A Student-Run Clinic as an Approach to Refugee Health

Background: Texas is one of the top U.S. states for refugee resettlement, receiving 9% of the country’s refugees from October 2018 to February 2019 alone. The Congolese and Burmese comprise most of the refugee populations in Texas, holding 57% and 21% of state arrivals, respectively. Within Texas, Tarrant county is currently one of the top counties where refugees are resettled. Before a refugee resettled in the U.S., they must undergo a tedious resettlement process that consists of biographical data collection, medical and security screenings, and interviews. Once approved, refugees are assigned to a non-governmental organization that aids in the often difficult transition to their new lives in the U.S. Many challenges during the resettlement process may prevent the individual from obtaining adequate medical care. Language, cultural beliefs, and socioeconomic factors are the major barriers to accessing health care services resulting in the underutilization of resources. Access to community health resources is often also hindered by I-485 form processing times approaching 2 years. As a result, many refugees do not seek out care until medical emergencies arise. Refugee Health Initiative’s goal is to establish continuity of care by connecting refugees seen at our health clinics with pertinent healthcare resources. Case Information: From October 2018 to February 2019, we have held 4 clinics at 2 locations and have seen a total of 67 refugees, of which, 23 were males and 44 were females. The average age of patients seen was 41.73 years. While all were seen for a general screening, common co-occurring complaints included cold and flu symptoms, blood glucose screening, abdominal pain, headache, and dysuria. Patient medical histories included diabetes, hypertension, nephrolithiasis, hyperlipidemia, and hypothyroidism. Conclusions: Refugee experiences in the clinic setting reveal problems in navigating the health care system. Language barriers prevent many from understanding diagnoses and medications, while those who are unsure of their insurance status are often lost to follow-up. Although breakthroughs are being made in outreach, continued innovation in approaching these populations is essential in developing a relationship of trust with Western health care methods. The Refugee Health Initiative’s clinic has the potential to become an entry point of care that can improve health promotion and deconstruct cultural misunderstandings of the healthcare system.