Health and health care of African refugees: an underrecognized minority.
OBJECTIVE
The United States is home to 300000 refugees from around the world, with 69000 from 51 African countries. Refugees face significant challenges in accessing quality health care and present challenges to clinicians and medical institutions in providing care. There is limited published literature on health disparities experienced by African refugees who settle in the United States.


METHODS
The University of Virginia International Family Medicine Clinic (IFMC) was started in 2002 to serve the growing local refugee population. Residents, attending physicians, social workers, and community agencies collaboratively care for refugee patients. A database is kept with information about all patient encounters.


RESULTS
The IFMC serves 300 African patients; their mean age is 26.1 years. Countries of origin include Somalia (24%); Liberia (16%); the Democratic Republic of the Congo (15%); Sudan (7%); Togo, Kenya, and Burundi (each 6%); and others. Patients present with communicable diseases, nutrition-related diseases, and problems related to physical and emotional trauma.


CONCLUSIONS
In this paper, we: (1) describe the health screenings that African refugees receive overseas and upon entry to the United States; (2) describe the medical and psychological conditions of African refugees; (3) identify the challenges that refugees face in obtaining care and those that clinicians face in providing this care; (4) discuss the health disparities that African refugees experience; and (5) describe the IFMC as a model of collaborative, multidisciplinary care. Additional research is needed to further our understanding of the unique cultural, medical, and psychological needs of the diverse African refugee community.
Department of Family Medicine, School of Medicine, University of Virginia, PO Box 800729, Charlottesville, VA 22908 USA. frh8e@virginia.edu
Fern R
FR
Hauck
Kelly E
KE
Corr
Sarah H
SH
Lewis
M Norman
MN
Oliver
D000328:Adult; D000349:Africa; D054242:Emigrants and Immigrants / Q000523:psychology; D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D006304:Health Status; D006509:Hepatitis B / Q000453:epidemiology; D006801:Humans; D020407:Internet; D008297:Male; D017146:Models, Organizational; D011320:Primary Health Care / Q000458:organization & administration*; D012036:Refugees / Q000523:psychology; D014376:Tuberculosis / Q000453:epidemiology