consideration the unique needs of children with respect to age, development and the effects of trauma,” says Noor.
Such services are becoming increasingly vital, with 100,000 unaccompanied or asylum-seeking minors entering the United States each of the last two years. Just in 2021, the Oakland School District welcomed nearly 1,000 such individuals. Before launching their pediatric clinic, Noor and Gutierrez had been involved with the UCSF Human Rights Collective, which also provides free forensic medical exams for asylum seekers but mostly focuses on adults.
“Feedback from our legal partners confirms that these medical exams can truly change the course of a person’s life. Our impact continues to expand as we train more examiners, refine best practices and help more people going through the difficult asylum process,” says Noor.
Going Further for Those in Need
Recognizing that children seeking asylum often face complex health issues that can be made worse by barriers to needed health services, the team at the clinic is committed to doing everything they can to secure care for someone who comes to the clinic with unaddressed medical needs.
One 16-year-old client had been marked for immediate follow-up due to trauma from severe bullying. Their mother had been requesting the county for mental health services for weeks but couldn’t make any progress. They felt completely blocked and didn’t have any other options to pursue given their immigration status as asylum seekers.
“We deployed our medical student care team, who initially ran into some barriers finding the status of the mother’s request due to strict privacy laws. But, together with the child and mother on a conference call, the assigned medical student helped them navigate the system and book a therapist,” says Noor.
Mentoring the Next Generation
Noor and Gutierrez also created and co-direct the UCSF Center of Excellence for Immigrant Child Health and Wellbeing, which serves as an institutional hub to support actions that improve healthcare equity for children in immigrant families, such as the Pediatric Asylum Clinic. Their immigrant health curriculum trains pediatric residents on the multi-layered determinants of health for immigrant populations and how best to serve them.
In addition, Noor wants to help address the global shortage of medical forensic examiners by opening medical students to the impact of this work early in their training.
“Our asylum clinic is co-coordinated by medical students, giving them invaluable direct exposure to the needs of immigrant populations and the importance of trauma-informed care with cultural humility,” says Noor.
The UCSF Pediatric Human Rights Collaborative-East Bay provides in-person services once per month by referral only. Referrals must be submitted by a client’s legal representation. To submit a referral, please visit the UCSF Health and Human Rights Initiative.