The following is a general outline on approaching  care of a refugee or immigrant child.

Comprehensive Health Screen –In addition to a general history and physical, providers should be aware of the unique health care needs of the immigrant or refugee child. The following are examples of what a pediatrician should consider when evaluating the health of an immigrant or refugee child:

• Nutrition (under-nutrition, malnutrition, vitamin/ nutrient deficiency or obesity)
• Exposures (lead, opium, heroin, betel nut, herbal treatments)
• Infectious Diseases (endemic to country of origin)
• Mental Health (depression, anxiety, post-traumatic stress disorder)
• Cultural Practices (female genital cutting or traditional cutting)

Access- connect children with public benefits and ensure that there is proper access to healthcare while in the States.

Status– Remind parents that immigration information  shared in the healthcare setting is confidential and not associated with immigration enforcement.

If immigrant enforcement contacts you for patient information, please refer to your facility’s legal department or personal lawyer.

Advocate- Pediatricians can become involved in different types of advocacy:

• Case- asking for resources for an individual child
• Systems- ensuring care/ resources for many children
• Policy– changing policies/ laws/ regulations that will affect most of the youth

To be an effective advocate, ensure that you properly define the problem. Also, outline proposed solutions and ensure that the data or evidence supports proposed ideas. Please evaluate if any proposed change is culturally sensitive.

Princy George, MD

Sources:

Please visit American Academy of Pediatrics website for more in- depth resources- AAP Immigrant ChildCare Toolkit.

https://www.aap.org/en-us/about-the-aap/Committees-Councils-Sections/Council-on-Community-Pediatrics/Pages/Immigrant-Child-Health-Toolkit.aspx

http://www.kidsnewtocanada.ca/

http://www.pewresearch.org/fact-tank/2014/07/28/where-refugees-to-the-u-s-come-from/