Published June 12, 2014
A UB physician and expert in refugee health has been named the primary clinician and medical director of the Western New York Center for Survivors of Refugee Trauma and Torture. The center is a collaborative initiative conceived and funded by Jewish Family Service of Buffalo and Erie County through a grant from the New York State Health Foundation.
Kim Griswold, associate professor in the departments of Family Medicine and Psychiatry in the School of Medicine and Biomedical Sciences, will conduct forensic exams of refugees from all over the world who are being resettled in Buffalo and Rochester.
Certified by Physicians for Human Rights, her work with the center involves documenting and assessing evidence of torture and trauma in refugees and asylum-seekers. She also is required to provide testimony at asylum hearings.
“The UB Department of Family Medicine has been highly visible in serving this region’s immigrant population,” says Marlene Schillinger, president and chief executive officer of Jewish Family Service of Buffalo and Erie County. “We are mounting this critically needed project with the goal of integrating physical and behavioral health care for refugees. Dr. Griswold has unique qualifications to do this.”
Jewish Family Service is one of Buffalo’s four federally certified refugee-resettlement agencies. In addition to UB Family Medicine, partners in the recently launched project are Lake Shore Behavioral Health, Journey’s End Refugee Services and Vive La Casa, with Rochester Catholic Family Center as a regional collaborator. Other UB partners on the project include the UB Global Health Initiative in the School of Public Health and Health Professions.
More than 90 percent of the state’s refugees settle in upstate New York. An estimated 1,500 new refugees resettle in Western New York annually from Sudan, Somalia, Burma, Iraq, Bhutan, Nepal and other conflict-ridden countries.
“The more refugees coming from places experiencing major conflicts, like Syria, the more there is a chance that they may have suffered trauma and/or torture,” says Griswold. “They have a trauma history that we, as their providers, need to know about. They may have witnessed violence or been beaten or raped, and we, as objective assessors for court testimony, need to know how to do a sensitive inquiry. There are specific techniques that we are trained to use, a process of inquiry and documentation that allows us to identify trauma and torture.”
According to Griswold, broaching these subjects with victims requires extraordinary care.
“Survivors have their armor on,” she says. “They want to protect you from knowing what has happened to them. You don’t want to strip off all the armor in one piece. They would fall apart. It’s a process. Providers have to learn how to work well with interpreters and to be culturally competent.”
Griswold says the types of torture and trauma many resettled refugees experience range from sexual violence to state-sponsored violence in order to elicit information, or being forced to witness violence against a family member.
“Sometimes it’s not torture per se, but extreme trauma,” says Griswold. “They have seen horrible things that don’t leave a physical mark, but leave an imprint forever.”
The center will help create a coordinated network of care for these populations.
“Now, if we have a referral for a specific refugee or asylum-seeker, we’ll have a better network of providers who can care for them,” Griswold explains. “Whether it’s medical, social work or mental health counseling, we’ll have a better fabric of providers who can seamlessly care for this person.”
Pam Kefi, JFS Buffalo’s director of program development and implementation, notes that from a human rights perspective, “it’s important to help remove barriers to self-sufficiency. We hope to improve people’s ability to live independently well.”
In addition to providing care directly to Buffalo’s refugee population, Griswold will conduct research on how well the project is going in order to assess its success.
“The research aspect will show us where there are gaps in service,” she explains. “It also will demonstrate how this project can help us use resources more wisely. Treating people who have been victims of torture and trauma will, in the end, result in their becoming more successful, contributing members of the community.”
Interprofessional education among UB’s health sciences schools also will be impacted, as students will have opportunities to become more familiar with issues in the refugee community. This summer, two UB medical students will be working with Griswold to help identify health and medical networks in Buffalo for this population and to identify services that may be missing.
“From my perspective, refugees and asylees are incredibly vulnerable populations,” says Kathleen Soltis, president of the UB student chapter of Physicians for Human Rights and a second-year medical student. “We don’t receive a lot of education on them in the formal medical curriculum, but through our clinical work with mentors in the community, we often come into contact with them. It gives us the opportunity to learn about different medical issues that refugees experience that you don’t see in the rest of the community.”