The Importance of Self Sufficiency

This week I was informed that in the month of January, Nationalities Service Center (NSC) is set to welcome 60 refugees to Philadelphia. NSC is a refugee resettlement nonprofit that provides comprehensive services to immigrants and refugees, including legal aid, community integration opportunities, access to health and wellness services, and English classes. As a part of the NSC health team, two other NHC members and I are tasked with forming a medical home for these new arrivals. What does this “medical home” mean? As it is explained by employees at my host site, this concept requires establishing care with culturally competent medical professionals, advocating for language access and using the model of self-sufficiency to promote overall well-being. Logistically our role entails providing an orientation on the US health system, insurance enrollment, scheduling doctor’s appointments and accompanying clients to health screenings. Although completing such steps is a main goal, the real measure of our work is whether our clients can access their medical homes without our assistance. This is because self-sufficiency is an essential part of our well-being, a lesson I have learned through my service. 

The model at NSC is to build a foundation for a self-sustaining future through empowerment and preparation. For us in the health team, that means providing clients a lot of health education and social service navigation. It also requires educating clients on every detail of their health journey with us. For example, pointing out signs and landmarks when traveling to appointments or practicing words and important health questions in English while waiting in the lobby. Although these are little details, this education really does empower clients to feel comfortable in taking ownership of their health. In the beginning of my service I forgot to prioritize these interactions. I was too focused on the tasks and felt like I was burdening clients or infantilizing them by teaching what were from my perspective such simple concepts. I also felt inclined to do everything for my clients because I thought they deserved the best care and didn’t want to add more stress to their lives. I quickly saw through interactions with clients that denying one this information is distancing them from having control of their medical home and the freedom to make decisions. It is hard to promote self – sufficiency when there are many barriers to care in the healthcare system, that require assistance. In addition, for my clients there are linguistic and cultural differences that often provide issues. But the one thing I have witnessed daily in clients is that people have the tremendous tenacity to transcend challenging circumstances if supplied the tools to do so.

The access to simple information increases the ability to determine their own course. Self-efficacy is improved by education and promoting an important aspect of mental health. The self-confidence that comes with being able to understand parts of the health care system and how to navigate one’s medical home helps to promote healthy behaviors and breaks down some barriers to receiving care. Self-sufficiency is important to everyone’s self-esteem but it takes on a new meaning to the clients of NSC. Many immigrants and refugees lost this essential part of well-being and have come to the US to determine their own course, to make their own decisions, rather than having life determined by others. As health promoters, we put emphasis on empowering clients in integration to strengthen self-confidence and promote emotional and intellectual well-being.

This blog post was written by NHC Philadelphia member Rachael Wright.
Rachael serves as a Clinic Liasion at Nationalities Service Center.