Reynolds Christopher W, Ramanathan Vidya, Lorenzana Elena, Das Porag J, Sagal Kyra M, Lozada-Soto Kristen M, Deda Linda Camaj, Haque Anisa S, Schmitzberger Florian F, Quiroga Grecia, Raven Sarah A, Heisler Michele
University of Michigan Medical School, Ann Arbor, Michigan, USA.
University of Michigan Asylum Collaborative, Ann Arbor, Michigan, USA.
Health Equity. 2021 Apr 13;5(1):169-180. doi: 10.1089/heq.2020.0110. eCollection 2021.
The coronavirus disease 2019 (COVID-19) pandemic presents health care challenges to asylum seekers living in congregate encampments, including those along the U.S.-Mexico border. It is necessary to understand the impact of the pandemic among this population to address health care needs, reduce transmission, and diminish COVID-19-related morbidity. Thirty interviews were conducted with asylum seekers and health care professionals in a temporary camp in Matamoros, Mexico to determine challenges, perceptions, and effects of the COVID-19 pandemic. Interviews were coded in NVivo12 by using a team-based approach. The pandemic caused significant mental health burdens but no perceived adverse physical effects, with the U.S. border closure and health care access barriers as more pressing concerns. Participants reported access to information about COVID-19 but had varied levels of knowledge and adherence to disease reduction strategies due to camp conditions. Most participants believed that they had special protection from COVID-19, including strong immune systems or from God. The nongovernmental organizations providing health care and sanitation faced multiple challenges to implement new policies to manage COVID-19. The institution of required temperature checks and quarantine of COVID-19 positive patients led to distrust, decreased seeking of health care services among asylum seekers, and possible underreporting of COVID-19 cases. Our findings among asylum seekers in a Matamoros camp highlight the challenges to implementing disease reduction policies in low-resource congregate camps. Policies to address disease outbreaks focusing on the social determinants of health, health care access barriers, and community engagement may be more acceptable to asylum seekers, suggesting the need for effective strategies to provide prevention information that complements such measures.
2019年冠状病毒病（COVID-19）大流行给居住在集体营地的寻求庇护者带来了医疗保健方面的挑战，包括美国与墨西哥边境沿线的那些寻求庇护者。有必要了解这一人群中该大流行的影响，以满足医疗保健需求、减少传播并降低与COVID-19相关的发病率。在墨西哥马塔莫罗斯的一个临时营地，对寻求庇护者和医疗保健专业人员进行了30次访谈，以确定COVID-19大流行带来的挑战、看法和影响。访谈通过基于团队的方法在NVivo12中进行编码。该大流行造成了严重的心理健康负担，但未察觉到有不利的身体影响，美国边境关闭和医疗保健获取障碍是更紧迫的问题。参与者报告称能够获取有关COVID-19的信息，但由于营地条件，他们对疾病预防策略的了解程度和遵守情况各不相同。大多数参与者认为他们对COVID-19有特殊的保护，包括强大的免疫系统或来自上帝的保护。提供医疗保健和卫生设施的非政府组织在实施管理COVID-19的新政策时面临多重挑战。对COVID-19阳性患者进行强制体温检测和隔离的做法导致了不信任、寻求庇护者对医疗保健服务的寻求减少以及COVID-19病例可能报告不足。我们在马塔莫罗斯营地对寻求庇护者的研究结果凸显了在资源匮乏的集体营地实施疾病预防政策所面临的挑战。针对疾病爆发的政策若侧重于健康的社会决定因素、医疗保健获取障碍和社区参与，可能会更容易被寻求庇护者接受，这表明需要有效的策略来提供补充此类措施的预防信息。
