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For One Iraqi Neurologist, Visa Landmines Hamper the Road to Boston

Ellis, Fay

doi: 10.1097/01.NT.0000271235.51743.67
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  • ✓ An Iraqi neurologist's frustrated efforts to get a visa to attend the AAN annual meeting prompt discussion about the challenges of travel to international meetings in the post 9–11 world.

Fizel Al-Himyari, MD, considers himself lucky. This week, he managed to avoid the central area of Hilla, a city in Babylon Province, some 67 miles south of Baghdad, where missiles demolished a family home, taking human lives.

The assistant professor of neurology at Babylon Medical College — who counts himself among the few neurologists left in Iraq — manages to stay upbeat. “At least, it is safer here than in Baghdad,” he said. But in a telephone interview with Neurology Today, there is an unmistakable strain in Dr. Al-Himyari's voice.

All he wants to do, he said, is update his training in the US and become a fellow of the AAN. And he is so close to achieving that goal. The two abstracts he submitted on the use of honey in ancient Mesopotamia for neurological symptoms were accepted for presentation at the upcoming AAN Annual Meeting in Boston, and the AAN has awarded him a scholarship to cover his expenses in the city.

But there is one problem — he cannot leave his country. Iraqi citizens, he was told by the US Embassy (Consul) in Baghdad, cannot obtain visas unless their travel is sponsored by either the Iraqi or the US government; alternatively, the traveler must be a diplomat, a representative to an international organization, or a participant in a US government-funded exchange visitors program.

Dr. Al-Himyari does not meet these criteria, and his options are limited. He could go to a neighboring country, like Jordan, and get a visa from the US embassy there. But the road to Jordan is dangerous, he said, filled with landmines and terrorists. What's more, he cannot afford the trip, and he is running out of time. The process could take at least a month.

So he is resigned to the fact that he may not make it to the annual meeting this year. There is always next year. “I will try again, next time working much earlier in advance,” he said.

Dr. Al-Himyari's case is not unique, according to Christine Phelps, AAN associate executive director and director of education, science, and meeting services. In the post-9–11 world, international travel to medical meetings has become increasingly restricted. Each year, the AAN works behind the scenes to help international members caught up in the logjam.



At press time, AAN General Counsel Murray Sagsveen and AAN Chief Operating Officer Mary Post were directing an intensive campaign to help Dr. Al-Himyari get to Boston through letters, e-mails, and calls back and forth to the US Consul in Baghdad as well as to the Office of the Minister of Health there. In addition, they were working closely with the leader of a group of neurologists who went to Baghdad in 2004; the group is still active and travels in and out of Kurdestan on a regular basis.

Said AAN's Phelps: “Increasingly, international associations are trying to address these visa problems through advocacy on the federal and international level.”

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The US Treasury Department Office of Foreign Assets Control (OFAC) maintains a list of embargoed countries deemed a potential threat to the US —Cuba, the Sudan, Iran, North Korea, among them. But international medical associations have also had occasional problems with countries not on the list, including China and Nepal, according to An Devriese, global outreach programs manager for the International Society of Nephrology (ISN), which is based in Brussels, Belgium. Devriese is also on staff at MCI, Europe's largest meeting- and association-management organization.

“These restrictions threaten our principles of scientific freedom and universality,” Devriese said in an e-mail. “Oddly enough, travel grants to attend foreign meetings appear to be one of the only means of financial support permitted by the authorities.”

She noted that the ISN helps its members by preparing specific visa procurement letters months in advance of the meeting, but success is never guaranteed. “The situation still depends on the individual visa applicant and the ‘mood’ of the embassy official dealing with the application. Every embassy and consulate seems to have a different approach.”

Devriese said the ISN also seeks legal advice from attorneys who specialize in OFAC regulations. Travel grants and library support (through free subscriptions) are permitted to members from embargoed countries, and exemptions from the regulations will be considered on a case-by-case basis. But the process can be time consuming and the results uncertain.



“There are some bizarre loopholes to the OFAC exemptions,” she noted. “For example, fellows from embargoed countries may train in the US (but nowhere else in the world) if they manage to obtain a J-1 visa. Of course, this is almost unobtainable, and the process requires a lot of advance planning time — which most meeting attendees don't have.”

(The J-1 Visa is granted to foreign medical graduates who want to pursue graduate medical training in the US. The visa allows holders to remain in the US until their studies are completed, at which point they are expected to return to their home countries for two years before applying for a permanent visa in the US.)

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The travel restrictions or challenges may no longer be confined to association members from countries outside of the US land borders. By December 2007, the US government plans to phase in new rules — as part of its Western Hemisphere Travel Initiative (WHTI) — requiring travelers to show passports and other secure documents when entering, re-entering, or leaving US-Canadian land borders. Previously, a birth certificate was all that was required.

People attending meetings across these borders will need to make sure they have a current passport, said James Clarke, senior vice president of public policy at the American Society of Association Executives (ASAE), an organization comprising representatives from 11,000 trade, membership societies, and voluntary organizations in the US and 50 countries. The new rules are certain to create more delays as more and more people apply for passports.

“Homeland security is a top priority for the US right now,” he said, “and travel across the borders to international meetings invites discussion of how open we want to keep our US borders.”

The ASAE and other industry organizations are advocating that visa applications by legitimate foreign business travelers receive “full and timely” attention. It is also actively involved — along with the Tourism Association of Canada and the Passport Coalition — to promote policies that “strike a balance between the need for homeland security while protecting the economic vitality of the travel industry.”

Meanwhile, he advises associations and meeting planners to find, and work closely, with representatives in Congress who are sympathetic to the challenges posed by the visa restrictions.

For Dr. Al-Himyari, however, time may just be running out.

© 2007 American Academy of Neurology