Recent political dialogue has brought refugees under fierce scrutiny. As an emergency medicine doctor, I get to care for refugees in both the hospital and at two outpatient clinics specifically designated for refugees and immigrants in Philadelphia. Refugees do not drain resources from our healthcare system and our community benefits positively from refugees through economic and cultural vibrancy.
Rather than shun refugees, I advocate for an increase in the number of refugees Philadelphia accepts in coming years.
Let's bust some myths circulating about refugees, specifically with regards to healthcare.
Myth 1: They use up our healthcare resources
Many refugees I see at our Refugee Clinic tend to be younger (between the ages of 20-40) and have relatively few medical problems. Individuals who apply for refugee status often are adults who are well enough to obtain a job and support themselves and their families.
Statements have been made that refugees are 'pouring in,' overwhelming the healthcare system. In fact, Philadelphia accepts approximately 800 refugees per year, an extremely small number in comparison to the general population of over 1.5 million people. Similarly, Pennsylvania accepts approximately 3,000 refugees per year and the U.S. as a whole accepts around 70,000 per year - less than one percent of the nation's population.
Myth 2: They are a health hazard
Refugees undergo health screening prior to departure to assess for communicable medical conditions that would prohibit them from resettlement. At our clinic, and most around the nation, refugees must see a provider within 30 days of arrival, and again undergo comprehensive health screening including testing for conditions like tuberculosis, measles, mumps and rubella. In order to obtain a job, green card, and access to education, refugees must provide records of immunizations and screening for specific medical conditions. Further, the U.S. Centers for Disease Control and Prevention (CDC) closely monitors all newly arrived refugees.
Myth 3: We don't know who they are.
Given the comprehensive screening process refugees undergo, we have adequate knowledge of who they are. In Philadelphia, refugees primarily come from Bhutan, Burma, Iraq, Congo and now Syria. The process they go through to become a refugee is actually very rigorous with multiple security checks, often taking two years. When a refugee applicant is referred to the U.S., the application is reviewed by four separate governmental organizations, multiple international nongovernmental organizations, and multiple domestic nongovernmental organization. Through this process, the refugee's application is reviewed multiple times with enhanced security screenings, an in-person interview, medical screening prior to departure to ensure applicants with a contagious disease are excluded, and a pre-departure cultural orientation.
Myth 4: Refugees are dangerous and 'bad hombres'
As previously described, refugees go through the highest level of security screening in addition to multiple other screenings. Since 9/11, 800,000 refugees have been admitted to the U.S. No refugee during this period carried out an act of domestic terrorism. On the contrary, many refugees I see are far more likely to be victims of terrorism, often fleeing violence and persecution in their home country. Finally, many refugees, specifically Syrian refugees, are overwhelmingly women and children.
Myth 5: They use up our non-healthcare resources
A study conducted in Cleveland found that refugees there typically obtained employment within 5 months of arrival. Data from 2009-2011 found that "refugee men were more likely to work than men born in the U.S., while refugee women were just as likely to work as U.S.-born women." They often enter economic sectors that do not have adequate numbers of native workers. Further, refugees are subject to the same taxes as any U.S. citizen despite the fact that they cannot vote.
The cost of resettlement is approximately $2,000 per refugee, a tiny figure in comparison to the cost required to pursue military involvement in many of the countries the refugees come from.
Call to Action
As a healthcare provider who works with refugees, I can attest that refugees do not burden our healthcare system. On the contrary, they contribute positively to multiple sectors of our community. In Philadelphia, where the population declined by almost 25 percent from 1950 to 2000, foreign-born citizens comprise most of the recent population growth, growth that has contributed to recent urban renewal across the city.
Philadelphia and Pennsylvania should accept more refugees in the coming years. Philadelphia is uniquely positioned to accept more refugees given the infrastructure for refugee resettlement and screening that is already in place.
Refugees are an integral part of our country and should continue to be. Our city, and our country, is already great because of our citizens, many of whom are refugees. As President Obama has stated, "Protecting and assisting refugees is a part of our history as a nation, and we will continue to alleviate the suffering of refugees abroad, and to welcome them here at home."
Amy Waldner is a third year Emergency Medicine Resident at The Hospital of The University of Pennsylvania, as well as a volunteer resident physician at Penn Center for Primary Care Refugee Clinic and at Puentes de Salud. She also is a volunteer physician through Physician for Human Rights where she performs medical asylum evaluations.