When Hawa Kassire first came through the doors of Bellevue Hospital, the doctors knew that the scars from an acid attack went deeper than those visible on her face.
Ms. Kassire, 47, was attacked in Haiti by her ex-husband in 2017. The acid claimed her nose and an ear, and left excruciating burns along the right side of her body. And she carried the trauma — of living with the memories of that night, and of fearing for the safety of her children.
Ms. Kassire was medically evacuated from Haiti and later admitted to the Bellevue Program for Survivors of Torture in New York, receiving not only medical care but connections with social workers, pickups and drop-offs for surgeries, and appointments with therapists who helped her rebound from the grief.
This month, Ms. Kassire’s doctor told her that Bellevue is shutting the storied program.
“I see my face in the mirror and I know my face is horrible, but these people tell you, ‘You are beautiful and good,’” Ms. Kassire said. “These people, when they’re taken from your life, it’s like they’re taking your soul.”
The decision to close the program by mid-May is a story of administrators trying to navigate the Trump administration and its crackdown on immigrants.
During the past three decades, the program has treated more than 10,000 patients who arrived in the United States after having fled persecution.
NYC Health and Hospitals, the city agency that runs Bellevue, said that the more than 600 patients currently in the program will continue being treated elsewhere at the hospital. But the leaders of the survivor program argue that their patients arrive with particularly weighty needs, and could fall through the cracks when being funneled into Bellevue’s sprawling system.
Dr. Allen Keller, the program’s founder, helped conduct a study that found that torture survivors often don’t disclose their traumatic history to primary care providers. The research appeared in the Western Journal of Medicine in 2000.
“People come to us because they feel safe, they come to us because they feel they have nowhere else to turn,” Dr. Keller said. “We’re going backward and ignoring 30 years of history and proven success.”
The Bellevue Program for Survivors of Torture was created in 1995. At first, it was privately funded but has received federal funding since 1998, when Congress passed the Torture Victims Relief Act. Since then, the program has been funded largely by two federal grants, adding up to roughly $1 million annually, from the Office of Refugee Resettlement at the Department of Health and Human Services. One of the grants mostly supports the program’s administration and operations; the other primarily goes to patient care.
Last summer, Bellevue, the country’s oldest public hospital and a key part of New York’s massive health care system, began the cumbersome task of sifting through the federal grants it receives. Administrators wanted to assess what accepting government funds under the second Trump administration might mean for patients, according to a city official who spoke on the condition of anonymity to discuss sensitive city matters.
Bellevue administrators became concerned that accepting the federal grants could force them to collect and possibly disclose data on the immigration status of patients in that program and across the system. (Bellevue sees thousands of undocumented patients every year.)
Dr. Mitchell Katz, chief executive of NYC Health and Hospitals, described this concern in an email that was sent to a program supporter and shared with The New York Times. Dr. Katz said that the grants would “threaten the lives of our patients because it requires us to collect and potentially disclose their immigration status to the federal government.” Staff members of the torture survivor program dispute that assertion.
Earlier this year, Bellevue notified the team running the Program for Survivors of Torture — often referred to by its initials, P.S.O.T. — that it would be closed. The team’s 14 members are either being reassigned elsewhere in the hospital, having their time cut back or, in some cases, at risk of having their positions eliminated.
Bellevue administrators have scrambled to assure the program leaders that their patients will be absorbed into the broader care program. The hospital is creating a clinic, not federally funded, that will serve these patients and connect them to the medical and other services Bellevue offers, including social work and housing assistance.
“The safety, health and well-being of our patients in the P.S.O.T. program, and throughout the public health care system, are paramount,” said Adam Shrier, press secretary for NYC Health and Hospitals. “There will be no disruption in care for patients, new or existing.”
The program’s staff members gathered in recent days to vent their frustration at the notion that patients would be equally well cared for in the broader Bellevue system, according to a recording of the meeting shared with The Times. “I feel like we’re running out of tissues in the office because everybody is mourning the loss,” one staff member said.
“A lot of our work is to help people comprehend the incomprehensible, tolerate the intolerable,” said Dr. Hawthorne Smith, the clinical director of the program, who started there 31 years ago as an intern. He has treated rape victims, war survivors and a mother who fled Congo after rebels attacked her with a machete.
There has been confusion over whether the terms of the grants do pose a risk for immigrants and undocumented patients. Dr. Keller and others in the program said that they collect aggregate data on patients’ immigration status, but don’t report it at the individual level.
The program’s administrators have received emails from officials in the Office of Refugee Resettlement saying that it is not necessary to document an individual patient’s immigration status.
Emily Hilliard, a Department of Health and Human Services spokeswoman, said in an email that refugees and asylum seekers are already known to federal agencies. Medical providers must screen individuals to determine eligibility based on program criteria.
Around the country, doctors who treat torture survivors were chilled by the closure of Bellevue’s program, which some saw as a retreat from the commitment to fully and sensitively address the needs of torture survivors and asylum seekers.
“I think of it in this larger context of people pre-emptively conforming to the expectation of not supporting the undocumented,” said Dr. Vincent Iacopino, former medical director of Physicians for Human Rights, who helped shape the Torture Victims Relief Act. “It seems like the kind of choices higher education institutions and legal firms are having to make.”
Nearly three dozen programs across the country receive comparable federal funding to treat torture survivors, and some Bellevue doctors worry that New York’s decision could set a precedent.
Another local program that cares for torture survivors, the Libertas Center for Human Rights at Elmhurst Hospital, receives similar federal support and remains open. Libertas did not respond to a request for comment.
On Thursday, Dr. Keller, the director, was still fielding calls from prospective patients.
Faria, who asked to be identified only by her first name because of concerns about being detained by immigration authorities, arrived in New York nine months ago from Pakistan, where she feared for her life because of threats from relatives. She found an apartment in Queens, where she said she was raped by her roommate.
“I have nothing in all the world,” the patient said, pleading with Dr. Keller on the phone.
“I want to promise you something — we’ve been doing this for 30 years,” Dr. Keller said. “There’s nothing I or my colleagues can do to undo the horrible things that happened to you, but I want you to know we have cared for many individuals in your situation.”
“Please, I need your help,” the patient told him.
Dr. Keller didn’t skip a beat. “Can you see me around 5 today?”
Emma Goldberg is a Times reporter who writes about political subcultures and the way we live now.
The post They Survived Torture. Why Is the Program That Helped Them Closing? appeared first on New York Times.
