The University's Medical Center is a vital regional institution, but it also reaches out beyond the United States through its International Family Medicine Clinic. Medical School Prof. Dr. Fern Hauck, who works in the Department of Family Medicine, founded the clinic in October 2002, and it now treats refugees and immigrants from Somalia, Liberia, Burma, Iraq, and Central and South America. The clinic sees patients coming through the International Rescue Committee, where patients are screened for infectious diseases, and those who have received clearance from the Charlottesville Health Department.
Each year, specially-trained residents screen their own panel of refugee patients for tropical diseases, such as tuberculosis and malaria, as well as psychological stresses. The patients undergo a thorough one-hour initial visit which details past medical and immigration history and asks about torture and violence in the patient's past.
"Doctors who are doing this, through seeing people and talking with them while hearing their stories, become sensitized to the issues and to the experiences that the refugees go through," Hauck said. "They also have a monthly seminar series that the residents attend that goes through various topics about global health and the psychological aspects."
A senior resident in the psychiatry faculty also treats patients who are referred to him because other residents believe the stress these patients feel needs more psychiatric and psychological support.\nWorking with patients from diverse backgrounds requires physicians to know more than simply medicine.
"Becoming aware is important," said Dr. Benjamin Silverberg, a resident at the clinic. "I've learned about Sikhism and the humanitarian crisis in Myanmar through the IFMC. One way in which I connect with my patients is to know a few words or phrases in Arabic, Hindi, Russian, etc. It's amazing how those few words make someone feel comfortable. It shows them you're interested in connecting with them and their culture."
Dr. Rebekah Compton, associate medical director in Family Medicine, said, "Many patients will present with certain types of pain, chest pain, or stomach pain, and certainly [the clinic has] to figure out if that's actually a complaint versus a post-traumatic stress symptom. The patient will have vague complaints that may be related to depression issues from what they've had to endure."
But not all patients are forthcoming with every medical professional.
"It's quite likely women may not feel comfortable telling me these things," Silverberg said. "Gender and, separately, (perceived) authority play a huge part in our interactions with our refugee patients."
Silverberg said he asks all his patients about Post-Traumatic Stress Disorder-related problems, but many cannot relate the experience to him.
"One of my patients has PTSD from being beaten by a police officer at a protest in Iran," he said. "He seems to have physical damage from this as well, but I think he's less willing to speak up now, even if I'm giving him permission and autonomy to ask questions or voice his opinion."
Physicians at the clinic find it rewarding to assist people who have faced such intense hardship.
"Some of the stories are very, very tragic, sad, and emotional," Hauck said. "As a physician, it does not make us immune to the feeling side of things, but it feels very good to help them and give them a place where they feel they're understood and they can seek help"
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