What is the definition of a refugee?
“A refugee is any person who is outside his or her country of nationality who is unable or unwilling to return to that country because of persecution or a well-founded fear of persecution.” 
There are 59 ethnicities and nationalities represented in the state of Utah. More than 53 languages are spoken in Utah by persons of refugee status. This creates potential and existing communication barriers. To compound this matter, some refugee populations, including the Somali Bantu, did not have a written language in their respective countries. This makes telling time, reading calendars to make appointments, and dispensing health promotion literature ineffective.
Salt Lake City is one of seventeen refugee resettlement cities in the United States with an International Rescue Committee (IRC) office. All persons of refugee status arriving in Utah start with assistance from the International Rescue Committee or Catholic Community Services (CCS) of Utah; this assistance typically lasts the first six to eight months (with some exceptions). Within the first thirty days of refugee resettlement in Utah, these organizations arrange for each person to have a health screening at the Salt Lake Family Health Center. Appropriate referrals are made to specialists for the various chief complaints and abnormal findings. Each person is given a case manager for the first six months and each family is assigned a primary care provider. Medical expenses are guaranteed under Medicaid for the first eight months and may be continued depending on income and family size. Medicaid covers dental care for children less than 18 years of age and pregnant individuals, but does not cover eye care. Bus passes and other transportation accommodations may be provided for transportation to medical appointments. After the initial eight months, persons of refugee status are referred to Asian Association of Utah, Somali Community Development of Utah, Hartland Partnerships and other community organizations for services.
The Utah Department of Health primarily monitors communicable diseases within the state, which includes those individuals of refugee status. Other health issues such as chronic diseases and reproductive health are not monitored. However, significant key trends were that persons of refugee status arriving from refugee camps tended to have not just more medical needs than the general population, but also more severe medical problems. Many refugees do not seek preventive health care services, indicating reasons such as the “lack of these services in the country of origin, unfamiliarity with these services, and a cultural attitude of seeking health care for symptomatic complaints, not prevention” . This can also increase the use of emergent services.
Female Refugee Health Status in Utah
Specific information about female refugees is collected differently by the different assistance organizations. In 2006, the International Rescue Committee (IRC) reported 42 female refugees who arrived from Somalia, 36 from Mesh Turk Russia, 17 from Burma, 16 from Cuba, 8 from Sudan, 8 from Congo, 6 from Iran, 5 from Liberia, and 1 from Eritrea.
In 2005, Catholic Community Services (CCS) reported 202 female refugees from the following countries: Congo, Liberia, Ethiopia, Eritrea, Somalia, Sudan, Russia, Cuba, Iran and Iraq. In 2002, CCS reported 247 female refugees from the following countries-Congo, Liberia, Somalia, Sudan, Togo, Bosnia, Serbia, Russia, Iran, Iraq, Lebanon, Afghanistan, Pakistan, and Vietnam.
The International Rescue Committee, Catholic Community Services, Asian Association of Utah, Somali Community Development of Utah (SCDU), and Hartland Partnerships, have noted several important trends in regards to the female refugee health status in Utah: (personal communication Terena Jepson of SCDU December 4, 2006). Among African refugees, especially the Somali Bantu, many women have undergone genital circumcision in their home country as an acceptable cultural procedure. This practice can create health issues that need to be handled with cultural sensitivity and necessitate educating women about its risks. Depression and post traumatic stress disorder are noted in this population due to the stressors of fleeing a war torn country, poor conditions in refugee camps, and possible abuse. Knowledge deficits related to contemporary American practices such as general hygiene necessitate health education.
Positive efforts, like the Health Access Project and Hartland Partnerships, are being made to connect female refugees with accessible healthcare, but improvements can be made. Increased attention to issues surrounding reproductive health are needed. Increased educational outreach efforts to help refugees better comprehend organ systems and not just symptoms are also needed. Classes on nutrition and immunizations are desired to reach more mothers and or care providers.
- Center for Disease Control and Prevention. (2006, November 28). Frequently Asked Questions: Domestic Refugee Health Program FAQs. Immigrant, Refugee and Migrant Health. Retrieved December 10, 2006, from http://www.cdc.gov/ncidod/dq/refugee/faq/faq.htm
- Department of Workforce Services. (2006, November 13). An Introduction to Refugee Resettlement. Refugee Working Group. Retrieved December 10, 2006, from http://www.jobs.utah.gov/refugeeworkinggroup/meetings/refugeeresettlement.pdf
- International Rescue Committee. (2007). IRC Worldwide. Retrieved January 31, 2007, from http://www.theirc.org/where/
- National Diabetes Education Program. (2003). Focus Group Observations on Diabetes in Southeast Asians. 2003. Retrieved April 4,2007, from http://ndep.nih.gov/resources/SilentTrauma.htm