As founder and director of the Bellevue/NYU Program for Survivors of Torture, alumnus Allen Keller works to mend the bodies, minds, and spirits of people who have suffered the worst evils humans can inflict on each other.
By Margot Horwitz | Photo by Candace diCarlo
Abdoulaye,* a lanky young man with a shy smile, walks into the clinic of Dr. Allen Keller C’81 at the Bellevue/New York University School of Medicine Program for Survivors of Torture in New York City. The doctor greets him warmly, and the two men shake hands. The patient sits down, casually draping his jacket over his left hand. With the help of an interpreter, they chat for a few minutes.
Then Abdoulaye begins to speak of his current health complaint, stomach pains. After a few questions, the doctor learns that the man has been eating meagerly during the Muslim holy month of Ramadan, causing problems to his digestive system—a common complaint among his Muslim patients at this time of year, Keller says.
A bit later, he glances at Abdoulaye’s covered left hand. “Let’s see how you’re doing,” he says. The patient pulls away the jacket to reveal a disfigured hand.
Rebels poured gasoline on Abdoulaye’s arm and set it on fire when they attacked his village during Sierra Leone’s brutal civil war. When he first came to the Bellevue/NYU Program, all of his fingers were encased in flesh from a rudimentary skin graft performed in his country.
Now, after several hand surgeries and physical therapy at Bellevue Hospital, Abdoulaye has regained the use of several fingers. “It’s looking much better,” comments Keller. “The last surgery made a real difference.” Abdoulaye smiles and nods; almost as an afterthought, he bends down to tie his shoes.
Keller is pleased with the continuing progress of the refugee from Sierra Leone. When Abdoulaye first came to the program, he was despondent. He could not sleep, and when he did, he had nightmares about his abuse. Following the interdisciplinary philosophy of the Bellevue/NYU Program to deal with such trauma, in addition to his hand surgeries and other medical care, he has been given individual and group counseling and assistance with his application for political asylum.
“His entire affect has changed,” says Keller. “His nightmares, finally, are gone. He’s hopeful about his future.”
Other refugees patiently wait their turn to be seen by Keller during the Monday-night clinic. Naresh and his wife, Konica, do not need an interpreter, and their greetings to the doctor are warm and informal. The two have been in the United States for a while, and they speak easily to hospital staff members.
While Naresh has recovered from the severe torture he suffered in Bangladesh, he worries about his wife, who has headaches and stomach aches—the reason for this day’s visit. Keller recommends a gynecological check-up and prescribes medicines for her head and stomach pains, and the couple smiles with relief as they leave the tiny examining room, making way for others who have brought their physical and emotional problems to the place where they have learned to trust those in charge.
The clinic waiting room is a microcosm of life at Bellevue Hospital, which Keller refers to as a “big village, a real community,” adding, “We experience every known disease and condition here. As they say, if you don’t see it at Bellevue, it doesn’t exist!” Children and adults, chattering in more than a dozen languages, mill around the first-floor lobby off 27th Street and First Avenue in Manhattan, the center of a labyrinth of clinics and offices that make up the oldest public hospital in the country.
The multicultural face of Bellevue/NYU makes it an ideal setting for the Program for Survivors of Torture and the more than 1,500 patients, or clients as they are often called, who have been cared for since the program started in 1995—men, women, and children from all parts of the world, whose lives have been turned upside down, jailed and tortured for all kinds of reasons, from striving peacefully for their nation’s independence to their own sexual orientation. People who have survived the worst evils humans can do to each other and have begun to put their lives back together.
A few examples:
• Boubacar, a young Guinean law student, was jailed for mobilizing his friends against the totalitarian government. He was beaten so severely that his gangrene-infected leg had to be amputated at the hip when he was finally released. Finding his way to the United States, and then to the Program for Survivors of Torture, Boubacar was fitted for a prosthesis. He discovered the Achilles Track Club, which links disabled with able-bodied runners, and he has won several races. He says he “plans to be part of American sports history—even world history.”
• Samten’s family had been persecuted for peaceful political activism since the 1959 Chinese invasion of Tibet. The talented artist, who ignored the government’s prohibition on illustrating Tibetan history, was jailed and tortured, his hands severely burned. He managed to escape, hiking over the Himalayan mountains into Nepal, then India, where he was able to obtain a visa to the United States. Finding the Torture Survivors Program, he received medical and mental health care and social services. He is once again able to paint unique Tibetan murals to help pay his living expenses.
• A photojournalist who does not want even her first name published exemplifies some clients’ hidden scars. As she was visiting this country with other photographic exhibitors, war broke out in her native Ivory Coast. The woman was not allowed to return because of her husband’s political activities, and she has been only in phone contact with her young children for years. She worries constantly about them, but she has been heartened by the help she has received from the Survivors Program—medical, psychological, and vocational.
The job of helping people rebuild their lives is handled by what Keller calls an “amazingly caring, committed staff.” Primary-care physicians, psychiatrists, psychologists, social workers, and other health professionals, as well as volunteers who teach English, have worked with more than 600 clients in the past year alone—providing medical care to mend their shattered bodies and psychiatric and psychological treatment to ease their persistent nightmares, as well as helping them learn to live in this country by finding apartments and jobs to give them a feeling of independence.
Keller’s patients are of many nationalities, and his work with torture survivors takes him all over the world, but he learned his bedside manner and philosophy of compassionate care-giving in middle-class Woodcliff Lake, New Jersey, from his father, a dentist deeply loved by his patients. The senior Dr. Keller always put the people in his care first—supported by his wife, who managed the office. He was always available, something his son realized at an early age was an integral part of being a health professional.
At Penn in the late 1970s, Keller took the pre-medical courses required to start his own medical career as well as plunging into the liberal arts. A chance conversation with Chemistry Professor James Davis—during the 1978 College Hall sit-in his freshman year—changed his focus in that direction. But he only minored in chemistry; his major was in European history—“a good liberal arts subject,” he says.
The broad range of civilization at the heart of liberal arts “opened my eyes to the world,” says Keller and, though he didn’t realize it at the time, set the tone for his future work. He particularly recalls a course on “The City,” exploring the political, historical, and social context of urban development that engendered “intense discussions of life with my friends, far into the night,” he says. “And many of these college friends are still close to me now.”
After college, and a brief research stint at Mt. Sinai School of Medicine, Keller took a year off to travel, first cross-country to Oregon and Lake Tahoe, California, where he indulged his love of skiing, and then to Europe, hiking through the Pyrenees in Spain and exploring the French countryside in Normandy.
He then enrolled at NYU School of Medicine, expecting to work flat-out and come up for air four years later, medical degree in hand. But after his second year, feeling stressed and burned-out, he knew he had to get away and try to find work overseas. To their great credit, Keller notes, the deans at the medical school recognized his need to broaden his medical horizons and granted him a leave of absence.
This exploration began along the Thai-Cambodian border, where he found a job with an international aid organization, the American Refugee Committee. “It was not easy, especially at first,” he says. “I had no previous experience that would prepare me for those early days in refugee camps. The lives of the Cambodian refugees I met were completely beyond my understanding.”
Keller helped run a laboratory, examining blood smears for malaria and sputum for tuberculosis in a hospital made entirely of bamboo. Beyond the issue of disease, he was stunned by the refugees’ tales of the brutal Cambodian reign of terror and torture, the ghastly civil war and the damage from land mines throughout the region. “My heart opened to these people,” he says. “They literally changed my life.”
The bare-bones bamboo hospital, where he learned physical diagnosis from Cambodian medics, also gave Keller a new view of medicine. Several of the medics, trained by the American Refugee Committee, were “among the most gifted clinicians I’ve ever met,” he says. “They made a major impact on me.” Cases of typhoid fever, malaria, and cholera vied with grotesque land-mine injuries to create a health crisis beyond anything he had ever imagined.
But what Keller took away from the experience most of all was a new awareness of the horrific health consequences of the abuses Cambodians and refugees around the world had endured, and the interrelationship between health and human rights—the first step on his path to a unique medical career of caring for those suffering the effects of human cruelty.
Returning to medical school with a “recharged attitude,” Keller realized his good fortune in being part of the NYU-Bellevue complex. Bellevue, he says, is a “refugee camp with elevators—but it is much more than that. The staff is not only talented, but committed to the blending of health and social justice. On a daily basis, they have an essential social contract with their patients, the vulnerable, homeless, and uninsured.”
Even before Keller helped found the Program for Survivors of Torture, he was working with an immigrant and refugee population, many of whom had experienced torture. “I saw the dedication of the medical staff, their professionalism and sincere caring for the victims who put their lives into our hands.”
After his 1988 medical-school graduation, Keller did his internship and residency at NYU/Bellevue, working in primary-care internal medicine, then returned to Cambodia to practice basic public health and help set up community-health programs. He also developed a United Nations-sponsored curriculum for Cambodian health-professionals in documenting human-rights abuses. The medical and psychological consequences of land-mind injuries were particularly critical to his work. “Land mines impose an unfair burden of suffering on civilians,” Keller notes. “They can’t tell the difference between the footsteps of a soldier or a child.”
While in Cambodia, Keller conducted a study documenting the health impact of land mines on civilians and subsequently co-authored one of the first articles in medical literature on the medical and social consequences of land mines. He became actively involved in the International Campaign to Ban Land Mines. He notes that 100 countries have signed a treaty banning land mines, though the United States has not.
In 1993, he returned to Bellevue Hospital as an attending physician. He had become involved with Physicians for Human Rights, a network of physicians, psychologists, and psychiatrists that assists immigrants applying for asylum by documenting the physical and psychological health consequences of the trauma they have suffered.
An estimated 5 percent to 25 percent of refugees and asylum seekers are victims of torture. When they arrive in this country with refugee status, they are entitled to a variety of benefits. But for an undocumented immigrant fleeing persecution, the asylum process is the opportunity for safety, and the first step toward a new life. Without asylum, they cannot get work papers to earn money for subsistence. It can take months, even years, for it to come through.
(The process has become even more difficult since 9/11, according to Survivors of Torture co-clinical directors Kate Porterfield and Hawthorne Smith. Smith relates a story of one judge who, before finally granting asylum to a dark-skinned Muslim from North Africa, shook his finger at him and warned, “You had better not be a terrorist!”)
It became clear to Keller that patients seeking asylum had unmet needs—psychological and social as well as medical. As he was also aware, a large proportion of refugees fleeing persecution who land in the United States come to New York City.
With the support of the Bellevue and NYU School of Medicine, the Program for Survivors of Torture was set up over the next few years, with Keller as its founder and director. People from 70 countries have been treated there, and there are many who want to join the program. The group works hard to raise funds, but with a decrease in federal grants, money has become a serious issue.
“We want to help as many people as we can—we get 5 to 10 new referrals a week, and we have a long waiting list. It would be great if our services would no longer be needed, but right now we’re more in demand than ever, and it’s tough,” says Keller. “Fund-raising is definitely the most difficult part of my job. Working with the clients, even those with heart-rending stories, is deeply satisfying. Worrying about whether we’ll be able to keep the lights on is truly stressful!”
(For more information, or to offer financial support, visit the website at www.survivorsoftorture.org or call 212-994-7158.)
Keller and his wife Suzanne Groisser live in Montclair, New Jersey, with their two children, 7-year-old Rachel and 4-year-old Jake. They were married in 1993, the same year he returned to Bellevue from Cambodia. They’d been introduced a few years earlier by a Penn friend who described Suzy to Keller as having “a social conscience like yours.” A Harvard Law School graduate, Suzy is an advocate in the field of domestic violence and formerly worked as a prosecutor in the Manhattan District Attorney’s Office.
One of Keller’s greatest joys is spending time with his wife and children, which he calls his “touchstone.” But juggling the growing demands on his time is not easy. Besides seeing clients and administering the program at Bellevue, he is assistant professor of medicine at NYU and society master for the May Chinn Society for Bioethics and Human Rights of the medical school’s Master Scholars Program. He also teaches seminars at Princeton and NYU on health and human rights. Recently, as a Soros Advocacy Fellow, he completed a study examining the health of asylum-seekers detained in the United States. Then there is the international travel, including being part of a Physicians for Human Rights team conducting an epidemiological survey of more than 1,200 Kosovar refugees in camps in Albania and Macedonia.
One of his most memorable forays overseas was a stay in Dharamsala, India, the seat of the Tibetan government in exile. Keller’s mission was to document reports of torture in Tibet among refugees who had fled into exile. Having heard of Keller’s work with refugees, the Dalai Lama invited him for an audience in the Buddhist equivalent of the Oval Office. It was a special moment for Keller, who asked for and received a blessing for his seriously ill father. Several years later, Keller brought some of the program’s clients to see the Dalai Lama when the Buddhist leader appeared at a Humanitarian Award ceremony in New York for the International Council for Torture Victims.Keller’s companion on the trip to Dharamsala was Dr. Glen Kim EAS’94. Keller had advised Kim at NYU School of Medicine, encouraging him to look beyond his studies and work in disadvantaged areas when he voiced discontent with the day-to-day grind. Working together in Dharamsala gave Kim the opportunity to see Keller in his hands-on work with refugees. Keller is “wholly committed to human-rights work and to his patients,” Kim says. “His guiding principle is the relationship between health and human rights.”
This engagement guides Keller and keeps him and his staff going during particularly trying periods. Sometimes there are unexpected set-backs, events which cause indirect but nonetheless devastating consequences. One such event was the terrorist attacks of September 11, 2001, which profoundly affected the survivors, according to co-clinical director Porterfield. “Their feeling of security was shaken,” she explains. “They had secondary trauma in what they considered a safe place when their new city was violated. This trauma was up close and personal, with our clients being very concerned about us. After all, we had not experienced anything like this before, and they helped us deal with it.”
The Abu Ghraib prison scandal was similarly unnerving. Program clients had strong reactions to the images of tortured prisoners in Iraq, including re-experiencing post-traumatic stress disorder. It was particularly upsetting and confusing because the torturers were Americans. The staff and volunteers worked hard to re-establish community among the survivors, and renew their sense of safety. As with 9/ll, the clients and the staff drew strength from each other.
Porterfield and Smith both credit Keller as an energetic, empathetic, principled leader, who is not only a gifted clinician, but also an extremely compassionate human being. The program’s clients are people who “have been through hell, often abused by people in authority,” says Porterfield. “But Allen makes them feel safe, able to open up and share their deepest problems.”
“When he meets with clients,” adds Smith, “he makes them feel that their well-being is important, valued—that is no small feat to the disempowered!”
Last year, Keller received the Barbara Chester Award, an international award given to a clinician in recognition of outstanding care provided to victims of torture. He was also honored in 1999 and again in 2001 with the NYU School of Medicine Humanism in Medicine Award. Keller believes that awards are useful for getting the name of the organization into the news, but it is the courage of the clients, the survivors of horror, who keep him focused as he works to help them recover and rebuild their lives.
Others involved with the Bellevue/NYU Program for Survivors of Torture echo these sentiments, saying that what keeps them going is the incredible resilience of the human spirit demonstrated by clients, many of whom have moved on to full and rewarding lives in their new country.
One of these success stories is Shiekh, who would allow neither severe torture in his native Liberia nor bureaucratic obstacles in the United States to keep him from a better life. The first member of the Mandingo tribe to be executive director of a major human-rights organization in Liberia, he was thrown into jail without being charged, enduring solitary confinement and extensive torture. Finally released through the efforts of the U.S. State Department and the U.S. Ambassador to Liberia, he made his way to this country.
But his challenges continued here, and for some time he was unable to get the right papers to remain; he was considered a “political case,” although he was anything but political. After many difficult months he came to New York and heard about the Program for Survivors. As a result, Shiekh says, “the program has made me feel as if I’m really in the United States. The people here have taken care of my medical problems and have built me up psychologically—something I needed from my post-traumatic stress. And they’ve make me independent by helping me find a job!”
A new concern for Keller is to ensure that the United States neither practices nor condones torture—even with regard to the War on Terror. Prior to the hearings to confirm Alberto Gonzalez as attorney general, he briefed the staff and lawyers of the Senate Judiciary Committee, telling them that the “stress and duress” techniques being used too often cross the line from interrogation to torture.
In Keller’s view, the United States must continue to embrace the moral values on which this country is founded. “When the United States in any way practices or condones torture, it cheapens who we are,” he says. “I also fear it puts innocent civilians around the world living under oppressive regimes at greater risk of being tortured—by validating torture—thus increasing an already worldwide public-health epidemic of torture.”
Health professionals have an important role to play in caring and advocating for torture victims, observes Keller. “In my work with torture survivors, I am reminded of the darker side of humanity and the potential for cruelty in the world. But I am also reminded by the survivors I have been privileged to care for of the hope, strength, and potential to help rebuild lives,” he says.
“It is for the sake of all of those who have suffered from torture or continue to face the risk of being tortured that we must commit ourselves to aiding torture victims, to speaking out against torture, and to ending this assault on human dignity.”
Margot F. Horwitz CW’58 ASC’62 is a freelance writer in Bryn Mawr, Pennsylvania.
* Clients have requested that only their first names be printed, to protect loved ones in their countries of origin.
