By Flora Zempleni
That’s the most important part of the health courses that are a part of the new Refugee Support Program, developed by Lutheran Family Services through collaboration with the University of Nebraska Medical Center and Southeast Community College ESL courses.
Lea Sheets, a refugee support program coordinator at Lutheran Family Services, said this program was created to supplement the cultural orientation that refugee aid organizations do, giving refugees the framework necessary to succeed in the U.S.
Refugees initially work with organizations, such as Lutheran Family Services and Catholic Social Services, for 90 days in an attempt to learn the basic cultural differences that exist in the U.S. compared to where they came from.
However, Sheets said 90 days often isn’t enough for refugees to learn all that they need about life in the U.S. So, this new program was created in an attempt to go into more depth in what the cultural orientation tries to do.
She and other caseworkers at Lutheran Family Services, a refugee resettlement organization, examined trends among the refugees with whom they worked to see where the confusion lay and where more in depth help was needed. They also looked through an old guide from the Center of Applied Linguistics to identify common issues with refugees adapting to life in the U.S. that they plan to incorporate as part of the program.
This included developing goals for their lives in the U.S. and looking at culture and cultural values.
“We value time, we value employment,” Sheets said.
But she said that health is one of the more pressing issues.
Sheets said this program is an attempt to help refugees understand this system so that any further illness can be prevented.
“We see all of these people that come in and they just don’t know how to make a doctor’s appointment,” Sheets said. “Or a doctor handed them an aftercare summary and it said ‘make an appointment with this specialist.’ Well, they never did because they can’t call, they can’t use the phone. Or maybe they thought the doctor would make them the appointment. Maybe they misunderstood.”
Sheets said that there are trends that she and co-workers have seen at Lutheran Family Services that she wants to address with this program.
“People don’t know how to make these appointments,” she said. “People don’t know the difference between an urgent care emergency doctor and a specialist.”
Sharon Baker, an instructor for the UNMC College of Nursing, said it is essential to measure what the community needs when providing these health care classes.
“What we need to do as a healthcare organization is bring education to the community where they live, and that’s thinking upstream, so that we prevent. It’s all about prevention that’s our model,” Baker said. “We have to go to where the people are. From a healthcare perspective, we can’t sit in the hospital and assume we’re going to make a difference.”
Sheets said that these health classes are an attempt to teach the framework of the healthcare system, so that even if the refugees do not learn fluent English, they know how to access care.
One week, the refugees were given a thermometer and taught how to determine when they need to go to the hospital, versus a doctor, an urgent care clinic or when to just stay at home.
Another week, they were taught about hepatitis B and tuberculosis, infectious diseases that Sheets said were important to address, which were the subject of the first course in early November.
Twelve refugees sat on olive green metal chairs that were covered in a bright orange fabric around four tables in the basement of First Presbyterian Church, located at 840 S. 17th St. in Lincoln.
The tables were arranged in a semi-circle, allowing everyone to see Beata Tabaka, a nursing student at UNMC, who stood at the front of the room.
It was silent, with most of the refugees sitting there waiting for Tabaka to begin her talk.
Around them food was laid out – mini muffins, fruit platters, coffee and tea – which was almost all untouched as the refugees were ready to give their full attention to Tabaka.
Tabaka’s lecture focused on the identification, prevention and treatment of infectious diseases, specifically tuberculosis and hepatitis B.
These are the diseases that Tabaka said are most common in refugees and immigrants, which was why she said it was important to discuss what the symptoms and treatments are.
Tabaka was careful in explaining why this was important, what symptoms were and what to do if help was needed.
She first listed off those who are most at risk for TB: people who live in overcrowded areas and apartments, those who are already sick or have weak immune systems, children, the elderly and people who use alcohol or illegal drugs.
Then she explained what a latent infection was. That if you have latent tuberculosis you still have the disease, it’s just not actively affecting people, that there are no symptoms then or possibilities of infecting others.
But she spent most of her time speaking about prevention, symptoms and treatment.
Tabaka spoke haltingly, as she paused halfway through her sentences, giving translators time to repeat what was just said.
The basement room was filled with different languages that overlapped, teaching different groups of refugees what was being said.
Tabaka mimed her words, when describing symptoms, treatment and side effects.
“You will cough,” she said explaining a symptom of tuberculosis and then coughed to show what the word meant.
The word “sneeze” was followed by a dramatic example.
Fingers became a make-believe needle when she talked about shots and vaccinations.
Although the lecture was primarily about these diseases, much time was also spent teaching refugees what to do if they needed any help.
Important phrases, such as “I need an interpreter” were reinforced, as Tabaka and Sheets emphasized what refugees need to know when feeling ill.
Medical advice flies at them.
“What you tell a doctor is confidential. They won’t tell anyone.”
“Visit a doctor regularly. It’s not too expensive, even without insurance.”
“Keep vaccination records.”
“Always ask questions, (doctors) will explain it.”
Some refugees had notebooks and wrote down the information. Others just listened.
At the end they played a game matching symptoms and treatments to either infectious disease. They split up girls against boys, rewarded with candy and mini-muffins.
Baker said that these games are not just for fun, but they also allowed she and Tabaka to see that the refugees understood what was said and had gained a better understanding of the healthcare system.
As each question was asked excited voices yelled over one another.
“No, hepatitis! Hepatitis!”
They tied 3-3, ready to come back and learn more the next week.