Author: Lydia Samoff | Major: Nursing

During one of the first days of my internship I was at the Community Clinic in Fayetteville, feeling quite nervous. I was about to shadow the healthcare team for the initial appointment of a refugee family who had recently arrived in the United States. Their primary language was Kinyarwanda, a language spoken in Rwanda and several other countries. Because of this, the providers would have to rely on a remote interpreting service called Propio where an interpreter would be on a call. A lot of trust was involved. The healthcare team was trusting me (an intern they had just met), the family was trusting providers from another culture, and everyone was trusting the interpreter to be accurate with their words.

During my sophomore year, I studied abroad in Jordan and learned about the refugee context in that country, and how various NGOs (non-governmental organizations) are involved in humanitarian aid. I also got to shadow at a clinic for refugees. For my honors thesis, I wanted to find an internship here in the United States for me to study similar themes in the context of my own country. The Community Clinic here in Northwest Arkansas graciously offered to partner with me to create an internship to explore these topics. During the internship I shadowed healthcare teams in several locations as they did the initial appointment for new arrival refugee families. I also had a chance to talk to professionals from multiple disciplines and ask them their perspectives about gaps in care for these families. I talked with a nurse specializing in adult vaccines, case managers from Canopy (our local refugee resettling organization), and interns from a civil surgeon team. After these meetings I practiced writing reflective reports on what was discussed. It was interesting to hear concerns and ideas from each organization that works with these families and where there were overlaps or differences in perspectives.

Before this internship with the Community Clinic, I had little understanding of the challenges involved in refugee families’ initial appointments in the US. In addition to being treated for healthcare needs they have, the families also must do a lab draw, vaccines, and other tests, such as for parasites. When working with an interpreter, everything is twice as long, and when the interpreter is accessed through technology, it takes even longer. Other challenges included transportation timeliness and miscommunications about the pharmacy and future appointments. My experience in the clinic showed me that although it is challenging, providing good primary care for these families is still possible!

One project I worked on was creating a release of information form specifically to send refugee health information to a civil surgeon team necessary for a form called the I-693. This team works on immigration requirements for these refugee families. Community Clinic could not send this information directly to the team because of HIPAA violations, and the difficulty was that there was no form catered to what the team needed for the I-693. Hopefully the new form will allow the patients to understand what health information is being sent and where it is going, and give the civil surgeon team just the information they need.

One of my long-term goals is to work internationally with refugee communities. This internship exposed me to what primary care for refugee families looks like during the first couple of months of being in the United States. It showed me how important collaboration and communication between different organizations is and how it takes time to make a process run efficiently and smoothly.

I am grateful for Community Clinic and the way they serve our refugee community, and for their flexibility in letting me learn from them this summer!