Background and Purpose: The United States is home to 300 000 refugees from around the world, with 69 000 from 51 African countries. Refugees face significant challenges in accessing quality health care and present challenges to clinicians and medical institutions in providing care. There is limited published literature on health disparities experienced by African refugees who settle in the United States. Methods: The University of Virginia International Family Medicine Clinic (IFMC) was started in 2002 to serve the growing local refugee population. Residents, attending physicians, social workers, and community agencies collaboratively care for refugee patients. A database is kept with information about all patient encounters. Findings: The IFMC serves 300 African patients; their mean age is 26.1 years. Countries of origin include Somalia (24%); Liberia (16%); the Democratic Republic of the Congo (15%); Sudan (7%); Togo, Kenya, and Burundi (each 6%); and others. Patients present with communicable diseases, nutrition-related diseases, and problems related to physical and emotional trauma. Conclusions: In this paper, we: (1) describe the health screenings that African refugees receive overseas and upon entry to the United States; (2) describe the medical and psychological conditions of African refugees; (3) identify the challenges that refugees face in obtaining care and those that clinicians face in providing this care; (4) discuss the health disparities that African refugees experience; and (5) describe the IFMC as a model of collaborative, multidisciplinary care. Additional research is needed to further our understanding of the unique cultural, medical, and psychological needs of the diverse African refugee community.

immigrants health disparities Cultural competence Africans

patient information refugee Human immunodeficiency virus infection mass screening public health service tricyclic antidepressant agent medical examination mental health human pyridoxine gastrointestinal disease nutritional disorder priority journal Malaria general practitioner BCG vaccine Kenya Democratic Republic Congo social worker doxycycline recombinant alpha interferon Burundi anemia lung tuberculosis peripheral neuropathy blood cell count social problem enzyme linked immunosorbent assay Africa Liberia hepatitis Article health care communicable disease tuberculin test isoniazid lamivudine health care access Somalia thorax radiography Togo vitamin supplementation posttraumatic stress disorder malnutrition hepatitis B surface antigen trazodone ethambutol psychotrauma hepatitis B family medicine rifampicin pyrazinamide quinine sulfate health care disparity mixed infection chloroquine Sudan