25 I Refugee Series—The Human Faces of Refugee Trauma: Dr. Barakat Shares Stories of Survival

• Timespan: 41 minutes 
• Transcription Type: Cleaned Verbatim
• Speakers: Suzanne Barakat

Raj Sundar  00:00

Hi, I'm Dr. Raj Sundar, a family physician, and a community organizer. You're listening to healthcare for humans, the show dedicated to educating you on how to care for culturally diverse communities, so you can be a better healer. This is about everything that you wish you knew, to really care for the person in front of you, not just a body system. Let's learn together. Before we start today, I want to provide a sensitive content warning. This episode will touch on topics that include violence, and loss. If these themes are distressing to you, please consider whether now is the right time to listen. This is part of our refugee health series. And this series is coming directly live from the North American refugee conference organized by the Society of refugee health care providers. This series will be different from our typical conversations. It'll feature keynotes from the recent conference, which was held in Calgary, and end with the recap session from the conference. It was my first time there and I'll say I met some extraordinary people who are caring and resilient. Today, you'll hear from one of them Dr. Bearcat Dr. Bearkat, as a family physician and the Executive Director of the Health and Human Rights Initiative at University of California, San Francisco. She's done groundbreaking work there. If you take care of refugees and asylum seekers get this this center achieves 100% Asylum grant rates. You know how incredible this is because the national average is 55%. If you don't take care of refugees, she'll clarify the terminology of refugees, asylum seekers, and stateless persons and discuss a bit of the history around this work. But no matter who you are, this keynote is about her story and her family's story. It is relevant to you. Because people around you whether they're new refugees, refugees who've been in the US for decades, who don't identify as refugees at all anymore, or immigrants who came for different reason, are carrying these kinds of stories, stories of trauma, and you're likely never in a position to hear them fully. Here's your chance. And you know, stories are what bridges the gap between all of us. It's how we are as humans, it gives us insight into other people's struggles shows us their resilience and aspirations. And stories ultimately move us to act. And sharing these kinds of stories can be emotionally taxing for the storytellers. Dr. Bearcat tells us that the deeper she touches her trauma, the more it moves people, but at a substantial personal cost. People like Dr. Bearcat choose to share their stories and trauma repeatedly, not for entertainment. She does it for impact, to change the way we perceive, treat and support refugees and other marginalized communities. I hope you take the time to listen to this full episode, and reflect on what it means for you. Here's Dr. Bearkat.

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Good morning, everyone. What a privilege and honor it is to stand in front of all of you who similarly carry stories filled with resiliency, trauma, hope. Thank you for inviting me. I want to start by saying that I take this opportunity very seriously. It's a responsibility and a heavier weight than you may realize, to try and get it just right. To be a voice for the voiceless, to honor memories of those no longer with us to move us all collectively by a fire to do better for our sisters and brothers around the world who depend on us to make it right. I acknowledge the privilege I and all of us here, carry in the safety and coolness of this conference hall. I also hold the trauma, whether directly or vicariously experienced by all of us doing the vital work that we do. Over the next hour I'm going to take you through the last decade or so of my journey in this work. My story starts as a medical student at UNC Chapel Hill in North Carolina where I was born and raised. My parents are Syrian, and we used to spend funfilled summers in Syria growing up. It live in particular. It's about 30 minutes from Turkey's border. And we haven't been since the conflict started when I was in medical school. an oversimplified high level summary of what happened in Syria. For those who aren't as familiar the Arabs Spring across the Middle East inspired Syrians to also peacefully protest against their dictatorship government that they thought might be met with receptivity, given President Assad Jr. is an ophthalmologist, and the First Lady educated at the London School of Economics, with an inspiring image of modernity that was sweeping through the country. Instead, peaceful protests were met with violence by the government, just like his father, Assad senior had performed mass killings in the 80s of Syrians who revolted against his presidency. It gets complicated with the proxy wars, the vacuum of leadership and accountability that allowed the incubation of extremist groups like ISIS. But at the core, this is a regime killing its people. And the victims of all said players are Syrian families, like yours and mine, who just wants to live and give their children an opportunity have a good life. I used elective time in med school to travel to the turkey Syria border, I worked at a makeshift polyclinic and culus. And further north at the Gaziantep School of Medicine emergency room as the only Arabic speaking provider. On my very first pot, a bus ride down from Gaziantep to culus. I met this family. They had been traveling in Turkey for two weeks going from refugee camp to camp, awaiting admission, all at full capacity. It was a hot, arid summer day. He pointed out my plastic water bottle and said your water bottle is more expensive than Syrian blood. I was able to visit some of the official refugee camps in Turkey. In general Turkish camps were much better than those in neighboring countries like Jordan or Lebanon. They had access to clean water stipends for food, medical clinic and a school. No one wants to live in a refugee camp and yet these were considered the lucky ones. Most people however, couldn't access the camps. People squatting under tarps with no clean water, no food, no protection from the hot summers and harsh winters. Clinics waiting room staffed by physicians from Aleppo who themselves became refugees seeing 500 patients a day. As a medical student, I saw 80 patients today with lots of waterborne illnesses. Basic advice like wash your hands and hydrate were things that you just could not say there was no clean water. This is a child with quashy workers. One of the many patients who come in to his mother was still in Syria and a hospital being operated on. After damage from shrapnel injuries. The dad made it across the border with his son to try and get him help. And you can see here we realized he had a cleft palate and therefore wasn't able to sustain a lacZ and was starving. We were able to get him from Gaziantep emergent from the School of Medicine a pediatric NG tube and get him plugged into one of the cleft palate nonprofits and ended up doing well. But that's one of the happier stories. This was the pharmacy in the polyclinic, severely understocked One of the patients you'd see would be a five year old who had an infected abdominal Moon wound from shrapnel injuries, and there were no antibiotics. There was no insulin for diabetics, the things we take for granted no birth control or abortion care access. It's a medical student, I fundraise that summer $10,000 to get some medications, including IEDs at $3 a pop, the US needs to learn from that. But it lasted two months. And that was just a drop in the bucket. But I remind myself that still mattered. Nearby the clinic where these makeshift PT centers run by lay people tending to youth who've been paralyzed neck down from shrapnel injuries. It was too much. Five weeks 80 patients a day and more people kept coming. More people kept dying, more chemical warfare killing children. No accountability, No justice, no outcry, no international response. We turned a blind eye and frankly, no one gave a damn. That was over 10 years ago. It hasn't stopped. Even at conferences like this Syria is forgotten. My water bottle is worth more than their blood. I want to switch gears for a minute and quickly review some history of refugees. In the aftermath of World War Two 40 million displaced people prompted the international ratification of declarations granting formal legal status to refugees. It started with the 1948 Universal Declaration of Human Rights followed by the 51 convention that created the main internet She'll instrument a refugee law. And in 1967, it expanded the scope beyond European refugees impacted by World War Two. The UNHCR serves as the guardian of the 51 convention overseas this it is their mandate to ensure that the rights of refugees that belong within this definition are respected and protected. So what is the definition of a refugee to legally defined as someone who has fled their country of origin, unable or unwilling to return due to well founded fear of persecution based on five things, race, religion, nationality, political opinion, or membership in a particular social group. And if granted refugee status by the UNHCR, they have specific rights internationally, non refoulement, meaning they can't be forced back into their country of origin, their freedom of movement within and outside their host country. They have rights to family reunification, to legal representation, and access to education and health services. And under the US system, for example, refugees are those seeking entry from a third country, which means what can Syrian refugees come directly from Syria? Know, they seek asylum in a different country and their apply for refugee status by UNHCR and then it's determined which host country will receive them. An important distinction from an asylum seeker who was an individual who has fled their country of origin and applied for recognition as a refugee, and is entitled to freedom from detention. And the opportunity to be employed while awaiting status determination in the US and asylum seeker would apply from within the US are at ports of entry. Whereas an internally displaced person or an IDP is someone who was forced to flee their home but never crossed international border, and therefore they are not protected by international law because they are still under the jurisdiction of their country's government. And then we have a stateless person who is not a citizen of any country. The Universal Declaration of Human Rights underlines that everyone has the right to a nationality. Examples of stateless persons include the Rohingya and Palestinians. Just looking at data really quickly from 2021. There are an estimated and severely under reported 84 million people forcibly displaced people worldwide. More than half of those are IDPs 26 million are refugees. A year later, in 2022, that number went up from 84 million to one Oh 3 million from 26 million refugees to 32 million refugees. Remember that number change, okay. And according to the UNHCR more than two thirds of refugees come from these five countries in descending order, Syria, Venezuela, avana, Stan, South Sudan and Myanmar. Is there anyone missing on the list? That looks obvious? Palestine, according to UN, our WA, Palestine would ranked second in terms of number of refugees. So an important question is where is Palestine on the list?

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The United Nations conciliation commission for Palestine was tasked with resolving the refugee question in Palestine and therefore created un IWA, or the United Nations Relief and Works Agency which came into existence to serve that mandate. Meanwhile, UNHCR was established to deal with millions of European refugees that were displaced by World War Two. And after displacement continued to occur in other parts of the world, so UNHCR expanded its role to tackle refugee emergencies outside of Europe. In other words, the UN our WGA already existed. By the time the UNHCR was created, and they both were tasked with serving different mandates. Palestinian refugees have a very narrow and specific legal definition. They are persons whose normal place of residence was Palestine, between 46 and 48. doesn't count if it was before or after, and who lost both homes and means of livelihood as a result of the 48 conflict. They are not afforded the same legal rights as refugees defined under UNHCR mandate. And since Palestine is not recognized as an official state, all Palestinians are considered stateless persons. So Palestinians do not benefit from any of the funding, the advocacy, the coordination, the resources that the UNHCR has, which is what we think of as the umbrella of refugee work. So if you recall the numbers from that change from 20 In 21 to 2022, we had a rise in over 20 million forcibly displaced persons. We look at a snapshot here in the US. 2021 was the lowest admission rate in US history. 11,411 refugees were admitted into the United States. So back to having a spotlight on the Syrian refugee crisis. As of February 2021 10 years of the crisis, Syria remains to this day the world's largest refugee crisis. 7 million forced to flee their country and other seven internally displaced again severely underreported, and the vast majority live in neighboring countries in descending order. Turkey, Lebanon, Jordan, right off Egypt, most in rural and urban settings, and only 5% live in refugee camps and fast forwarding to 2015. At this time, there was a mass exodus of people leaving on foot. There was news coverage of the unprecedented amount of people crossing the agency from Turkey to the Greek island of Lesbos, with rafts capsizing being the expectation. I was following the family Whatsapp group tracking some cousins as they journeyed on foot from Syria to Germany, with one cousin on those rafts with kerosene leaking down her leg and burning her but no ability to move from how over crowded at was. Or another uncle who texted us that the raft he was supposed to be on ended up capsizing and his family miraculously made it okay on the next one. He created what is now known as the life fest graveyard in Lesbos, with over half a million deserted life vests. We had recently lost my cousin, Mohamed briquette, who was shot on his balcony in Idlib, Syria by regime soldiers as he was yelling at the soldiers to let go of his baby brother, the same balcony. I had spent summer evenings taking in the lovely breeze listening to some old school Arabic music sipping on late night tea. So it wasn't totally shocking when I was at San Francisco General in a busy pediatric Urgent Care Clinic, wrapping up when my phone started blowing up with condolences. Surely it was someone in Syria. I actually ignored my phone at first because of how busy we were. But then calls started coming in Zia, my baby brother, a second year dental student at UNC Chapel Hill, his wife, your son of six weeks, who just got accepted to join him at UNC dental school. And her baby sister is in an architectural engineering student at NC State were murdered, execution style in the safety of their Chapel Hill home by their white supremacist neighbor, because they were Muslim. I take a red eye and by the time I land in RDU, the police had issued a premature statement calling this a parking dispute. Taking the words of the murderer who turned himself in chuckling saying he did it over a parking dispute without anyone bothering to check if there was a parking dispute. In a 24 hour media news cycle, when this wasn't even making it on local news, Muslim Twitter lit up demanding coverage. And within 24 hours, I was on Anderson Cooper. And if you go back in history to that day, what was glaring on the news was the death of Kayla Mueller. A white girl held in captivity by ISIS who ironically was killed by an American drone. And the anger I felt you had three American kids murdered execution style on American soil in their home while eating dinner. And it can't even make it to the local news. But if roles were reversed, and this was a brown or a Muslim person who had killed three white kids in the liberal college town of Chapel Hill, you all would have heard about it. Actually, we would have called it something else we would have called it a terrorist attack. Just exactly what this was ideologically motivated act of violence. But that's not how the media treated this. Instead, I was responding to tell us about this parking dispute. What people didn't know at the time. Imagine as a physician, reading the autopsy reports of three young healthy family members cause of death bullet to the brain. lacerating the midbrain Imagine watching the video Know that dia had the foresight to film in his breast pocket, recording the entire encounter that showed that there was no dispute. This was premeditated murder. Hearing the cries of the girls after deer gets shot up, watching the video and seeing him come back for an eighth bullet to the face. Imagine days after going on the news and the day of the funeral and seeing him in the open casket for the first time and seeing a circular gaping gap in his teeth. From the hatred. The irony that his profession was to perfect the smiles of people. This is no I was invited to give a TED Talk that highlighted the rise and fatal nature of Islamophobia. Did you know that hate crimes rise in parallel to presidential elections? The fear mongering the scapegoating, let's choose which group is the scapegoat of the season. This talk was released on the eve of the election Trump was elected. I was invited to attend a roundtable with then President Obama. And frankly, it's when I hit my worst depression. Up until this point, I was so busy getting my story heard and correcting the narrative, making sure people understood the truth of what happened. I made my story heard to the most powerful leader in the world. And nothing actually changed. Actually, things got worse, not long after the Muslim ban prevented family from being able to come over. Hate Crimes continued to rise. Later that year, I decided to go back to the turkey Syria border. I was in residency at this point. The border town polyclinic, and the Gaziantep emergency room where I see brain matter on stretchers us way too traumatic, particularly with everything I had just gone through and I thought I'd do something a little beer bringing babies into the world. Except the conditions were far from happy. 60% of the patients were Syrian refugees. Without a single Arabic speaking provider in the hospital. Many women laboring on a single bed than forced to walk while crowning to a delivery station, where an anesthetized a PCR dummy was performed. The moms averaged 14 to 15 years old, mostly from a LiPo. Their options were get killed in a LiPo get rate as was an is a common war crime or get married off to a Syrian boy already in Turkey. The ones I saw were in the latter group with no access to birth control, abortion care, postpartum care. Up until this point, many extended family members were still in Syria. They'd become internally displaced, then choose to cross the dangerous border to Turkey. But then cost of living was too high in Turkey and violence calmed down a bit they'd make the dangerous trek back to their home and Syrian has happened many times until it became definitively unlivable. They have all since left northwestern Syria.

23:25

I visited many of them in re Hunley just 30 minutes from Idlib fewer to drive. They haven't seen it in over a decade. They are a beautiful, dignified, resilient people and I have a lot to learn from them. A year later, I'm wrapping up residency also on call when I learned that my cousin, a Syrian American journalist born in North Carolina, and who had freelanced with ABC New York and her mother, Dr. Oba betta cat, a political activist who was outspoken against acid seniors regime were assassinated and found dead in their Istanbul apartment. Their throats are slit bodies wrapped in rugs doused in lime detergent to delay decomposition. Days before they were killed, they shared with an ABC investigative journalist that they had been receiving death threats, and they had possession of evidence of the presence of crematoriums in Assad's prisons. Before this became public knowledge. They were featured on ABC Nightline in their role supporting their friend Kayla Mueller, and her family in an effort to release her from ISIS captivity. It's crazy, right? But you know what? There was no outrage, no real outcry. Not long before this. Journalist Jamal Khashoggi was assassinated and yet the response from the US government around the political killing of an American journalist was met with silence. What it did do however, was send ripple was a fear in the activist community across the Middle East. Because for the first time, people vocal against assets outside of Syria were targeted women in the safe city of Istanbul. It sent the very clear message Syrian activists aren't safe anywhere. It was somewhat of a deja vu or reflexive muscle memory from the way I found out to how I reacted immediately activating people I knew and had cultivated and media and government from my other traumatic experience and frankly demanding meetings at the State Department. Given Hellas relationship with journalists and Abc New York, and Hala and Dr. Otto buzz prior appearance on Nightline, Abc New York and the reveal podcast leveraged an extensive investigative reporting team in Turkey, the UK and the US to bring their story and truth to light. The reveal podcast did an hour long segment, which I encourage you all to listen to, which was featured on NPR imagine being a physician but also playing detective and working on smuggling evidence that the Turkish government didn't want to bring back to American labs for gas chromatography. My life is out of a movie. So at this point, I have lost beautiful service oriented family members to senseless hate fueled violence, religious persecution for being Muslim in North Carolina, political persecution for being vocal against a raging government. I couldn't understand it. How? How can hate be so powerful it kills? How do we do this to one another. The pyramid of hate provides a good framework for understanding human rights violations and their differing contexts. We all carry implicit biases, fear of difference, which can lead to acts of bias like micro aggression, cultural appropriation, which can lead to systemic discrimination, think criminal justice disparities, immigration and border policies, double standard media representation, which can lead to bias motivated violence, like rape, murder, terrorism, and can ultimately lead to genocide, or killing of entire groups of people. In other words, when we otherwise people we dehumanize them, which then allows us to justify something like violence or murder, or even an eradication of an entire population. Let's use this as an example. A Ukrainian refugee boy, age 11. He had traveled 600 Miles alone to the Slovakian border with a number written on his hand. He was hailed as a hero, a dignified refugee, like every refugee should be treated. Here we have a South American boy, same age travels to the US border. And what do we do to him? We place him in detention. And we label him and an unaccompanied asylum seeking minor. I had shared this example in a global health lecture I teach at UCSF, and a Ukrainian student shared with tears tears in her eyes, that she had family that was able to flee Ukraine just weeks prior as this was all unfolding, and crossed the Polish border. While Syrian refugees who were waiting there for years were still not allowed through. Let that sink in for a second. I was practicing full spectrum family medicine, but also with ad hoc speaking engagements or meetings at the White House, and was trying to figure out how to combine my reluctant activist hats and find a way to do that alongside my clinical roles. I joined UCSF to lead the Health and Human Rights Initiative, where we provide pro bono, forensic, medical and psychological evals for asylum seekers to support their immigration cases for asylum. I was tired of just doing humanitarian relief work, which was a drop in a bottomless bucket that did nothing to stop the injustice nor hold anyone accountable. I understood from experience the importance of pivoting clinicians from just humanitarians to becoming tools of justice. at UCSF, we are one of 19 medical student led HRCs and growing in the country. Nationally, we know that 15% of asylum seekers win their immigration case and obtain asylum without attorney representation when they have legal representation, which is hard to come by and remember, it is not a legal right that they have won provided for them. 45% of asylum seekers win their case nationally, which means 55% are deported. When you add a forensic medical evaluation in collaboration with an attorney, that number goes up to an 85% success rate. At our UCSF Human Rights Clinic, we have a 100% Asylum grant rate to date for cases that have been adjudicated. We also built a digital tool using red cap standardizing how forensic medical evaluations are documented and recorded, while also collecting de identified data that can help shape future policy and funding priorities. Particularly as we expand this work nationally. We can do multivariate analyses using this data and published research that's never been done before. We are also focusing on building the pipeline of forensic experts to continue to lead this work. Shout out to my colleague, Dr. Cervini DeFries. She co led a national effort and built a national certification model called the asylum medicine training initiative, or Amti. To train clinicians how to do forensic medical evaluations, which is now becoming the standard to enter into the work. We also created the first clinical human rights fellowship in the world. And we are now year two in training. We also train practicing clinicians globally. An example of this our faculty travels to Turkey annually, and trained Syrian physicians how to document evidence of torture, and ill treatment. These very affidavits, were subsequently used in a landmark conviction prosecuting a high ranking Syrian official of war crimes. It was the first of its kind. And it was made possible by taking the skills we already have as physicians and using them to document evidence that can be used in a court of law. It's incredible work right. Can you imagine this work done at scale nationally. But do you know how impossibly difficult it has been to make this work sustainable, difficult enough that we don't have enough funding for my position next year.

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It's really hard to find asylum work in traditional fundraising methods. It's too much of a niche with its politicized nature, often affiliated with academic centers that are less attractive to funders. And frankly, the model isn't sustainable as a pro bono model, at least not for institutional building, standardization and advocacy work. It requires advocacy on numerous levels to become sustainable and federally funded. Here's or funding, that pie is pretty small. We need to be doing some DOJ lobbying and advocacy to reallocate funding that's there and towards this work. We need to be working at gates foundation level philanthropy to focus on the problem nationally rather than our little clinics all over the country. We're working on creating Medicaid codes for reimbursement of forensic medical evaluations at the state and federal level as a start. And then February of this year happened. A 7.8 earthquake rattles southeast Turkey and northern Syria with its epicenter near Gaziantep. Where the majority of Syrian migrants and refugees have fled to the death toll believed to be severely underreported at around 60,000 deaths. The magnitude of this class three disaster is really incomprehensible. The largest refugee crisis in the world, historically, is that of Syrians. The largest natural disaster of the century is this earthquake. If you recall, I spent a bit of time in Gaziantep. I texted my colleague and friend, the Medical Director of the Gaziantep emergency room, to check in on him and see what could be done. And he said in a matter of minutes 50,000 high rise buildings collapse to the ground in this city alone. Only God can help us. When the earthquakes to hit, there was one formal crossing open between Turkey and Syria at Babel. Hello. People were trapped in the rubble in freezing cold temperatures. And with each passing day slowly, the voices and cries quieted. It took seven days for the first UN envoy to enter into northern Syria for support. Eventually, these two other crossings were opened temporarily to allow minimal aid that came in. This isn't to discount the impact on the Turks. But the Turkish government began delivering aid to its people on day one, extracting people from the rubble feeding and keeping warm the now hundreds of 1000s suddenly homeless The IDPs and residents of northern Syria have no protection under international law, remember, because they're under the jurisdiction of their own country's government. But recall, the Syrian Government is attacking its people. And not only did it not provide aid to go to Northern Syria, but it actively prevented it from making it through. This was a photo sent to me on WhatsApp by a friend in northern Syria who was part of the White Helmets. If you recall, the White Helmets and there's a wonderful Netflix documentary that I recommend you watching are made of a group of volunteers, initially to pull people outside of the rubble. After the bombing and air raids and shelling of the Assad regime. They repurpose those extraction skills and equipment. In the aftermath of the earthquakes. You can see buildings that were completely leveled. And in northern Syria, there was no help. No one gave a damn. All you could see in the days after, particularly on the Turkish side, were piles of body bags as the extraction efforts continued. And truly in disbelief, my family experienced even more loss. My father's cousin, a physician himself, and his family had fled war, violence and Idlib Syria and were crushed dead by their new home and on takia turkey. I'm still not sure all the remains were able to be hauled my family and Ray Hanley after trying for years to settle into a foreign land lost neighbor's property, family, the trauma of the children crying from the repeated aftershocks and not being able to protect their children. Their home was too fractured and unstable. And they were one of the lucky ones. They made it. Once again, they found themselves packing what little they had, and migrating to another city of North hoping that the Turkish Government will approve their permanent move to a different province. When my grandmother died, they had to smuggle her body to the mosque, which was literally next door in between crossfire. Her children who live two buildings down couldn't attend her funeral services or burial. Because it was too unsafe to walk down the street. This grandmother on the right with me, was able to make it to Turkey as a refugee in her 80s She left the only place she knew as home. And due to Trump's Muslim ban, we weren't able to bring her to the US. She died in Turkey, on foreign soil without immediate family nearby during the COVID locked down without the ability to travel to her funeral services. So I'm going to ask this again. Where is the outcry? What is our response going to be? What are you going to do about it? Believe me preparing for this talk. It's the first time I've had to bring all of it together was more difficult than you can imagine. I am not dredging up the worst traumas of my life for entertainment points. I am here for impact. Has there been an individual in this journey that I shared with you today that has lit a fire in you to do something, mobilize, organize, lead execute fund within your capacity, we can do amazing things together. We have done important life saving work. And we have so much more to do. What are your asks going to be higher and promote dei leaders lobby your government representatives for equitable funding and immigration policies they work for you use your voice to elevate the voices of those who can't share your platform. And better yet, make your platform accessible to the communities you serve. Lastly, and most importantly, take care of yourself first. So you can do this heavy trauma field work for others. I say this to myself before anyone else. And trust me, I am heading straight under the covers after this. We can't do this work alone. And we must sustain ourselves. Take breaks, exercise self compassion, and find joy in the little things to keep this work moving forward.

Raj Sundar  39:33

What an incredible keynote. So where do we go from here? You might not be able to single handedly solve many of the geopolitical issues that you've heard about the Syrian conflict the Palestinian conflict or the disasters like the Turkish earthquake. Still, we all play a role as tools of justice. As Dr. Barrett gets us Here's a list of things you can do that will also be in the show notes for this episode. Watch the white helmet documentary on Netflix or the reveal podcast to dive deeper into the stories that Dr. Burkett mentions, support the work of UCSF to lead the Health and Human Rights Initiative. Get trained through the asylum medicine training initiative to do forensic medical evaluation, or lobby or local government officials and elevate the voices of the people that are not heard enough. That's partly what this podcast hopes to do. There's always something to do, and you can be part of the change we need to make. Thank you for listening. And I'll see you for our next episode from the North American refugee conference.

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This podcast is intended for educational and entertainment purposes only views and opinions expressed in this podcast do not represent any of the participants past current or future employers unless explicitly expressed as so all we seek advice of your physician or other qualified health care provider with regards to your own personal questions about what medical conditions you may be experiencing this healthcare for humans project is based on Duwamish land and makes a regular commitment to real rent Duwamish