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Many issues affect refugee children

Anjali SubbaswamyI recently spoke with Dr. Jennifer Garcia, from the Young Children’s Health Clinic (YCHC) in Albuquerque’s Southeast Heights, about Albuquerque’s refugee population and their children.

How does a child become a refugee?

A refugee is someone forced to flee their country because of persecution or war, and who has a substantial fear of persecution based on race, religion, politics or social group. They receive temporary asylum in a refugee camp, where the average time spent is 20 years. Many refugee children are born in camps. The United Nations High Commission for Refugees conducts interviews to determine if a person is granted refugee status.

Once granted, there are three durable solutions 1) voluntary repatriation to home country 2) integration into country of asylum 3) resettlement in a third country. Less than 1 percent of people granted refugee status are resettled in a third country. For a refugee to be resettled in the U.S., they interview with U.S. Citizen and Immigration Services (USCIS) and must demonstrate a compelling history of persecution, or be a member of an ethnic/religious group considered by U.S. to be of “special humanitarian concern.”

Alternatively, they could be the spouse, unmarried child or parent of a resettled refugee/permanent resident.

After that, the resettlement process begins at an Overseas Resettlement Support Center – more interviews, a medical exam, background check, personal work history, education and information about resettled relatives. The International Organization for Migration (IOM) arranges transportation to the U.S, a cost that the refugee must eventually repay. Upon arrival in the U.S., the refugee is met at the airport by one of the volunteer agencies (VOLAGs), who typically provide services for 90 days — housing, basic supplies, cultural orientation, referrals to social services and employment. In Albuquerque, the VOLAG is Lutheran Family Services.

What health care resources are available for refugee children?

All refugee children are eligible for the same health insurance and access to care as U.S.-born children. Most end up with Medicaid, based on their parents’ income level.

What healt hcare issues are prevalent among refugee children?

We see children with malnourishment, anemia, high lead levels, dental caries and latent tuberculosis infection (exposed to TB, but not contagious).

What do refugee families think about U.S. health care?

Most parents are generally very accepting of recommendations made by health care providers.

However, the difficulties with transportation, health literacy (understanding instructions about meds, filling prescriptions), language barrier (reading labels) and sometimes lack of insurance coverage for certain medications are significant. Scheduling appointments is challenging due to language barriers and difficulty navigating the automated phone system. This can be a barrier to receiving preventive care and immunizations.

For adults, the wait to see a primary care provider can take months. Therefore, after arrival, the Public Health Office assists families with scheduling their first PCP appointment. Families may be used to seeing a provider without an appointment when they are sick in their home country, so the idea of scheduling an appointment for non-emergent illnesses can take some adjustment.

How do the families integrate into this new society?

There are a variety of groups and social supports for families. For example, UNM has a Refugee Well-Being Project, a program that brings together newly arrived refugees (from Iraq, Syria, Afghanistan, Rwanda, the Democratic Republic of Congo and Burundi) and students from UNM.

Students spend 4-6 hours per week with refugee families working on things such as English, getting health care or applying to jobs. They spend time with the children, taking them to parks, working on reading and just getting to know them. They become very bonded, and are a terrific resource for the families.

How long can refugee families stay in the U.S.?

They can become U.S. citizens and do not have to leave.

Is there a quota for refugees in New Mexico?

There is not a quota. In fiscal year 2017, 51,392 Individuals were resettled in the U.S. NM received 154 refugees (0.3 percent).

What services does YCHC provide to refugee children?

YCHC is a UNM Pediatric Clinic with pediatric medical providers, social workers, behavioral health specialists, and access to a variety of language interpreters. We are close to the Southeast Heights Public Health Office, where most initial refugee health screenings are performed, in the neighborhood where many refugee families are resettled. We treat many of the refugee children living in our city.

Are there any volunteer opportunities?

Two opportunities I am familiar with are Catholic Charities’ Team Refugee and Youth Mentoring Program.

Anjali Subbaswamy is a Pediatric Intensive Care Physician at UNM. Please send your questions to her at asubbaswamy@salud.unm.edu

 

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