Altaf Saadi, MD, MSc, is an instructor in neurology at Massachusetts General Hospital (MGH), where she is also associate director of the MGH Asylum Clinic at the Center for Global Health and principal investigator of the Neurodisparities and Health Justice Research Lab. As part of our Visiting Research Internship Program, she served as a mentor this summer for Jasmin Williams, who will be starting her second year at University of Connecticut School of Medicine.

Why did you decide to mentor for VRIP this summer?

This was my first time mentoring in the program. I was drawn to participate because it provides an opportunity and access to research opportunities, particularly for students of color. Mentorship has been so crucial to my own experience and path as a researcher that it’s critical for me to give back as a mentor. It was also important for me to showcase a pathway in health disparities research within neurology. The work that I do at the intersection of neurology and health disparities is a newer path in my specialty, and I am excited to show rising medical students and researchers that it can be part of a fulfilling and exciting career in neurology. We need people prioritizing health equity in all specialties of medicine.

“Mentorship has been so crucial to my own experience and path as a researcher that it’s critical for me to give back as a mentor.”

It was great to mentor Jasmin. She had prior experience in traumatic brain injury research. She also had just completed training to volunteer at the UConn Health Asylum Clinic, which is part of the Physicians for Human Rights Asylum Network that I am also associated with. She was a perfect fit for my research team.

Can you tell us more about the traumatic brain injury (TBI) project Jasmin Williams worked on with you and your findings?

I have a longstanding commitment to working with refugee, asylum seeker, and immigrant communities—as a clinician, physician-researcher, and advocate. I am associate director of the MGH Asylum Clinic and spend clinical time at MGH Chelsea HealthCare Center, which serves a largely immigrant community as well as refugee populations. I am also a medical expert for Physicians for Human Rights, a nonprofit organization known for its global efforts to lend medical and scientific expertise to documenting and speaking out against human rights violations.

This project, a systematic review of the global prevalence of TBI among refugees and asylum seekers, came out of my work in all these contexts. That work identified TBI as an under-recognized and under-studied phenomenon in a population that is not only subject to incredible psychological trauma, but also physical trauma, including brain injury.

We’re still finalizing our preliminary analyses and have plans to submit our findings for peer review publication this fall. Here are a few examples of what we’re seeing. TBI is a common phenomenon among refugees and asylum seekers, affecting about one-third of them at least. Among adult refugees and asylum seekers, there seems to be a higher risk of TBI than their non-refugee counterparts. But the studies we have identified do not use a consistent definition of TBI or a standardized way to assess for TBI, so there’s a lot of room for improvement in data gathering.

We also found that men were the predominant focus of many studies, with some studies not even including women at all. This underestimates brain injury in the context of intimate partner violence, which is one of the reasons refugees and asylum seekers flee their native countries. And intimate partner violence is not a rare event even in the general population.

“TBI is a common phenomenon among refugees and asylum seekers, affecting about one-third of them at least.”

What are some other examples of your research?

My prior work has looked at disparities in access to neurological care in the U.S., the impact of immigration policies on health, and how health systems can be more immigrant-friendly. It includes the health of immigrants in detention, the impact of lifetime trauma on cognition, and how memory loss manifests among trauma-exposed asylum seekers, which has significant implications for their legal cases.

I have several ongoing projects, including examining the neuropsychiatric health impacts of individuals released from immigration detention in the context of the COVID-19 pandemic and the burden of neurological disease among resettled refugees. Broadly, I am interested in contributing to an evidence base for community, institutional, and policy-level changes that promote equity—within neurology but also outside of my specialty—and especially for refugee, asylum seeker, and immigrant communities.

Why is this work so important for you?

My personal experience as an immigrant has deeply shaped my understanding of how so many factors above and beyond the individual level impact health. We have to look towards structural factors to make lasting change when it comes to health equity. If we don’t, the same inequities will surface and re-surface, as we saw play out in the COVID-19 pandemic.

This is why it is so important for me that my research is policy-relevant and driven by community needs. At the end of the day, this work is important to me because it’s not about me. It’s about the experiences and voices of communities that are too often relegated to the periphery in academia, healthcare, and other spaces. I feel a deep sense of responsibility to use my expertise as a physician and researcher to do this work in the service of my mission to promote health equity and justice.

Personally, how do you stay balanced amid all the stress and tragic news from the border?

Often, the stories of refugees and asylum seekers end up being centered around their trauma, but that ignores the incredible resilience, growth, and humanity throughout their journeys. The work that I do can be difficult, but it is also incredibly inspiring. Honestly, the stories that I bear witness to help me keep things in perspective and remain motivated to continue doing this work.

What also helps me stay balanced is spending time with my family. I have a toddler who keeps me very busy and infuses each day with so much joy. And my husband, who has always been a partner and cheerleader for me professionally, reminds me constantly to live a full life outside of my professional roles.