Feature: May/June 2013

Pre-travel Counseling for Persons Visiting Friends and Relatives (VFRs)

Providers who care for the medical needs of immigrant and refugee patients are familiar with their inevitable decision to return home for a visit. For many, this return is a momentous event. They may have left in terror, to only now return in safety for a long-imagined reunion.The exposures many risk upon return are sometimes minimized as patients may not realize that years later their health cannot tolerate the insults to their immune system they might have weathered back home in their youth. Others will want whatever treatment they can get but not realize the expenses may not be covered by Medicaid or their insurance. 

This article, authored by International Medicine Clinic's Medical Director, Dr. Carey Jackson, offers useful tips and guidelines as you discuss issues with traveling patients.  Considerations include the significance of the occasion for the patient, the decisions to immunize, prophylax, or treat when symptoms arise, with calculations based on the duration of the trip, geographic areas and seasonal prevalence of disease, settings to be visited, and the condition and co-morbidities of the traveler. The article includes links to guidance provided by Public Health Seattle & King County and the CDC.  Read more...

Recent Feature:

Cambodian Terms For Hypertension May Cause Misunderstandings about the Disease

A population-based survey conducted in Cambodia in 2007 by the Ministry of Health found self-reported rates of high blood pressure of about 50% were significantly higher than the actual prevalence of high blood pressure of about 12% (Saphonn & Prak, 2008). This raised a question about what the terms used for high blood pressure by health professionals meant to patients, and whether the surveyed population had a different perspective from health professionals. These terms, which suggest that hypertension is an illness related to blood volume—and not pressure—may influence patients’ understanding of the disease.  If so, such confusion may increase the risk of poorer health outcomes if adequate education about the disease is not imparted. The Khmer terms for hypertension used by interpreters and patients in the Seattle area are the same as those in Cambodia. We explored whether the terminology used may be a source of confusion for Cambodian immigrants and found that indeed, the same misunderstandings exist among many Cambodians in our area. The article explores the misunderstandings and contains practical suggestions from patients, interpreters, and health care providers for education about hypertension.  Read more...

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