Taking a closer look: negative reporting and positive experiences with healthcare for East African refugees in Boston
Waller, Katherine Conway
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This thesis explores the experiences of the health care system for East African refugees in Boston. I argue that refugee experiences lie on a spectrum ranging from inadequate to exceptional, and that by exploring what makes care both a negative and positive experience for refugees it may be possible to better serve the community. I conceptualize these experiences using the metaphor of a rope bridge: at the beginning, refugees are stuck in a formal structure that limits their movements and agency; throughout the middle, they are forced into a liminal space in which both their identity and experiences are made ambiguous; on the far end of the bridge; they have mitigated the deleterious effects of structural violence and liminality through practices involving selective acculturation, resilience, and self-verification. My participants reported being dissatisfied with the bureaucratic barriers to health care they encountered and with the power imbalances they felt when interacting with clinicians. They also spoke about the encounters they had with clinicians that made them feel listened to, cared for, and empowered. Much of the distinction between good and bad care relied on whether the patient felt like they were respected by their doctor, and whether they felt like they had a say in their own care and treatment. Due to the limited nature of this endeavor, further research is recommended on: 1) the role of memory in recovery; 2) liminality as it applies to the resettlement experience; 3) maintaining and bolstering the assets that allow refugees to mitigate the effects of structural violence; and 4) in what ways the health care system is working for refugees, and how those can be expanded upon.
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