The first 100 days of U.S. President Donald Trump’s second term have already undermined human rights and access to health care, both in the United States and across the globe. Several executive actions signed by the president target people seeking asylum and other migrants to the United States, while other new policies erode public safety, jeopardize reproductive health, and undermine global health cooperation. Taken together, President Trump’s policy agenda threatens public health and violates fundamental rights.  

As an organization dedicated to the promotion and protection of human rights and health, Physicians for Human Rights (PHR) is alarmed at the dangerous trajectory of these policies. In response PHR will continue to mobilize our networks of clinicians – including nurses, doctors, and psychologists – as well as our expert teams of lawyers, policy and human rights advocates, and researchers to protect the rights of asylum seekers, freedom of expression and peaceful assembly, the right to comprehensive reproductive care, and the right to health, among others. 

Here’s a look at executive actions taken by President Trump in his first 100 days.  

Updated April 28, 2025 

Attacks on Immigrants and Dismantling the Right to Seek Asylum  

President Trump’s 2025 executive actions dismantled immigration and asylum policies and adopted a policy of “deterrence through cruelty.” It is now even more difficult, and in some cases, impossible, for individuals fleeing violence and persecution to seek refuge in the United States, especially those seeking to cross the U.S.-Mexico border.  

With mandatory detention for noncitizens now enshrined in federal law, immigrant communities are facing a sweeping expansion of criminalization and detention. Under these policies, individuals who are merely suspected or arrested for crimes such as burglary, theft, larceny, shoplifting, can be subjected to prolonged detention without individualized assessments of risk or release eligibility. This framework conflates immigration enforcement with criminal punishment, reinforcing a punitive system that disproportionately targets immigrants for detention and deportation, even when they have not been convicted of a crime. 

The Trump administration prepared the Guantánamo Bay prison in Cuba to detain migrants and began to send people to the site infamous for torture and isolation from judicial oversight. Among the 178 migrants held in the prison in February, 51 were nonviolent, “low risk” detainees who lacked criminal records, despite the administration’s claims to only hold the “worst of the worse” at the site. PHR filed an official complaint to the Department of Homeland Security Office of Civil Rights and Civil Liberties (CRCL) – responsible for ensuring that policies and actions by the Department of Homeland Security (DHS) respect civil rights and liberties. The complaint calls for the government to release the names of those detained in order to facilitate contact with attorneys, investigate conditions in the prison, and to ultimately end the use of Guantanamo for immigration detention. CRCL was dismantled less than two weeks later, eliminating a critical safeguard intended to hold DHS accountable for abuses, and increasing the risk of unchecked violations. As of April 22, it is unclear how many migrants remain at the facility.  

The decision to rescind the “Sensitive Locations policy,” previously preventing immigration enforcement in or around hospitals, schools, and places of worship, has already impacted access to health care within our borders. Preliminary findings from a survey of clinicians in PHR’s Asylum Network across the country suggest that the rollback of suck protections has contributed to a pervasive climate of fear. Care providers reported that this fear is already contributing to negative health outcomes among individuals of a broad range of immigration status, including delayed care, missed preventive services, and treatment interruptions. Many note that patients are arriving sicker, with some anticipating more advanced disease presentations, such as late-stage cancers. Children in mixed-status families are especially vulnerable, with parents in some cases refusing essential services like post-surgical rehabilitation due to immigration-related concerns, indicating a broader, long-term public health impact that extends beyond individual patients. 

Over the past 100 days, immigration enforcement agencies have been empowered to detain and expel immigrants without due process and blatant disregard for the judiciary. Nearly 300 people who had attempted to seek asylum in the United States were expelled to Panama via military planes. In response to this, PHR mobilized four physicians and one psychologist to fly to Panama. After being released from detention in Panama and given limited protected status by the Panamanian Government, PHR’s clinicians conducted 27 in-depth medico legal evaluations. The individuals evaluated included a women’s rights advocate and a former military officer who had fought against the Taliban and now faced extreme danger or potential death in Afghanistan; people in Iran who had converted from Islam to Christianity, where such conversions are punishable by imprisonment or even execution, and individuals targeted and threatened with imprisonment because of their sexual orientation. Evidence from these evaluations was prepared by PHR and formed part of an ongoing lawsuit filed by the Global Strategic Litigation Council before the Inter American Commission on Human Rights on behalf individuals expelled from the US and detained in Panama.  

As the government dismantles long-standing protections and accelerates policies designed to deter people from seeking asylum in the United States – and expel those that already have made it into the country – PHR’s 2,000-strong Asylum Network continues to provide pro bono forensic medical evaluations to support ongoing asylum cases. With our partners, PHR will continue to defend the internationally recognized right to seek asylum and advocate for the dignity, health, and safety of immigrants put at risk by punitive U.S. policies. 

If you are a health care provider, please use this guide to navigate the evolving enforcement landscape while upholding your duties as a health care professional, “Health Care and U.S. Immigration Enforcement: What Providers Should Know,” jointly published with the National Immigration Law Center (NILC) 

Read PHR’s statement on Trump’s new executive orders on asylum and immigration, our reaction to the rescinding of the “sensitive locations” policy, and our reaction to the plan to use Guantánamo Bay prison to detain migrants.  

Freezing of International Aid 

The Trump administration’s abrupt and massive cuts to foreign aid imperils millions of people by shuttering USAID. Across the African continent, where the United States had been a leading supporter of life-saving food, medicine, and other vital health services that curbed the spread of HIV as well as other infectious diseases, the sudden slashing of U.S. aid jeopardizes the health of populations already enduring conflict, displacement, and insecurity, including women and children.  

Critically, the shuttering of USAID will dramatically increase the spread of new infections and lead to thousands of unnecessary deaths. According to the World Health Organization (WHO), health systems are already at heightened risk for supply chain collapse and problems with surveillance in at least 18 countries that depended on the United States for 89% of their funding for tuberculosis care. Health studies predict that the loss of USAID funding, without a replacement from other funding sources, could result in 15.2 million addition AIDs deaths, 2.2 million additional deaths from tuberculosis, and 7.9 million additional child deaths from other causes.

PHR shared evidence with the House Foreign Affairs Committee that showed that the DRC faced losses of up to 70% of its foreign aid, rendering hospitals unable to provide critical services and respond to disease outbreaks. Halts in care for survivors of sexual violence come at a particularly critical time. Humanitarian actors reported more than 895 cases of rape in February alone, averaging more than 60 cases a day. PHR also reported that aid cuts threaten to collapse the health system in Ethiopia. USAID funding was critical for supporting water, sanitation, food, and health care needs of internally displaced populations, operation costs for clinics that treat survivors of sexual violence, and programs for distributing HIV medication. 5,000 health care workers were furloughed by the Ethiopian Ministry of Health as of late March. PHR urges the administration to reinstate vital funding for health and human rights sectors, as well as other essential work by our partners and other beneficiaries of U.S. foreign aid.  

Attacks on Reproductive Rights 

Among the first actions taken by President Trump in 2025 was the reinstatement and expansion of the so-called Global Gag Rule, a policy that prohibits organizations that receive U.S. global health assistance from providing legal abortion services or referrals, while also barring advocacy for abortion law reform –  even if it is done with the NGO’s own, non-U.S. funds. By restricting U.S. funding for organizations that provide comprehensive reproductive health services, the Trump administration is threatening the health and rights of millions of individuals of reproductive age, particularly in low- and middle-income countries.  

Meanwhile, here in the United States, President Trump pardoned 23 anti-abortion extremists who attacked abortion clinics and harassed clinicians. The pardons come as anti-abortion officials in states like Louisiana and Texas use the courts to target doctors who mail abortion medications across state lines. The Department of Justice also announced that it is dropping its case against the state of Idaho requiring that hospitals still provide emergency abortion care under the Emergency Medical Treatment & Labor Act (EMTALA). This decision represents a significant break in government policy, which previously ensured that doctors could help pregnant patients suffering from life-threatening conditions before patients were on the brink of death. Funding freezes on Title X by the Department of Health and Human Services (HHS) have targeted clinics that provide affordable birth control, STI testing, and other essential health services, on the grounds that these clinics promote diversity, equity and inclusion. 

PHR recognizes that access to abortion care is part of reproductive rights and justice, whether abroad or here in the United States. PHR’s research with our partners have exposed the unworkability and harms of abortion bans in several U.S. states including Idaho, Oklahoma, Louisiana, and Florida, impacting clinicians and patients alike. We commend state governments like that of New York which are redoubling their commitment to shield health workers in their state from prosecution and other penalties under other state’s bans. We call for an end to the criminalization of abortion care, for both patients and clinicians alike.  

Ending Bans on “No-Knock” Warrants, Choke Holds, and Militarized Policing 

Another troubling move by the Trump administration  was the reintroduction of federal “no-knock” warrants, which allow law enforcement officers to enter private homes without prior notice or announcement, and an end to the federal ban on the use of choke holds. This move reverses important reforms that sought to end these dangerous practices and increases the risk of deadly confrontations between law enforcement and communities of color. Both the use of no-knock warrants and choke holds have already led to numerous high-profile cases of police violence, often with fatal consequences, and disproportionately impact Black, Latino, and Indigenous communities. 

PHR has documented excessive force used by law enforcement against communities across the United States, including the dangerous and sometimes deadly use of crowd-control weapons. Our work has also helped debunk pseudo-scientific terms with racist origins like “excited delirium”, motivating leading medical associations and multiple U.S. states to ban the term.  

Withdrawal from the World Health Organization and other International Bodies 

Another dangerous action taken by President Trump was to withdraw the United States from the World Health Organization (WHO). This decision directly undermines international health cooperation, weakening global efforts to combat infectious diseases, and limiting access to health care resources in countries that need it most. The United States’ exit from the WHO reduces the ability of health professionals around the world to coordinate responses to health emergencies and threatens the global health infrastructure that has been vital in preventing and managing public health crises. These actions limit the United States’ ability to confront the active outbreaks of avian flu, Ebola, and Marburg virus – threatening the health of people in the United States and abroad alike. PHR has long supported the work of the WHO in promoting universal access to health care and addressing health inequities. PHR has documented how the Trump administration’s previous efforts to distance the United States from international health organizations have had damaging effects on global health, including during emergencies such as the COVID-19 pandemic.  

In February, President Trump signed another Executive Order ending U.S. participation in the United Nations Human Rights Council (UNHRC) and ordered a review of the U.S. relationship with all other international bodies. Unlike the U.S. withdrawal from the UNHRC during the first Trump administration, the U.S. is not currently a Member State of the UNHRC, so its withdrawal will be less immediately disruptive. However, by exiting these multilateral fora, the United States will be abandoning its leadership on the global stage in addressing, mitigating, or shaping human rights and other crises around the world. 

Sanctions Against the International Criminal Court  

In January 2025, President Trump revoked the Biden Administration’s previous order that rescinded the first Trump administration’s sanctions against officials of the International Criminal Court (ICC) in The Hague. In February, the president issued sanctions against individuals and their families who assist the ICC in investigations of citizens of the United States or its allies who are not a state party to the Rome Statute. U.S. Congress is actively considering legislation that would enact new, far-reaching sanctions against the ICC, as well as individuals cooperating with the ICC.  

PHR has long supported the work of the ICC in bringing justice to victims and survivors of atrocities, particularly in places where local justice systems are unable or unwilling to hold perpetrators accountable. PHR has supported case building and evidence sharing on war crimes and other atrocity crimes in countries like the Democratic Republic of Congo, Sudan, Ukraine, and others, The ICC remains a vital part of the global justice infrastructure that helps ensure reparations for victims and survivors of war crimes, crimes against humanity, and genocide. PHR renews its call for the United States to lift any sanctions or penalties against individuals for their work supporting justice and accountability in the international court system and continues its long-standing call on the United States to join the Rome Statute supporting this international court of last resort. 

Looking Ahead

This year, the human rights record of the United States will be the subject of scrutiny before the United Nations Universal Periodic Review (UPR). To support the UPR process, PHR and our partners have submitted our evidence and recomendations on urgent health and human rights developments in the United States. Explore our submissions here. PHR will continue to monitor these developments and advocate for the rights of those most at risk. To stay informed on the ongoing impact of these policies, please subscribe for updates and explore our resources. 

The Universal Periodic Review (UPR) is a groundbreaking United Nations process initiated in 2006 that evaluates the human rights records of all 193 Member States on an equal footing. This year, the human rights record of the United States will be the subject of scrutiny. To help inform the UPR of the United States in November 2025, PHR’s submissions are listed below. 

What is the UPR? As a core mechanism of the Human Rights Council, the UPR fosters global dialogue, encourages countries to address human rights challenges, and promotes the sharing of best practices. Non-governmental organizations (NGOs) like PHR contribute submissions to the UPR process to help share information and shape outcomes, further helping the UPR’s vital role in reporting on and improving human rights conditions worldwide.  

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PHR’s Submission to the Universal Periodic Review of the United States 

PHR’s submission covers the health and human rights impacts of: abortion restrictions on providers and patients in several U.S. states; abuses in U.S. immigration detention facilities, presence of immigration authorities in health care settings, and the erosion of protections for asylum seekers; and the continued use of “excited delirium”, a pseudoscientific term with racist roots that is often used to deny accountability for deaths during interactions with law enforcement. 

Read the submission

Joint Submission on Diminishing Reproductive and Bodily Autonomy in the United States  

Abortion bans in the United States violate the human rights to life, health, privacy, freedom from torture, freedom of movement, non-discrimination, and more. PHR’s joint submission explores this human rights crisis by gathering data from those most impacted. Jointly submitted with partners including: Global Justice Center, Ipas, Guttmacher Institute, Birthmark, Louisiana Abortion Fund, Louisiana Coalition for Reproductive Freedom, ReJAC, Jane’s Due Process, The Afiya Center, and Lift Louisiana. 

 Read the submission

Joint Submission of Coalition of Immigrant Rights Organizations to the United Nations Universal Periodic Review of the United States 

This submission to the Human Rights Council for the 2025 Universal Periodic Review (UPR) of the United States is a joint report from a coalition of 23 United States-based non-profit organizations that defend the human rights of non-citizens. The information presented shows that the United States has failed to meaningfully address Member States’ 2020 UPR recommendations to the United States to remedy human rights violations of non-citizens. Instead, the United States continues to violate the human rights of non-citizens through mass detention, denial of due process, abusive and discriminatory policing, labor exploitation, and suppression of civic space. 

Read the submission

Joint Submission on Excessive Use of Force by Law Enforcement 

The excessive use of force by law enforcement remains a prevalent issue in the United States. In responding to the Black Lives Matter protests of 2020, law enforcement in the United States repeatedly failed to comply with domestic and international standards on the use of less lethal weapons. American companies are involved in the global trade of inherently abusive goods, contrary to international obligations. Government efforts to promote oversight, controls, and accountability remain insufficient to mitigate future violations, and have been undermined by recent policy changes in 2025. This submission, co-authored with Omega Research Foundation, highlights the need for the United States to fulfill its obligations to respect the rights to peaceful assembly and prevent the excessive use of force, as committed to in the last UPR cycle.  

Read the submission

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.

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.”

The current climate surrounding immigration enforcement and deportation has created widespread fear that, according to health care providers, is directly reducing health care utilization. This avoidance extends beyond those that are undocumented to visa-holding immigrants, mixed-status families, and even U.S. citizens. Telehealth has emerged as a vital tool for maintaining access to care while minimizing perceived risks of immigration enforcement encounters, reflecting both patient preference and provider adaptation. However, telehealth has limitations: many health conditions require in-person care, not just as a preference but as a necessity, which restricts the extent to which telehealth can be relied upon as a meaningful mitigation tool.

Providers report that fear is already contributing to negative health outcomes among individuals of a broad range of immigration status, including delayed care, missed preventive services, and treatment interruptions. Many note that patients are arriving sicker, with some anticipating more advanced disease presentations, such as late-stage cancers. Children in mixed-status families are especially vulnerable, with parents in some cases refusing essential services like post-surgical rehabilitation due to immigration-related concerns, indicating a broader, long-term public health impact that extends beyond individual patients.

At the institutional level, responses to immigration enforcement pressures vary widely. While some health care systems have implemented clear protocols and staff training, others offer little guidance or have removed patient-facing materials altogether. This moment presents an opportunity for institutions to lead with clarity by establishing standardized best practices that protect both patients and providers, and by reinforcing the health system’s role as a trusted space for all.

Many health care workers described experiencing situations consistent with “dual loyalty,” whereby they navigate conflicting demands between their professional obligations and institutional or perceived legal constraints. In the absence of consistent institutional support and to respond to their dilemma, some health care providers have developed informal strategies to protect their patients, including modifying documentation practices, adjusting referral patterns, and expanding telehealth services – efforts that highlight both the resilience of providers and the pressing need for systemic solutions.

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Are you a health care professional based in the United States? If so, you have unique insights into how federal policy changes, including President Trump’s Executive Orders (EOs), initiated on or after January 20th, 2025, affect both health care access and delivery.

This confidential survey, which takes no more than 15 minutes to complete, seeks to understand how Trump-era policies have directly or indirectly affected your patients who are undocumented or have insecure immigration status, as well as the ethical and institutional challenges faced by healthcare providers. Findings from this research will inform policy recommendations to safeguard healthcare access and ethical medical practice for all.

Deceptively known as “less-lethal,” these weapons can in fact cause severe injuries and even death when used with excessive force. Physicians for Human Rights has worked extensively on the health impacts of these weapons and has issued the following guidance to help people seeking to exercise their right to protest prepare for, protect against, and treat tear gas and other chemical irritant (e.g., pepper spray) exposure.

What to wear to protect yourself against tear gas and other chemical agents when protesting:

• Facemask. Scarves or bandanas large enough to cover your face from nose to chin can serve as substitutes.
• Shatter-resistant eye protection (e.g. shatter-resistant sunglasses, swim goggles, or a gas mask)
• Clothing covering all your skin as much as possible
• Comfortable, closed, protective shoes that you can run in
• AVOID wearing contact lenses, which can trap irritating chemicals, such as tear gas powder, underneath. If you do wear contacts lenses, keep a full facial gas mask or goggles on at all times.
• AVOID wearing makeup such as eyeliner, for the same reason.

What to bring to a protest:

• Water in your own plastic bottle with a squirt top (to drink and to wash off your skin or eyes)
• A backpack or a drawstring bag – rather than an over-the-shoulder or a cross-body bag – in case you need to run
• Identification and/or emergency contact information (consider writing this on your skin)
• Cash for food and transportation or cash bail, in case you are arrested. Check how much bail is in your location.
• Inhaler, epipen, and several days of prescription medication, in case you are arrested
• A medical alert bracelet or information about any chronic medical conditions or allergies
• A change of clothes, in case you are exposed to chemical irritants

How to protect yourself against tear gas and other chemical irritants:

Agent CS, the most commonly used form of tear gas, is a crystalline powder that is converted into a fine spray and propelled from a grenade or canister by a small pyrotechnic explosion. Agent OC, commonly known as pepper spray, is essentially a highly concentrated form of hot pepper. Though tear gas was classified as a chemical weapon in 1993 and banned from use in international warfare, law enforcement officers are still allowed to use it on civilians in the United States. Some localities are starting to ban use of these chemicals for crowd control by police in the wake of Black Lives Matter protests and their violent disruptions.

When a tear gas canister explodes, CS powder sprays into the air and adheres to any moisture it can find, including the tears in your eyes, the sweat on your skin, the grease in your hair, and the saliva and mucus that cover your mouth and airways.

Symptoms of tear gas exposure can include the following, according to the CDC:

• Eyes: Excessive tearing, redness, burning, blurred vision
• Skin: Burns and rash
• Mouth: Burning, irritation, drooling, trouble swallowing
• Nose: Running, burning, and swelling
• Lungs: Chest tightness, shortness of breath, wheezing, coughing, choking sensation
• Stomach: Nausea and vomiting

What to do if you’re exposed to tear gas or other chemical irritants:

What to do immediately:

• Get out of the cloud of tear gas and away from the general area as soon as you can. Seek high ground, as most forms of tear gas are heavy; the closer you are to the ground, the higher the concentration of gas.
• Walk, don’t run. Running may cause you to breath more heavily, filling your lungs with more tear gas. Try to keep your breathing even.
• If your eyes have been exposed and are burning or blurry, flush them with water immediately. Try not to touch your eyes, nose, or mouth. Use water from your water bottle to flush. If you can find an open drinking fountain or sink in a public restroom, flush your eyes with water for 10 to 15 minutes.
• There is no evidence that baking soda or milk is better than cool water alone. There is one small randomized controlled trial that found that baby shampoo is no better than water. Using baby wipes or makeup wipes if water is not immediately available may cause increased irritation.
• If possible, and you are not affected yourself, help others by moving them to a clean and ventilated area.
• Do not try to remove the tear gas canisters, as doing so may put you at an increased risk for further harm and injury.

How to further get rid of the chemical irritant:

• Change your clothes as soon as possible. Rinse your body as soon as you get to a location with a shower. Take off your shoes outside your home to keep them from bringing any powder indoors.
• Shed all the clothes you were wearing and hang them in an open, ventilated area for at least 48 hours before washing them. If you are not able to keep them in an open place, story them in a sealed bag until they are ready to be washed. Do not mix them with uncontaminated garments, as CS powder can be active for as long as five days after being released.
• Take a cold shower for at least 20 minutes to prevent the chemicals from irritating your skin any further. Do your best not to breathe in more tear gas during the shower, and keep your eyes closed. Wash your hair especially well.
• If you’re still having symptoms 30 minutes or so after getting all the agents off, are having eye or lung issues, or are at all concerned about your exposure, seek medical care.

What to do if your rights have been violated:

• Review “Know Your Rights” documents before heading out to a protest, such as this ACLU guide.
• If your rights are violated by law enforcements officers, when you can, write down everything you remember from the scene, including the officers’ badge and patrol car numbers.
• Get contact information for witnesses.
• Take photographs of any injuries. Get medical treatment right away if you need it and ask for a copy of any medical records.

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Resources:

1. Physicians for Human Rights: “Lethal in Disguise: The Health Consequences of Crowd-Control Weapons”
2. Physicians for Human Rights:  Crowd-control Weapons Fact Sheets

Recent changes in regarding U.S. immigration enforcement have created new challenges for health care providers who are committed to ensuring care for all patients. This guide does not constitute legal advice but offers essential information to navigate the evolving enforcement landscape while upholding your duties as a health care professional. As a health care provider, your primary responsibilities are to:

• Maintain trust with all patients, regardless of immigration status

• Understand your legal rights and obligations

• Know how to respond if immigration enforcement occurs in your facility

• Advocate for institutional policies that protect patient access to care

As a Health Care Worker, What Can You Do?

Despite these challenges, health care facilities still maintain legal protections that they can assert if confronted with warrantless enforcement actions. As a health care provider, you have both legal rights and ethical responsibilities to maintain spaces for your patients that are free from immigration enforcement within medical settings.

Medical ethics underscore that health care workers’ responsibility is to maintain strong therapeutic relationships with your patients. This means clinicians have ethical obligations to prioritize preserving patient trust and confidentiality in all clinical interactions. Health care facilities provide services essential for the health, wellness, and safety of not only patients, but also for the whole community.

Proactively Reassure Patients

Clearly communicate that immigration status does not affect a patient’s right to receive medical care.  For example: “We provide care regardless of immigration status” and “You have the right to remain silent if approached by immigration authorities.” Reinforce HIPAA and other privacy requirements.

Do Not Ask About Immigration Status Unless Required

As an ethical best practice, avoid asking for patients’ immigration status. If you must collect such information for a patient, ensure that information is secure and separate from medical records. If state laws require asking about status, inform patients they are not required to answer, using language like:

“I am required to ask you the following question about your presence in the United States. You do not have to answer this question.”

Monitor and Address Rumors in the Community

If false reports of immigration enforcement presence spread, issue accurate information to patients and local networks in a timely manner to reduce cancellations and fear. NYC Health + Hospitals had to do this on January 30, 2025 in response to misinformation circulating that they were handing information to ICE. Their statement, shared on social media, read: “We care about your health, not your immigration status. Despite misinformation on Instagram, NYC Health + Hospitals/Elmhurst is NOT reporting any person or patient seeking care to the police. All New Yorkers should seek care without fear.”

Share Know-Your-Rights Information

Display or distribute Know-Your-Rights Information to help ensure that patients understand their rights. Share how you are ensuring that ICE cannot enter private medical spaces without a judicial warrant. Make materials available in multiple languages relevant to your patient population.

Ensure Institutional Preparedness and Protections Against Immigration Enforcement

All health care facilities, including hospitals, clinics, mobile clinics, and community-facing health events, should have clear protocols for responding to immigration enforcement. Health care workers should advocate to their institutions to have clear policies in place. Hospitals should train staff to ensure that enforcement agents do not enter private spaces without verification from a designated staff member and a judicial warrant. Institutions should establish designated private areas where enforcement actions are restricted and develop clear response protocols for law enforcement requests. Institutions should also ensure all public-facing staff are trained on how to interact with immigration authorities and have access to the contact information for the designated administrator or legal team in case of enforcement encounters.

Letter from the Executive Director

The state of the world is harrowing. 5.7 billion people live in autocracies, a 23 percent increase compared to ten years ago, meanwhile more than 120 armed conflicts are happening around the world and there are more refugees than ever before. Compounding these problems, climate change radically threatens the lives and livelihood of people around the world. An increasing number of authoritarian regimes are actively undermining the international human rights legal framework; alarmingly, the United States is also now weakening respect for human rights and accountability and even hindering the lifesaving work of the World Health Organization. These regressive forces threaten the well-being of people everywhere.

To meet this moment, PHR will double down on our effective strategies for stemming human rights abuses.

To meet this moment, PHR will double down on our effective strategies for stemming human rights abuses. We will wield the power of the health care community to promote justice and healing to protect those who are particularly vulnerable. We will mobilize to protect asylum seekers, women whose reproductive rights are under attack, and minorities who are all too often targeted by police in the United States as well as sexual violence and torture survivors and health care professionals working in conflict zones globally, among others.

PHR’s strategic plan for 2025 to 2028 allows us to meet the urgent need for the expertise and insight of health professionals, who are uniquely positioned to have a powerful impact at the intersection of health and human rights. Health professionals are not only able to assess and document human rights abuses, but they are also often among the first to recognize emerging crises as frontline responders providing critical medical care to those affected. When health professionals embrace the role of human rights advocates, they are some of the strongest assets in the fight against injustice.

PHR’s strategic plan for 2025 to 2028 allows us to meet the urgent need for the expertise and insight of health professionals, who are uniquely positioned to have a powerful impact at the intersection of health and human rights.

Therefore, a key component of PHR’s strategic plan for 2025 to 2028 is to strengthen our networks of health professionals by expanding partnerships and creating new opportunities for health professionals and allied partners to speak out and share their expertise to inform policymakers, opinion-shapers, and the public. In this consequential time for global human rights, this strategic plan will allow PHR to wield our proven approaches against serious violations including sexual violence, torture, and attacks on health in conflict, while ensuring we are able to respond effectively and nimbly to new challenges such as climate change.

Cover: Injured patients in the wards of Bukavu General Hospital days after M23 rebels launched their attack on Bukavu, Democratic Republic of Congo, 2025. Photo by Hugh Kinsella Cunningham/Getty Images

I will never forget when violence broke out during Ukraine’s Revolution of Dignity in 2013-2014. On a very cold winter day in Kyiv, confrontation between police and protesters escalated. I watched a bus burn in front of me on a central street. Even then, it seemed to me like an omen. Those of us who hoped the protests would bring about a brighter future in Ukraine knew the country would never be the same. Many lives were lost, but Ukraine chose a path of transformation. What followed, however, was beyond what any of us could have imagined.

Russia’s annexation of Crimea in 2014 felt almost physical – like losing a part of your own body. As Russian-backed militias took over Ukrainian administrations in Donetsk and Luhansk, we waited for the world to react. The response was timid. With time, we turned inward, focusing on reforms and making sure the sacrifices of those years were not in vain.

I was in the United States when Russia launched its full-scale invasion of Ukraine in February 2022. My friends and family back home were under bombardment, trying to evacuate or joining the fight. I spent sleepless night thousands of miles away, waiting to hear if they were alive. I did what I could do from afar – protests, donations, volunteering. But I knew I had to return. I knew I had to let the world see, hear, and understand what was happening to Ukraine.

I found my purpose in documenting war crimes in Ukraine with Physicians for Human Rights (PHR), ensuring that what was happening to Ukraine was being witnessed around the globe.

Attacks on Health as a Strategy of War

We knew that documenting these attacks was critical not only for collecting evidence but also for capturing patterns of violence in conflict and analyzing the broader impacts on the population. Documentation is so much more than gathering facts: it is also about memorialization, ensuring that truth is preserved to help future generations remember their history.

Documentation is so much more than gathering facts: it is also about memorialization, ensuring that truth is preserved to help future generations remember their history.

As we reach three years since Russia’s full-scale invasion in February 2022, the scale of destruction in my country is staggering. From the outset, health care was in the crosshairs. Russia immediately began attacking hospitals and health care workers, a tactic it honed for years in Syria, meant to break resistance and terrorize civilians. This assault on the health care system is not incidental – it is a war strategy. The destruction of hospitals, targeting of medical personnel, and coercive measures against health care workers and patients in occupied areas all serve to weaponize Ukrainians’ access to medical care, and maximize suffering, ultimately jeopardizing our way of life and making it impossible to lead a normal existence on these territories.

Russia’s attacks on energy infrastructure routinely disrupt power supply for our daily life; At my home in Kyiv we deal with power blackouts and utility shutdowns regularly. But many have not fully appreciated how these attacks also triggered a cascade effect on health care. Ninety-two percent of health care workers surveyed by PHR reported power outages in their facilities due to Russian attacks on energy. Two-thirds of the health care workers we surveyed told us these outages affected medical procedures, with surgeries postponed and interrupted, water supply interrupted, diagnostic equipment rendered unusable, and medication storage affected leading to spoilage.

The destruction of hospitals, targeting of medical personnel, and coercive measures against health care workers and patients in occupied areas all serve to weaponize Ukrainians’ access to medical care, and maximize suffering, ultimately jeopardizing our way of life.

The war is in every darkened operating room where doctors perform surgeries by flashlight and in every occupied hospital where Russian forces dictate which patients receive care.

Since 2022, Ukraine’s health care workforce has shrunk by 20 percent, and those who remain, continue to care for their patients under impossible conditions. An overwhelming majority – 83 percent – of health workers surveyed by PHR reported increased stress, burnout, and other challenges due to attacks on energy infrastructure and disruption of services.

Pathways to Justice

Attacks on health in conflict zones around the world are on the rise. Health facilities and workers are protected under international humanitarian law: in conflict settings, attacks on health facilities and workers can amount to war crimes or crimes against humanity. Yet these attacks have gone unpunished for decades. From Chechnya to Syria, from Sudan to Myanmar, Russia and other perpetrators have destroyed hospitals and clinics with impunity. The barrage of attacks on health in Ukraine is a chance for the international justice system to finally take a stand.

In 2024, the International Criminal Court (ICC) issued charges against Russian commanders for war crimes related to attacks on Ukraine’s energy infrastructure, citing “alleged strikes … directed against civilian objects” and “the expected incidental civilian harm and damage … clearly excessive to the anticipated military advantage.” This is an important step, but it is not enough.

Attacks on health must be prosecuted as the international crimes that they are. The ICC, national courts, and mechanisms of the United Nations must ensure these violations are investigated. Additionally, the international community should pressure those states which provide Russia with the weapons used to destroy hospitals – accountability must extend to those who enable these attacks.

Justice, however, is not just about courtrooms. For survivors of attacks, conflict-related sexual violence, torture and other violations, justice means recognition, safety, and support. Survivors in Ukraine need access to medical and psychological support, as well as trauma-informed forensic documentation. The Ukrainian government has taken important steps in this direction, creating new investigative units and support centers. But much more is needed: better training for health professionals, an enabling legal and policy environment, stronger coordination between legal and medical sectors, and survivor-centered approaches to justice.

Justice, however, is not just about courtrooms. For survivors of attacks, conflict-related sexual violence, torture and other violations, justice means recognition, safety, and support.

Health care workers, hospitals, and civilian infrastructure need urgent financial assistance, and survivors require continued support. Recent cuts by the United States to its international aid has put millions at risk in Ukraine.

Resilience and Hope

By the end of the third year of the full-scale invasion and after 11 years of war, we are understandably tired. International support is wavering and the Trump administration is embracing Russian talking points. But this is not the time to turn away. The consequences of disengagement are not just about Ukraine; they are about the future of international law, state sovereignty, and global stability. Strongmen of the world are emboldened by impunity and are testing the limits of international resolve. By ensuring accountability for the crimes being committed in Ukraine, we are all safer from the threat of aggression and tyranny.

By ensuring accountability for the crimes being committed in Ukraine, we are all safer from the threat of aggression and tyranny.

There are a lot of ways in which our lives in Ukraine have changed over the last few years. Falling asleep and waking up to the sounds of explosions, swooshing missiles, and buzzing drones, trying to squeeze life in between blackouts, and getting painfully used to losses – all of this does not come easily. But this is also the most rewarding place for me to be as Ukrainians and people from other countries come together in their resolve to support a more just future.

The countless stories of Ukrainian clinicians’ resilience give me hope:

The doctor from a town near Kyiv who provided care for her whole community during Russian occupation, despite knowing her husband and son were being held captive by Russian forces.

A doctor in an occupied city who refused to transfer identifying information about his patients to the new Russian authorities at grave personal risk.

The medic held in a Russian prison camp, trying to treat his comrades despite inhumane conditions and no available medications.

A doctor performing surgeries under bombardment and threats of the Russian army.

A pediatrician rushing to save colleagues and patients after a cluster munition attack on the hospital.

An obstetrician in a bomb shelter, caring for pregnant women and new mothers, and the youngest generation of Ukrainians.

These stories of defiance and dedication in the direst of circumstances, though, demand more than admiration. It’s up to all of us – in Ukraine and globally – to ensure their courage is met with documentation, memorialization, justice, accountability, and redress.