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POV: Health Care Professionals Must Redouble Efforts to Care for Refugees

Amid political uncertainty, surge of PTSD symptoms reported

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At Boston Medical Center’s Immigrant and Refugee Health Clinic recently, we cared for a young woman from Eastern Africa who had been trafficked as a sex slave to Yemen before arriving in the United States as a refugee. She is now grieving for her son, whom she fears will be trapped in Yemen.

Since President Trump’s immigration executive order was issued January 27, asylum seekers fleeing persecution are experiencing an unprecedented flare-up of post-traumatic stress disorder (PTSD) symptoms ignited by the deep fear of uncertain futures, even with the travel ban now blocked by an appeals court. Some are afraid to come to the hospital for care and are even staying away from schools. Their anxiety is exacerbated by reports of recent immigration raids by US Immigration and Customs Enforcement (ICE), and political rhetoric that equates immigrants and refugees with criminals and terrorists.

Refugees, by definition, are already traumatized. Many suffer from physical injuries sustained during their arduous journey fleeing persecution. We know that about 30 percent of refugees suffer from post-traumatic stress and 30 percent from depression. Reports from Germany indicate that more than 50 percent of newly arrived refugees are experiencing serious mental health symptoms. Many are struggling with the loss of homeland, culture, and identity. They need our understanding and empathy.

As clinicians, we see the impact of the uncertainty and suffering that characterizes the experience of undocumented persons, asylum seekers, and refugees. We know the individual and societal effects of trauma are profound and reverberate through generations. We have collectively cared for thousands of refugees who have fled violence and torture in their homelands. Their injuries are compounded by marginalization in the United States The legal roller coaster of the past month has caused even more chaos, confusion, uncertainty, and fear.

The current outpouring of support in Boston is promising, but must be sustained once the dust settles over the legal wrangling. It is time for clinicians and community leaders alike to engage in thoughtful reflection and analysis on the refugee crisis and reclaim our ground as healers for those suffering. The current pandemonium cannot distract us from pursuing this goal.

Clinicians must insist that hospitals and clinics remain as safe spaces for immigrants and refugees to receive health care, without fear of having information turned over to immigration authorities or of being apprehended. Healing and rebuilding require a safe environment, which includes legal protection, stable housing, holistic health care based on trust and empathy, meaningful employment, and access to education. In the early stages of resettlement, newly arrived refugees may require intensive case management to help them acclimate to the new environment. Opportunities for cultural reciprocity, in the form of dialogue and artistic exchange with host communities, can also contribute to reducing stigma and building relationships.

We must remain focused on providing for the evolving needs of our immigrant and refugee patients in a challenging environment, and we must take individual responsibility to address our own anxiety in uncertain times. As health care professionals, we cannot be bystanders to human suffering in any form. Our moral imperative is to promote the well-being of all of our residents—no matter their place of birth or religion. That is who we are.

Sondra Crosby is a School of Medicine associate professor of internal medicine and a School of Public Health associate professor of health law, policy, and management. She can be reached at scrosby@bu.edu.

Nisha Sajnani, a Lesley University associate professor of drama therapy, coauthored this POV.

“POV” is an opinion page that provides timely commentaries from students, faculty, and staff on a variety of issues: on-campus, local, state, national, or international. Anyone interested in submitting a piece, which should be about 700 words long, should contact Rich Barlow at barlowr@bu.eduBU Today reserves the right to reject or edit submissions. The views expressed are solely those of the author and are not intended to represent the views of Boston University.

8 Comments

8 Comments on POV: Health Care Professionals Must Redouble Efforts to Care for Refugees

  • Peter on 03.07.2017 at 6:43 am

    So why wasn’t this young woman repatriated to east Africa? Im having trouble paying for my own needs and don’t have the resources to save the world. Now thousands of these “refugees” will take my benefits, FOR LIFE.

    Better to concentrate on preventing US involvement in war making and population displacement to begin with.

    Remember, think nationally, act locally.

  • Peter on 03.07.2017 at 7:01 am

    Let’s take care of the 50000 homeless vets in the US, many with ptsd, who are committing suicide at the rate of 22 a day. Yet our VA is a total fail!

    • mari on 03.07.2017 at 5:01 pm

      I agree with you Peter but lets not forget the rest of the needy US citizens who lack healthcare or any other kind of care.

      • Eric on 03.08.2017 at 1:19 pm

        Thank you for your well worded article. Just a thought: With a finite resource pool – dollars and healthcare providers – there is without a doubt a trade-off being made to support refugees and asylum seekers. Perhaps our priorities should stay focused on our homeless, our vets, our disabled and our underserved. One needs not travel far to find citizens that require help now right here at home, many with equally shocking stories of war and abuse.

  • Jen DiTomasso Jacobsen on 03.07.2017 at 10:31 am

    Thank you for doing this amazing work, and sharing it with us. I’m a BU alum.

  • we on 03.07.2017 at 12:20 pm

    Who will pay these refugees?

  • Holly on 03.07.2017 at 8:15 pm

    Many refugees are in desperate need of help when they first arrive. But refugees are NOT eternal drains on resources – they are individuals capable of making wonderful contributions to our country. They have survived situations that many people likely could not. If we welcome refugees with kindness, the vast majority of them will repay us a hundredfold.

    I have experienced this firsthand. A hardworking, compassionate young woman who recently graduated college with honors and is working for a non-profit helping folks in need as she saves for graduate school, the best bus driver I’ve ever had who has now driven more than a million miles safely and swiftly and has brightened many of my days with his empathy and humor, a daycare owner who has put dozens of special needs children on the path to future success – they all came here as refugees, but this country is lucky to have them. They have already given far, far more than they took.

  • a colleague of Prof Crosby on 03.08.2017 at 10:20 pm

    As all generalizations,
    “As health care professionals, we cannot be bystanders to human suffering in any form. Our moral imperative is to promote the well-being of all of our residents”,
    this is hazardous.
    I have visited as a professional places in Europe that were defaced to the influx of immigrants. Communities that for centuries had functioned on the “honor system”, where refugee women (yes, through no fault of their, “sex slaves”) introduced prostitution, AIDS, and drugs; the men robbing and raping the locals. I do understand that we owe help to anyone in distress, but do we not have a responsibility to protect our communities? Will we not, before performing random acts of compassion, think about policies, best practices, lobbying to foreign governments, so that we can restore the health of those communities, protect and mentor those citizens, where they were born and raised, to preserve their heritage and culture? Please, if you are so eager to help, consider joining Doctors Without Borders, bring your moral imperative to Eastern Africa, e.g., bring succor and research there, and provide safety and treatment to our wounded here. As previous comments passionately say, they need us enough.

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