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Refugee and Immigrant Health

  • Refugee and Immigrant Clinic

Refugee and Immigrant Clinic

In an effort to increase access to care among recently arrived residents to Guilford County, the Cone Health Family Medicine Refugee and Immigrant Health Clinic was established in October 2014 by Dr. Jeff Walden, a graduate of Cone Family Medicine Residency. The clinic serves a dual purpose: to provide care for newly arrived and typically underserved patients while also providing education to residents and medical students on the medical, psychological, and social needs of refugees and immigrants.

Patients

Historically, North Carolina ranks in the top 10 states for resettled refugees, and Guilford County receives a high proportion of these, between 800–1000 refugees each year. For the greater Greensboro Area, our patients have originated in countries as wide-ranging as the Democratic Republic of Congo, Sudan, Iraq, Eritrea, the Central African Republic, Southeast Asia, and Syria as well as Central and South American countries.

Refugees

Refugees

Training

Residents rotate through the Refugee and Immigrant Clinic during all three years of residency. Residents spend time in the clinic during outpatient rotations in the first year and during the Community Medicine rotation in the second and third years. Residents are also able to spend more time in this clinic during elective time. The first 30 minutes of each clinic are spent as dedicated didactic time, following an established curriculum in refugee health.

Fourth-year medical students from UNC-Chapel Hill can also rotate through this clinic as elective course GLBE 402: Refugee and Immigrant Care.

The Clinic / Services Provided

This clinic serves as an educational opportunity, with time set aside to obtain the often-complicated histories of these patients. Full interpretative services are provided, through in-person interpretation or video interpretation. We work closely with local volunteer resettlement agencies as well as the Center for New North Carolinians and New Arrivals Institute to provide care for our patients.

The clinic serves as an introduction for residents to the refugee and immigrant process. Other important goals for learning include aspects unique to the medical and psychological care of recently arrived persons. We also emphasize teaching the fundamentals of cultural competency, cross-cultural medicine, and working with interpreters.

Other Services

N-648 Clinics

  • After a brief time receiving support for case management, social services, and medical insurance, refugees are expected to become self-sufficient. Within a year after arrival, they can apply for Legal Permanent Residence (LPR – aka a “Green Card”), and after seven years can apply for citizenship. Yet many refugees suffer from medical conditions that might preclude them from meeting the language and civics requirements for citizenship.
  • A joint task force led by the UNC-Chapel Hill Physicians for Human Rights Chapter and Cone Family Medicine has worked to address disparities resulting from the inability to meet the citizenship requirements by developing an ongoing N-648 Clinic. In this clinic, students, residents, and attending physicians meet with and evaluate refugees to document any evidence of mental or physical conditions. Students conduct the examinations and complete the N-648 paperwork based on their findings alongside qualified attending physicians.
  • Based on our work, the clinic was awarded a prestigious NC Schweitzer Fellowship for 2018-2019.

Collaborations and Resources

Further Training

  • Cone Health Family Medicine and Greensboro AHEC have held annual statewide Refugee Health Forums in Greensboro, NC to meet the challenges faced by refugees as well as to help those caring for this population learn best practices, establish networks, and hear from former refugees.
  • Held generally in March of each year, the conference has hosted speakers from the Centers for Disease Control (CDC), the Office of Refugee Resettlement (ORR), Georgetown University, Duke University, the University of North Carolina–Chapel Hill, Elon Immigration Law Clinic, the University of North Carolina–Greensboro, the NC Division of Public Health, and numerous other refugee agencies from across the state and southeast.
  • The conference is geared toward those interested in providing care for refugee patients, and remains a training opportunity for physicians, nurses,
  • Look for information on Greensboro AHEC’s website.

Click here to read more about a Syrian refugee family who relocated to Greensboro.

For more information about our clinic, please contact Dr. Carina Brown at carina.brown@conehealth.com.