6.20.14 Issue

by Claudia Sherman

There are an estimated 25,000 refugees in Nebraska with 15,000 in Omaha alone, according to Omaha resettlement agencies and federal resettlement reports. On Saturday, June 21, hundreds of them are expected to attend a health fair from 11 a.m. to 3 p.m. at Benson High School. The health fair is part of World Refugee Day, a free event organized by the Omaha Refugee Task Force.

Established by the United Nations, World Refugee Day is observed in numerous countries every year to honor the courage, strength, and determination of women, men, and children who are forced to flee their homeland under threat of persecution, conflict, and violence.

Overseeing the health fair is the University of Nebraska Medical Center’s Inter-Professional Service Learning Academy (SLA). Ruth Margalit, MD, is the founding director of the SLA and an associate professor, College of Public Health, Health Promotion, Social and Behavioral Health, University of Nebraska Medical Center (UNMC) faculty.

In addition to UNMC’s College of Public Health, the Service Learning Academy, and Bridge to Care, other sponsors of the local World Refugee Day are Southern Sudan Community Association, Lutheran Family Services, Embrace the Nations, Omaha Together One Community, Institute of Public Life, Nebraska Department of Health and Human Services, Douglas County Health Department, Ready in Five, Alegent-Creighton Florence Clinic, One World Community Health Centers, Omaha Public Schools, and more than 250 refugee leaders and key community members.

As director of the Service Learning Academy, Dr. Margalit and a medical student created the Bridge to Care program in 2010. A partnership between health profession students, leaders from city and state refugee service organizations  and refugee leaders, Bridge to Care is a student-led organization that strives to engage with refugees, develop cultural sensitivity and provide services that address community identified needs.

“The partnerships with the resettlement organizations make this project successful,” said Dr. Margalit. The SLA facilitates four other campus-wide inter-professional community-based experiences like Bridge to Care. According to Dr. Margalit, “Bridge to Care provides opportunities for students to engage in experiences that are not otherwise available in their standard curriculum. While providing essential services, students are able to enhance cultural and communications skills and gain experience working with an inter-professional team.”

Prior to resettlement, refugees have limited access to health services and arrive with inadequate knowledge of basic hygiene practices, general health care issues, and little understanding of the American health care system. Refugees begin the process of seeking resettlement after fleeing their home countries. When arriving at the nation providing asylum or temporary residence, they face three possible endpoints, one of which is resettlement in a third country such as the United States. This process often takes more than five years while refugees live in harsh conditions.

In fiscal year 2013, there was a record high of 1,006 refugees resettled in Omaha, reported Dr. Margalit. Over the years, refugees from Sudan, Somalia, Burma, Bhutan, Nepal, Iraq, Afghanistan, Ethiopia, Liberia, Congo, and Burundi have been resettled in Nebraska. As of 2006, it’s estimated that more than 50 percent of the Sudanese population in the USA settled in Nebraska. In more recent years, the majority of resettled refugees come from camps in Thailand after fleeing Burma (Myanmar).

It’s not unusual to find individuals with complicated health issues that continue for years following resettlement. Past histories of poor nutrition, poor sanitation, exposure to on-going violence, and lack of adequate medical care all play a part in contributing to poor health.

In addition to health education sessions and focused services like flu shot clinics, Bridge to Care organizes two major health fairs/linkage-to-care events each year. The fairs offer a wide range of education opportunities including information related to proper hygiene, nutrition, immunizations, mental health and chronic disease management, and maternal and child health. Prescription and over-the-counter medication counseling are also available at the health fairs. Free preventative services are also provided.

Dr. Margalit’s husband, Eyal Margalit, MD, PhD, an ophthalmologist and retina specialist at UNMC, and six to ten other faculty members help supervise the students working at the health fair. He and another ophthalmologist will examine hundreds of refugees and help provide glasses donated during UNMC’s spring drive.

Since April 2010, more than 700 students and 4,000 refugees have worked together to address health needs. Through this engagement, students benefit from improving their communication skills, developing compassion, and enhancing cross cultural awareness. All are important skills that will impact how these future health professionals care for patients who are likely to come from various cultural backgrounds.

Funding for Bridge to Care activities comes from local and national grants, in-kind contributions, and fundraising.  “The amount of effort that goes into this project is well worth it,” explained Dr. Margalit. “Bridge to Care has formed numerous partnerships with local businesses and service providers. For example, for the second year now, when flu shots were not available from the government, Walgreens stepped up and contributed over 400 vaccines with pharmacist-volunteers. We are constantly looking for more resources and funding so we can respond appropriately to the vast needs. Cash and material contributions, resources and volunteers are much appreciated!

“The stories refugees share with us remind me again and again of the racial atrocities and persecutions the Jewish people suffered. My mother survived the Warsaw Ghetto and came to Israel on a refugee boat,” Dr. Margalit, pointed out. “Perhaps we as Jewish people have a special role in responding to populations saved from ethnic violence. Please come and see for yourself — a celebration of now free people from around the world resettled in our Omaha community.”

For volunteer opportunities, contributions, and questions, please contact Dr. Ruth Margalit at rmargalit@unmc.edu.