Primarily authored by EthnoMed Director Dr. Carey Jackson, these posts explore current issues and spotlight organizations related to immigrant and refugee health care. We also occasionally feature guest authors.


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Sign saying immigrants and refugees welcome

Anti-immigrant Sentiments Affect Immigrant Health

The rhetoric around immigration has again reached a fever pitch. It did after 9/11, it has repeatedly, and it has again. Migrant children fleeing intolerable gang and domestic violence in Central America have crowded the Southern border. Refugees fleeing Syria are swarming over Eastern Europe and a chronic flow of migrants from East Africa stream north and cross the Mediterranean in precarious flotillas. The West feels under siege and frightened. There are many with distinct political agendas that capitalize on this fear and propagate unwarranted anxiety for their own ends. We see this in national political debates and we see it daily in local politics.

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blood test in a syringe

Hepatitis B Research and Immigrant and Refugee Communities

By Margaret Shuhart, MD, MS Director, Hepatitis and Liver Clinic, Harborview Medical Center

Hepatitis B research traditionally has been underfunded, as diseases such as HIV and hepatitis Chave been given higher priority by funding agencies. More recently, the NIH has established the Hepatitis B Research Network (HBRN), a group of 28 clinical sites across the US and Canada designed to address important clinical questions pertaining to hepatitis B in both children (7 sites)and adults (21 sites). Seattle has both adult and pediatric sites. Broad questions being asked by the HBRN include why some develop severe liver disease and liver cancer while others have inactive disease, how to improve the response to current treatments, and whether indefinite treatment is really required in those who have e antigen-negative disease.

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Research spelled in scrabble pieces

Health Disparities and Clinical Research

This year the Vietnamese remember the end of a long civil war. Many of us who are old enough know exactly where we were 40 years ago when we were told that Saigon had fallen. So many Vietnamese lives in the North and the South were lost in that war, so many French and then American lives were spent fighting that war. In the chaos of the immediate aftermath of the war, and then for years to come, there was an exodus of Vietnamese to the West. The U.S. received over 1,000,000 Vietnamese refugees when all was said and done, and then the Vietnamese-American community has grown from there. In the first decades after the war it became evident that there were a number of conditions disproportionately prevalent in the Vietnamese community; diseases such as tuberculosis, hepatitis B, liver cancer, and cervical cancer to name a few.

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Sign saying "We are not criminals, we are hard workers"

Profiling Populations and Health Disparities

“There it was: AIDS as the litmus test for nurses and physicians, a means of identifying who would and who wouldn’t. I had seen this before in Boston…..

“So,” I asked, “is this kind of stuff still going on now, with Gordon?”

“Hell yes! Except they know who is and who is not willing to take care of a patient like Gordon. I am willing. Mary is willing. And quite a few others. But I don’t think they should take advantage of us for that reason. It’s convenient for them. Because if they bitch and moan and if they don’t take care of the patient right, then I feel like I have to step in. I can’t let that happen.”

Verghese, Abraham. My Own Country: A Doctor’s Story. Vintage, 1995.

Through this exchange with a nurse, Abraham Verghese recalls attitudes in the 1980s among medical staff engaged in the care of the first HIV patients in rural Tennessee. His remarkable memoir of his years as an Infectious Disease specialist during the early days of HIV recapturesthe palpable possibility that contamination with HIV was a death sentence faced by many in operating rooms and on medical wards, a belief held by some among medical professionals and civic leaders. In repeated vignettes Vergesse describes how these attitudes affected the resources and care gay men received.

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