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Zaw Win Aung Special Medical Case Manager
1125 Brookside Ave. Suite C9 Indianapolis IN 46202
317-921-0836 www.exodusrefugee.org
Presentation Title | Page 3 Exodus Refugee The Life Ahead
Exodus Refugee Immigration works with refugees—worldwide victims of persecution, injustice and war— to establish
self-sufficient lives in freedom and sanctuary for themselves and their families in Indiana.
Mission Statement
Presentation Title | Page 4 Exodus Refugee The Life Ahead
“a person who "owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social
group, or political opinion, is outside the country of his nationality, and is unable to or, owing to
such fear, is unwilling to avail himself of the protection of that country."
A REFUGEE IS…
Presentation Title | Page 5 Exodus Refugee The Life Ahead
Resettlement
• Airport Pick-Up & Welcome • Orientations -Life in America, culture, apartment, safety budget, employment, resettlement plan
• Services - Welfare (within 7 days) - Social security (10 days) - Employment referral & English classes (10 days) - School enrollment (30 days) - Health screening & referral for treatment (30 days)
• Goals employment by 90 days, self-sufficiency by 180
Presentation Title | Page 6 Exodus Refugee The Life Ahead
Why Indiana? • Welcoming Community • Resources services, transportation • Employment • Cost of living • Safety • A future
Welcome to the
Hoosier State Refugee Communities • Experienced traumatic circumstances • Loss of homeland, familiar • Strong sense of community, ethnic and national pride • Courageous, full of hope • Strong sense of community • Ethnic and national pride
Presentation Title | Page 7 Exodus Refugee The Life Ahead
Refugee Contributions • Food, art, ritual • Diversity • Language, religion • Strong family values • Community service • Civic pride • Consumers • Industrious workforce • Professionals in a variety of fields • Generations of passionate, committed citizens
Presentation Title | Page 8 Exodus Refugee The Life Ahead
Ethnicities Resettled 2013
Iraq, 22
Congo, 15 Bhutan, 14
Eritrea, 8
China, 7
Somalia, 3 Ethiopia, 2
Chin, 523
Karen, 71
Karenni, 16
Burmese, 14 Kachin, 11 Arkanese, 5 Mon, 4 Arakan, 1
90% from Burma, 73% Chin 71 of 716
individuals from other countries
Presentation Title | Page 9 Exodus Refugee The Life Ahead
Burma (Myanmar)
Presentation Title | Page 10 Exodus Refugee The Life Ahead
The People of Burma
States • Chin State • Kachin State • Kayin (Karen) State • Kayah (Karenni)
State • Mon State • Rakhine (Arakan)
State • Shan State
Presentation Title | Page 11 Exodus Refugee The Life Ahead
Many Languages • More than 100 dialects spoken in Burma
• Today, Burmese is the Official Language, English is secondary • Burmese taught in schools in the major cities; Military Regime prohibits
education in ethnic dialects
• Usage of minority languages is discouraged
• Other major languages spoken: Shan3,200,000 Karen dialects2,600,000 Kachin900,000 Chin dialects780,000 Mon750,000 Rakhine730,000 Karenni/Kayah
Presentation Title | Page 12 Exodus Refugee The Life Ahead
History of Burma • 1948 Independence from British rule Democracy • 1962 Military Rule • 1962-1977 Student Protests • 1988 Uprising-Security forces massacred 1000s of students and protestors
Presentation Title | Page 13 Exodus Refugee The Life Ahead
Why People are Fleeing Burma • Forced labor • Economic oppression • Political suppression • Racial discrimination
• Ethnic Fighting • Religious persecutions • Silencing those speaking out against military rule
Chin State Flag Karen State Flag
Presentation Title | Page 14 Exodus Refugee The Life Ahead
Fleeing Their Homeland • Lives Threatened
• Forced to leave without warning
• Not able to bring much, sometimes just family and clothes on their backs
• Families may be separated
In danger along the way:
• Fleeing in the jungle
• Malaria
• Starvation
Presentation Title | Page 15 Exodus Refugee The Life Ahead
Thailand Refugee Camps Refugees in Malaysia
Presentation Title | Page 16 Exodus Refugee The Life Ahead
Life in a Refugee Camp
You are living outside of space and of time, you have no roots, you have no past, you don’t know whether you have a future. You have no rights, you have no voice, you have nothing to participate in, you are not a citizen, you have no papers, sometimes you haven’t even got your name. You have to pinch yourself to reassure yourself that, yes, I am alive, I am me, I am a human being. I am a person.
• Strict rules
• Basic Health Care
• Basic Education
• Crime
• No citizenship
• Overcrowded & Under-supplied
• Exposed to disease
• Disabling – cooking, working
-Vaira Vike-Freiberga, Latvian president and former refugee
Presentation Title | Page 17 Exodus Refugee The Life Ahead
Nel Plah’s Karen Story
Presentation Title | Page 18 Exodus Refugee The Life Ahead
Overseas Medical Screening
U.S. State Department Each person is rigorously screened before released to come to the U.S. Not cleared to travel until not a threat to others Classified as: “A” immediate follow up required upon arrival to the US “B” may require follow up
Presentation Title | Page 19 Exodus Refugee The Life Ahead
Health Screening Part 2: Indianapolis
• Marion County Refugee Clinic
• TB (skin test), Immunizations, Parasites, Hepatitis A,B,C, Lead, Sickle Cell, Gen exam… etc.
• TB Suspects referred to TARC
• All referred to Primary Care
Presentation Title | Page 20 Exodus Refugee The Life Ahead
Challenges: Navigating the U.S. Healthcare System
• Language 100s of dialects
• Miscommunication • Say “yes” when they do not understand • Say what they think you want to hear out of respect & politeness
• Showing emotion may not be culturally appropriate
• Misunderstanding of medical advice
• Open-ended questions helpful
• System/ Insurance/ Transportation
Presentation Title | Page 21 Exodus Refugee The Life Ahead
Cultural Differences
• Female/Male doctor & patient relationships
• Changes in diet are used to treat illness
• Disease caused by spirit/Nat/ancestor
• Betel Nuts use (seed of Betel Palm- Areca catechu)
• Yellow lotion/make up
• Pregnancy and Delivery Rituals
• Traditional Medicine Used in Burma o Hot/Cold balance o Herbs, Coining o Lead and arsenic in child meds
• Breastfeeding o Publicly o Until child is 2 years old
Presentation Title | Page 22 Exodus Refugee The Life Ahead
Health Statistics (WHO) Total population (2012) 52,797,000
GDP per capita (current USD) $1144
Life expectancy at birth m/f (years, 2012) 64/68
Probability of dying under five (per 1 000 live births, 2012)
52
Probability of dying between 15 and 60 years m/f (per 1 000 population, 2012)
242/184
Total expenditure on health per capita (Intl $, 2012)
25
Total expenditure on health as % of GDP (2012)
1.8 (US- 17.9, Malaysia- 4, India- 4.1)
Presentation Title | Page 23 Exodus Refugee The Life Ahead
Hospitals in Burma Total Number of Hospitals 924 Total beds available 41,804 Patients admitted 1,324,979 Highest causes of death: Pregnancy, child birth, puerperium 17.9% Infectious and parasitic diseases 16.7% Injury, poisoning, other externals 16.5% Source: Ministry of Health 2011
Thank you!
Exodus Refugee Immigration 1125 Brookside Ave, Suite C9 Indianapolis, Indiana 46202
317.921.0836
exodusrefugee.org