Category: health issues

Refugee children arrive with health problems: follow-up spotty

~ Ann Corcoran ~ Leave a comment

Yesterday I came across a press release from the Hasbro Children’s Hospital in Rhode Island.   Several of their doctors prepared papers on the health of refugee children for presentation to a Pediatric Conference on-going in Hawaii.   

The first paper says that refugee children are arriving in greater numbers to the US with a large burden of disease and other health issues requiring followup by medical specialists.   Additionally the paper discusses the variability in screening. 

ABSTRACT: Newly arrived refugees are an increasing presence in the American health care system. Research has shown that newly arrived refugee children have an appreciable burden of disease. Little is known, however, about subspecialty referral for identified morbidities.

The objective of this study was to describe the health status and the subspecialty needs of a pediatric refugee population in the first year after resettlement. The results of the study demonstrate a high disease burden in a population of newly arrived pediatric refugees, with rates of disease similar to those found in other studies of refugee children. Although the burden of disease justifies screening at arrival, there was variability in the specific screening tests performed. The study also highlights the common subspecialty needs of this population. More than half of the patients were referred to a subspecialist, and they interfaced with a wide variety of subspecialists. A medical home that includes primary care and subspecialty providers who have an understanding of the medical needs of refugee children will likely improve health care for this vulnerable population. 

The second paper reports that vaccination schedules for preventable disease is often not followed up.  Although this abstract doesn’t say it, I suspect this is the fault of the volags who resettle refugees and in many cases do not even know where the families are in 4-6 months after arrival in the US.    For instance, the Somali refugees are nomadic and I doubt they are reporting in to the health department as they move from city to city.

ABSTRACT:

Newly arrived refugee children are at risk for vaccine preventable diseases due to incomplete immunization. Catch-up vaccination requires multiple visits to a primary care provider. There has been little research addressing vaccination status of refugee children after resettlement.

 

The objective of this study was to assess immunization rates for refugee children who have been in the United States for at least one year. Findings showed that low overall rates of complete immunization were found in a population of pediatric refugees after resettlement. These low rates were mostly due to children who were lost to follow-up within the first year. For those refugees attending a primary care clinic throughout the first year of resettlement, immunization rates were comparable to rates in the general population. The creation of a medical home for refugee children will likely increase immunization completion rates. 

Our attention was first drawn to this issue in reports from Ft. Wayne, IN last September where its health department was stretched to the max by the large numbers of refugees arriving in that city.   See our whole Ft. Wayne archive here and learn how one city has struggled to pay for this health care burden. 

To learn more about health related problems with refugees see our “health issues” category. 

 

Fort Wayne can just say “no”

~ Ann Corcoran ~ Leave a comment

Update  2/22/08:  Here is the latest from Ft. Wayne today.   

We’ve been writing on and off FOR MONTHS about Fort Wayne, Indiana’s problem with way too many refugees for the county health department to handle.   I was therefore surprised to get a news alert tonight about yet another plea from the stretched city for funds from the federal government.  Read about how Ft. Wayne is getting advice but no money so far.

 The county has not tapped into any new funding streams, but a federal agency devoted to helping re-settle refugees in this country has people in the city this week advising local officials on what help may be out there.

Ft. Wayne has had problems with large numbers of refugees arriving wth TB and the city is anticipating another 800 refugees this year.

We’ve said it before, and we will say it again.  The city could just say “NO”—no new refugees until funding is found.

We have a whole archive of Ft. Wayne posts here.

Why do we keep reading stories about volags not doing their jobs?

~ Ann Corcoran ~ Leave a comment

 Update 2/17/08:  See my post that follows up on this one here.

 Update 2/20/08:  New information on this story here.

Just this morning I posted on a ho-hum article about Burmese refugees arriving in Connecticut and now, thanks to a reader, I’m posting on another article from the same paper about a volag not taking care of refugees.

This happened in Hagerstown, MD near where we live and it’s what Chris Coen of Friends of Refugees described to us too—non-profit groups funded by the federal government leaving refugees in a lurch.  Luckily in Waterbury, CT the refugees have some church people looking out for them.   This time the culprit appears to be the International Institute of CT which must be a subcontractor of the US Committee for Refugees and Immigration.

Confusion about late fees for missed rent payments, missed doctor’s appointments and letters from the Department of Social Services have left many refugees frustrated and angry. Some no longer trust the institute to handle their concerns, said Diana Monti of the Living Faith Christian Church. But Oliver denies that. “That’s not what we’re hearing from them,” she said. “They’re going to have to have confidence in us. They’re going to have to trust us and we are going to respond to their concerns.”

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Additionally, a nurse at a local middle school says she has called the institute four to six times over the last two months to facilitate immunization requests for six refugee students. Brenda Gugliotti, of West Side Middle School, says the institute has not returned her phone calls and if the students do not receive immunizations by mid-March, they will be excluded from school. “I try to be fair,” said Gugliotti. “But this is my last warning… It’s very frustrating and it’s very, very time consuming… I have a few children in the building who are medically fragile. It’s not fair. The International Institute does not answer. These are not the only six children in the building.”

This article raises a couple of issues.   I really don’t get it, why aren’t these NGO’s who are contracted to take care of the refugees taking care of them?  Read the whole article and you’ll see that the volag people are throwing blame to the refugees.   Can you imagine being in a very foreign country and within a few months being expected to fend for yourself with government bureaucracy?  

And, then the second issue it raises is the one about health.  Ft. Wayne, IN has had a very challenging time dealing with health issues with its Burmese population and Waterbury, CT really must get on top of any problems right away.   In Ft. Wayne the big concern has been the cost of immunization and the high number of refugees with TB.  For readers interested in health issues see our whole category on the subject here.

Shelbyville Bantu Background

~ Ann Corcoran ~ Leave a comment

I missed this article in the Times-Gazette of Shelbyville, TN yesterday when I wrote about Somalis swarming to that city.  The extreme cultural adjustment problems of Somalis are ones we have heard about elsewhere.

The Bantu have enormous barriers to overcome in their introduction to American society. Their status as immigrants, their lack of English skills, illiteracy and the fact they possess no modern job skills, will only make the challenge that much harder.

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The Center [Cultural Orientation Resource Center] also states that resettlement professionals will have to deal with significant health care, sanitation, and social support issues relating to small children and mothers, pointing out that the Bantu use pit latrines and “are unfamiliar with typical American bathroom facilities and common sanitation items such as diapers and feminine care products.”

Look out Fort Wayne, IN, 1000 more refugees expected in ’08

~ Ann Corcoran ~ Leave a comment

We have written about problems the city of Ft. Wayne (Allen County) Indiana has had with the impact on the Health Department with increasing numbers of refugees with TB, now it looks like the impact will be felt throughout all community services.   According to the News-Sentinel yesterday, the President of the United Way has called for a closed to the public meeting to address the coming “surge.”   

In addition to the 800 anticipated direct resettlement Burmese the community has been warned the number could go over 1000 when the refugees who have been resettled elsewhere also come to Ft. Wayne (this is called secondary migration).   Attendees at the closed meeting will discuss issues that should concern taxpayers such as housing, health, schools, translation services and so on.   Meanwhile Debbie Schmidt, executive director of Catholic Charities is headed to Washington to find more federal money for the volags.

Schmidt is planning a return trip to Washington to talk with HHS [Health and Human Services, Office of Refugee Resettlement] officials to get more money for Indiana’s four refugee resettlement-sponsoring agencies [non-profit federal contractors such as Catholic Charities].

We’ve heard rumblings that a culture clash is coming in Ft. Wayne as Karin Christians are being placed in neighborhoods with Burmese Muslims.   What I would like to know is why would these volags assume that conflicts from the camps would not extend to neighborhoods in America?

One final thought–if the community of Ft. Wayne is all for more refugee resettlement, why close the meeting to the public?   Doesn’t Indiana have ‘open meeting’ laws?