At the peak of the influx of refugees from Afghanistan, Dulles International Airport in Virginia was receiving just under 5,000 refugees daily. It was not uncommon for about 50 of these arrivals each day to need medical care at a hospital. There were a variety of reasons the medical needs were so high. Refugees experienced long holding times overseas with little to no medical care, so the conditions of people with chronic medical issues or more fragile populations such as children and the elderly deteriorated before their arrival in the US. Additionally, some people arrived with traumatic injuries inflicted by Taliban and ISIS-K. There also were many pregnant women, who may have had little or no prenatal care before coming to the US.
For 10 days in late August and early September, Christopher Wanka, a first-year Yale School of Medicine Physician Assistant Online student, played an active role in helping manage the influx of refugees. Wanka lives in Northern Virginia and connected with the refugee effort through his past career as a firefighter and paramedic. Wanka was working with the non-profit Northern Virginia Emergency Response System (NVERS), a non-governmental organization (NGO) comprised of representatives from fire & rescue, emergency medical services (EMS), hospitals, hazardous materials, law enforcement, emergency management, public health, public information, and information technology from cities and counties in Northern Virginia. NVERS, a small organization, temporarily hired Wanka as a "patient tracking specialist."
Wanka explains that the influx of a significant number of patients was complicated because local hospitals already were overwhelmed with COVID-19 patients and other high-acuity medical issues. Many refugee patients therefore had to go to hospitals further away. This raised concerns about keeping track of them, particularly since many did not have family or friends in the US.
One tool NVERS used in this effort is electronic patient tracking software. With iPads spread throughout the region, it can track patients transported to hospitals. When the Afghan refugees started coming to Northern Virginia, NVERS had all EMS providers start using the electronic patient tracking feature with triage tags/wristbands for all refugee patients transported to hospitals. That way, when organizations, such as the State Department or US Customs and Border Protection, or family members were trying to find a patient, NVERS was able to provide that information. “We heavily relied on the patient tracking software to coordinate and ‘find’ people transported to hospitals and by EMS,” Wanka explains. “In my previous job I had used this software since its implementation, and as an EMS supervisor trained others in its use, so it was a familiar job/experience for me.” Wanka adds that before NVERS started its work coordinating transportation of patients, the closest hospital was overwhelmed with EMS transports, and had to divert new patients. NVERS efforts allowed for a more coordinated approach.
Wanka’s responsibilities involved the transportation/reunification of patients from hospitals to either the intake/processing facility (where the State Department would give them their visa), a hotel to connect with family living in the US, or a refugee housing area at the Marine Corps Base Quantico. Occasionally individuals were transported to refugee housing areas in other states. Wanka coordinated transport locations with the State Department. Another key role Wanka had was communicating any follow-up care needed, such as prescriptions, appointments, and chronic care instructions, with either medical staff at the State Department processing center or military corpsmen and other medical providers at Quantico. Because of the high needs of refugees, Wanka explains the NVERS team took on other unofficial tasks, some very basic, such as providing wristwatches or helping refugees set up the cell phones they were provided.
The State Department, Wanka says, was overwhelmed by the influx of refugees. “It was not uncommon that people just became lost after their arrival here to the US if they needed any kind of medical care. So, it was very beneficial to all involved to be able to know where people were located, and get them back to their family and friends at the appropriate location,” he said.
It was not uncommon that people just became lost after their arrival here to the US if they needed any kind of medical care. So, it was very beneficial to all involved to be able to know where people were located, and get them back to their family and friends at the appropriate location.
Christopher Wanka, first-year Yale PA Online student
As a PA, Wanka hopes to do more disaster/global health work, either with the federal Disaster Medical Assistance Teams (DMAT) or one of several NGOs that are used for domestic and international disaster relief efforts.