Health needs of a large cohort of newly arrived Afghan evacuee children following arrival in the United States

Lauren Palladino; Katherine Yun; Shraddha Mittal; Rachel Martin-Blais; Mary Fabio; Meera Siddharth; Prakriti Gill; Alexandra Linn; Mohammad Iqbal Mir Wali Khan; Sage Myers; Jay Greenspan; Alexandra M. Vinograd

doi:10.5055/jem.0883

Authors

Lauren Palladino, MD, MSHP, DTM&H https://orcid.org/0000-0003-2499-7952
Katherine Yun, MD, MHS
Shraddha Mittal, MD, MBBS
Rachel Martin-Blais, MD, DTM&H
Mary Fabio, MD
Meera Siddharth, MD, MAUB
Prakriti Gill, MD, DTM&H
Alexandra Linn, MD
Mohammad Iqbal Mir Wali Khan, MBBS, MS, FMAS
Sage Myers, MD, MSCE
Jay Greenspan, MD
Alexandra M. Vinograd, MD, MSHP, DTM&H

DOI:

https://doi.org/10.5055/jem.0883

Keywords:

Afghan, refugee, pediatric newcomer health, children with disabilities, disaster medicine

Abstract

Objective: In 2021, approximately 82,000 Afghan civilians were emergently evacuated to the United States (US). Almost half of them were children. This study describes the healthcare needs of all evacuee children referred for urgent or emergent care in two large health systems in the months following the evacuation, highlighting important considerations for emergency response in pediatric evacuee populations.

Methods: This is a descriptive cross-sectional study of all Afghan evacuee children referred for care at an urban quaternary care children’s hospital and an affiliated community hospital system between August 2021 and February 2022. Both were located near a military base that served as a temporary residential facility for evacuees immediately after their arrival in the US. Data were abstracted into a secure online database, and descriptive statistics were examined to identify trends in health status, diagnoses, and utilization.

Results: We identified 477 children and 681 individual encounters. Fifty-two children (10.9 percent) were medically complex and accounted for 30.1 percent of all visits. The most common diagnoses were traumatic injuries (93, 13.7 percent), respiratory illnesses (70, 10.3 percent), and complex chronic diseases (53, 7.8 percent). Proper patient identification, language access, and cultural engagement were key challenges.

Conclusion: Emergency response teams should be prepared to encounter a diverse range of common and increasingly complex pediatric health needs in disasters. Strategies such as employing cultural liaisons, expanding the availability of language services, and issuing standardized identification documents should be implemented.

Author Biographies

Lauren Palladino, MD, MSHP, DTM&H

Section of Pediatric Emergency Medicine, Yale New Haven Children’s Hospital, New Haven, Connecticut

Katherine Yun, MD, MHS

Division of General Pediatrics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania

Shraddha Mittal, MD, MBBS

Children’s Hospital of Philadelphia at Virtua, Virtua Voorhees, Voorhees, New Jersey

Rachel Martin-Blais, MD, DTM&H

Section of Pediatric Infectious Diseases, Nationwide Children’s Hospital, Columbus, Ohio

Mary Fabio, MD

Refugee Health Program, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania

Meera Siddharth, MD, MAUB

Children’s Hospital of Philadelphia Care Network-South Philadelphia, Philadelphia, Pennsylvania

Prakriti Gill, MD, DTM&H

Division of Emergency Medicine, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York

Alexandra Linn, MD

Beth Israel Deaconess Medical Center/Boston Children’s Hospital, Boston, Massachusetts

Mohammad Iqbal Mir Wali Khan, MBBS, MS, FMAS

Primary Care, Multi- Cultural Health Evaluation Delivery System, Erie, Pennsylvania

Sage Myers, MD, MSCE

Division of Emergency Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania

Jay Greenspan, MD

Division of Neonatology, Nemours Children’s Health, Philadelphia, Pennsylvania

Alexandra M. Vinograd, MD, MSHP, DTM&H

Division of Emergency Medicine, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania

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