Healthy Futures for Refugee Families

The Early Childhood Medical Care Coordination Program (ECMCC) is a special program run by the International Rescue Committee‘s Family and Youth Services Program that helps refugee families learn how to access and navigate healthcare services and successfully care for their children from birth to age five.

“It is hard for refugees - and even many Americans - to navigate the U.S. healthcare system on their own,” said Debbie Larimer, Clinical Care Coordinator at the IRC in Phoenix.

Recently, an enrolled mother reported to her clinical care coordinator that her four year old daughter was suffering from tooth pain. The mother wanted to have her teeth pulled out, but her clinical care coordinator encouraged the mother to see a pediatric dental specialist for another opinion; she then helped ensure that the family was able to get to the appointment. The specialist found the child suffered from very serious tooth decay and advised that root canal procedures would be the best option for the problem so as to not interfere with future developmental milestones. The mother listened and agreed to the specialist’s plan, which took three visits to complete.

“Because of the intervention of the Early Childhood Medical Care Coordination Program and the patience of the dental pediatric surgeon, the child has her teeth and has recovered beautifully without the loss of speech or eating restrictions,” Larimer said. 
“The family is very grateful to this program for making it possible as this family would have faced serious challenges maneuvering everything to have this level of care completed.”
The ECMCC program has two full-time staff members: Debbie Larimer, who has over 20 years experience in early childhood development, and Eileen MacDonald, who has a background in nursing and has worked with Doctors Without Borders. Shadie Tofigh, MPH, also works as a part-time clinical care coordinator in both the Pre and Postnatal Program and the ECMCC program. All three employees bring critical new skills sets to the Phoenix office as they support refugee health and wellness in the United States.

When clients first enroll in the program, they are interviewed by their clinical care coordinators to understand the family’s health background and health care needs of each child. The staff also looks at language competency, medical history and parents’ basic questions about wellness and child development.

The care coordinators conduct in home visits to enrolled families every other month.  At these visits, families are offered mini workshops on a variety of topics of their choosing.  Some of these topics include how to choose doctors, healthcare emergencies, nutrition, as well as a variety of child development topics.  In addition, care coordinators conduct Ages & Stages Questionnaires for each child.  The ASQ’s help identify any developmental delays a child may be experiencing in areas such as gross motor skills, fine motor skills, or personal and social development.  This enables the care coordinators to arrange for early intervention as soon as possible.

Families are enrolled in the ECMCC program for a period of six months and then evaluated at the end of the period to see if they are ready to handle their own medical appointments and feel confident navigating the U.S. healthcare system. Larimer says a client’s successful completion of the program depends on a number of factors, such as their level of formal education and English proficiency since those skills affect their ability to be independent and assimilate more smoothly into the American culture.

“The clients who have lived primarily in refugee camps for long periods of time are usually   more dependent.  Many don’t understand the concept of preventive healthcare and may not know how to prioritize healthcare needs,” she said.
Some clients are also nervous going into unfamiliar medical buildings and hospitals, trying to arrange transportation and to deal with the language and cultural barriers they may experience with some doctors. The ECMCC program strives to address those concerns and works with the clients to overcome their fears.

The IRC’s ECMCC program has had a significant impact on the lives of incoming refugees. The ECMCC Program has served 228 refugee children from July 2011 to February 2012. In addition, 162 families are currently enrolled in the program.
The ultimate goal is to increase refugees’ confidence to advocate for themselves and manage their family’s medical care independently.  The Program is funded by First Things First.

If you know of a refugee family in the Phoenix area with children in need of medical care coordination, please contact our office at (602) 433-2440 and ask for the Early Childhood Clinical Care Coordination team.