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Several years ago a young man came to see me in my clinic. He told me he was running for his life.
几年前，一个年轻人来到了我的诊所。他告诉我说他正在逃亡。
He said that he fled his home, because there, homosexuality wasn't just illegal, in some cases it was punishable by death.
他逃离了自己的家乡，因为在那里，同性恋是非法的，某些情况下甚至会被判处死刑。
So when his sexual orientation was exposed, his family rejected him,
所以当他的性取向暴露之后，他的家人把他赶出了家门，
his boss fired him and angry mobs repeatedly attacked him in the streets.
老板炒了他鱿鱼，愤怒的暴徒不断在街上袭击他。
And each time the police arrived only to arrest him, detain and torture him further.
然而警察的到来却并非为了保护，而是逮捕他，好将他拘留，进一步折磨他。
And he knew that if he couldn't escape the cycle of violence, he would surely be killed.
他知道如果他不能逃脱这个暴力的循环，那么死亡将是他唯一的结局。
So he had to do what he needed to do to survive. He left everything behind. All of his friends, his family, his career.
为了生存，他只能丢下所有，孑然一身的离开。他将朋友、家人和事业全都抛之脑后。
He fled his home, he escaped to the United States and here he applied for asylum.
他逃离了自己的家乡，逃到了美国，在这里他申请了庇护。
But like many people fleeing this kind of persecution, he couldn't carry much.
但就像很多想逃离这些迫害的人一样，他几乎带不走什么。
He had some basic ID, barely any money and a few other belongings.
他只携带了基本的身份证明，除了一点随身物品之外，他身无分文。
He certainly didn't bring official documents from the police who tortured him.
有关他身份的官方证件，当然都留在了那些折磨他的警察那里。
No videos from the mob that tried to kill him. He didn't have this kind of evidence to help support his claims,
因为记录暴徒恶行的影像资料的缺失，他没有办法提出有效的指控，
yet here he was, sitting in my clinic, showing me some of the most powerful evidence of his persecution.
但现在，他坐在我的诊所里，给我展示了一些能证明他所受到的折磨的最有力的证据。
That was the physical and psychological scars that he brought with him.
他生理和心理上厚厚的疮疤。
You see, he suffered from chronic, debilitating pain.
很明显，他正在遭受着长期的折磨，使他身心俱疲。
He had severe scars scattered over his body, poorly healing wounds that got infected over and over again.
他身上到处都是严重的伤疤，反复感染且久不愈合的伤口。
He suffered from severe depression and continued to have regular, paralyzing flashbacks and nightmares from PTSD.
他患有严重的抑郁症，并继续定期出现创伤后应激障碍带来的惊愕回忆与噩梦。
So we continued our work. We met regularly for months, documenting each of these pieces of medical evidence.
我们继续着他的治疗。几个月来，我们经常见面，详细记录每一项医学证据。
We went over the details of every attack, photographed his scars, documented his injuries and wounds,
我们仔细回忆了每次袭击的细节，对他的伤疤进行拍摄，记录了他的伤口，
and we were even able to start chronicling his slow but steady recovery while under our care.
在这样的照顾下，我们甚至可以开始记录他缓慢但稳定的康复过程。
Working closely with his lawyers, I submitted a detailed affidavit,
通过与他的律师密切合作，我提交了详细的证明书，
including the findings of this forensic medical evaluation, and we included it as part of his asylum application.
包括法医鉴定的结果，我们把它作为他庇护申请的一部分证明材料。
And then we waited for several long years while he navigated the courts.
然后我们开始等待，他在法庭上挣扎了好几年。
And then one day I got an email from him. It said that he was granted asylum. And everyone in the clinic was overjoyed.
有一天我收到了他的邮件。上面说他已经获得了庇护。诊所里的每个人都欣喜若狂。
He said in his email that this was the first time in years that he didn't fear deportation and death.
他在电子邮件中说，这是多年来，他头一次成功逃离了被驱逐和死亡的阴影。
It was the first time in years that he truly felt safe, that he had the security to rebuild his life all over again.
这是多年来，他第一次真正感到安全，并且重新有了安全生活的保障。
And it was only through this medical and legal advocacy
只有通过这种医疗手段和法律辩护，
that we were able to help restore his legal status and his rights, that he could do that, all through asylum.
我们才能够帮助恢复他的合法地位和权利，他能做到这些，都要依赖庇护系统。
Now for many people fleeing persecution, they come to programs and clinics like this
现在有许多人为了逃避迫害，来到类似的项目和诊所，
telling unimaginable tales of violence and different reasons they were persecuted.
讲述发生在他们身上的令人难以想象的暴力故事，他们被迫害的原因有很多。
But one thing is always the same. The violence meted against them was done with complete impunity,
但有一件事总是一样的。他们被暴力袭击，但施暴者却没有受到惩罚。
sometimes by the hands of the state directly through police or military officials.
施暴者有时是由国家直接指派的警察，有时是军官。
In other cases, the state just turns a blind eye and condones the acts of paramilitary groups or even violent domestic partners.
在其他情况下，政府只是睁一只眼闭一只眼，纵容这些非法军事组织的行为，或是有暴力倾向的家庭伴侣。
In other cases, state is completely powerless to protect the vulnerable from powerful gangs.
在其他情况下，国家在保护弱势群体不受强大帮派的侵害时，往往显得无计可施。
Now we know that social determinants of health play a huge role in determining the health and well-being of our patients:
现在我们知道，社会因素在决定病人的健康和福祉方面起着巨大的作用，
housing, income, education, race, social inclusion.
比如住房、收入、教育、种族，还有社会包容程度。
But the same can be true for equal protection in the law -- due process.
同样重要的还有法律中的同等保护权--“正当法律程序”。
Especially in societies for the most vulnerable, the marginalized and even those who are actively targeted,
特别是对那些被社会边缘化的人、弱势群体和那些经常被针对的人来说，
their access to these human rights protections that can mean the difference between sickness and health,
他们获得这些人权保护的机会，可能决定了他们是否能健康的生活，
and often it's the difference between life and death.
通常这就是生与死的区别。
And for millions of people who endure persecution and torture,
对于成千上万遭受迫害和折磨的人来说，
the only way to heal is to acknowledge the human rights abuses that have occurred and to help restore the rights and protections that were so violated.
治愈伤痛的唯一办法，就是承认已经发生的侵犯人权的行为，然后帮助恢复他们被严重侵犯的权利和庇护。
After the atrocities of World War II, the asylum system was set up as one pathway to that kind of relief.
在第二次世界大战的暴行之后所设立的收容制度，就是实现这种援助的一个有效途径。
But these days it seems like that pathway has turned into an obstacle course, setting people up to fail.
但如今，这条道路似乎已经铺满了障碍，让人难以获得帮助。
Asylum seekers oftentimes don't know how to start, let alone complete the process that can drag on for years.
寻求庇护者往往不知道如何开始，更不用说完成这个可能要拖上好几年了。
They're not entitled to lawyers, so they don't know their rights.
他们没有权利请律师，所以他们不知道自己的权利。
Increasingly, they're even being barred from setting foot in places of potential refuge.
他们甚至被禁止踏入可能的避难所。
They're arrested or prosecuted, even deported before they ever get to see an asylum officer.
他们被逮捕或起诉，甚至在见到庇护官之前就被驱逐出境。
And even if they do make it through the process, asylum grant rates can be as low as 20 percent and far worse for some.
即使他们真的通过了这个过程，成功获得庇护的概率可能也只有区区20%，对一些人来说这个数字还要更低。
It's almost like the system was designed to keep people from exercising their right.
这个系统就像是设计好的一样，故意阻止人们行使他们的权利。
But there is something that many of these people can do.
但有些事情是这些人可以做的。
Something that can potentially increase their chances of success to 90 percent or more.
可以潜在的将他们获得庇护的概率提升至90%或以上。
So what makes the difference? Getting a lawyer and having a medical evaluation. It's as simple as that.
那么是什么造成了这种差异呢？正是请一个律师和进行医疗评估。就这么简单。
The man who came to my clinic and won his asylum case.
对于那个来我诊所，并获得了庇护申请的人来说。
Doctors and lawyers working together to present all of the evidence,
他的医生和律师合作，一起拿出所有的证据，
including the medical evidence, to the courts allows judges to make informed and just decisions.
包括医学上的证据呈至法庭，帮助法官了解情况，以做出公正的裁决。
And it's this kind of medical-legal partnership that's now more important than ever,
正是这种医疗法律合作关系，在现在比以往任何时候都重要。
because we live in a time of epic, forced migration due to violence and conflict.
由于暴力和冲突，我们生活在一个漫长艰难的、被迫迁徙的时代。
In 2018 there were 70 million people worldwide forcibly displaced due to war, conflict and persecution.
2018年，由于战争、冲突和迫害，全球有7000万人被迫流离失所。
It includes 40 million internally displaced, 25 million refugees and three million asylum seekers.
其中包括4000万境内无家可归者，2500万难民和300万寻求庇护者。
Here in the United States, we see the impact of escalating violence in places like El Salvador, Guatemala and Honduras,
在美国，我们可以看到由于萨尔瓦多、危地马拉和洪都拉斯不断恶化的暴力所带来的影响，
where murder rates can be as high as those in Syria and Afghanistan.
那里的谋杀率可能和叙利亚、阿富汗一样高。
Where police corruption and gang violence are on the rise, where poverty and child abuse are widespread and tolerated,
那里的警察腐败和帮派暴力呈上升趋势，贫困和虐待儿童现象普遍存在，并被纵容，
where basic systems of governance -- public safety, child protection -- are ineffective.
而且那里的基本治理制度--公共安全、儿童保护，都是无效的。
It's no surprise then that many of the most vulnerable in some of these societies -- children, women and other targeted groups
因此，在这些社会中,许多最脆弱的群体--儿童、妇女，和其他被针对的群体，
they're growing increasingly desperate and fleeing in unprecedented numbers.
越来越绝望，逃离人数越来越多，也就不足为奇了。
Like over the past 10 years, the numbers of unaccompanied children trying to seek safety at our southwest border has increased 18-fold,
在过去的10年里，试图在我们的西南边境寻求庇护的、与父母失散的儿童的数量增加了18倍
from 3,300 in 2009 to over 62,000 this past year.
从2009年的3300人增加到去年的62000多人。
That's in addition to nearly half a million people traveling as families.
除此之外，还有近50万人和家人一起逃离。
Men, women and children trying to seek refuge at our borders, but who are stranded in a humanitarian crisis.
陷入了人道主义危机的男女老少，试图在我们的边境寻求庇护。
And what makes matters worse is that they're caught in this fog of claims and counterclaims about who they are,
更糟糕的是，他们陷入了诉讼和反诉讼的迷雾中，被反复询问他们是谁，
what they've experienced, where the proof is and what they deserve. Do they deserve our help?
他们经历了什么，证据在哪里，以及他们的诉求。他们值得我们的帮助吗？
Sometimes people make claims that they're not fleeing human rights abuses but are simply economic migrants.
有时人们会说他们不是在饱受侵犯人权之苦的难民，而只是经济移民。
Others say these children are actually being exploited and trafficked by their parents.
其他人说，这些孩子实际上是在被他们父母剥削，以获取身份的工具。
Others say they're not even children at all; they're hardened criminals, they're gang members trying to infiltrate our country.
其他人说他们根本就不是孩子；而是心狠手辣的罪犯，他们是企图渗透到我们国家的黑帮成员。
To cut through some of this fog, my colleagues and I conducted a study.
为了驱散这层迷雾，我和同事进行了一项研究。
We looked at data from children seeking asylum who had medical evaluations. And this is what the evidence told us.
我们查看了寻求庇护，并进行了医学评估的儿童的数据。这是我们通过分析证据而得出的结论。
80 percent of these children had evidence of exposure to repeated physical violence: assault and torture.
80%的孩子有经常遭受身体暴力的证据：包括人身攻击和折磨。
60 percent of the girls and at least 10 percent of the boys had evidence of repeated exposure to sexual violence.
有证据表明，60%的女孩和至少10%的男孩曾经多次遭受性暴力。
One young girl, telling a story and having corroborating evidence of being detained, beaten and raped over the course of three years,
一个有着确凿证据的年轻女孩向我们讲述了她曾被拘留、殴打和强奸了三年，
trafficked to other men and even having the threats of the murder of her entire family if she should ever escape or try to seek help.
并被卖给其他人的经历，如果她逃跑或试图寻求帮助，她的家人就会被灭口。
90 percent of these children had evidence of psychological harm from indirect violence,
这些儿童中有90%有从间接暴力带来的心理创伤的证据，
including such severe threats, but also witnessing untold atrocities with their very eyes.
像是这种严重的威胁和亲眼目睹了无数暴行。
One young boy described the terror and the grief and the utter fear of seeing the mutilated bodies and faces of his younger brother,
一个小男孩描述了看到他弟弟残缺不全的尸体和脸时所受到的惊吓、心中的悲伤和彻骨的恐惧，
his aunt, his uncle, his cousin, all killed in a single gang attack meant to send the community a message.
他的阿姨、他的叔叔、他的表弟，也都在一次帮派袭击中被杀，只为了向他的社区发出警告。
And of course the psychological toll is immense.
因此，这些儿童往往都伴有严重的心理问题。
19 percent of these children had signs of anxiety disorder; 41 percent, depression and 64 percent, PTSD.
其中19%的儿童有焦虑障碍的迹象；41%的人出现抑郁症状，64%的人出现了创伤后应激障碍（PTSD）的症状。
21 percent also had signs of suicidality as children.
21%的儿童有自杀倾向。
To put this into some perspective, returning combat veterans, they have PTSD on the order of 10 to 20 percent.
对比来看，就算是退伍军人，他们得上PTSD的概率也不过10%到20%。
These children at three to six times more likely to have PTSD than a soldier returning from war.
而这些儿童患PTSD的可能性，是退伍军人的三到六倍。
Now despite this burden and despite this trauma, there are many others, still.
尽管承受着这样的负担和创伤，他们中依然有许多人。
Children who come to seek safety and enter into our immigration system only to find further abuse
那些为寻求安全而进入我们移民系统的儿童，却受到了更多的虐待，
and even torture reminiscent of the places that they fled.
并勾起了更多痛苦回忆。
You might remember some of those headlines, some of those images this past year. Children being ripped from the arms of their parents.
你们可能还记得去年的一些新闻标题和一些图片。孩子们从父母的怀抱中被抢走。
Toddlers, infants in cold and unsanitary cages. The absence of food, water clothing and even soap.
幼童和婴儿住在又冷又不卫生的笼子里。没有食物、水、衣服，甚至肥皂。
There's also increasing reports of medical negligence, preventable complications, child abuse, sexual abuse and even child deaths in US custody.
关于医疗事故，原本可预防的并发症、儿童虐待和性虐待的报告也越来越多，甚至在美国，监护期间的儿童死亡率也在上升。
Sadly, many of these abuses and crimes aren't new.
可悲的是，这些虐待和犯罪早已不是新鲜事了。
Some date back many years and even across administrations. But something's changed.
有些现象可以追溯到许多年前，甚至横跨多届政府变更。但是有些事情发生了变化。
The scope and scale of these abuses and crimes, the systematic and seemingly purposeful endangerment of asylum seekers
这些虐待和罪行的范围和规模，对寻求庇护者的系统性和看似有预谋的危害，
and also the impunity with which it's being done has raised the harm to an entirely new level.
以及罪犯的逍遥法外，已经把危害提升到了一个全新的高度。
It reminds me of one of the girls in the study
这让我想起了调查里的一个女孩，
who told us how she pleaded with one of her attackers, asking him to stop, asking why she was targeted.
她告诉我们她是如何恳求其中一个袭击者停下来，问她为什么成为受害者。
And do you what his response was?
你们知道他的回答是什么吗？
He says, "We can do this, because there's no one here to protect you."
他说，“我们之所以这样，是因为这里没有人保护你。”
We can't let this be true of children and other asylum seekers trying to find help at our borders. But what do we do?
我们不能让儿童和其他试图在我们边境寻求帮助的人往火坑里推。但我们该怎么办呢？
As a physician, I'm often dealing with difficult decisions with some of my sickest and most complex patients.
作为一名医生，我经常需要做出艰难的决定，与一些病情最严重、最复杂的病人打交道。
Of course we want to keep our focus on their health, their well-being, their quality of life,
当然我们要关注他们的健康，他们的处境，保证他们的生活质量，
but sometimes it requires a deeper exploration of their values to really understand how to move forward.
但有时需要对他们的价值观进行更深入的探索，才能真正搞清楚下一步该怎么做。
In a similar way, our nation is facing a crisis with the increasing number of asylum seekers at our borders and in our communities,
同样的，我们的国家正面临着危机，随着边境和我们的社区里寻求庇护者人数的增加，
and it compels us to re-examine some of our own fundamental values.
它迫使我们重新审视我们的一些基本价值观。
What does it mean when we value health and safety?
当我们说我们重视健康和安全时，它意味着什么？
What does it mean when we value security, life, liberty, the life of children?
我们说我们重视国家安全、生命、自由、孩子的生活，又意味着什么？
What about this one -- what does it mean when we say we value law and order?
那这个呢--当我们说我们重视法律和秩序时，这意味着什么？
Does that also include respecting due process rights for an asylum seeker?
这是否也包括尊重寻求庇护者获得正当程序的权利？
Now for some, when they hear these terms they immediately gravitate towards wanting to build more walls,
对于一些人来说，当他们听到这些术语时，他们马上就想要建造更多的墙，
deploying more border patrol, deporting more people even if it means separating children from their families,
部署更多的边境巡逻力量，驱逐更多的人，即使这意味着把孩子和他们的家人分开，
subjecting them to psychological torture or deporting them to places where they might die.
使他们遭受心理折磨，或者将他们驱逐到会面临死亡危险的地方。
All in the name of security. All in our name.
而这些全都是以安全的名义。以我们的名义。
But for me and for many others, when I think of these values, that pushes me in an entirely new direction and renews my commitment
但对我和其他很多人来说，当我想到这些事情时，这把我推向了一个全新的方向，令我重申我的决心，
to try to meet the needs of these asylum seekers with every tool I have at my disposal.
尽我所能去努力满足这些寻求庇护者的需求。
So that when we say that we value life and liberty,
所以当我们说我们珍视生命和自由时，
we'll see these people who have taken unimaginable risks to flee imminent danger and harm to try to find safety.
我们会看到这些人冒着难以想象的风险，逃避近在眼前的危险和伤害，去寻找安全的环境。
We'll meet them where they are and provide food, water, shelter, clothing.
我们将在他们所在的地方与他们见面，并提供食物、水、住所和衣服。
And we'll certainly meet them with medical care and mental health care that they so desperately need.
我们也定会给他们提供医疗服务以及他们迫切需要的心理健康护理。
When we say that we value the rule of law, and not just the privileges it provides a few but the responsibilities it requires of all of us,
当我们说我们重视法治，而不仅仅是它提供给少数人的特权，而是它要求我们所有人所需承担的责任，
we'll make sure that we have a functioning immigration system. We'll make sure that we have trained judges.
我们将确保我们有一个健全的的移民体系。我们会确保我们有训练有素的法官。
We'll make sure that we're not settling for the illusion of law and order that maybe a tall wall or a militarized border might provide us.
我们将确保我们不会满足于一堵高墙，或军事化边界带来的有关法律和秩序的幻想。
We want the real thing. We want judges to be able to evaluate the evidence, including the medical evidence,
我们希望能有实际的行动。我们希望法官能够评估证据，包括医学证据，
and we want them to administer justice... fairly.
并且能公正的主持司法。
When we say that we value health and well-being, that we don't want to perpetuate harm,
当我们说我们重视健康和幸福，我们不想让伤害持续下去时，
then we'll deploy trauma-informed strategies at all levels of the immigration system.
我们应在移民系统的各个层面实施真正了解并能有效愈合创伤的措施。
It might start with retraining border patrol agents or immigration officials,
也许从重新培训边境巡逻人员或移民官员开始，
but it needs more medical, mental health and child welfare experts across the whole system.
但我们还需要在整个系统里分配更多的医疗、心理健康和儿童福利专家。
And when we say that we value justice, we won't let ourselves be turned into the torturers that many of these children and other people fled.
当我们说我们重视公正时，我们不能让自己变成施虐者，变成那些儿童和其他人避之不及的人。
We'll open up our detention centers and our courts to experts and advocates to hold ourselves accountable.
我们将向专家和律师们开放居留中心和法庭，让我们自己负起责任。
And we may find that we need to shut down most of them and close these camps.
我们也许需要关闭大多数，或停止设立一些难民营。
I believe that by working in effective partnerships with lawyers, doctors, human rights advocates and many others,
我相信通过与律师、医生、人权倡导者和其他有志者建立有效的伙伴关系，
that we can work together to meet these asylum seekers' needs, that we can meet our historical, humanitarian and legal obligations to them.
我们可以共同努力，满足这些寻求庇护者的需求，并能够履行我们曾对他们许诺的人道主义待遇和法律义务。
And when we do, I think something powerful will unfold.
当我们这样做的时候，我认为这样就会带来一些意义深远的影响。
Not only will these asylum seekers -- like the man who came to my clinic and won his asylum case,
不仅是这些寻求庇护者--就像那个来我诊所获得了庇护的人，
like the children in the study or the many thousands of others seeking a new life, they'll be able to find that safety and security.
像是我的研究中的孩子一样，还是成千上万寻求新生活的人，他们都能获得安全的保障。
We'll recognize the abuses that have occurred, and we'll restore the rights and protections that were lost.
我们会认识到曾发生过的权力滥用现象，且将恢复他们曾失去的权利和保护措施。
And I think that we'll be in wonder when we see them in the fullness of their humanity.
我想，当我们看到他们重获人性与活力的时候，我们会感到非常惊讶。
Not just their strengths and weaknesses, their hopes and joys, not just the trauma that we acknowledge,
惊讶于他们的长处和弱点，还有他们的喜悦和希望，而不仅仅是我们发现的创伤，
but we'll also stand with them and we'll be inspired by their resilience.
但我们也将与他们站在一起，被他们的坚韧精神所鼓舞。
They'll blossom, and they'll add to the richness of this nation.
他们的人生会如花般绽放，并为这个国家增添财富。
I think by staying true to our fundamental values in the way that I've described, that's how we build a sane and humane immigration system.
我认为，通过我所描述的方式来忠实于我们的基本价值观，将是我们建立一个理智、人道的移民体系的方式。
That's how we remain the golden door. And that's how it happens that we remain the shining light of the world. Thank you.
这就是我们让那扇金色大门保持敞开的方式。同时，我们也仍是世界上那束耀眼的光芒。谢谢。
