Government and Public Policy Social Work

Kyle Taylor, Caritas of Austin

Refugee Resettlement: A View from the Caritas of Austin Employment Department

Refugees: Where They Come From & Where They Go

According to the 1951 Geneva Convention Relating to the Status of Refugees, a refugee is defined as any person who:

              owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group, or political opinion, is outside the country of his nationality, and is unable or unwilling to or, owing to such fear is unwilling to avail himself of the protection of that country (UNHCR: http://www.unhcr.org/3b66c2aa10.html).

The topic of refugees has been heavily covered by the media recently, as increasing numbers of Syrians are fleeing from their homes to escape the deadly conflict that began in 2011. According to the U.N., there were 19.5 million refugees in 2014, up nearly 3 million from the year before (UNHCR: http://www.unhcr.org.uk/about-us/key-facts-and-figures.html). This number is sure to increase by the conclusion of 2015, as the war continues to intensify in Syria.

While much of the focus in the media has been on Syrian refugees, refugees come from a variety of different countries. The overwhelming majority, however, currently originate from three countries: Syria, Afghanistan, and Somalia. The refugees from these three countries constitute 52% of the total refugee world population (UNHCR: http://www.unhcr.org/pages/4a013eb06.html).

There are three eventual outcomes for most refugees. The first is repatriation, where the UNHCR works with the host country and country of origin to help refugees return home. This option is typically most desirable for both the refugee and the host country. The second option is local integration, where the host community agrees to become a permanent home to the refugee. Host communities are almost always neighboring countries to the country of origin. For example, Lebanon hosts about 1.5 million Syrian refugees (UNHCR: http://data.unhcr.org/syrianrefugees/country.php?id=122). The last option is resettlement. The U.N. defines resettlement as “…the transfer of refugees from an asylum country to another state that has agreed to admit them and ultimately grant them permanent resettlement” (UNHCR: http://www.unhcr.org/pages/4a16b1676.html). Less than 1% of all refugees are resettled to a third country, such as the United States. Of that 1%, the U.S. has accepted 70,000 per year for the last three years. Over the next year, the U.S. plans to increase that number to 85,000, including 10,000 Syrians (Wall Street Journal: http://www.wsj.com/articles/how-many-refugees-the-u-s-takes-in-and-where-they-go-1448414018).

There are numerous agencies around the U.S. that provide refugee social services that include housing resettlement and employment services, Caritas being one of the premiere agencies in Austin. Over the course of the fall semester of 2015, I conducted an internship at Caritas of Austin in the employment department. My official position as an intern was titled “Employment Guide”. Essentially, I assisted an employment specialist (ES) with finding employment for his refugee clients. The intent of this report is to describe the organization of Caritas, the challenges refugees face in the U.S., and what my responsibilities were as an intern. Additionally, I aim to examine the relationship between nutrition and the prevalence of diet-related health conditions in refugee populations, and to explore what opportunities exist for refugees to receive nutrition education.

About Caritas of Austin: Mission & Services

Located in downtown Austin, Caritas of Austin is a non-profit organization that works with a variety of community-based organizations in order to meet the needs of the growing refugee and homeless population in Austin, Texas. According to their website, Caritas’s mission is to “provide a service continuum for those experiencing poverty that begins with a safety net and links them to resources to achieve self-sufficiency” (Mission, www.caritasofaustin.org/about/our-mission). Caritas was founded in 1964 by Father Richard McCabe in order to “fill the gap between needs of poor and the benefits of public assistance” (Caritas 101 Training Packet: 2). Since then, the clientele and range of services has broadened to include a greater emphasis on social services for displaced people. Today, the organization works almost exclusively with immigrant populations, who have refugee, asylee, or parolee status, and also with veterans in need of housing and stability services. Last year, they resettled 535 refugees, 500 of whom were placed into jobs. Additionally, 110 veteran families and 130 chronically homeless individuals were housed (About Caritas of Austin- Handout).

Fieldwork: Resettlement & Health Screening

When refugees first arrive into the U.S., the case managers are at the airport to greet them and afterwards, assist them with settling into their new housing arrangements. Additionally, the case managers accompany clients to their first few health care clinic visits.

First, the case manager resettles the client into his or her new housing arrangement and explains various facets of the apartment. Housing arrangements are made by the case manager pre-arrival to the U.S., and each apartment comes fully furnished with the first month’s rent paid. Many refugees have no experience with electricity, running water, or many of the appliances that Americans tend to take for granted, and so the case manager carefully explains how all of these appliances work. After the clients are settled into their new homes, the client and case manager agree on an appointment time to complete the intake assessment at the Caritas office.

Following the intake assessment (see next section for description), the case manager accompanies the client to his or her appointment at the Refugee Health Clinic, so that the he or she can undergo a health screening. A determination can then be made regarding the overall health of the refugee. Some clients may be recovering from a health condition that needs to be addressed before being enrolled for employment services. On my first day at Caritas, for example, I met with a Congolese man with a severe case of appendicitis, who required surgery immediately upon arriving in the U.S. Subsequently, his enrollment into the program was delayed 3 months until he fully recovered. Some clients receive complete exemption status with regards to employment, due to a disability or preexisting health condition. These determinations are based on the doctor’s assessment of the client.

Office Work: Intake Assessment, Cash Assistance, and Class Enrollment

The intake assessment is a crucial appointment between the client and case manager, where the client is walked through the bureaucratic maze associated with being a new American citizen. The case manager collects all demographic information about the client, helps him or her enroll into a financial assistance program, and applies for SNAP (food stamps). Additionally, the case manager helps the client apply for a social security card, an EAD (employment authorization document), and a Texas ID. The purpose of the intake is to begin the process that eventually leads to the client’s citizenship, and to apply for the appropriate financial assistance programs.

The two main financial assistance programs that refugees qualify for are Refugee Cash Assistance (RCA) and Match Grant, both of which are intended to be short term. Both programs are funded at the federal and state level. Based on family size, income, and a few other factors, the amount of financial assistance is determined. The money is distributed via monthly checks. If a client meets all of the requirements of the program in a timely manner, he or she may receive incentive checks. RCA and Match Grant last for only eight months, highlighting the short term nature of the programs. Additionally, at four months the amount on the check is reduced to less than half of the original amount. If a client continues to need financial assistance after eight months, then he or she will be referred to another organization, such as Refugee Services of Texas (RST), that offers extended case management. The only additional services that Caritas offers after the eight-month period are in the employment department, helping clients find jobs.

Lastly, the case manager enrolls the refugee in English as a Secondary Language (ESL) and Refugee Orientation (RO) classes, both of which help the client adjust to life in the U.S., learn about American culture, and advance his or her English competence. Refugees arrive in the U.S. with varying levels of English competence, and so the classes are organized based on skill level and native language. While Caritas offers ESL classes internally, they also provide the clients with the option to attend classes at a local church or other program of their desire. Typically, the younger generations within refugee families have a much easier time learning to read and write the English language than their elders. This phenomenon can probably be explained by increased exposure to the language in schools (Patil et al 2010: 147). The RO classes cover a wide range of topics, including personal finances, energy conservation, parenting in the U.S., tax system, general safety, family relationships, and several others (Caritas: http://go9host.com/caritas/index.php/refugee-orientation). These classes assist the client with adjusting to American culture in a variety of ways.

Following the intake and enrollment, the client will be enrolled in the employment program and assigned an employment specialist (ES). Employment specialists are assigned clients by the case manager based on common language and cultural knowledge on the part of the ES. After a client is enrolled into the employment program, the case manager continues to provide services to the client in matters unrelated to employment.

Employment Services: Barriers, Resumes, and Interviews

  • Barriers

Refugees face a variety of barriers in obtaining employment. These barriers include knowledge of the English language, lack of education, lack of formal job training, and unfamiliarity with American work culture. Because of these obstacles, many clients have difficulty obtaining jobs outside of the hospitality industry (Welsh 2015:1). During the pre-employment stage, the ES refers the client to Job Readiness Class to supplement ESL and RO. Together, these classes assist the client with gaining skills in many of these deficient areas. Additionally, the ES helps the client to overcome barriers by providing resume building and interview preparation services. Both of these services were the main areas in which I assisted during my internship.

  • Resume Building

Resume building sessions play a crucial role in the majority of clients’ employment paths. In resume building sessions, I initiated by explaining the purpose of the resume and the weight it holds in obtaining employment, as most clients are entirely unfamiliar with this type of document. I answered any questions that clients had about the resume, and then proceeded to ask a series of questions regarding their education and work experience. As the client answered, I took detailed notes so that I could construct the best resume possible. Additionally, I informed the client of any vocational or educational programs for which he or she might qualify, based on age and occupational interests. Gary Job Corps, for example, is a vocational program for young adults that provides clients with the opportunity to obtain a GED or receive certification in a specific area of interest. My supervisor always encouraged me to introduce educational programs to his younger clients whenever possible, as education greatly increases the chances of obtaining a better job with higher pay. After my meeting with the client, I constructed a resume based on the notes I took. Eventually, this resume is used as the main tool of obtaining employment, or at least securing an interview.

  • Interview Preparation

Interview preparation was another major part of my internship responsibilities, as the interview presents a significant challenge to refugees. Similar to the resume-building sessions, I began interview preparation sessions with an explanation of what an interview consists of, and the importance it holds in getting hired. In addition to providing basic information about the types of questions employers ask, I reviewed the importance of non-verbal communication. Many clients are unaware of the formal etiquette required when meeting an employer. Factors such as appropriate dress, handshakes, hygiene, and eye contact are all important, and need to be stressed to the client. Cultural standards of cleanliness and basic social etiquette differ greatly among refugee groups. Several of the clients I encountered had to be instructed to take showers more frequently. Body odor, for example, can present an obstacle in the client’s path to employment. Being aware of the nonverbal aspects of impressing an employer can significantly help a client succeed in an interview.

Towards the end of the preparation session, I conducted a mock interview, in which I pretended to be an employer interviewing the client. Afterwards, I provided feedback to the client and encouraged him or her to practice answering the questions independently in front of a family member or mirror. The mock interview portion of the session was necessary to prepare the client for the real interview, so that they know what to expect in terms of the common questions asked, and what employers look for in an ideal candidate.

These face-to-face interactions in the resume and interview preparation sessions provided the greatest opportunity to learn about the culture of the refugees and the challenges they face. Many clients with whom I worked expressed frustration with the interview process, because in their home countries, family referrals are the main pathway to employment. I found this to be especially true for clients from Iraq. Ultimately, resume and interview sessions were not only a major part of my duties as an intern, but they are important steps in the program, as they can directly affect a client’s chances of gaining employment.

Searching for Employment

Following this preparation process, the ES begins to search for job opportunities that match with the experience and skill set of the client. I assisted my supervisor in this capacity as well. The employment specialist with whom I worked provided me with a client’s resume, and requested that I conduct a web-based search for job opportunities. These opportunities must match the experience, skills, and certifications of the particular client. After compiling a list of several possible leads, either the ES or I contacted the client to gauge his or her interest in the possible leads. Afterwards, I began applying for the jobs in which the client was most interested.

Post-employment

After the clients obtain employment, post-employment services are provided, which basically consists of the ES checking in with the clients to make sure they are still employed, stable, and content with their employment situation. Additionally, the ES assists with post-hire paperwork and follow-up. After 90 days of gainful employment, a client’s case will be closed and services will be terminated. Throughout this entire process, the case manager and employment specialist continuously communicate with one another to ensure that the client and his or her family are stable and steadily making progress towards the goals of the program.

Other Barriers to Employment

There are a number of other obstacles that surface during a client’s progression through the employment program, missing classes and transportation being two major ones. Frequently, I would be given a list of clients and phone numbers, and instructed to call the clients to remind them to attend a certain class, whether it be Job Readiness or ESL classes. Very quickly, this task forced me to become skilled at utilizing interpreters. Typically, my supervisor’s clients were Arabic, Somali, and Spanish speakers. A client’s failure to attend a class represents a failure to meet a program requirement. After missing a certain number of classes without a legitimate excuse, the client is in danger of losing financial assistance, a reality that I strived to make clear in these phone conversations.

Additionally, the vast majority of refugees do not have reliable transportation or own vehicles. Consequently, they often need to be driven to various places if public transportation is not direct enough (Patil 2010: 150). These places include the health clinic, job interviews, clothing stores, stores with school supplies, and food pantries.

Despite the financial assistance that clients receive, they often do not have enough money to make important purchases. Caritas often assists clients with these purchases, provided it directly increases a client’s chances of gaining employment or improves his or her employment situation in a dramatic way. One Iraqi client whom I assisted was a mechanic, who was being severely underpaid because he did not own his own tools. Caritas assisted this client with the purchase of tools. These kinds of purchases are possible due to the amount of philanthropic donations made to the organization. This funding is described as nonrestrictive, and amounted to 2.39 million dollars last year (About Caritas of Austin Handout).

Refugees, Diet, & Health

Despite the breadth of classes and services discussed above, anthropologists have noted a paucity in refugee nutrition education with regards to the American food industry, which I likewise observed during my internship (Patil et al 2010: 153). While America on the whole suffers from obesity and other related diseases such as diabetes and heart disease, refugee populations are especially susceptible to these diet-related health conditions. Several reasons for this susceptibility have been proposed. Transition from a subsistence diet to a processed foods diet, differing cultural standards, poverty, and lack of education are all viable explanations for this phenomenon. Through the careful examination of these possibilities, resettlement organizations can begin to address the issue of diet-related health conditions in refugee populations.

First, the transition from a subsistence diet to a diet rich in processed foods contributes to the prevalence of conditions such as diabetes and obesity in refugee groups. In a study conducted on a community of East African refugees, Crystal Patil found that high status foods, such as meat, were eaten regularly in the U.S. Conversely, Patil found that in East Africa high status foods were eaten solely on special occasions or reserved for the elders in the family (Patil 2010: 144). Among the health issues in the community she studied, she found cardiovascular disease, blood pressure, and child obesity to be of gravest concern (Patil 2010: 144). Unfettered access to foods higher in fat content may be a major reason for the prevalence of these conditions in refugee populations. These effects are especially felt by children, who are exposed to a plethora of fatty American foods in school cafeterias. After being exposed to foods such as pizza and French fries, children become less likely to comply with parents’ requests to eat according to their cultural dietary practices. Ultimately, refugee parents must budget to purchase foods that they know their kids will eat. As a result, refugee parents are buying and consuming foods that would otherwise not be consumed regularly according to typical cultural standards.

Secondly, cultural standards with regards to parenting and health also play an important role in nutrition. In many refugees’ home countries, food is not nearly as accessible as it is in the U.S. Providing children with as much food as possible may represent an adaptive strategy in cases of food scarcity. Hmong parents, for example, typically overfeed their children because “…healthy people are more chubby and plump than skinny people” (Culhane-Pera et al 2007). This perception originates in Hmong refugee camps in Laos, where overfeeding was an adaptive strategy to combat food deprivation (Fadiman 1998: 117). The rapid transition from a refugee camp to an American city, where fast-food is never more than a few minutes away, can result in diet-related conditions that were absent in these communities prior to resettlement.

Thirdly, socioeconomics plays a critical role in food choices for refugees, and for Americans on the whole. There is a strong correlation between obesity and poverty in the U.S. This correlation is due to the fact that impoverished communities are unable to afford fresh, healthy food. James Levine studied the connection between poverty and diet-related diseases in 3,139 counties in America, and found that the most impoverished counties in America also had the highest rates of diabetes (Levine 2011). Most refugees come to the U.S. with little to no income, and for the first few months, depend solely on Federal cash assistance such as RCA or Match Grants. As a result, they are often resettled into affordable housing found in poorer neighborhoods of cities. These neighborhoods are often void of healthy food alternatives (Carter et al 2009: 17). Although most refugees receive SNAP benefits, budgetary constraints are a major reason that refugees opt for less healthy, cheaper foods. Refugees eating habits fall in line with the general dietary trend of poor Americans, and thus also suffer disproportionately from diet-related health conditions.

Lastly, refugee families are simply not receiving enough education regarding healthy diet choices. Between a lack of funding for non-profits and the hectic schedule of case workers, nutritional services are often overlooked. While some resettlement agencies have hired trained professionals to provide nutritional education to refugee clients, this practice has not been the standard (Trapp 2010:163). I have witnessed firsthand that, for most refugees, the extent of health education they receive comes in the initial trips to the grocery store with their case managers. While case managers may do their best to provide useful guidance, they are far from trained professionals in the arena of diet and nutrition. Confirming this observation, Patil found, “The interaction between a caseworker and refugee can impact subsequent dietary choices and health because every caseworker has his/her own conceptions of nutrition, economizing, or what is ‘best’ for refugee clients” (Patil 2010: 155). Ultimately, the need for more educational resources regarding health and diet are limited by stringent funding for resettlement agencies. With the limited funding that they have, case managers aim to address the issues that affect their clients most directly, such as finding employment and affordable housing.

However, by understanding the various factors that impact dietary choices made by refugees, resettlement agencies can begin to devise programs with diet and health considerations in mind. Lack of funding and the heavy caseloads of case managers present a couple of obstacles to the implementation of these programs. For the most part, however, the diet-related conditions that affect refugee populations reflect a disturbing trend in the American population as a whole. Addressing the nutritional needs of refugees might begin with acknowledging the need for better nutrition education in schools across America. Trapp captures this sentiment when he states, “Youth have the potential to see beyond the individual and push for much needed structural change of the institutions that shape the consumer eating habits of the United States” (Trapp 2010: 173).

Personal Impact

My internship at Caritas helped me to develop several important skills that I will utilize to accomplish my future goals. These skills include cross-cultural communication, technical writing, public speaking, organization, and time management. It has also vastly improved my knowledge regarding how non-profit organizations function. Perhaps the most valuable part of my internship experience, however, has been the opportunity to learn about the refugees themselves: where they come from, reason for resettlement, cultural customs, and the difficulties they face in the U.S. Over the course of this semester, I have developed a strong interest in refugees and the non-profit organizations that support them. In particular, I am interested in the health and psycho-social well-being of refugees, and how they interact with the American healthcare system. As more refugees are resettled into the U.S., non-profits such as Caritas will continue to address issues of diet, discrimination, acculturation, and poverty related to health outcomes and quality of care. In order to deepen my understanding of these issues and gain more experience in a non-profit setting, I plan to continue volunteering at Caritas. Given the enormous amount of displaced persons in the world, issues surrounding refugee resettlement will continue to be a crucial area of study for anthropologists and social workers. My experiences at Caritas of Austin have led to my consideration of refugee health studies as a potential area of interest for graduate school.

References

Caritas of Austin. 2015. About Caritas of Austin Handout: Facts and Figures.

Caritas of Austin. 2013. Caritas 101 Training Packet: What It Means to be a Caritas Community

Advocate.

Carter, Thomas and Osborne, John. 2009. Housing and Neighbourhood Challenges of Refugee

Resettlement in Declining Inner City neighbourhoods: A Winnipeg Case Study. Journal of Immigrant and Refugee Studies 7(3): 17.

Culthane-Pera, Kathleen and Bee Her Chang Her. 2007. “We Are Out of Balance Here”: A

Hmong Cultural Model of Diabetes. Journal of Immigrant and Minority Health 9 (3): 179-190.

Fadiman, Anne. 1998. The spirit catches you and you fall down: a Hmong child, her American

doctors, and the collision of two cultures. New York: Farrar, Straus and Giroux.

Jordan, Miriam and Joseph de Avila. 2015. How Man Refugees the U.S. Takes in and Where

They Go. The Wall Street Journal. http://www.wsj.com/articles/how-many-refugees-the-u-s-takes-in-and-where-they-go-1448414018 (Accessed 11/20/15).

Levine, James. 2011. Poverty and Obesity in the U.S. U.S. National Library of Medicine 60(11):

1667-1668

Patil, Crystal, Molly McGown, Perpetue Nahayo, and Craig Hadley. 2010. Forced Migration:

Complexities in Food and Health for Refugees Resettled in the United States. National Association for the Practice of Anthropology Bulletin. 34(1): 141-160.

Trapp, Micah. 2010. What’s On the Table: Nutrition Programming for Refugees in the United

States. NAPA Bulletin 34: 161-175.

Welsh, Teresa. 2015. 8 Facts About the U.S. Program to Resettle Syrian Refugees. U.S. News

Report. http://www.usnews.com/news/articles/2015/11/20/8-facts-about-the-us-program-to-resettle-syrian-refugees (Accessed 12/6/15).

About the author

The Internship Coordinator

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