I smiled as the Afghan family of six approached my triage station in the Philadelphia airport. The three young boys were laughing, playful, and full of energy despite the long journey. The oldest, who looked about 10 years old, sat on a chair and immediately began describing his symptoms—sore throat and cough, most likely a viral upper respiratory tract infection. I completed my physical exam as the medical student flipped through a sticker book with the other children. If we weren’t sitting on folding chairs amidst the cacophony of a makeshift clinic, it would have felt like my usual clinic appointments. I marveled at their resilience as the children left my triage station. My mind also raced through countless questions. Would they find a safe, welcoming home in this new country? Would they have the resources they need to thrive?
Over the past four weeks, more than 65,000 Afghan individuals have been evacuated from their home and endured the long journey from Kabul to military bases in Qatar, Germany, and Italy. They ultimately arrive in the U.S. or military bases abroad. Some are admitted with legal refugee status or are undergoing the challenging process of applying for Special Immigrant Visas (SIVs). Others, especially women, human rights workers, and those at high risk of experiencing direct threats to their safety, have entered through Humanitarian Parole. This process allows for quicker entry to the U.S. for “urgent humanitarian reasons.” It affords certain benefits, including temporary work authorization, but does not provide clear paths to lawful immigration or permanent residency. As a result, families face a host of uncertainties as they navigate their new lives abroad, including questions about their children’s futures.
Refugee children face numerous challenges as they resettle in new countries. They have often witnessed or experienced trauma in their home country and braved limited access to food, water, and proper sanitation during their emigration. Once in a new country, refugee children must acclimate to a new culture, often encountering language barriers, social exclusion, and discrimination from peers. These stressors have profound long-term health consequences, such as increased rates of anxiety and memory difficulties.
Several Afghan children have been admitted to hospitals throughout the country, including in Philadelphia. Pediatricians, nurses, and social workers have mobilized to support refugee children and their families. However, more is needed to ensure their long-term health and wellness. Families may require food, clothing, stable housing, books, and toys, all of which contribute to children’s mental and physical wellbeing. Children also need medical care that can meet the specific needs of refugees. This includes access to interpreters, knowledge of local resources for refugees, and the ability to provide culturally competent care.
While there are community programs and resources available to refugees, lack of awareness of these resources, prolonged processing times, or feelings of being overwhelmed and lost in a new environment may prevent families from accessing them. Refugee families may require assistance enrolling children in school, navigating school and health care systems, and accessing resources to support learning, medical care, and mental health. These needs must be prioritized in resettlement efforts at all levels, from the national government to the community programs and individuals working directly with Afghan families.
Fortunately, there are many opportunities to advocate for and support Afghan children. You can advocate for Congress to allocate emergency funding for organizations caring for children in Afghanistan, since the challenges children face may begin before they arrive in the U.S.
You can also send a message to President Biden and Congress to expand access to the Afghan SIV program, which gives Afghan evacuees access to resettlement services, including housing assistance, English-language classes, and help enrolling children in school. Lastly, consider donating to and volunteering with local organizations such as the Nationalities Service Center or HIAS Pennsylvania, which are committed to providing comprehensive services to support the health and wellness of refugees.
Though I continue to wonder about the future of the precious children I met at the airport, my hope is that everyone will see the role they can play in caring for them. From donating a book of stickers to writing to your local legislators, your efforts can make a difference.
Bianca Nfonoyim and Rebecca Whitmire are pediatric residents.
Image credit: Shutterstock.com
