Refugees require medical care when arriving in CT from abroad. UConn Immigrant Health has seen over 1,000 patients and counting.

When refugees arrive in the Hartford area, one of their first stops is UConn Immigrant Health.

Indeed, each refugee must undergo a health assessment within 30 days of arrival. UConn Immigrant Health, led by Dr. Susan Levine, saw more than 1,000 refugees from more than 40 countries for this assessment, as well as follow-up care.

“I’m someone with a very long interest in global health and I regularly work overseas,” said Levine, director of the program she started in 2017. The program has three components: care clinics, training of residents and medical students. and advocacy for refugees and immigrants, she said.

“The clinical care element provides newly arrived refugee health assessments, which are really a kind of specific set of CDC-guided screenings that must take place for any refugee in the United States within 30 days of his arrival,” Levine said.

“A lot of times the resettlement agency contacts me directly to say, hey, we have this family from wherever they came to the United States two weeks ago. They need a checkup in a week’s time” , she said.

The guidelines call for identifying significant diseases that could threaten public health and updating vaccinations. “Often people can migrate over the years through a variety of camps, and they may have little or no record of the vaccines they’ve had before. So there’s a lot of catching up to do,” Levine said. .

However, many refugees will stay with Levine as a primary care physician, she said, and they undergo further testing to find out if they need treatment for an illness such as hepatitis B. The result is a thriving refugee community in Farmington, where UConn Health is located, Levine said.

“I’m actually interned in tropical medicine, knowing what diseases are endemic where they come from,” she said. “And could this migration story have anything to do with current health risks? So it’s part of medical care.

John Dempsey Hospital residents and UConn School of Medicine students receive training in refugee treatment through UConn Immigrant Health.

“Medical students are exposed to refugee and immigrant health and they learn how migration affects a person’s health care, how important it is to think about where you were born and where you lived “, said Levine.

There is a six-month elective course in medical school that focuses on the subject. Among the diseases studied by the students are leishmaniasis, a parasitic skin disease found in Afghanistan, and latent tuberculosis. People from the Middle East can get thalassemia, an inherited blood disorder.

“These patients are fascinating because they can have two, three, or four different infections at the same time,” Levine said. “So you kind of have to know when to look a little deeper when you have symptoms that just aren’t fully explained by the data you have so far.”

Many refugees have not received the human papillomavirus vaccine which prevents cervical cancer, for example. A Pap smear or mammogram may be given to an older woman because she has never had one, although Pap smears are not given to older women in the United States.

The advocacy portion of the program is for asylum seekers, who do not have the same rights as other refugees until their asylum status is granted, Levine said.

“If an immigrant is applying for asylum, it’s a lot harder to get through than getting a refugee visa,” she said. “In either case, you must show that you have a well-founded fear of persecution on very specific grounds, either race, religion, ethnic origin or membership in a particular social or political group.”

For refugees, it’s “nailed down before anyone sets foot on American soil,” she said, so they’ll have federal health benefits and other rights upon arrival.

“But if someone is applying for asylum, they don’t have access to any of those things,” Levine said. “They still have to prove that they were persecuted on the same grounds, but they end up going to immigration court and then…it may take a few years to get your court date and in the meantime, they don’t. have access to health care and all those other benefits.

Asylum seekers must go to federally licensed health clinics or a hospital emergency department to receive their care, Levine said.

While students administer the asylum program, act as scribes during asylum interviews and write medical affidavits, specially trained professors consult with immigration attorneys, which greatly improves refugees’ chances of obtaining asylum, Levine said. Having a doctor consulting the lawyer improves the odds by 30% to nearly 90%, she said.

“We’re partnered with something called Physicians for Human Rights, which is a big international organization that has trained doctors on how to provide forensic evidence,” Levine said. “So the assistants who work with me do training with PHR as for students.” UConn is one of 19 medical schools nationwide that has a PHR-sanctioned asylum clinic.

Nargis Safi from East Hartford arrived in the United States with her family on November 18, 2021, along with her husband, Waheedullah, who worked with the United States military in Afghanistan, and their three children, ages 1, 3, and 6. (the youngest was 1 month when they arrived).

She said she appreciates what UConn Immigrant Health has done for her family. “When we come here, the doctors help us a lot. They do our vaccinations” and other exams, she says. A dentist performed an oral exam and removed two of her daughter’s teeth, Safi said.

Waheedullah Safi was working at the US Embassy when the Taliban arrived in Kabul. A teacher in Afghanistan, Nargis Safi works part-time at the Hockanum Early Childhood Learning Centre, replacing teachers at lunchtime.

Ed Stannard can be reached at estannard@courant.com.