PHILADELPHIA — When refugees from Afghanistan arrive at Philadelphia International Airport, some of the first people they meet are the doctors and nurses staffing long lines of triage stations, prepared to care for people who’ve been in transit for days or weeks, and perhaps suffering trauma for even longer.
The all-hands-on-deck effort — staffed by health care workers from around the region — is a mark of how crucial health care is for the new arrivals. Many left quickly, with no time to bring vaccination or health care records or to get the medical checkups normally required before leaving for the United States. Some have suffered the physical and emotional trauma of struggling to get to airports blocked by weapons-wielding Taliban and once there, waiting days to get a flight.
When they land in Philadelphia, new arrivals are tested for illnesses including COVID-19 — most are negative, and many accept the offer of vaccination, said Rohit Gulati, Einstein Health System’s chief medical officer, who’s been working shifts at the airport. Those who have tested positive are isolating. Marc Altshuler, the director of Jefferson University Hospital’s Center for Refugee Health, said doctors are being asked to vaccinate patients for measles at their first checkups after the CDC identified a few isolated cases; those exposed were also quarantined.
Rather than subject them to the ordeal of an emergency room visit, health workers try to treat acute medical needs on the spot, anything from gastroenteritis after days of traveling to colds caught on long flights in frigid military planes.
“There’s not a lot that can be done in the airport terminal, but it’s nice if we can spare people from going to emergency rooms,” said Jessica Deffler, a Jefferson University Hospital physician and the medical director at the Hansjörg Wyss Wellness Center, a South Philadelphia primary care clinic whose clientele includes a large number of immigrants and refugees.
Even when a hospital visit is necessary, physicians are finding ways to avoid separating refugees from their families. When Bibi Samira Khalil arrived in Philadelphia in early August with her husband, Mohammad Sabour Khalil, and their three young children, she had to be taken to an emergency room to be tested for suspected tuberculosis. Instead of waiting at the airport, the entire family went with her. (Khalil tested negative.)
“Keeping families together was very important,” said Altshuler.
Many of the refugees coming through Philadelphia’s airport will settle elsewhere. Patients who do stay in the area and are working with local resettlement agencies are required to undergo an initial checkup, but Altshuler’s center works to build lasting relationships with patients beyond that appointment. “In addition to giving them [their first medical exam], we become their medical home,” he said. Some patients may need preventive care or treatment for chronic diseases that they were unable to get while waiting for placement. The center also offers mental health screening specific to the needs of people grappling with trauma from their home countries, and who now must adjust to life in a new country.
Mohammad Sadiq Sadeed, who worked for years at the U.S. Embassy in Kabul, knows well the kind of trauma the new arrivals are facing. He arrived in Philadelphia in 2019 shortly after getting his special immigrant visa. Because his life was at risk from the Taliban, he fled quickly: He hadn’t even had time to register with the International Organization for Migration, which can help refugees and SIV holders access housing and health care.
The family had to find their own housing, and Sadeed’s five children couldn’t enroll in school for nearly a month because they had no vaccination records. Once settled into their home in Northeast Philadelphia, the family faced the kind of health care system problems that many Americans share: Sadeed remembers his shock at a $700 bill for a root canal and his frustration at getting a needed appointment with a specialist, even though he had private insurance.