Search results

The purpose of this paper is to provide a comprehensive perspective of the documented physical and mental health issues Karen refugees from Burma face as a result of war and refugee trauma, and migration. The review will address the question: What is the impact of trauma and migration on the physical and mental health of Karen refugees?

A total of 18 articles were systematically selected for inclusion in the final review. The focal content for included articles includes qualitative and quantitative research representative of the health and migration experiences of Karen refugees.

The findings of this review demonstrate significance for health providers from a public health standpoint as programs and services are targeted to meet the specific health needs of the Karen community. It also highlights the contribution of the Karen forced migration experience to the complexity of individual and community health needs, particularly as a result of the protracted conflict.

This critical appraisal of the body of literature describing the health experiences of Karen refugees from Burma, with a particular focus on outcomes relevant to resettlement, demonstrates value as programs are developed with an integrated refugee perspective.

This paper's aim is to describe the health experiences of a recently arrived group of refugees, the Karen from Burma, in an American midwestern city.

Four focus groups were conducted in their native language with 40 Karen refugees: one group of ten Sgaw Karen speaking men and one of women, one of East Pwo Karen speaking men and one of women. The focus groups and two additional individual interviews were coded using NVivo‐9.

The findings emphasize the significant communication barriers experienced by the Karen. The data provide rich insights into the struggles being experienced by these new Americans in their own words and highlight some of their differences from previous Asian refugees.

These data are derived from focus groups with refugees in one city in the USA with few available demographic details. Their experiences and observations may not apply to other Burmese refugee groups in other cities and countries.

The data emphasize the complexity of language of this group of Burmese refugees which acts as a significant barrier to accessing health care. Poor or improper interpretation has increased obstacles. Data indicate that many struggle with simple health care tasks that are likely taken for granted by most providers. There appears to be more alcohol and tobacco usage amongst both genders than in other recently arrived Asian groups.

This is original research, which supplements a prior chart review and overview paper by the first author and supplements the otherwise scant literature on this group outside Asia.

The purpose of this paper is to describe Karen refugee women’s experience of resettlement and the factors which structured community capacity to support their mental health and well-being.

A postcolonial and feminist standpoint was used to bring Karen women’s voice to the knowledge production process. Data were collected through ethnographic field observation, in-depth semi-structured individual and focus group interviews with Karen women as well as healthcare and social service providers.

Three interrelated themes emerged from the data: Karen women’s construction of mental health as “stress and worry”; gender, language and health literacy intersected, shaping Karen women’s access to health care and social resources; flexible partnerships between settlement agencies, primary care and public health promoted community capacity but were challenged by neoliberalism.

Karen women and families are a diverse group with a unique historical context. Not all the findings are applicable across refugee women.

This paper highlights the social determinants of mental health for Karen women and community responses for mitigating psychological distress during resettlement.

Public health policy requires a contextualized understanding of refugee women’s mental health. Health promotion in resettlement must include culturally safe provision of health care to mitigate sources of psychological distress during resettlement.

This research brings a postcolonial and feminist analysis to community capacity as a public health strategy.

The purpose of this paper is to further understand the medical experiences of Karen refugees who have been resettled to the USA. It examines the use of traditional medicine throughout the transition from Burma to the USA, as well as refugees’ experiences in the American healthcare system. This study aims to identify shortcomings in refugees’ access to preferred methods of healthcare.

Interviews were conducted with 39 Karen refugees in 3 US cities with large populations of refugees from Burma – Fort Wayne, Indiana; Amarillo, Texas; and Buffalo, New York. Participants were asked questions about their healthcare experiences in Burma and the USA, their use of traditional medicine in both countries and their satisfaction with medical care in the USA.

Nearly all interviewees reported using traditional medicine in Burma, but only six felt able to continue to use traditional methods in the USA. Most participants had positive experiences with healthcare in America, but 15 expressed dissatisfaction with obtaining health insurance and confusion over its coverage. Findings also indicate that refugees do not feel that traditional practices are accepted in the USA.

Due to the language barrier, a phone interpreter was used for non-English-speaking participants, which may have affected proper understanding or clarity of answers.

This study brings to attention the need to improve refugee healthcare by encouraging traditional practices and assisting refugees with obtaining health insurance.

This paper identifies the importance of analyzing the accessibility of various forms of healthcare, including traditional medicine, to refugees in the USA.

The purpose of this paper is to describe and compare the health behaviors of Karen youth with that of the other subpopulation seen at a Minnesota clinic.

Demographic information and data on health status, recommended health behaviors and goal-setting patterns were collected via a review of the medical records of patients seen at a family medicine residency clinic in St Paul, Minnesota during a one-year period (July 2015–June 2016). Data were summarized using descriptive statistics. Data on Karen patients were compared with data on other populations.

The study included 765 youths aged 3–17 years. The Karen youth in the study engaged in recommended health behaviors more frequently than their peers on almost every measure. There were statistically significant differences in the amount of sleep, intake of fruits and vegetables, screen time, number of active days per week and consumption of sugar-sweetened drinks between the Karen and their peers overall. Karen youth also reported consuming fewer sweets and fried or processed food than their peers, and they had lower BMI percentiles than other youth.

The study relied on participant self-report, which is subject to potential inaccuracies in recall and reporting.

To the authors’ knowledge, this is the first study detailing health behaviors of Karen youth in the USA. The findings suggest a window of opportunity to support and empower Karen families to maintain healthy habits in order to prevent the development of chronic disease in this community.

The purpose of this paper is to explore the “active ingredients” of integrated behavioral health care (IBHC) from the perspective of Karen refugee participants in an IBHC intervention.

This paper is based on in-depth, semi-structured interviews with participants (n=40) who have received an IBHC intervention for one year. These qualitative data are supplemented by descriptive quantitative data from those same participants.

This research suggested that IBHC increased awareness and access to behavioral health services, and that IBHC may be especially amenable to treating complex health conditions. The research also found that IBHC provided a point of regular contact for patients who had limited time with their primary care providers, which helped to enhance access to and engagement with health care.

IBHC has the potential to meet the complex needs of Karen resettled refugees living in an urban setting in the USA.

IBHC is a promising approach to help meet the mental health needs of refugees in the USA. There are, however, gaps in knowledge about the “active ingredients” of IBHC. This paper helps fill these gaps by studying how IBHC works from the perspective of a group of Karen refugees; these are critical perspectives, missing in the literature, which must be heard in order to better address the complex conditions and needs of resettled refugees.

Canada’s immigration goals are multifaceted and ambitious, reflecting both a desire to attract those who can contribute economically and culturally and offer protection to the displaced and the persecuted. Alongside these goals is a pledge that newcomers will receive the services and supports they need to fully integrate into Canada’s cultural and economic landscape. This chapter argues that post-secondary institutions, working in partnership with community organizations and primary/secondary schools, are well positioned to facilitate economic and cultural integration, particularly for otherwise vulnerable refugee groups. However, the authors’ previous research illustrates the many barriers refugee youth face in accessing Canadian post-secondary education. The authors hypothesize that efforts to increase post-secondary access – and, thereby, facilitate the accomplishment of immigration goals – will be most effective when specific age groups within the refugee demographic are targeted; in particular, younger children who have spent more time in the Canadian education system. This approach requires a shift in settlement practice from that of meeting only initial, urgent settlement needs, to one that enables the development of economic and cultural capacity. The authors envision a program that, on the one hand, helps refugees to value and gain the broad benefits of post-secondary education, while, on the other hand, directs post-secondary institutions to offer programs and pathways that are more inclusive to the unique challenges faced by this vulnerable demographic.

Karen people from Burma are a new population in resettlement countries. While research increasingly documents their health needs, few studies describe how health-care providers adapt their practices to serve this group. The purpose of this study was to explore the experiences of providers who work with Karen patients/clients in health settings, documenting the challenges they face, how they adapt their practice and recommendations.

This study used a qualitative survey and one phone interview with a total of 20 providers who had first-hand experience caring for Karen people in health settings. Data were analyzed using qualitative content analysis.

Two main categories described challenges providers faced in working with Karen people in health settings: system-level challenges and interpersonal communication challenges. Five main categories described specific strategies and support needed to adapt practice for Karen patients in health settings: strategies for improving communication and mutual understanding; partnering with Karen staff, interpreters and cultural brokers; strategies for building trust and rapport; addressing needs related to case management, care coordination and social determinants of health; recommendations for provider training.

This paper contributes suggestions for adapting practice to meet the health needs of Karen people from the perspective of health-care providers in a location that is nationally recognized for its excellence in refugee health.

The Thai–Burma refugee program of Australian Catholic University (ACU) brings young Burmese refugees from camps in Thailand to an internet-equipped teaching center to study for a Diploma in Liberal Studies. Some of the learning is carried out online and some in face-to-face mode provided by ACU or partner universities.

The authors detail the methodologies followed, combining sound pedagogy with an integral human development approach. This changed the students’ mode of learning from rote to critical thinking which, in turn, improved their self-confidence, gave them a good ethical and culturally acceptable grounding and provided them with fluency in oral and written academic English. In addition, the authors recount the many challenges faced by bringing together students from diverse ethnic and religious backgrounds with all the baggage brought from a conflict ridden and divided country emerging out of decades of dictatorship.

The program’s results have been remarkable. Many students have found high-quality employment after graduating, especially with non-governmental organizations on the border or in Burma or in some other job serving the needs of their own people. Others have used the Diploma to go on to full degree courses in a number of countries in Asia, North America, and Europe.