REFUGEES AND THE MYTH OF THE PROMISE LAND

Nassrine Noureddine Ed.D., MSN, RN

Assistance Professor,

California State University, Sacramento

UNHCR

Global

Glance

2015

Figures

at a

Glance

CA REFUGEES ARRIVAL DATA

https://www.acf.hhs.gov/orr/resource/refugee-arrival-data

Year

Refugees

SIVs

2008

9,480

128

2009

11278

386

2010

8577

262

2011

4,975

105

2012

5,173

384

2013

6,383

307

2014

6,108

2,455

2015

5,718

N/A

Total

57,764

4027

Afghanis

tan 44 49 70 103 105 119 162 215 867

Iran 4,380 4,239 122 1,151 745 1,403 1,668 1,852 15,560

Iraq 2,924 4837 1110 2,292 2,912 3,691 3,049 1,715 18,194

Syria 0 8 11 8 8 3 32 182 252

COST OF DESTRUCTION IN SYRIA $250 BILLION THE SYRIAN ECONOMIC FORUM DEC. 2015

http://www.syrianef.org/En/2015/12/an-official-in-the-syrian-regime-the-estimated-cost-of-destruction-in-syria-is-250-billion

Displaced In Neighboring Countries Around 5 Million

Internally Displaced

6.3 Million

A group of Syrian refugees arrive on the Island of Lesbo.s alter rravelllng In an tnnatabte raft from Turkey, near Skala Syl<amlnlas, Greece. t5July. 2015. PhO!o: C>UNHCR/Andrew McConnell

SAHA HEALTH CENTER (SHC) BACK GROUND

The mission of SHC is to provide free high quality and culturally competent primary health care services to underserved individuals with the least access to health care.

Diverse patient population over 50% are refugees and asylees

Main health issues encountered are:

1. Diabetes

2. Hypertension

3. Cancer

4. Mental Health issues

SERVICES PROVIDED AT SHC

Culturally and linguistically competent free primary health care for over 400 patients (1028) encounters.

Discounted labs and imaging

Free flu shots

Affordable prescriptions

Health education

Referral to specialty services and women’s health

Help with signing up for Covered California ACA

Help with applying to social services when needed

OTHER SOCIAL SERVICES WE PROVIDE

• Mentoring for refugees to meet their needs to adjust to the new culture and provide assistance with the following:

o Financial aid, college and university applications

o Filing taxes

o Employment applications

• Youth educational and mentoring program

oStarted a Arabic language Sunday school in Sep. 2014

oWorking on a community youth scouts program and soccer team

REFUGEES POST- RESETTLEMENT CHALLENGES

1. Learn new language, a potentially new work skills

2. Adjust to a new culture

3. Navigate a new system while taking care of family

4. Deal with unemployment, underemployment & exploitation

5. De-professionalization

6. Loss of resources, assets, ending up in poverty & on well fair

7. Receive health care that is most of the time lacking cultural and linguistic competence

8. Live in poor housing conditions especially with big families

MORE PROBLEMS FOR REFUGEES & ASYLEES

9. Loss of social support

10. Need for day care

11. Lack of transportation means

12. Unable to effectively communicate with teachers and school due to language barriers

13. Lack of effective linguistically competent interpreting services

14. Deal with an inequitable legal system

15. Deal with the lately increasing Islamophobia and anti –refugee sentiment

16. Living in constant fear….

WITH THE NEW EXECUTIVE ORDERS REFUGEES ARE LIVING IN CONSTANT FEAR

1. Deportation especially for none-citizen (refugees and asylees)

2. Inability to unite/visit with family members outside the US

3. Persecution and discrimination

4. Personal safety, hate crimes and attacks on worship places

5. Practicing their religion (harassing girls and women adhering to the Islamic dress code)

6. Bullying of kids at schools

7. Find jobs or maintain their current jobs if they have one

8. Loss of access to health care

These are just some of the issues and not all the issues.

THE HEALTH CARE SYSTEM IS THE MOST AFFECTED BY THE NEW IMMIGRATION POLICY

Health Care

System

Poverty & Hunger

Immigration & Stress

Homelessness

Advocacy for needed

policy

change

Unresolved

Social

Problems

HOW CAN YOU HELP?

• Create and support a universal health plan policy

• Advocate for refugees’ equal opportunity employment and fight exploitation

• Advocate for policies to help providing culturally and linguistically health care professionals

• Equal housing opportunity

• Eliminate inequitable legal practices

• Change the negative stereotype on refugees

• Get advantage of refugees as an educated workforce

For example: CA has close to 150 internationally prepared refugee physicians

STATISTICS FOR ACADEMIC YEARS 2012-2013 THROUGH 2016-2017 AVERAGE STUDENT TUITION, INSURANCE AND FEES

Type of Institution Public

Resident

Public

Nonresident

Private

Average Cost per

Year

$34,592 $54,078 $50,078

Average Total

coast of the

program

$138,368 $278,455

$207,866

https://www.aamc.org/data/tuitionandstudentfees/

ANALYSIS: WORKING IN SILOS

1. Fragmented ineffective services at all levels: Social, educational, medical etc.

2. Lack of communication among all stakeholders:

• Resettlement agencies

• Agencies providing social services

• The school system

• The health care system

• Local communities

3. Lack of cultural competence at all levels

4. Cultural dissonance

WE NEED DEFRAGMENTATION OF EFFORTS

• Get all stake holders together

• Consolidate efforts

• Consolidate funding

• Consolidate resources

A MESSAGE TO THE WORLD FROM REFUGEES….

20

Immigration Panel Important Hyperlinks – Nassrine Noureddine

Refugees Arrival Data

https://www.acf.hhs.gov/orr/resource/refugee-arrival-data

Sacramento County Refugee Arrival Data

http://www.cdss.ca.gov/refugeeprogram/PG1537.htm

Murder Rates, Immigrants, & the Anti-facts behind Presidential Policy Pronouncements

If+you+repeat+a+lie+often+enough,+loudly+enough,+and+long+after+it+has+been+publicly+d

ebunked,+does+it+become+a+good+basis+for+public+policy?

https://nonprofitquarterly.org/2017/02/08/murder-rates-immigrants-anti-facts-behind-

presidential-policy-pronouncements/

EXECUTIVE ORDER 13769: PROTECTING THE NATION FROM FOREIGN

TERRORIST ENTRY INTO THE UNITED STATES

January 27th

, 2017

https://www.whitehouse.gov/the-press-office/2017/01/27/executive-order-protecting-nation-

foreign-terrorist-entry-united-states

Executive Order 13780: Protecting The Nation From Foreign Terrorist Entry Into The

United States

March 06, 2017

https://www.whitehouse.gov/the-press-office/2017/03/06/executive-order-protecting-nation-

foreign-terrorist-entry-united-states

Homeland Security Fact Sheet

https://www.dhs.gov/news/2017/01/29/protecting-nation-foreign-terrorist-entry-united-states

Physicians reject House ACA replacement bill

Andrew W. Gurman, MD

President, American Medical Association

Mar 08, 2017

https://wire.ama-assn.org/ama-news/physicians-reject-house-aca-replacement-bill

The fierce urgency of addressing language, literacy care barriers

Kevin B. O'Reilly

Editor

AMA Wire

Mar 07, 2017

https://wire.ama-assn.org/delivering-care/fierce-urgency-addressing-language-literacy-care-

barriers

UNHCR underscores humanitarian imperative for refugees as new U.S. rules announced

6 Mach 2017

http://www.unhcr.org/en-us/news/press/2017/3/58bdd37e4/unhcr-underscores-humanitarian-

imperative-refugees-new-rules-announced.html

American Medical Association

The cost of Medical School

https://www.aamc.org/data/tuitionandstudentfees/