Hawthorne Smith doesn't just read the international section of the newspaper to stay up to date on global affairs: He does it in anticipation of who might walk into his office next. A crackdown on protesters in Tibet, a flare up in a West African civil war, and intensifying homophobia almost anywhere in the world—all clues.
"Set your calendars forward a couple of months and we will be seeing people from these conflicts," said Smith, the clinical director and a psychologist at the NYC Health + Hospitals/Bellevue Program for Survivors of Torture, one of the only comprehensive torture treatment centers in New York City.
Take an elevator to the seventh floor of Bellevue Hospital in New York City, turn left, and you'll find the program at the end of a hallway. It looks like any other room in the hospital—white walls, gray vinyl floors, a semi-broken water cooler—but the people seated on the blue waiting room chairs aren't typical patients. About 60 percent of asylum seekers who come to the US have experienced some form of torture, and each of the patients here has a heartbreaking story: female genital cutting, severed limbs, electrocution with rods.
"What we are about is rebuilding lives and individuals who come to us profoundly traumatized and brutalized physically, emotionally, and socially," said Dr. Allen Keller, who co-founded the program in 1995.
Keller worked in Cambodian refugee camps in the 1980s and documented atrocities during the Bosnian War, but it wasn't until he returned to the US and began writing detailed and horrific affidavits for the immigration cases of asylum seekers that the light went on.
"It became clear to me that even though those individuals were granted asylum," said Keller, "they had all of these huge unmet health, medical, mental health, social, and legal needs."
He pulled together others who shared the same concern—social workers, psychologist, psychiatrists, and medical doctors—to start working with a small number of torture survivors. Now, the program's staff of a dozen plus interns and volunteers work with almost 1,000 torture survivors each year.
About 67 percent of clients come from Africa and 16 percent from Asia, but nearly every part of the world is represented. Smith says that each area has its own prevalent form of torture: Severed limbs were common in Sierra Leone's civil war; Chinese refugees have often been tortured with electric cattle prods; in Cameroon, it's falanga, a form of torture involving beating the soles of someone's feet.
"Just like any part of the body can be treated by touching various nerves or pressure points in the feet," said Smith, "various parts of the body can be debilitated by beating part of the feet."
It became clear to me that even though those individuals were granted asylum, they had all of these huge unmet health, medical, mental health, social, and legal needs. — Allen Keller
By the United Nations' definition, torture is any kind of severe physical or mental pain or suffering intentionally inflicted on a person for punishment, to obtain a confession, or based on discrimination. Treating survivors requires a holistic approach and about one to two years of intensive services, according to Allen. A core part of the treatment plan is group therapy. If you come on a Tuesday or a Thursday, it's the French-language group for African men. Other days, there's a group for Tibetans, a group for those fleeing homophobia, and a culturally diverse English-speaking group.
"Many are coming to us with ideas of stigma regarding mental health, but culturally there might be the idea of the extended family or the communal support that is at the essence of healing," said Smith.
Clients also have access to one-on-one therapy, legal and social services, yoga, and art therapy. Bellevue Hospital, with the help of NYU, also provides medical services like reconstructive surgery for burned limbs and gynecologists for female genital cutting survivors.
The intensive nature of the program can be taxing on its staff, but working with people who see two options—America or death—is a reminder that life here is still an immigrant's dream, and a safe haven for the persecuted.
"Most people talk about the secondary trauma that we take on because of the intensity," said HangYi Cheng, a social worker at the clinic. "What they tend to overlook is the concept of vicarious resilience that we also take on from our clients."
There are plenty of examples of resilience at the center. One of them is Jean-Pierre Kamwa, a member of Cameroon's opposition party who was imprisoned for activism against the country's dictatorship. He eventually escaped prison, but not before he experienced falanga.
"It is extremely painful," Kamwa told me. "So, so, painful."
A family member managed to get him a plane ticket and a fake passport, with an American visa due to expire in eight days. Kamwa arrived at JFK airport on November 20, 1999—a date he easily recalls. He told the customs agent about the fake passport and why he had it, and they sent him to an immigrant detention center in Queens. Six months later, he was granted political asylum, moved to a homeless shelter, and his lawyer connected him with the Survivors of Torture program.
"We had a chance to speak out, to share our story. It made me realize I wasn't by myself," said Kamwa. He now has his own non-profit, which connects asylum seekers to a network of compassionate homes in Harlem.
There are a handful of other programs—the Center for Victims of Torture in St. Paul, the Harvard Program in Refugee Trauma in Boston, and the Center for Survivors of Torture in Dallas and Austin, to name a few—but not nearly enough for the number of refugees and asylum seekers who could benefit from them. At the Bellevue/NYU Program for Survivors of Torture, there's a four-month waiting list.
Allen knows the patients in his care are getting help they desperately need, but the wait list keeps him up at night. Last year, Allen spoke with a young African man who still had weeks to go before admission to the program. The man hadn't slept in months.
During one conversation, Allen asked the man if he ever thought of hurting himself. "Not this week," he answered.
"I said, 'Oh, tell me about last week,'" Allen said.
The man had walked into a garage, poured battery fluid into a cup, and lifted it to his lips. He hesitated when he thought of his family and God, he said. Allen immediately admitted him to the program.
"It sends shivers down my spine about the people waiting for our program," he said.
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