Community Health Navigator Program for Houston's Burmese refugees may become a national model

Physician Assistant Foundation, Baylor College of Medicine partner to create model for refugee health care

The Physician Assistant Foundation (PAF), Baylor College of Medicine and other local partners today unveiled their unique approach to providing health care and social services to Burmese refugees in Houston, with hopes the program could become a model for meeting similar needs of refugees across the country.

Facilitated by Epiphany Community Health Outreach Services (ECHOS), a Houston-based organization that specializes in connecting underserved communities with resources and services essential to their well-being, the Community Health Navigator Program is a pilot program intended to increase access to quality, affordable health and social services for Houston's Burmese refugees in ways that are culturally sensitive and linguistically appropriate, while also addressing other social challenges they may be facing, such as transportation and employment.

The Community Health Navigator Program engages physician assistants (PAs) — health professionals trained in the medical model — and Health Navigators — English-speaking individuals from within the refugee community trained to act as health educators as well as translators and cultural interpreters — to work with Burmese refugees, assessing their individual needs and identifying culturally appropriate solutions.

"With their extensive reach in the community, ECHOS knows first-hand the health problems facing the Burmese in Houston and the potential magnitude of these problems if left unattended," said Carl Fasser, PA, Baylor College of Medicine PA Program director. "The Baylor College of Medicine PA Program saw this as a great fit for our students;  they have the opportunity to put their general practice skills to use, truly match health care needs with culturally appropriate treatments and develop their advocacy skills."

According to the Texas Office of Immigrant and Refugee Affairs, the Burmese population is one of the largest refugee groups arriving in Houston and is one that needs extra support to adapt to life in the US. An initial assessment at the onset of the Community Health Navigator Program found that it would be challenging for the state's refugee resettlement program to meet the many varying and widespread health and social welfare needs of the Burmese refugees.

"The Burmese refugees who are now coming to the United States have spent years — if not their entire lives — in refugee camps, setting them apart from other refugee groups who have resettled in Texas," explains Jean Kegler, executive director of ECHOS.  "Many don't speak English, may not be literate in their own language and may have no employable skills. In order to become successful members of Houston's robust, diverse community, they need a little extra support. They need to learn how to use our health care system and our public transportation. They need to know where they can turn for health screening or help getting their children enrolled in school."  

The program's initial assessments revealed that the Burmese refugees are facing critical health care challenges: Disabled adults and children are in need of artificial limbs and wheelchairs, children with incapacitating illnesses need 24-hour medical attention and tube feedings, adults with chronic and infectious illnesses need treatment and refugees who received no or inadequate oral hygiene need significant dental care. Barriers to understanding English-language medical forms and documents may prevent many Burmese from seeking the health care and social services they need if assistance is not provided.  

"Through the Community Health Navigator Program, PAs have an opportunity to be part of a team that is guiding and supporting the Burmese in Houston as they integrate into their new society," says William Leinweber, interim executive director of PAF.  "We hope that through this experience, the Health Navigators and PA students will help the Burmese refugees establish a community that centers on health and well-being and that we're able to learn from and apply this model to address the unmet needs of other refugee populations."

Fasser, Kegler and Leinweber were joined today by Michael Milner, PA, chief health services officer, U.S. Public Health Service Commissioned Corps, and Aaron Tate, director of resettlement, Interfaith Ministries, for a roundtable discussion with Houston's health and social services community about the needs of the Burmese refugees in Houston and opportunities to further expand this program. The roundtable was followed by a health fair for the Burmese community in Houston, where they received complimentary health screenings for skin ailments, hypertension, trauma and dental work.

The Community Health Navigator Program is a collaboration among the PA Foundation, ECHOS, Baylor College of Medicine PA Program, Catholic Charities, Interfaith Ministries, YMCA International, the Alliance for Multi-cultural Community Services, Gateway to Care and Houston Community College.  Financial support for the program is provided by the Chevron Corporation.