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(upbeat music) (gong rings) - Good afternoon and welcome to the City Club of Cleveland, where we are devoted to conversations of consequence that help democracy thrive.

It's Friday, June 23rd, and I'm Dr. Austin Ratner, and as my cousin Jeremy has pointed out, I'm always Austin Ratner, every other day as well.

I'm pleased to be here to introduce today's forum in partnership with the George Gund Foundation and the Mount Sinai Health Foundation.

Before I introduce our speaker, I just wanted to make a couple of quick personal notes, and the first is to do with City Club.

I grew up in Cleveland, and I first heard of City Club in the late 1980s when I was on the high school debate team at Shaker Heights High School.

We all knew on the debate team that the best Lincoln Douglas debaters in the city would face off every year at the Hallowed city club, as they still do.

And I briefly fantasized that I would make it there myself, but debating made my shins hurt.

And according to my mantra at the time of no pain, no pain, I quit the team.

Much to my own detriment as father of two teenage boys whose parenting has required extensive debating skills.

So I lost my shot, I lost my original shot at City Club, but I'm back, finally, this is my chance.

I got to ring the gong.

(audience clapping) And I am here as a board member of Physicians for Human Rights, an organization that shared in the 1997 Nobel Peace Prize for helping to ban landmines internationally.

And so the second personal note that I wanted to share has to do with why I believe PHR's work is so important.

We're indeed, living in times where basic values like health and truth are under threat.

But I realized as I was thinking about it the last few days, that my identification with Physicians for Human Rights and its work runs much deeper than just the times that we're in.

It goes back to why I became a doctor in the first place, and that is because of a deep connection between medicine and justice.

Cancer touched my life very early as it's touched the lives of a great many people.

And while you seldom hear this adjective in connection with cancer, it really fits.

Cancer is unjust, innocent people get sick, suffer and die, and there's no rhyme or reason to who or when, but doctors have some answers to this intractable problem of the injustice of suffering in the world.

PHR is an organization that applies medical values at scale, documenting obstacles to the delivery of healthcare and defending the human right to it.

Their work is critical to realizing the ideals of a more rational and just world.

I left medicine and am now a writer and editor, and my involvement with PHR is in many ways how I feel I can still be a doctor and fight the injustice of illness.

And the great thing about this organization is that you can be involved with it and you can be an honorary doctor too.

And some of you are already involved.

We have some really important supporters here in the audience, and I hope that many of you who are not already supporters will consider becoming one.

Physicians for Human Rights was founded in 1986 by three doctors on the idea that health professionals can help prevent human rights abuses.

The organization works across the globe on a variety of issues, including asylum, sexual violence, and mass atrocities.

Research and investigations by the group have led to policy changes in the United States and have secured the rights and protection of asylum seekers, protestors, and frontline health workers.

Our guest today, Sam Zarifi, was named the next executive director for Physicians for Human Rights in March of this year.

He brings 30 years of experience in law and advocacy to the position, and before coming to Physicians for Human Rights, he was the Secretary General of the International Commission of Jurists, which sets international human rights standards and defends them through the legal system.

Today we'll hear more about how Sam will lead Physicians for Human Rights during a pivotal time as the organization tackles human rights violations in Ukraine, women's healthcare in a post Dobbs country and more.

Moderating this conversation today is Daniel Cohn, executive Vice President and Chief Strategy Officer of the Mount Sinai Health Foundation.

If you have a question for our speaker, you can text it to 330-541-5794, that's 330-541-5794.

You can also tweet your question @thecityclub and City Club staff will try to work it into the second half of the program.

Members and friends of the City Club of Cleveland, please join me in welcoming Sam Zarifi and Dan Cohn.

(audience clapping) - Thank you, thanks so much, Austin.

Thanks to the City Club for hosting us, to the Mount Sinai Foundation, to our board for bringing this incredible opportunity to Cleveland and of course our colleagues at the George Gund Foundation for supporting this endeavor.

And as I was just saying to Sam before the conversation, human rights was one of my first loves.

And so there's something sort of meta and deeply spiritual, frankly, to be on the stage with you.

And I'm really humbled by it, so thank you.

I actually first wanna start off at risk of sounding incredibly trite with the question of what are human rights?

I mean, it sounds good, people kind of throw it out there, but do people in this room really know what human rights are?

I'm not sure, I didn't know, I had to give myself a little bit of a brush up.

So can you just describe what human rights are?

- Sure, thanks, Dan.

Thanks Austin, thanks Gund Foundation, the Mount Sinai Foundation, thanks to the City Club.

It's not my first time in Cleveland, and I'm told that since I'm clearly not going to be invited to the Rock and Roll Hall of Fame, that this is the best thing that I can do in Cleveland short of that.

(audience laughs) Fingers are still crossed for the rock and roll.

I am the executive director of Physicians for Human Rights, but I'm on the human rights part of it, not the physicians part, as Austin said, I'm a lawyer.

I started as a corporate lawyer in the US, defending.

- I'm so sorry that happened to you.

- Defending large oil companies, making sure that their rights are protected.

And then I paid off my law school loans and to my parents' immense chagrin, I decided to take on a career in human rights.

I'm an immigrant.

I was born and raised in Iran, so issues of human rights were quite tangible to me when I moved.

But what are human rights?

That's a really good question.

This is the 75th anniversary actually of the Universal Declaration of Human Rights.

And the Declaration of Human Rights itself says that it was created clearly in response to the horrors of the first half of the 20th century, not just World War II, which was horrific, but World War I, the arms race, the Armenian genocide, the suffragette movement, the anti-colonial movement at the time, the growth of a civil rights movement in the US and in other places.

And that document sets forth really, really, really basic universal standards, which were revolutionary at the time and remain, I think, deeply revolutionary.

And I'm gonna talk about revolutions because revolutions affected my life quite a bit, and I've spent quite a bit of my time working on revolutions.

But the basic notion is that all humans are created equal.

They have equal rights.

They are entitled not to be discriminated against.

They are entitled to a certain number of basic rights, the right to life, among them crucially, the rights to a dignified life.

It's not just that they are alive, but that we assume that simply by being human, that there is a basic standard of dignity that you are entitled to.

This was revolutionary at the time.

Obviously it reflects deep historical occurrence, obviously it reflects Eleanor Roosevelt and the American experience.

But as I said, it reflected a lot of other things.

And there were a lot of streams from other parts of the world that fed into it.

And I say it's revolutionary because before that, and for the entirety of human civilization, that notion was not self-evident.

That all people are equal, that they should not be discriminated against, that crucially, if their rights are violated, they have a right to justice and to demand accountability.

This is actually an astonishing thing for people around the world to acknowledge.

And my work, most of my work has been outside the United States, but there's a reason why I'm here in Cleveland, one of the most astonishing things.

One of the greatest successes of this paradigm, of human rights for me is to engage with communities, with people who really have very little engagement with the wider world.

And when something bad happens to them, they will say, "I have a right to justice.

I have a right to my land.

I have a right not to be tortured."

And that is a revolutionary development in human society.

I think just this basic notion.

Now, the truth is people will say, oh, you know, nobody respects human rights.

They're violated all over the world.

What's the point of it?

It's only been 75 years.

We're working against 10,000 years of human civilization.

And I would say that in those- - That lands in a particular way in this room.

- Right, and I would say that, you know, so we've moved a lot, the world has improved in some significant ways because of this human rights paradigm.

And we are at a moment where the impact of that paradigm is in question.

I guess it's always been in question.

This is a line I've used, but it really is true.

I can say based on my experience and based on ideology, that in the last 75 years, the arc of human history has bent toward justice.

But that is not an inevitable bend at all.

It is a bend that requires real struggle.

You have to fight for it.

And we are at another inflection point right now, I think, and we are at a moment where I think there is huge potential for supporting human rights and for pushing the world toward a place where human dignity is accepted, and we can, it's within our reach.

But we are facing tremendous challenges.

We're facing tremendous challenges that in part specifically want to undermine this paradigm, this notion that humans are equal, that should not be discriminated against and that part of human society.

And to go back maybe to what we've heard so much about the City Club today, among the human rights are this notion that there is a right to freedom of expression.

There is a right to freedom of association.

And the foundational belief in that is that through discussion, open discussion through association, that in the marketplace of ideas, the truth will emerge.

And that truth is fact-based.

And that truth is something that if we, the same way it works in a game show, we know that even in a game show audience, when you reach out to the audience, the chances for getting the right answer are much higher than not.

Incidentally, I just saw research that that's even true when the audience is drunk.

So even drunk audiences are better than not.

But this notion that this discussion and free expression as we heard are the foundations of democracy is embedded into the global human rights framework.

But that depends on the notion that there is truth.

That we will make decisions based on facts.

And that's what Physicians for Human Rights is all about, is looking at facts, trying to document things, trying to achieve and arrive at policies based on evidence.

And that evidence-based policy will be better than not.

- I want to get to the work of PHR in just a moment and actually circle back to the issue of facts and truth and how suddenly those have become partisan issues.

But before I get there, I wanna stay at the ethereal level.

If you'll forgive me just for one more question, which is, you know, you mentioned the word accountability.

You mentioned Eleanor Roosevelt, certainly the United States has played a leading role in the notion of human rights in many ways.

And just like any other organization, any other person, human rights as an idea is fraught with contradiction.

You know, while we as an organ, as a country have led the creation of this framework in many ways, we are also not signatories to the Rome Statute.

We are among just a handful of major countries, China, Russia, United States, who are not accountable to the International Criminal Court.

Given that, given that contradiction, help us understand the utility of this human rights framework, given how young it is.

But help us understand the utility in terms of driving change and driving accountability.

- Look, at the same time as the Universal Declaration of Human Rights, we had the Nuremberg Trials and then the Tokyo Trials.

Now these were again, astonishing events.

The idea that instead of just shooting the Nazis, which is what Winston Churchill really wanted to do, was his preferred option, that we would put them on trial, that they would have defense, that there would be evidence.

And that through that process, we would find out what happened and that there would be some justice.

Now this was a huge moment, again, in human history, but it happened.

And then because of the Cold War, because of a number of reasons, the notion of accountability for human rights violations kind of died down actually.

It was just too complicated.

And then, of course, in the nineties, because of what happened in the Balkans, because of what happened in Rwanda, we saw, because of the end of the Cold War, we saw the notion of accountability come up again.

And amazingly miraculously, out of that same discussion came the International Criminal Court.

Again, this is mind boggling.

The idea, the idea that even a head of state can be held responsible for violating the rights of a person somewhere.

This was crazy.

I mean, this was, when I was in law school.

This would've been crazy talk, how can you even imagine it?

But it did happen.

And we saw the International Criminal Court, we saw the case against General Pinochet of Chile.

Now the criminal court is only itself about 25 years old.

We've kind of, it's been really interesting in the way the world works.

So we've gone from, oh, it's impossible.

They'll never put anyone on the dock because of this happening, because of violating human rights.

And now people are like, well, Putin is still out there.

So this whole thing is a joke.

Forget about it, it's pointless.

But there has been immense development in the notion of accountability, the International Criminal Court itself, and the fact that right now there is an arrest warrant for the head of Russia, for the head of a permanent member of the security council, for the head of one of the world's great superpowers.

That person faces an arrest warrant for violating human rights.

This is a huge step forward, but it's not just the International Criminal Court.

We've seen the growth of regional courts.

We've seen the principle of universal jurisdiction, which says that individual states have the responsibility of holding violators, perpetrators of mass atrocities to account.

And we're starting to see people who've been held now convicted, for instance, of genocide against Yazidi, a minority in Iraq, members of ISIS.

We were starting to see for violations in Syria, in Yemen, across Africa.

And this is a big part of what Physicians for Human Rights has done in the past, gathering the evidence, documenting these events, presenting them to a court, and demanding accountability.

So there is a sense looking around the world, Putin is rampant.

Terrible things are happening.

The sense of impunity is real, and the danger of impunity is real.

But we're also at a place where there is greater demand for accountability than we've ever seen.

Now, a crucial part of that is the United States.

The United States has really run hot and cold on international accountability, really run hot and cold.

We pushed for the Rome Statute of the International Criminal Court.

We were very excited.

But then when the court was established, we said, well, we actually don't really like it that much.

The court began looking at events in Afghanistan, which was a party to the courts.

And most of those violations were committed by the Taliban.

But of course there were US troops and NATO troops also on the ground.

And that raised the possibility that there would be demands for accountability for what American troops had done.

This, by the way, this is not a controversial thing.

If you ask the American military, you know, you have tens of thousands of American troops, they're in a wartime setting.

Sometimes they will do bad things and they will be held to justice under the military code of conduct.

And that should be the end of it.

The International Criminal Court cannot reach past the American justice system if the American justice system operates.

But what happened is the United States says, well, we will not hold them to account because actually, I don't know why, because, we won't.

But if the International Criminal Court dares to investigate them, the United States will send troops and rescue them from the Hague.

That's, by the way, that's true.

And the United States government not only did that, but it went farther than the previous administration.

And it sanctioned the prosecutor of the International Criminal Court, Fatou Bensouda, herself, this woman who just spent her entire life prosecuting human rights violators, was suddenly facing sanctions.

Her bank account in the US was frozen.

Why, because she said, I need to look at potentially what the United States did in Afghanistan.

Then fast forward a little bit, Russia invades Ukraine and the United States, well, this is outrageous.

Where is the accountability?

Who is holding Putin to account?

And of course, it's the International Criminal Court, it's the International Criminal Court that's trying to hold Putin to account.

But the lack of leadership, the vacillation in US policy has been, I think, a grave harm to the movement for accountability.

And I think to the United States itself, I think the world would've been a much better place if the United States had said back in 2000 that we are going to support the International Criminal Court.

The United States has a very robust judicial system.

There is almost no possibility that the International Criminal Court would have to be engaged in anything that the US does.

We will be part of this.

We will demand global accountability, and that will send a message.

And so we are at this place where I think, again, looking at what's happened, we have real opportunities for accountability at the global level, at the national level.

But it requires evidence, it requires documentation, it requires political will among the member states.

- I appreciate that.

And thanks for kind of painting the picture of the landscape for us.

I do want to dive a little bit deeper into the work of Physicians for Human Rights and talk.

As I understand it, you're moving, you know, your mission is global.

The United States happens to be part of the globe.

So it's not as if the United States was outside of that mission before, but you really are moving some programming to focus here domestically.

And you've mentioned reproductive health.

We talked a little bit previously about the treatment of asylum seekers, about police behaviors and the militarization of police.

I'd love to just get a sense of what your work on the ground domestically looks like, and if you could, the role of physicians and healthcare workers in human rights.

- Sure, well, you know, Physicians for Human Rights is, the name is on the tin.

It uses the expertise and the privileged position of physicians and of healthcare workers to demand human rights.

We're not a humanitarian organization.

We're not the Red Cross.

We're not Doctors Without Borders.

We are there, we're engaged across the world, mostly to gather evidence when bad things have happened, to use the position of doctors and healthcare workers to speak out about it, but also crucially to defend healthcare workers and physicians around the world.

So we have been doing this work since 1986 around the world.

Just to give you a quick sense of some of these issues that we're working on.

For instance, the norm against attacks on healthcare goes back 150 years.

The idea that you really should not shoot doctors and ambulances in wartime.

This norm is now under grave pressure.

And we are part of a coalition that documents this.

Last year we documented around 2000 attacks in 2022, 2000 attacks on healthcare professionals, healthcare facilities around the world.

That's a 45% increase over the previous year.

And that increase is almost entirely due to Russian activity in Ukraine.

The Russians, as we have documented, going back to Chechnya, going back to Syria, have developed a military strategy that involves attacking healthcare.

That's because when you attack a hospital, a clinic, a pharmacy, you destroy the ability of that community to heal itself.

You lower its resilience.

We've been working on those issues quite a bit around the world, looking at sexual violence, looking at asylum seekers around the world.

It is to my distress, I admit as an immigrant, as someone who mostly has worked outside that over the last 10 or so years, going back farther than that, but especially in the last 10 or so years, we've seen a lot of the same problems now occurring in the United States.

And that's really, that's heartbreaking for me.

And to have groups, our colleagues, our partners that we work with around the United States, come to us and say, we need you to use the same methodology to look at what's happening in the United States.

PHR had worked on sexual violence and women's access to sexual and reproductive health around the world.

And we had seen places where, for instance, bans on abortion or restrictions on access to sexual and reproductive health, had gravely, gravely harmed the rights of women and girls.

Syria, Yemen, Democratic Public of the Congo.

It's now exactly a year since the Dobbs decision.

This is not an area that we had worked on significantly before.

But after Dobbs, our partners, our colleagues, many of whom have been working for years on these issues, came to us and they said, we have to look at this in different ways.

This is a human rights violation.

This is no longer a partisan issue.

This is not just a political issue.

This is now a human rights violation.

We are now seeing put in place, for instance, the report that we just worked on, and my colleague Michelle Heisler, by the way, just so you don't think it's just lawyers there, our medical director from University of Michigan is here, this research focused on what's happening in Oklahoma, which has four different bans on abortion, criminal and civil liabilities.

And we looked at 34 out of the 37 hospitals in Oklahoma and the emergency facilities there.

And we asked the question, asked patients, what do we do if we have a pregnant person who is facing medical emergency?

And the vast majority of those hospitals could not give a proper answer.

They could not give a proper answer to what they're going to do.

And this is obviously terrible for the pregnant people.

And it's also horrible for the doctors, for the healthcare workers, because they don't know what to do.

They have a legal obligation, they have a moral obligation, they have an ethical obligation, a professional obligation to help their patients.

But now that decision is blocked by legislation, poorly drafted legislation.

And I want to be clear on a nonpartisan level, regardless of your views on abortion, or the right to life or, these laws are bad laws.

They're just bad laws.

These are laws that are harming people.

They're harming innocent people for no reason.

And the fact that now it is PHR that is in the position to have to document this and to challenge this in the United States, to me is disappointing.

But here we are because the front lines of this battle issues, again on asylum, on militarization of police.

We had worked on police attacking protestors.

This is something that happened everywhere in the world.

Police at some point stopped shooting, yay, success, started using rubber bullets, tear gas, water cannons, and these things when misused really can injure people and kill people.

And unfortunately, again, we've seen over the last 10 or 15 years increased militarization of American policing and the misuse of the same tactics.

And so we have been forced, we have been forced, we've been asked to come and work in the United States to work in Portland, to work in the Bronx.

But a success.

And in terms of the value of evidence, you know, when George Floyd was killed, one of the things that came out was that police, American police in multiple jurisdictions were using the diagnosis of excited delirium to justify why the police had to use excessive force.

The idea was that especially young African-American male men under the influence of drugs, of psychosis were impervious to police commands, were impervious to typical use of police restrictive measures.

And so they had to be treated with excessive force.

Now, when we started looking at this, working with our colleagues, our experts, our huge network of healthcare professionals around the US, they looked at this excited delirium and they said, this is junk.

This is no diagnosis, there is no scientific basis for this.

Who said this, who said this?

When the police just put down excited delirium, on what basis are they putting this down?

And you know, the fact that this wasn't coming from the pesky lawyers at the ACLU or Amnesty International, this was doctors, doctors were saying, we do not recognize your diagnosis.

Your diagnosis is junk.

And also the ability to therefore engage with the American College of Emergency Medicine.

And other appropriate healthcare associations really questioned that and very successfully, they have now withdrawn that diagnosis and that means that the police can no longer put that down.

And that to me is the incredible power both of this particular group of people, physicians, healthcare workers, and the reliance on evidence, even in the midst of a political toxic environment, when you can bring real evidence to bear when you can say that this is what the facts are, I still think we can win and we can demand the accountability.

And that's what PHR does.

(audience clapping) - So I appreciate that.

And I'm looking at time, I know we wanna save some time.

I don't know where Cynthia is, some time for audience questions, but I have one last one and it's, thank you for the segue because you know, sometimes when I really think about this stuff, I either feel the deep desire to drink or eat a lot of ice cream or just sleep it off, and I don't wanna do that today.

So what gives you hope?

How can people walk out of this room and feel like there is something to look forward to after this conversation?

- I think that example that I gave, it is still my firm belief that if you have the facts, if you are working within this human rights paradigm, that we can win.

It's not, again, it's not at all inevitable.

There are huge political issues, but that reliance on facts, the demand for evidence is crucial to me.

And it's important.

And Physicians for Human Rights, I'm immensely proud to say, can work on the ground with the mud and the blood, and gather the evidence and it can bring that evidence into the corridors of power and the network that it has, it's not just us.

We're, you know, we're our organization around 45, 50 full-time staff.

I dunno, 8 million, 10 million budget.

But the network that we have and the people that we can tap into are enormously helpful.

And again, I'm here in Cleveland because I can see that these issues, these human rights issues understood as human rights issues, these are not just American political issues.

These are issues of human rights are being fought in places like Ohio.

These are live issues.

And for me, as an immigrant to the US who spent most of my professional life working abroad, the important thing is for the United States to understand that it is linked to this world, that the problems of the world are the problems of the United States, but that the United States remains remarkably, perhaps uniquely empowered to lead the world towards solutions.

And that if we can seek solutions here and if we can work with other people and learn the lessons and demand and stick to the principle of defending human rights that it will also work in the United States.

It's going to be a long fight.

But I'm here for the fight, I'm here for the fight.

- Thank you, and we are grateful you are.

(audience clapping) - Thank you so much.

We are about to begin the audience Q&A.

I'm Cynthia Connolly, director of programming here at the City Club.

We are joined by Sam Zarifi, executive director of Physicians for Human Rights.

And moderating the conversation is Daniel Cohn, executive vice president and chief strategy officer at the Mount Sinai Health Foundation.

We welcome questions from everyone, City Club members, guests, students, and those joining the livestream at cityclub.org or our live radio broadcast at 89.7 WKSU Idea Stream Public Media.

If you'd like to tweet a question for our speaker, please tweet it @thecityclub.

You can also text it to 330-541-5794, that's 330-541-5794.

And our city club staff will try our best to work it into the program.

May we have our first question, please.

- Okay, I'm wondering if you would comment on when doctors are part of the human rights problem, there's more and more laws that are being passed to allow the healthcare profession to choose who they're going to provide services to based upon their alleged moral beliefs.

What do you think should be done by the profession?

Not necessarily relying on legislators, but by the profession itself to respond to that movement?

- Well far be it from me as a lawyer to say anything about what doctors to do.

Look, the healthcare professionals do have an ethical obligation, universally recognize the ethical obligation, the notion of providing the right to health for people everywhere is a core part of the mission.

And I think that is something that the profession itself should take very, very seriously.

We have, of course seen around the world this notion of dual loyalty where physicians and for instance, are involved even in carrying out acts of torture, right?

Because they think they should or, and that is a violation of human rights.

It's a violation, I think, of their professional obligations.

But to have that discussion is really, really important.

One of the things that gives me hope is PHR has a network of working with medical students around the world.

I think we have around 200 chapters, just in the US.

And that group of people are incredibly inspiring to see, they're medical students, but they understand that they are now involved in a world where they have to make very tough decisions where there's increasing pressure to become politicized.

Another area where this is really important, I didn't even get a chance to talk about it.

The COVID pandemic, the global COVID pandemic really, really highlighted the close interaction between the right to health and human rights.

We saw, well, we saw one that the impact of the disease on people whose rights were marginalized was already massive.

Women greatly suffered, the poor suffered, discriminated against populations suffered more than anyone else.

We also saw COVID used as an excuse to restrict human rights in many ways that we had not seen before.

And third, very disappointingly, we saw a massive failure, a global failure to respond to this global problem in terms of vaccine distribution, in terms of healthcare provision.

We saw pharmaceutical companies that said, even though they'd made, I dunno, 500% profit already, that they demanded to make even more profit, even more profit.

And this is something that PHR is involved with right now at the World Health Organization around the discussions around the pandemic treaty, around the international health regulation.

And one of the perhaps positive outcomes of all of this is that the engagement between the healthcare community and the human rights community is now much more clearly understood.

And this is the first, at least for me as a lawyer, for instance, that I've been involved in the work of the World Health Organization.

And again, this is something that I would look to, to the profession itself, to take this matter very seriously, for doctors to understand what human rights are, what their obligations under human rights are, and to understand and grasp the incredible power and privilege that they have in protecting human rights.

- Hi, how are you?

Thank you very much, my name is Michelle.

I'm a nurse for the Cleveland Clinic and my role there is a forensic nurse.

So we care for victims of crime, whether it be sexual assault, physical assault, domestic violence, elder abuse, child abuse, and then human trafficking.

So my question for you is really how we blend science and medicine to help those, particularly those that are being exploited through labor or sex trafficking, and what do you see the role of your organization or medicine in helping to combat that?

- Oh, first of all, thank you.

Again, we're called Physicians for Human Rights.

We always struggle with this, should we call it Healthcare Workers for Human rights, you know, Psychologists for Human Rights, Nurses for Human Rights, because of course those are all important.

Anyway, we're sticking with Physicians for Human rights for now, or PHR which kind of sounds like KFC, but you know, it's like, what is it?

- [Dan] Slightly less delicious.

- Slightly less finger licking good.

But what you're doing is exactly at the heart of a large part of what Physicians for Human Rights does, which is actually just documenting violations.

We are working in Iraq, in Kenya, in the Democratic Republic of Congo with nurses, with clinicians, but also with police, with judges with attorneys general to make sure that evidence can be gathered, that it can be held safely, privately and appropriately.

And that it can be shared with an end user, with a court ultimately to provide some assistance.

One of the major successes of Physicians for Human Rights is something called the Istanbul Protocol, which are basic protocol for how to document sexual violence.

And this is something that we have been able to disseminate around the world that is now the globally accepted standard.

But you are a well trained professional, but many, many survivors around the world don't have access to people like you.

And so disseminating the Istanbul Protocol, moving into the new century, we've also come up with an app, Medicapp, which is astonishing, which allows clinicians to take documentation of sexual violence.

And through the use of this app, don't ask me about how it all works, but somehow it is protected.

It is properly categorized as evidence and it is held privately and safely.

And we're able to use that in, like I said, in multiple places, in the Democratic Republic of Congo, where this problem is rife.

We've seen real advances because everybody, everybody does now have access to a smartphone, especially clinicians.

And they are able to use, even in situations where there isn't any internet to gather this evidence and hold it and use it.

And we've seen real advances.

So this is something we work on around the world.

The crucial part, the crucial part is what you are doing to gather that evidence.

But then we also have to work with law enforcement and with judges to make sure that they understand how to use this evidence.

And of course it is true even in the United States, that looking at sexual violence remains handicapped by tremendous gender discrimination, by discriminatory attitudes.

And we still see that.

And part of what we do is to build the capacity of law enforcement and to train the trainers that can work with law enforcement to make sure that the evidence that you gather is then appropriately used.

- My name is Graham Ball with the US Committee for Refugees and Immigrants.

I'm asking regarding Article 14 of the Universal Declaration of Human Rights, which grants the right of asylum to those seeking refuge.

Yet at our southern border during Title 42, COVID was used as an excuse to reject more than a million asylum applicants.

Of those asylees who did make it across the border and came to Cleveland, 88% have been rejected by the immigration court in Cleveland and are deported to face persecution and violence.

So my question is, what do you think about the precedent set by Title 42 as a public health exemption and what can we as Clevelanders and as Americans do to better fulfill this obligation to asylees?

- Well, thanks very much, and for your work.

Title 42 was junk science.

And we challenged it as such.

We filed an amicus working with lawyers to challenge it.

I mean, it was just, like I said, it was just bad.

It was just bad science.

The deeper questions around the right to asylum and the right to seek refuge are, on the one hand, I have to say to me, relatively simple.

I've spent quite a bit of time in refugee camps around the world.

The United States isn't even close to the top 10 in terms of countries that are taking in refugees.

I mean, considering the wealth of the country, it's, you know, the moral panic that you see around this is so absurd.

You just have to spend some time, I dunno, in Pakistan and Lebanon and Turkey, in Ethiopia where you see just the vast scale of refugees.

But the refugee convention, just to go back to it, maybe this is something important to point out.

The refugee convention was drafted in response to the horrors of World War II.

The refugees that were going to be helped were European refugees.

And we seem to have forgotten this basic fact of humanity.

I can really tell you, I don't how many people, how many refugees I've interviewed, probably a thousand, just that I've directly interviewed.

Nobody leaves their home for the hell of it.

Nobody, I mean, just this notion that there's a caravan of people coming to the United States because they think it's great.

This is not, people do not leave their homes, they don't leave their families.

They don't make themselves vulnerable to all kinds of hardship because they feel like they have an option.

And international law on this is fairly clear.

If you really face the threat of persecution, mental or physical harm, then you have a right to demand asylum.

Now, what PHR does on that is we have built a network of clinicians that can provide that assessment to asylum seekers and refugees.

This is a major problem.

To document your case, you need to have a medical assessment that shows that you have been subject to torture or violence.

And very few asylum seekers right now in the US have access to that.

And so recognizing that issue, PHR has set up this network of clinicians who are able to visit facilities, where asylum seekers are and to assess them and to do a medical assessment.

And again, the value of evidence is that in people who are assessed and have a medical assessment by PHR have more than double the chances of having their claims accepted.

So that's a really important thing.

It's something that we should be doing more of.

We should be doing it in the Mediterranean, we should be doing it in Central Africa.

We should be doing it in Southeast Asia with the Rohingya.

We should be doing this more.

But these are the resources that we have.

What can we do in Cleveland?

What can we do in the United States?

I think again, just the reality of it.

I mean, what is the moral panic?

What is the threat that is posed by refugees and asylum seekers and especially for a country.

Now, I did not come here as an asylum seeker.

I came on a student visa, but I came because I was fleeing my country.

There's no question, but for the privilege of my parents who could afford it, I would've been a refugee.

And that's something to look at.

What is it that we are so afraid of?

It is so easy.

And we have seen historically, we have seen this so clearly historically, the demonization of refugees of foreigners is such an easy tool for riling up political favor.

And it's something that we have to challenge.

We just cannot accept this.

And as human rights workers and as Physicians for Human Rights, our task is to try to inject as much documentation, as much evidence, as much facts into that debate as is possible.

And to ensure that the United States follows the rules, that it set up, the rules that it set up around the world.

That we honor the notion that human beings have the right to live in dignity.

And that when they're genuinely escaping horrors that we should welcome them and that it's better to do so than not.

- Mr. Zarifi, thank you for coming to Cleveland today.

My name's John Lichen and I have the privilege this year of serving as the board chair of our Legal Aid Society here in Cleveland.

And as I was listening to you speak, I was thinking about an event that we had last week where we celebrated our 20 year anniversary of our medical legal partnership here in Cleveland where we, I have some colleagues from Legal Aid here with me today.

We placed Legal Aid lawyers, wonderful people, wonderful organization, thank you.

(audience clapping) And Legal Aid places Legal Aid lawyers in our hospital systems and all of the hospital systems in Cleveland participate in this.

But what we found when we started the program was that there was this kind of false barrier between the law and medicine where initially the doctors and the hospitals felt like, we don't want lawyers here.

Lawyers sue hospitals, they sue doctors.

And this is a kind of scrutiny that's unhelpful.

But over time, the two professions realized this is not two different jobs.

It's actually two different disciplines that kind of search for truth together.

And it seems to me the work that you're doing around the world is dismantling that exact barrier.

And I'm just curious whether you feel like that barrier is coming down or whether it still exists around the world.

People not understanding that law and medicine really do go hand in hand.

- Thank you for your work.

I do think, I mentioned the case of COVID and the pandemic, it's the same thing.

I've been in Geneva for years.

It was the first time I walked into the World Health Organization and you know, they couldn't touch me with a 10 foot pole.

It was like, what are you doing here?

You know, messing up our pristine discussions.

I do believe that those barriers are coming down and they have to come down and let me, if I can, well, it's not political, but let me sound a little ideological.

The challenges to human rights, the jingoism, the anti-immigrant rhetoric that we see, oddly enough is hugely coordinated around the world.

There are vast international networks that pedal garbage, that translate videos and WhatsApp messages from the Philippines to India, to the United States that are pedaling the same nonsense, that are going to central Africa to put in place laws that have nothing to do with the culture of that place.

So there is a vast international network that is in fact trying to dismantle the human rights paradigm.

And it is therefore important for all of us in whatever professions.

But law and medicine are particularly powerful, privileged professions.

It is important for those communities to work together.

And I would say not in a politicized way, but to say this is the law and these are the facts.

And when you have the law and when you have the facts, you should win that argument.

And this is precisely what PHR has been doing for the past 36 years.

And I think, I hope that we can do even more of it now in the US because it's clear that we are facing a real challenge, a crisis in the United States that requires these networks coming together.

(audience clapping) - Thank you so much Sam and Dan for joining us at the City Club today.

Today's forum is the Margaret W. Wong Endowed Forum on foreign born individuals of distinction.

Months before her birth, Ms. Wong's Chinese parents fled the political repression and civil war caused by the communist takeover in China.

Because of her personal experiences obtaining citizenship under US immigration law, Ms. Wong recognized the need for guidance and opened her own law practice.

Today, Margaret W. Wong and Associates, LLC is a nationally and internationally renowned law firm, lauded for its knowledge on immigration and nationality law.

We are grateful for the support of City Club member Margaret Wong, who made this annual forum possible.

Thank you.

(audience clapping) Today's forum is also presented with support from the George Gund Foundation and Mount Sinai Health Foundation.

And we would like to welcome guests at tables hosted by Beyond Breakthrough, the Cleveland Clinic, Diebold Nixdorf Foundation, Global Cleveland, the George Gund Foundation, In Motion, Mount Sinai Health Foundation, Physicians for Human Rights, and Zach Paris, John Carroll, thank you all for being here today.

(audience clapping) There is a lot coming up at the City Club.

And next Wednesday, June 28th, we will be at Jacob's Pavilion for the 2023 State of the County with county executive Chris Ronayne.

General admission tickets are still available and can be purchased at Jacob's pavilion's website.

And next Friday we will be off in observance of Independence Day, but will return on Friday, July 7th to hear from Pastor Michael McBride on efforts to reduce gun violence in our communities.

You can learn more about these forums and others at cityclub.org.

And that brings us to the end of today's forum.

Thank you once again to Sam Zarifi and Daniel Cohn.

And thank you members and friends of the City Club.

I'm Cynthia Connolly, and this forum is now adjourned.

(audience clapping) - [Narrator] For information on upcoming speakers or for podcasts of the City Club, go to cityclub.org.

- [Announcer] Production and distribution of City Club Forums on Idea Stream Public Media are made possible by PNC, and the United Black Fund of Greater Cleveland Incorporated.