Socio-Medical Challenges of Asylum Seekers Prior and After Coming to the US

Refugee asylum seekers face complex social and medical challenges. We evaluated 30 consecutive asylees in New York for socio-demographic and health backgrounds, characteristics of torture, presentations and medico legal path. Results: Majority was male, young, educated from sub-Saharan Africa. In home countries, all had employment; 58 % had fair or good access to healthcare; 36 % used traditional medicine; and 14 % had insurance. In the US, social support and accommodations were provided by countrymen; overwhelmingly they were unemployed; none had insurance; and 57 % never had any contact with healthcare system. Sixty nine percent had PTSD and 69 % depression. Almost all had scars with significant sequelae. Eighty eight percent were granted asylum. Ironically, asylees had better access to social and health services in home countries than the US. We recommend better recognition of, and addressing asylees' social and health needs through a multidisciplinary approach drawing on other countries' experience, and expanding existent programs for refugees to cover asylees.