EXAMINATION OF ALIENS ABROAD All applicants for immigrant visas, and a small proportion of applicants for nonimmigrant visas, averaging about 5 percent, receive a medical examination abroad. About 60 percent of the examinations are conducted by the Division of Foreign Quarantine of the Public Health Service. The remainder are performed by local physicians appointed to a panel by the visa-issuing consular authority at the place of application. The Public Health Service has no direct responsibility for or control of panel physicians. The applicants for nonimmigrant visas who are examined are (1) students applying to remain in the United States 120 days or more, (2) certain categories of exchange visitors, and (3) any applicant for a nonimmigrant visa who the consular authority suspects has an excludable medical condition and is referred for examination. Applicants for parole to enter the United States may or may not be medically examined abroad, depending upon the circumstances. For instance, refugees from Cuba are not examined in Cuba. On the other hand, Chinese refugees in Hong Kong who have applied for parole are medically examined there by the Division of Foreign Quarantine in the same way as are applicants for visas. EXAMINATIONS BY THE PUBLIC HEALTH SERVICE Program description.-Medical examinations of aliens are conducted at 22 medical examination units maintained by the Division of Foreign Quarantine abroad, and at 8 quarantine stations along the Mexican border which serve as examination units for American consular offices in nearby Mexican cities. The present personnel pattern at these units, including local physicians employed by the Public Health Service, is shown in table 1 and their geographical distribution in map 1. The program has been developed in cooperation and according to agreements with the Department of State. The best developed part of the oversea organization is that of the European area, which has responsibilities for Europe, the Azores, all countries bordering the Mediterranean, Jordan, Iraq, and Iran. An area headquarters maintained in Paris affords administrative and clinical consultative support for the area generally. The office at Montreal serves as area headquarters for eastern Canada, that at Vancouver for western Canada, that at Jamaica for the countries bordering the Caribbean, and that at Hong Kong for the western Pacific. There is an area headquarters at El Paso which has responsibility for Mexico. Other parts of the world, such as mid-Asia, Africa other than the northern rim, and South America other than the northern rim, receive the limited attention which can be given by the Headquarters of the Division of Foreign Quarantine. At each examination unit, examinations are performed in accordance with the "Manual for the Medical Examination of Aliens" of the Division of Foreign Quarantine. TABLE 1.-Staffing of Public Health Service medical examination units abroad and on Mexican border, fiscal year 1963 Taking the unit at Naples, Italy, as an example, the officer in charge is a commissioned medical officer of the Public Health Service. He is responsible for the administration of the unit under the supervision of the medical officer in charge, European area, Paris. He performs some of the medical examinations and supervises the remainder. He advises the consul general on public health and medical matters. He collects epidemiological information and forwards it to the European area headquarters and Division headquarters. He is responsible for such administrative duties, field visits, and consultative assistance to examination units and consular offices as are delegated by the European area medical officer in charge. The medical officer in charge of the Naples unit is assisted by a local physician and staff who are employed by, and who have been trained by, the Division of Foreign Quarantine. Aliens are referred for medical examination to the unit by the visa personnel of the consulate general. These personnel send along notes relating their findings and impression of the applicant, and such medical records as have become available to them. The examination is then conducted as follows: 1. The alien is interviewed by an aid who is alert for any unusual sign of mental aberration. Findings are noted and passed on to the physician. 2. Applicants over 14 years of age have a serologic test for syphilis performed at a private laboratory selected by the Public Health Service. |