Community Spotlight-Refugee Health


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Community Spotlight-Refugee Health

March 16, 2022 | Haley Smith | HIV, Hep C, STI

My name is Haley Smith, and I have been working as a housing case manager at the Southern Arizona AIDS Foundation (SAAF) for 5 years. I have a background in biology and psychology, and my passion lies in working with underserved and vulnerable populations. Not long after I started working at SAAF, an elderly Burundian client came in and was trying to convey something to her case manager – the case manager speaking English, and the Burundian woman speaking Swahili – with little success. I overheard the conversation, and asked the client in French if she possibly speaks French (as I had some knowledge of the history of colonization in Africa) and fortunately she did. Needless to say, the client was immediately reassigned to me so that she could share a common language with her case manager. This simple interaction was how I started working with refugees.

Having a shared language truly brought to my attention how, though the needs of a refugee client do not differ from those of a non-refugee client, they are vastly different in how they are filled. From healthcare, nutrition, education, and more, the needs can only be addressed from a culturally competent perspective. From what started as having one refugee client, I grew to having 30 refugee clients on my caseload, speaking languages from Dinka to Somali, Tigrinya to Kinyarwanda. I continue to actively listen to my clients and ask detailed questions, to best know what needs are lacking and how to assist them in filling those needs, and then I strengthen my knowledge and cultural competency base by reading books on the history of Africa, the history and current situation of HIV/AIDS in Africa, and peer reviewed journals on refugee resettlement and challenges therein. I actively study Swahili and am now conversational in this language, and I have committed to memory greetings in myriad other African-based languages. I learned very quickly that being able to say even one or two words in the client’s language helps to build a trusting relationship.

If I could give just two pieces of advice to case managers working with refugees, it would be to always use an interpreter if the refugee does not have a solid understanding of English, and to try to problem solve ahead of time. To best explain what I mean by problem solving ahead of time for refugee clients, especially those that have limited English proficiency, is to try to put yourself in their position. First, think about the items that your client may need to accomplish, for instance refilling their medication at the pharmacy, paying a cell phone bill, or renewing their driver’s license, and then think about what challenges you would have completing these items if you found yourself in Ethiopia, South Sudan, Democratic Republic of the Congo, or any other country where to don’t speak the language, or understand the customs. What barriers would you need help with? Would it be needing help to call the pharmacist for a medication refill, understanding directions of where to go to pay your cell phone bill, or filling out the required paperwork to renew your license?

There are many barriers to basic care that refugees face, which are invisible to those of us who speak English and understand American culture. Working with the refugee clients to alleviate barriers that are refugee-specific is important in helping them gain stability and growth in their new homeland.

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