The Refugee Clinic at the Penn Center for Primary Care (PCPC) is run as a collaborative effort between the Primary Care and Global Health tracks of the Internal Medicine Residency program at the University of Pennsylvania, and our partner resettlement agency, HIAS Pennsylvania. Opened on October 15, 2010 as a partnership between PCPC and HIAS Pennsylvania, the clinic currently operates every Monday afternoon with 27 rotating residents, and sees over 75 new arrivals each year. Six attending physicians precept in the clinic, all of whom are experienced in global health, travel medicine or infectious diseases.
All new arrivals are seen by a physician within 30 days of arrival, many within a week of arrival in the US. For many, this is the first visit with a physician (besides overseas screening) that they have ever had. While bridging language and cultural barriers is difficult, the care provided to the refugees, and the learning experience for residents, are both unique and high quality. Residents gain experience and comfort with diagnosing and treating parasitic diseases (malaria, strongyloidiasis, schistosomiasis, intestinal parasites, among others), screening for tuberculosis, identifying nutritional deficiencies, assessing for a history of torture and PTSD, working with interpreters, and coordinating care with a diverse team of pharmacists, case managers and volunteers.
Eight different languages are commonly spoken in clinic. About 60% of the patients seen have come from Bhutan, 20% from Burma, and 20% from Africa (Eritrea, Liberia, Darfur). Residents from five different residency programs contribute to care in the clinic (Primary Care, Global Health, Med/Peds, Med/Derm and Psychiatry) and the clinic hosts a once-monthly Mental Health clinic operated by the Psychiatry Department, and a weekly Latent Tuberculosis Infection (LTBI) clinic, run by a Pharmacist and pharmacy students, in addition to full primary care and women’s health services.
Philadelphia is a unique city for refugee care; all six clinics and all three resettlement agencies city-wide that serve refugees have united to form a collaborative, the Philadelphia Refugee Health Collaborative (www.philarefugeehealth.org). This is the only such coalition in existence nationwide, and has allowed for a rich exchange of ideas, collaboration on research, and coordination of patient care. The Philadelphia model has been looked at by other cities nationwide, and members of the collaborative (including PCPC and HIAS Pennsylvania) have been invited speakers nationally, at the 2011 National Consultation of the Office of Refugee Resettlement in Washington DC, and across the state at a number of venues, including in meetings with the state Refugee Health Coordinator. The Collaborative has been awarded grants from the United Way and several other local foundations for its work.