Making the connection

Refugee health program now in its third year

T-R PHOTO BY SARA JORDAN-HEINTZ Child Abuse Prevention Services’ (CAPS) Refugee Health Connection program serves the area’s Southeast Asian refugee population. Here, community health worker Lydia Lian, left, meets with a local couple, Hrang Nawl, center, and Cin Tial, right, to discuss childhood development. The pair have three children: John Bawi, 3, Lovely Chin, nine months old, and Aily Ber (not pictured).

Alone. Scared. Unable to speak English. Uncertain of what the future holds.

The influx of Southeast Asian refugees coming to the United States is accompanied by cultural, educational, health and language barriers, which can conspire to complicate the resettlement process.

In the last few years, around 5,000 of these individuals have relocated to Marshalltown, having come from Burma, Thailand and Malaysia, seeking a fresh start. Almost three years ago, Child Abuse Prevention Services (CAPS), headquartered at 811 E. Main St., rolled out a premier program entitled Refugee Health Connection (RHC) with one primary goal in mind: to help ensure these refugee families receive proper nutrition, medical attention and pre-natal care.

In 2015, CAPS received a $200,000 rural health care grant to fund the program — and develop it into the first of its exact kind in the nation. Since its inception, RHC has enrolled 106 families, served 167 children, conducted 3,302 home visits, provided transportation to 745 medical services and completed 77 health sessions.

“One of the biggest needs we see with this population is dental care,” said Esmeralda Monroy, program supervisor at RHC. “We also see a lot of gestational diabetes and hepatitis. A lot of these families are expressing to us how prenatal care and immunizations are really new to them.”

Refugee families enrolled in the program participate in health workshops held at CAPS’s headquarters, and get one-on-one in-home counseling from community workers: Plu Meh, Lydia Lian and Christina Kyaw, all women who speak various Southeast Asian languages and dialects. Among them, they can speak Burmese, Karen, Chin, Karenni and Thai.

“Our girls are what make the program,” Monroy said. “It’s so important to our families to have workers that get it, and have faced similar struggles. Two of them actually came from refugee camps … Anytime you can provide a direct service instead of going through a third party, like a language translation line, it provides for better relationship building between our families and workers.”

Cin Tial and Hrang Nawl, a couple originally from Burma, came to Marshalltown from Malaysia about two years ago. They linked up with a friend residing here, who put them in touch with CAPS and its RHC program. Together they have three children: Aily Ber, 6, John Bawi, 3, and Lovely Chin, nine months old.

“I gained a lot of knowledge. We didn’t know where to go for check-ups and dental care,” Cin Tial said through a translator. “We had a lot of needs. Even though we had friends here, they couldn’t help us. They had no car and spoke no English, and because of this program, we have help.”

In the beginning, the refugee families receive services weekly or even several times a week, to help with filling out paperwork for jobs, school and medical assistance.

“They don’t need Lydia as much anymore because now Hrang Nawl has a job and car,” Monroy said. “Now she just meets with them monthly.”

The home visits consist of childhood development evaluations, mental health screenings and ensuring the children are in a safe, healthy environment.

“For instance, their little boy, John Bawi, was slow to start speaking, but with our help, now he’s ready to start preschool,” Monroy said.

CAPS and RHC have partnered with agencies that are able to share health information about program participants, and vice versa.

“Our main focus is to decrease health discrepancies, and help to build better relationships between the refugees and the healthcare providers. We are so thankful to the local agencies working on our behalf,” Monroy said.

Like most non-profit agencies, finances are always a concern. Funding for the RHC program expires April 30, 2018.

“We’ve reapplied for continued funding, and are always exploring any and all grant options. We don’t want there to be any interruptions in these services,” Monroy said. “Since our program started, Marshalltown has become a more permanent home for these refugees. A lot of families are starting to purchase homes. They’re making an investment in our community, and we need to encourage others to make that investment in them.”

To be eligible for the RHC program, participants must self-identify as Southeast Asian refugees and be either pregnant or have children age five or younger. When they are no longer eligible for program services, these families may still qualify for some of CAPS’s other services. For more information, contact CAPS at: 641-752-1730.


Contact Sara Jordan-Heintz at 641-753-6611 or