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A (Simulated) Mile in Someone Else’s Shoes

A (Simulated) Mile in Someone Else’s Shoes

A (Simulated) Mile in Someone Else’s Shoes

One of my favorite parts of my job at MeHAF is visiting with amazing nonprofit organizations around the state and attending community events that highlight innovative work to promote health in Maine.  One of these was the recent World Refugee Day celebration in Lewiston, which brought together hundreds of people from dozens of countries to share food, games, music, and learning.  By all measures, the day was a great success.  One activity drew my interest the moment I heard about it: the “Far from Home” Refugee Simulation.  This activity gave participants a chance to spend 45 minutes walking through a simulated refugee experience, and thinking about the kinds of challenges and decisions that come with being put in that almost unimaginably difficult situation.

My simulation began with me and about a dozen other participants invited to imagine Maine as an independent country.  We had grown up there, and had each been associated in some way with the “Dirigo Party,” which had governed Maine for decades.  After a recent coup by the opposition “Baxter Party,” members and associates of the Dirigo Party were being arrested or killed.  Many of our friends and neighbors had gone missing and everyday life was growing more chaotic and unsettling.  As the situation deteriorated, it became clear that our lives, and those of our families, were in serious danger.

Against this backdrop, we were informed of a chance to escape in a transport truck headed for New Hampshire.  The truck would arrive imminently, and we had just two minutes to choose five items we could take with us from our homes in Maine.  We had to abandon everything else to save our lives.  Over the next half hour of simulation, our group tried, and repeatedly failed, to escape our homeland.  The border crossing at York had been closed by Baxter Party forces.  An attempt to cross instead into Canada via Machias was similarly blocked.  Those of us who had money or valuables were able to purchase a spot on a boat in an attempt to reach Canada by sea, only to be turned away by Canadian officials.  Finally, after giving up our group’s remaining valuable possessions, we were able to board a second boat and reach Massachusetts.  There, we were given paperwork to complete and subjected to individual interrogation, all in a language none of us understood.

In the end, some of my fellow “refugees” were singled out for deportation back to Maine, where they no longer had homes or possessions and where their lives were in certain danger.  Others were not admitted into Massachusetts, but were told if they had the resources to make their own way to California, they might be able to claim asylum.  The rest of us were accepted into a refugee camp, where we learned the average stay is about ten years, and where adequate food, water, medical care and sanitation would likely not be commonly available.  After our ten-year stay, if we were lucky, we would complete a rigorous screening process and be resettled in a new home country.  We would not have a say in choosing that country, and chances were high that it would be one where the language spoken was different from both our native language and the one spoken in the refugee camp.

A number of things struck me as I made my way through the simulation.  The first was my complete lack of control over how the situation played out.  The refugee experience requires abandoning almost everything you’ve had and putting yourself at the mercy others.  We repeatedly had to make decisions about how to proceed, but the only real options I had were in the first few minutes, when choosing the few items to bring with me from home.  Another reality the exercise conveyed was the level of trauma involved with surviving the refugee experience.  It begins with a flight for your life, and often requires enduring violence, losing people close to you, and spending significant time without any possible way to meet basic needs for yourself and your family.

And of course, it made me think about the many impacts of that experience on a person’s health.  Whether it’s trauma, injuries from violence, the effects of malnutrition and substandard sanitation in a refugee camp, or the challenges of navigating a foreign health care system once you are resettled, there are a lot of forces working against refugees achieving and maintaining good health.  Luckily for immigrants and refugees settled in Maine, there are a number of excellent organizations working in our state to help people overcome these challenges.  Several of these groups were among the organizers of the World Refugee Day event, and they were kind enough to offer MeHAF some thoughts about immigrant and refugee health for this post, and to share some details of their work:

New Mainers Public Health Initiative (NMPHI) - Abdulkerim Said, Executive Director
New Mainers Public Health Initiative (NMPHI) is an ethnic community-based organization that focuses on educating the community about the Social Determinants of Health (SDOH) in the Lewiston-Auburn area to empower the community. The mission of NMPHI is to empower, advocate, inform, and educate immigrants, refugees, and asylum seekers about preventive health measures through the promotion of healthy habits and by developing the capacity to mobilize community partnerships in identifying and solving health problems, and also to bridge the gap in health inequity, thereby reducing racial health inequalities and identifying the social determinants of health.

Refugee Day showed how multicultural coexistence is possible for Lewiston-Auburn. Despite the weather, which was forecasted to be rainy, the community came out with support for local New Americans.  Providers as well as community members came out to show support for their new neighbors and try out new food despite the long lines and crowds. The celebration of diversity and the unity it brought for Lewiston-Auburn gives me hope that the twin cities are moving in the right direction.

Celebrating Refugee day helped bring our community one step closer to joining together to fight problems that affect native Mainers and New Mainers alike. For example, social issues such as low wages, high poverty rates, and lead-contaminated homes could be fought side by side, with Lewiston and Auburn town governments standing together with residents of all backgrounds.  In the current climate, New Mainers also need support to fight against racism and bigotry now more than ever.  We ask native Mainers to build upon World Refugee Day’s success by supporting and building relationships with their new neighbors. History will judge us harshly if we do not actively push back against hate and prejudice.

NMPHI strongly believes in using education, advocacy, and empowerment to help New Mainers reach their highest potential to live a healthy life in Lewiston-Auburn. Our weekend educational classes focus on educating the community on health issues, women’s health, developmental delay among our youth, and most of all, on the dangers of lead-contaminated homes. Discussing this issue and empowering the community with proper knowledge is one goal that NMPHI holds dear and we will continue to take the message to those who are affected most.

Immigrant Resource Center of Maine (IRCM) - Fatuma Hussein, Executive Director
The American healthcare system is complex for American born citizens let alone a foreign born individual. Needless to say that immigrants and refugees often have come from war torn countries. They have been exposed to torture, killings, rape, sexual assault, lack of healthcare, malnutrition and poor living conditions in the refugee camps. They spend many years in the refugee camps while waiting for countries such as the United States to resettle them.

Upon arrival, refugees and migrants experience significant challenges settling in Maine.  The progression of an individual in the primary refugee community is often as follows: from life in a poor war-torn country with inadequate healthcare, nutrition and other resources, to a refugee camp rife with communicable diseases, to relocation into a completely different culture.

These individuals experience sudden culture shock. They have few or no financial resources, and no working knowledge of the culture into which they have arrived.  Many social and economic factors create barriers for refugees and immigrants to access services. Service delivery staff report difficulty in addressing these issues when the staff is not familiar with the cultures of the immigrant and refugee communities, and do not recognize what specific services are needed.

Barriers such as language access, culturally sensitive health care services, lack of trained staff on the national standards for Culturally and Linguistically Appropriate Services (CLAS) often create layers of barriers and a complex system of services that discourage the immigrant and refugee community from accessing health care services. 

For the past 15 years, the Immigrant Resource Center of Maine (IRCM) has delivered health education and the CLAS standards training to support both the health care systems and the immigrant and refugee community to ensure quality culturally sensitive health care services while fostering partnerships and collaborative efforts to meet the unique health care needs of these vulnerable communities.

The national CLAS standards training has been developed and adopted from the US Health and Human Service Office of Minority Health. The CLAS standards are designed and intended to advance health equity, improve quality and help eliminate health disparities. Over the years, IRC partnered with the many health care providers across the State to provide trainings, assess gaps in services and to develop culturally specific health care services such as cultural broker services for the immigrant and refugee community.

For example, IRC partnered with the State of Maine Childhood Lead Poisoning Prevention Program to address lead poisoning in immigrant and refugee children. We held two focus groups and convened 35 community participants to talk about lead poisoning. Of course the issue was new to them and not to mention, according to the Office of Refugee Resettlement, refugee children already are at a higher risk with lead poisoning because they are coming from countries that have not banned lead in paints and therefore these children are coming with elevated lead levels. This became a big concern and was putting many children at risk. After gathering information and connecting with the various partners, we developed an educational campaign through videos, one-on-one education, cultural broker and interpreter services and much more to address the threats of lead and how our children can be safe and healthy. Although the lead poisoning issue still exists and in fact most poisoned children in the Lewiston-Auburn area are immigrant and refugee children, our education and training campaign achieved our goal. We educated the community and trained the providers on how to respond to the unique needs of our populations.

IRC utilizes unique models in bringing the community and the systems to identify an emerging need, develop a strategy to respond to the need and foster long lasting relationships to build healthy and thriving communities. Through system advocacy, culturally specific direct services, community integration & education and service provider trainings, we strive to build culturally sensitive healthcare systems and culturally & linguistically specific services. For more information on our services, training needs and contact information please visit our website at www.ircofmaine.org or contact fhussein@uswofmaine.org

Maine Immigrant & Refugee Services (MEIRS) - Rilwan Osman, Executive Director   
Since 2008, Maine Immigrant and Refugee Services (MEIRS) has been serving new arrivals to Maine, providing academic and athletic programs for youth, language and job training for adults, behavioral health assistance, and much more. MEIRS is honored to be a partner in the Communities Against Hate Initiative, funded by the Open Society Foundations this year. The Maine Communities Against Hate priority is to lessen the ongoing surge in hate incidents in Maine and to counter the negative impact these actions are having on our society. Through this public awareness campaign and direct outreach to affected individuals and communities, MEIRS is taking steps to bring about positive change. We were excited to sponsor this year’s World Refugee Day where we collected more than 600 pledges to stop bullying and hate from our state.

MEIRS provides counseling and case management to victims of hate and bullying.

By documenting hate incidents, MEIRS is providing a powerful tool to combat the committing of hate crimes and hate violence in the United States by:

  • Protecting the rights of communities that are most vulnerable;
  • Connecting victims of hate incidents to services while also protecting their privacy; and,
  • Using data collection of hate incidents as a tool for education and policy change.

To report a hate incident, access help for victims of hate, or to learn more about the Maine Communities Against Hate initiative, please visit the Maine Immigrant and Refugee Services website, email mainecommunitiesagainsthate@meirs.org, or call 207-241-8345 (English, Somali and Arabic available by phone and on our website).Your privacy will be protected.

MEIRS, with offices in Lewiston and Portland, can provide case management services and counseling to victims of hate violence. To learn more about our many services, please visit www.meirs.org.

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