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.

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

Union Tribune Commentary – Refugees in San Diego are struggling with pandemic challenges. We know, we surveyed them.

By REEM N. ZUBAIDI, AMINA SHEIK MOHAMED
NOV. 16, 2020 5:11 PM PT

As winter approaches and cases of the coronavirus again begin to surge, we need to learn from the challenges our communities experienced during earlier waves of the pandemic and take steps to prevent or reduce additional hardships in the months to come.

Even before the arrival of the pandemic, immigrants and refugees in San Diego County struggled to access employment, affordable housing, educational opportunities and health care. The pandemic has made these challenges worse while cutting off access to critical social supports and connections when they’re needed most.

The San Diego Refugee Communities Coalition recently surveyed the clients of our member organizations to get a better sense of what they have faced since the arrival of the coronavirus that causes COVID-19. We heard from 300 households representing more than 1,400 residents who are refugees and new immigrants of East African, Middle Eastern, Central and South Asian, and Haitian descent.

We learned that 70 percent of these families are concerned about having enough food, and 60 percent are unable to pay all of their rent. More than half of the families said at least one family member has lost a job or income or has had to close a business. Many refugees work in the service industry as rideshare or taxi drivers or in hotels and retail, sectors that have contracted during the pandemic, so it’s not surprising that economic concerns are paramount.

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We also heard that students are struggling. Overall, 85 percent of families with school-age children say that — despite schools’ best efforts — their children are not getting the support they need to participate in distance learning. These students face barriers that many of their peers don’t encounter — like not having a place to work or reliable access to a computer or the internet. Others are dealing with language challenges or don’t have anyone at home who is able to support their learning.

Prior negative experiences, language barriers and difficulty navigating confusing health-care systems have deterred or delayed families from accessing treatment they need. More than 30 percent of families told us that they have canceled or missed a medical appointment because of the pandemic. Fears of contracting COVID-19 mean that many families are avoiding in-person visits, yet very few families are comfortable with tele-health alternatives. There is a general mistrust of technology, particularly when it comes to keeping health information private. There are also practical barriers to having a private health consultation via Zoom from a small apartment shared with school age-children and other family members.

These challenges take a toll: 40 percent of respondents to our survey said they are extremely concerned about the emotional health impacts of the pandemic. In a focus group conducted with community leaders, we heard reports of increased domestic violence, as well as alcohol use and drug use in some communities, especially among younger males. Meanwhile, 80 percent of families are concerned about the impact of the coronavirus pandemic on their ability to access places of worship, an important source of connection and support.

Amid these daunting challenges are sources of hope. San Diego County’s Health and Human Services Agency is funding eight ethnic community-based organizations to provide bilingual outreach and education to help ensure that refugee communities have access to accurate and current information about coronavirus testing sites and resources. Emergency response funds and rent-relief programs have helped keep a number of families afloat and in their homes. Most families report that they are happy with the communication from their schools, and many have received supports such tutoring, school supplies, computers and WiFi assistance. And the vast majority of those who responded to our survey said they had at least one person they could count on for support in dealing with the stress resulting from the pandemic.

But much need remains. Working through community organizations with the knowledge and trust of those they serve, we see many more opportunities to promote hope and resilience among immigrant and refugee families in San Diego County, from supporting digital literacy for families of school-aged children to ensuring that voices of refugee communities are represented in regional economic development and planning conversations.

As we face another wave of COVID-19 cases, we need to act now to ensure that all communities in San Diego County have the education, opportunities and access they need to weather this difficult season, recover and thrive.

Zubaidi and Mohamed work in the Refugee Health Unit of the UC San Diego Center for Community Health. Zubaidi lives in Mission Valley. Mohamed lives in La Mesa.

 

Read article on Union Tribune here: https://www.sandiegouniontribune.com/opinion/commentary/story/2020-11-16/commentary-refugees-in-san-diego-are-struggling-with-pandemic-challenges-we-know-we-surveyed-them