Wednesday, January 13, 2010

Refugee case managers

On Tuesday, January 12, NBC Nightly News featured a refugee-related story in its "Making a Difference" segment. The story is about an Iraqi woman--a single mom--who became a case manager once she felt comfortable in her own resettlement. This is a very nicely-produced piece that gives a good snapshot of why so many case managers were once refugees themselves. the next time your student tells you there is no case manager helping her, take a moment to think about what you see in this news story.

The story is about two minutes long, but there is a mandatory 15-second commercial at the beginning. You can watch from this screen, or click here to see the full-screen version on the NBC Website.

Visit msnbc.com for breaking news, world news, and news about the economy

Wednesday, January 6, 2010

Rain Memories from Burma

As I've been preparing today's blog post, the temperature has been steadily dropping outside. My office is chilly, but I'm prepared for the trip home later today--I have my gloves, heavy coat, and extra-long wool scarf. As much as I dislike the cold and snow, I take it in stride because I know what to expect and how to prepare. Still, memories of the 2006 and 2007 Christmas blizzards have left me with Post-Traumatic Snow Disorder; that is, it doesn't take much to raise my snow-related anxiety level.

Our weather-related memories are part of us on an almost cellular level. At least when you understand what is or isn't normal, you tend to feel more in control of your own world. How we interpret what we see when we travel to a new climate is based almost entirely on the experiences we've had elsewhere. It is important to keep this in mind as we attempt to help newly arrived refugees adjust to their new environment. We all assume wrong at some point. Read on for some insight about how and why this happens. --SM


A snow shower or storm evokes reactions of glee from sledders, moans from drivers and shovelers, but terror from those unfamiliar with snow but familiar with cyclones. Please be aware of the fears and terror invoked during snow showers and storms where winds blow snow flakes and clusters laterally, sometimes almost to the horizontal. People unfamiliar with snow may equate winds that blow snow laterally with cyclones and other storms that have caused massive death and destruction in their tropical homelands. Snow and rain are both precipitation, but snowflakes are much lighter and are more easily (and dramatically) blown by wind.

I visited a Karen family during such a laterally falling snow shower. I was struck by the terror on their faces, blankets over windows, and their self-induced seclusion in their bedrooms. The daughter finally told me that trees were being uprooted by the snow storm. Upon further questioning I realized she was assuming that must be happening if the snowfall was lateral. They equated the winds that blew snow laterally with that of a cyclone.

Cyclone Nargis hit Burma in May 2008. The death and destruction affected the whole country and its memory still terrorizes people from Burma. Stories have emerged about Nargis survivors, especially children, who become paralyzed with fear whenever it rains. Many people in other areas lost family and friends. Others who were untouched were still affected by the terror, suffering and destruction and the inhumanity connected with Burma's ruling military's actions toward survivors in the cyclone's aftermath. This affected everyone from Burma whether or not they were or knew any victims.

During Burma's rainy season, June through October, it can rain for days and travel is very difficult. Malaria and other mosquito and water born illnesses flourish. Despite the heat and high humidity, upper respiratory infections (URI's) are very common during the rainy season. Chronic malnourishment contributes to these URI's and the many secondary pneumonia, skin infections and other sequelae we see as the exception in the United States.

The rainy season is also the time of year that large-scale and lengthy attacks by Burma's military repeatedly occur upon ethnic minorities. Civilians are not just driven off their land; they are also hunted down and raped, tortured and/or killed if caught. So, their escape into the jungle is fraught with multiple barriers to reaching safety, including rain, muddy terrain, constantly wet clothes, inadequate clothing and gear due to a hasty escape, the chill that accompanies constant wetness, forbidden warming or cooking fires that will send a signal of their location with the smoke, and forbidden crying, coughing or talking that may alert the hunting military.

Think of the emotions during the escape: Memories of the attack, seeing loved ones attacked or finding their body parts amongst ashes, not knowing who survived, having been attacked and/or raped, running while injured and suffering, being a child thrust into this world of constant fear and discomfort, having to run while in labor, miscarrying, or with a dying child.

These memories and fears may contribute, in addition to the extreme discomfort from the cold, to the reluctance of refugees from Burma to leave their homes during snowy or rainy weather. When I have taught English to refugees from Burma, I have been confused and frustrated at the lack of class attendance during the smallest of rain fall. Rain is a part of life in Burma, but memories of the Cyclone and lack of rain gear in a new environment contribute to their self-induced seclusion.

Our refugee clients don't want to be pitied. They felt weak and helpless during the hard times. Many don't want to revisit what they have been through to talk about it. Encouragement and acknowledgement of the strength that they had to possess to survive is essential.

Our awareness, patience, and information about snow and winter weather apparel may help ease the transition from fear or moans to glee.

Dr. Nora R. Rowley is a physician who practiced Emergency Room Medicine for 15 years, mainly in the Midwest. After leaving her hospital career to pursue humanitarian work, she volunteered with Doctors Without Borders inside Burma where she worked as a field medical doctor for six months.

Since returning to the U.S. in early 2007, she has dedicated a great deal of time to learning about the human rights crisis in Burma. She is currently on the Board of Directors of the U.S. Campaign for Burma(USCB)
www.uscampaignforburma.org.