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A Network for Better Care

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The IRC and University of Virginia Health System collaborate for exceptional refugee health care.

Written by Joshua Okada, Resource Development Intern at the IRC in Charlottesville

Fifteen years ago, a three-way collaboration emerged out of necessity to better meet the health needs of refugees. The Charlottesville International Rescue Committee (IRC), the Virginia Department of Health, and the University of Virginia Health System have been working hand-in-hand for improved organization and coordination of refugee clients through what is called the International Family Medicine Clinic (IFMC).

Dr. Fern Hauck, the founder of the IFMC, envisioned the Charlottesville program after noticing the cultural gaps between refugees and physicians, as well as the lack of health information on individual refugees to most efficiently provide their needed care. She met with representatives from the IRC and the health department to formulate a working solution.

“Basically we sat around talking about what the numbers were,” said Hauck. “I learned about the IRC and their programs, how many refugees were coming in at the time, what the requirements were in terms of medical care for refugees, learning the only requirement was to have a health department screening. At that time that meant screening for infectious diseases, like TB, Hepatitis, and HIV, and they would check a basic finger-stick blood count, but really didn't do much in terms of the chronic area.”

The center provides thorough screening and care for refugees with chronic diseases as some refugee camps only meet basic health care needs, leaving chronic disease untreated.  According to Hauck, refugees are often not accustomed to treating chronic diseases, perhaps lacking the experience with such diagnosis and limited exposure to Western medicine.

“...Because people do not have a lot of experience with chronic disease management in taking medication on a chronic basis, that is one of our biggest challenges: explaining to someone that you have high blood pressure and you need to take this medicine everyday even though you don't necessarily feel sick,” said Hauck.

The IFMC bridges these experiential and cultural gaps by way of training facility staff on refugee health care. To incorporate university resources, the center also encourages medical students to submit research papers on cultural implications on care, lending to a student cohort committed to refugee issues.

When Ramadan is around the corner, a message is sent throughout to clinics, doctors, and nurses as a reminder to treat patients while being aware of their different lifestyles, said Hauck.

“We have to work around [it],” said Hauck. “If I know someone is observing Ramadan, I will ask them how they are taking their medication...Or if someone is frail and if fasting would be a problem, then we have a conversation in terms of whether it’s wise from the medical standpoint for them to fast. So we have conversations about that, taking into account the patient’s beliefs as well as their preferences, but also bringing in the medical opinion. Most people are open to discussion about that.”

Navigating the U.S. healthcare system can be a challenge for many Americans.  The challenge is only exacerbated for refugees, especially for those with little to no English-speaking capabilities.  The strong partnership between the IRC and IFMC helps reduce these challenges through its ongoing care coordination and collaboration. The IRC Medical Case Manager, Erica Uhlmann, works closely with IFMC staff to help ensure healthcare services are delivered to families in an effective and efficient way.  

“I am in regular contact with the IFMC nurse care coordinator, and we work together to make sure any issues and/or concerns are addressed,” said Uhlmann. “This is especially important for our families arriving with special medical conditions. We want to ensure that they are seen by the appropriate specialist in a timely manner and a plan of care is in place for treatment.”

“My colleagues in other resettlement agencies throughout the state do not have a hospital system like UVA to work with,” said Uhlmann. “It is a  very valuable partnership because it provides our refugee families with quality health care services. We are very fortunate, and we are considered a good model for delivering refugee health care services.”