Published by the Students of Johns Hopkins since 1896
May 23, 2024

Humans of Hopkins: Ilil Benjamin

By AIMEE CHO | April 25, 2024



Benjamin shared stories from her fieldwork that illustrate the complex dilemmas that aid workers face.

Ilil Benjamin is a senior lecturer in the Department of Sociology at Hopkins. In an interview with The News-Letter, Benjamin described her experience working in a humanitarian NGO for refugees as well as how her classes intersect with her research.

The News-Letter: How did you become interested in humanitarian aid?

Ilil Benjamin: I read an article about Palestinians who were living in the West Bank. American psychologists had come to do mindfulness therapy with them, supposedly to help them cope with the day-to-day difficulties of living under a military occupation. These were well-meaning psychologists who wanted to use their toolkit to provide assistance, but many Palestinians saw that as a depoliticizing act. They were worried that it would distract from larger political and social questions. 

I interviewed some of the psychologists later on, and [people in the West Bank] said that they don't want to be pacified, and they don't want to live more comfortably with this reality. They wanted to remain angry and to resist it. They worried that, with mindfulness therapy, the focus is turned inward when really the world's eyes should be on the external forces.

I thought that was very interesting. How is it possible for psychological aid and humanitarian aid to distract from a larger question? That was my initial question. I later discovered that it was much more complicated. In some cases, it's useful to have different kinds of humanitarian assistance, but you also need a human rights complement. You also need activism in aid that is more macro, that strives to hold larger parties accountable.

N-L: What was your experience working in a humanitarian organization?

IB: I was struggling to get aid workers to answer my requests to interview them. [My great aunt] knew a doctor who was volunteering with a joint Israeli-Palestinian organization called Physicians for Human Rights–Israel, and she told me to contact him. I did, and he said, “We are having a medical mission this afternoon in the West Bank. Do you want to come join us?” And it really all spiraled from there.

I was mainly in their open humanitarian clinic [in Jaffa] for refugees from Sudan and Eritrea coming to Israel. Even though many of them were hoping to become officially-recognized refugees in Israel, very few of them have been. The majority of them [live in Israel] on short-term stay visas with very few work rights or health care rights, without access to the Israeli state single-payer health-care system. The NGOs fill the gap by providing free medical care for this population. 

Suppose you have the flu or you have a minor burn. You go to this humanitarian clinic, they give you flu medication and they could treat it on-site. But what happens if you have cancer, and you're a refugee, and you don't have access to a formal health-care system? Sometimes, they were able to get surgery in Israeli state hospitals. There is a patient rights act that says if you have an immediate, life-threatening emergency, you can't be turned away from a state hospital even if you don't have access to the state system. But, even if you have stage four cancer, that doesn't necessarily mean you qualify under this law because you might still have a few weeks to live. 

There was one asylum seeker who had Hodgkin's lymphoma. He was still working in construction despite the illness [because] he needed to make ends meet. I remember we connected him to our volunteer oncologist, who would collect chemotherapy pills from patients who were deceased and from other oncologists who would send their pills that were no longer needed. She wasn't able to use her professional facilities [to treat him] because this person was not technically permitted to use them. So, she would mix [the medicine] in her kitchen and drive to the scaffolding of the construction site where he worked. She would inject him with the chemo, and then he would pull up his pants again, go back up and continue his work. 

But the thing that was always difficult for me is, What happens if this oncologist goes on vacation or burns out and decides not to volunteer at the organization anymore? If you don't have these charismatic, extremely dedicated individuals, then you can't count on there being treatment for patients when it's not grounded in rights. It's not an empowered contract between the doctor and the patient.

N-L: What were some of the dilemmas you faced as an aid worker?

IB: There was one middle-aged asylum seeker from Eritrea who was working as a cleaning lady. She had a complex orthopedic condition that was quite debilitating. She begged for us to help her fundraise for surgery. My shift supervisor bent down to this woman crying in this crowded and cramped clinic and said, “I'm so sorry, but orthopedic conditions are the hardest for us to find volunteers for.” She was trying her best to comfort the woman.

But, when the woman left, the supervisor privately told me that, while it sounds really horrible, who is going to care about this refugee's ankles? This woman was not dying. There's something about the humanitarian encounter that requires a very arbitrary and unjust hierarchy of deservedness. People who seem to be suffering more are often deemed more deserving and pluck the heartstrings more, and it becomes very difficult because that's not all of suffering. There are many forms of suffering and, unfortunately, this clinic was really only able to deal well with certain kinds of suffering, ones that were more acute. It was really heart-wrenching, and I would come home sometimes crying myself to sleep. 

I remember thinking, Why don't we just expand the clinic? There are so many patients that need help. We're clearly not providing them with a quality medical solution. When I would go to my supervisors, they would say, “That’s the state's responsibility. We cannot become the permanent solution for this population. It needs to be grounded in rights. We're lobbying for the government to change its laws, but, in the meantime, we do what we can.”

In a way, ironically, there was also this perverse incentive to not get too good at saving lives. If we recruit too many volunteers and if we become their main solution, then we basically become a pseudo-Ministry of Health for them. Then, the state will have no incentive to take responsibility, give them refugee status and give them access to state health care. The dilemma: If you expand, you exonerate the state of its responsibilities because the state will use you as a pawn to continue its exclusions. But if you don't, if the suffering exists, the state won't be able to look away.

Maybe there'll be a legislative change in 10 or 15 years. But does this matter to people who need surgery now, who are in pain? Is it really fair to tell them you need to suffer so that the future people who come will have it better? That's why so many of us were really torn about this tension between aid and advocacy, and I'll never forget how bitter it made a lot of us. We understood there was no win. And it became a really horrible choice between two really complicated and imperfect decisions.

N-L: What did you learn from being a volunteer on the field instead of an outsider researcher?

IB: Unfortunately, the public image of humanitarian aid is very different from how it feels to actually be inside and faced with impossible decisions. This is not a dilemma that's unique to this region; you find it everywhere. You're always going to have the same kind of dilemma because, if these [organizations] were not there, then the suffering, public protest and outcry would be so great that the state would have no choice but to act. But the fact that they are receiving so much assistance from well-meaning humanitarian organizations, churches, advocacy groups and nonprofits is, in some ways, allowing state neglect to persist. And that's a troubling problem that I don't think we'll ever really find a solution to. You might think that the humanitarian clinic or volunteer is full of really grateful patients and very fulfilled aid workers, but, in practice, it was a zone of deep, moral ambiguity.

Patients were often upset with us for not providing better quality of care, and we were often quite sad that we couldn't or that there was kind of a worry that, if we did, we would be there indefinitely. Humanitarian aid is often a way to keep people temporarily alive but does not improve their condition permanently. That's why human rights advocacy as a complement is so important. I was really intrigued by how aid workers were trying to play both games at once, trying to do advocacy while they were also providing aid. Listening to them, talking to them and understanding what dilemmas they faced, I felt that even I would be able to maybe cast a little bit of new light on the dilemma that aid workers have lived with for centuries.

It's a situation that sets you up for permanent frustration and dissatisfaction. None of the people I worked with then are still there. They all left within a year or two, all burnt out. [I asked] one of the clinic managers [why she] left. She said, “When I first started as clinic manager, I would have a heart attack over every kid's snotty nose, but, within a year, I didn't even cry when they were dying of cancer. So, then, I knew I shouldn't do this anymore.”

N-L: What do your classes look like?

IB: We usually read ethnographic frontline reports and analyses of ethics and politics and then discuss them in class. I tried to combine the theoretical texts with experiences and examples from my research. One of the more controversial themes in [Refugees, Human Rights, and Sovereignty] is what is the difference between an economic migrant and a refugee. In theory, according to the 1951 United Nations Refugee Convention, a refugee is someone who is fleeing outside their home country and has a well-founded fear of persecution on grounds of race, religion, nationality, political opinion or social group membership. The perception is that forced migrants have no choice [whereas] economic migrants have the choice and that it's not as urgent. But, in actuality, the line between the two is much blurrier and muddier than it seems. We spend all semester exploring that kind of idea from different angles.

For example, a lot of Sudanese and Eritrean people who are seeking refugee status would go to the Israeli border, where they would be intercepted by the Israeli military. Israeli Defense Forces soldiers would interview them sometimes and ask them, “Why are you here?” Many more than I ever thought would say they came to work. I completely understand why they would say that; they don't want to be seen as a burden on the Israeli economy. But, actually, that's the worst thing that they can say because they're going to be applying for asylum. The asylum regime assumes that there is a clear distinction between economic migration and forced migration. If you are applying for refugee status but you are perceived to have economic motives, it would make it exceedingly hard for a judge to believe that you're fleeing persecution. Some of my colleagues [in NGOs] would rush to the border whenever there were rumors of an incoming group of migrants, trying to get to these asylum seekers before the soldiers and tell them not to say they came to work. 

Of course, the asylum seekers came for safety, but they also came for work. Everybody needs to live; everybody needs to work. But the refugee system is so exclusionary and only admits those who can demonstrate a well-founded fear of persecution. It doesn't really provide any protection or assistance to economic migrants.

[In my classes], we also do arts and crafts, decorate cookies, and do t-shirt competitions. Before I came to Hopkins, I taught for a year at a small liberal arts college in Wisconsin. There, the relationship between professors and students was much closer, and we did a lot of these kinds of activities. I thought it would be nice to bring some of that atmosphere to Hopkins because, from what I understand, a lot of my students take a lot of large lecture classes where they feel just like a number and they don't really get to do fun things in class.

N-L: How does your class relate to your research?

IB: One of the most surprising findings that I have seen over and over, both in the classroom setting and in my research, is that the official structures in place to help people dealing with war or with forced displacement don't do justice to their real stories, lives and priorities. We also see that with refugee policies. Asylum seekers who want to be considered for refugee status have to tell a very clear narrative that identifies their perpetrators, talks about their victimization and explains why they have a well-founded fear. 

I once volunteered with a legal aid clinic. It was a nonprofit helping asylum seekers by doing a first read of their narratives and helping them to reframe their narratives to be more persuasive to asylum officers or judges. We had one asylum seeker from Nigeria, and, in his first narrative, I remember he titled it, “Dear Brethren of my Savior Jesus Christ.” The lawyer immediately said, “Take that out. That's not going to help you. Just because they might be Jewish people who are the brethren of your savior doesn't mean that they necessarily would empathize with you as a Christian. Better for you to just say, Dear Sir — or Madam — and then tell the story of a persecution.” But this asylum seeker was a very faithful, devout man. He really wanted to talk about Jesus in his asylum narrative. He kept coming back week after week with new versions that still mentioned some kind of divine being saving and protecting him, and the lawyers would tell him repeatedly, “We understand that this is important to you, but you need to take it out or else it will bias the judge against you. You need to be factual and specific.”

As one of my friends who was a refugee brilliantly put it, our lives are just papers on someone's desk, and we have to fit their rubrics and their requirements if we are going to win protection. It shouldn't be like that. We should be able to tell an honest story. 

I've never seen a solution to this, and I don't think there is one. How could you provide assistance or adjudicate refugee claims fairly in ways that also allow people to retain their honest selves, stories and dignity? The trade-off is that to win protection, you have to appear in a certain way. That may be the most complex and troubling dilemma that we talk about in my classes, too.

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