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Post by strainsk on Jan 31, 2022 2:36:02 GMT
c. Mother, father and 2 young children from Haiti who were just allowed asylum in the US after being detained at the US/Mexico border for three weeks - For all family members - access to shelter, health services, food/water, etc that would be in jeopardy likely coming with little-to-nothing
- Father/mother specifically- finding work can be a major issue, do they have doucmentation/paperwork, the communication, and even the transportation to keep a job and provide for their family
- For the kids- their social developement will likely be strained given their likely inability to communciate with other kids and participate in their educational development/go to school
- For the community- how can the community better respond and help those who are assimilating to a brand new culture in a sustainful and non-judgemental manner, aside from our political differences
- For the government- how can the local and national government practically respond and implement policies to take part in improving global health, minimizing political views, and providing the resources needed for those granted asylum (even improving the aslym process)
- For physicians- recognizing the special need, not only short-term, but long term to make a substantial impact on the overall health of these patients such that these patients are not lost to follow-up/neglected/down-played in their need for services such as preventative health
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Post by shobanaram on Feb 1, 2022 20:00:34 GMT
"Mother, father and 2 young children from Haiti who were just allowed asylum in the US after being detained at the US/Mexico border for three weeks"
In thinking about the specific health concerns of this family, it is imperative to start from a perspective of mental health and trauma informed care. Imagining for the children the impact of seeing the othering of family members or of themselves, emotional/physical/sexual abuse from authorities/traffickers/detention centers along the journey, deprivation of basic necessities contribute to elevated ACE scoring which is shown to leading to increased risk of PTSD, depression, substance use disorder, heart disease, and diabetes. In the parents, the experiences of trauma along the journey put them at risk for similar health concerns: severe depression, PTSD, anxiety with panic, suicidality, complex trauma syndrome.
Furthermore, there has been note that asylum seekers at the US-mexico border often struggle to find housing and often end up in overcrowded spaces/rooms or otherwise without housing. This puts them at risk for infectious disease, particularly for tuberculosis, scabies, gastroenteritis, flu, or more recently COVID. Malnourishment, chronic dehydration and long term exposure to smoke/dust all contribute to the higher risks for chronic non-communicable disease including diabetes, chronic respiratory disease, and heart disease. The lack of access to basic health care puts this family and any asylum seekers at even more risk for worsening of chronic disease or uncontrolled infection which further increases mortality rates.
Source: chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/viewer.html?pdfurl=https%3A%2F%2Fwww.wmsmp.org.uk%2Fwp-content%2Fuploads%2FACEs-in-Child-Refugee-and-Asylum-Seekers-Report-English-final.pdf&clen=2557100&chunk=true chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/viewer.html?pdfurl=https%3A%2F%2Fglobalhealth.harvard.edu%2Fwp-content%2Fuploads%2F2020%2F07%2FA_Population_in_Peril.pdf&clen=2477627&chunk=true
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Post by Audrey on Feb 3, 2022 6:22:53 GMT
1. anxiety, adjustment, and stress-related mental health concerns - This family may be experiencing symptoms of acute stress, adjustment disorder, anxiety, and/or PTSD related to their detainment at the border and any prior trauma preceding their leaving Haiti. As they acclimate to the United States, they will likely face further stress due to language barriers, racial discrimination, adjusting to new cultural norms, and finding work in the United States. Their conception of mental health may differ from their providers, and so it is incumbent on the provider to ask about mental health-related concerns in a culturally sensitive and trauma-informed perspective as described above. - Providers should use a translator during visits and use language that normalizes and de-stigmatizes mental illness. - Providers should work together with local refugee resettlement agencies such as NICE to ensure the family has access to community resources for language acquisition, tutoring, job placement, transportation, housing, and mental health services.
2. acute health concerns - Detainment at the border for 3 weeks puts the family at risk for communicable disease, exacerbation of chronic disease, and physical abuse. Providers should screen and examine for signs of abuse and ask family members what chronic health problems they were managing prior to arrival.
3. health maintenance - Primary care providers should provide routine health maintenance and additionally fill in the gaps for pre-immigration screenings such as TB testing. - PCPs should also be aware of how cultural norms inform illness scripts. For example, Paul Farmer describes how patients at Zanmi Lasante often attributed chronic TB to supernatural factors rather than a biopsychosocial model of health. As a provider he was able to acknowledge these differences and make medical recommendations while respecting the patients' beliefs, and the clinic found no differences in medication adherence or cure among those who attributed their chronic TB to biologic infection or to bad Vodou.
4. preventive care - PCPs should review vaccinations and routine screenings with the parents, realizing they may not have any health records on hand. The children will likely need to repeat childhood vaccines that can't be confirmed and may not be routine in Haiti.
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