Refugee and International Health Quarterly - October 2018

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Refugee and International Health Quarterly

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October 2018

Greetings from the Refugee and International Health Program

In this edition of our newsletter, we provide an update on the Minnesota Female Genital Cutting (FGC) Prevention and Outreach Project, including the statewide Working Group and the four organizations funded through the grant program. Our Community Spotlight features the Congolese community in Minnesota. We share video resources designed for Congolese and Somali refugee communities, developed by the Office of Refugee Resettlement. The Data section outlines current Minnesota refugee resettlement numbers. Check out our Refugee Health Statistics webpage to see all the updated data on refugee resettlement in our state, including arrival numbers and regions, health screening rates and information on secondary refugees. Also in this newsletter, see our recap of the Refugee Adolescent and Women’s Health Regional Training hosted by the Minnesota Center of Excellence in Refugee Health in September.

Being part of events like the Regional Training and collaborations such as the FGC Working Group keeps us energized and inspired. We are so fortunate to partner with all of you in addressing the many challenges confronting people with refugee status. We appreciate our state’s strong network of professionals and other community members dedicated to ensuring that all Minnesotans, including those with refugee status, have what they need to attain their highest possible level of health.

Progress Update: Minnesota Female Genital Cutting (FGC) Prevention and Outreach Project

Congratulations to the Minnesota FGC Prevention and Outreach grantees! MDH awarded one-time grants to four community-based organizations serving Minnesota communities impacted by FGC. The grant recipients are African Immigrants Community Services (in partnership with YIELD); East African Health Project; Planned Parenthood of Minnesota, North Dakota, and South Dakota; and WellShare International. The grantees have undertaken activities to achieve more open communication about FGC, greater awareness of the health and legal consequences associated with FGC, and stronger commitment to protecting community members from FGC. Grantees are hosting community forums and intergenerational workshops, training adult and youth peer educators, engaging faith leaders, and developing educational resources. They are reaching broad audiences through TV, radio, and social media. The grant program runs through April 2019.

The grantees have also joined the Minnesota FGC Prevention and Outreach Working Group, co-led by International Institute of Minnesota and MDH. The Working Group, comprised of stakeholders from diverse professions and communities, formed committees: Impacted Communities Engagement and Education, Legal and Law Enforcement, Health Care, and Other Professionals / Broader Community. After recruiting members with wide-ranging expertise, the committees have been gathering information via interviews, informal focus groups, and surveys. The Working Group has also benefited from connections with national and international partners, such as the U.S. Network for FGM/C Prevention, Sahiyo, and Equality Now. The group is preparing to develop recommendations for FGC prevention among Minnesota communities, which will be published in spring or summer 2019.

The Working Group invites health care providers, social service professionals, educators, and others to complete a brief survey about current practices and needs in engaging with those who have experienced or are at risk for FGC (links below). Responses will be used to inform the upcoming recommendations for FGC prevention in MN. Surveys are anonymous unless you choose to provide your contact info. We appreciate your input; thank you!

Female Genital Cutting (FGC) Questions for Health Care Professionals
Physicians, nurses, community health workers, etc.

Female Genital Cutting (FGC) Questions for Other Professionals
Child protection professionals, social workers, educators, school nurses, school counselors, community health educators, etc.

If you would like to learn more about the Minnesota FGC Prevention and Outreach Working Group and Grant Program or provide input, please contact Ann Linde.


Data: January 2017 to June 2018 Refugee Arrivals

From January 1 to December 31, 2017, 1,103 primary refugees resettled in Minnesota. Among these, 1,089 were eligible for a post-arrival Refugee Health Assessment (RHA), typically initiated within 90 days of U.S. arrival, and 1,068 (98%) received a RHA. Components of the RHA include a health history and physical examination; immunization assessment and update; screening for infectious diseases; lead screening for children under 17 years; and assessment and referral for health problems including dental, vision, and mental health. Demographics, screening rates, and health summaries for 2017 primary and secondary refugee arrivals are available on the Refugee Health Statistics webpage.

From January to June 2018, 531 primary refugees arrived to Minnesota, a decrease of 28 percent compared to the same time period in 2017. The majority of arrivals were from Burma (48 percent), Somalia (12 percent), Ethiopia (9 percent), and the Democratic Republic of the Congo (8 percent) (Figure 1).

Pie chart of primary refugee arrivals to Minnesota from January to June 2018 by country of origin

Sixty-one percent resettled in Ramsey County, 11 percent resettled in Hennepin County, and the remaining 28 percent resettled in 18 other counties across the state (Figure 2).

primary refugee arrivals to Minnesota from January to June 2018 by county of resettlement

Provider Update: Refugee Adolescent and Women’s Health Regional Training

The Minnesota Center of Excellence in Refugee Health hosted the Refugee Adolescent and Women’s Health Regional Training on September 21, 2018, in Bloomington. The Minnesota Center of Excellence in Refugee Health, supported by funding from the Centers for Disease Prevention and Control (CDC), is a collaboration between the Minnesota Department of Health Refugee Health Program, the University of Minnesota, HealthPartners, and the Philadelphia Refugee Health Collaborative. At the training event and the networking session the night before, colleagues in Minnesota and beyond had the opportunity to connect with others working in refugee health. Nearly 170 professionals from Minnesota and neighboring states attended the full-day training. Presenters and participants discussed key health issues affecting adolescents and women with refugee status, shared best clinical practices in caring for these groups, and described effective relationship-building approaches to improve health outcomes. Topics included reproductive health, healthy relationships, and female genital cutting (FGC). Presenters offered a wealth of experience from clinical and community perspectives and shared resources for ongoing use. For example, keynote speaker Dr. Crista Johnson-Agbakwu presented an overview of refugee women’s health and the experiences of her clinic and partners. She also shared the videos designed for Congolese communities highlighted in this newsletter. Events of this kind disseminate knowledge and help create networks of dedicated professionals learning from one another.

Refugee Adolescent and Women’s Health Regional Training

Community Spotlight: Congolese in Minnesota

Globally, there are nearly 750,000 people with refugee status from the Democratic Republic of the Congo (DRC), and an additional 4.5 million people are displaced within the DRC according to the UN Refugee Agency. Due to ongoing violence, a large number of refugees continue to flee to neighboring countries, such as Uganda, Tanzania and Burundi. Over the past five years, nearly 280 refugees from the DRC have resettled in Minnesota, and we expect ongoing resettlement of this population in the coming years.

Bar graph of primary refugee arriavles to Minnesota from the Democratic Republic of the Congo from 1999 to June 2018

At the September meeting of the Metro Immigrant and Refugee Health Network, members of the Congolese community in Minnesota, including staff from the Voice in the Wilderness Organization, discussed the historical background of the country, factors in the ongoing conflict and violence, and the cultural/traditional practices of the community in Minnesota.

The mission of the Voice in the Wilderness Organization is to “enhance the quality of life of Congolese refugees by providing the essential basic human services [to] achieve stability and move toward a healthy integration as they replant their lives in Minnesota and throughout the U.S.”

CDC Refugee Health Spotlight: Democratic Republic of the Congo

A series of targeted short videos on key health topics was developed for and in collaboration with the Congolese community. With the support of the Office of Refugee Resettlement, the Phoenix Congolese Community of Arizona and the Refugee Women’s Health Clinic of Maricopa Integrated Health System created the videos. The video series is narrated in Kiswahili, and English subtitles can be activated by clicking on the closed caption (CC) button in the YouTube player. The videos are free and were made with the goal of national dissemination, including use by the Cultural Orientation Resource Exchange of the International Rescue Committee.

Video Series: Getting and Staying Well for Congolese Refugees

Episodes:

  • Introduction to Healthcare in the U.S. explains the role of healthcare providers, preventive care, and health insurance.
  • Your Body Before, During, and After Pregnancy is a two-part video that describes the reproductive system, prenatal care, pregnancy, birth, and birth control methods.
  • Men Speak: Helping Women Heal is a dramatic skit with two Congolese men talking about the gender-based violence inflicted on their wives before resettlement and the path toward healing.
  • Women Speak: Finding Wellness After War is a two-part dramatic skit with Congolese women in a support group talking about the gender-based violence they have experienced and finding strength in each other. 

A user’s guide in PDF format is also available. 

Published by the Office of Refugee Resettlement, November 2015.

RIH Community Events: Summer 2018

Pictured below are Ellen Frerich and Yasmin Odowa at the first ever Karen Health Resources Fair on August 25, 2018. The event included a youth soccer tournament, women’s volleyball tournament, poetry contest, and art contest. All of these activities related to the overarching theme of health.

MDH table at Karen Health Resources Fair

Esther Mwangi and Hannah Volkman tabled at the 2nd Annual Taste of Liberia: Liberian Food & Cultural Festival held on Saturday, September 8, 2018.

MDH table at the 2018 Taste of Liberia festival