As refugees flee their home countries, they search for safety from persecution. But even after reaching another country, their journeys are not over.

Instead, they face an arduous process of applying for asylum after landing in their new homes, leaving their fate uncertain. In 2014, 41,920 people applied for asylum in the United States, of which only 13,253 were actually granted asylum.

Georgetown University graduate students are working to make that process easier for applicants, with student-driven clinics at both Georgetown University Medical Center and Law Center providing crucial services to assist refugees on their path to safety.

Medical students opened the Georgetown Asylum Clinic in January to provide free physical and psychological evaluations to those seeking asylum in the United States.

The student chapter is the result of a collaboration with Physicians for Human Rights, a multinational organization of health care professionals dedicated to advancing human rights. Students started their clinic from scratch, and Kelly DiLorenzo (MED ’15), Nicholas Stukel (MED ’17) and Nathan Praschan (MED ’17) serve as clinic co-directors.

“Starting a clinic is not a joke,” Stukel said. “It’s a really slow, clunky, difficult, but at the same time really enlightening and empowering process.”

The clinic provides free evaluations to asylum seekers as part of the legal process of being granted asylum. The seekers are referred to the clinic by Physicians for Human Rights, which receives the cases from lawyers for the asylum seekers. After evaluating the patient, a physician or assistant writes a medical affidavit that becomes part of the legal testimony.

Sarah Kureshi, an assistant professor in the school of medicine who works with Physicians for Human Rights and has performed many asylum evaluations, provided guidance to the students as they set up their clinic. According to Kureshi, it is the physician’s job to determine if a patient’s story matches up with medical evidence, as well as decide if the patient is in legitimate danger if they return to their home country.

“We tell our students in training it is not our job to get emotionally involved or advocate for the patient,” Kureshi said. “We’re providing a legal document that is a medical evaluation.”

Kureshi described graphic scenes of refugees she has evaluated who have been tortured both psychologically and physically, suffering from cigarette burns, beatings with metal batons, rectal trauma and mutilation.

Although Kureshi stressed that the physical and psychological evaluations are objective evaluations, their existence as official records increases the likelihood of being granted asylum.

“Your chances of getting asylum are typically 38 percent or so without a medical affidavit, and with one it goes up to about 90 percent, sometimes even a little higher,” Stukel said.

After three months of training and logistical preparation, the student-run clinic performed its first evaluation last week on an individual who fled Russia after being tortured for political activity and sexual identity. Elizabeth Pickle (MED ’18) assisted the physician in the evaluation and wrote the medical affidavit. In addition to helping the patient in their quest for asylum, Pickle said she was able to benefit from the experience as well.

“So much of medical school is getting mired in the day-to-day stress of academics and learning biochemical pathways, and you always feel like you’re just setting up for the day when you’ll somehow be able to make a difference in a patient’s life,” Pickle said. “To be able to do that as a first year and go into a room and feel like I did something that could actually change a person’s life, I think that’s one of the greatest things the network has done for me.”

A second evaluation is scheduled to take place this week, with the goal of 10 completed evaluations by the end of June.

Medical students are not the only Georgetown graduate students helping refugees seeking asylum. The Center for Applied Legal Studies at the Law Center runs a 10-credit, one-semester clinic that assigns six pairs of law students to a real asylum case.

Unlike the student-run medical clinic that is just getting on its feet, CALS is a faculty-run program that has been assisting asylum seekers since 1995.

“The clinic for the students is a transformative moment because they’re moving from being students who listen to professors in front of classrooms or engage with them in dialogue to actual lawyers who are responsible for a case,” law professor and CALS Fall Director Andrew Schoenholtz said. “It is a huge transformation that occurs because the students have the full responsibility for the clients.”

Kelly Hughes (LAW ’16), a past CALS participant, said she was profoundly impacted by her work with a Hispanic male seeking asylum in the United States, which she said exposed flaws in the asylum system.

“We allow people to get asylum if they are facing persecution based on religion, race, political affiliation or membership in a particular social group, but we don’t allow them to get asylum if they are fleeing a civil war or the gang and drug violence in Mexico and Central America,” Hughes wrote in an email. “It really struck me that we have a law that creates this distinction that’s really somewhat meaningless for the people who need protection.”

Although both law and medical students have become activists in a field that draws on both professions, they have yet to begin collaborating. Schoenholtz indicated he was previously unaware of the student-run asylum clinic, but was optimistic about their efforts.

“I’m so glad to hear that we now have at Georgetown [University Medical Center] serious student engagement in this,” Schoenholtz said.

Praschan said medical students want to eventually work with the law center’s program.

“We want to build toward collaboration with the law school,” Praschan said.

At a time when civil and ethnic conflicts around the world are still prevalent, activists at both the law center and medical center hope to institutionalize and expand the programs for refugees in the future.

“Ultimately in the future it would be really nice to be able to be a lot more proactive with connecting the refugees with different services throughout D.C. or even having our own food and clothing bank or things like that,” Stukel said. “For right now, we’ve been pretty fortunate.”