Refugees accurately diagnose the problem. Other problems

Refugees andimmigrants along with their children escaping from harsh conditions in othercountries come into the United States hoping their struggles will be over.  However most of the time this is far from thecase. Children of refugees and immigrants face many barriers once they reachAmerican shores especially when they need medical care.

              Childrenof immigrants are the fastest growing component of the U.S. child population,representing 24% of all U.S. children. Many citizens in Americaare not multilingual.  If the refugees orimmigrants come into the United States illegally or are not documented, theyare often afraid to seek needed services for fear that they maybedeported.  So often they will avoidreaching out for help when in fact it is so badly needed.

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  Some of the barriers they face involve languagebarriers when they attempt to schedule or make appointments for their children.  Their inability to communicate in English cannegatively impact health care in emergencies. If they can not speak English and there is no interpreter there is areal problem with the physicians understanding the medical symptoms and how toaccurately diagnose the problem.  Otherproblems include scheduling and making appointments and filling outprescriptions when there is a language barrier.

            Justlike the language barrier imposes a major obstacle to access to medical care,cultural barriers also impact every aspect of the lives of children of refugeesand immigrants who often are not familiar with preventative care.  In many cultures, medical care is only soughtif someone is sick but not to prevent sickness. Also, it is rare in other cultures to seek medical care for mentalhealth issues where often a stigma is attached. There is often a real lack of understanding about mental healthconditions.

    Before a child is born toan expecting mother of a refugee faces cultural barriers that greatly impactsher use of Western medicine.  Manyexpecting mothers are very afraid of c-section deliveries of babies and manytimes are frustrated with the fast pace in the delivery of babies in modern U.S. hospitals.  Many refugees and their children are afraidof hospitals.  Another problem with thecultural barriers is understanding side effects.  If a family can fill a medical prescriptionthey often do not understand side effects of prescriptions and they will juststop taking the medicines.  Refugees attimes have different medical explanations for their medical condition.

  In some cultures, it is believed that thebody does not remake blood cells and has a limited amount of blood in the bodyso they would rather go see a healer than go to a hospital.            Anotherreal problem for refugee and immigrants is having incorrect interpreters withtranslational services.  Manyinterpreters have not had proper training in language interpretation.

  If the translator has not had proper trainingit can cause a real danger for the doctor and patient trying to make adiagnosis and can make compliance more confusing and difficult.  Often there is great stress in refugees inthe translation services.  Many timeschildren are required to serve as interpreters for their own families. This canbe detrimental to everyone involved. Often children do not have an advanced vocabulary or understanding or maturityto serve as a helpful translator.  Thisputs children in a position of great responsibility and stress.  Sometimes, this tremendous amount of stressplaced on children in a family can lead to power battles within a family and itcan lead to loss of the authority of a parent figure.

  When a translator or interpreter is welltrained in the language of the refugee or immigrant family it makes communicationsbetween them and healthcare providers much easier especially when there is acultural connection.  One of the simplethings people can do when they want to help refugees or immigrants and theirfamilies is to start a conversation with them and have an appreciation of whatthey have been through to come to the United States.  So many times, they feel invisible and feellike outsiders in a foreign country.

 Many times children of refugees or immigrants are placed in school bytheir age not for their ability to learn in a new school system.  For children who are unable to speak Englishit is a real struggle to keep up with school. When the parents also can not speak English it is hard for them to helptheir children or to be able to ask for help at the school for their kids.  Refugee parents often see their childrenstruggling in school, and see bullying and discrimination as a result ofcultural differences.

            Oneof the issues that affects access for children to medical care and to manyother areas of their lives is trouble finding transportation.  If the parent of refugee or immigrant childgoes to get a driver’s license they can run into a number of problems.  If they do not speak English, they need atranslator to help and they can be hard to find at times.  The person seeking to get the license has tobe able to speak English to pass the written exam and this can be a majorobstacle when they are not familiar with the English language.  If a family can share their car with them, itcan be a real challenge getting children to school and getting their parents towork.  If the father drives the car tohis job to provide for the family, it is up to the women and mothers to gettransportation for themselves and the children who need to go to the school andto the store to buy groceries for their families.  To get to a medical appointment is that evengreater a challenge with no transportation.

 In large cities there is public transportation but to some refugees andimmigrants it can be a real scary experience. If someone is unable to speak English, they are not able to read streetsigns such as crossing a street or stopping at a light.  Even understanding the names of roads orstreets is a hardship and when someone can’t speak English to ask for help makestransportation a real difficulty.  Forthe adults and parents of refugee children and immigrants there are ESL classessuch as English as a Second Language but again getting to these classes withtransportation problems is a real stumbling block to learning English and if aparent works and has to have the car the other parent is not able to get tothese classes.  These classes can help afamily a great deal with taking care of their children’s medical needs andcommunication with healthcare providers when they can learn English and learnit better.            Otherstructural barriers facing medical care to children of refugees and immigrantsis fear of being deported.

  Many times afamily really is in need to seek help medically or legally but is truly afraidif they are undocumented immigrants. Sometimes the traumatic events in their lives that they have personallyseen and witnessed really justifies them seeing a doctor and getting medicalattention but they just do not know how to get help. In some foreign culturesmental health cases are looked at as taboo in other nations and that can createanother obstacle to getting medical care. The logistics of getting to a phone or trying to make an appointmentwith a doctor and to get to a pharmacy to pick up a medicine can be truechallenges.  That is if they are luckyenough to have been able to get to a doctor and be accurately diagnosed gettingpast this third barrier getting to a pharmacy to pick up the medicine has to beovercome. Having the money to pay for the medical exam and to pay for themedicine prescribed is the hardest obstacle. For this reason, many children of refugees and immigrants can only beseen in a local emergency room in a hospital and will need the emergency roomstaff to fill their prescriptions even for small health problems.

            Thereare many ways Americans can reach out and help these families andchildren.  So many of them are verystrong people and are very grateful just be living in the United States.  Many time what they dream of for theirfamilies are very basic dreams.  Just toprovide their children with education and to have a place to live with a roofover their head.

  All of this in aculture to them may seem so foreign. When Americans can help these families inany way it really can make a big difference in the lives of these children andtheir families.  Extending a helping handto care or a friendship can make a big difference in this world.


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