A Muslim Graduate Student From Sudan Trapped by the Travel Ban

Executive Order 13769, titled “Protecting the Nation From Foreign Terrorist Entry Into the United States,” decreased the number of refugees to be admitted into the country in 2017, temporarily suspended the U.S. Refugee Admissions Program, banned the entry of citizens from Iran, Iraq, Libya, Somalia, Sudan, Syria, and Yemen, and suspended the entry of Syrian refugees indefinitely. This Executive Order was dubbed the “Muslim Ban” because it targeted only Muslim-majority countries. The timing of the Executive Order coincided with the highest level of hate crimes against Muslims residing in America. The Council on American-Islamic Relations reports that attacks on Muslims occur almost daily and that anti-Muslim bias incidents increased by more than 67% in 2016 (1).

The far-reaching ban intended for terrorists in reality affected countless ordinary people who wished to pursue the American Dream and were committed to the American ideal of “pulling themselves up by their bootstraps.” Ms. A is an exemplary case of one such immigrant, who had taken the best of what this country has to offer and had been a productive and devoted resident. At 14, she emigrated from Sudan after being awarded a scholarship to complete high school in the United States. She later graduated from an Ivy League university on a full scholarship, and then entered a Ph.D. program.

Limiting travel from the countries targeted by the ban did not just limit academic pursuits and contributions by people like Ms. A. It also denied entry to those most in need of help, such as refugees and persons in need of medical attention. Additionally, the aftermath of the ban has negatively affected even green card holders and naturalized citizens, many of whom are from mixed-status families. The ban wreaked havoc on their family structure and sense of safety despite their status as legal permanent residents or citizens of this country.

Furthermore, the ripple effect of the ban continues to be felt by many marginalized communities who identify closely with those the ban directly targeted (2). Examples of this include all immigrants and Muslims who are from countries other than the seven targeted by the ban. The Executive Order shattered the sense of safety of communities of people who now feel that they could be targeted next because of their ethnic or religious background.

Our patients who are from the countries targeted by the travel ban or share similar characteristics (i.e., immigrants, Muslims) experience compounded levels of trauma. Some patients, like Ms. A, have experienced previous individual trauma in addition to the general trauma of growing up in a war-torn or conflict-heavy region of the world. Additionally, resettling in a new country and the tenuous immigration status that then ensues is itself traumatizing. Moreover, the harsh handling and long detainments by U.S. Customs and Border Protection as a result of the ban is retraumatizing to those already vulnerable. Once successfully in the United States, the sense of feeling unwelcome because of anti-immigration and anti-Muslim rhetoric from the highest levels of the country’s leadership is immensely traumatizing. By the time such patients reach our care, they have endured several layers of trauma, each of which needs to be carefully peeled back and addressed.

Perhaps the single most valuable asset for clinicians working with such populations is cultural sensitivity training. Ms. A reported several failed attempts at therapy either because the clinicians she saw only offered pity or because the cultural divide was so wide that she felt exhausted by just “catching up” her therapists, and she quit before truly addressing her problems. It is imperative that this training be both culturally and religiously congruent (3), and it should address issues of culture, faith, and immigration status as it relates to trauma. In addition to being trained in trauma-informed care, we also found it helpful for clinicians to undergo implicit bias training (such as that provided by Project Implicit; https://implicit.harvard.edu/).

We further discovered that it was useful for clinicians to offer or refer their patients to support groups for similarly affected individuals. Our experience has been that students affected by the ban were not willing to seek out counseling support unless their sessions were anonymous. These patients expressed fear that having their religious affiliation or immigration status documented in their chart could potentially put them at further risk. Support groups and anonymous drop-in sessions were important forms of support for members of marginalized communities and those with tenuous immigration status.

More specialized culturally and religiously congruent care is also needed for affected communities—such as the spiritually integrated therapy model the Khalil Center (khalilcenter.com) offers for the Muslim community. Likewise, we have found it mutually beneficial to be involved in psychoeducational initiatives with marginalized communities who shoulder the additional burden of high levels of stigma against mental health care in their communities (4).