08242017Headline:

As Refugees Settle In, Health Care Becomes A Hurdle

Waktola said the International Rescue Committee recently started sending him more refugee patients, partly because he speaks Amharic and understands Tigrina, two languages spoken in Ethiopia and Eritrea. And regardless of whether they are covered under an insurance plan or not, he said he will not turn a refugee away.

“Just because you’re in a safe place doesn’t mean you’re not frightened,” Waktola said of treating refugees. “But I want them to understand their choices in this system.”

To maintain affordable care, the physician said he keeps overhead costs low. All of the tables and patient beds in the clinic were second-hand or free, and only one other staff member, a receptionist, works in the office. Waktola said he and his wife also committed to a simple life in order to serve lower income patients – she does the billing from home, and he takes a bus to work.

When refugees come to his office, Waktola said he takes at least 30 minutes with each one, and tries to understand their mental health and lifestyle along with their physical health. Sometimes, he said, they have quietly suffered a traumatic, difficult life.

For the Rais, a difficult life is both recent and easy to remember. Jaya Laxchi and Megh Bir owned a farm in the Sanchi district of Bhutan, the mountainous country landlocked between China and India, until early 1990s. With armies marching through their village and one son taken into captivity, they fled to a refugee camp in the bordering country of Nepal.

After more than a decade in the camp, the Rais heard of an opportunity to go to the United States through United Nations High Commissioner for Refugees. It was, they thought, a road to education for the children and jobs for the adults. It was also their last resort; they couldn’t return to Bhutan.

This kind of forced displacement can make refugees particularly vulnerable to mental illness, Burke said. And their treatment is further complicated by distrust in pharmacies, doctors and a system that could be very different than what they were accustomed to back home.

“We could do a lot more to understand the challenges they go through,” Burke said. “And for them to understand how our system works would go a long way.”

Waktola said that when it came to issues like mental health or preventive treatment, refugees are often less inclined to get the care they need than with acute, immediate health issues. Instead they focus on the anxiety around jobs, income and supporting their families.

To help them navigate the health system further, Waktola keeps a register of local specialists, like cardiologists and pediatricians, who offer low-cost care on a regular basis. He also calls multiple pharmacies when he is prescribing a medicine to find out which one offers the generic version with the cheapest price tag.

For Jaya Laxchi, a stable life is the only thing her family really needs — the only thing that promises good health and calm after years of movement and transition. She said her son, who takes the bus to his factory job each day, struggles to support her family while her daughter-in-law takes English classes, and her two teenage grandchildren adjust to their public schools.

Stirring white sugar into a glass of milky coffee, the quiet matriarch mulled over the family’s long journey from their village in Bhutan to their Riverdale apartment.

“Our lives have changed a lot and we are grateful,” she said. “But in a way we were forced to choose this life and say we are happy.”

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