The woman seated facing me smiled briefly as she recalled her work in Afghanistan with a nongovernmental organization that supported women’s voting rights. This was before the Taliban takeover in 2021 – before her organization’s offices were ransacked and directors imprisoned, before her town’s mayor warned that she was on a list of women wanted by the Taliban, before she fled her home to hide with relatives. Despite going into hiding in Afghanistan, a group of men found her, beat and raped her, warning they would return to imprison and kill her. With financial support from her relatives, she fled Afghanistan and made her way to the United States-Mexico border with the goal of requesting asylum and joining her family members in California.
Earlier that same day, a woman who had converted from Islam to Christianity in Iran told me that after her religious conversion was publicly revealed, she fled Iran to avoid imprisonment and possible execution for what the Islamic regime considers a severe crime.
The day before, an Afghani military colonel who had fought with U.S. forces against the Taliban described his fear of execution if forced to return to Afghanistan. And a Cameroonian English-speaking teacher had recounted her detention and torture after being labeled as a “separatist” by government officials for her peaceful campaigning against discrimination targeting English-speaking people in Cameroon.
These heart-wrenching accounts are among many that were relayed to me at a school-turned-shelter in Panama City last month, where scores of people who were expelled from the United States to Panama had taken refuge after they had been released from detention in Panama.
As a physician with expertise in documenting torture, I conduct medical-legal examinations to evaluate the consistency of physical and psychological symptoms and signs with reported torture and ill-treatment. I have conducted hundreds of evaluations like these around the world. The resulting written reports from such evaluations are frequently cited as evidence in courts to hold perpetrators accountable for their crimes or as evidence in an individual’s legal claims for asylum or other forms of protection.
Yet, these evaluations in Panama were unlike any I had ever conducted before.
A group of lawyers who had filed a petition to the Inter-American Commission on Human Rights against the government of Panama for its treatment of individuals expelled from the United States had asked me and three other clinicians from Physicians for Human Rights (PHR) to come to Panama City in mid-March 2025. We conducted evaluations of 29 of approximately 300 people from countries such as China, Russia, Eritrea, Cameroon, Afghanistan, and Iran. Upon arriving at the U.S. southern border, they had been detained in U.S. detention centers and in mid-February 2025, were forced onto military planes from the United States to Panama without being told where they were going. In Panama, they had been further detained in abhorrent conditions and held incommunicado for several weeks, until they were subsequently released with temporary protected status for 30 days after the petition had been filed.
Within days of the filing of the petition, 108 of those expelled from the United States were released from detention and given a temporary permit allowing them to remain in Panama. The group of lawyers and human rights activists then helped them find temporary shelter after the government abandoned them in the capital.
The lawyers’ request for us was to focus on physical and psychological effects of the treatment by U.S. and Panamanian officials, as well as their fear of returning to their country of origin. And indeed, their accounts of their treatment by U.S. and Panamanian officials were harrowing.
We heard about their desperate attempts to explain to U.S. immigration officials why they had a credible fear of returning to their countries and wished to seek asylum, only to be silenced, denied the chance to speak, and offered no translators. U.S. immigration officials confiscated their cell phones, and most of those we evaluated reported not being allowed to call family, friends, or request a lawyer; they were only given their phones back when finally released many weeks later from detention in Panama. One woman described being treated as “less than animals” by U.S. immigration officials.
Most of those we evaluated reported not being allowed to call family, friends, or request a lawyer; they were only given their phones back when finally released many weeks later from detention in Panama. One woman described being treated as “less than animals” by U.S. immigration officials.
In the United States, when they were taken by bus to military planes they were not told where they were going. While detained in Panama, most were still not permitted to contact family or friends. Many described even more vicious insults and abuse from the Panamanian officials guarding them, being told that they were criminals who had no rights, that they had to voluntarily agree to return to their countries or be forced to under military guard, and that they should not bother trying to apply for asylum in Panama as they would never receive it.
The people we met who remained at the large school gymnasium run by the Catholic organization Fe y Alegría as shelter were terrified about their futures. Others had agreed weeks before to be flown back to their countries of origin – the only option being offered at the time – but those we evaluated reported fear of persecution and even death if returned to their homes. They continued to resist being forced to return to their countries. Many shared feeling emotionally exhausted from being asked to repeatedly recount their experiences in United States and Panamanian detention without knowing what will happen to them next.
As clinicians, we could offer each of them concrete assistance. In our medical-legal evaluations, we could fully document their accounts of what they had experienced in their countries and subsequent psychological and physical sequelae. We could ensure that they each received a copy of their own report so they would have it if they were offered the opportunity to apply for asylum. Evidence shows that these medical-legal affidavits can significantly increase the likelihood of being granted asylum compared to cases without such affidavits.
We have now completed all medical-legal affidavits and shared them with each person we evaluated for their records. The findings of our evaluations will be submitted to the Inter-American Commission on Human Rights to support efforts to seek justice for the human rights violations and health harms from the U.S. expulsion and Panamanian detention of these individuals.
But it is still unclear what will happen to them. With the United States effectively ending the availability of asylum at the southern border, it is also unclear whether more groups of people seeking to migrate to or seek asylum in the United States will continue to be expelled without any due process to countries like Panama, Costa Rica – or even worse, to be disappeared and imprisoned in brutal El Salvador prisons like the groups of Venezuelans expelled by the Trump administration.
…It also unclear whether more groups of people seeking to migrate to or seek asylum in the United States will continue to be expelled without any due process to countries like Panama, Costa Rica – or even worse, to be disappeared and imprisoned in brutal El Salvador prisons like the groups of Venezuelans expelled by the Trump administration.
I hope our medical-legal documentation will help provide effective evidence for the collective lawsuit and for each of these individuals’ efforts to find legal protection in a safe country. Despite the Trump administration’s ongoing attacks on people who flee torture and ill-treatment to seek safety in the United States, PHR will continue to advocate for a humane and rights-respecting asylum system.
Meanwhile, even now from thousands of miles away in my home in Michigan, the words of the courageous Afghani women’s voting rights activist echo through my head:
“My dream was to build a better society for all in Afghanistan. I know I can’t do that now. But I still dream of helping improve conditions for women somewhere. I know I can make a contribution. I am being treated like a criminal with nothing to offer. But I refuse to give up hope. I know I have so much to give. I do.”