Great expectations: the retraining of refugee health care personnel.

The refugee population's basic unfamiliarity with Western health care concepts and the equal unfamiliarity of Western health care providers with the refugee's perceptions of health care, disease, and treatment, have presented a major problem for all involved. Although interpreters were occasionally asked about patient preferences, Western health care was promoted according to the principle that what was best for native born Americans was best for Southeast Asian refugees. 105 individuals who responded to a general community announcement about this project were contacted and interviewed. 48 students who remained in the program underwent a 4 week pre-vocational course designed to assist them in their preparation for the health training program. After the 30 day pre-vocational course, students were interviewed again to go over their test results and also to offer program options. Because of this program, 9 students were placed in new careers in health occupations; 6 of these had been receiving public assistance. Besides the benefit of providing employment and educational opportunities for the students in the program, refugee students serve as role models, draw other Southeast Asian patients to the clinics where they are employed, and act as liasons when communication problems arise between patient and doctor. The most frustrating obstacle that stood between the students and licensure was the actual licensing examination. Not only was the vocabulary foreign to the students, but the exam has a distinctly Western flavor that did not always test basic nursing concepts.