Caring for Refugee Children.

Abstract

1. Thomas Seery, MD* 2. Hillary Boswell, MD† 3. Anna Lara, MD, MPH‡ 1. *Division of Pediatric Cardiology, Texas Children’s Hospital, Houston, TX. 2. †Department of Obstetrics and Gynecology, The Woman’s Hospital of Texas, Houston, TX. 3. ‡Hope Clinic, Houston, TX. Managing the medical, developmental, and psychosocial needs of children and adolescents in the resettled refugee population is a complex task. Primary care clinicians who encounter these patients after their arrival to the United States must be familiar with their unique customs and common illnesses as well as the barriers to health-care access that these populations face. The office of the United Nations High Commissioner for Refugees reported 10.4 million refugees worldwide at the beginning of 2013, 50% of whom were children. (1) These refugees are spread around the world, with 50% in Asia and approximately 28% in Africa. A total of 58,179 persons were admitted to the United States (U.S.) as refugees in 2012, 32% of whom were younger than 18 years of age. (1) A refugee is defined as any person who is outside his or her country of origin and cannot return because of persecution or the well-founded fear of persecution due to race, religion, membership in a particular social group, or political opinion. Refugees are recognized before arrival to the U.S., while an asylum seeker seeks to be recognized as someone seeking asylum from persecution in his or her home country after arrival. Compared to an immigrant, who chooses to settle in another country, a refugee is forced to flee his or her country. (2) This review is directed toward the primary care clinician initially evaluating refugee children and adolescents following arrival to the U.S., but should also prove useful for those providing longitudinal or sporadic care to this population. The goal is to summarize the unique medical, developmental, and psychosocial needs of refugees …