W6: Refugees and Healthcare

It is important to understand the Hmong political history to fully get why the Lee family was so strong in their medical decisions. The Hmong people were forced to fight back against the communist government by the American people during the Vietnam War. After the war ended there was still great tension among the Hmong people and Laos and the American’s did nothing to help resolve the issues that were essentially created by them. From this history one could understand why the Lee family was very skeptical of the US healthcare system and its providers.

I cannot personally relate to the Lee family because I am not a parent nor have I ever been in a situation where I had to make the executive medical decisions but my mom has. When I was a junior in high school I fell very ill with my autoimmune disease and I actually did develop sepsis. Mine was also due to a weakened immune system from medication. My mother had to make the medical decisions for me because I was a minor and I was also not in the mental state to make my own decisions. But I obviously did not suffer as badly as Lia did as I am attending college and able to live on my own without assistance.

I know under the Affordable care Act refugees are offered healthcare and government assistance for refugees but it is also mandatory that everyone has health insurance to avoid fines. I think to improve healthcare for refugees that have jjust come to the US from living in refugee camps we should take into consideration their backgrounds and religions and allow them to refuse medical attention. I also don’t think it is right that child protective services is called if a parent refuses medical care for their child. Many people say parents know what’s best for their child and I strongly believe that. Unless a child is clearly in harms way or there is evidence of child abuse CPS should stay out of the situation. Also we shouldn’t force refugees to obtain vaccinations and immunizations that they do not want or is medically necessary. My friend is actually a refugee from Zimbabwe and she has explained to me all of the shots she has had to have to stay in the US and it is unreal. I also think healthcare providers should treat the refugees as humans and be more comforting in their situation because they did just come from a very rough encounter if they are seeking refuge in another country.

“Refugee Health TA.” Refugee Health TA. 2011. Accessed August 10, 2016. http://refugeehealthta.org/access-to-care/.

4 thoughts on “W6: Refugees and Healthcare

  1. Hey Alizabeth!

    I loved the points you made! You wrote great and it was super detailed.

    In the beginning, you went into the part about the Hmong political background. I also think that it is very important to understand that aspect of the Hmong history before jumping in and judging them. Most physicians probably did not know this of the Hmong and were getting frustrated when the Hmong were skeptical. Also, they should be allowed to be skeptical. I know Americans who are skeptical, but they do not get their kids taken away. The Lee family did not give Lia her epilepsy medication. I know multiple families who do not get vaccines. I think this is practically the same thing. Lia has epilepsy and taking the medication would help her; if she did not take the medication, the only person it would effect is Lia. My family friends have 4 kids without vaccinations. If they do not take them and get sick, they could be infecting other kids with diseases we are trying to eradicate here in the United States. I do agree with you one hundred percent about the parents knowing what is best for the kids. I just do not understand why Lia was taken from her parents. I feel like that was a huge fault on the United States.

    I also agree with you when you mention that we shouldn’t be forcing foreign born immigrants or refugees into getting medical attention. They have their own beliefs and we need to learn to be more culturally aware of that and make sure that we are not infringing on their rights.

    Through this whole unit, I hope that everyone taking this class can get to the point we are at, Alizabeth, to realize that the Hmong people and other refugees are going to have their own beliefs and we need to respect that.

  2. Alizabeth,
    You brought up some great points in your paper. However, I disagree that immigrants should have a right to refuse medical attention when first being admitted to the United States. These preliminary vaccinations are for everyone’s safety, in which coming into the United States immigrants face foreign germs and also spread germs that would be foreign to other citizens. For instance, a refugee camp could have an outbreak of the flu, but when one refugee family comes to the United States, this particular strain could cause another outbreak across an entire state, or even the entire country. Because it is so genetically different than the flu strains that we deal with and monitor already, the CDC would struggle to quickly come up with a new vaccination to suppress this foreign invader, and we could see an increase in case mortality as a result. Another example would be the increased incidences of drug-resistant Tuberculosis (MDR-TB) abroad, something that is very serious. A recent outbreak in Italy caused WHO to focus on identification of MDR-TB strains to manage the spread globally (Fattorini et al). Even in the U.S., the number of foreign-born patients with TB makes up 2/3 of the cases, and most missed the opportunity for TB- prevention (Davidow et al). Because it is so difficult to treat, imagine a refugee refusing medical help and introducing it to the United States. It would be smart for the U.S. to require medical attention before entering so that these things can be caught before it’s too late. Although, I believe once admitted to the United States, immigrants can choose whether to seek further medical help or not.
    I do agree that Child Protective Services should not get involved in clinical cases unless neglect or abuse is suspected. As long as parents decline treatment and discuss their plan for alternative medicine for their child, I see no reason for the government to get involved. Although, this is hard to say as a student because as a doctor, it must be frustrating to see a child who obviously needs medicine leave the clinic and get worse over time. I suppose with my statement I would just hope that the parents would be smart enough to bring the child back in if their health did not get better, but cultural differences lead me to confliction, knowing that some cultural beliefs go against some or all of biomedical practices, just as the Hmong culture does with injections and blood transfusions.

    Fattorini, Lanfranco, Alessandro Mustazzolu, Giovanni Piccaro, Manuela Pardini, and Perla Filippini. Drug-resistant tuberculosis among foreign-born persons in Italy. 2nd ed. Vol. 40. N.p.: European Respiratory Journal, 2012. http://erj.ersjournals.com/content/40/2/497.full.

    Davidow, Amy L., Dolly Katz, Smita Ghosh, Henry Blumberg, and Ashutosh Tamhane. Preventing Infectious Pulmonary Tuberculosis Among Foreign-Born Residents of the United States. 9th ed. Vol. 105. N.p.: AJPH, 2015. http://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.2015.302662.

  3. Hey Alizabeth, I enjoyed reading your post. I thought you brought up some great points especially about child protective services and how they should stay out of situations regarding parents refusing to give their kids medical care. The parents and children should be able to make decisions for themselves without facing repercussions. America is known as the land of the free and it seems kind of ironic how much little freedom there is regarding this issue. I can relate to you in terms of being very ill at a young age and my parents making all the decisions for me. I suffered from mono and strep throat numerous times when I was younger and didn’t know how to properly treat these viruses. I am fortunate enough for my parents being able to properly figure out my medication without having any issues, unlike Lia. Parents know what is best for their children and have the most knowledge about their health issues. Dealing with refugees can be tricky but I also agree with taking into consideration their background and beliefs when it comes to illnesses. Considering all of the shots your friend had to take just to stay in the United States is unfortunate though. Good read!

  4. Hi Alizabeth,
    Personally, I disagree with certain points you made, but there are also some I agree with. Firstly, I feel that you simply stated the Hmong had an involvement in the war, followed it up with a mention that they distrust American health care, but did not do much to relate the two- which was part of this week’s writing prompt. I’m not disagreeing with your claim, I’m only saying that if I was not familiar with the story I would be a bit skeptical due to your lack of reasoning to back it up.
    I agree that refugees, or anyone, should have the right to deny medical treatment, but only under certain circumstances. For example, non-transferable diseases, such as cancer, should be treated to the digression of the patient (or their parents if they are a minor). Cancer does not medically affect the people around you. However, somebody with a disease such as Ebola, who could also transfer that disease to multitudes of people, can deny treatment only if they agree to be kept in quarantine, away from all healthy people. Although it is any human’s right to free will, it is unacceptable to put others in danger because of it. For that reason, I disagree with your perspective of vaccines. If children born in the US are given a plethora of vaccines, why should we treat people moving here from other countries any differently? To allow them to enter the country without medical exams and vaccinations is putting other people at risk. While it is true that people should be allowed to decide for themselves what treatments they receive, it is not worth catering to one individual’s religious or spiritual beliefs if that means risking the lives of an entire population. Lastly, I believe that CPS should most definitely be allowed to take a child away for medical reasons. For example, in Lia’s case, her seizures put her at risk of death. The only two options in that case are to bring a nurse into the home to administer treatment, or take the child away to be cared for. The parents don’t usually know best, in my opinion, because their decisions are based in emotion and not logic. As an example, that is why we take our children to schools rather than home-schooling.

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