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Refugees fall into gaps in the US health care system. This Tampa free clinic steps in to help

Tatiana, a Ukrainian refugee with long brown hair, wears a black and white dress and sits in a patient room by a calendar
Daylina Miller / WUSF Public Media
Tatiana is from Ukraine, and says escaping the war, and leaving her mother behind, are weighing on her mind.

The project began just before the pandemic, in 2020, as an offshoot of an already established street medicine clinic run by USF faculty and students.

In early February of last year, Natalia went to a doctor in her hometown, near Kiev, for a thyroid exam. The doctor recommended a biopsy. But Russia invaded Ukraine two weeks later, and she and her husband had to flee.

Almost a year later, the couple is living in the Tampa area, and a free clinic at the University of South Florida is helping Natalia, 59, finally get the biopsy she needs.

“I didn’t get a chance in Ukraine, because of the war,” said Natalia, whose last name is not being published for privacy reasons.

Natalia is not alone. Millions of Ukrainians left their homeland after the invasion, leaving untold numbers of people to face similar issues with interrupted health care.

For the more than 150,000 Ukrainians who arrived in the United States, there’s an additional wrinkle: health care coverage provided by a federally funded program to help refugees transition to life here, runs out after eight months, according to Lynette Menezes, a professor of medicine at USF.

“That's when they fall out. So as a free clinic, we can only see those patients without any insurance, or those who you are in the process of getting it," Menezes said one evening in December, in the lobby of a USF Health medical school building, where the pop-up clinic is held.

Natalia and Alex take green bag filled with food from Richa Bischt at the refugee clinic.
Allison Long/Allison Long
/
USF Health
Richa Bisht (right), a fourth-year Morsani College of Medicine medical student and co-director of USF Health’s Refugee Clinic, distributes a gift bag to Ukrainian refugees, Natalia and her husband Alex, during the USF Health Tampa Bay Street Medicine's Refugee Clinic at the USF Health Carol and Frank Morsani Center for Advanced Healthcare.

The refugee clinic began in February 2020, right before the start of the coronavirus pandemic. It was added to a long-running street medicine clinic, through which USF medical students go out and provide care for people living on the streets in Tampa.

"We've already been doing this with the homeless,” said Menezes. “And we said, why not add another population that needs help so much?"

The clinic is all volunteer. The goal is to help people, whether they are seeking asylum, or are undocumented.

It is staffed by doctors and medical students, many of whom had parents who were immigrants themselves, like clinic co-director Richa Bischt, a fourth-year medical student at USF. Her parents came to America from India.

"If you're in a new country, not having access to health care is one more burden that makes transitioning to life here more difficult. So I think the services we provide are essential," said Bischt.

Lynette Menezes, a professor of medicine at USF, wears a face mask and looks up at a medical student at the clinic
Daylina Miller / WUSF Public Media
Lynette Menezes, Assistant Dean, USF Medicine International

Once a month, the clinic is for people from all over -- Venezuela, Cuba, Afghanistan, Myanmar and beyond. People who are undocumented can also get help, like a Serbando, 54-year-old man from the Philippines.

“Have you been having any pain here?” a medical student asks him, inside an office nook converted to a patient room.

Serbando said he was working as a welder when a piece of hot metal broke off, scorching a six-inch long wound in his shoulder. That injury happened in 2019 and didn't heal well.

Several weeks ago, the refugee clinic arranged a surgery for him, to remove a hard lump that formed in his scar tissue.

With the help of a translator dialed in by phone, the student tells him he sees no sign of infection. It's looking better now.

Serbando is relieved to hear that.

“I was actually very scared about it. It's just really a good thing that they helped me here at the refugee center and they were able to remove the mass on my arm," he said through a translator.

WUSF reporter Kerry Sheridan talks to Serbando, a man from the Phillippines who is getting treatment at the clinic
Daylina Miller / WUSF Public Media
WUSF reporter Kerry Sheridan speaks to a patient at the clinic, Serbando.

A second monthly clinic is specifically for Ukrainians who've arrived since the war with Russia began a year ago.

The patients' stories are all different. For 28-year-old Tatiana, who worked as a tailor in Ukraine, the memories of escaping her home in Kharkiv are still fresh.

The sounds of bombing woke her in the night. "And I came to the window. The sky was all red,” she recalled.

She fled her homeland, and later learned that Russian soldiers raided her shop. All the clothes and sewing equipment were gone.

“After this, my heart broke, because I understand, it has all died. All I do, what I love, you know, all died," she said.

Medical students wearing blue scrubs and white jackets sit around a table with laptops open, discussing the clinic ahead.
Daylina Miller / WUSF Public Media
Medical students and USF doctors meet before the clinic starts, one evening in mid-December 2022.

As she tries to start over in America, the refugee clinic has helped her get health care for herself and immunizations for her son, so he can attend school. Tatiana said it really helps that it's free.

"It's all expensive -- all expensive. I do not have money to pay in America," she said.

The refugee clinic provides a wide range of health care services, including psychological and psychiatric care. Lucy Guerra, professor of medicine at USF Health, said that’s because the patients share a common thread.

"Most of them are people who have left their country for religious reasons, persecution, for political reasons, some because of their sexual orientation. All of them have experienced some type of trauma, whether it's physical or emotional trauma,” said Guerra.

Volunteering at the clinic has made fourth-year medical student Ahmad Harb, who is Lebanese-American, want to focus on global health in his career.

Ahmad Harb wears a white doctor jacket and a Santa hat and talks to another person, not visible
Daylina Miller / WUSF Public Media
Ahmad Harb says working at the refugee clinic has been a fulfilling experience that has shaped his outlook as a clinician.

“The patients that affect me the most are the ones that come from such traumatic experiences, have faced such serious issues, and then we're able to provide them some level of care that kind of gives them peace of mind,” said Harb, who has used his Arabic-language skills to help translate for Syrian refugees at the clinic.

“That's shaped how I think as a clinician, overall,” he added. “Because of how capitalistic our health care system is, the sky-high prices of medications, of testing, it's a little disheartening, and especially the pitfalls that we see,” said Harb.

"We all deserve some certain level of respect and quality of life. To be able to provide that to refugees, I think, is very fulfilling. And to provide it to anybody who is in need, I think is what being human is about."

I cover health and K-12 education – two topics that have overlapped a lot since the pandemic began.
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