Summary of Impact Reports

The San Diego Refugee Communities Coalition’s COVID-19 Community Impact Assessment is the result of an unprecedented effort by the San Diego Refugee Communities Coalition, a collaborative of eleven ethnic-community based organizations, as well as local partners including Alliance Healthcare Foundation, The California Endowment, Price Philanthropies, San Diego Unified School District, and the San Diego Foundation with technical assistance and support by the University of California San Diego Center for Community Health’s Refugee Health Unit and Nash & Associates. The goal was to develop and deliver a comprehensive assessment that answers the question  “How is the COVID-19 Pandemic Impacting families within San Diego’s Refugee Communities?”

The assessment process consisted of:

  • Survey instrument creation and review for issues of cultural sensitivity.
  • Recruitment and training of more than 20 staff and volunteers by SDRCC members to administer the survey.
  • Phone or in-person survey administration with 306 families representing 18 countries from Africa, Middle East, Central, and South Asia, and the Caribbean. The survey was administered in 12 languages.
  • A focus group session and individual key informant interviews with 11 community leaders.

UC San Diego Center for Community Health’s Refugee Health Unit (RHU) facilitated the planning process and serves as the “backbone” organization for the SDRCC. Founded and led by Amina  Sheik Mohammed, RHU’s role is to:

  • Coordinate coalition meetings and facilitate collaborative decision-making and planning.
  • Develop and oversee community-based participatory action research, assessments,  evaluation, and performance measurement.
  • Build capacity through training, technical assistance, leadership support, and coaching
  • Conduct outreach to community partners and stakeholders to engage in the development and delivery of strategies that improve outcomes for refugee communities.

 

COVID-19 Vaccine Report

San Diego Refugee Coalition Communities (SDRCC) members believe it is imperative that promotion and delivery of COVID-19 vaccinations be informed by an understanding of factors that influence the decisions of communities that are being disproportionately impacted by the pandemic – including refugee communities. As part of this effort, the SDRCC has recruited a team of Community Health Workers (CHWs) who are considered front-line trusted messengers and service providers who can effectively communicate to their communities to deliver important information in relevant ways and in their communities’ primary languages.

SDRCC joined the Refugee Communities COVID-19 Communication and Health Outreach Initiative of the County of San Diego Health & Human Services Agency in September 2020. SDRCC members are providing contracted outreach and education services to refugee communities within the region through a team of 18 CHWs. The contract was recently extended through July 2021.

The lead for this work is the United Women of East Africa Support Team, supported by SDRCC members such as:

Haitian Bridge Alliance 

Karen Organization of San Diego 

Majdal Center 

License to Freedom 

Refugee Assistance Center 

Somali Bantu Community of San Diego 

Southern Sudanese Community Center of San Diego 

Coordination and technical assistance are provided by UC San Diego Refugee Health Unit and Nash & Associates. The CHWs are a peer-based workforce who are members of the communities they serve. One of the roles that they play is to serve as a bridge between their communities and systems and organizations. During weekly peer-focused training and support meetings several CHWs shared that they were receiving questions regarding COVID-19 vaccinations that they were not well equipped to answer and that members of the community were voicing concerns.

SDRCC Social Media Internship Summer 2021

The San Diego Refugee Communities Coalition recruited youth and young adults ages 16-24 to be part of a team of Social Media Interns. The program started June 15th and ran until August 27th. The final cohort was made up of 13 youth from ages 15-20 spanning across 10 different refugee and immigrant communities who had previous experience with content creation and active social media presences.

The team worked to promote the national “We Can Do This” Public Education Campaign with the aim of increasing public confidence in and uptake of COVID-19 vaccines while reinforcing basic prevention measures such as mask-wearing and social distancing. Participants were tasked with taking information from this campaign and adapting it for a younger demographic, specifically targeting peers from their own communities.

The cohort members In our cohort, 11 languages were represented: English, Arabic, Dari, Pashto, Tamizh/Tamil, Hindi, Karen, Tagalog, Kizigua, Somali, and Chaldean/Aramaic. The interns used their multilingual skill sets to translate existing content, and also create new content that accurately represented and spoke to the native languages and cultural practices of their communities. Over the course of the internship, the youth met with SDRCC staff on a weekly basis to share content, provide feedback, and research ideas for messaging in order to create and post at least two pieces of social media content per week. Throughout this process, the interns recorded the metrics of their content and adapted their methods to increase engagement. The internship concluded with an Exit Survey, where the cohort members reflected on their experiences and had a chance to give feedback on the program.

Opening of the Office of Refugee and Immigrant Affairs

On June 7th, the County of San Diego Supervisors Nathan Fletcher and Nora Vargas presented their proposal for the Office of Immigrant and Refugee Affairs at a press conference held at the County Administration Building. The SDRCC was among several supporters of the proposal. Executive Director for the Karen Organization of San Diego Nao Kabashima spoke at the press conference in support of the proposal, highlighting the need for an office in San Diego.

 

The mission of the OIRA is to provide resources and information to refugees and immigrants who are new arrivals to San Diego County with the goal of connecting individuals and families to local service providers. The office will be managed by the County Refugee Coordinator. This office will be an important asset to the County and the work we do, especially considering the diversity of San Diego’s refugee and immigrant communities.

 

During the press conference, Supervisor Fletcher stated: “We are creating a framework for our future that ensures San Diego County is welcoming and everyone feels like they belong.”

Supervisor Vargas also spoke at the press conference: “As the first immigrant elected to the San Diego County Board of Supervisors it is an honor to champion an initiative so personal to me,” Vargas also stated, “To fulfill our vision of creating stronger and healthier communities, the Office of Immigrant and Refugee Affairs will work for everyone by creating a central hub of services and resources and uplift the positive contributions that our immigrant and refugee communities have on our economy and culture.”

Union Tribune Commentary – To vaccinate refugees, shame won’t work. Engagement that considers trauma will.

A trauma-informed approach is needed to move some vaccine-hesitant individuals from a fight, flee or freeze state to one of comfort, confidence and action.

Nash is principal of Nash & Associates and a senior development consultant to the San Diego Refugee Communities Coalition. She lives in South Park.

The race to vaccinate as many people as possible, and as soon as possible, has created challenges and opportunities for grassroots organizations working with marginalized populations. Many have firsthand knowledge of how experiences of individual or collective trauma can create a sense of fear and mistrust of authority and influence decision-making.

As a result, some of these organizations are now adding “trauma-informed” as a best practice approach to building confidence in government led COVID-19 vaccination efforts and making progress because of it.

The San Diego Refugee Communities Coalition is made up of 11 ethnic community organizations working with populations whose primary languages would be unfamiliar to the average American — including Tigrinya, Karenni, Haitian Kreyol, Pashto and Dari. But language is only one barrier to accessing public health services. Layered on top of that are experiences of discrimination, persecution, and a myriad of social and economic stressors. These barriers and stressors are not new. What is new is the political will to address the disparities and conditions that predate COVID-19, and which are driving lower vaccination rates among the Black, Brown and immigrant communities.

San Diego Refugee Communities Coalition members know that a heavy-handed, guilt- and shame-driven approach for vaccinations will have limited success. In fact, such an approach could put at risk the hard-won trust we have built over decades of front-line service. What we believe will work is a community engagement model that doesn’t dismiss the role that past or current traumatic experience plays in shaping responses to the pandemic. People who have had close family members deported are not lining up at government run vaccination sites. Families who have had health issues held against them in their immigration process don’t want to risk a positive COVID-19 test or side effects from vaccination. Individuals who have firsthand experience of abuses of power don’t know whom to believe or whom to trust.

Our coalition members believe that a trauma-informed approach, which incorporates linguistic and cultural competency, is needed to move some vaccine-hesitant individuals from a fight, flee or freeze state to one of comfort, confidence and action.

A trauma-informed approach means respecting the well-founded reasons for mistrust and hesitancy, and meeting people where they are in their questions and fears. Trauma-informed practices include providing information regarding which vaccine is being administered, providing a peer navigator to be on hand as needed, creating private vaccination spaces for women and children only, addressing non-COVID-19 basic needs, and establishing a welcoming environment.

Funded by foundations, the county and state health agencies, the San Diego Refugee Communities Coalition’s peer-based workforce is equipped for the job at hand. Our entire workforce of more than 40 full and part-time staff members is bilingual and collectively cover 26 languages and dialects. All are members of the community they serve. They shop at the same ethnic markets, attend the same mosques and churches, and have shared experiences of what it takes to navigate the ups and downs that come with building a new life in the United States.

Partnering with local clinics, health-care providers and faith-based organizations, we have been hosting vaccination events since May, and have vaccinated over 1,600 of our community members so far. Each event is focused on a particular refugee or immigrant community. In late July, more than 100 members of San Diego’s Haitian community came to a vaccination event in the parking lot of the Haitian Methodist Ministry. Community Health Workers from Haitian Bridge Alliance greeted families with self-care packages, diapers, children’s books and clothing, Haitian soda and food. Haitian Kreyol-speaking community support navigators from the state’s CalHOPE Program were on hand to provide information about resources and programs, answer questions, and dispel vaccination related rumors and myths. Similar events, that pair vaccinations with bundled services and resources, happened this past weekend for Afghan, Iraq, Syrian, Sudanese and Somali Bantu communities, and additional events are planned monthly for other communities.

As the U.S. sees a rise in COVID-19 case rates and hospitalizations, public health departments and their community partners across the country are ramping up efforts to continue getting as many people vaccinated as possible. Trauma-informed practices of understanding, empathy and caring may be the best way to get some people across the finish line.

Read the article in the San Diego Union Tribune: https://www.sandiegouniontribune.com/opinion/commentary/story/2021-09-01/vaccine-hesistancy-refugees-minorities