Community Health Nursing Diagnosis
In recent times, refugees and their resettlement have posed serious health problems in America. Texas has been one of the most adversely affected states as the state received the highest number of refugees to be resettled as part of the federal refugee resettlement plan. In my community health survey, I studied a population of resettled minors mainly from Mexico. The study community was based in Roysa, which is in North Texas. Most of the group were adolescents and young adults; some of the young adults were parents (Chiquillo, 2015). The most vulnerable population in this community were the children younger than five years; whether accompanied by their parents or not. This paper is an analysis of the community health nursing problems of the refugee community in Roysa, Texas, with particular emphasis on the children under the age of five.
Vulnerable Population Overview
The children below five years of age are the most vulnerable group in the refugee community of Roysa. Some of the children are accompanied by their parents while others are accompanied by their older siblings yet others are on their own with no older person identified with them. From the windshield survey, the children among the refugees in Roysa are in a bad state. Most of the children are suffering from various diseases and are malnourished. The situation is even worse for children who are not affiliated to any adult within the camp.
Generally, the children in Roysa are suffering from immunizable diseases at far higher rates when compared to children in other parts of USA. From the survey, an excess of 10% of the children was suffering from whooping cough; a disease which is extremely rare in other parts of the USA. Several cases of measles had also been reported in the camp in recent times. Cases of diarrhea probably due to rotavirus infection or unhygienic conditions in the camp were galore. The situation was made worse by the difficulty that the people in Roysa had to access proper medical care since they were not American citizens and lacked insurance.
Risk Factors for Disease and Barriers to Good Health of Vulnerable Population
The main risk factor that we identified as a contributor to increased disease prevalence among children under five in Roysa was congestion. Congestion invariably led to poor hygiene in the camp hence increased the incidence of diarrheal diseases (Garakasha, 2014). Congestion also enhanced the spread of infectious diseases such as rotavirus diarrhea and whooping cough (Garakasha, 2014). Another risk factor identified was poor nutritional status. A good number of children under five in Roysa were malnourished on the basis of MUAC. Malnourishment derails one’s immunity hence increasing their susceptibility to infectious diseases (Garakasha, 2014). Thirdly, inability to access proper healthcare posed a significant risk to the good health of the children in Roysa.
In our windshield survey, we were unable to get immunization records of most children. Even those who had the records, the immunization was incomplete. Lack of immunization and awareness on its importance posed a major barrier to the provision of proper healthcare to the people of Roysa. Moreover, the fact that the people were foreigners and a good number of them were incompetent in English was a major barrier in interacting with the refugees in Roysa for the benefit of their health.
Community Health Resources
The most resourceful organization for refugees in Texas especially the children under five is The Refugees Services of Texas. In North Texas, this organization is based in Dallas and Austin. They provide numerous services including custody and healthcare for unaccompanied children (Refugees Services of Texas, 2016). They also provide medical case management, counseling, and English classes to the children.
There are other organizations which also provide charity to refugees in North Texas. These include the Kaleo Missions, Catholic Charities of Dallas, Benin Community of Texas, and International Rescue Committee of Dallas (Volunteer Match, 2016). All these organizations have an office in Dallas, Texas. They have been very resourceful and instrumental in the provision of improved healthcare to refugees in Texas.
Community Health Diagnosis
From our survey, the main problem in the refugee community of Roysa in regards to the health of children under five is the lack of awareness on the importance and procedures of immunization. Most children have not been immunized at all or have not completed the immunization schedule because their parents lack information on why immunization is important, when to take their children for immunization, and where to take their children for immunization (Chattopadhyay, 2011). Immunization is not the only health area that people in refugee camps lack information about. As Chattopadhyay (2011) found out, these people also lack information about nutrition and management of diarrhea using oral rehydration salts.
It is the role of nurses to educate parents and guardians on why immunization is important. Nurses are also the health workers mostly responsible for the administration of vaccines. Ignorance of a community on the role of immunization in healthcare is, therefore, a nursing health problem. One of the goals of Healthy People 2020 is to do away with all preventable diseases and handle lifestyle diseases whose prevalence is on the rise. Having children who are not immunized in the community undermines this goal. Moreover, unimmunized children in a community reduce herd immunity hence increasing the prevalence of the disease in question. The refugees in Roysa need to be educated on why they need to take their children under the age of five years for immunization as scheduled. The immunization schedule should be availed to all parents or guardians in the camp. Children below the age of five who are not affiliated to any adult should be removed from the camp and taken to somewhere where their health needs can be catered for in a better way.
Summary
Refugees face many problems in Texas. The greatest victims of the plight of refugees are usually children under five years. The children under five years in Roysa refugee camp, for instance, have increased the incidence of diseases which can be easily prevented by immunization like whooping cough and rotavirus diarrhea. Congestion, malnutrition, and lack of immunization were found to be the main problems contributing to the morbidity of children in Roysa. The main nursing community health problem among the people of Roysa is their ignorance on the importance and procedure of immunization. One positive, however, is the fact that there are numerous charity organizations which support the wellbeing of refugees in North Texas and the organizations are based in Dallas. In essence, it is the role of all of us to help the child in Roysa to get immunized so as to help in freeing America of all preventable diseases by 2020.
Reference
Chattopadhyay, K. (2011). Awareness of Oral Rehydration Salt (ORS) among Mothers of Under-Five Children in Kamala Village, West Bengal, India: A Cross-Sectional Study. Universal-Publishers.
Chiquillo, J. (2015, Dec 21). Third camp in North Texas to receive migrant children from Central America. Retrieved from http://www.dallasnews.com/news/news/2015/12/21/third-camp-in-north-texas-to-receive-migrant-children-from-central-america
Garakasha, N. (2014). Working with refugee young people: A nurse’s perspective. Australian Journal of Advanced Nursing, The, 32(2), 24-31.
Refugees Services of Texas. (2016). About us. http://www.rstx.org/about-us.html
Volunteer Match. (2016). Organizations in the immigrants and refugees. Retrieved from www.volunteersmatch.org
