Opportunities and challenges in implementing a community-based screening for diabetes and cardiovascular risks among refugees from Nepal to Massachusetts, US

Boston-based International Health Organization (IHO) is helping a seriously disenfranchised refugee population in USA which was had been twice displaced in their native countries of Bhutan and Nepal, by providing them free health screening and health education. The OBJECTIVES are: To help a severely traumatized refugee population by providing screening for preventable diseases; to monitor the impact of change in their life-styles after their arrival in US, and attendant healthcare services. This presentation will provide insight on the challenges encountered in conducting a health screening intervention for a greatly traumatized refugee population and share helpful lessons learnt in helping other refugee populations. METHODOLOGY: In 2011, IHO started a longitudinal, prospective, multi-year screening program for recently arrived refugees from Nepal in Massachusetts who were previously expelled from Bhutan. The screenings are being conducted through their community leaders with help from volunteers from IHO. RESULTS: Major challenges encountered which have had an adverse bearing upon the health screening program have been: their psychological state of seize; communication barriers; shifting priorities with preventive health being a very low priority; economic hardships; depression; family structures; generational gap among family members; perceived barriers; logistical barriers such as transportation; fear and skepticism of people in the adopted country, among others. This presentation will discuss these challenges and IHO's strategies to overcome them. CONCLUSION: This is the first such intervention which has looked specifically at this particular refugee population and has provided insight into critical factors which can determine the success of a preventive health program.