Why I Chose Refugee Medicine.

I am a Primary Care Physician Assistant to the Refugee Community.  I am both proud and humbled that this is the path I am on. I used to think primary care might be boring or monotonous but my experience has shown me that it is quite the opposite. Partly, this is because our unique population comes with very interesting challenges. Another reason is that primary care clinicians see anything and everything! While, some days (especially cold & flu season) it feels monotonous with dozens of colds, other days we see challenging, crazy, interesting, or rare cases. Most days, we are managing chronic conditions like diabetes, high blood pressure, obesity, & chronic lung diseases — sometimes with visible success but much of the time very slow progress or none at all. The fact that Primary care sees all ages and all diseases makes it especially challenging. The biggest challenges by far in our particular practice, are the language and cultural barriers we face on a daily basis.

There currently is a great need for primary care clinicians (in fact, this is one of the reasons the PA profession was created). I hope by writing about my experience I can spark some interest in the field, and greater respect toward the fields of primary care and/or underserved medicine and that some of you will end up in primary care like me! I hope also to encourage any readers who are interested or already studying in the medical field to learn about the underserved areas or peoples nearest to you and get involved serving them.

I actually went to PA school with a global mindset, hoping to graduate and do full-time missionary work overseas. This desire was planted in me in high school when I was first exposed to poverty during a mission trip to Nicaragua.  After this first trip, I went on more trips— Honduras, Guatemala, Uganda, and China. Each trip grew my love for cultural diversity, languages, and overseas medicine. I was fascinated by the differences and fueled by the needs I saw. I knew that this was my calling. I just did not know in what capacity.

I wrote about my reasons for becoming a PA in another post, but this post explains how I started down the global medicine route. The PA school I went to was very mission minded and supportive of students having interests in overseas medicine. We took a trip during PA school to Guatemala (my second time there) and my friend Sarah and I initiated and planned a 6-week clinical rotation to Uganda.

As I neared the end of PA school, the reality of debt became more real. For 2.5 years of school, I was in nearly 90,000 dollars of debt. I had graciously been given donations and gifts from my parents, friends, and family to go on these medical mission trips, but now not only could I not pay for overseas mission trips on my own, I was now worth $ -90,000. I did not rule out the option of going overseas full-time completely.  But I did become more open minded about serving low-income and underserved communities in the US until I could pay off my debt.

Additionally, after the experiences of these trips and the surge of trips like them happening in the US christian culture, God began to teach me about some ways that “helping can hurt“. One of the things that I learned as I prayed and researched about this next step was the obvious fact of my inexperience. In many developing countries around the world where they lack medical care and other physical services, local people become desperate for anyone who will help. So, if you look like a doctor, talk like a doctor, or have any experience whatsoever, they let you help. This is not necessarily beneficial for their immediate health nor long-term sustainability. I began to realize it would be very beneficial to learn and grow in experience as I paid off my debt. Then I could truly offer quality healthcare to people in poverty around the world.

For the first year after I graduated PA school, I took a geriatric medicine fellowship position at the VA hospital in Houston. I chose this for a few reasons: I was not quite confident in myself yet, I wanted an extra year of training, and I love geriatrics and think that it is an essential part of primary care and global medicine. Geriatrics can integrate well into general primary care and having the fellowship year I believe, brought more depth to my preparation to work in primary care with underserved & vulnerable populations. It also helped me gain the confidence I needed to start practicing more independently in the professional medical world.

The opportunity to work at Ardas Family Medicine with refugees came toward the end of my fellowship year, and it came rather divinely. I was running toward a completely different opportunity and this one just fell into my lap (although I know it was God who placed it in my lap!) As I interviewed with my now boss, I saw that literally, all my worlds were colliding. I had been to Asia, Africa, and Central America to go TO the nations, but when I walked into Ardas literally the nations were coming TO Ardas.

This was a clinic where I could earn an income to pay off my loan, meet people from all over the world, learn about different languages and cultures, and make a difference by serving the refugee community. This was the perfect opportunity for me! Never in my wildest dreams would I imagine that this would be what I would end up doing, but as I look back on my path since high school, it makes so much sense that this is the exact place I would end up. Not only do I get to meet people from all over the world, meet their needs in the medical realm, but I get to learn and prepare for whatever overseas opportunity comes! How awesome!

So, all that being said, working with refugees is the perfect job (for me)…but that does NOT mean that it is easy! I love the challenges that come with this job, but it can be incredibly exhausting. Even if we have a day like I talked about earlier (coughs and stomach bugs all day, etc etc) we still have to deal with language and cultural barriers in EVERY SINGLE encounter. I am a white American girl serving patients on a daily basis who are of very different cultural and language backgrounds than myself, and that is incredibly challenging. We have interpreters, but the language just scratches the surface of what barriers there are.

It is important to mention that we are not just seeing ONE population of people from ONE country, we are seeing almost ALL refugee populations in Denver.. Nepali, Burmese, African (Dominican Rep of Congo, Somali, Ethiopian), Cuban, Iraqi, Afghani, Russian, etc etc etc. These are people who, even within their own country have many different languages and cultures. However, despite ALL these challenges, I love the opportunity to slowly get to know our patients and provide incredible access to primary care services for them.

One last important reason I will mention (that I am now realizing in hindsight) that I chose refugee medicine, is because of the time in history we are in and the current stigma of refugees. I take great pride in serving refugees during the current refugee crisis.  I believe there is much that is misunderstood about refugees (their immigration status, vetting, religious affiliation, etc) and I am proud to stand behind the refugee community when I talk to people who have questions or strong opinions toward refugees and other immigrants.

During this time in history, It is incredibly important to KNOW refugees personally and to SERVE them in humility and love. No matter what religion/political party we come from and no matter what country/nationality/religion they come from. It gives me such joy to know I get to stand with the refugee community in support of their worth as human beings.

I want to know…. Do you have refugees in your community? Have you had opportunities to serve them? What are some questions you have about refugees and/or refugee medicine? How have they been a blessing to you and/or what frustrations have you felt working with refugees? If you have not served refugees, why not? do you find it hard to find opportunities?