Global Healthcare at our Doorstep.

Abstract

During one recent half-day session at the hospital-based primary care clinic in New Haven, CT where I practice, I saw for a routine visit a teenager from a Syrian family that I had known for many years who were still coping with the aftereffects of war in that country, a 5 year old from an Afghan refugee family who was struggling in school, and a 6 year old (along with his uncle) who had arrived in the U.S. from Guatemala two weeks ago and had no record of any previous health care or immunizations. That, I would say, is a rather typical day in my practice setting. Interpreters who speak Arabic or Pashto join our team of providers daily in the clinic. Also, the two-way telephones in each exam room and the iPads or tablets on rolling stands which electronically connect to the hospital's superb interpreter service are always being put to good use. New Haven has a large refugee population, and is characterized as a sanctuary city. While the need for care and support services is great, it has also been impressive to witness the expansion of resources in the city dedicated to the care of refugee children and families. For example, our primary care center holds a dedicated weekly Refugee Clinic, which – through an interdisciplinary model – provides comprehensive screening, preventative guidelines, health promotion, and linkages to social support. In addition to determining the current immunization status of the children and initiating catch-up schedules as indicated, the clinic also routinely screens for lead levels, anemia, parasitic infections, dental needs, tuberculosis, hepatitis, vitamin D levels, and HIV. The Refugee Clinic operates in collaboration with the Integrated Refugee Immigration Services (also known as IRIS; https://www.irisct.org/), which is a federally recognized refugee resettlement agency based in New Haven. Founded over 30 years ago, the staff and many volunteers at IRIS assist over 500 refugees annually, many of whom are newly arrived in the U.S. Most of the refugees currently come from many war-torn countries, including the Sudan, the Democratic Republic of the Congo, Afghanistan, Iraq, and Syria. The challenges for a refugee family to assimilate into this country are indeed daunting as they struggle to locate jobs, housing, food sources, schools, learn a new language, and utilize transportation and technology. Through dedicated efforts and their Cultural Companion program, the staff and volunteers at IRIS (including many students and faculty of the health professional and Divinity schools at Yale) provide intensive, hands-on, often one-on-one guidance to help these families adapt. Through community cosponsorships, IRIS is also involved in enhancing refugee resettlement efforts around the globe. In 2019, IRIS hosted representatives from programs nationwide who attended workshops in New Haven regarding their unique cosponsorship model. I continue to be impressed with the amazing resilience of the refugee families that I regularly see as they take on the challenges of learning a new culture and new language, as well as changing much of their lifestyle. I have many stories and cases like the three recent cases that I have described, but I know that many of you have stories of your own. Let us hear from you: whether you would like to share a case study, a narrative review of clinical challenges in caring for refugee families, or your own personal insights as they may pertain to professional issues and challenges. And to give you some follow-up regarding the teen from Syria whom I recently saw, she came in to show me her acceptance letter to a top tier University, and to get her physical and immunization form to submit to the school. How cool is that!