An educational curriculum to train graduate public health students in health and human rights and health needs of asylum seekers/torture survivors; Domestic global public health

Background: 7-12% of foreign-born patients have experienced torture. Little formal training exists that introduces and equips graduate public health students with the skills to identify and address the needs of this population. Methods: We developed and implemented a graduate course that included: 1) didactic sessions covering demographics and epidemiology of torture and human rights abuses, medical and psychological sequelae of torture, international and national asylum and refugee laws, and the approaches to evaluate and address the public health and social needs of survivors, 2) panel discussion with survivors, and 3) opportunity to attend the clinical evaluation sessions of asylum seekers and being involved in the mentored affidavit-writing. Pre- and post-course questionnaires evaluating attitudes, knowledge, and self-efficacy were administered. Results: Since 2009, 40 graduate students without clinical background participated in the course and completed the curriculum. Post-intervention, students were more likely to recognize heath care professional obligations towards survivors (p<0.01) and to have knowledge of the most common sequelae of torture and the health and social needs of survivors (p<0.01). Students' attitudes toward working with torture survivors improved (p<0.05) along with self-efficacy in identifying populations at risk for torture and evaluation of health needs of survivors (p<0.05). Conclusion: Students showed significant improvement in attitudes and self-efficacy to evaluate the needs of survivors, which will likely serve them in assessing and providing healthcare to other vulnerable populations. The curriculum was feasible, was well-received, and served as an eye opener for graduate students towards the health and human rights issues at home.