Last March, we shared a blog post about HealthPoint’s role in the refugee resettlement process and our efforts to be both an effective health care home and stewards of a welcoming America for many of our region’s most vulnerable residents..png)
Since then, much has changed, both in the country and in our clinics. An ongoing barrage of policy shifts, rollouts, and repeals has created a near constant state of fear, anxiety, and heartbreak for many in our HealthPoint community.
In honor of World Refugee Day, we’d like to take a moment to share and reflect on some of these changes.
External Changes (a small sampling):
- Despite global refugee numbers reaching a record high, the number entering King County has slowed to a trickle. This is due to a record low refugee admission cap. At most, our country will accept 45,000 refugees this year. This is less than 2017 (50,000) and significantly less than 2016 (85,000).
- Refugee and asylees can no longer reunite with their families using the follow-to-join visa program. This program, put on indefinite hold last fall, allowed refugees and asylees in the U.S. to apply for visas for a spouse or unmarried child under the age of 21.
- Since early May, 2,342 children have been separated from their parents after crossing the Southern U.S. border. This separation is part of a “zero-tolerance policy” for illegal border crossings that was announced in April.
- UPDATE: At 3 p.m. (EST) today (6/20), the president signed an executive order to end this policy. It remains unclear how and when families will be reunited.
- As of June 11, victims of domestic violence and gang violence are no longer eligible for asylum in the United States.
- Approximately 200 of these asylum seekers are currently detained at a Federal Detention Center in SeaTac. Many of these detainees are women from Central America who have been separated from their children. Read one woman’s story here.
Internal Updates & Changes:
- In the first blog post on this topic, we described our new Refugee Health Clinics. By “clinics,” we don’t mean a new physical space, but rather using our existing spaces and resources in new ways to better serve our refugee patients.
What’s special about these clinics? For one, the entire family is seen together. Instead of the usual 15 minute appointment, the provider spends an entire hour with the family, welcoming them and addressing their needs.
During the appointment, the family also receives dental appointments or same-day dental care, access to behavioral health and nutrition counseling, assistance with insurance, transportation, and food resources and, if needed, prescriptions that are filled on-site by HealthPoint’s pharmacy.
We’ve now been offering these clinics at our Midway location for over a year. Here are a few of the results so far:
- The number of refugees we see each month has doubled.
- The appointment wait-time for refugee families has decreased from 3 months to less than one month.
- Our average no-show rate for refugee appointments has dropped from 39% to 4% in our Refugee Health Clinics.
- 67% of refugee appointments now have in-person interpreters, compared to less than 10% previously.
- 91% of our Refugee Health Clinic patients now receive dental care at HealthPoint.
- We recently shared this model, its initial outcomes, and patient feedback at the North American Refugee Health Conference.
- Our Afghan refugee patient population continues to grow. This mirrors trends at the county level: Afghans now make up 43% of the total incoming refugee population, compared to 20% in 2016. HealthPoint is the initial health care home for 78% of Afghan refugees in King County. 
- As we’ve cared for these families, we’ve noticed patterns in the challenges they face. Many of the women are socially isolated and chronically stressed. Most have left their support systems behind, continents away. What is unique about this group of refugees is that many of them have a husband who came on an SIV (special immigrant visa) because they worked with the US military in Afghanistan. Because of their US military ties, many of the husbands speak English, and thus quickly obtain jobs upon resettlement. This often leaves their non-English speaking wives at home alone (or with children) before these women have the opportunity to build community, learn English, or find work themselves. Additionally, family planning and/or pregnancy are frequently one of the most immediate medical needs upon arrival for this group: 13% of newly arrived Afghan refugee women are pregnant, compared to 3% in our overall refugee population.
- In response to these needs and barriers, we’ve created a special prenatal group for Afghan women. This group uses a CenteringPregnancy model that takes prenatal care out of the exam room and into a comfortable, supportive group setting. While moms-to-be still have private time with their provider, they also get to connect with other women and learn about timely topics like nutrition during pregnancy, stress management, and breast-feeding. We co-lead this group with our partners from Public Health’s WIC & MSS programs and with help from in-person Dari and Farsi interpreters. Our goals for the group are to:
- Improve perinatal outcomes for pregnant Afghan women including: preterm deliveries, low birth weights, breastfeeding and pregnancy spacing.
- Improve social cohesion and community support for pregnant Afghan women.
- Finally, we’re honored to share that in 2017 we received the inaugural Refugee Health Award from the Washington State Department of Health.
It’s been a busy year and there’s still so much more that we want to do; will you join us?
Here’s how YOU can help HealthPoint patients and refugees across our region:
- Attend Rock for Refuge, a concert benefitting the Refugee Women’s Alliance.
- Coordinate a food or hygiene drive for Refugees Northwest. They are out of food and hygiene supplies for our asylum seekers. Click here to learn more.
- Stop by the Namaste Farm Stand in Tukwila Village. It’s open every Wednesday from 4-7pm. The food is grown by the International Rescue Committee’s Community Garden and the proceeds benefits programs for refugees.
- If you’re a medical or behavioral health providers: consider volunteering as an Asylum Evaluator.
- If you’re ANYONE, consider donating your dollars, time, or talents to organizations that support, empower, and advocate for refugees.
- HealthPoint
- Lutheran Community Services
- World Relief Seattle
- International Rescue Committee
- Jewish Family Service
- Episcopal Migration Ministries
Acknowledgements
Many, many thanks to Drs. Shoshana Aleinikoff and Karp for sharing their NARHC presentation and data with us, as well as the whole Midway Team for collecting the data and continuing to innovate in the name of GREAT CARE for ALL. Thanks as well to Dr. Liza Perpuse for sharing background information and opportunities to get involved.