| Refugee
Health Program
Our
Services | Our Impact | Children's
Stories
About the Program
Up to 75,000 refugees arrive each year in the United
States, and about 5% of them have settled in Massachusetts in recent
years. Just under one third of all refugees who enter Massachusetts
each year pass through the International Clinic. Most refugees come
from Somalia, Bosnia, Iraq, Cuba, with smaller numbers from the
newly independent states of the former USSR and other parts of Africa.
All refugees are entitled to a health assessment
which needs to be initiated within three months of arrival in the
U.S. Refugees are directed to the International Clinic by their
sponsoring agencies. Trained medical interpreters and outreach workers
affiliated with Boston Medical Center and the Refugee Health Program
of the Department of Public Health provide interpretation of language
as well as information about cultural traditions and practices which
may impact upon health.
The goals of the refugee health assessment are:
- General health assessment, including vision, hearing and dental
screening
- Identification and treatment of immediate health needs
- Diagnosis and treatment of communicable diseases
- Immunization
- Orientation to the health system in the United States
- Transition to a primary care provider
back to
the top
Our Services
War, violence, and extreme living conditions are
experiences shared by many refugee children. A survey of Bosnian
children performed in the clinic showed that most children or their
parents reported multiple exposures to wartime violence. Behavioral
symptoms possibly related to these exposures were reported to be
present in nearly half of all children.
Because of the problems identified in the first groups
of refugee children, the International Clinic has gradually expanded
its role to provide additional services. These involve collaboration
with many programs already in place at Boston Medical Center.
These services include:
- Providing school forms and immunizations to facilitate school
entry
- Identifying exposures to violence and torture and providing
appropriate referrals to psychiatric services or the Witness to
Violence program at Boston Medical Center
- Enrolling eligible children and mothers in WIC and providing
additional nutritional support to families as needed
- Identifying the need and making arrangements for subspecialty
services, including developmental assessment and referral for
mental health services
- Assessing literacy and school readiness
back to
the top
Our Impact
In the first 16 months of the program, 263 children
were seen in the International Clinic for health assessment. Just
over half were from Somalia, and about one third were from Bosnia.
Almost half of all children required treatment for intestinal parasites,
and about one third were treated for previous exposure to tuberculosis.
Four cases of malaria and three of schistosomiasis were diagnosed
and treated. Only 10% of children arrived with any immunization
records; not a single child was up-to-date with immunizations. More
than one third of all children had dental problems, and about 10%
had either abnormal vision or abnormal hearing.
All children were referred to primary care physicians.
back to
the top
Children's Stories
Treating a War Victim
Eleven-year-old Elvira's smile lit up the
examination room in the International Clinic at Boston Medical
Center, where she was being seen for a health assessment. She
had been born 3 months prematurely in Sarajevo. After a difficult
period in the hospital, she was thriving – until the onset
of the war in 1992. While she was playing with her brother one
afternoon, a grenade exploded nearby, causing her to lose her
left eye and leaving her face badly disfigured. Her family needed
help in caring for her glass eye, and wondered whether something
could be done to repair the damage to her face.
Within days of her visit to the International Clinic,
Elvira was able to receive the necessary solutions and information
about keeping her glass eye clean and free of infection. Her family
got information about arranging for repair of the cosmetic defects
for her face. In addition, she received the first set of immunizations
required for school, and was referred to a primary care pediatrician.
Her family was offered the services of the Boston Medical Center
Witness to Violence Program, which has expertise in helping children
and families who have had exposure to war and violence. Elvira
is learning English rapidly and is excited about her new school.
Fostering Speech Development
Abdulrazak's quiet behavior was conspicuous
in the exam room filled with his four active and talkative brothers
and sisters. The four-year-old was born in a refugee camp in Kenya,
his family having left war-torn Somalia several years earlier.
During his health assessment in the International Clinic, it became
clear that he was unable to speak, and had developmental delays
in other areas as well. His family communicated with him through
an elaborate language of gestures that they had created.
After he completed his health assessment and received
his first immunizations, he was referred to the Developmental
Assessment Clinic and staff from the Family Advocacy Program worked
with the public school system to be able to provide therapies
for him during the school day. He is now attending school full
time and speaks in English.
back to
the top
For more information, please contact:
Clinic Coordinator: 617-414-5671
Nurse Coordinator: 617-414-7455
International Clinic
Boston Medical Center
Dowling - Ground Floor
818 Harrison Ave.
Boston MA 02118
|
