Aniyizhai Annamalai. Editor. Refugee Health Care. An Essential Medical Guide

Transcription

1 Refugee Health Care

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3 Aniyizhai Annamalai Editor Refugee Health Care An Essential Medical Guide

4 Editor Aniyizhai Annamalai, M.D. Yale University School of Medicine New Haven, CT, USA ISBN ISBN (ebook) DOI / Springer New York Heidelberg Dordrecht London Library of Congress Control Number: Springer Science+Business Media New York 2014 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifically for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher s location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (

5 For my mother, Nageswari Annamalai, for her absolute support at every step in my journey as a doctor.

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7 Preface The field of refugee health has grown tremendously in recent years. Refugees are a heterogeneous group as they originate from different parts of the world and each refugee s path to resettlement is different. Consequently, risk factors for illness are not uniform among all refugee populations. However, there are some unifying features. Refugees come from parts of the world where illness demographics are often different from those of the countries they resettle in. Certain infectious diseases and nutritional deficiencies are more common in some countries of origin. Some refugee populations have a cardiovascular risk profile comparable to that of the Western world. Chronic pain and other physical symptoms are prevalent in many refugees. By definition, they have all experienced some form of persecution, and psychiatric illness is often a significant part of their presentation. Social factors including access to health care greatly impact the level of preventive care refugees have received. Finally, refugees are a diversely multicultural group, and provision of culturally sensitive health care is of paramount importance. This book provides an overview of refugee health. There is greater emphasis on health issues relevant at screening and in the first few months of resettlement. Within refugee health, screening is the area with the most evidence-based information. Clinical issues such as aging and end-of-life care in refugees are less well studied and are not addressed in this book. Infectious diseases prevalent in other parts of the world but rarely encountered in existing refugee populations are not discussed. Chronic disease in refugees is a developing area, and clinical management of chronic physical and mental illness is discussed. Given the high burden of mental health problems and its impact on self-sufficiency and successful acculturation, there is an entire section devoted to discussion of mental illness in refugees. Recommendations for behavioral health screening in primary care settings are provided. While integrated physical and mental health care is optimal for refugees, there is no single health care delivery model, and a detailed discussion of different models is beyond the scope of this book. vii

8 viii Preface Many health care providers encounter refugees in their practice, and there is an increasing need for them to familiarize themselves with health issues specific to refugees. Primary care practitioners are usually the first point of contact for refugees within the US health care system when they are seen for a screening medical examination soon after arrival in the country. The book is intended as a reference for these primary care practitioners as well as mental health providers who care for refugees. As in many areas of medicine, knowledge base is expanding rapidly and recommendations are constantly updated. Top experts in the field have gathered together the latest evidence-based information and presented it in a concise and clinically useful format. Academic institutions have begun to include topics on refugee health in their curriculum as trainees are frequently called upon to provide care for refugees. This book will be a useful reference for this curriculum. Refugee health is also part of global health, and this book will be useful in global health curricula for medical and public health students. Refugees are a uniquely vulnerable population. With appropriate support, many refugees can and do succeed in their new society. Providing appropriate physical and mental health care can go a long way in helping refugees in their journey to a healthy and productive life. Many providers want to care for refugees but lack the necessary knowledge and resources. My hope is that this book will be useful to fill this gap. New Haven, CT, USA Aniyizhai Annamalai

9 Acknowledgements I want to thank Springer Science+Business Media for inviting me to write this timely and much needed book. I am very grateful to all the contributors who are experts in the field of refugee health and have been willing and gracious in helping bring this book together. I thank them and the community of refugee health care providers from whom I have learned much. I sincerely appreciate all the hard work of the Yale resident volunteers without whom we could not serve refugees in our community. Finally, I thank my family my father and sister for their support and encouragement and my husband for comfort and a hot meal whenever I returned late from refugee clinic. ix

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11 Contents Part I Introduction and Overview 1 Introduction to Refugees... 3 Kelly Hebrank 2 Culturally Appropriate Care Aniyizhai Annamalai 3 Overview of Domestic Screening Aniyizhai Annamalai and Paul L. Geltman Part II Primary Care 4 Immunizations and Refugees Erika Schumacher 5 Tuberculosis Andrew T. Boyd 6 Intestinal Parasites James Wallace, Anne E.P. Frosch and William Stauffer 7 Viral Hepatitis Douglas J. Pryce and Asha M.J. Madhar 8 Malaria Kristina Krohn and William Stauffer 9 HIV and Other Sexually Transmitted Infections: Testing and Treatment Considerations for Refugees Sachin Jain and Jennifer Adelson-Mitty 10 Chronic Disease Management in Refugees Peter Cronkright and Astha K. Ramaiya xi

12 xii Contents Part III Mental Health 11 Risk Factors and Prevalence of Mental Illness in Refugees Paula Zimbrean 12 Mental Health Screening Susan Heffner Rhema, Amber Gray, Sasha Verbillis-Kolp, Beth Farmer, and Michael Hollifield 13 Treatment of Mental Illness Aniyizhai Annamalai and Maya Prabhu 14 Torture and Refugees Mara Rabin and Cynthia Willard Part IV Special Groups 15 Refugee Women s Health Geetha Fink, Tara Helm, Kaya Belknap, and Crista E. Johnson-Agbakwu 16 Health Issues in Refugee Children Sural Shah, Meera Siddharth, and Katherine Yun 17 Medical Evaluation of Asylum Seekers Katherine C. McKenzie Index

13 Contributors Jennifer Adelson-Mitty, M.D., M.P.H. Department of Infectious Diseases, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA Aniyizhai Annamalai, M.D. Yale University School of Medicine, New Haven, CT, USA Kaya Belknap College of Medicine - Phoenix, University of Arizona, Phoenix, AZ, USA Andrew T. Boyd, M.D. Médecins Sans Frontières, New York, NY, USA Yale Internal Medicine Residency, New Haven, CT, USA Peter Cronkright, M.D. Department of Medicine, Upstate Medical University, Syracuse, NY, USA Beth Farmer, M.S.W. International Counseling and Community Services Program, Lutheran Community Services Northwest, SeaTac, WA, USA Geetha Fink, M.D., M.P.H. Obstetrics and Gynecology, Phoenix Integrated Residency in Obstetrics and Gynecology, Phoenix, AZ, USA Paul L. Geltman, M.D., M.P.H. Department of Pediatrics, Cambridge Health Alliance and Harvard Medical School, Cambridge, MA, USA Refugee and Immigrant Health Program, Massachusetts Department of Public Health, Jamaica Plain, MA, USA Amber Gray, M.P.H., M.A. New Mexico Department of Health, Santa Fe, NM, USA Kelly Hebrank, B.A. IRIS Integrated Refugee & Immigrant Services, New Haven, CT, USA Tara Helm, M.P.H., B.S.N. Family Nurse Practitioner Program, Frontier Nursing University, Hyden, KY, USA xiii

14 xiv Contributors Michael Hollifield, M.D. Program for Traumatic Stress, VA Long Beach, Long Beach, CA, USA Pacific Institute for Research and Evaluation, Albuquerque, NM, USA Sachin Jain, M.D., M.P.H. Department of Infectious Diseases, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA Crista E. Johnson-Agbakwu, M.D., M.Sc., F.A.C.O.G. Obstetrics & Gynecology, Maricopa Integrated Health System, Phoenix, AZ, USA Kristina Krohn, M.D. Department of Internal Medicine and Pediatrics, University of Minnesota, Minneapolis, MN, USA Asha M.J. Madhar, M.D. General Internal Medicine, Hennepin Country Medical Center, University of Minnesota, Minneapolis, MN, USA Katherine C. McKenzie, M.D. Department of Medicine, Yale School of Medicine, New Haven, CT, USA Anne E.P. Frosch, M.D., M.P.H. Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN, USA Maya Prabhu, M.D., L.L.B. Law and Psychiatry Division, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA Douglas J. Pryce, M.D. General Internal Medicine, Hennepin Country Medical Center, University of Minnesota, Minneapolis, MN, USA Mara Rabin, M.D. Utah Health and Human Rights, Salt Lake City, UT, USA Astha K. Ramaiya, M.Sc. Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, NY, USA Susan Heffner Rhema, L.C.S.W., A.B.D. Kent School, University of Louisville, Louisville, KY, USA Erika Schumacher, M.D., F.A.A.P. Pediatrics, Yale University, New Haven, CT, USA Sural Shah, M.D. Internal Medicine and Pediatrics, Children s Hospital of Philadelphia, Hospital of the University of Pennsylvania, Philadelphia, PA, USA Meera Siddharth, M.D., F.A.A.P. Primary Care, Karabots Primary Care Centre, Children s Hospital of Philadelphia, Philadelphia, PA, USA William Stauffer, M.D., M.S.P.H., CTropMed, F.A.S.T.M.H. Division of Infectious Diseases and International Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN, USA Sasha Verbillis-Kolp, M.S.W. Lutheran Community Services Northwest, Portland, OR, USA

15 Contributors xv James Wallace, M.D., M.S.P.H. Department of Medicine, University of Minnesota Medical Center, Minneapolis, MN, USA Cynthia Willard, M.D., M.P.H. Department of Community and Family Medicine, Keck School of Medicine, Chapcare Health Center, University of Southern California, Pasadena, CA, USA Katherine Yun, M.D. Pediatrics, Perelman School of Medicine & The Children s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA Paula Zimbrean, M.D. Department of Psychiatry, Yale University, New Haven, CT, USA