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Tufts Public Health » Disparities, Immigration, Mental Health, Refugees, Violence » Supporting refugees: A public health perspective

Supporting refugees: A public health perspective

“Some bullets came to my house and went through the window,” said Murhaf, who fled Syria with his family two years ago and came to the United States, in an interview with Kaiser Health News (KHN). “I was afraid for the safety of my kids. They never sleep.”

Murfah and his family fled their homeland to escape war. Other people have struggled in similar situations over time, and the international community has gathered before to discuss the needs and rights of people oppressed in their homeland. Following widespread displacement of populations during the First and Second World War, the United Nations held a conference in Geneva. This 1951 Convention defines a refugee as someone who, due to “well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion,” has left his or her country and cannot or will not return “owing to such fear.”

The needs of refugees vary among different communities, according to KHN. Members of some groups have spent decades in refugee camps, where poor conditions can contribute to the spread of infectious diseases such as tuberculosis. However, people arriving recently from places like Syria and Iraq are more likely to suffer mental and physical health symptoms tied to their recent experience of trauma.

“Understanding what trends are at a community or population level helps us build more effective intervention strategies” to improve health needs, says Fernando Ona, MSW, LCSW, MPH, PhD, Assistant Professor of Public Health and Community Medicine. He works with survivors of torture at the Boston Center for Refugee Health and Human Rights (BCRHHR).

Many of his patients are affected by conditions such as post-traumatic stress disorder and anxiety, as well as symptoms such as persistent headaches and back pain. He explains that the trauma they have experienced, combined with adjusting to life in a new country, impacts facets of their lives ranging from finding housing to accessing education. The clinic helps patients navigate these hurdles, linking them to job readiness programs and food assistance as well as to social support and “community that they feel like they have lost,” he says.

Ona urges public health professionals to consider multiple avenues for improving the health of these communities. When he visits refugee camps, he works to prevent mental health issues from emerging in members of these vulnerable populations. Then, once people arrive in the U.S., he says, we must “systematically think about how we rebuild communities…and the health and wellbeing of the populations.”

Ona talks about the power of storytelling to both inform the design of interventions to help these communities and also to act as a call to action for rights-based public health work. Underlying the obstacles facing refugees are “larger challenges that seem intractable,” says Ona, questions that public health professionals must grapple with as “citizens of the world. What does a public health intervention strategy look like around war and conflict?”

For those wondering how to get involved, Ona says simply, “Start! Start with openness and without expectations….Trust yourself and trust the process, as long as you are true and honest.” Although the process is imperfect and difficult, says Ona, people learn by engaging authentically with aspects of the work that captivate them.

Organizations involved with this work include the National Consortium of Torture Treatment Programs, of which BCRHHR is a member, Physicians for Human Rights, the International Institute of New England, the Community Legal Services and Counseling Center the Lowell Community Health Center, and the Harvard Program in Refugee Trauma,. The Center for Victims of Torture maintains a virtual forum to get information, share resources and get involved nationally. For further academic reading, see Health and Human Rights in a Changing World, edited by Grodin et al. and Power, Suffering, and the Struggle for Dignity: Human Rights Frameworks for Health and Why They Matter, by Alicia Ely Yamin. There are a number of fiction and non-fiction books about the refugee experience; for example, Ona just finished Moshin Hamid’s Exit West.

by Cayla Saret, MPH Candidate ’17

Filed under: Disparities, Immigration, Mental Health, Refugees, Violence

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