Carolyn Ream

Reflections on Community Health from a Refugee Resettlement Perspective

While interviewing my chosen staff member on the Refugee Health team at Nationalities Service Center, she painted a picture of the Afghan refugee community in Philadelphia as a diverse, often misunderstood, unjustly marginalized, yet a resilient group of individuals and families. When I asked her what she would want people who hadn’t interacted with the Afghan refugee to know, she stressed that the misconception that the community’s struggles entered once they entered the U.S. was just that - a misconception. She explained, “It’s not a handout. It’s not an easy process. These people are not just hopping on a plane and arriving and having these brand-new lives set up for them and handed to them.” The isolation of families necessitated by COVID-19 surges in the fall and winter of 2021 and 2022 was an additional challenge in the past year, and mental health concerns were of significant import to the agency and my staff member. As many clients navigated the trauma of evacuating their home country, sometimes compounded by anxiety for families who had to leave their spouses or children behind, this isolation was emotionally draining.

Despite the challenges faced by new refugees in the United States, this staff member glowed when she explained to me the support networks that grew organically within the community. These new Americans supported each other as they navigated the complex systems intended to help them, which were sometimes inaccessible for pre-literate community members, those with limited English proficiency, or those who experienced cultural barriers to navigating social systems. She talked about one specific community member who was constantly out and about with other families, showing them the ropes in their new Philadelphia community and always making a point to include Pashto-speaking women, who composed a minority of the community dominated by Dari speakers.

This staff member also described the rich and holistic view of health that many Afghan refugee clients endorse. She reflected, “Oh gosh, it’s everything… mental, physical, emotional…” and continued to describe the dire circumstances under which many clients were evacuated and housed on military bases before their eventual permanent resettlement in the United States. She concluded by saying, “I think it’s going to be a really long journey and a long road for these people to address their health needs, but our team starting with the very tangible medical needs upon their arrival was at least a good step to let them know that it is a priority.” Beyond making connections within the Philadelphia healthcare system and ensuring that all clients have access to affordable health insurance and primary care providers, the Refugee Health team encourages clients to build independence. This skill is one that many staff members lauded for not only improving clients’ quality of life but also ensuring that staff members remember that they are not clients’ saviors, a sentiment which this staff member clearly understood and took to heart.