Trump’s Bigoted Attack on Somalis Denounced From Minneapolis to DC to Mogadishu

Rep. Ilhan Omar said that the president “fails to realize how deeply Somali Americans love this country.”

Rep. Ilhan Omar (D-Minn.) attends a news conference about Islamophobia on Capitol Hill on November 30, 2021 in Washington, DC.
(Photo by Drew Angerer/Getty Images)

Brad Reed
Dec 04, 2025
COMMON DREAMS

President Donald Trump is being roundly condemned for making bigoted attacks on Somalis, whom he referred to collectively as “garbage” earlier this week.

During a Tuesday Cabinet meeting at the White House, Trump unleashed a racist tirade against Somali Americans living in Minnesota, whom he falsely portrayed as layabouts who sponge up welfare money.
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In ‘Political Attack,’ Trump Revokes Protected Status for Minnesota Somalis



After Trump’s Latest Racist Rant, Ilhan Omar Hopes ‘He Gets the Help He Desperately Needs’

“I don’t want ‘em in our country, I’ll be honest with you,” Trump said. “Their country’s no good for a reason. Their country stinks, and we don’t want ‘em in our country. I can say that about other countries too... We’re going to go the wrong way if we keep taking in garbage into our country.”

Trump then singled out Rep. Ilhan Omar (D-Minn.), a refugee from Somalia, as being “garbage,” and then added that “her friends are garbage.”





Omar fired back at Trump in an op-ed published Thursday in the New York Times in which she said the president was resorting to overt bigotry against her community because he is rapidly losing popularity as his major policy initiatives fall apart.

Omar also defended her community against the false stereotypes deployed by Trump to disparage it.

“[Trump] fails to realize how deeply Somali Americans love this country,” she wrote. “We are doctors, teachers, police officers, and elected leaders working to make our country better. Over 90% of Somalis living in my home state, Minnesota, are American citizens by birth or naturalization.”

Speaking on behalf of the Congressional Progressive Caucus, Rep. Chuy García (D-Ill.) defended Omar and the Somali community, and called Trump’s attacks on them “unacceptable and un-American.”

“Not only does Trump’s dehumanizing language put a target on her back and put her family at risk, it endangers so many across our country who share her identities and heritage,” García added. “We know just how dangerous this racist and inflammatory rhetoric is in an already polarized country.”

In an interview with Al-Jazeera, Minnesota state Sen. Omar Fateh (D-62), who is also of Somali descent, said Trump’s attacks were “hurtful” and “flat-out wrong” given what many Somalis in the US have accomplished.

“It is a community that has been resilient, that has produced so much,” he said. “We are teachers and doctors and lawyers and even politicians taking part in every part of Minnesota’s economy and the nation’s economy.”

He also emphasized that Trump’s rhetoric was putting the entire Somali community in danger.

“We’ve had our mosques be targeted,” he said. “Myself, I had a campaign office vandalized earlier this year, and so we want to make sure that our neighbors understand that we’re standing up for one another, showing up in this time in which we have a hostile federal government.”

Trump’s bigoted attacks on Somalis are also making waves overseas. Al-Jazeera also spoke with a resident of Mogadishu named Abdisalan Ahmed, who described Trump’s remarks as “intolerable.”

“Trump insults Somalis several times every day, calling us garbage and other derogatory names we can no longer tolerate,” he said. “Our leaders should address his remarks.”

Somalis arrested in Minneapolis immigration operation, officials say

By Heather Schlitz and Andrew Hay
Thu, December 4, 2025 


MINNEAPOLIS - People of Somali origin are among those arrested in an immigration crackdown in Minneapolis, federal officials said on Thursday, two days after President ​Donald Trump hurled insults at immigrants from the Horn of Africa country and said he ‌wanted them out of the United States.

The Minneapolis arrests began on Monday, the Department of Homeland Security said in its first statement ‌on the operation. Officials did not give a total arrest figure but gave profiles of 12 people apprehended, five of them from Somalia, the rest from Mexico and El Salvador.

In the statement, Homeland Security Assistant Secretary Tricia McLaughlin portrayed them all as dangerous criminals with convictions ranging from fraud and vehicle theft to criminal sexual conduct ⁠and driving under the influence.

Minneapolis Mayor ‌Jacob Frey, a Democrat, has strongly criticized Trump’s attacks on the city's Somali population and on Thursday called on Americans to "love and respect" Minnesota's Somali immigrant community, which ‍is the largest in North America.

Trump's racist rhetoric against Somalis, and attacks on Minnesota politicians who defend them, has been applauded by his allies. On Tuesday, during a televised cabinet meeting, he reacted to reports of government fraud among ​pockets of Minnesota's large Somali population by calling immigrants there "garbage" and saying he wanted them sent "back to ‌where they came from."

Anti-immigration rhetoric was a major part of Trump's campaign. Since taking office in January he has overseen aggressive operations by masked federal agents across the country in a bid to drive deportations to record levels. Along the way, Trump's public language when speaking about immigrants has grown harsher.

CRACKDOWN IN NEW ORLEANS

Also on Thursday, federal officials said they had arrested dozens of people in New Orleans, another Democratic-run city.

On day ⁠two of the New Orleans operation, protesters disrupted a city ​council meeting to demand councillors declare city property "ICE Free" zones where ​federal immigration agents could not stage operations.

Protesters accused federal agents of indiscriminately targeting people of color, including U.S. citizens, with no criminal record, an allegation the Department of Homeland ‍Security denies.

New Orleans Mayor-elect Helena ⁠Moreno said in a statement on Wednesday the operation had created a culture of fear among the city's most vulnerable residents.

"We must do what we can to protect New Orleans and ensure ⁠due process is followed for all of our residents," she said, announcing an online portal for citizens to report abuse from ‌federal immigration officers.

Louisiana Governor Jeff Landry, a Republican, has supported federal immigration enforcement efforts.

(Reporting by ‌Andrew Hay; Editing by Donna Bryson and Stephen Coates)

Kristi Noem claims 50% of Minnesota visas and programs are fraudulent. Here's what data shows

Laerke Christensen

Fri, December 5, 2025 



Getty Images


A claim circulated online in December 2025 that 50% of visas in Minnesota were fraudulent. It came from U.S. Secretary of Homeland Security Kristi Noem, who said at a Dec. 2 Cabinet meeting, "You told me to look into Minnesota and their fraud on visas and their programs. Fifty percent of them are fraudulent."


Neither Noem nor the DHS established exactly which of the many lawful ways to enter the U.S. the secretary included in the "visas" and "programs" that allegedly had a 50% fraud rate.


A U.S. Citizenship and Immigration Services investigation in Minneapolis-St. Paul in September 2025 reportedly found "evidence of fraud, non-compliance, or public safety or national security concerns" in 275 out of more than 1,000 cases it looked into, meaning no more than 27.5%. That data did not support Noem's claim.


USCIS, which oversees immigration in the U.S. and whose Fraud Detection and National Security Directorate investigates immigration-related fraud, referred Snopes' query to the DHS. Noem's and the DHS' reluctance to comment on the evidence for Noem's claim meant it was not possible to independently verify its accuracy.

In December 2025, a claim circulated online that 50% of visas in Minnesota were fraudulent.

The claim spread after U.S. Secretary of Homeland Security Kristi Noem said at a Cabinet meeting on Dec. 2, "You told me to look into Minnesota and their fraud on visas and their programs. Fifty percent of them are fraudulent.

The news aggregator NewsWire wrote on X (archived) that day, "NOEM: 50% OF VISAS IN MINNESOTA ARE FRAUDULENT"



The claim also circulated on Facebook (archived), Instagram (archived), Threads (archived) and Bluesky (archived).

Noem's claim was difficult to independently verify.

It was unclear exactly which of the many lawful ways to enter the U.S. Noem included in "visas" and "programs" that allegedly had a 50% fraud rate. Noem did not cite any data to back her claim during the Cabinet meeting, nor did a spokesperson for the Department of Homeland Security leads reply to clarifying questions when Snopes asked via email.

U.S. Citizenship and Immigration Services, which oversees immigration in the U.S. and whose Fraud Detection and National Security Directorate investigates immigration-related fraud, referred Snopes' query to the DHS.

Given that we could not establish what Noem based her claim on or even to which types of "visas" and "programs" it pertained, we leave this claim unrated.

We also reached out to the State Department, which issues visas, to ask if the agency knew what data Noem used to back her claim and await a reply.
Noem blamed Walz for fraudulent visas

During the Dec. 2 Cabinet meeting, Noem appeared to blame the high rate of perceived visa fraud on Minnesota's Democratic Gov. Tim Walz. Noem said Walz "brought people in there illegally that never should have been in this country."

The spokesperson added: "We don't lead immigration investigations and we do not track fraud in immigration cases or federal run programs."

It is true that states generally do not regulate immigration or issue visas. The USCIS, part of DHS, has overseen immigration since 2003. The federal government has been responsible for immigration since 1891. The State Department issues visas to people wishing to enter the U.S.

Recent investigation did support Noem's claim

The most recent data about immigration fraud in Minnesota appeared to come from a September USCIS investigation that the agency carried out in Minneapolis-St. Paul and surrounding areas.

That investigation reportedly found "evidence of fraud, non-compliance, or public safety or national security concerns" in 275 out of more than 1,000 cases it looked into, meaning no more than 27.5%. USCIS said agents found evidence of fraud in 44% of the cases they interviewed, though the agency did not say how many interviews it carried out in the investigation.

In total, "Operation Twin Shield" led to 42 referrals to Immigration and Customs Enforcement and four arrests. That data did not directly support Noem's claim.

Noem's and the DHS' reluctance to comment on the exact evidence for Noem's claim meant it was not possible to independently verify its accuracy.

One former immigration attorney, Professor Ana Pottratz Acosta, a visiting fellow at the University of Minnesota, told Minneapolis news station WCCO she would need "more specific data" from the DHS before "giving any credence" to Noem's claim.
Sources:

Our History | USCIS. 21 July 2025, https://www.uscis.gov/about-us/our-history.


Prof. Ana Pottratz Acosta Interviewed by WCCO News About DHS' Claim of 50% Fraudulent Visas in Minnesota | University of Minnesota Law School. https://law.umn.edu/news/2025-12-03-prof-ana-pottratz-acosta-interviewed-wcco-news-about-dhs-claim-50-fraudulent-visas. Accessed 5 Dec. 2025.

The White House. "President Trump Hosts a Cabinet Meeting, Dec. 2, 2025." YouTube, 2 Dec. 2025, https://www.youtube.com/live/pZSd7jn9CSc?t=5085s.

USCIS Announces Results of Operation Twin Shield, a Large-Scale Immigration Fraud Investigation | USCIS. 30 Sept. 2025, https://www.uscis.gov/newsroom/news-releases/uscis-announces-results-of-operation-twin-shield-a-large-scale-immigration-fraud-investigation.

ECOCIDE

Senate GOP Sends Trump Bill Handing Over Arctic Refuge to Big Oil

“Once again, oil and gas development is taking precedence over science-based solutions for conserving wildlife and mitigating climate change,” said one campaigner.

Polar bears feed on whale carcasses in Kaktovik, Alaska on July 1, 2024. The fate of the Arctic National Wildlife Refuge, its wildlife, and the oil reserves within it have been fought over for a half-century.
(Photo by Carolyn Van Houten/The Washington Post via Getty Images)

Jessica Corbett
Dec 04, 2025
COMMON DREAMS

Climate campaigners, conservationists, and Indigenous people vowed to keep defending the Arctic National Wildlife Refuge after US Senate Republicans on Thursday sent legislation that would restart fossil fuel leasing in ANWR’s Coastal Plain to President Donald Trump’s desk.

All Republicans present except Sen. Susan Collins of Maine supported House Joint Resolution 131. The 49-45 vote came after three Democrats—Reps. Jim Costa (Calif.), Henry Cuellar (Texas), and Vicente Gonzalez (Texas)—joined all GOP House members but Congressman Brian Fitzpatrick (Pa.) in advancing the bill last month.
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If Big Oil-backed Trump signs the joint resolution of disapproval, as expected, it will nullify the Biden administration’s December 2024 efforts to protect over 1 million acres of land in Alaska from planet-wrecking oil and gas exploration.

“Simply put, the Arctic refuge is the crown jewel of the American National Wildlife Refuge System,” Sen. Martin Heinrich (D-NM) said in a Wednesday floor speech against the measure, noting that the area is “home to hundreds of iconic wildlife species.”

“The Arctic refuge is also deeply connected to the traditions and daily life of the people who have lived there for thousands of years,” the senator continued, ripping “the Trump administration’s relentless attacks on public lands.”

Heinrich’s speech was welcomed by groups including the Alaska Wilderness League, League of Conservation Voters, and Defenders of Wildlife, whose vice president of government relations, Robert Dewey, also blasted lawmakers’ use of the Congressional Review Act (CRA) to repeal the refuge’s protections.

“Once again, oil and gas development is taking precedence over science-based solutions for conserving wildlife and mitigating climate change. In these instances, the use of the CRA accomplishes nothing meaningful and instead harms iconic species such as polar bears, caribou, wolves, and migratory birds,” Dewey said after the vote. “In addition to threatening wildlife, severe regulatory disruption in Alaska is the inevitable result of targeted rollbacks in one of America’s most ecologically critical regions.”



Andy Moderow, senior director of policy at Alaska Wilderness League, said Thursday that “while we are deeply disappointed by the final vote, we’re grateful to see bipartisan support from lawmakers who stood up for the Refuge and upheld a long-standing, cross-party legacy of protecting this truly incredible place.”

“America’s public lands—including the iconic Arctic refuge—shouldn’t be on the shortlist for a public land selloff to the oil and gas industry,” Moderow continued. “We’ll continue fighting the management chaos brought by today’s vote in favor of actions that respect the Arctic Refuge for what it actually is: a national wildlife refuge, and not an oilfield.”

Kristen Moreland, executive director of the Gwich’in Steering Committee, a group formed decades ago by Alaska Natives in response to proposed oil drilling in the Coastal Plain, also spoke out after the Senate vote.

“The Gwich’in Nation views the decision by lawmakers to leverage the Congressional Review Act to advance oil and gas development in the Arctic National Wildlife Refuge as a deliberate attempt to undercut the standards and laws that are designed to protect this sacred landscape,” Moreland said.

“This action from DC ignores years of consultation and communication with our Gwich’in communities that rely on this landscape for not only our subsistence and survival, but also our culture and spiritual health and well-being,” she added. “We stand united in our opposition to any oil and gas development in the Arctic refuge, and will continue to fight this effort from the Trump administration and decision-makers who ignore our voices.”

 Microplastics Make Up Majority of US National Park Trash, Waste Audit Finds

“Even in landscapes that appeared untouched,” volunteers found “thousands of plastic pellets and fragments that pose a clear threat to the environment, wildlife, and human health,” said a 5 Gyres Institute spokesperson.


Trash is seen strewn along the road at Joshua Tree National Park in California, on October 10, 2025, on the 10th day of the federal government shutdown.
(Photo by Frederic J. Brown/AFP)

Stephen Prager
Dec 04, 2025
COMMON DREAMS


More than half the trash polluting America’s national parks and federal lands contains hazardous microplastics, according to a waste audit published Thursday.

As part of its annual “TrashBlitz” effort to document the scale of plastic pollution in national parks and federal lands across the US, volunteers with the 5 Gyres Institute collected nearly 24,000 pieces of garbage at 59 federally protected locations.

In each of the four years the group has done the audit, they’ve found that plastic has made up the vast majority of trash in the sites.

They found that, again this year, plastic made up 85% of the waste they logged, with 25% of it single-use plastics like bottle caps, food wrappers, bags, and cups.

But for the first time, they also broke down the plastics category to account for microplastics, the small fragments that can lodge permanently in the human body and cause numerous harmful health effects.

As a Stanford University report from January 2025 explained:
In the past year alone, headlines have sounded the alarm about particles in tea bags, seafood, meat, and bottled water. Scientists have estimated that adults ingest the equivalent of one credit card per week in microplastics. Studies in animals and human cells suggest microplastics exposure could be linked to cancer, heart attacks, reproductive problems, and a host of other harms.

Microplastics come in two main forms: pre-production plastic pellets, sometimes known as “nurdles,” which are melted down to make other products; and fragments of larger plastic items that break down over time.

The volunteers found that microplastic pellets and fragments made up more than half the trash they found over the course of their survey.

“Even in landscapes that appeared untouched, a closer look at trails, riverbeds, and coastlines revealed thousands of plastic pellets and fragments that pose a clear threat to the environment, wildlife, and human health,” said Nick Kemble, programs manager at the 5 Gyres Institute.

Most of the microplastics they found came in the form of pellets, which the group’s report notes often “spill in transit from boats and trains, entering waterways that carry them further into the environment or deposit them on shorelines.”

The surveyors identified the Altria Group—a leading manufacturer of cigarettes—PepsiCo, Anheuser-Busch InBev, the Coca-Cola Company, and Mars as the top corporate polluters whose names appeared on branded trash.

But the vast majority of microplastic waste discovered was unbranded. According to the Coastal & Estuarine Research Federation, petrochemical companies such as Dow, ExxonMobil, Shell, and Formosa are among the leading manufacturers of pellets found strewn across America’s bodies of water.

The 5 Gyres report notes that “at the federal level in the United States, there is no comprehensive regulatory framework that specifically holds these polluters accountable, resulting in widespread pollution that threatens ecosystems and wildlife.”

The group called on Congress to pass the Reducing Waste in National Parks Act, introduced in 2023 by Sen. Jeff Merkley (D-Ore.), which would reduce the sale of single-use plastics in national parks. It also advocated for the Plastic Pellet Free Waters Act, introduced last year by Rep. Mike Levin (D-Calif.) and then-Rep. Mary Peltola (D-Alaska), which would prohibit the discharge of pre-production plastic pellets into waterways, storm drains, and sewers.

“It’s time that our elected officials act on the warnings we’ve raised for years—single-use plastics and microplastics pose an immediate threat to our environment and public health,” said Paulita Bennett-Martin, senior strategist of policy initiatives at 5 Gyres. “TrashBlitz volunteers uncovered thousands of microplastics in our nation’s most protected spaces, and we’re urging decisive action that addresses this issue at the source.”

Microplastics filter inspired by fish

Researchers at the University of Bonn want to make wastewater cleaner

University of Bonn

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image: 

of this anchovy, plankton particles are captured by the gill arch system. 

view more 

Credit: Photo: Jens Hamann

Wastewater from washing machines is considered a major source of microplastics – tiny plastic particles that are suspected of harming human and animal health. Researchers at the University of Bonn now have developed a filter to curb this problem. Their filter was inspired by the gill arch system in fish. In initial tests, the now patent-pending filter was able to remove over 99 percent of plastic fibers from washing machine wastewater. The results now have been published in the journal npj Emerging Contaminants.

Wastewater from a washing machine in a four-person household produces up to 500 grams of microplastics each year, mainly caused by textile abrasion. The household appliances are thus one of the most important sources of the tiny particles. Microplastics currently make their way directly into the sewage sludge of wastewater treatment plants. As this sludge is often used as fertilizer, the fibers ultimately end up on the fields.

Many manufacturers have thus been searching for ways to remove microplastics from washing water to prevent them from entering the environment. “The filter systems available so far, however, have various disadvantages,” explains Dr. Leandra Hamann from the Institute for Organismic Biology at the University of Bonn. “Some of them quickly become clogged, others do not offer adequate filtration.”

Looking inside the mouths of fish

The scientist, alongside her doctoral supervisor Dr. Alexander Blanke and colleagues, has thus turned to the animal kingdom in her search for possible solutions. The team focused on fish that can be considered true masters of filter technology – and have evolved this filtration over hundreds of millions of years.

Some fish feed by means of filtration; these include, for example, mackerel, sardines, and anchovies. They swim through the water with their mouths open and sift out the plankton with their gill arch system. “We took a closer look at the construction of this system and used it as the model for developing a filter that can be used in washing machines,” says Blanke, who is a member of the transdisciplinary research areas “Life & Health” and “Sustainable Futures” at the University of Bonn.

During their evolution these fish have developed a technique similar to cross-flow filtration. Their gill arch system is shaped like a funnel that is widest at the fish’s mouth and tapers towards their gullet. The walls of the funnel are shaped by the branchial arches. These feature comb-like structures, the arches, which are themselves covered in small teeth. This creates a kind of mesh that is stretched by the branchial arches.

Self-cleaning: plankton rolls towards the gullet

“During food intake, the water flows through the permeable funnel wall, is filtered, and the particle-free water is then released back into the environment via the gills,” explains Blanke. “However, the plankton is too big for this; it is held back by the natural sieve structure. Thanks to the funnel shape, it then rolls towards the gullet, where it is collected until the fish swallows, which empties and cleans the system.”

This principle prevents the filter from being blocked – instead of hitting the filter head-on, the fibers roll along it towards the gullet. The process is also highly effective, as it removes almost all of the plankton from the water. Both are aspects that a microplastic filter must also be able to deliver. The researchers thus replicated the gill arch system. In doing so, they varied both the mesh size of the sieve structure and the opening angle of the funnel.

Filter achieves high efficiency

“We have thus found a combination of parameters that enable our filter to separate more than 99 percent of the microplastics out of the water but not become blocked,” says Hamann. To achieve this, the team used not only experiments but also computer simulations. The filter modelled on nature does not contain any elaborate mechanics and should thus be very inexpensive to manufacture.

The microplastics that it filters out of the washing water collect in the filter outlet and are then suctioned away several times a minute. According to the researcher, who has now moved to the University of Alberta in Edmonton, Canada, they could then, for example, be pressed in the machine to remove the remaining water. The plastic pellet created in this manner could then be removed every few dozen washes and disposed of with general waste.

The team from the University of Bonn and the Fraunhofer Institute for Environmental, Safety, and Energy Technology UMSICHT has already applied for a patent for its development in Germany; EU-wide patenting is currently underway. The researchers now hope that manufacturers will further develop the filter and integrate it into future generations of washing machines. This would stem the spread of microplastics from textiles, at least to some extent. And that is also necessary: analyses indicate that the particles may cause serious damage to health. They have already been found in breast milk and in the placenta – and even in the brain.

Participating institutions and funding:

In addition to the University of Bonn, the Fraunhofer Institute for Environmental, Safety, and Energy Technology UMSICHT was also involved in the study. The work was supported with funding from the Federal Ministry of Research, Technology and Space (BMFTR) and the European Research Council (ERC). The protection and marketing of the invention is supported by the Transfer Center enaCom at the University of Bonn in close cooperation with PROvendis GmbH, a service provider of the NRW university network for knowledge and technology transfer “innovation2business.nrw.”

Publication: Leandra Hamann et. al. (2025): A self-cleaning, bio-inspired high retention filter for a major entry path of microplastics; npj Emerging Contaminants; DOI: https://doi.org/10.1038/s44454-025-00020-2

the gill rakers are covered with denticles forming a mesh structure that catches the particles.

Credit

Photo: Leandra Hamann

imitates the gill arch system of the fish. The filter housing enables periodic cleaning and installation in washing machines. 

Credit

Illustration: Christian Reuß/Leandra Hamann

front Dr. Leandra Hamann, right Dr. Alexander Blanke, center material researcher Christian Reuß, left biologist Dr. Hendrik Herzog.

Credit

Photo: Peter Rühr/Uni Bonn

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DOI

10.1038/s44454-025-00020-2 

Method of Research

Experimental study

Subject of Research

Animals

Article Title

A self-cleaning, bio-inspired high retention filter for a major entry path of microplastics

Article Publication Date

5-Dec-2025

 

Beyond biology: Why social context is the key for improving modern medicine

A new series in "The Lancet" led by a UC Berkeley professor equips policymakers and clinicians with a toolkit to break out of silos and make more informed health decisions.

University of California - Berkeley

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Can doctors in California learn from a patient who was bounced from one specialist to another in Japan? Can clinicians in London take lessons from a patient seeking asylum while suffering a medical emergency at the U.S.-Mexico border? Can doctors treating refugees in Africa inform health policy around the world? 

Dr. Seth Holmes believes so. 

Holmes is Chancellor’s Professor of Environmental Science, Policy and Management at UC Berkeley. A physician and a cultural and medical anthropologist, he studies social hierarchies and global health disparities. He also co-chairs the Berkeley Center for Social Medicine and co-directs the joint medical anthropology Ph.D. program between Berkeley and UCSF.

Like many doctors, he’s spent decades learning from clinical case studies in leading medical journals. These brief digests are written and reviewed through medical frameworks exclusively, and they describe a patient’s predicament alongside a clinician’s assessment, diagnosis and treatment. They’re a fixture in medical journals and a primary way doctors and all health professionals continue learning after their training. 

Now a new monthly series in The Lancet led by Holmes is going beyond clinical diagnoses, tapping experts from the social sciences and humanities, as well as community members from around the world.

The resulting cases provide a critical lens into the cultural and social forces that contribute to each patient’s condition — not just the biological factors. Each unpacks a framework or concept in the social sciences and humanities that researchers hope readers will incorporate into their own practice, leadership or policy-making. The team developed this “translational social medicine toolkit” to help health professionals and policymakers address the deep social and structural causes of global health inequities. 

“We hope that these cases will help orient health care practice and become a source of solidarity as we organize to confront obstacles to health and well-being for all in an interconnected world,” Holmes wrote in an essay introducing the series.

It launched with the case of a 22-year-old woman in Japan who suffered from a rare genetic disorder. She was denied admission to a special elementary school because officials said her physical and mental impairments were not severe enough. Psychiatrists declined to prescribe her medications because they could aggravate her heart condition. When she went to the hospital during a crisis, she was denied care because the hospital lacked adequate staffing. 

In unpacking her case, the research team explained the concept of “medical compartmentalization” — the fragmentation of medical services that harms people whose complex conditions do not fit neatly into simple categories. The physicians and social scientists who wrote the case together said it illustrated clear ways the system can be improved.

“We want a middle-range theory that can be relevant in lots of other clinics, hospitals, policies and countries in the world but also really touches ground with this particular patient or case,” Holmes said. “And then we try to make sure the theory would both show the depth of social theory and be really understandable.”

The latest piece in the series, published Thursday, describes the experience of a 45-year-old asylum seeker suffering from kidney stone complications. A volunteer clinician in Tijuana treated the man before he crossed into the U.S. Once detained in an Immigration and Customs Enforcement facility, the man sought help from a nonprofit that could help advocate for him when he was given inadequate medical treatment. But when the organization requested the man’s medical records, the doctor from Tijuana became concerned about privacy laws and legal liabilities. 

The case demonstrates the need for what the researchers term “structural intercompetency,” or the ability of experts to be aware of and address social, political, legal and economic processes and systems affecting a patient’s health that extend beyond health care alone. It showcases the importance of doctors needing to work in new, more collaborative ways, said Carlos Martinez, the case’s lead author and an assistant professor of Latin American and Latino studies at UC Santa Cruz.

“They, of course, cannot be experts in all those systems,” said Martinez, a Berkeley alum who was mentored by Holmes. “What we’re really asking is that clinicians become familiar with the other experts who could help in a given patient’s care.” 

The project has been a long time coming. Holmes and his colleagues first envisioned it  over 20 years ago, when he was a student interested in bridging the fields of medicine and the social sciences and humanities. They eventually launched a similar series in the New England Journal of Medicine, with cases that were primarily rooted in the U.S. 

With the series in The Lancet — one of the world’s most esteemed medical journals —  they’re broadening the topics to a global audience. 

They solicited hundreds of cases from research institutions, clinics and scholars around the world. Then, the 15-person project team — including MD/Ph.D. student researchers from UC Berkeley and UCSF — sifted through over 400 submitted abstracts and identified those that might have the most relevant applications for social concepts.  

Last year, they hosted a three-day mini-conference in Chicago, co-sponsored by Berkeley and co-funded by the National Institutes of Health, and flew people in from around the world. There were doctors, nurses and medical researchers as well as scholars from the social sciences and humanities. Community members from an array of backgrounds contributed too, including a Florida-based human rights organizer and an Indigenous health worker from the Amazon of Brazil. Even doctors who work in the Sahrawi refugee camps in Algeria joined to contribute their perspectives. 

“One of the goals of the team was to reach out as far as we could beyond the usual places,” Holmes said. “To support people whose lives, stories, health, health care and concepts could be really important for the world to read but who might not usually have as easy a time publishing in a place like The Lancet.”

The series is expected to run for 12 months, with the possibility of extending. Holmes said it was especially meaningful work to be doing now, given the shifting political landscape in the U.S. and globally.

“How much can one article a month do in the midst of active authoritarian regimes? I’m not sure,” Holmes said. “But we’re all working hard to develop these articles to keep people who care about health thinking critically and aware of what’s going on, to have empathy and solidarity for people who they might otherwise consider quite different than them.”

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Journal

The Lancet

Method of Research

Case study

Article Title

Translational social medicine for global health: introducing Cases in Global Social Medicine