Breaking News
October 19, 2018 - Nutrition has bigger positive impact on bone mass and strength than exercise
October 19, 2018 - Study finds lack of progress in media representation of nurses over last 20 years
October 19, 2018 - Many people have trouble understanding differences between OCD and OCPD
October 19, 2018 - New family planning app found to be as effective as modern methods
October 19, 2018 - Gastric Banding, Metformin Similar for Improving Glycemia
October 19, 2018 - Physiologist publishes findings on the role of the protein titin in muscle contraction
October 19, 2018 - What digital health companies need to do to succeed
October 19, 2018 - N. Carolina Sees Alarming Spike in Heart Infections Among Opioid Users
October 19, 2018 - Video monitoring of TB therapy works well in urban and rural areas
October 19, 2018 - Determining acid-neutralizing capacity for OTC antacids
October 19, 2018 - Males who spend more time taking care of kids have greater reproductive success
October 18, 2018 - Study to explore bioethics of brain organoids
October 18, 2018 - Environmental conditions may drive development of multiple sclerosis
October 18, 2018 - Genetically modifying zebrafish provides more accurate disease models
October 18, 2018 - Purdue Pharma, Eisai announce positive topline results from Phase 3 study of lemborexant
October 18, 2018 - 5 Strength-Training Mistakes to Avoid
October 18, 2018 - Immune system’s balancing act keeps bowel disease in check
October 18, 2018 - Anti-inflammatory drug effective for treating lymphedema symptoms | News Center
October 18, 2018 - Keeping Your Voice Young
October 18, 2018 - One-time universal screening recommended to tackle increase in hepatitis C
October 18, 2018 - Researchers to develop new stem cell-based strategies for treating vision disorders
October 18, 2018 - Detecting epigenetic signature may help people stay ahead of inflammatory bowel disease
October 18, 2018 - Understanding AFib: Slowing down the dancing heart
October 18, 2018 - Using NMR to Reduce Fraud
October 18, 2018 - New automated model identifies dense breast tissue in mammograms
October 18, 2018 - Mysterious polio-like illness baffles medical experts while frightening parents
October 18, 2018 - Cases of Acute Flaccid Myelitis on the rise across U.S.
October 18, 2018 - Dietary fiber reduces brain inflammation during aging
October 18, 2018 - New tool could help prioritize recovery efforts for the poorest hit by natural disasters
October 18, 2018 - Hundreds of dietary supplements shown to contain unapproved drugs
October 18, 2018 - Active Pharmaceuticals ID’d in >700 Dietary Supplements
October 18, 2018 - Cell death protein also damps inflammation
October 18, 2018 - AI pathology diagnostic tool developed using deep learning technology from Olympus
October 18, 2018 - Health Highlights: Oct. 15, 2018
October 18, 2018 - Largest study of ‘post-treatment controllers’ reveals clues about HIV remission
October 18, 2018 - Bad Blood in Silicon Valley: A conversation with John Carreyrou
October 18, 2018 - ANTRUK’s Annual Lecture sends out message on shortage of funds for antibiotic research
October 18, 2018 - NAM special publication outlines steps to ensure interoperability of health care systems
October 18, 2018 - Novel method uses just a drop of blood to monitor effect of lung cancer therapy
October 18, 2018 - New blood test could spare cancer patients from unnecessary chemotherapy
October 18, 2018 - Training young researchers to work with data volumes arising in the health sector
October 18, 2018 - New Metrohm IC method is reliable and convenient to use for zinc oxide assay
October 18, 2018 - Global AIDS, TB fight needs more money: health fund
October 18, 2018 - Understanding the forces that cause sports concussions
October 18, 2018 - Research points to new target for treating periodontitis
October 18, 2018 - New tool improves assessment of postpartum depression symptoms
October 18, 2018 - From Biopsy to Diagnosis
October 18, 2018 - Sexual harassment and assault linked to worse physical/mental health among midlife women
October 18, 2018 - Stumped by medical school? A Q&A with a learning specialist
October 18, 2018 - Report predicts life expectancy in 2040, Spain comes out on top
October 18, 2018 - Self-lubricating condoms may help raise condom usage
October 18, 2018 - Targeting immune checkpoints in microglia could reduce out-of-control neuroinflammation
October 18, 2018 - Study finds changes in antiepileptic drug metabolism during different trimesters of pregnancy
October 18, 2018 - Autonomic nervous system directly controls stem cell proliferation, study shows
October 18, 2018 - FDA Approves Talzenna (talazoparib) for gBRCAm HER2-Negative Locally Advanced or Metastatic Breast Cancer
October 18, 2018 - Sleeping Beauty technique helps identify genes responsible for NAFLD-associated liver cancer
October 18, 2018 - Many U.S. adults confused about primary care, study shows
October 18, 2018 - UC researcher focuses on light-mediated therapies to target breast cancer
October 18, 2018 - With philanthropic gifts, Stanford poised to make major advances in neurosciences | News Center
October 18, 2018 - Mice study shows antibiotics are not always necessary to cure sepsis
October 18, 2018 - Researchers discover why heart contractions are weaker in individuals with HCM
October 18, 2018 - Participation in organized sport during childhood may have long-term skeletal benefits
October 18, 2018 - Probiotic/antibiotic combination could eradicate drug-resistant bacteria
October 17, 2018 - More Socioeconomic Challenges for Hispanic Women With HIV
October 17, 2018 - 49,XXXXY syndrome – Genetics Home Reference
October 17, 2018 - Scientists uncover possible new causes of Tourette syndrome
October 17, 2018 - Girl undergoes unusual heart surgery after compassionate-use exemption | News Center
October 17, 2018 - Health Issues That Are Sometimes Mistaken for Gluten Sensitivity
October 17, 2018 - Elective induction of labor at 39 weeks may be beneficial option for women and their babies
October 17, 2018 - New smart watch algorithms can accurately monitor wearers’ sleep patterns
October 17, 2018 - Researchers demonstrate epigenetic memory transmission via sperm
October 17, 2018 - FDA, DHS announce memorandum of agreement to address cybersecurity in medical devices
October 17, 2018 - Health Tip: Know the Risks of Chicken Pox
October 17, 2018 - Immunotherapy effective against hereditary melanoma
October 17, 2018 - Researchers reveal new mechanism for how animal cells stay intact | News Center
October 17, 2018 - Alzheimer's Goes Under the Cryo-Electron Microscope
October 17, 2018 - Medicare for all? CMS chief warns program has enough problems already
October 17, 2018 - Metrohm Raman introduces Mira P handheld Raman system
October 17, 2018 - Expanding the knowledge about hippocampus to better understand cognitive deficits in MS
October 17, 2018 - Study of Nigerian breast cancer patients reveals prevalence of aggressive molecular features
Refugees seek care for wounds of war

Refugees seek care for wounds of war

image_pdfDownload PDFimage_print

Mahmoud said his captors, foot soldiers of Syrian President Bashar Assad, tortured him and shot him in the leg.

“I was in jail for seven months. They let me go, but I was physically sick, and tired,” the 29-year-old refugee said, speaking inside a cheerful, modern medical clinic here with signs posted in English and Arabic. “I had infections, inflammation. I’m still trying to get treated for it all.”

Mahmoud, tall and friendly, agreed to be interviewed on the condition that only his first name be used for fear of retaliation against family back home. He settled in one of the largest Syrian refugee communities in the United States — a midsize California town near San Diego.

And by virtue of this influx of refugees, it has become a health care hub for a traumatized and physically ailing population.

On an old-fashioned Main Street, among Western-themed murals, thrift shops and halal markets, sits the bustling El Cajon Family Health Center, serving Mahmoud and other victims of the devastating civil war in Syria.

Syrian refugees struggle disproportionately with post-traumatic stress disorder, anxiety and depression because of their exposure to extreme violence and anxiety about relatives still in Syria, clinic staff and community volunteers say. Most who have fled spent years holed up in camps or apartments, with little access to routine medical care for war wounds or chronic conditions such as diabetes or heart disease.

Virtually all of the people who enter this country as part of the federal government’s refugee resettlement program qualify by income for Medicaid, the government-run health insurance program for low-income people (known as Medi-Cal in California).

Physicians and others who work with Syrian patients say that the refugees experience long waits and must often travel long distances to see specialists — challenges shared by many other low-income groups.

But access to medical interpreters is woefully insufficient, and refugees are often stymied by the paperwork and bureaucracy so unlike what they had back home. There, they were accustomed to walking in and seeing a doctor without having to wait, said Suzanne Akhras Sahloul, founder of the Syrian Community Network, a Chicago-based nonprofit that aids refugees.

Patients are often confused by Medicaid and the managed-care plans that provide it. They sometimes switch health plans inadvertently, which can lead to delays in care, El Cajon Family Health Center physicians and caseworkers said.

Of the 5.6 million people who have fled Syria since its civil conflict broke out in 2011, only a tiny fraction — around 21,000 — resettled in the U.S.

More Syrian refugees came to San Diego County than any other U.S. metro area — over 1,000 as of the first quarter of 2017, according to the State Department. And more than 80 percent of them live in El Cajon, where county service providers and resettlement agency offices abound, said Chris Williams, executive director of the Syrian Community Network-San Diego, a local branch of the aid organization.

Resettlement agencies, which work with the State Department to smooth entry into the U.S., generally help refugees sign up for Medicaid and get the care they need for their first three months in this country. After that, they are largely on their own to maintain coverage and get care.

“They will say, ‘Why do I need to visit the family doctor? Why can’t I go to the specialist?’” said Aileen Dehnel, a case manager at the El Cajon Family Health Center.

“Everywhere we go, people are helpful,” said Mahmoud, who now lives in Anaheim, Calif. “But the No. 1 challenge is the language.”

Relatively few trained interpreters in the area speak Arabic, and they are in high demand. In a communication vacuum, Mahmoud said, information gets passed from neighbor to neighbor, changing slightly with each telling, as in a game of telephone.

“We don’t know what’s going on,” he said.

Translators don’t always help, Mahmoud said. One time, he had to rush to the emergency room after a gallbladder attack, and an interpreter on the phone kept asking everyone to repeat themselves, blaming the difficulty on bad audio equipment. Mahmoud and his wife, Noura, became so frustrated that she used Google Translate to figure out what the nurses and doctors were saying. (Noura also spoke on the condition her last name not be used.)

Another refugee, 34-year-old Nisreen Tlaas, recalled having fainting spells after her arrival from Homs, Syria, in 2016. Two emergency rooms misdiagnosed her illness before the staff at a third hospital performed an MRI and saw an aneurysm in her brain.

She finally received lifesaving surgery — but only after a caseworker from the Syrian Community Network smoothed communications between a surgeon and a medical interpreter.

Dehnel, of the El Cajon Family Health Center, writes detailed instructions in Arabic for the patients she works with, and many pharmacies in El Cajon now print prescription labels in Arabic as well. But that’s not enough to make sure a diabetic patient gets his insulin or a pregnant woman takes her prenatal vitamins correctly, because many of the patients can’t read in any language, she said.

Language frustrations aside, the main challenge facing many Syrian refugees is psychological distress.

PTSD among Syrian refugees contributes to physical symptoms such as chronic pain, said Dr. Mai Duong, a family doctor at the El Cajon Family Health Center.

Some patients have seen relatives hurt or killed in fighting. Others don’t know if their friends and family are safe. Syria is among the countries affected by the Trump administration’s “travel ban,” and the administration also recently cracked down on refugee admissions in general.

Adjusting to life in the U.S. also can cause enormous anxiety. But many Syrian refugees resist asking for help for fear that authorities will swoop in.

“People always downplay their distress,” Duong said. “They worry that their kids will be taken from them.”

Mahmoud has tried talking to psychologists. But they haven’t been able to help him escape his dark thoughts.

“Our families are in a war zone right now,” he said. “I’m always in fear that my family will be killed.”

This story was produced by Kaiser Health News, which publishes California Healthline, a service of the California Health Care Foundation.

Heidi de Marco: [email protected], @Heidi_deMarco

Kaiser Health NewsThis article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

Tagged with:

About author

Related Articles