Question: Bana is a 24-year-old Muslim woman who was recently relocated to the United States as a refugee from Syria, along with her husband and three young children. She arrives at your office today for a physical with her children and a case manager. Her English is limited, and she relies on her case manager to explain the details of her situation, although the case manager does not speak Arabic and thus cannot interpret for her.

In interviewing Bana with the help of the case manager, you learn that her husband is currently looking for a job and that she works at night cleaning office buildings. Her last menstrual period was about 8 weeks ago, and she has been experiencing nausea and vomiting in the mornings recently. A pregnancy test proves positive, and you provide some prenatal education to the client.

During the physical, you notice recent bruises around her throat. She is embarrassed by them and indicates that she was assaulted in Syria before flying to the United States several weeks ago. On questioning further about the assault, Bana appears not to understand and looks at her case manager for help.

  1. What is the biggest barrier you face in providing care to Bana at this point?
  2. What is the priority action for you to take at this time?
  3. What action is most important for you to take to ensure the health and safety of the fetus?
  4. Given Bana’s financial situation, you are concerned about her and her family having adequate nutrition. Which intervention would best address this concern?

Answer: The biggest barrier is communication, since she has recently relocated to the US……