Addressing the Health Status of Internally Displaced and Refugee Children
By Jacqueline Lee
EXECUTIVE SUMMARY
Children constitute a significant portion of the global refugee and internally displaced (IDP) population, many of whom are now migrating to urban settings instead of traditional migrant camps. The health needs of these children are distinct from those of children in their native communities, in regard to both their physical and mental health needs. Non-profit organizations are uniquely positioned to serve this population by leveraging a family- and community-based approach to providing health care services. Following the anecdotal success of non-profit organizations such as Misión de Caridad in Mexico, there is now a need for funding to support systematic research studies of this organization’s programming for improving health outcomes in this population.
BACKGROUND
The global burden of refugee and IDP children is estimated to be over 35 million, and this population is growing at an unprecedented pace.15 Within this population, some children are living in displacement camps while others have settled in urban settings. Identifying child refugees and IDPs in urban settings and supporting their healthcare needs is a unique challenge.1 The burden of refugee and IDP children in Mexico is especially challenging, as there has been a recent increase of their migration into Mexico, and an estimated one-third of migrants are now children, half of whom traveled without their parents.2 One urban setting where this problem has become particularly obvious is San Luis Rio Colorado, a border town in the state of Sonora, Mexico.19
The health epidemic amongst refugee and IDP children is urgent and under-treated.16 The physical health concerns of refugee and IDP children include malnutrition, diarrheal disease, respiratory infections, measles, and malaria.14 In addition to these physical health concerns, there are unique mental health concerns for this population, including abandonment of community, post-traumatic stress disorder, depression, and stigma.10
RECOMMENDATIONS
Among the multifactorial approaches to serve the needs of refugee and IDP children, non-profit organizations are uniquely positioned to support the health care needs of this population.8 Non-profit organizations can support this population through family-based and community-based approaches to care.11
➔ Innovative Health Intervention: In San Luis Rio Colorado, Mexico, the healthcare epidemic of refugee and IDP children has been the primary focus of a non-profit organization, Misión de Caridad.9 One of the ways in which they employed an innovative approach is through weekly Super Saturday events. At these events, women and children from the local community of refugees and IDPs come together to participate in educational, financial, and wellness programming. These events succeeded in leveraging the family unit to support children’s health, strengthening the ties of family units by educating the women and children together, and establishing social connectivity by bringing together women and children from throughout the urban community. This weekly programming decreased the self-reported rate of health related concerns and daily soda consumption, and increased the subjective community engagement and participation. Based on the strong anecdotal and subjective reports of success of this programming, what is needed next is a systematic prospective research study of this intervention, which will provide data to support future work, to support funding applications for operations and staffing, as well as establish the potential for applying this approach in other urban refugee and IDP settings.
➔ Health Education: The health education provided to children and parents are essential and should include the importance of nutrition, clean water, mental health concerns, and preventive health services, as well as where to access these resources in their urban setting.5,13,14 By leveraging the urban health care resource such as midwives, local elders, and traditional health providers to teach refugee and IDP children and parents, non-profit organizations can share the information about protecting the health of refugee and IDP children in urban settings. There must also be consideration of the community-based approach, as well, given that many refugee and IDP children migrate alone without parents,2 and that community integration plays a critical role in the successful transition of refugees and IDPs.17
➔ Family-based approach: The family-based approach to care is important for this population because of the vulnerability and reliance of children upon their families, as well as the recognition that family is the primary social unit for refugees and IDPs.18 Building upon the strength of the family unit for this population, interventions can integrate health literacy and education into family services.6 In an urban setting, this can best be accomplished with the assistance of local support and resources such as skilled neighbors, elders, and health providers, who are already integrated into these urban communities.1
➔ Partnering with Paraprofessional and Local Personnel: This can also be accomplished through health care training of para-professional persons in migrant settings, who can then provide a connection to health services for their neighbors.3 Non-profit organizations can then expand upon this initiative by facilitating local integration and community-building to strengthen ties, which helps to facilitate the connectedness and access to resources of newly arrived migrants. Migrants are susceptible to loneliness and other mental health stressors,12 but with an established social network, they have a greater sense of connection and empowerment, which directly improves their ability to adapt in their new setting.7
CONCLUSION
The health epidemic of refugee and IDP children continues to present a challenge in urban settings, where the pace of migration is increasing. The role for non-profit organizations in addressing the health care needs of these children is critical, and can best be leveraged through a family-based and innovative health education focused approach. This approach takes advantage of the strength of the family unit in this population, and provides valuable health training in a manner that also strengthens community ties to facilitate a more successful integration. Building upon the anecdotal success of non-profit organizations such as Misión de Caridad in Mexico, there is now a need for funding to support systematic research of this methodology in order to improve the future health services in this and other migrant communities.
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Misión de Caridad (MdC) is a United States 501C3 non-profit organization, founded together by citizens in the United States and Mexico.
Our mission is to advocate, support, facilitate, and implement programs to improve the lives of women and children, refugees, migrants,internationally displaced populations living on the Mexico side of the U.S. border.
MdC has a team living and serving in the border town of San Luis Rio Colorado in Sonora.