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Hopes for Health in the New World; Refugees find help; gaps in food stamps coverage hurts

November 30, 2009

Monday, November 30, 2009
By Aaron Nicodemus 
(c) Telegram & Gazette

WORCESTER - Patrice Dinaye and his wife, Noela Madji, are hopeful her third pregnancy will be different. 

The couple are refugees from the Central African Republic, a landlocked country riven by war and poverty. They arrived in Worcester in September, with legal status but initially overwhelmed by a language barrier and unfamiliarity with urban, Western living. They are two of the estimated 580 to 600 refugees who are placed in Greater Worcester by the U.S. State Department every year. 

Before they came to Worcester, they lived in a refugee camp in Chad, a country on the border of the Central African Republic. 

Ms. Madji was pregnant twice in the refugee camp: Her first baby, a little girl, died at birth. Her second pregnancy ended in a miscarriage

Medical care in the refugee camp was a problem, the couple said. There was one open-air clinic to serve 1,000 people. You waited all day in line, and sometimes, you could not see a doctor or a nurse. You had to come back the next day, Mr. Dinaye said. 

"The hospital here is so much better," said Mr. Dinaye in Sangho, a language spoken in the Central African Republic. "We appreciate it very much." 

Other refugees are also hopeful about the American medical system. 

During his initial medical visit at the Family Health Center in Worcester, Iraqi refugee Kathim Saud told Dr. Christina Blejan that he has a chronic disease for which he has not been properly treated. 

Mr. Saud, who lived in Baghdad, said he regularly visited a clinic until 2006, when it was shut down. Unable to get the medication he needs to live, he asked his brother, who was living in the United States, to mail it to him. 

"I was getting my medicine that way," he said in his native Arabic. "When we left, my wife started to feel sick, and they didn't diagnose her." 

He said people in Iraq only see a doctor when they are seriously hurt or ill. 

"We go to the hospitals only when we have to," he said. 

Refugees who arrive in the United States come with a host of issues that hinder their ability to get medical care, say doctors and social workers who work with them. 

Many come from rural areas that lack basic medical care, and most would see a doctor only in an emergency. They have likely not been vaccinated against most diseases, and often have no medical records. 

In Worcester, refugees get an initial health screening at the Great Brook Valley Health Center and at the Family Health Center. 

Frances M. Anthes, executive director of the Family Health Center, said the needs of arriving refugees are great. 

"These are people who have suffered some pretty traumatic events," she said. "When they get here, they know no one. They're in an unfamiliar place, they can't speak the language. I think a lot of people are realizing that refugees are being resettled here without a lot of resources." 

Dr. Blejan said she asks refugees the basics about their health. 

"I ask them if they're sleeping, if they're eating. I try to ask them open-ended questions to see if I can get them to open up," she said. 

Refugees typically see a doctor at the Family Health Center two or three times before their state MassHealth benefits start. They can then choose a primary care doctor. 

Mr. Dinaye and his wife have been lucky. For their first month in Worcester, they struggled to be understood. They both speak Kaba, the language of their tribe, as well as Sangho, a trade language understood by all of the different tribes in the Central African Republic. Mr. Dinaye speaks French as well, and a little English. 

Noreen Johnson Smith, an administrator at Family Health Center, served in the Peace Corps in the 1980s in the Central African Republic. She happens to speak Sangho, probably one of only a handful of Sangho speakers in the state. Ms. Johnson Smith contacted Lutheran Social Services, the agency that placed the couple in the apartment, and asked to be introduced. 

She said that when she found Mr. Dinaye and Ms. Madji, they did not have enough food, so she and her husband took them to the supermarket. They took them to visit other CAR refugees in Providence. Ten people, including several children, were in an apartment without any food. 

Refugees receive emergency food stamps and qualify to receive regular food stamps. Apparently, some refugees find there is a gap between when their emergency food stamps run out and when their regular food stamps arrive. 

"I was shocked," Ms. Johnson Smith said. "We're inviting them into our country, and this is how we treat them?" 

She said she wrote President Barack Obama expressing her concern about the refugee program in the United States. 

Ms. Johnson Smith invited the couple to her home for Thanksgiving. And she has been given the honor of naming their child. 

"This child will be an American," explained Mr. Dinaye. "We want the child to have an American name." 

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