Building Social Capital for a Healthier Community

Serving at my host site these past few months, I have begun to understand more fully the different roles a physician can take on within the bigger sphere of public health. I serve at Nationalities Service Center (NSC), a refugee and immigrant resettlement agency, which relies heavily on its social capital to serve the needs of its clientele. One major component of said social capital is NSC’s relationships with the several health systems within the greater Philadelphia area. I am able to observe these relationships through my role as Health Access Liaison. Through my role, I help refugees from various nations navigate the healthcare system in the United States. This means working closely with our partner clinics and providers to ensure appointment compliance and understanding on behalf of our clients. Serving with a non-profit that has been resettling refugees and immigrants for the past 95 years, I am able to see how the clout of my organization is able to function to serve the needs of our clientele. On a daily basis, I am able to communicate with any one of our partner clinics to arrange specialty appointments or emergency sick-visits because of the very relationships NSC has fostered and maintained over the years. NSC uses these relationships to ensure health and health access is a seamless process for refugees upon arrival to the United States and their new home in Philadelphia. 
In order to understand how much of a role healthcare plays in refugee and immigrant resettlement, let me walk you through the simplified journey of a refugee to the United States. Once a refugee or refugee family has been added to the “pipeline” of thousands of refugees headed for the United States, their information is then passed onto nine national Voluntary Agencies or “Volags.” These Volags rely heavily on non-profits such as NSC to then resettle refugees across the country. It then falls on these mostly non-profit resettlement agencies to “pick and choose” the refugees they will accept into their agency. This selection process is based on how strong of match the individual or family is to the resettlement agency and its respective location. One such determinant is their health status. Luckily enough for NSC and those we resettle, we are located in the center of several world-class health institutions and can accept several more unique health cases than other agencies. For those of us in the health and wellness office at NSC, doctors appointments are oftentimes made even weeks before a refugee arrives. 

Once refugees arrive, they are required to enroll in Medicaid, see their primary care provider, and receive vaccinations within thirty days of arrival. All of this is made possible by the relationships NSC has built within the surrounding area and the willingness of physicians to see our clients.

As one can imagine, these cases are often not simple and require more time than the average doctor-patient encounter where both parties speak the same language. The use of interpretation services for detailed medical histories and physical exams often means that physicians have to book double the typical amount of time for one refugee client visit. Yet, time and time again, I witness physicians willing to see additional clients or make time for a sick visit so our clients do not have to go to the emergency room. The sustained relationships between practitioners and NSC is what makes it possible for us to resettle a young girl from Syria with advanced phenylketonuria or a man from Iran who needs extensive orthopedic work up for a prosthetic foot. Experiences such as these have empowered me to seek out such community engagement opportunities when I become a physician. Serving at the intersection of doctor and patient, I am able to witness the  incredible commitment of our partner clinics to the population we serve. Through my service term at NSC, my eyes have been opened to the great impact providers can have when they choose to “opt-in” to understanding and responding to their community health needs.
 

This blog post was written by NHC Philadelphia member Natalie Shovlin-Bankole.
Natalie serves as the Health Access Liaison at Nationalites Service Center.