Refugee health: Important for overall health of Nebraska Part 3

Refugees entering the U.S. receive a health check through the International Organization for Migration or a designated physician by the U.S. Embassy during the screening process, making sure individuals don't have any communicable diseases that could pose a threat to public health, protecting refugees – as well as the Nebraskan’s already here.

"A lot of our families have experienced trauma, I think the trauma of even moving to the United States is a big deal," says Lacey Studnicka with Lutheran Family Services of Nebraska.

She says many of the people that are resettled in Nebraska have experienced violence.

"Most of the folks that we have in Lincoln that we resettle are from Iraq, and they are; a lot of them are the Yazidi population who have been especially tortured and traumatized by terrorism."

Josie Rodriguez, administrator of the Office of Health Disparities and Health Equity with the Nebraska Department Health and Human Services (DHHS), says the health of refugees is as important to the health of the state.

"People focus on Nebraska becoming the healthiest state in the nation, if we can improve the health of minorities, including refugees, it's really going to have Nebraska be a lot healthier."

When refugees arrive to Nebraska, DHHS takes care of their medical needs during the first 90 days before establishing a medical home.

"The health department has the contract to do the initial refugee health screening and then they're responsible for doing any immunizations," explains Shirley Terry, Regional Administrator for Behavioral Health or Southeast Nebraska for Lutheran Family Services and COO for Health 360 Integrated Health Clinic.

It’s a one stop shop for anyone in the Lincoln community. She says it's a place where refugees can get medical attention for themselves and their family, seek help with mental health issues, get their medication and visit with their case worker at the Refugee Resettlement Program located in the same building.

"We're always looking for red flags for any of our patients that come in, we have depression screenings that we do and if they're positive we have more in depth assessments that we can do, that's the reason why we have the behavioral health consultant to kind of look for some of those red flags."

Health 360 is a program that is only available in Lincoln and is funded from the Community Health Endowment and anyone can be seen at the clinic. They also have a behavioral health consultant that is on hand to provide 15-30 minute interventions for crisis’ they may be facing.

Dr. Sarah Castillo, a physician at Health 360, sees many refugee families dealing with depression and an overwhelming concern for family left behind.

"Obviously most that come over here don't come with the expectation necessarily of being reunited with their family over here in a safe environment, but that's always their hope."

She sees many refugees that have the repercussions of the violence they've been witness to victims of back home, "A lot of semantic complaints, abdominal pain, headaches, back pain and a lot more symptoms of post-traumatic stress disorder, depression, anxiety."

Bashar Karim and his wife say they left their whole lives behind, but what worries them the most is the family that still lives in Iraq.

"Extremely difficult because basically I was looking after them, my mom she's living in a house right now, it's only her and my 17–year–old sister."

His wife, Dilbar Betto, says things have slowly gotten better and they are learning to adapt to their new life, "It was difficult in the beginning, but now it's much better, I like it.”

Rodriguez says there is a lack of census information regarding refugee health and in order to figure out their health, DHHS plans to launch a Behavioral Risk Factor Surveillance Survey (BRFSS) this summer.

"There are so many different components of one being healthy, but yes there are things in there that ask about diabetes, there are things in there about if you've been told by a doctor if you have different ailments, so there is a lot of information in the BRFSS that we are trying to gather."

She says the survey is long and language can be a barrier, so other leaders in Nebraska and members of the health industry have been getting together to figure out what groups to focus on and what languages. She adds that the current census doesn’t really have a component in which refugees can identify themselves as a refugee.

Funding for the pilot survey comes directly from federal grants, there are no state funds used for this survey. They hope to have a final report out by summer 2018.

Related Stories; Refugees in Nebraska: Seeking the Good Life Part 1 and Refugees in Nebraska Part 2:Vetting and Financial Resources for Resettlement

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