A cry for access and equality

Price Mundeke, a refugee from the DRC says health insurance is expensive. (Photographed by Amina Accram)

The healthcare dilemma faced by Durham noncitizen residents.

Durham, N.C – Forty-year-old Price Mundeke came to Durham in 2015 as a refugee from Africa seeking a better life. As an immigrant with refugee status, Mundeke, a former citizen of the Democratic Republic of Congo, was able to get government-assisted medical insurance. However, the insurance eventually expired, leaving him without medical aid. 

“It is very stressful when you have no medical aid. The one you get expires, and that is why the community leaders help. There needs to be more health facilities for immigrants,” said Mundeke. 

Refugee and immigrants who are admitted to the United States have access to health insurance through Medicaid, the Children’s Health Insurance Program (CHIP) and Refugee Medical Assistance. 

This coverage is limited to six to eight months. Members must renew after the expiration date. 

Mundeke said some immigrants are undocumented. When they get sick, they do not go to the hospital. 

“Undocumented immigrants often fear hospital visits due to concerns about potential arrests as hospitals typically request social security and address information. A client in our organization who was undocumented faced substantial medical expenses after seeking treatment. His $50,000 bill for surgery was forgiven through a foundation we approached,” said Mundeke.

Health practitioners and officials of area non-profit organizations said there is an urgent need to increase healthcare facilities for the immigrant population. 

They are urging Durham to improve access to free clinics targeting refugee and immigrants. 

A 2016-2020 report by the Census Bureau’s American Community Survey revealed 11.8 % of foreign-born residents live in Durham County. The largest number are from Latin America. However, people from Africa and Asia have steadily increased by 44% and 24% respectively. 

“We now have around fourteen percent and that is around 47,000 or 48,000 foreign born living in Durham. A lot of people do not really know where to go when they need resources. The 

reason for that is we do not have a system that shows available resources. That might have to do with the language barrier and connection when people arrive,” said Koko Nayo, Durham City-County immigration, and refugee affairs coordinator. 

“Often, we have events like Durham Refugee Day, for instance, where we invite all these departments from the Durham City to enable dialogue and collaboration. We are currently working with researchers to create a sustainable data to identify needs for the immigrant and refugee community,” said Nayo. 

Adam Clark, executive director of World Relief, a nonprofit that helps refugees in the Triangle, said immigrants tend to work in low-wage jobs that do not offer health insurance. World Relief operates a refugee resettlement program with the state to help persecuted individuals who come through humanitarian channels restart their lives in Durham. 

“It is a struggle to provide or create a little bit more health equity for noncitizens. We however, help connect them to special medical services, enrol their children in schools and address their immigration legal needs. It is a kind of wraparound support service for the refugees. We also serve refugees and many other types of immigrants regardless of their status and multilingual academic support,” said Clark. 

If a refugee or immigrant does not have medical insurance, they can utilize the same resources that other uninsured residents use. They would have to access health centers like Samaritan Health or Lincoln Health Center. In an emergency they would have to go to an emergency room.

Another nonprofit organization, CWS Durham, also provides social and legal services to immigrants and refugees who resettle in Durham. Refugee resettlement in North Carolina is subject to federal regulation due to its association with immigration legislation. 

“When refugees arrive, CWS staff meets them at the airport and ensures they have safe housing to go to. We help families access important resources, and benefits. We help them access available healthcare. We do not provide medical assistance on- site,” said Ellen Andrews, regional director for CWS Durham. 

“Lincoln Health Center, which operates throughout the county, is a great partner of ours. They offer many services tailored to refugees. There are numerous health screenings for refugees, but the volume of need relative to the availability of those services is a great challenge,” said Clark. 

Another Durham clinic, the Samaritans, assists immigrants regardless of their status. Clark said the majority of the organization’s clients are documented immigrants on a path to citizenship. 

The North Carolina governor’s office launched a new initiative last year in collaboration with the city of Durham to address challenges facing the immigrant community. The Diversity, Equality and Inclusion Working Group for New Americans held its final listening session last month, in downtown Durham. In her keynote address, Director of the initiative Cristina Espana, said her office will continue to strengthen diversity programs in the county. It will also prioritize education, health, and housing initiatives for noncitizens.