Video: No refuge for people forced from home

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Stephen Figge: Okay. Hi, guys. Sorry about that. Sorry for the delay, guys. Thanks for coming today to the Knight Studio at the Newseum. For those of you ... Oh, I'm Stephen Figge. I'm the events manager at Doctors Without Borders. So I'm just going to take care of a little bit of housekeeping before we get started. It's an event, so please turn off your phones or anything else that's going to make a noise. And for our D.C. audience, I do know that, hopefully you were given cards to write questions. We'll gather them up a little later and give them to the moderator to read off. Also for those people who are watching on our stream, if you want to ask questions or submit questions, we can get them to the moderator as well if you use the chat function, which is activated by clicking the speech bubble icon in the upper right-hand side of your screen. For those on Facebook live, you can submit questions in the comments system. Or in the comment section. Excuse me.

Stephen: Many of our panelists are from Doctors Without Borders. They're going to say MSF a lot today. MSF stands for Medecins Sans Frontieres. It's our French name. And what we usually call ourselves internally. So don't get a little confused on that.

Stephen: So, I think that's it. So welcome to today's event. It is Turned Away: No Refuge for People Forced from Home. I'd like to thank Sarah Stillman. Oh, hi, Sarah. Our moderator today. She's a staff writer at the New Yorker, and the director of the Global Migration Project at the Columbia School of Journalism. All right. So we'll get started. Sarah?

Sarah Stillman: Yeah, thank you so much, Stephen. And thank you, all of you, for joining us here today at the Newseum in Washington, D.C. to discuss such a pressing topic. Normally it's hyperbole when you say you're discussing one of the most important things in the world, but I think that's a fair thing to assert today. And a warm welcome to all of you who are joining us online as well.

Sarah: So, as Stephen mentioned, my name is Sarah Stillman, and I'm a staff writer at the New Yorker magazine, where I tend to cover immigration and criminal justice which started out for me as two very separate beats. And as we're going to discuss today, have really converged into this one central kind of overlapping set of themes.

Sarah: So, I don't know if any of you saw, but just this morning, UNHCR released the new numbers of people who are fleeing war, persecution, and conflict. And they say that number now exceeds an astonishing 70 million people worldwide. And that, they said, was the highest number they have ever seen in the agency's existence. In the 70 years of their existence.

Sarah: So, we're here today to discuss some of the troubling consequences of that crisis. And in particular, the breakdown of the global commitment to provide safe refuge for those who are fleeing for their lives. And in some cases, the outright criminalization of asylum seekers and migrants and refugees, and also those who seek to aid them in the humanitarian context.

Sarah: We've got about an hour to cover the largest refugee crisis in our history, so hopefully we'll leave here with some answers. But more importantly, we want to hear your questions as well. So we've got 40 minutes to hear from these incredible panelists, and then we're going to turn it over to you. And those of you online, as Stephen mentioned, can put your questions via Facebook or livestream in the comments section. And those of you in the audience can put them on the note cards, and we will get those passed to us.

Sarah: So, I want to dive in. And I'd love to start with each of the panelists introducing themselves. I'm sure that could take the whole day, too, so we're just going to do a really quick kickoff here. The latest titles and what you've been working on, and then we're going to dive into the conversation.

Craig Spencer: Great. Thanks, Sarah. My name is Craig Spencer. I'm the director of Global Health and Emergency Medicine at Columbia University Medical Center. And I'm also on the board of directors for MSF USA.

María Matas: Hello. My name is Maria Hernandez. I was Field Coordinator for Mexico Immigrant Project. For one year, more or less.

Omar Jadwat: I'm Omar Jadwat. I'm the director of the Immigrants' Rights Project at the ACLU.

Bianca Benvenut: Hello. I'm Bianca Benvenuti and I'm the MSF Italy Advocacy Officer working mainly on migration.

Sarah: Great. So we've got a lot of experience on many different continents on the stage today, and I wanted to begin very quickly by just reading a few lines of a poem that I think sets the stage for the conversation that I want to have. And a friend who works with refugees just shared this with me. It's by a British poet with Somali roots, named Warsan Shire. And it's called Home.

Sarah: And Shire writes, "No one leaves home unless home is the mouth of a shark. You only run for the border when you see the whole city running as well." And the poem continues with this line that really stood out in terms of what I want us to discuss, "You have to understand that no one would put their children in a boat unless the sea is safer than the land."

Sarah: So with that, I'd like to start with you, Dr. Spencer, given that you led the medical team onboard the Aquarius, the Doctors Without Borders search and rescue mission in the Mediterranean. And you've rescued more than, I believe, 30,000 migrants at sea and refugees at sea. So I'm hoping you can tell us a little bit more about the efforts on board the ship, and in particular, since we're going to have this conversation first hearing a little bit about what migrants are facing on the journey, some of the actual dangers, can you tell us about who's coming right now, what they're enduring, and what you've seen through that work?

Craig: Sure, absolutely. Thanks for reading that poem as well. That's something I've thought about a lot while working on the Aquarius, specifically after having seen women arrive with newborn babies or having, in some circumstances, having assisted in the delivery of babies in the middle of the Mediterranean Sea. Which for me was something that I'd one, never prepared for in medical school and two, could never really imagine as a real possibility.

Craig: And I think what those events highlighted for me, and really the reason that MSF started getting involved in search and rescue in the Mediterranean is because we recognized very early on that capacity didn't exist to provide search and rescue and to provide medical care to many of the people that were fleeing violence, fleeing torture and rape and abuse in the detention centers of Libya.

Craig: And so onboard, when I was on in 2017 and 2018 as well, we took care of many people. Many small children, many newborns. We delivered a few babies. But the majority of what we saw when we rescued people in the Mediterranean was severe dehydration, psychological shock, many people with the stigmata of frequent and repeated abuse. And it's almost impossible to really explain what it's like seeing patient after patient in the clinic who tells you exactly what they experience in these detention centers in Libya.

Craig: Maybe some of you have heard. It's become a bigger crisis in the past couple months. But there are tens of thousands, maybe hundreds of thousands of people who are in detention in Libya who are being held. Largely kidnapped or held for ransom. And generally what happens is that people, their family members are called on WhatsApp or on any type of video service, and their family is forced to watch while their sons or daughters or families get tortured or abused in an attempt to get ransom to get money from them.

Craig: And so many people have been doing whatever they can to try to escape these detention centers. And the only way out for many is into the sea.

Craig: There's just one story that I'm going to think, coming back to throughout the day, and it's a story of a boy named Mousa onboard who was 15 years old who left home in an attempt to get a better life for him and his family. And throughout the day, and really throughout the conversation we have on migration, we talk about things as economic migrants. We talk about people in a very simplistic and dehumanizing language, in a way that overlooks the experiences that many of them have, the protection risks that they have. Mousa was an unaccompanied minor and was repeatedly kidnapped and tortured and abused before I met him on the Aquarius.

Craig: So, something that we need to remember as we celebrate World Refugee Day, that these are people as well, regardless of what the labels are that we give to them.

Sarah: Thank you. That's really powerful to hear about.

Sarah: Maria, I'd love to turn to you now. You've also done work all around the world with Doctors Without Borders. South Sudan, and Yemen, and the Central African Republic. But I'd really like to focus now on your most recent work in Mexico as the migrants project coordinator for Doctors Without Borders.

Sarah: I think many of us in this room will know that the journey through Mexico, especially for Central Americans fleeing gang violence and other abuses, is one of the world's most dangerous trips. But I'm not sure we really know at the granular level what that specific threat looks like along the route. So I'm hoping you can tell us more. I'd seen, for instance, that in MSF's materials, they'd done some research that said 68% of MSF's patients who are migrants who had traveled through Mexico had faced some kind of violence along the route. So can you tell us more about what that actually looks like, and what has surprised you the most, doing the work from the ground, in terms of what you've seen?

María: Thank you, Sarah. Just to link up as well with what my colleague, Craig, was saying, the most important message I want to pass is that these people are not criminal. I really start losing hope in humanity when we need to repeat more and more often this statement. They are just people.

María: I'm also a migrant. The only difference is I have the right passport and the right opportunities. What I see when I arrived to Mexico ... As Sarah was saying, I have been working ... I don't have that much experience. Only since 2015. But in really war zones. This was my first mission in America. I arrived June last year. And I was shock. I was not expecting to find here the same level of violence I was witnessing in Yemen and Central African Republic or South Sudan.

María: This is what is going on in Mexico. And I think it's important to give voice to the people. To give voice to that. To listen their stories. And this is what I want to share with you. The stories that my colleagues right now, in our clinics in Honduras and El Salvador and Mexico, the stories that they are listening every day.

María: So, I just pick one. It's a 16-year-old teenager that I met in Coatzacoalcos in the south of Mexico. Those are his word. "I'm traveling to help my grandma, to offer her a better life. When I was one year old, she brought us to Mexico, but we were caught by Migration, and we have to go back to Honduras. There, you have few opportunities. Your only option are the gangs, and I don't want to go into that world. I want to do things right, to work to help my grandma and my brother, who has a son. Once you entered into the gangs, you cannot go out. They kill my father when I was seven years old. And my uncle when I was six-year-old. One of my cousin, as well.

María: "I am now traveling with my brother, who has already been to the United States but was deported. But we are going back. We don't have other option. We cannot stay in Honduras. This road is not easy. We are hungry. We were beaten. We have to sleep in the street. A lot of tiredness from walking for days. But we have to get up and continue.

María: "We are taking care about migration, but also criminals and people who don't have good intention. That's why we go together. This road is not simple, but what else can we do?"

María: To understand migration, we need to think globally. The things and the suffering I was witnessing during one year in Mexico are not that different from the ones that are happening in Europe. These people from Honduras, from El Salvador, from Mexico as well, because we need to remember that Mexico is not a safe country. We have clinics in Guerrero states, which is one of the most dangerous there, and people are literally trap in their communities because all this violence.

María: These people is fleeing violence. What they found in the road through Mexico is more violence. And what happen if they manage to cross to USA? A vast majority of the people that manage to arrive to USA, they will be detained. Even if you ask for asylum, you first will be detained.

María: We are working in the northern border of Mexico, as well with the Mexican deportees who are here in the States, and then returned to their country. And we met people that had been living here for 30, 40 years. And they are sent back to a country that is not anymore its own.

María: For me, one of the things that shock me the most is doesn't matter if the person was caught just crossing or if the person was living here for many years, they all talk about these frigid holding cells. These hieleras, no? These freezers. And all the patient tell us the same. It's not the fact of sleeping on the floor. It's not even the fact of having almost putrefied food. It's not the cold. It's the inhuman treatment that they receive in these detention center. And when my colleague talks about Libya, and I can find parallels with the detention center in the States. I pick up the detention centers in the State, but we could talk about the Mexican detention center and the condition.

María: I was in Nuevo Laredo just one week ago, and I was talking with one colleague. A psychologist. He was explaining me one of the techniques that he's using with these deportees. With these people that are just coming back from the States. And he said me, "The main message that I'm passing is: you are humans." I mean, if the US or Europe doesn't have the capacity to answer to this migration flow in a human way, who will?

Sarah: We're going to dig more deeply into that. I want to make sure that everyone-

María: Yeah, sorry.

Sarah: No, there's so much. So many connections, also, between the work. So feel free if you want to say any wrap-up comment and then we'll ... Okay, great. Thank you so much, Maria.

Sarah: Omar, I'd love for you to chime in here. As the director of the ACLU's Immigrants' Rights Project, I know that you have seen the dangers facing asylum seekers, very closely through the lens of litigation, and you have sued the Trump administration on almost every possible front. I don't actually know when you find time to sleep, because the number of ACLU suits on this specific issue we're talking about today is really astonishing. So I'm hoping that you can tell us a little bit more first of all about what asylum seekers affirmative rights are, what does the government owe people when they show up seeking safety at the US/Mexico border? And then if you can tell us about some of your clients who have had those most basic rights ripped from them, and how your team has been responding.

Omar: Sure. And so ... We have an asylum system in this country that's based on, I think largely grows out of, an acknowledgement and understanding that we had nationally and that existed internationally as well, that what the US did and what other members of the international community did right before and during World War II was a huge failure. That turning away ships full of people fleeing the Nazis, returning them to be killed in their home countries, was something that should never happen again. Right?

Omar: And so that translated into a whole system of international and national laws, domestic laws, that are designed to make it possible for people who reach the United States to seek protection from persecution. And so there're international obligations, there's domestic obligations, but the law as it's written makes it very clear that we as a nation have committed to the idea that if you come to this country and you can show that you have a well-founded fear of persecution, that you will receive refuge here.

Omar: And in addition, of course we have a Constitution here in this country which sets out a lot of rights and a lot of restrictions on how the government can treat people. Fundamental notions of due process. Other basic protections that apply, certainly to everybody in the United States. And against that backdrop, we have a government that is very forthrightly, I think, trying to shut down the asylum system. Notwithstanding the laws on the books, notwithstanding the Constitution. To do as much as they can to make asylum unattainable. And to punish people for trying to seek it. In part to deter other people from trying the same thing.

Omar: And so, we have, just to give a few examples of things that we have been suing over, we had a family separation policy at the border, right? You asked about effects on the people we represent. The very first person who we represented in our family separation lawsuit, the person who brought an individual lawsuit that became a broader lawsuit about the police came to the US from the Congo, with her seven-year-old daughter. They were initially detained together and then her daughter was taken from her. Sent 2,000 miles away. Their home language was Lingala. They were both detained in places where few people spoke their language, and where they had no idea when, if ever, they would be able to be reunited.

Omar: There's a lot of stories, some of which you may have heard before about people being ... People who leave their kids for a minute because they think they're going to a brief appointment, have to talk to an official or something, and they come back and their child is gone. And as you know, or as has become clear, the government did this without any system for tracking what they were doing with the parents and the children. And literally didn't know, when we first won a court order in this case, didn't know how to find out what had happened to the parents of the children in their custody. Didn't even know which families they'd separated.

Omar: So family separation, which was very clearly designed to punish people and to deter people from coming. John Kelly was on TV saying we will take away your child if you come to the United States. Or considering doing it, and then they started doing it.

Omar: And it goes back to the poem, right? And to your experience in the Mediterranean. Not a situation that anyone wants to be in or wants to put their child in. Just the experience of the journey in the first place, and then at the end, after making your way through Mexico, finding your way to the United States where, on paper, you're going to have a chance to actually tell your story. And at that point to have your child taken away from you.

Omar: So, family separation. They've tried to change the asylum standard so that gang violence and domestic violence, even where the government is allowing it to happen, can't form part of the basis for an asylum claim. They're trying to ratchet up detention of asylum seekers in the United States so that people don't have a chance to present to a judge the fact that they're not dangerous, that there's no reason for them to be detained while their asylum proceedings go on. They tried to just flat-out close the asylum system except at ports of entry. To ban asylum even though the law very clearly says you can apply for asylum whether or not you're at a port of entry, and no matter how you came to the United States. They said, "No. We're going to say unless you put yourself on a list, wait months, and then maybe are allowed to present your claim at a port of entry, we're just not going to consider your claim at all."

Omar: And of course, now we have a forced return policy under which, without hearing people's asylum claims, people who make it to the United States and apply for asylum are being sent back to Mexico, again without any hearing on whether they have a legitimate claim or not, to wait there while their claims make their way through the system here. And right now, over 10,000 people are stuck in Mexico, subject to the violence that you've just heard about, while their cases proceed here. And I could talk more about it, but there's ... Yeah.

Sarah: Yeah, hopefully we'll get to the connections between what both of you are doing.

Omar: Just a sense of kind of what the asylum system is facing in the United States. What has happened to that commitment and how it's being daily denied.

Sarah: Eroded. Yeah. I'm glad you brought us back to the World War II context as well, and hopefully we can get to that, how we even crafted the whole construct of a refugee in that post-World War context as a matter of atonement, to some extent.

Sarah: And I wonder, Bianca, if we can shift to you and hear ... You're the advocacy officer and migration policy specialist for MSF Italy. And you've examined how Europe's migration management policies have affected, and in many cases undermined, the well-being of asylum-seekers and migrants. And I'm curious, for those in the audience who aren't as familiar with the European context, if you could kind of walk us through this notion of border externalization and tell us a little bit about how you've seen it play out and the work and the research that you do. Particularly, perhaps, in the context of Libya.

Bianca: Sure. So one of the main priorities of the government in Europe, and perhaps not only Europe but in other location, has been to stop migration. So rather than managing migration, avoid migrants from reaching Europe. Externalization policies seem to be the long-sought magical want to achieve this goal by pushing the border outside of Europe, and expanding in this way, the fortress Europe by outsourcing migration control to third countries.

Bianca: So, what does this practically mean? Third countries with which Europe has relation, can achieve a very good relation with the European Union if they serve the agenda of migration control. On the other hand, European Union is providing funding to this country and is strengthening their border control securities and so on and so forth. To make sure that migration flows are stop even before people reach Europe.

Bianca: Of course, they are portrayed in these policies as a great success in which the European Union managed to secure the external border of Europe, but they did so in complete disregard of, first of all, international law and secondly of what should be our main priority which is people's protection. So these policies are actually putting migrants, people in general, in a position of being much more vulnerable than they were when they started the journey.

Bianca: So if we look, for example, in the context of the EU-Turkey deal that is one of these externalization agreement that Europe signed with Turkey three years ago. So three years after the implementation of this deal, we still have around 12,000 people stuck on the Greek islands awaiting to be either returned back to Turkey or being resettled to the Greek mainland to have their asylum request assessed. So MSF works in the Greek island and is witnessing, on a daily base, the consequence of dire living condition on people's well-being and mental health, especially. These 12,000 people lives in camp that are extremely overcrowded, where security is not ensured, and they have extreme problems in accessing health care and basic rights.

Bianca: Actually, many observers and researchers pointed out how the countries that are prioritized for these externalization policies are countries that have a very bad record of human rights and that have very strong human rights violation. And some of them did not even sign the Geneva Convention for the Protection of Migrants and Refugees.

Bianca: And with regards to this, it's absolutely the most striking example is Libya. So at the moment, migrants in Libya, leaving what we can only define as hell. Which is extremely hard to really, for me, even to tell you and make you understand what these people go through. At the moment, in the country we have 6,000 people that are arbitrarily detained in detention centers where they are exposed to a never-ending circle of abuse, violence, and torture. All of this has been very well documented by UN agencies, NGOs, and many other organization, but still the European Union, Italy, backed by the European Union, signed an externalization agreement with Libya. So it's now funding and training the Libyan Coast Guard to intercept and return people to Libya.

Bianca: Libya's always been very important for Italy, because of course it's on the other side of the Mediterranean Sea, so it's the most important partner to stop the migration flow through the central Mediterranean Sea. But what we are basically doing, what our government is basically doing, is returning people to extreme suffering and human rights violation. The situation of migrants, and in general of the population in Libya, deteriorated after the war. We can call it a war. Started again in April this year. So now we have fighting in Tripoli where first of all, yeah, the local population is exposed to extreme violence. In fact, we have already 90,000 people who have been displaced to other places, while 3,000 migrants in detention centers, with no right to move, are stuck in the city and are exposed to this fighting.

Bianca: So as MSF, we work in detention centers, and we have worked, as Craig was mentioning before, in the Mediterranean Sea. And we heard the most terrible stories about what happens in Libya. And yet, it's hard for us to really advocate for the government to stop sending people back.

Sarah: This is really helpful. So, I think now you can start to see how some of these threads are intertwined, insofar as what we're seeing in the Mediterranean, what we're seeing at the US/Mexico border, what we're seeing in the detention context in Libya, these trends of criminalization.

Sarah: I'd like to transition now to how concrete policies have led to that, and to dig in a little bit more to some of what you were describing with border externalization. And I think, Craig, this is a good moment perhaps to turn to you to hear a little bit about the work you've been doing in the Sahel. Because I think that's a region that's less well understood in terms of how policy is directly endangering the lives of migrants and asylum seekers. And can you tell us just about some of the work you've done there on human rights abuses, mortality, and how it's connected to policy shifts?

Craig: Absolutely, yeah. So I had mentioned this story about Mousa, this young boy that was traveling across West Africa from Gambia, up to where I eventually met him on the Aquarius. And we sat down one day and we drew a map of everywhere that he had gone. And he had mentioned that being in the Mediterranean was tough. He had gone out three different times, and each time he had some trouble. One time he went out and they lost their way and they came back, and the person that was driving the boat was shot on sight. Another time they said they went out on the boat and someone tried capsizing their boat, or sinking their boat with a big piece of wood with a nail on the end of it. Third time I actually saw him, and he told me that the Mediterranean was tough, that being in detention in Libya was absolutely horrible, but one of the toughest things for him was actually getting across the desert in Niger.

Craig: Many of us, quite honestly, may not know where Niger is, or all that much about it. It is this incredible contradiction because it's one of the poorest countries in the world, and it is now the largest recipient per capita of European Union funding, which is largely linked to stopping migration. And so bringing together all these threads in terms of criminalization and externalization, this idea of putting your borders not where we think they are, not in the Mediterranean Sea, maybe not even in a place like Libya which is so unstable, but even further back in the deserts of the Sahel, in places like Niger.

Craig: So, this has been outside MSF so I'm speaking more on my work through Columbia University, but we're running a project trying to measure human rights violations and death amongst people that are trying to get past this. This is the border of Agadez. This is just right outside of town. Agadez is an oasis city in the middle of the desert. It has been there longer than the United States has been a country. And basically, what's happened is that in the past couple years, the European Union has been funding the army and been funding government in Niger to prevent people from going any further north of Agadez, despite there being a visa agreement in place amongst 14 or 15 ECOWAS (Economic Community of West African States) communities and countries in West Africa that allow visa-free travel.

Craig: And the point is, there was an attempted to try and hide this criminalization, or this crackdown on migration in the Mediterranean, but groups like Doctors Without Borders and other NGOs were there. We have been since removed, forcibly removed largely, from the Mediterranean. And now this push against migration has gone further back into the deserts where, quite frankly, the majority of people are unwilling to go to see what's happening. And so in visits that I've made there, and speaking with people on the Aquarius, and speaking with people in Agadez, everyone has seen people dead in the desert. We know that people are being forcibly pushed across borders from Algeria back into Niger. And a lot of this is being done at the behest and with funding from the European Union. And it's a convenient way to hide the impact of these policies that people just don't know.

Craig: I think what's really important to point out here is that although the policies might be a little bit different, what they all represent is an attack on the same human values, the same inalienable values that we all adopted in the wake of World War II, as Omar pointed out. We gave primacy to human rights. We said that people should not be arbitrarily detained if they're seeing refuge. And what we're seeing now is active measure in the US and in the Sahel and many other places to not only prevent people from migrating, but also in several ways to punish them.

Craig: So the impact of this in Niger has been that where before people would go in caravans of many cars, they would be escorted, sometimes by an army escort to prevent against being attacked by bandits, they would go into towns where they could buy water and food, now none of those things happen. They go in the middle of the night. They may not have enough food or water. They may get lost because they're trying to take different routes through the desert. So we actually have no idea how many people are dead. We don't know what happens to people. And I think this is the intended impact of this policy, unfortunately.

Sarah: Yeah. I'm glad you brought up the issue of who's profiting from this. And as you were speaking about the desert, I was very much reminded of the policies changed in the US in the 1990s. The idea of prevention through deterrence. And the idea was kind of shifting people from crossing the border at these high urban traffic areas and shift them into the desert where the mortality rates very swiftly shot up.

Sarah: So I think this is a very good moment to transition back to Maria and Omar to just hear a little bit more about that at the US/Mexico border, and in the context specifically of how certain policies are leading to the criminalization of asylum seekers. So we've talked about family separations which is a very obvious instantiation of that. Criminal prosecutions through zero tolerance. But I'm wondering if both of you could tell us about perhaps some of the lesser known ways in which asylum seekers in that context are being criminalized.

Omar: Go ahead.

Sarah: Maria.

María: Okay. So when I was listening to my colleagues, I realize that migration is used as economical and political tool. This is clear. And this externalization of borders is certainly USA is doing with Mexico. So of course we are a humanitarian medical organization and I don't know, or I don't have the legitimacy to say what are the policies that are ... the migratory policies that a country should apply or not. But what I can say is to highlight and to point out the consequences of those policies.

María: So I will take two recent change. The first one is the militarization and massive detention in the southern border of Mexico. Okay? This happened couple of weeks ago. We have mobile clinics that is working in Coatzacoalcos, Veracruz. South of Mexico. And we wait for the patient, for the people that are traveling in this train. Sometimes they are avoiding the train, so they walk more or less five days. They arrive dehydrated, with a skin infection, gastrointestinal, with panic, because most of them has been robbed, assault. Sexual violence is a powerful tool that is used in the south of Mexico by these criminal gangs.

María: So, we were waiting for this population in Coatzacoalcos. And at the same time, our teams were giving these first medical care with mental health consultations. Some distribution of kits. A raid from the immigration authorities has start. They start detaining people while we were giving medical assistance. Despite this is violating some laws, because you are avoiding these people to get healthcare. It's inhuman.

María: And the second policy that I want to share with you that Omar mentioned before is this remain in Mexico, no? When the people arrive to USA to seek asylum, so we are talking about very vulnerable people, they are going to be sent back to Mexico to wait for their resolution. This waiting period, and you will correct me, but sometimes is almost one year.

Omar: More.

María: Or more. So I just came from Nuevo Laredo. Nuevo Laredo is in Tamaulipas state. It's a region that is completely controlled by criminal and organized crime. To give some data from this area, 37% of the patient we see in our mental health consultation has been kidnapped in the previous week. This is only a small picture about what is going there.

María: I remember, this was couple of months ago, a mama that was in one of the centers that we are working, and we were treating her baby. And there was some complication and we have to refer the baby to the hospital because we didn't have the means to give her good health assistance there. So we refer the baby. And the mama was so scared to go out. To go outside, to go up the street, that she refused the referral. She didn't want to bring her baby to the hospital because she was about to be kidnapped again. And this is the place where the US government is planning to send back the asylum seekers.

María: So those are the two points I wanted to share.

Sarah: Wow. No, that's important. Thank you.

Sarah: We're nearing the 40-minute mark so I want to quickly remind all of you if you have burning questions, please do write them down. Or if you have questions online, please do put them in the comments section and we'll get to that very shortly. But we'll do the lightning round of finishing up this part of the conversation.

Omar: Sure. I would just add on the question about criminalization, it's maybe not unknown, but it's ... I don't think people often really understand. So when you talk to my three-year-old’s about what it means, what crime control means, and all that stuff, they're always talking about putting people in jail, right? That's what police do. They arrest people. They put them in jail. And the overuse of detention in our US immigration system generally, but especially with respect to asylum seekers, is immense. The people are treated like criminals. Without ever being prosecuted as criminals. But being treated as criminals. In these hieleras.

Omar: And then potentially for years thereafter being held, sometimes, as I mentioned before, without any chance to even make a claim that, "You can let me out on bond. I will return," by any standard that you would ordinarily assess somebody in the criminal system about whether to give them bond. No question that these people will come back. But the government refuses, and parts of our law allow them to refuse in certain circumstances. There's obviously a lot of disagreement about what those are. To let them go.

Omar: The effect it has on people who are trying to assert claims, I think also is maybe obviously if you think about it, but is easily lost when you talk about the fact that there's a civil detention system and the people are subject to the civil detention system.

Omar: So the number of people that we've talked to who have totally legitimate asylum claims but who day to day are facing this impossible choice about whether to remain in jail with no particular end in sight, no sense of how long it's really going to take, and no assurance that they're ever going to get a fair shake in making that claim, versus returning to a place where they're in mortal danger. It's not actually an easy choice. And so many people give up legitimate claims and return themselves to danger because they can't take being in jail for these extended periods.

Omar: And so it's just when I think about criminalization, that's one of the things I think about the most.

Sarah: Yeah. No, that's powerful. I can really quickly share. I was recently in El Salvador interviewing a transgender woman, the loved ones of a transgender woman who had fled after she was being persecuted by police. She was detained, although she identifies as female, in a male facility for a long time, facing all the atrocious conditions you describe, and ultimately her and her good friend ... She was tricked into signing paperwork to be sent back, and the friend just couldn't endure the conditions and was sent back. And shortly thereafter, several months later, she was killed by the very people that she had feared would kill her. So I think you're absolutely right that the consequences aren't just abstractly potentially dangerous, but that your team has really documented the concrete consequences for people who may have given up legitimate claims.

Sarah: Bianca, I'd love to turn to you for the last question of this round about this issue, not only of the criminalization of asylum seekers, but the criminalization, increasingly, of those who attempt to provide humanitarian aid. So you've seen that through your work at MSF, how people doing the kind of work you do, are increasingly criminalized. Can you tell us a little bit about that?

Bianca: Yeah. I'd say when the so-called migration crisis started, this triggered the wave of solidarity all across Europe. This was actually a very good thing. Citizens and civil society organizations have organized and started providing assistance to migrants, especially in those locations where the lack of state assistance created the gap in assisting migrants.

Bianca: Instead of praising this kind of behavior, states soon started criminalizing this kind of act and these kind of activities. And when we talk about criminalization of solidarity, it's very hard to categorize what this criminalization means, because the word criminalization makes us think about legal proceeding, but that's not the case. That's not only the case. It's not only about legal proceeding. It's mostly about intimidation, threats, and perhaps harassment, and being portrayed in the media and social media as a criminal. Like you're doing a criminal activity because you are engaging migrants.

Bianca: So just to give you a couple of examples to have a clearer idea, we had a lot of activists and volunteers being criminalized at the borders between Italy and France because they helped migrant crossing. Migrants were walking through the mountains in wintertime, often without shoes, freezing to death. And some people just passing by this road just gave them a lift. And these people found themselves being prosecuted for facilitating irregular migration.

Bianca: We have one very specific and interesting case there, which is the one of Cedric Herrou, which is a French farmer who hosted hundreds of migrants in his house at the border with Italy. And he was prosecuted for facilitating irregular migration, and after he got many conviction for his action, but at the end, the French Constitutional Court said that actually his actions were in line with the principle of fraternity, solidarity, you know? Brotherhood, that is written in the French Constitution.

Bianca: So again, as I was mentioning before, and if we look at also other cases of other volunteers and activists, many of the legal proceeding at the end are closed and activist and volunteers are cleared from all accusation, but what are the consequences of what's happening? What are the consequences of being targeted by the media as a criminal because you are helping illegal migrants, like as if someone can be considered illegal. One of the main consequence that I think is extremely worrying is that people are deterred from engaging with migrants. And this increases the policy of exclusion of migrants that are more and more segregated in our society. And people don't want to engage with them because they are scared. They are scared of going through the same things these activists have been going through.

Bianca: Another thing that I would like to say about active criminalization of civil society organization, and I think it's one of the maybe most symbolic example nowadays, is the criminalization of search and rescue operation in the Mediterranean Sea. I think the criminalization of NGOs work, like the rescuing of migrants at sea, is happening mainly because NGOs are challenging European deterrence policy. They are challenging this externalization policy. Just think about the fact that compared to last year, the mortality rate in the Mediterranean Sea increased four times. And while in the past we had NGOs and independent actors witnessing what was happening, now there is only one boat left in the Mediterranean Sea, and that boat is actually now, as we speak, is stuck south of Lampedusa, which is one of the most souther part of Italy, with more than 50 migrants on board, awaiting for a place of safety to be given from the Italian government.

Bianca: So, I think this is also very important thing. Civil society is criminalized when they are trying to voice concern and showing what are the consequences of these government policies on migrant population. And most importantly, being the one that provide assistance to the migrants in the first place, when they are criminalized, first of all, they lose time because responding to criminalization is time-consuming. So you don't really have time to do what you wanted to do in the first place, which is assisting people.

Sarah: Yeah. This is another arena in which the parallels to the US are really striking. People have probably heard about the case of Scott Warren. Is everyone familiar with that? This man who ... A group of people in Arizona who are now facing criminal prosecution for providing food and beds and water and clean clothing to migrants in the desert there. So I think there's quite an interesting, or troubling, I should say, trend which we're seeing in the US as well. People may know this. He's facing 20 years in prison, and there was just a hung jury and I'm not quite sure what's going to happen with that case. But it reminded me of what you were just describing.

Sarah: So, I'm going to transition to the audience questions. I so appreciate whoever wrote this first one, because I really wanted to make sure we didn't leave you on a despairing note. And I was hoping to hear about some bright spots. And thankfully someone in our audience wrote the question, "Are there any countries that are responding in a humane way?" So maybe we can hear from each of you, or one of you, about that. Are there any bright spots? Any good responses? Or better than average?

Omar: I mean, one thing I would say, and it's not exactly the answer to the question, but there are parts of this country that are responding in a humane way, right? I think we ... There are very few things that have convinced ... I mean, the amount of public response and outrage to the family separation policy, for example, is part of what ended that policy. And I think one of the things you've seen is that all of the attacks on immigrants and on migrants have actually only deepened public support. Unfortunately, that doesn't get translated well through our political system, but it has only really deepened political support. I mean public support, for immigrants and for immigration.

Omar: And I think our experience as lawyers has been that, not to the extent that we would wish, meaning we don't win every single case all the time, but there has been a significant ability to defend the rule of law by challenging these policies, and stopped many of them from going forward. So, the list that I ticked off earlier, most of those have been stopped through litigation, and I think that's a reflection of the fact that there is hope that you can put in some aspects of the system we have set up.

Craig: Can I add one thing?

Sarah: Did you want to chime in? Yeah.

Craig: Yeah, just quickly. You had mentioned that over 70 million people that have been forced to move around the world, and we talk about this migration crisis in the US or in Europe. The crisis is not in the US or in Europe, and it's not a crisis. And if it was, it would be in places, the countries around where people are fleeing from. Places like Lebanon, Jordan, Turkey. The majority, the overwhelming majority of people that have been forced to flee are stuck in their home country and don't have access to safety. Once many of them are able to leave, they cross a border and they don't get much further than that. The overwhelming majority of Syrian refugees are in countries around Syria. They are not in Germany. They are not in the United States.

Craig: So one thing that we talk about in terms of migration is these waves or hordes of migrants. They're not here. They haven't made it that far. The majority of them are being hosted by welcoming communities either within their country or within countries right around them, and we don't talk about that enough. So I think those communities and those countries in some respects are doing a lot better job.

Sarah: Yeah. Okay, to try to keep up our positive momentum, we have from Lynn on Facebook, "This is all so sad. And I feel the need to be doing something. What can those of us do who are viewing and maybe not working on these issues every day?" Do you have any thoughts? Bianca?

Bianca: Yeah, maybe considering also what I was saying before, I think that one of the way normal citizens can actually mobilize is just by engaging with migrants. If I talk to most of my even family member in Italy, they've never spoken to a migrant. And still, how our policy ... We are every day listening to news about migration and our government agenda, it's all about migration. So how can you really have an opinion if you never spoke with these people? So I think this is a very basic step and it doesn't take too long, because they live in our society and they are just ... They are our peers. I don't know. And in order to resist this policy attempt to divide us, we should make an extra effort to be together.

Sarah: Can you talk about some of the ways people can do that? And I'm curious, Maria, if you have any thoughts on this as well. If we were to try to actualize the beautiful words Bianca just shared, what are ways that people might do that? To get involved, to get engaged, to meet migrants, people in the community that they could actually get to know and hopefully have some positive effect.

María: Well, I think Bianca recommendation is the best one, no? We need to start talking with these people, because they are just people. And our stories cross, no? I'm surprised in Mexico to find people from Congo. There are very few, but little by little, they are coming more often. All the way crossing the ocean, arriving to Ecuador or Brazil, and then going up. And when they tell you their trip of months. I was working in Central African Republic two years ago. And they just cross half of the world. So they have beautiful stories. Yeah. I think this is the first step.

María: And then talking and knowing this reality from the very basic, you will find your way to help.

Sarah: Yeah, I learned a really beautiful word when I was on this trip through Mexico a number of years ago with a group of mothers whose children had disappeared, or whose husbands had disappeared trying to get to the US. And so we went thousands of miles through Mexico trying to look for their missing loved ones. And the women would just stand in the town square with a photograph of their loved ones around their neck and say, "Has anyone seen my daughter? Has anyone seen my son?" And in the process they would tell their stories with people in the streets. Anyone who would listen. And one of the mothers taught me this word in Spanish, “desahogarse.” To undrown oneself. And I thought it was such a beautiful word about when all of us, even those of you who are here in the audience today, when you're telling stories to friends, to family members, and engaging them in this conversation, that's kind of part of a collective act of undrowning. So I've always kind of treasured that word.

Sarah: We're going to move onto a question from Christine on the chat. "Can Omar," and perhaps Maria, you might want to elaborate on this as well, "Can Omar elaborate on the news that sexual and gender-based violence is no longer grounds for seeking asylum in the US." I think this is a reference to the Matter of A-B- decision.

Omar: Yeah, so ... That's not-

Sarah: Or tell us.

Omar: Yeah, so there's been ... There was a ruling by the previous Attorney General that tried to take these types of claims off the table, right? To make it impossible to assert asylum claims that involved gender-based violence or gang violence. And so we actually challenged that policy and now have a ruling from a court that says that, at least at the initial stage of asylum proceedings, the initial screening stage, that that ruling by Attorney General Sessions can't be applied. And so there are additional contexts in which the application of that policy still needs to be litigated out, but this kind of initial stage litigation has been successful in putting it on hold.

Sarah: Great. And Maria, do you want to speak to anything you've seen in terms of survivors of sexual or gender-based violence who are asylum seekers?

María: Sexual violence is the defined as a medical emergency. For us in Doctors Without Borders, it's medical emergency. It's treated like that. There are period, and you have 72 hours to give that treatment. If it's between 72 and 120, this other protocol.

María: So again, I'm not a legal person, so maybe that's why I don't understand this kind of proposal. I remember some cases. We have a specialized treatment center in Mexico City of the more extreme cases of violence and torture which is in Mexico City. And I remember a case. It's from El Salvador. Women from the LGTB community that has suffer, among others. Repeatedly sexual violence. She was force. She was recruited by force by a criminal group, forced to have sexual relations. This was one of the things that they have done to her.

María: So, I cannot understand why this type of violence cannot be considered to apply for asylum, because we know that sexual violence is also used as a tool. It's used as a war tool in some countries. And here in the countries in the northern jungle of Central America, it's also used.

Sarah: Yeah. And it's good to know that the ACLU has successfully been fighting that particular fight.

Sarah: So we're going to end with a question from Annette, and I'm going to add a little bit to it because she asked a good question. "Many of my high school students don't have papers. What can they do? What is the first step?" And I wonder if we can also add onto this, for young people who might want to get involved, to just kind of return to that question of how people can engage, particularly those who may be in their own precarious situations like some of these high school students who may be living with the fear of not being documented.

Bianca: Well, I can't say much about this context, obviously, but I mean, luckily enough, in Italy, we have a good system of protection for undocumented minors. So, it doesn't happen too much that they are at school with no documents. They are quite protected in this. And as for like going back to the question we were discussing before about engaging with migrants, again, I'm not from this context, I don't know. But if any of you ever travel to Europe, I think it's extremely easy to engage because the ... I mean, migrant population live with us. And again, when we think that it's so hard, like, "What can I do? How can I find them?" We are falling into the trap they are selling us.

Bianca: The migrant is the person working in the café next to my house or is the guys living at the station. And we are so scared of talking. And you just go and talk with these people. Or just give them a smile, and the second day they will see you, they will smile back. And maybe on the third day, they want to talk to you. Or maybe they don't and it's fine. If they don't want to talk to you, it's fine, because they are not supposed to share their stories. I mean, they are not supposed to be a witness of what they've been going through. We are the one who are supposed to make an extra effort.

Sarah: I think that's a really good note on which to end, unless Dr. Spencer, did you want to add anything in particular about either the young man that you mentioned to us and where he ... what his current circumstances are, or anything that you didn't get to share?

Craig: Sure, and I think that's great. Mousa, I know, was one of the few people that we were able to follow up with once he was disembarked. And I know that he was doing much better. He had lost 40 kilos, so close to 100 pounds on his journey, in addition to everything else that he experienced. And again, this was someone who was still a teenager. So I think for me, it was interesting to hear his story and to use it to highlight a lot of the issues that we're talking about.

Craig: And in terms of how I think we can engage, everyone in here has heard dehumanizing language about migrants almost on a daily basis. Either via presidential tweet or in newspapers or even in conversation. How many of you have heard of the Lancet report that was done within the past year that showed that migrants are less likely to be ill? Migrants are less likely to bring diseases, or have diseases, than host populations. These are things that we overlook, and we don't use as tools in changing the narrative and changing the language because what's slowly happening is that this dehumanizing language is becoming a lot more normal. And I think something that we can all do is educate ourselves and educate others around what migration is, what are the stories that you hear up here, the stories of Mousa and others. And how we can actually help other people regardless of the color of their skin or the country that they're from.

Sarah: Wow. Well, thank you for such an engaging conversation. Thanks to Doctors Without Borders for hosting us, and thanks to all of you for taking the time to come out and invest in caring about this issue. Really appreciate your being here. That wraps up.