UC San Diego: Individuals from refugee community waiting for COVID-19 vaccine.

When COVID-19 officially became a pandemic in March 2020, the world and life as we knew it changed. Grocery store shelves emptied. Shelter-at-home orders were given. Fears about a previously unknown virus ran amok. For refugees living in San Diego, these challenges were magnified in a city they had just begun to call home.

In response, the UC San Diego Refugee Health Unit shifted its focus to supporting members of communities that are facing systemic inequities that have caused many to suffer during the public health crisis. Work began with a survey of the San Diego refugee community, the first in more than 15 years, conducted in partnership with the San Diego Refugee Communities Coalition, a grassroots group of ethnic community-based organizations. The UC San Diego Refugee Health Unit is part of the Center for Community Health at UC San Diego School of Medicine.

“The COVID-19 pandemic exacerbated existing systemic racism issues and highlighted the health inequities within our communities,” said Amina Sheik Mohamed, founding director of the Refugee Health Unit. “Through our survey, we found that employment was hugely impacted, but so was housing availability, digital literacy and the ability to navigate system resources, such as at-home virtual learning for children and mental health support services.

“We administered the survey through community leaders more as a trusted interview instead of the typical survey and the results were very informing.”

Sheik Mohamed said the survey looked at social determinates of health—social, home and economic—and used the information to find immediate assistance and resources for individuals.

Amina Sheik Mohamed, Blanca Melendrez and Reem Zubaidi.
From left, Amina Sheik Mohamed, founding director of the Refugee Health Unit, Blanca Melendrez, executive director for the Center for Community Health and community engagement liaison to the Altman Clinical and Translational Research Institute at UC San Diego, and Reem Zubaidi, manager of the Refugee Health Unit.

As part of the survey, community leaders worked with their own community health care workers to conduct phone and in-person interviews in 12 different languages with 306 refugee families currently living in San Diego. Families interviewed were from Afghanistan, Burma, the Democratic Republic of Congo, Haiti, Somalia, Sudan and Syria.

The survey found that during the pandemic, nearly one-third of families canceled or missed health appointments. In more than 40 percent of surveyed families, at least one member lost their job; 60 percent of families couldn’t pay rent and feared they would be evicted.

The team provided the survey responses to County of San Diego to assist in its relief efforts.

Since the survey results were compiled last fall, the Refugee Health Unit has served as a conduit between the refugee community and the County of San Diego, holding weekly meetings with community health care workers and county officials.

“We receive weekly updates from the County on the pandemic, including vaccine eligibility and tier restrictions, and then take those updates back to our community health care workers who distribute the information to our refugee community members,” said Reem Zubaidi, manager of the Refugee Health Unit. “This is essential to the whole process. We can’t understate how important it is to provide this information in a person’s primary language from someone who they can relate with and converse with in their preferred communications method. It’s not just translation, it’s cultural.”

The Refugee Health Unit also collaborates with the San Diego Refugee Communities Coalition to develop and coordinate grant writing and funding distribution. Since March 2020, it has received approximately $3 million in grants, which are shared among community and ethnic-based organizations in need. Peer-based, bilingual community health care has also grown, with 40 new hires since last year. These workers provide assistance in navigating health care and crisis resolution.

“Every month we’re writing a grant, small or mid-sized, to support the refugee community,” said Zubaidi.

With vaccine eligibility expanding to everyone 16 years old and above on April 15, the team has pivoted to provide more information on the vaccines, including safety and efficacy data to address vaccine hesitancy. Recently, they partnered with UC San Diego Health’s mobile vaccine clinic to deliver vaccinations directly to communities in need.

As a leading advocate and provider for health care across the region, UC San Diego Health joined efforts to ensure equitable distribution of COVID-19 vaccines. Launched March 3, 2021, the mobile vaccine clinic travels to communities most affected by COVID-19, helping ease obstacles, such as access, lack of transportation and distrust in health care providers outside of local communities.

The Refugee Health Unit has coordinated two different mobile vaccine clinics with UC San Diego Health, vaccinating approximately 1,500 individuals from the refugee community and people of color.

Refugee Health Unit team with community health care workers.
Team members from the Refugee Health Unit along with community health care workers.

“The mobile vaccine clinic is a racial equity project led by UC San Diego Health and it makes us so proud to be a part of this effort,” said Blanca Melendrez, executive director for the Center for Community Health and community engagement liaison to the Altman Clinical and Translational Research Institute at UC San Diego. “Through this work, we ensure our most vulnerable populations who want a COVID-19 vaccine can receive one. We make it accessible by meeting the communities where they are.”

According to the San Diego Refugee Communities Coalition, San Diego County is a primary destination for refugees seeking to establish a new home in the United States. Between October 2009 and September 2017, more than 50,000 refugees entered California, with more than 40 percent of these individuals resettling in San Diego County.

For the past 30 years, the Center for Community Health at UC San Diego School of Medicine has provided support to underrepresented communities through policy work, advocacy and research. Launched in 2017, the Refugee Health Unit focuses on helping refugee communities overcome health inequities and improve their agency so individuals feel represented as part of the larger community.

“For us, our work is more about looking at the issue of systemic racism and tackling that,” said Sheik Mohamed. “Right now we’re figuring out where the gaps are to meet the community where they are. With our approach, we collect information on what is needed and we determine how to get these resources to the community, and go on to the next problem. We’re going up the ladder together, it’s not one group, but all of us, and it’s something to be proud of.”

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