PIE
on the web
A Program and Information Exchange Newsletter
for the USCCB/MRS Refugee Resettlement Programs
Volume 10, Issue 2
June 2002


Meeting the Needs:
Strategies to Serve Refugees with Disabilities

Anastasia Brown
Assistant Director for Processing Operations
USCCB/MRS, Washington, DC

It has become apparent to all who are dedicated to assisting refugees in need of resettlement that the population has changed significantly from those arriving 10 years ago. There are obvious differences such as the countries of origin of refugees, but the cases have also become much more needy and are often not easy to place. This is true not only in the area of case composition, where we are seeing increasing numbers of single-parent families, but also in the general health condition of the refugees.

MRS/USCCB faces the difficult task of placing and serving refugees with physical disabilities. The U.S. refugee program has placed great emphasis on increasing the number of cases referred by the UNHCR. These cases are often victims of violence, torture victims and persons in need of immediate medical attention. Prolonged stays in refugee camps with limited food and assistance have also compounded health conditions. Often an injury which would have been correctible with medical attention becomes a permanent disability.


Examples of recent cases include a woman with severe acid burns and impairment of mobility, victims of torture, spinal injuries, paralysis, paraplegics and amputees. In some instances, these individuals are the principal applicants and there are no other "employable" members of the family. These tragic cases reinforce the need for resettlement programs to look beyond the funding of the R&P grant and reach out to available resources in the community to serve these needy and deserving refugees. Over the years, case biographical information has not always provided sufficient details concerning the physical and mental health status of individual refugees. Consequently, problems may not always be known until the refugee arrives. Nonetheless, biographical information is often sufficient to inform the resettlement process at the local level. The U.S. Department of State reports, however, that significantly more information will be made available once the new Worldwide Refugee Processing System (WRAPS) goes into effect beginning with the Former Soviet Union Region this fall. Until WRAPS is fully operational, however, resettlement staff are encouraged to contact their designated case manager in MRS/Processing Operations if additional biographical details are required.


As an increasing number of cases with disabilities are being referred to UNHCR, it is critical for local resettlement staff to prepare for the resettlement of refugees with physical and mental handicaps by becoming fully familiar with all available resources in the community. This issue of PIE is designed to provide information and resources to assist in developing local diocesan resources to resettle cases that will require special care and attention.

Diocese of Phoenix, Arizona
Ready to Take On New Challenges

Lisa Armijo, Resettlement Supervisor
Catholic Social Service, Refugee Resettlement Program
Phoenix, AZ

At the Catholic Social Service Refugee Resettlement Program, we are always ready to take on new challenges and aid people in the most difficult of circumstances. With the start of the Special Medical Program, we welcomed the opportunity to work with refugees who are HIV positive. All refugees must contend with many arduous issues ranging from fleeing their country and adapting to a new culture, to healing from the scars of war, violence and persecution. A refugee who is HIV positive is challenged that much more, often arriving very ill to the U.S. with many immediate medical needs. Sandy Grimalauskso, the Medical Case Manager who runs the Special Medical Program, embraces these challenges. Since its inception in September 2000, Sandy's passion for the mission and compassion for the people are clearly evident.
The program was for started for "humanitarian purposes" and "to help insure family unity." Previously, individuals who tested as HIV positive were unable to come to the U.S. and were often left behind when other family members received admittance. The people left in their countries were harshly ostracized by individuals in refugee camps and some were even murdered because of their disease. Now with the new HIV waiver granted by the U.N. and I.N.S., people are given a second chance at life and resettlement in the U.S.

Since September 2000, we have assisted 19 individuals, surpassing the contracted requirements to assist 15 people. Through the program, people receive medical attention, transportation, linkages to counseling, and assistance with learning about the U.S. culture. People are assisted with moving toward independence and planning for short and long term goals. Refugees also learn about medical treatment and health management techniques that help them to extend their lives. The program prides itself in surpassing the medical adherence requirements of U.S. citizens with HIV. Sandy, with the assistance of the Maricopa County Health Department, has also championed efforts to develop a network of HIV/AIDS professionals in the Phoenix metropolitan area. This well-developed network helps to ensure that the utmost attention is given to refugees who have contracted this disease.

Many refugees who are HIV positive or who have AIDS arrive in the U.S. accepting that they will die. Some come with the idea that they will be healed by medication. No matter what their impression, helping them is a process. In this process, people come to terms with learning to live with their condition knowing that medication extends their life but will not cure them. They adjust to the fact that their medical needs, with medication administered for as long as 3 ½ hours per day, must take precedence over work or school.

Refugees often arrive fearful of the medical system and finding it difficult to trust doctors and service providers. Many deal with shame connected with the disease, particularly women who were raped and intentionally infected through genocide. Needing to move slowly with the refugees to overcome shame and fear, coupled with their immediate needs for assistance and medical attention, is challenging. To meet this challenge, refugees are slowly introduced to providers. Staff, like Sandy, helps them to understand the medical and social service systems and empowers them with knowledge about personal privacy rights and strategies about when to disclose their status.
Refugees learn about U.S. laws that help protect them against discrimination. Hope is instilled, and people work toward achieving a balance between the realities of the disease and living life as fully as possible.

Even with the shame, medical needs, and the shock of cultural adaptation, people still flourish. Fifty percent of the refugees, deemed as unable to work prior to their arrival in Phoenix, are now working because of the assistance received in the Special Medical Program. Others who are unable to be employed are taking measures toward personal growth. Sandy remembers one family in particular consisting of a mother who has AIDS and her two sons who are HIV positive. Although doctors only gave the family only months to live, after many hospitalizations and much perseverance, the two children are growing at a normal rate, the family is involved in a literacy program, and the mother is completing her G.E.D. Each person encountered in the program is amazing in his or her own respect, and much fulfillment is received from seeing their lives blossom.

In the future, much work is left to be done concerning AIDS. All people need to understand the magnitude of AIDS and its global effects. More doors need to be opened with service providers to work with all people with this disease, but especially with refugees who are even more marginalized. More education is needed so that people are not unnecessarily fearful of people who are HIV positive. Additionally, people should continue to advocate for additional governmental assistance and work toward preventive measures, while inspiring others to help with this cause.

As each new refugee is met here at the C.S.S. Refugee Resettlement Program, we become more aware of their suffering but also of their resilience. Our mission is to focus on the person and not on the disease, to network with professionals to provide greater opportunities for refugees, and to treat people with compassion and understanding. Above all, we have hope for each individual and work to help ensure that everyone has such opportunities.

Best Practices
Serving Clients with Disabilities

Rebecca Jordan, Resettlement Director
Archdiocese of Louisville, KY

In 1999, Catholic Charities agreed to resettle several refugee families with disabilities. The cases included a family with one parent and one child (who was an infant) who had a brittle bone disease; a client who was blind; one family with a child who had cerebral palsy; and another family whose child was a double amputee. Catholic Charities still continues to accept the responsibility of resettling families or single clients with disabilities.

When agreeing to accept a refugee with disabilities there are three questions to ask:

  1. How will the agency be able to provide services to the client?
  2. Can the refugee take care of him or herself or is assistance required?
  3. What plans do we need to make to ensure that, after the initial resettlement service period is completed, the client will be able to take care of him/herself in the long term?
The first question may seem a bit obvious, but service delivery becomes problematic if the building where the refugee department is located is not handicapped-accessible. Catholic Charities in Louisville, until approximately one year ago, was not handicapped-accessible. The building was constructed about 80 years ago and, though modernized and equipped with an elevator, it was impossible for a client in a wheelchair to gain entry to the building. Resettlement staff had to arrange all assessments, intakes, and all other appointments to take place at the home of the client. Resettlement staff also ensured that the housing where the refugee family is living is handicapped-accessible.

The second aspect of service delivery, and the most important, is for the case management staff to immediately make referrals to community service providers who will be able to assist the families with disabilities upon arrival. This will ensure the family will be able to care for the family member and ensure that long-term care will be provided after the initial resettlement period is over. Catholic Charities was able to refer these families to a service provider in the community who assisted with these referrals and provided follow-up for the families. Case management staff also had to advocate on behalf of the client to ensure service providers arranged for interpreters to be available for appointments. Referrals to service providers provided the families with some of the following: wheel chairs specifically designed for the disability, prosthetics, physical therapy, Section 8 housing, mental health counseling, parenting classes and home health care.

Catholic Charities also recruited individual volunteers and parishes to assist these families. Volunteers were able to transport clients to innumerable appointments with social service and medical providers. Because the volunteers would spend more time with the family than resettlement staff, volunteers provided insightful feedback on how the family was coping and reported any problems. Volunteers also provided in-home ESL instruction for either the client who had the disability or for the family member who had to remain at home to take care of the disabled family member.

The most important aspect in assisting clients with disabilities is to ensure that clients are able to access community services and then advocate for the clients to ensure that they receive all the necessary services. Parish and volunteer involvement provides the families and resettlement staff with additional assistance necessary in the resettlement of refugees with disabilities.


Diocesan Health Care Initiatives

Winona, MN:

New refugees often require health appointments. Pathfinders is an organization that teaches refugees how to make medical appointments, arrive on time, procure translators, and pinpoint transportation. Many anchor relatives and families are taking advantage of this wonderful resource. It has saved many staff and volunteer hours and has provided refugees with new skills that help them to build self-esteem and achieve self-sufficiency.

Boston, MA:

The diocese offered an art therapy program for the Sudanese young men. this program provided a safe environment for participants to explore their fears and concerns, and to learn skills that enhance their transition to their new life. As we continue to orient the Sudanese young adults, we are recognizing the difficulty they are having processing the events they have experienced in Sudan, Kenya and America. Many are in need of mental health services but are uncomfortable with individual counseling. We feel that art therapy programs could be an effective way to support their transition to life in the U.S.

Albuquerque, NM:

Addressing the mental health concerns of newly-arrived refugees continues to be a priority. The program worked closely with the Catholic Charities Counseling Department to provide social adjustment services to refugee clients. One hundred percent of all new arrivals received an orientation to mental health services in the community. However, despite regular reports of conflicts both at home as well as in the work place, the number of clients accessing the Catholic Charities Counseling remains low. In addition, the Counseling Department together with a University of New Mexico professor of Psychology are developing a mental health assessment that will be given to all new arrivals at orientation. The assessment will assist our staff to identify clients needing further attention, as well as to provide important information for case management and follow-up.

Lansing, MI:

As we explored new ideas involving mental health services and youth services for our clients, we found that our new partnership with a youth-focused program addressed some of the needs specifically geared to children. Project CLAY (Community, Love, Activating, Youth) is a non-profit project, founded and run by a Catholic priest, Fr. Mark DeHater, and was incorporated into Catholic Social Services of Lansing in January 2001. Such partnerships serve as catalysts for more refugee youth-focused programs.


Special Needs in Smaller Sites

Barbara Smith, Roanoke Regional Director
Diocese of Richmond, VA

Roanoke, Virginia is a city of 95,000 within a metro area of 230,000 nestled in the heart of the Blue Ridge Mountains. We (Refugee & Immigration Services) resettle about 180 refugees each year including special needs cases. We recently arranged a cochlear implant for a deaf Sudanese man. Because Roanoke hospitals do not perform this surgery, Medicaid provided transportation to the University of Virginia hospital in Charlottesville. For the first time in over 12 years, the man can hear again. The entire staff of our office received training from the local AIDS Council and, subsequently, we have resettled HIV-positive cases. Other special needs have included blindness, paralysis, mental illness, amputation, cancer, and mental retardation.

This is how we have prepared for special needs cases:

  1. We built a relationship with our local Health Department that has resulted in three to four Refugee Clinics each month, during which every refugee receives a complete physical. Therefore, Health Department staff facilitate referrals to medical specialists and treatment is expedited.

  2. As with the arrival of new ethnic groups, Refugee and Immigration Services requests a speaker to provide in-service sessions to educate staff and discuss the new case.

  3. Depending on confidentiality requirements, the local ethnic community is asked to give a special welcome and assist with the efforts to support this special person.
We acknowledge the extra effort required to accomplish such resettlements by providing a luncheon every other month. We invite the special volunteers, as well as staff from other agencies, to home-cooked (by our staff) ethnic lunches to thank them for their help. Smaller resettlement sites can handle special needs cases but only with an informed staff and strong community support.


National Consortium of Torture Treatment Programs and ORR Category I Grantees

The following programs provide treatment for torture victims nationwide, not all of these projects are funded by Office of Refugee Resettlement (ORR). Obviously, those with federal funds have more capacity for services. Soon the updated list will be on the ORR website.

ACCESS Psychosocial Rehabilitation Center
Dr. M. F. Farrag
5489 Schaefer
Dearborn, MI 48126
Phone: (313) 945-8137 - Fax: (313) 945-8933
Email: mfarrag@accesscommunity.org Website: www.accesscommunity.org

Advocates for Survivors of Torture and Trauma
Karen Hanscom
P.O. Box 5645
Baltimore, MD 21210
Phone: (410) 467-7664 - Fax: (410) 467-1744
Email: klh@igc.org Website: www.ASTT.org

Amigos de los Sobrevivientes
German Nieto-Maquehue
P.O. Box 50473
Eugene, OR 97405
Phone: (541) 484-2450 - Fax: (541) 485-7293
Email: amigos@efn.org Website: www.pacinfo.com/eugene/tsnet

Bellevue/NYU Program for Survivors of Torture
Allen Keller
NYU School of Medicine
c/o Division of Primary Care Internal Medicine
550 1st Avenue
New York, NY 10016
Phone: (212) 263-8269 - Fax: (212) 263-8234
Email: ask45@aol.com Website: www.survivorsoftorture.org

Boston Center for Refugee Health and Human Rights
Lin Piwowarczyk
Boston Medical Center
Dowling 7
1 Boston Medical Center Place
Boston, MA 02118
Phone: (617) 414-5082 Fax: (617) 414-6855
Email: piwo@bu.edu Website: www.glphr.org/bcrhhr.htm

Catholic Social Services of Central and Northern Arizona
Barbara Klimek
1610 Camelback Road
Phoenix, AZ 85015
Phone: (602) 997-6105
Email: bklimek@diocesephoenix.org

Center for Survivors of Torture
Gerald Gray
2400 Moorpark Ave.
San Jose, CA 95128
Phone: (408) 975-2750 x250 Fax: (408) 975-2745
Email: gerald.gray@aaci.org. Website: www.aaci.org/adult/adult_cst.html

Center for Survivors of Torture and War Trauma
Jean Abbott
1077 S. Newsstead
St. Louis, MO 63110
Phone: (314) 371-6500 Fax: (314) 371-6510
Email: jeanabbott4400@aol.com

Center for the Prevention and Resolution of Violence
Amy Shubitz
317 W. 23rd St.
Tucson, AZ 85713
Phone: (520) 628-7525 Fax: (520) 295-0116
Email: ashubitz@aol.com

Cross Cultural Counseling Center
Sara Kahn
International Institute of New Jersey
880 Bergen Avenue, 5th Floor
Jersey City, NJ 07306
Phone: (201) 653-3888 x 12 Fax: (201) 963-0252
Email: skahn@iinj.org

Doctors of the World
Maki Katoh
375 West Broadway, 4th Floor
New York, NY 10012
Phone: (212) 226-9890 x 230 Fax: (212) 226-7026
Email: katohm@dowusa.org Website: www.doctorsoftheworld.org

F.I.R.S.T. Project, Inc.
Maria Prendes-Lintel
1550 S 70th St.
Suite 201
Lincoln, NE 68510
Phone: (402) 488-6760 Fax: (402) 488-6742
Email: mlintel@aol.com

Florida Center for Survivors of Torture
Faina Sakovich
407 S Arcturus
Clearwater, FL 33765
Phone: (727) 298-2749 x22 Fax: (727) 535-4774
Email: refugeemh@yahoo.com Website: www.gcjfs.org

Harvard Program in Refugee Trauma
Richard Mollica
22 Putnam Ave
Cambridge, MA 02139
Phone: (617) 876-7879 Fax: (617) 876-2360
Email: rmollica@partners.org

Institute for the Study of Psychosocial Trauma
Carlos Gonsalves
380 Edlee Ave.
Palo Alto, CA 94306
Phone: (650) 424-1314 Fax: (650) 424-0304
Email: cjgons@speakeasy.net

International Survivors Center
Westy Egmont
c/o International Institute of Boston
One Milk Street
Boston, MA 02109
Phone: (617) 695-9990 Fax: (617) 695-9191
Email: wegmont@iiboston.org Website: www.iiboson.org

Jewish Family Services of Columbus
Laura Southern
1151 College Avenue
Columbus, OH 43209
Phone: (614) 231-1890 x131 Fax: (614) 231-4978
Email: lsouthern@jfscolumbus.org

Khmer Health Advocates
Mary Scully
29 Shadow Lane
W. Hartford, CT 06110
Phone: (860) 561-3345 Fax: (860) 561-3538
Email: mfs47@aol.com

Legal Aid Foundation of Los Angeles Torture Survivors Legal Assistance Project
Michael Ortiz
5228 East Whittier Boulevard
Los Angeles, CA 90022
Phone: (213) 640-3921 Fax: (213) 640-3911
Email: mortiz@lafla.org

Liberty Center for Survivors of Torture
Fernando Chang-Muy
University of Pennsylvania
School of Law
3400 Chestnut Street
Philadelphia, PA 19104
Phone: (215) 669-7111
Email: fernando@lcfsinpa.org

Lutheran Immigration and Refugee Service
Matt Wilch
700 Light Street
Baltimore, MD 21230
Phone: (410) 230-2721 Fax: (410) 230-2813
Email: mwilch@LIRS.org

Minnesota Advocates for Human Rights
Michele Garnett McKinzie
Acting Program Director
310 Fourth Avenue S, Ste.
Minneapolis, MN 55415
Phone: (612) 341-3302 x1117 Fax: (612) 341-2971
Email: mckenzie@mnadvocates.org

Program for Survivors of Torture & Severe Trauma (PSTT)
Judy Okawa
701 W. Broad Street, Ste. 305
Falls Church, VA 22046
Phone: (703) 533-3302 x 143 Fax: (703) 237-2083
Email: okawaj@aol.com

Program for Torture Victims
Michael Nutkiewicz
3655 S. Grand Ave., Suite 290
Los Angeles, CA 90007-4356
Phone: (213) 747-4944 x 253 Fax: (213) 747-4662
Email: nutkiewicz@ptvla.org Website: www.ptvla.org

Refuge
Jack Saul
NYU International Trauma Studies Program
114 East 32nd St., Ste. 505
New York, NY 10016
Phone: (212) 992-9669 Fax: (212) 995-4143
Email: jmsaul@rcn.com

Rocky Mountain Survivor Center
Paul Stein
1547 Gaylord Street, #100
Denver, CO 80206
Phone: (303) 321-3221 x 214 Fax: (303) 321-3314
Email: pstein@rmscdenver.org

Safe Horizon/Solace
Ernest Duff
74-09 37th Avenue
Room 412
Jackson Heights, NY 11372
Phone: (718) 899-1233 X 101 Fax: (718) 457-6071
Email: eduff@safehorizon.org Website: www.safehorizon.org

Survivors International of Northern California
Margaret Kokka
447 Sutter Street, #811
San Francisco, CA 94108
Phone: (415) 765-6999 Fax: (415) 765-6995
Email: survivorsi@sbcglobal.net Website: www.survivorsintl.org

Survivors of Torture International
Kathi Anderson
P.O. Box 151240
San Diego, CA 92175
Phone: (619) 278-2407 Fax: (619) 294-9429
Email: kanderson@notorture.org Website: www.notorture.org

The Center for Justice and Accountability
Sandra Coliver
870 Sutter Street, Suite 684
San Francisco, CA 94102
Phone: (415) 544-0444 Fax: (415) 544-0456
Email: scoliver@cja.org Website: www.cja.org

The Center for Survivors of Torture
Manuel Balbona
5200 Bryan Street
Dallas, TX 75206
P.O. Box 720663
Dallas, TX 75372-0663
Phone: (972) 317-2883 Fax: (972) 317-4433
Email: mbalbona@airmail.net

The Center for Victims of Torture
Douglas Johnson
717 East River Road
Minneapolis, MN 55455
Phone: (612) 626-1400 Fax: (612) 646-4246
Email: 104677.3412@compuserve.com Website: www.cvt.org

The Marjorie Kovler Center for the Treatment of Survivors of Torture
Mary Fabri
4750 N Sheridan Road, Suite 300
Chicago, IL 60640
Phone: (773) 751-4090 (Mary Fabri direct) (773) 271-6357 – Kovler general #
Fax: (773) 271-0601 Email: mrfabri@hotmail.com

Torture Treatment Center of Oregon
Crystal Riley
OHSU
3181 S.W. Sam Jackson Park Road
UHN 88
Portland, OR 97201-3098
Phone: (503) 494-6140 - Fax: (503) 494-6143
Email: rileyc@ohsu.edu

In what ways could PIE be improved? Please send any ideas or suggestions to Salah Hammad via Shammad@usccb.org


What's In A Word?

Words, whether spoken or signed, are the basic means by which people communicate. Words are powerful tools which can affirm and empower. At the same time, the misuse of words can belittle and demean. Language used to describe people with disabilities often focuses on lack of ability rather than on competency. Age-old terms such as " deaf and dumb," "invalid," or "idiot" continue to be used despite their disrespectful tone and the inaccurate message they convey.
When we write or speak about people with disabilities, we should choose words with care in order to promote dignity and positive image. The following suggestions may assist in this process:

The following terms should be avoided because they have negative connotations and evoke pity:

abnormal
burden
derformed
incapacitated
imbecile
maimed		 moron
palsied
pathetic
pitiful
poor
spastic
stricken with		 suffer
tragedy
unfortunate

It is important to approach the use of words with the proper attitude. Language varies due to a number of factors including geography, culture and personal preference. While we may make general recommendations as in the information above, language is fluid. What is acceptable one day may no longer be so at a later date. Often terminology changes as a certain word acquires negative connotations and becomes stereotyped. People then focus on a new word, hoping that it will bring acceptability. Words alone, however, cannot build acceptance and, thus, the ongoing evolution.

__________________________
Excerpted from Opening Doors to People with Disabilities, Volume II - The Resource File, 1997, National Catholic Office for Persons with Disabilities, Washington, D.C.


Resource Guide


A PROGRAM AND INFORMATION EXCHANGE NEWSLETTER
FOR THE USCCB/MRS REFUGEE RESETTLEMENT PROGRAMS

USCCB/MRS
3211 4th Street, N.E.
Washington, DC 20017

Tel: 202-541-5409
Fax: 202-722-8750
For any comments or questions, please contact: Salah Hammad
Email: shammad@usccb.org





__________________________________

Office of Migration & Refugee Services
United States Conference of Catholic Bishops
3211 4th Street, N.E., Washington, DC 20017-1194 (202) 541-3000