Friends of Refugees

A U.S. Refugee Resettlement Program Watchdog Group

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Resettlement and Isolation

Posted by Christopher Coen on March 27, 2012

A single mother of a refugee family from the Central African Republic finds herself alone and isolated (a condition correlated with refugee suicides) five months after resettlement to Portland via Lutheran Community Services Northwest. Interviewed about six weeks after her arrival, she only knew how to get to the grocery store and to an organization which offers employment training and referrals, though her resettlement agency was required to give her community orientation. The family’s apartment is sparsely furnished, with not enough heat to stay warm and little light (this, though the State Department’s Operational Guidance contract document supposedly requires resettlement contractors to provide refugees with one lamp per room unless installed lighting is present). An article in the Portland Tribune describes the refugee family’s initial resettlement to Portland:

Monique Detoloum…[a] new Portland resident has found peace for herself and her four children, after surviving a reign of terror in the Central African Republic and six years in limbo in neighboring Cameroon…

…Monique and her children arrived here in late October, settling in East Portland. They are among the 944 refugees from more than a dozen nations who resettled in Oregon last year, mostly in Portland. Nearly 60,000 refugees from around the world have landed here since 1975. That’s an average of 135 newcomers a month, a steady stream of foreigners who are gradually expanding the Portland area’s ethnic mix and forever changing its complexion…

…Somewhat arbitrarily, since Monique had no family or connections here, she was assigned to Portland, aided by Lutheran Community Services Northwest.

Agency staff picked up Monique’s family at the airport, found her housing in an apartment on Southeast Division Street near 126th Avenue, helped enroll her children into David Douglas schools, arranged medical screenings and financial support.

Within her first week in town, Monique was referred to East Portland’s Immigrant and Refugee Community Organization [IRCO], which offers employment training and referrals, among other services…

…Interviewed about six weeks after her arrival, Monique knew how to get to IRCO and the Winco grocery store on Northeast 122nd Avenue, but hadn’t ventured further on her own. She was too flustered to think about going downtown, feeling pretty helpless without any English skills…

…Now, after five months, here she is still having trouble adjusting to cold weather. She just experienced her first snow, and says she doesn’t like it.

The family’s two-bedroom, one-bath apartment is sparsely furnished, with little light and not enough heat to stay warm…

…Monique has found a Baptist Church she wants to attend. But she says she is feeling isolated here, with no friends to talk to, only her children…

…Refugees rarely go back to their home country, Tauch says, but they do move around once they’re here, especially to find work. In January, a recruiter came to town and offered seasonal jobs to 52 Portland-area refugees at a Kodiak, Alaska, cannery, Tauch says. Last year, a Nebraska employer offered 100 permanent jobs to local refugees… Read more here

Posted in alienation-isolation, Central African Republic, furnishings, lack of, housing, language, Lutheran Community Services Northwest, mental health, Operational Guidance, Portland | Tagged: , , , , , , , | Leave a Comment »

In Boise 400 Refugee Women Lose Breast Cancer Screenings

Posted by Christopher Coen on February 1, 2012

"An investigation..."

***UPDATE*** February 3, 2012 — Washington Post announces that Komen Foundation ambiguously reverses its decision, here.

Due to a new Susan B. Komen for the Cure (the pink ribbon group) policy to halt funding for any group “under investigation by federal, state or local authorities”, 400 refugee women in Boise will now no longer receive critical annual breast cancer screenings, unless new funding is found. Planned Parenthood was receiving funds, now cut, from the Susan B. Komen for the Cure Foundation for 170,000 clinical breast exams nationwide over the past five years) US House of Representatives right-wing Republicans recently began a politically motivated “investigation” of Planned Parenthood’s so-called use of public funds for abortion. This policy now needlessly pits two leading women’s health groups against each other by rewarding a congressman for merely starting an investigation – no matter the facts in the case, or if there is even any basis for the investigation (that’s like rewarding malicious gossiping and rumor mongering or being found guilty simply for being accused of something). No doubt this unwise Komen policy will affect many more refugee women than the 400 in Boise. An article at Crosscut explains:

Because a Florida congressman demands an investigation of abortion spending, some 400 women in rural areas of Clallam County in Washington face the loss of breast cancer screening. So do another 400 in the Boise, Idaho, area, but they face a worse dilemma: They’re refugee women from Africa and Asia, relocated to Idaho through the International Rescue Committee, and most lack the language skills to look for mammogram providers and other breast cancer support on their own.

For years, Planned Parenthood of the Great Northwest has used funds from the huge Susan B. Komen for the Cure Foundation to provide cancer screening treatments to women in Clallam County and in the Boise/Twin Falls area, administered by Planned Parenthood’s Puget Sound affiliate in Seattle. But as of this week, under congressional pressure over Planned Parenthood’s abortion assistance, the Komen Foundation has ended its contributions to Planned Parenthood’s breast cancer screening programs. Nineteen of Planned Parenthood’s 83 affiliates will be affected by the cut, including the two in Idaho and Clallam County. The organization says Komen funds have provided 170,000 clinical breast exams nationwide.

 “Komen got bullied by anti-choice politicians,” says Kristin Tlundberg of Planned Parenthood of the Great Northwest, which supports clinics in Washington, Idaho and Alaska, from its office in Seattle. “It’s a shame these two incredibly strong women’s organizations, both working to prevent cancer, have been forced into opposing positions by anti-choice forces determined to harm Planned Parenthood.”… Read more here

Posted in Boise, Congress, funding, health, right-wing, women | Tagged: , , , , , | Leave a Comment »

Focusing On Physical Symptoms When Helping Refugees With PTSD

Posted by Christopher Coen on January 21, 2012

Refugees with post-traumatic stress disorder (PTSD) need specialized and competent care at mental health centers to get back on their feet (why the federal refugee resettlement program doesn’t mandate mental health screening for refugees makes little sense to me). A specialist at a center in Kent, in Washington state, has found that focusing on a patient’s physical symptoms is useful in helping refugee clients. An article at KUOW tells the story of an Iraqi refugee struggling to survive with PTSD (he didn’t get a proper referral until he tried to jump off a roof):

The Kuba family lives in a small ground–floor apartment in Kent…

…But there’s a lot more space here than they had a few weeks ago, when they were living in their car.

Amer Kuba: “I leave my home. And all my stuff in the street cause I don’t have money for truck.”

This is Amer Kuba. He is a refugee from Iraq. At his first apartment, rent was $735. But he only got $560 in refugee cash assistance. It caught up with him, and he was evicted.

Kuba: “I take just my clothes and I sleep in my car almost three month. I drive in night, and my family sleep in car.”

…Amer, his pregnant wife and their young son came to Seattle in April 2010.

Amer says he didn’t leave the house for the first six months. He was afraid al–Qaida would find him here.

Kuba: “And I have psychological problem. And I can’t speak with anybody and confuse all the time and I still inside my house, I don’t go outside because I afraid.”…

…Beth Farmer runs the International Counseling Service, a community mental health center. Almost all of her clientele are refugees from Africa, the former Soviet Union and the Middle East.

Farmer: “If you are already having post–traumatic stress disorder symptoms, you are really poised to fall through the cracks.”

That’s because there is no standardized way to make sure refugees with severe mental health problems are funneled into treatment as soon as they arrive.

Amer didn’t get sent to Beth’s clinic until he attempted suicide. He tried to jump off the roof of the Department of Social and Health Services building in Downtown Seattle.

Overall, Beth says refugees are 10 times more likely to have PTSD than the general population. But it can be hard to get patients like Amer into treatment.

Many refugees with PTSD share his fear of going outside. And that’s only amplified by how hard it can be to find your way around a new city, especially if you don’t have a car or speak the language.

Even the idea of mental health treatment can be scary.

Farmer: “For a long time, people didn’t think that they could address mental health issues because the stigma in the refugee community was so high.”

Getting counseling or psychiatric treatment might be seen as selfish or wimpy, or even dangerous. For some refugees, mental hospitals are a place where political dissidents are sent.

Beth has found that focusing on physical symptoms gets the best results. She starts by asking a patient how they’re sleeping… Read more here

Posted in Iraqi, Kent, PTSD | Tagged: , , , , | Leave a Comment »

Refugee Medical Professionals Need Not Work Forever As Taxi Drivers and Parking-Lot Attendants

Posted by Christopher Coen on January 19, 2012

A pair of enterprising immigrant medical professionals in Minnesota are showing that with a bit of help refugee medical professionals can get back into their professions. An article in the Minnesota Post details the story:

…They have treated patients in some of the world’s toughest places: Pakistan’s earthquake-stricken mountains, Burma’s embattled neighborhoods and crowded camps where Bhutanese families sought refuge.

What hundreds of these doctors and nurses haven’t been able to do is treat anyone in Minnesota where barriers to foreign-trained medical workers are formidable.

Now, they are surmounting those barriers — and, in the process, filling serious gaps in Minnesota’s health care delivery — thanks to Dr. Wilhelmina Holder and Stephen Nguyagwa.

From scratch, Holder and Nguyagwa built a ground-breaking system for supporting foreign-trained doctors and nurses in their struggle to win the credentials they need to practice in Minnesota…

Their leadership rose from deeply disappointing personal experience…

…Holder, 64, was a medical doctor whose career was shattered by civil war in her homeland, Liberia, where her father had been the president. Like millions of other refugees, she found herself absorbed for years in the distractions of settling in a new land and caring for the needs of a displaced family. By the time she was free to resume her practice, doors had closed to her in Minnesota, even though she had updated her skills.

“To my amazement, I realized I never would get into residency,” Holder said.

Instead, she channeled her energy into helping others overcome the same obstacles. She knew doctors who were working as taxi drivers and parking-lot attendants even while their communities cried for their professional services…

…Of some 250 medical professionals who have participated in the association’s program, only about 20 doctors have stepped up to residency programs so far, Nguyagwa said. About 20 nurses have gone all of the way to nursing jobs, he said. A few dentists, pharmacists and professionals in other medical specialties also have gone through the program and landed jobs…

…All three Somali doctors who went through the program last year won residency slots. So prospects are bright for this year’s class… Read more here

Posted in Burma/Myanmar, Cuban, economic self-sufficiency, health, Minnesota, Nepali Bhutanese, professionals, Somali | Tagged: , , , , , | Leave a Comment »

Lead Poisoning In Refugee Kids From Myanmar

Posted by Christopher Coen on January 18, 2012

Researchers at the Centers for Disease Control and Prevention (CDC) have found that lead poisoning is common among refugee children from Burma/Myanmar. The CDC recommends that all refugee children have their lead levels checked within three months of arriving in the US, be screened for anemia, and that resettlement agencies place refugee families in “lead-safe” housing. The CDC also advises that after their first lead test, children younger than 6 should be re-tested within six months of settling into permanent housing. Reuters has the story:

(Reuters Health) – Many Burmese refugee children bound for the U.S. may have dangerously high levels of lead in their blood, a new government study finds.

Researchers at the Centers for Disease Control and Prevention (CDC) found that of 642 U.S.-bound Burmese children, 90 percent had some amount of lead in their blood. Overall, 5 percent had lead poisoning — including nearly 15 percent of children younger than 2.

High lead exposure is especially dangerous for young children, since it can permanently damage their developing brains…

…The CDC already recommends that all refugee children have their lead levels checked within three months of arriving in the U.S…

 …the biggest factor seemed to be anemia, which is most often caused by iron deficiency. Anemia is known to make children more vulnerable to lead poisoning.

The CDC recommends that when refugee children in the U.S. are tested for lead levels, they also be screened for anemia and have a “nutritional assessment.”…

…Once children are in the U.S., the CDC researchers say, families should be placed in “lead-safe” housing. And after their first lead test, children younger than 6 should be re-tested within six months of settling into permanent housing… Read more here

Posted in Burma/Myanmar, CDC, children, health | Tagged: , , , , , | Leave a Comment »

Sub-Saharan African Refugees Must be Screened for Hepatitis C

Posted by Christopher Coen on January 3, 2012

New studies released by the Mayo Clinic identify hepatitis C as a cause of liver cancer. One study found that, among Somali refugees in Olmsted County in Minnesota, 80 percent of liver cancer was due to hepatitis C. Currently, refugees coming to the US aren’t even regularly screened for hepatitis C. Yet, people who have hepatitis should get blood drawn every year, as well as get ultrasound of the liver every six months. An article at MPRnews addresses the issue:

St. Paul, Minn. — The Mayo Clinic released a study today that identifies hepatitis C as a cause of rising liver cancer rates. Researchers say with that information, more people can be screened for hepatitis C and prevent cancer.

The finding may have a particular impact on the Somali community. That’s because a second study published by Mayo today says hepatitis C rates among Somalis are much higher than previously suspected.

The first study from the Mayo Clinic confirms that scarring from hepatitis C can develop over decades into liver cancer…

The study, while in progress, caught the attention of Mayo researcher Abdirashid Shire, who visits most of the Somali patients at Mayo and is Somali himself. He’s seen many friends die of advanced liver cancer. So Shire led a second study by digging into the Mayo database, picking out the Somali names, and looking for patterns.

“When we looked at those who develop liver cancer, during the timeframe we looked at between 1996 and 2001, we found 30 people who developed liver cancer,” said Shire. “And can you imagine — almost 80 percent, the liver cancer was due to hepatitis C.”

Until now, Shire says the medical community only knew of one strain of the hepatitis virus prevalent among sub-Saharan Africans — hepatitis B. Currently, Somali refugees coming to the US aren’t even regularly screened for hepatitis C. Shire says if they were, doctors could catch liver problems before they progress past the point of treatment.

There are few early signs of hepatitis C. The virus is transferred through sex or blood transfusions — and it can run rampant in places like Somalia or African refugee camps, where physicians may not always sterilize needles thoroughly between patients.

Shire says people often don’t know they have hepatitis C until decades after the initial infection. By that time, it can be too late…

…Ayan Hassan, who’s a nurse, says her brother got hepatitis C through a blood transfusion in Somalia.

“It really upset me when I find out his doctor was not doing ultrasound, because people who have hepatitis should get blood drawn every year and they should be getting ultrasound every six months,” she said… Read more here

Posted in health, medical care, Minnesota, Somali | Tagged: , , , , , , , , , | 2 Comments »

Changes to Maine law prevent lawful permanent residents access to Medicaid

Posted by Christopher Coen on December 30, 2011

**Clarification** – Refugees (they may apply to become Lawful Permanent Residents after one year in the US) are exempt from this new rule, although other Lawful Permanent Residents are not exempted (e.g. refugees’ family members who immigrate via family member status), except for pregnant women and children (those under age 21) . See January 5, 2012 Sun Journal article.

Changes to Maine law governing its Medicaid program (MaineCare), sold to voters by Gov. Paul LePage as a way to save money, are now preventing lawful permanent residents from access to Medicaid during their first 5 years (this does not affect refugees access to Medicaid during their first 8 months in the US). The changes also scapegoats, and singles out for exclusion, people waiting on decisions to their asylum applications. All of these people are poor, and many are elderly, disabled or frail, and have serious health care needs. An Op-ed in the Portland Press Herald details the case:

In October, about 500 legal immigrants, mostly living in Portland and Lewiston, lost their health insurance coverage, which had been provided through MaineCare.

The change in law affects lawful permanent residents who haven’t had that status for at least five years, as well as asylum seekers who have a pending application with the federal government.

Just like refugees, many of these folks have escaped atrocities in their own country or faced persecution based on their race, religion or political beliefs.

Now they are being singled out again…

…While the decision to eliminate health insurance coverage was sold as a way to save money by Gov. Paul LePage, that will not be the end result. 

This insensitive change in the law merely shifts and hides costs, while leaving 500 people in our communities at risk of reduced access to health care.

All of these individuals are poor, and many are elderly, disabled or frail. 

Many have serious health care needs, and in many cases, the community supports that do exist are unable to meet their serious health care needs when they become uninsured. 

The cost will fall back on the state either way…

But perhaps, even more distressing, the policy doesn’t really accomplish its stated goal, which is to reduce costs.

While the money to pay for MaineCare for 500 people is removed from the state budget, the need for medical care doesn’t disappear.

It is shifted onto communities and health care providers such as clinics and hospitals.

Instead of receiving assistance through MaineCare, which has cost controls and a focus on preventative care, they are forced to rely upon emergency rooms, where the cost of care is the highest… Read more here

and

…Many of the new immigrants in Maine fall into a category described as asylum seekers because they are individuals waiting for an asylum decision from the federal government. As a result of new state laws, many of these individuals can no longer get help from the safety net programs administered by the state.

Being a person seeking asylum in a new country is already an uncertain time. It’s a time of limbo and people in this position may need some assistance from others until the immigration process grants the permits necessary to be able to get a paid job. It’s a time that calls for compassion… Read more here

Also see Maine Equal Justice Partners handout, here.

Posted in asylees, health, legislation, Maine | Tagged: , , , , , , , , , | Leave a Comment »

State Department Spokeswoman Says Resettlement Guidelines Don’t Consider Crime Rates

Posted by Christopher Coen on December 28, 2011

An article in the San Francisco Chronicle identifies the many Iraqi refugees who have been attacked in East Oakland. In response, the State Department’s PRM spokeswoman, Beth Schlachter, reminds us about its lax, partner-friendly regulations by saying that the department’s guidelines for relocating refugees don’t even consider crime rates (funny how that works). A reader commenting on the article reminds us that Bosnian refugees had similar problems in the 90s, so the private resettlement agencies and their friends at government oversight agencies have obviously long-known about this problem. Refugees from Burma/Myanmar in the area have also experienced muggings and robberies, as have refugees from Bhutan/Nepal. The article details the situation in Oakland for Iraqi refugees:

…In June 2008, [Ghazwan Al-Sharif] moved in with two other Iraqi refugees, sharing a two-bedroom apartment in Oakland’s Fruitvale neighborhood – a situation arranged by the nonprofit International Rescue Committee…

…One night, he decided to walk home alone. Two men attacked him, bashing him in the face with a metal object and robbing him of some money, his cell phone and his ID. He was left screaming on the ground, his face gushing blood.

He said the police never identified his attackers.

Al-Sharif, 40, is one of more than 50 Iraqi refugees who have been moved to East Oakland by the International Rescue Committee. The nonprofit’s officials say they won’t settle refugees in unsafe neighborhoods, but Al-Sharif and dozens of other Iraqis blame the organization for exposing them to an unfamiliar type of violence – one perpetrated by gangs rather than political militants…

…Like many of his fellow Bay Area refugees, Al-Sharif does not believe the International Rescue Committee has done enough. “Why are you putting them in Oakland and letting them suffer?” he said, referring to his fellow refugees. “I want to be safe. … I can find work and manage to survive, but I need to be safe.”

Oakland as refuge

Oakland has a long history of hosting immigrants from around the world. Affordable housing, easy access to city services, efficient transportation such as BART, and an accepting, multicultural society make the city a great place for refugees, said rescue committee spokeswoman Melissa Winkler.

But the nonprofit receives only $1,800 in federal funding to provide each refugee with housing, employment and other basic needs. That doesn’t go far in the Bay Area, and refugees are expected to be financially self-sufficient within four months.

That’s why the IRC chose to resettle many of them in Oakland, where housing is often inexpensive…

…Unfortunately, the city also has one of the country’s highest crime rates, according to federal statistics and other studies.

Beth Schlachter, spokeswoman for the Bureau of Population, Refugees and Migration at the State Department, said government guidelines for relocating refugees don’t consider crime rates. The requirements for “decent, safe and sanitary housing,” she said, extend only “from the apartment itself to the building or apartment complex they’re living in.”…

…[Harith Al-Kaiate, 47] hasn’t forgotten the time a nighttime gunfight near his home left his car, which was parked outside, riddled with bullets…

…Ragheed Abdulameer, 32, another recent arrival, [was] robbed at gunpoint earlier this year just a few blocks from his home at East 24th Street and 14th Avenue…One of Abdulameer’s friends has yet to bring his wife and children from Iraq, believing they’re safer in Basra. The friend declined to be interviewed or identified for this article, saying he fears retaliation from federal authorities and the rescue committee.

More than a dozen Iraqi refugees who have been resettled in Oakland say they live in varying degrees of fear.

“Had I known about this place, I’d never have agreed to come,” said Oday Fatah, 33…

…the only solution for you is to get beaten or mugged and then you can get out,” quipped Al-Sharif, who says he became depressed and attempted suicide after he was mugged. His condition persuaded the International Rescue Committee to help relocate him to San Francisco.

The rescue committee agreed to move another refugee and his family after he was shot multiple times in a drive-by shooting outside a Fruitvale mini-mart earlier this year, Climent said.

[Iraqi refugees who make it to the US] almost certainly suffered horrendous trauma in their home country.

“They’ve survived, and they’ve come to the U.S. to start a new life, and if you settle them in an environment like that, you bring back all these things,” Abdulkhaleq said… Read more here

Posted in dangerous neighborhoods, Iraqi, IRC, Oakland, PRM, public/private partnership, safety, San Francisco, State Department, suicide | Tagged: , , , , , , , , , | Leave a Comment »

Justice Leads a Young Man to Help/Heal His Community

Posted by Christopher Coen on December 12, 2011

A story from our friends Down Under about the healing power of justice involving a Somali refugee gives us a hint of the world we could create if  justice was an actual priority. An article in The Age tells the story:

…It was Valentine’s Day 2007 when Dini was hit in the mouth during an incident between police and some African youths. As well as damage to three teeth, Dini copped a cluster of police charges that included affray, assault and recklessly causing injury.

What irony – he had avoided the violence that plagued his six years in a Kenyan refugee camp only to be hurt in the family’s safe haven...

…Initially I was really angry – why would the police charge me? I was so stressed, I knew I had done nothing wrong but a lot of friends told me the court system would not work. So there was a tear in my eye when the judge said I was not guilty. I sat back in my chair. It was the biggest relief in my life.”

A dentist could fix that broken tooth, of course, and Dini had intended to have it done but now he sees it almost as a badge of honour. “This makes me Ahmed Dini now,” he says, “the man with the gap in his teeth. The thing that fixed my heart, that fixed me as a person, was the court decision, and that’s why I love this country more than any in the world. When I say that, some of my Somali friends ask: ‘are you serious?’ But for me to spend 10 days in court and to hear the judge say: I believe Ahmed Dini’s version of the story, well …”…

…Dini completed secondary education in Melbourne and did two years of university before deciding to help young Africans. “There was a lot of trouble in the community, no role models,” he says, “so I decided as a young person I would become the public voice.

”I went to any meeting involving Africans – council, police meetings. African elders were going but not young people. Slowly, but slowly I saw change. Then I got a role coaching the under 13s at the Flemington Eagles, a refugee-based soccer club.”

Last year, Dini formed the Australian Somali Football Association. It held a tournament, which drew 4500 spectators, where eight teams played over six days. The 2011 tournament is at the end of this month and 12 teams will play.

At 24, Ahmed Dini makes an impressive advocate… Read more here

Posted in Australian refugee resettlement prgm, court, democracy, men, mental health, police, Somali | Tagged: , , , , , , | Leave a Comment »

Refugee mental health screenings not mandated, therefore cut in some locations where offered

Posted by Christopher Coen on November 30, 2011

Although the US refugee resettlement program does not mandate mental health screenings for refugees, some resettlement locations have provided these screenings, such as Utica, New York. Refugees there, however, will no longer get the screenings since services which are not mandated are the first to go during budget cuts. An Observer-Dispatch article gives the details:

Mid-year funding cuts by the financially struggling state are hitting social programs that help the mentally ill.

Some programs that received money through the Oneida Coun­ty Department of Mental Health are seeing their funding dry up at the end of the year, while others are seeing steep reductions.

Oneida County Executive Anthony Picente didn’t hold out much hope that the money might be restored.

“It’s the consequences of the state cuts,” he said. “We can obviously fight for it, but it’s one of those areas that aren’t going to get resolved.”

Among the cuts:…

…* The Mohawk Valley Resource Center for Refugees is losing $38,583, which funded mental health screenings for refugees…

…State funds for the county Mental Health department have been slashed from $9,542,793 in 2011 to $9,122,378 in 2012, budget documents show.County officials said the department had to cut programs that do not provide mandated services.

Mental health advocates said the cuts might save money in the short term but will cost more in the end.

“It ends with people unfortunately losing services, ending up in emergency rooms, homeless or in the criminal justice system,” said Glenn Liebman, of the Mental Health Association of New York State. “No one wants those outcomes, and it’s more costly for the taxpayers.”… Read more here

Posted in mental health, Mohawk Valley Resource Center for Refugees, Utica | Tagged: , , , , , | Leave a Comment »

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