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Critical outreach to immigrant patients jeopardized during pandemic :

April 29, 2020

Editor’s note:Pediatricians around the country have risen to the challenges posed by the coronavirus disease 2019 pandemic. Some are on the front lines battling the virus; others are connecting with patients while hunkered down at home. They are relying on creativity, ingenuity and tenacity to keep their patients healthy and their practices afloat. Here is one pediatrician’s story.

For Kimberly A. Mukerjee, M.D., M.P.H., FAAP, and colleagues in New Orleans, the state’s stay-at-home order to help stop the spread of the virus has had a downside: They can’t monitor the health and well-being of many of their immigrant patients.

Dr. Mukerjee, who speaks Spanish, said most of the patients she sees at various clinics lack insurance. The pandemic has caused many of them to go off the radar.

“For me, it’s been a bit of a struggle knowing how to reach families and trying to address the full breath of their needs. I worry so much about the economic impact on families,” said Dr. Mukerjee, assistant professor of clinical pediatrics and director of Immigrant and Refugee Health, Section of Community Pediatrics and Immigrant Health at Tulane University School of Medicine.

In a recent case, a patient family came to a clinic after being threatened with eviction. They had no income for months after the father was detained by U.S. Immigration and Customs Enforcement. Although the mother found employment, she had to stay home due to the pandemic. Ineligible for the Supplemental Nutrition Assistance Program, the family was without formula and food. The clinic was trying to connect them to resources such as the school district’s lunches for children.

“We’ve been following the family for a long time; now the situation is so much more dire,” said Dr. Mukerjee.

Normally, the providers can rely on a robust support system of social workers, school nurses and others. With school out, that link is gone.

“We are walking the line between two worlds,” Dr. Mukerjee said, “trying to do the best for our patients and advocating for their comprehensive needs …”

Overall, her patient load has dropped significantly. Dr. Mukerjee wonders, “Do they know we’re still here, that they can access care? Are they worried about cost?”

Dr. Mukerjee also is filling in as program director of the pediatric residency program.

Some residents are frustrated that they can’t do more to help on the front lines. Dr. Mukerjee reminds them not to overlook their contributions. That includes providing guidance to parents, giving advice on how to talk with children about their fears and advocating for children’s access to resources like food and social supports — “just like we do every single day.”

To read other pediatricians’ stories, visit https://www.aappublications.org/news/2020/04/21/covidvignettes042120.

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