HealthRight International

HealthRight Outreach clinic touches lives

In our efforts to build access to health for excluded communities, HealthRight runs outreach clinics in sites throughout northern Kenya. On the 21^st of February, 2012 HealthRight International took its outreach in West Pokot to the Senetwo location in a village known as Chepturnguny.

This particular village was picked as an outreach site because of its great distance from the next nearest healthcare facility, and the fact that it had the groundwork in place of a non immunizing dispensary. It is approximately 20 km from Chepareria Sub District Hospital which is the closest hospital in the area. It has a catchment population of 1,373. Most of the patients who responded to our mobilization came for immunization (27) and antenatal care (8), and we distributed a total of 22 nets for the afore mentioned vulnerable groups. However, we were also able to see some few cases that required referrals. This included 5 infants suffering from malnutrition due to the absence of rain and a total of 15 patients for general ailments.

One of the patients for whom we could provide a referral was an adolescent woman who suffered from cancer of the mouth.     . Priscah Chepsal ,14yrs old ,is the first born child in a family that is run by her mother, as her father is mentally challenged. Prescah and her family live 2 km from Chepturnguny Dispensary. When Prescah started suffering from a swelling on her cheek, her mother attributed it to a fall. The swelling persisted and progressed to a wound, at which point the child was taken to Chepareria to a private facility. That facility simply gave her a course of antibiotic injections, but by the time she received her fourth shot, the tumor in her mouth had begun to lose teeth as a result of the growth of the tumor inside her mouth. Prescah’s mother decided to seek treatment in Chepareria sub-district hospital, where they finally diagnosed the growth as cancer  and referred her to Kapenguria district hospital and subsequently to Moi Teaching Referral hospital. After such a challenging journey towards health care, Prescah’s mother was forced return home due to the lack of funds. There, she was convinced to seek the services of a traditional healer. Unfortunately, the traditional healer could not improve the situation, and the tumor advanced to an oozing abscess that had  formed a communicating hole to the outside of the chin. When HealthRight encountered Prescah, the swelling inside her mouth had grown so rapidly that it obstructed her throat.

However, HealthRight acted quickly.  After meeting her during the outreach, she was referred to another facility. HealthRight and available staff undertook  a small fundraising effort to facilitate her travel to Moi Teaching and Referral Hospital in Eldoret, a national hospital where high quality treatment for this cancer is available.

Voices from the Community
Since 2005, HealthRight International has been implementing a project in West Pokot County to improve the lives of mothers and newborns. The project was developed in response to the fact that many pregnant women did not attend antenatal clinics and then deliver at home, a trend which is associated with high maternal mortality rates. Through concerted effort, HealthRight managed to inform the community about the importance of going to antenatal clinics and delivering in the hospitals. However, even when the community had demonstrated a desire to attend clinics and deliver in hospitals, certain barriers remained. Many women lived so far from the hospital that they needed to travel there before going into labor. However, the cost of extended hospitalization before birth prevented many women from accessing medical care. To solve this challenge, HealthRight came up with a Maternity Waiting Home (MWH) model, or a “kiror”, to accommodate mothers for free in a location where hospital health workers can easily monitor them as they await the onset of labor.
Currently, we have three kirors, one at Ortum Mission Hospital, one at Kapenguria district hospital and one at the Kaibichbich Health Centre. At any one time, each kiror can accommodate about 20 pregnant mothers.
HealthRight recently held a community awareness event, attended by women who were staying in the kiror or who had stayed there in the past, as well as supportive members of the community. Here’s what some of them had to say about their experiences.
Everlne Chemket Kaptilit, (traveled over 50kms to the kiror) “I am expecting my first born and decided to come to the kiror since I have seen mothers who have successfully given birth in the hospital. There are so many challenges facing pregnant women in our area. It is difficult to get vehicles and one has to mobilize the community to carry a pregnant mother using man made stretcher in the absence of a vehicle especially where there are no roads. This is more expensive than the money one would have spent at the hospital”
Gladys Cheposepoi (traveled over 40kms from Sina to Ortum) “a kiror is like a home where you are comfortable knowing that there is someone who cares about you and will detect any complications.”
Joyce Samson (traveled with a friend to the kiror) “We are two pregnant women from our village in the kiror, and if we had not come to the kiror, one of us would have had a problem because the baby was big and was delivered through cesarean section.”
Florence Musa, (traveled over 30kms from Sekerr) “there are so many problems facing pregnant mothers with little or no information about the kiror.” Florence was referred by a traditional birth attendant (TBA) and will share information about her experience with her community when she goes back home.

Written by Lopa Basu, MD,
Human Rights Clinic Volunteer, Baltimore, MD

TRANSGENDERED: A JOURNEY TOWARDS SAFETY?

The drive to Rappahanock Regional Jail in Stafford, VA was long. I was about to meet my first transgender client through the Human Rights Clinic of HealthRight International. Reviewing the notes from the attorney and the client’s history of past persecution in Mexico for being a transgender woman, I contemplated the traumas experienced by her and other transgender people who have been victims of torture in their home countries and seek asylum in the United States.

The initial interaction with the clerk behind the desk was frustrating as she asked me for numerous documents to prove my identity as a physician and repeated questions regarding clearance to see my client. The language interpreter arrived with the attorney shortly after and it immediately felt like a powerful female team who shared minority experiences and felt empowered to help our client. The attorney asked to wait in the waiting area as she was giving a ride to the volunteer interpreter, however, the clerk quickly turned cold and stressed that attorneys were not allowed to wait in the empty waiting area.

Nancy, the language interpreter, was an eager, energetic student who brought two books that highlighted difficult medical and social science Spanish terminology. She was astute and well-versed on the difficulties of Hispanics attempting to make a home in a current political culture riddled with fear-driven tactics involving immigration legislation. Nancy, even at her young age, was already creating a role as an advocate for vulnerable populations and we both bonded over our excitement to meet our client and attempt to record her story.

After an hour of waiting, we were escorted down a long concrete hallway to the medical rooms to meet the client. Before entering the small, sterile medical room, a quiet young detainee was sitting in a chair. She wore a bright orange jumpsuit and had long brown hair, pulled back in a ponytail. Within minutes, she politely entered the medical room and avoided eye contact. Her facial hair was thick and her quiet voice was warm and calm. As I introduced myself, the client seemed relieved that we were both women. I explained that we would be asking potentially difficult questions about her experiences in Mexico and tears rolled down her face as she prepared herself to relive the traumas of her past. She had a quiet strength and explained how she struggled as a small child with her gender, how she ran away from home at a young age and joined the local circus, creating a family of wanderers with whom she shared her insecurities and fears. As we started to ask her more about her trauma, she described a haunting day when she was invited by one local man on a date and was quickly taken to an abandoned house where his friends met them. She started to breathe more quickly and tried to formulate the words to explain how she was beaten and gang raped by all four men. As her tears continued to roll down her face, she kept repeating in Spanish: “I screamed for help and I cried, but no one came to help me.” It was eerie how several sentences could never capture the enormity of her experience. It was as though what she described as an incident of an hour, felt like days for her as she was left there after the men ridiculed her and threatened to kill her asking her if she now felt like a woman.

At one point during the interview, she asked for medication to help her calm down, but somehow we were able to get her to breathe deeply and slow down her words. One of the most difficult parts was asking the interpreter, a young woman herself to clarify graphic images and words to record the survivor’s personal story.

Before we left the room, she repeatedly thanked us for our help and as we walked out, I felt a huge heaviness. The interpreter and I walked in silence until we returned to the front entrance of the detention center.

I got in my car and drove down the same long, winding, wooded road that had brought me to the detention center. I couldn’t help wondering- ‘How many other transgender people suffer such traumas? How could we give a voice to these vulnerable populations? Even if my client is granted asylum status in the US, will she not suffer the same discrimination in our own country?’

PROVIDING COUNSELING, CLASSES AND WORKSHOPS TO TORTURE SURVIVORS IN DENVER

The Human Rights Clinic has been highlighting partner organizations that serve HRC clients through our ASSIST program. HRC volunteer clinicians play an essential role in connecting clients to much-needed medical, mental health, and social services by conducting needs assessments as a part of their client evaluations. These needs assessments allow HRC staff to refer clients to organizations that welcome and assist survivors of torture.

INTRODUCING: PEOPLE HOUSE
People House www.peoplehouse.org
People House has offered reduced-cost individual and group counseling, personal and spiritual growth classes, and programs such as yoga sessions and meditation to the Denver community for over 30 years. Reverend Lori Ohlson, MA, LPC, a psychotherapist and non-sectarian minister, is the Director of the Affordable Counseling program at People House, and an HRC volunteer. In addition to providing pro bono psychological evaluations for HRC clients, Reverend Ohlson has been instrumental in connecting clients to mental health care at People House through the ASSIST program.
Reverend Ohlson finds one of the most rewarding aspects of working with survivors of torture to be “knowing that [she’s] been of service to someone who doesn’t have the resources or opportunities” that she does, along with having the opportunity to learn about other cultures. HRC clients referred to the People House report that counseling and meditation classes have been particularly helpful to them as they seek healing from the trauma they have endured.
Zach Parish, who served as case management intern for the ASSIST program in the second half of 2011, expressed gratitude to Reverend Ohlson and the staff at People House for providing a “safe environment” in which clients can find help. People House effectively meets the needs of torture survivors in the Denver area by offering programs, such as yoga and financial management classes, which clients are welcome to enjoy for free along with individual counseling. The accessibility of these services, combined with the secure environment in which they are provided, makes People House a valuable ASSIST partner, and we look forward to a continued relationship in 2012.

We continue our “Volunteer Appreciation Month” series by highlighting partner organizations that serve Human Rights Clinic clients through our ASSIST program. HRC volunteer clinicians play an essential role in connecting clients to much-needed medical, mental health, and social services by conducting needs assessments as a part of their client evaluations. These needs assessments allow HRC staff to refer clients to organizations that welcome and offer assistance to survivors of torture. 

Founded in 1918, the International Institute of New Jersey (IINJ) has long served the immigrant population of northern New Jersey. Today, IINJ provides a range of psychosocial and legal services to refugees, asylum seekers, survivors of domestic violence, and other immigrant groups. Staff from IINJ’s Cross-Cultural Counseling Center (CCCC) shared their views on the work with immigrant victims of violence.

What services does your organization provide?

For more than a decade, through the CCCC, we have met the complex needs of survivors of torture, trafficking and domestic violence. At  CCCC, the multidisciplinary team of counselors, case managers, clinical interns and volunteers provides holistic, culturally/linguistically accessible services. These services include individual, family, and group counseling, case management, legal services, community outreach, and translation/interpretation.

What do you find most rewarding about working with survivors of torture?

Often, the sense of having control in one’s life is disrupted as a result of torture. Therefore, the most rewarding aspect of our work with survivors of torture is accompanying these individuals on their journey to identify and build upon their strengths to regain a sense of agency in their lives.

What do you enjoy most about working with HealthRight as a referral partner?  How has our partnership benefitted our referred clients?

HealthRight has been the premier agency in providing pro bono clinical evaluations to survivors of torture. Not only has IINJ been pleased with the quality of the evaluations and their positive contribution to favorable outcomes for asylum applicants, but we also appreciate the sensitive, culturally-competent process in conducting the evaluations by physicians and mental health professionals trained by HealthRight.

Do you have any client success stories, statistics, or information about special programs you’d like to share?

We are proud of the many support groups, workshops, and other events our staff and volunteers have run this past year. Some of the highlights include: “Juntas Hacia La Libertad” or “Together towards Liberty”, a psychoeducational support group created by survivors of domestic violence; a weekly yoga and nutrition workshop; a pottery painting workshop; our “Just Between Friends” support group for immigrants adjusting to the life in the United States,; and beading workshops. As one client commented: “I wear the jewelry I made [at the beading workshop] and as I see it in the mirror it reminds me that I am worthy and it makes me feel good”.