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UVa medical clinic's special event helps prepare for refugee wave

A University of Virginia Medical Center clinic saw nearly three dozen patients on Saturday in a day-long event that provided initial visits to many of the refugees and special visa holders who arrived in Central Virginia this summer.

The event helped get the new arrivals, mostly from Afghanistan, into regular family medical care at the International Family Medicine Clinic at UVa Health ahead of the anticipated arrival of as many as 250 more, most of who fled after the Taliban took over Afghanistan on Aug. 15, in the wake of the U.S. withdrawal of forces.

“When we started, the initial group was originally from Afghanistan. They were refugees from when the Taliban were taking over,” said Dr. Fern Hauck, who founded the clinic in 2002. “The Taliban were kicked out and they’re back again and now we have more coming in from Afghanistan. We’ve come full circle.”

The clinic is part of the UVa Health system’s Department of Family Medicine. Hauck created it in cooperation with the International Refugee Committee, the organization that sponsors and settles refugees in the area.

“We’re a clinic within a clinic. We provide special services to refugees as well as special immigrant visa holders, many of whom have been coming from Afghanistan in the past five to six years,” Hauck said. “We have received a fair number of arrivals over the summer. To keep up and be sure we are seeing them in timely manner, we set up the special clinic. They’re basically all arrivals from Afghanistan.”

The Taliban ran Afghanistan from 1996 to 2001. During that time strict enforcement of conservative laws based on Taliban interpretation of Islam was imposed. Women could not attend school or work outside of their home, had to be covered head-to-toe and be accompanied by a male relative whenever they went outside.

A coalition of military forces led by the U.S. invaded the country after the Sept. 11, 2001 attacks at the Pentagon and World Trade Center, and defeated the Taliban, which continued to run a guerilla military campaign and eventually became a powerful insurgent organization during the next two decades of war between insurgents and the coalition.

President Donald Trump began negotiations with the Taliban for the anticipated U.S. withdrawal that ended with a February 2020 agreement including a timeline for coalition forces to leave the country by May 1, 2021 and the release of 5,000 imprisoned Taliban members and 1,000 prisoners held by the Taliban.

The U.S. decreased the number of troops in the country during 2020 even though the Taliban violated the agreement by increasing terror attacks and military operations.

“We’re dealing very well with the Taliban,” Trump said in a Sept. 18, 2020 press conference. “They’re very tough, they’re very smart, they’re very sharp. But, you know, it’s been 19 years, and even they are tired of fighting, in all fairness.”

They weren’t that tired apparently. The Taliban continued military operations and the withdrawal date was extended to Sept. 11 by President Joe Biden. In early July, Biden moved it to Aug. 31, saying “speed is safety” as the Taliban’s increased military and terror operations proved successful.

The Taliban’s success caused many pundits and reporters to draw parallels to the fall of Saigon in 1975. When asked about a possible similarity between Afghanistan and Vietnam, Biden said that comparisons were not valid.

“The Taliban is not the North Vietnamese army. They’re not remotely comparable in terms of capability. There’s going to be no circumstance where you see people being lifted off the roof of an embassy of the United States from Afghanistan. It is not at all comparable.”

On Aug. 6, the Taliban took control of its first province, the capital of Nimroz province in Afghanistan, in violation of the negotiated agreement.

On Aug. 15 the Taliban took Kabul, the Afghan president fled his country and the U.S. evacuated diplomats from its embassy by helicopter.

Afghans flooded the Kabul airport trying to leave the country, clambering aboard U.S. military cargo planes and trying to find flights out of the country as the Taliban tightened its control.

For those making it to the U.S., the first stop for thousands has been the Fort Lee U.S. Army post near Petersburg. Charlottesville’s branch of the IRC has been helping to settle refugees in the area. The UVa international clinic becomes their primary medical care provider.

The international clinic is designed to provide comprehensive, timely, culturally sensitive, and high-quality health care to the growing immigrant and refugee populations in the region. Medical students and residents studying family medicine are required to work in the clinic and receive special training to do so.

The clinic has interpreters available both in-person and via telecommunications for a variety of languages. On Saturday, interpreters provided language services for Dari and Pashtu, the two primary languages of Afghanistan.

Clinic staff meets with all newly arrived refugees to conduct an initial health screening and start addressing their medical issues, which range from chronic conditions such as high-blood pressure to acute mental health concerns.

Many of the refugees have experienced trauma from living in a war zone and violence in refugee camps, so the clinic also provides mental health services by counselors through the UVa Family Stress Clinic and Dr. Richard Merkel.

“We have a special curriculum that teaches [medical residents] cultural competency, how to work with interpreters and some of the medical problems they’ll be encountering,” Hauck said. “There are mental health needs we address as well, because mental health needs are paramount for many of the folks who are arriving from war-torn countries. Many have been in refugee camps for years and they have a variety of medical conditions that have not been addressed overseas.”

Those resettled are first screened for health issues by the Blue Ridge Health District and then sent to the UVa clinic for medical care. The clinic has treated an estimated 4,000 patients from more than 60 countries in its two decades, according to the UVa Health statistics.

As of March, 23% of those patients hailed from Afghanistan, a number which will rise as more Afghanis are resettled in the region. Iraqis make up about 11% of the clinic’s patients and 10% are from Bhutan/Nepal.

“We have people from all over the world who come to the clinic and it’s really an amazing opportunity for our students and clinicians to care for this interesting and appreciative population. It gives us a great deal of pride,” Hauck said.

Saturday’s event relied on volunteers from a wide variety of UVa organizations. IRC volunteers helped transport patients to the clinic.

“We don’t normally see patients on the weekends so we had to get nursing support and pharmacy support,” Hauck said, adding that COVID vaccinations and other vaccinations were given as well. “We have laboratory services providing a phlebotomist and registration staff. It’s been an amazing operation.”


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