Afghan Immigrants

Afghan immigrants can speak multiple different languages depending on their ethnic background and region of origin

Afghanistan has two official languages

• • Darsi (Afghan Persian): spoken among Hazaras, Tajiks, and some Pashtuns

  • Pashto: spoken among Pashtuns

Other languages Uzbek, Turkmen, Hazaragi, Balochi, Nuristani

Interpreters are recommended/preferably of the same gender

Cardiovascular Disease

• • hypertension, coronary artery disease, and stroke risk are common

Diabetes

• • incidence of type 2 diabetes is rising with dietary shifts and urban lifestyles

Cancer

• • concern for interrupted cancer treatments

Tuberculosis

• • higher rates of latent and active TB

Hepatitis B

• • high prevalence of hepatitis B

Parasitic Infections

• • due to poor conditions in refugee camps

Dental Issues

• • due to lack of dental care

Maternal Health

• • inadequate prenatal care and malnutrition

Pediatric Health

• • incomplete vaccination series

  • malnutrition 

  • lead screening

  • behavioral or developmental delays due to displacement or trauma

Stigma

• • negative cultural beliefs towards mental illness may limit individuals from seeking help

Post Traumatic Stress Disorder (PTSD)

• • many Afghan refugees have experienced war-related trauma, loss of home, and violence

  • PTSD is common among veterans, civilians from occupies territories, and children exposed to displacement

Depression and Anxiety

• • high rates of depression, anxiety, and adjustment disorders 

  • commonly affects women who fled with children, elderly who lost support systems, young people coping with interrupted education or career paths

Intergenerational Trauma

• • children of refugees may develop psychological symptoms from their parents’ stress known as secondary traumatic stress or vicarious trauma

Communication Style

• • often avoid direct eye contact as a sign of respect

  • use of formal titles and respectful addressing of older adults

  • reserved interaction style vs expressive gestures/touching

View on Health and Medicine

• • may be wary of medical systems due to experience in home country

  • self mediation and folk remedies  are common due to experiences in shortage of healthcare

  • may prefer same-gender health care provider especially with reproductive health issues

  • less familiar with preventive care: immunizations/screening

  • deference to authority: may hesitate to question a doctor’s opinion

Family and Decision Making

• • family plays a central role in support and decision-making

  • religion can be a source of decision-making and comfort 

Religion

• • most Afghans are Muslim

  • don’t eat pork

  • some only eat halal food

  • avoid animal gelatin containing medicine

  • have specific end of life rituals

  • observe periods of fasting

Health Literacy

• • limited education and low health literacy

  • simple language, visual aids, teach-back method are helpful tools in providing education

Diet Nutrition

• • traditional Afghan diet is high in bread, potatoes, meat, and dairy

  • can impact compliance with dietary recommendations 

  • dietary restrictions as above

Transportation

• • Metro Transit:  MetroBus and MetroLink - https://www.metrostlouis.org/

  • Metro Call-A-Ride:  paratransit service for individuals with limited access to public transportation including disabled persons - www.metrostlouis.org/metro-call-a-ride/

  • Society of St. Vincent de Paul:  this organization offers transportation assistance through services like car repairs, purchases, and low interest loans - svdpstlouis.org

  • Welcome Neighbor STL:  this organization  coordinates volunteer drives for transportation needs including appointments  - www.welcomeneighborstl.org

  • FindHelp:  this platform allows searches for transportation needs among other things - findhelp.org

  • Marillac Mission Fund:  this fund supports programs that address transportation needs for immigrants and refugees in the St. Louis region - marillacmissionfund.org

Interpreter Assistance

• • Monarch Immigrant Services:  offers interpretation and translation services in person, telephonic, and audiovisual - monarchstl.org, (314) 645-7800

  • LAMP (Language Access Metro Project):  provides 24/7 in person and virtual interpreting and translation services - lampinterpreters.org, (877) 240-6398

  • Bilingual International Assistant Services: provides multilingual support in healthcare with specialization serving elderly and disabled immigrants - bilingualstl.org, (314) 645-7800

Support/Resettlement Agencies

• • International Institute of St. Louis: leading agency providing wide range of support from English classes to employment help - www.iistl.org, (314) 773-9090

  • MICA Project (Migrants and Immigrants Community Action Project) - provides legal services, advocacy, and community education - www.mica-project.org

  • Casa de Salud:  provides low cost health care - www.casadesaludstl.org

  • St. Francis Community Services:  provides legal assistance, case management, education, housing help, mental health support, www.slps.org/AdultEd

  • Refugee Empowerment Program:  provides services like ESL classes and workforce development - moora.org/programs/refugee-empowerment-program

Afghan Organizations

• • Masjid Abu Bakr Al Siddiq: www.facebook.com/masjidabubakrsiddiqstl/, 

  • Quoba Masjid:  masjidqooba.org

  • Afghan Community Center:  afghancenter.org

  • Afghan Chamber of Commerce:  afghanchamber.org

  • Afghan Journal:  afghancenter.org/afghan-journal/

Information in regards to follow visit summary, follow up appointments, preventive care should be provided in written format

Instructions should be provided in English or an Afghan language per patient preference