Population Health Blog

Population Health Blog

Why It Matters

The pressures of refugees navigating the health system motivate Schweitzer Fellows

November 2, 2018 | Comment

By Nadeen Dakhlallah and Yusef Bazzy

The saying, “With knowledge comes power, and with power comes great responsibility,” took new meaning one cold winter afternoon volunteering for Zaman International. Amid packing and delivering food to a group of refugee clients we knocked on an apartment door on Detroit’s west side that housed five children and their mother. As the door opened it was an orchestra of deep coughing and sneezing. When we asked the mother if the young children were okay, she shared with us, in her native Arabic dialect, that the children have been sick for over two weeks and now she is starting to become ill herself. Knowing that medical services were available to her family we asked why she has not sought medical attention without hesitation. To our disbelief she responded by telling us how as a refugee she has lost trust in the medical profession and fears the American medical system due to the language and literacy barrier. Distraught by her words we asked her to elaborate and she shared an instance where she attempted to go to the emergency room for a ruptured appendix but left prior to admission, as she felt overwhelmed by the paperwork, physician questions, and lack of cultural competency.

After speaking with this mother at length we got back in the car and sat in silence. Our hearts hurt as we reflected on helpless words of this mother and the view of her innocent sick children. Although we were unaware at the time it was in this very moment that our journey to the Albert Schweitzer Fellowship began. The knowledge of this experience, both of our pursuits to become physicians, and the realization that there are thousands of additional marginalized women and children not receiving medical attention because of lack of understanding and fear of the American medical system lit a fire within us. We knew that as a brother and sister to all of mankind, let alone medical students who have taken an oath to heal humanity, we could not turn a blind eye to this situation. We felt that the knowledge of the situation and the power of our medical education have created a great responsibility for us.

As a part of the Albert Schweitzer Fellowship and working with Zaman International, we have put together Passport SAHA. Passport SAHA begins with ownership of one’s health and freedom to make life choices that can prevent chronic illness. Our philosophy is designed to keep the mother stable so her children have a fighting chance to beat the social determinants of health. We believe that owning one’s health begins with self-worth. We chose a passport concept because for many immigrants, and especially refugees, it is a symbol of movement and freedom. It is coveted and often means you leave something behind to travel to something better. It is often something carried in your purse so it becomes a portable guideline for their health, especially if going to the emergency department and visiting new health clinics.

At the half way point of our project we are proud to announce that we have successfully created and vented the health passport with clients and physicians. In doing so we have completed a soft launch and worked with 25+ clients thus far. We typically begin with a brief presentation about the benefits of the passport, a short survey and then working with tutors to overcome any language barrier we filled out the passport. We have also built a short-term collaboration with the National Kidney Foundation and Michigan State University.

In the upcoming months we have many goals set up for our project. We hope to hold educational seminars regarding ways to maintain optimal mental and physical health. We believe that this next step in our mission will add another dimension of advancement and excitement. It has been a very educational experience thus far and we are looking forward to what comes next.

Nadeen Dakhallah and Yusef Bazzy are medical students at Michigan State University College of Osteopathic Medicine and are 2018-19 Albert Schweitzer Fellows

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