Protesters demonstrate against Trump's Executive Order affecting Entry and Re-entry into the USA. Targeted nations begin to react.

On 27 January 2017, U.S. President Donald Trump signed an executive order affecting the entry into the U.S. of refugees and individuals from Iran, Iraq, Syria, Somalia, Sudan, Libya and Yemen. No visas will be issued to citizens of these countries for a 90-day period, and individuals from those countries who already have a visa will also not be allowed to enter the U.S. In addition, the order prohibits the entry of refugees for 120 days; this measure applies to all refugees, regardless of nationality.

Already, the order has caused heartbreak for families whose members from affected countries with valid US papers were detained and refused entry on flights. It has also sparked protests at major US airports and created chaos for airlines, at least one of which hastily adjusted its flight crews to comply with the new requirements.

NBC is reporting that the document was not reviewed by DHS, the Justice Department, the State Department, or the Department of Defense, and that National Security Council lawyers were prevented from evaluating it. Moreover, the New York Times writes that Customs and Border Protection and U.S. Citizen and Immigration Services, the agencies tasked with carrying out the policy, were only given a briefing call while Trump was actually signing the order itself. Yesterday, the Department of Justice gave a “no comment” when asked whether the Office of Legal Counsel had reviewed Trump’s executive orders—including the order at hand. (OLC normally reviews every executive order.)

This malevolent act also affects travelers inbound for medical tourism, where the USA is the highly popular destination to received specialized medical services at many academic medical centers and upmarket branded health facilities, such as Cleveland Clinic, Mayo, Johns Hopkins, Harvard, NYU, Cornell, UCLA, and others.

Doctors Without Borders and other international groups said they will step up effort to provide care in countries impacted by the ban.

U.S. hospitals rely heavily on foreign labor to fill crucial gaps in care. As many as 25 percent of US physicians were born outside the US, not to mention huge numbers of nurses, researchers, and IT specialists who moved here to work in hospitals and clinics. Many of these workers are from the Middle East. A review of H1-B visa applications shows US health employers bring in thousands of workers every year.

• In 2014, the last year for which data is available, more than 15,000 foreign health care workers received H-1B visas. Nearly half were physicians and surgeons...not terrorists or jihadists.
• Last year, Cleveland Clinic sought to bring in nearly 200 foreign workers. Mayo Clinic (Minnesota, Arizona and Florida), Emory University (Atlanta) and William Beaumont Hospital (Michigan) also filed requests to bring in scores of employees from abroad.
• Meanwhile, 3,769 foreign medical graduates obtained first-year residency positions in the US in 2016, according to the American College of Physicians, which noted that the executive order could interrupt careers and impact care for thousands of patients.

It interrupted medical training for Suha Abushamma, MD, a medical intern at Cleveland Clinic, was detained upon arrival at John F. Kennedy International Airport Saturday morning, then sent back to her point of origin in Saudi Arabia 20 minutes before a federal judge issued a temporary injunction that blocked the deportation of travelers detained at airports. Cleveland Clinic also published a statement from Dr. Abushamma: "I want to personally thank everyone for their support and well wishes. Although this has been a difficult experience, I am grateful to be safe with my family in Saudi Arabia. Please know that I am deeply committed to my medical career and to helping patients at Cleveland Clinic."

It also impacts those resident Americans who are from another country who may have decided to seek treatment in their home country or another treatment destination where they could be treated in proximity to family and friends and social support. Imagine lying in a hospital bed in a foreign country wondering if you can come home upon discharge. Horriffic!

The President has created a target-rich environment for litigation that are likely to make his policies less effective than they would have been had he subjected his order to vetting one percent as extreme as the vetting to which he proposes to subject refugees from Bashar al-Assad and the bombing raids of Vladimir Putin.

After the executive order was issued, there was uncertainty regarding its effect on U.S. permanent residents (often referred to as green card holders). However, the Department of Homeland Security (DHS) stated on 28 January that green-card holders will continue to be allowed into the United States. An official stated that citizens of these seven countries who are green-card holders may go through additional screening and national security checks upon entry into the U.S. The travel ban also does not appear to apply to dual citizens of the U.S. and any of the seven aforementioned countries.

Following the order, immigration and customs officials at airports in the U.S. and abroad immediately began stopping and detaining individuals affected by the measure. On 28 January a federal judge in Brooklyn, New York, issued an emergency injunction barring customs officials from deporting visa holders who had already arrived in the U.S., but the order did not require officials to grant the individuals entry. Judges in several other states, including Virginia, Washington and Massachusetts issued similar rulings.

The ACLU has already succeeded in petitioning a federal court for a class-wide stay of deportations of immigrants and refugees trapped in airports by Trump’s order. And a federal judge in Virginia has issued a temporary restraining order preventing the removal of green card holders detained in Dulles International Airport and requiring that these legal residents of the United States have access to counsel.

Protests within the USA

The executive order sparked large-scale protests at several airports, including New York's John F. Kennedy Airport (KJFK/JFK), Los Angeles International Airport (KLAX/LAX), San Francisco International Airport (KSFO/SFO), Chicago O’Hare International Airport (KORD/ORD) and Boston’s Logan International Airport (KBOS/BOS). On 28 January approximately 2,000 people gathered outside the Terminal 4 arrivals hall of John F. Kennedy Airport. At approximately 1930 local time (0030 UTC on 29 January) airport officials were forced to halt AirTran shuttle service at the facility due to crowded conditions caused by the demonstrators. The protesters chanted slogans and banged on the walls of the terminal; however, there were no reports of violence or arrests. Drivers of the New York Taxi Workers Alliance reportedly joined the demonstration, refusing to pick up passengers at the airport between 1800 and 1900 local time, affecting transportation from the facility. On 29 January protests became disruptive at LAX when demonstrators blocked traffic and faced off with riot police officers. Thousands of protesters reportedly marched around the airport and sat down in the street in front of Tom Bradley International Terminal, causing many passengers to miss their flights. In the late evening hours, airport officials stated that they had brokered an agreement with the demonstrators to allow for upper and lower level roads to alternate as protest locations every 30 minutes. Although police officers allowed the demonstration to continue through the night, officers arrested at least two people for blocking a roadway.

On 29 January protests against the order also occurred at other locations in various cities across the country. Protests occurred at Boston’s Copely Square, as well as at New York City's Battery Park, and in front of the White House in Washington, D.C., among other locations. There were no reports of violence at any of the demonstrations.

One of the reasons there’s so much chaos going on right now, in fact, is that nobody really knows what the order means on important points or how to enforce it and comply.

IRAN Reacts

Meanwhile, on 28 January Iran’s Ministry of Foreign Affairs stated that the country will take reciprocal measures in view of the U.S. ban. Iranian officials stated that the measure only applies to U.S. citizens who do not currently hold an Iranian visa. In addition, on 30 January, the Iraqi parliament approved a ban on U.S. nationals entering the country. Reports are currently unclear as to how Iraqi authorities will implement the policy.

Mercury Health Travel, an international leader in the medical tourism industry will continue to monitor the situation closely. We feel (as the CEO, I maintain the prerogative to establish how the Mercury Healthcare International brand interprets this) that the it’s a very dangerous thing to have a White House that can’t with the remotest pretense of competence and governance put together a major policy document on a crucial set of national security issues without inducing an avalanche of litigation and wide diplomatic fallout causing business and personal disruption to so many people in and outside the USA. The quality of writing is that of a first week intern who was assigned to skip lunch and produce the document the President's signature in a haste.

Foreign Services Officers React with Dissent

Numerous Foreign Service officers and other diplomats have drafted a dissent memo expressing opposition to the executive order. ABC reported this morning on the draft, which is likely to be submitted today.

Here’s a copy of the actual draft. We've heard that hundreds of foreign service officers are planning to be party to the dissent memo; it’s still unclear exactly how many. The names and personally identifiable information have been redacted from the document.

The State Department’s Dissent Channel is a mechanism for employees to confidentially express policy disagreement, created in 1971 as a response to concerns within the Department over the government’s handling of the Vietnam War.

Authors of a memo submitted through the Channel, which is open to all regular employees of the State Department and USAID, may not be subject to any penalty or disciplinary action in response. Once a memo is submitted, the Secretary of State’s Policy Planning Staff must acknowledge its receipt within two working days and will usually distribute it to the Secretary of State, the Deputy Secretary of State, the Under Secretary for Political Affairs, the Chairperson of the Open Forum, and, if the memo’s author is employed by USAID, by the head of that agency as well.

Personally, I am saddened by the whole fiasco. I work internationally, my business is involved in international services at many levels. But above and beyond the business risk and turmoil I perceive, words fail me as I attempt to sort out my feelings about the awful the events of the past ten days. That's saying a lot as the author of 18 internationally published books and thousands of words in blog articles per week. Words are my tools and I suddenly don't have the right tool in the toolbox to express my disappointment, fear, and anathema for all of it.

Nominate Maria Todd as a LinkedInTop Voice for 2017