New Minnesota clinic for asylum seekers is first of its kind in state

NINA MOINI: There's a new medical clinic in town focused on a specific and pressing issue-- evaluations for asylum seekers to support their cases to remain in Minnesota. That means clinicians will work specifically with people in the metro who are going through the process of moving to the US government that their home country is no longer safe for them to stay.

A medical evaluation could make all the difference in those cases. And this would be the first clinic of its kind in Minnesota. Here to talk with me about the new asylum medicine clinic in Saint Paul is Dr. Nathan Bertelsen. Dr. Bertelsen worked closely with the Center for Victims of Torture to establish the clinic. Doctor, thanks for taking the time to be here this afternoon.

NATHAN BERTELSEN: Thank you for having me. Good afternoon.

NINA MOINI: Well, I am curious, why now? Why you decided to start the clinic now. What need were you seeing here in the Twin Cities?

NATHAN BERTELSEN: Well, that's a great question. Thank you. This is a clinic with Physicians for Human Rights. It's actually a Phillips neighborhood clinic activity, which is a long-standing relationship with the University of Minnesota and University of Minnesota physicians.

And we're partnering with the Center for Victims of Torture, which has been around. And to answer your question, they've been in Minnesota working for over 40 years. Outstanding giant in their field doing all sorts of different activities for survivors who are rebuilding their lives after suffering various forms of trauma.

So the Center for Victims of Torture has been doing this work for over 40 years. There's also a nationwide network with Physicians for Human Rights. And PHR has a number of these clinics on the East Coast, the West Coast. But there's really only one in the Midwest. So long story short, we just opened the second clinic in the Midwest to serve this need.

NINA MOINI: And I want to talk about the process a little bit, if you don't mind. I'm assuming you use what many would call trauma-informed practices, ultimately looking for signs of harm. So there is a component of individual service to every patient, I would assume. How do you approach these visits?

NATHAN BERTELSEN: Well, that's the most important part of the service, is to make sure that it's patient-centered and person-centered. One thing right off the bat is the language we use even starts with rethinking what we think about in medical visit. We call our participants clients.

We try to take every measure within the space in the clinic. We have a beautiful space hosted by the Center for Victims of Torture. It's called the Saint Paul Healing Center. And from the entire design of the room, to the positioning of the chairs, to the types of interpreters we work with, we really start before the client even walks into the door, to make it a positive, warm environment

Of all the things that I could say, I think that there's-- and I've been doing this work in New York City for many years before I recently relocated to the University of Minnesota to do it here. And I've spoken about this a lot.

If there's one thing that I've learned doing this work for 15 years is keeping it positive, keeping it positive in every approach. The language that we use, how we describe things, more often than we think, we can push a positive or negative connotation to it. So to answer your question, I really try to keep it person centered and positive and follow their lead as we have the conversations that we need to have. Thank you.

NINA MOINI: And what other venues would there be for asylum seekers in Minnesota to do the forensic testing and the evidence for their cases before this clinic or something like this came along?

NATHAN BERTELSEN: Yeah. So there had been-- I mean, there have been these medical evaluations for asylum seekers, I mean, as far as I know, going back as long as they've been around. This is a new clinic with PHR and the University of Minnesota. But there are countless providers across the state who have been doing this for asylum seekers, including physicians at CVT, physicians at public clinics, federal qualified health care clinics, and many other places.

An asylum seeker really just needs a physician who's aware of the service and they can provide this service. This clinic, what's new about it is it brings together these partners with the University and offers an academic meeting grounds for a lot of people who have already been doing this work. So really finding any physician who works with migrants and has been doing this kind of work.

NINA MOINI: And so how are people getting connected to your clinic specifically?

NATHAN BERTELSEN: We've sent out some announcements through various networks like CBT and other asylum networks. There's a number of lawyers obviously involved in this. We get the referrals from lawyers. So we're speaking with colleagues in the law school and other practices in order to get the word out.

And PHR has a nationwide referral network. So we've been basically sending it out to other migrant and refugee health networks in order to announce that we can offer this service now, too.

NINA MOINI: And this might be delicate, doctor, but what signs are you looking for in your patients that might support an asylum case?

NATHAN BERTELSEN: Well, that's an important question. And the first rule when we are asked to take these on is to really take an objective and impartial approach. Now, those of us who do this work, we are committed from our core for advocacy and providing good service.

And our approach is really we're asked by the legal community to really look at this as an objective lens to hear these clients' stories and basically identify clinical symptoms, any clinical diagnoses that we can see, and importantly, what would happen if those clients no longer had access to the outstanding medical care that they have access to in Minnesota.

So that's really the core of our approach, is to, in other words, take somebody's story, put a medical lens, a medical perspective on it, explain again what diagnoses we're seeing and what would happen if these clients lose access to those essential services.

NINA MOINI: And obviously, not everyone is seeking asylum in the US has been physically or mentally harmed. Often people need to escape their home country because of a threat to their well-being that looms over them. How do you help those asylum seekers?

NATHAN BERTELSEN: Yeah, it's an important question, too. Our referrals basically come from lawyers who've already initiated the process. And those lawyers have based the asylum case on the history of persecution in their home country and the risk of continued persecution if they were forced to return there.

NINA MOINI: The clinic, as you mentioned, is new. But I understand you have seen a handful of patients. I'm curious what differences you're seeing for these patients and, just more broadly, what your hope is for the future of the clinic.

NATHAN BERTELSEN: Well, I know time is short and so many things come to mind and a lot of different emotions. It's clearly very heavy work. We talk about this a lot. In the general medical community, some people often feel like something like asylum's beyond their scope or Center for Victims of Torture might be beyond their scope.

But what we always think to remind ourselves is trauma is unfortunately very prevalent. And I would say any physician, any health provider who's working with anybody deals with-- will run into trauma, whether we recognize it or not.

And going back to my thought about keeping it positive, we meet our patients where they're at. We meet our clients where they're at. And we focus on ways to build inclusion, ways that we can build community, and really underline the fact that we are community standing next to each other and providing the services that our neighbors need.

NINA MOINI: Dr. Bertelsen, thank you very much. I wish you well with all of your efforts.

NATHAN BERTELSEN: Thank you. Thanks for having me.

NINA MOINI: That was Dr. Nathan Bertelsen with the Asylum Medical Clinic in Saint Paul.