Lilian Montoya immigrated to the United States from Mexico 17 years ago. One day, she was home alone with her young son when his fever spiked so high his fingers started turning blue.
“I called the 9-1-1 because my son gets sick, and I didn’t know what to do,” said Montoya. “And I can’t even explain [to] them what happened. So I just remember the blueberries and I say blueberries fingers.”
She ended up getting her son to the emergency room. But she said it took her more than two years to feel like she really understood the U.S. health care system.
“When you arrive in a different place, you don’t know nothing,” said Montoya. “So I remember that I have to investigate everything by myself. And now I say, ‘Well, if I know the answer, why are gonna make people suffer if I can provide that information.’”
Montoya now shares that knowledge in her job as a case manager and health advocate for Catholic Social Services. She works with refugees — teaching health classes, working one-on-one and giving each new refugee a three-hour health orientation.
It’s part of a larger effort that Catholic Social Services launched in 2016 to make sure refugees understand the complex and often baffling U.S health care system. The number of refugees coming to Alaska in the last two years has soared; last year there were over 500 refugees, up from an average of around 100 in previous years. For the past five years, they’ve partnered with Providence Alaska for health screenings. And to meet growing demand, Catholic Social Services started offering new classes this spring and screenings through Anchorage Neighborhood Health Center. They’re also looking for a clinic to partner with in the Mat-Su Borough.
Abdul Wahidi, a medical case manager for Catholic Social Services, teaches classes to refugees. He shows them how to make medical appointments, how to cancel or reschedule them and the differences between urgent care, emergency rooms and primary care doctors.
Wahidi said in Afghanistan, where he’s from, you don’t need to make an appointment to see a doctor.
“If you call to schedule an appointment, they will just tell you, ‘You are the number two, you are number three,’” said Wahidi. “They don’t give you a specific time, this is the time that you have to come.”
Many refugees may have left traumatic situations or a country at war. But within 30 days of arriving, they need to have a thorough health screening. They may get vaccines and will get tested for contagious diseases like tuberculosis or syphilis. Navigating this visit is one more hoop they have to jump through, often in a new language.
Wahidullah Khan came here from a rural area in Afghanistan two years ago. Through a translator, Khan said the medical system in Afghanistan was much more simple.
“Back home when we get sick we directly go to the doctor without no appointment,” said Khan. “We go see the doctor, they will prescribe medication for a couple of days. If you get well with that medication, good. If [it] didn’t help, you have to go again.”
Khan said that it may be harder to see a doctor here, but they have more supplies.
“They have lots of tools like instruments or medical equipment, but back home they do not have [all this] stuff.”
Wahidi worked as a translator for the U.S. military in Afghanistan for eight years before he left the country, so he was very accustomed to U.S. culture, like being on time. But he said most refugees from Afghanistan have a much bigger adjustment to make.
“Most of these people were from villages. They were not living in the city,” said Wahidi. “So that’s why [when] they come here, you have to explain to them a lot to make them independent. But it takes a while to learn everything.”
Wahidi said his goal is to help refugees become independent. He teaches people how to ride the bus and how to make their own appointments.
And Montoya said she teaches clients to advocate for themselves.
“I learned that I can speak up and I say, ‘I don’t want the doctor, I need another one,;” said Montoya. “That’s the thing that I try to teach my clients: you have voice, you have rights.”
Refugees have a lot to navigate coming to Alaska. But Wahidi and Montoya’s work means that hopefully, the confusion of the medical system won’t be an additional burden.