This week at clinic...

This week at clinic we continued to try to help Wah Htoo, the Karen father in his mid-20s whose hospital bills have increased to over $12,000 since his auto accident in late July.  We've completed an application for charity care from the hospital, and are hopeful that his case will be accepted and that we can get all of the documentation necessary in time to prevent the bills from being sent to collections.


We saw several patients this week who complained about muscle and back pain, as well as trouble sleeping. We know from research and experience that these types of complaints are often physical symptoms that manifest as a result of emotional trauma.  Refugees have experienced tremendous loss--many have lost loved ones as a result of violence, and others have experienced violence personally.  While some are happy to be in the U.S., many feel lost, alone, and depressed.  When we see patients with back pain and trouble sleeping, we try to treat not only their presenting problem, but we also try to address their underlying mental health symptoms as well.  Sometimes this is done through medication, and other times we try to do this more informally by helping them to connect with other refugees at the clinic, encouraging them to return to clinic more frequently, and engaging with them in a way that hopefully helps them know that we care.

The photo above is Kai and Alex (Karen son of Paw Wah, our volunteer medical assistant and one of our interpreters on Sundays) playing with two sons of one of the Kenyan patients we saw on Sunday.

And...We're back!

Well, we never stopped doing what we were doing, but the blog project obviously took a back seat for a while.  I've decided  that in order to keep the blog going, I'll start posting an update every week and highlight several of our Sunday clinic stories.  For the past year, we've opened Agape Clinic on Sunday afternoons from 2:30-6:30 for refugee healthcare and social services.  It's completely volunteer-led, and we try to help mostly Karen refugees (but also some refugees and immigrants from several countries in Africa).  It's a walk-in clinic, and the services provided are free, though patients are encouraged to make a donation of $20 if they're able, as this helps to partially cover the cost of medications.  Today was a "slow" day, meaning we saw 9 patients.  Last week we saw 19, and next week we may see 4.  We never know what to expect, except that there is always someone that needs help, and we try to be there to do what we can.  It's a family affair for us, and Pla Shee, Kai and Ruby are an important part of our Sunday afternoons.  Ruby and her friend Ma Ri Nar are playing in the children's play area in the clinic's waiting room in the photograph above. Note Ruby's beautiful blue dress--it is a hand woven Karen dress given to her today by her Karen PiPi (Grandmother).

Today's highlights:

Soh Lah, a 60 year old Karen man currently living in Fort Worth was walking on the sidewalk near his apartment in May when a pebble was thrown from a nearby riding lawnmower and struck him in the left eye. Because he did not have insurance and was afraid of accumulating debt from hospital bills, Soh Lah did not visit a doctor and has not received any medical care since the accident.  His visit to our clinic today was the first time he has had any medical care since his arrival to the U.S.  We are currently attempting to find an eye specialist in Fort Worth that would be willing to provide Soh Lah charity care.

Wah Htoo, a 26 year old married Karen father of two living in Dallas visited the clinic for the first time today for assistance with medical bills.  Wah Htoo was in an auto accident in July and was taken by ambulance to the hospital, where he was admitted and spent one night and now has bills from the City and the hospital totaling close to $1600.00.  We're helping him complete paperwork from his auto and health insurance companies and applying for charity care from the hospital.

Thanks for reading this and please let us know if you'd like to get involved or learn more!

WORN

The following is a promotional video for WORN, a project I'm working on as an evaluator at the University of Texas at Arlington in collaboration with Catholic Charities Diocese of Fort Worth.  The research arm of the project is focused on the idea that if we're able to promote a venue for socialization and financial opportunity for refugee women, we may see benefits related to decreased depression, isolation, and PTSD as well as greater financial independence.  Check it out!

A Refugee Garden

There is a small movement in the refugee resettlement community to encourage community gardening.  Because many refugees spent much of their lives subsistence farming, the thought is that their expertise in agriculture and gardening may assist in the transition to life in the US. There have been a good number of anecdotal stories about successful gardens in refugee communies, and a fair number of published accounts of these experiences. 

So this year we decided to tap into some of the resources that we have living out in the country to put some of these ideas to the test with a sample size of one--our friend Pu Lue.  Pu Lue is a Karen refugee and a carpenter by trade; he stays with us several days each week building custom furniture to sell and this spring, planting and managing a rather large garden.  Our neighbor, a farmer who actively farms several hundered acres, generously donated a few acres for our project and has been an invaluable resource in helping Pu Lue to understand the ins and outs of growing vegetables in the U.S.

With Pu Lue's direction, we ordered hundreds of seeds from Thailand this past winter and had them shipped here in early February.  The seeds that we ordered were vegetables and fruits grown and enjoyed by the refugees that they have been unable to locate since their arrival in the U.S.  Pu Lue is thrilled with the garden, and painstakingly waters, weeds, and cares for the plants almost daily.  He is anxiously looking forward to the harvest that he will be able to share with the refugee community in Dallas.

A new family...a new challenge

Often, we work with families that challenge us and stretch our resources thin. This is a story about one of those families.

B.D. is married with three girls, ages 13, 9 and 7. They were resettled to the US in August 2010 to the state of Rhode Island. B.D.'s brother lives in Dallas so B.D. decided to move his family to Dallas in April 2011.

Some quick side notes about refugee resettlement.

Refugee families have a choice for the country they will be resettled. Although, about 90% of refugees resettled are resettled to the US. The families do NOT, however, get a choice of where in the US they are resettled. Even though B.D. had family members living in Dallas, they were not given the choice of states therefore they ended up being resettled to Rhode Island.

Another idiosyncrasy about refugee resettlement, the federal government is not directly resettling these families. The federal government awards grants, or contracts, with local voluntary agencies (called Volags). The federal government gives a set amount of monies to the volags to provide services to the recently resettled. These volags use this money to provide resettled families with the goods and services they need until they become "financially self-sufficient." In general, "financially self-sufficient" means that members of the family are working. Practically speaking, the families receive assistance from their volags for 6 months or so.

(Editorial comment - it's clear to us that having a job and being "financially self-sufficient" are not the same. Many families of 6 or more are deemed "financially self sufficient" when one family member is working at a job paying $8/hour. Employed? Yes!! Financially self-sufficient? Not even close!!)

The volags (in Dallas - International Rescue Committee, Catholic Charities and Refugee Services of Texas) use the federal dollars to pay for rent, utilities, case management services, employment services, etc. These agencies do amazing work with the resources they are provided. In working with these agencies, it's clear that all of them would like to continue providing services, however the financial restraints prevent them from continuing to assist these families. After the family is employed, services are discontinued - the volags must move on to new families and the previous family are often at a loss for what comes next. To put it in context, if I were to move to Burma, I would need some help. Giving me 6 months of assistance is great....I plant my crops, build a house, etc. But what should I do next, when do I harvest my crops? What do I do when my child is sick?

To take it one more step, the federal dollars provided to assist these families are given to volags that provide services to the geographic location where they are resettled. This means, if you choose to move from one place to another.....you no longer have formal case management services to assist you. You are on your own, you must find your way...or find someone willing to help even though there is no financial reimbursement for the assistance provided.

Because D.B. moved from Rhode Island to Dallas, he and his family lost all formal assistance. One of the cultural liaisons we work with told us about this family and we set off to see how we could help. We found D.B. and his family living at his brother's apartment. They had already signed a lease with an apartment complex, planning to move to their new apartment in a week or two.
As I had written previously, D.B. is married with 3 girls. The oldest (13 years) and the youngest (7 years) both have a rare genetic disorder called Osteogenesis Imperfecta. In short, Osteogenesis Imperfecta is a genetic disorder causing extremely fragile bones. Both of these girls require a wheelchair to be able to move about.

Over the course of the past three weeks, these are the things we've done to help this one family:

School
We enrolled all three girls in school, which was a process that involved a total of seven visits to the schools for academic placement testing, meetings with teachers and special education services, and arranging for bus transportation.  Two of the girls are required to wear uniforms, so we purchased two sets of uniforms for each child.

Healthcare
All three children had to have additional shots to attend school in Texas, so we made two trips to the free clinic to attain the necessary vaccinations.  This involves arriving at the clinic at 7 am.  One day we waited until 12 noon to be seen; the next day it was 1:30 pm.  Because of the girls' medical condition, we contacted the genetics clinic at Children's Medical Center to enroll them in a special clinical trial so that they will receive state of the art medical care.  Their first appointments are not until August, but we were relieved that they were accepted as new patients.

Medicaid and Food Stamps
Because Medicaid and Food Stamps are state run programs, not only do new applications need to be completed and submitted here in Texas, but in order to qualify we must prove that the family is no longer receiving these benefits in Rhode Island. This, apparently, can only be done in the form of a letter from the Social Services Department in Rhode Island.  I won't even go into how difficult it is to actually talk to a live person on the phone there, much less attempt to have a letter sent to us.  Instead, we must wait two months and then apply using the family's new address, foregoing the letter requirement.  So for two months the family will rely on donations and food from friends until their Food Stamp application can be submitted.

Settling in
D.B. and his family have an empty two bedroom apartment.  We've been working with our church and others to try to find donations of furniture, housewares, clothing, and toys to help the family piece their lives back together now that they're here in Dallas.

Last week when we showed up, the apartment was full of people.  We learned that 19 additional people--three more families--had just arrived from Rhode Island and were staying with D.B. and his family until they could find apartments of their own.  They had heard, like D.B., that the cost of living was lower in Texas and that job prospects are better here.  And so our work continues...

Reading is Fun!

We partnered with Phi Kappa Phi, an honors fraternity at the University of Texas at Arlington, to promote reading among kids and adolescents in the Karen refugee community just before spring break.  Student and faculty members of Phi Kappa Phi held a book drive on campus and encouraged donations of children's books.  Then several members joined us one Saturday in March at the apartment complexes to distribute the books and read stories.  We broke up into several groups, each with a student or faculty volunteer, a Karen leader, and a cultural broker.  We had a great time and the books were very much appreciated by all of the families we spent time with that day.  Below, some photos and a video from our day of reading.

Film Screening

Thanks so much to all who came to see Moving to Mars tonight at the Unitarian Universalist Church of Oak Cliff.  It was a wonderful fim, and we were thrilled that a number of our Karen and Karenni friends were able to join us at the screening and shared a few of their songs with us.  Here are a few pics from the evening:

Introducing the Karen and Karenni

Aaron talking about our efforts at One World Outreach

Karen teenagers singing a traditional song.

Pla Shee passing out bags of popcorn.

Pu Lue taking photos of the audience :)

Kai getting into the spirit of the event.