Building capacity and partnership with bhutanese refugees to access well-women preventive & health services

Significance: The Lhotshampa ethnic group migrated from Nepal to Bhutan in the 1800s. In the 1980s the Bhutanese monarchy implemented a “One Nation, One People” policy eliminating Nepali in schools and requiring documentation for citizenship. Over 85,000 Lhotshampa fled to Nepal in 1990 where they lived in refugee camps for 20 years before being resettled to the United States. The Bhutanese are the third largest refugee group in the US. Limited resettlement services in Arizona include financial assistance for up to 8 months; case management for 3 to 6 months; and health insurance by the Refugee Medical Assistance Program (RMAP) for 8 months. Significant challenges persist such as retaining health insurance, lack of transportation, unemployment, limited English proficiency, illiteracy in Nepali, health seeking practices, and difficulties understanding the US health system. Objective: The aim of this project is to increase access to well-women preventive and care services for the Bhutanese refugees. Methods: A small grant was obtained and a four-step strategy was implemented: orient mainstream service providers to Bhutanese community, train BMAAT community health educators, provide educational outreach in 3 Bhutanese neighborhoods, engage the local health department to bring the Mobile Van to the Bhutanese neighborhoods and offer a free clinic day. Results: Outcomes included; established a committed partnership, trained 6 BMAAT community health educators, carried out 6 community education sessions in the 3 Bhutanese neighborhoods reaching at least 200 community members, and provided preventive education, screening and clinical services to 45 women and their husbands.