What is the truth about HIV and refugees?

Yesterday the Washington Post published an opinion piece by Andrew Sullivan who says that all immigrants with HIV aids are barred from the US.     He begins “Phobia at the Gates”:

Twelve countries ban HIV-positive visitors, nonimmigrants and immigrants from their territory: Armenia, Brunei, Iraq, Libya, Moldova, Oman, Qatar, the Russian Federation, Saudi Arabia, South Korea, Sudan and . . . the United States. China recently acted to remove its ban on HIV-positive visitors because it feared embarrassment ahead of the Olympics. But America’s ban remains.

It seems unthinkable that the country that has been the most generous in helping people with HIV should legally ban all non-Americans who are HIV-positive. But it’s true: The leading center of public and private HIV research discriminates against those with HIV.

HIV is the only medical condition permanently designated in law — in the Immigration and Nationality Act — as grounds for inadmissibility to the United States. Even leprosy and tuberculosis are left to the discretion of the secretary of health and human services. 

I am sure that last fall when we had our September Forum (see our whole category) in Hagerstown, MD about refugee resettlement that the State Department representatives told us the ban on refugees with HIV had been lifted by the Clinton administration.    Here is a post in which I mentioned the supposed lifting of the ban.   Now I’m wondering if it isn’t really lifted but just ignored by those admitting refugees to the US.

By the way, one of the flaws in Sullivan’s argument involves who pays for HIV treatment of immigrants.  He says they should be required to carry private health insurance.  That is not going to happen with refugees who get medical care gratus from local governments.

Take a look at the problems some county health departments are having with the cost of health treatment for refugees.  Ft. Wayne, IN (Allen County) comes immediately to mind.

Would treating HIV like any other medical condition cost the United States if such visitors or immigrants at some point became public dependents? It’s possible — but all legal immigrants and their sponsors are required to prove that they can provide their own health insurance for at least 10 years after being admitted. Making private health insurance a condition of visiting or immigrating with HIV prevents any serious government costs, and the tax dollars that would be contributed by many of the otherwise qualified immigrants would be a net gain for the government — by some estimates, in the tens of millions of dollars.

Sullivan does mention that immigrants with all other diseases including leprosy and tuberculosis are not legally banned.   A Somali refugee died of TB in a Tyson’s meatpacking plant in Emporia, KS last year—funny you never heard that reported in the mainstream media.

I would really like to know what is the truth about refugees with HIV.

Haitian Immigrant brought AIDS to US

This report, originally from Reuters, was published all over the world yesterday.

The strain of HIV that touched off the US AIDS epidemic and fueled the global scourge of the disease came to the continent from Africa via Haiti, according to a study released Monday.

——-

“Haiti was the stepping stone the virus took when it left central Africa and started its sweep around the world,” said Michael Worobey, an assistant professor of evolutionary biology at the University of Arizona in Tucson, and senior author of the paper.

——-

The deadly virus probably arrived on US shores in about 1969, more than a decade before the full-blown US AIDS crisis of the 1980s, and may have been carried there by a single Haitian immigrant, according to the study.

What relevance to refugees?   During the Clinton Administration the ban on immigrants with HIV AIDS was lifted and refugees with AIDS are permitted entry into the US.   We pay for their treatment upon arrival.  This was confirmed by State Dept. representatives at the September Forum in Hagerstown.

From 1983 to 2005 we admitted 28,625 Haitians with the lions share resettled in Florida.  Just a reminder that the 2005 ORR Annual report to Congress is a handy source of information.   See Appendix A for country of origin and resettlement state.

Note:  We may soon make available DVD copies of the Public Forum on Refugee Resettlement held in Hagerstown, MD on September 19, 2007.    If you are new to RRW you might want to review the September Forum category here.

What about tuberculosis?

At the September 19 public meeting in Hagerstown, a question was asked about the high rate of tuberculosis among refugees. Ann had just found this in the Fort Wayne Sentinel and posted it:

McMahan  said about 50 percent of refugees arrive with TB infection and must be tested, treated and tracked. The TB clinic is already seeing a surge in patients this year, and they are sicker, she said, adding more nurses are needed now, even without the additional refugees.

One of the speakers, Terry Rausch from the State Department, said in reply that many refugees test positive for TB because they’ve been exposed, but are not infected now. (It’s true that this commonly happens. My father, who grew up in a Philadelphia slum, tested positive for TB although he never had it that he knew of.) We were also told that all potential refugees go through a health screening before they come here, and are then checked once they are here.

The statement was intended to reassure us that there’s really no health danger in bringing in refugees. I’ve just been searching for some more facts.

A report from the CDC (the federal government’s Centers for Disease Control), “Multidrug-Resistant Tuberculosis in Hmong Refugees Resettling from Thailand into the United States, 2004–2005.” Apparently the screening procedures were deficient, and there were cases of multidrug-resistant TB getting through. They changed the procedures, and since then none of these TB cases have been found among Hmong refugees.

But the CDC then points out that the refugees could have latent TB and need to be monitored to make sure these cases don’t become active TB. The article also includes these observations:

The global incidence of TB disease is increasing, and an increasing percentage of TB cases in the United States are occurring among foreign-born persons.

———————-

 These investigations and responses have required and will continue to demand considerable public health resources. Per person, the estimated costs of detecting disease and treating patients with LTBI range from $208 to $11,125, and the direct medical costs associated with TB and MDR TB disease range from $3,800 to $137,000, depending on case complexity. These projections underestimate the costs for treating Hmong refugees because they exclude the additional expenses of providing culturally appropriate outreach, interpretation, and transportation services.

—————–

The annual number of immigrants to the United States continues to increase, and TB is the medical condition most frequently diagnosed among applicants for permanent residence.

They point out that the number would be even higher were it not for screening. But it is obvious that the screening isn’t perfect. It’s clear from skimming through some of the articles on the web that TB among refugees is a problem. TB hasn’t been a problem in this country for many years, but now it’s becoming one.

Why do we need volags?

Your tax dollars: 

Last week at the forum in Hagerstown on Refugee Resettlement the first question may have been the most important.  Louise Dawson, a lifelong resident of Hagerstown, asked why can’t Refugee Resettlement be run completely by the government and the churches could just volunteer to help?   Here is the Herald-Mail’s coverage of what she said:

“I think the concern in our community is financial,” said Louise Dawson, who suggested that refugees be sponsored and resettled by volunteers within churches instead of through taxpayer funds.

The public doesn’t understand the importance of this line of questioning because most people do not know that the church groups (the volags) are paid by the taxpayer to do this work.  The federal government even pays for the entire Washington DC offices of the volags.    In addition, local volunteer hours can be translated into taxpayer funds to the volags via the Match Grant Program (among other ways of pulling in the taxpayer dollars).

The response from the State Department representatives was a weak comment about how this was a Public-Private Partnership, in other words, by just uttering that phrase it was deemed an adequate explanation.   Hum….could the government officials be afraid of the volags?

The Public-Private Partnership sure failed the public side of that partnership in the outrageous case of the volag, African Community Resource Center, Judy reported on a couple of days ago.  Is it the tip of an iceberg?

It’s time to revisit the Refugee Act of 1980.   We need a Congressional investigation, perhaps a General Accounting Office (GAO) study of the cozy arrangement the volags enjoy. 

 Louise Dawson’s first brushed-aside question needs to be answered.

Family Reunification–opportunity for fraud?

Did you know that refugees can apply to bring family members to America and the refugee becomes the sponsor for more refugees?  The volags (non-profit groups funded by you) take the applications for the extended family members and then are paid by the head for the additional refugees they resettle.

Anecdotal stories abound about how easy it is to defraud the government (and us).  I heard that one woman “found” ten adult children over the course of several years.  Apparently there is some truth to the stories.

At the September Forum last week in Hagerstown , I asked the US State Department Reps about a June 2007 Congressional Research Service Report for Congress which referred to fraud in the family reunification program of refugee resettlement.   This report was sent to me privately and I can’t find it on-line yet, but here is what it says:

During the late 1990’s the State Department found that a large number of Priority 3 (family reunification) applications were received from persons who did not qualify for refugee status and that there was significant amount of fraud associated with those applications.

The report goes on to discuss the fact that certain nationalities are ineligible from participation in the family reunification program because of rampant fraud. 

My question to the State Department ladies was three-fold:  What was the nature of the fraud?  Answer:  It happened a long time ago (the late ’90’s was a long time ago) and people were applying who were not eligible.

What nationalities have been barred from the program?   Answer:  there was no answer.

Was anyone admitted to the country fraudulently and then deported?   Answer:  Homeland Security has more important deportations than these.

When Judy posted the Los Angeles fraud arrest a couple of days ago.  I checked out the African Community Resource Center and found it to be a subcontractor of Ethiopean Community Development Council (one of the 10 major volags with State Department contracts).     Note that the African Community Center prominantly promotes its role in helping bring family members to America.  I just wonder, if someone is allegedly willing to steal from refugees and cheat the taxpayers, might they be tempted as well to find lots of missing children, brothers, sisters and long-lost cousins to bring to America as well?

We need to reform family reunification.  Only spouses and minor children should be permitted.

Inviting Perspectives

If you were at the Refugee Resettlement Forum in Hagerstown on September 19, and if you have some knowledge or insight you would like to share about the issues that were discussed or anything else about the Forum, please send your comments to us. We will publish short posts — no more than three paragraphs — in a new feature called Perspectives on the September Forum. If you were not heard at the Forum, or have not been able to get your letters or phone calls on the refugee issue into the Herald-Mail, this is an opportunity for your voice to be heard.

Send to:  refugeeresettlementwatch@vigilantfreedom.com

More on Hagerstown snow storm—how to trick the public

As I mentioned previously,  I had high hopes for straight answers at the Hagerstown Refugee Resettlement forum on September 19.    Here is an example of how government officials confuse the public:  

The question, asked of the US State Department, went something like this (shortened here):  Doesn’t Refugee Resettlement cost the taxpayers about one billion a year?   But, the questioner made the fatal error of using the word “grants” in the question somewhere.    This allowed the federal representative to say, according to her numbers the grants were around $500 million, not a billion.   

The average citizen has no clue about various funding mechanisms in differant agencies of the government,  and isn’t expected to know that there are government grants and contracts,  in addition to other funding categories. 

This is how the question should have been answered truthfully:   The grants portion is primarily a function of the Dept. of Health and Human Services and is in the vicinity of $500 million (actually I think its closer to $600 million this year), and our (State Dept.) portion includes contracts etc. and is around $200 million right now.   Homeland Security expends about $12  $20 million for its portion of refugee resettlement.  And then, yes, there are other expenses borne at various levels of government (school, medical and so on).   Then look the questioner in the eye and say YES, the cost for Refugee Resettlement is around one billion a year.   

Is that so hard?    Why play a little game of semantics?   Stop insulting us, and tell us the truth!  When you don’t, people ask, well what else are they not telling us?

See the September Forum category to follow our coverage of this meeting.

The State Department Ladies…wish I’d asked

Terry Rusch and Barbara Day from the State Department were the first speakers last night. They gave a fact-filled presentation that did a lot to put refugee resettlement in context. But there were only a few questions allowed after their presentation, and at the end they were in a hurry to leave, so not all questions for them got asked.

One thing I want to know is who decides which refugees to admit, and how it is decided. They mentioned a few groups who are coming in now — the Burmese in Thai refugee camps, Bhutanese, various Africans, and Iraqis. The Iraqi refugees are a big issue now, because many thousands have left Iraq, said to be in danger because of their involvement with the U.S. presence there. The International Herald Tribune has an article about them today. (I see Ann beat me to the punch and posted about the Iraqi refugees.)

Terry Rusch mentioned that Christian groups in Iraq are in danger, and seemed to be saying they are one of the refugee groups being admitted. I would like to know more. How many Christians will be among the 80,000 refugees next year? Where will they be from? Will they come in as intact communities?

Christians in Iraq, and elsewhere in the Middle East, are increasingly at risk from militant Muslims. Ancient Christian communities, in existence since the New Testament days of Paul, are being destroyed. America is not officially a Christian country, but I’ll bet that most Americans feel great sympathy for oppressed Christians around the world. It might be easier to place Christians in many places than other groups.

What would we do without Martin Ford?

Martin Ford is the assistant director of MONA, the Maryland Office for New Americans.  Thank goodness he spoke at the Hagerstown meeting last night! Otherwise, how would we ever know we were a nation of immigrants? We might not realize that our ancestors came here from other countries and had a hard time. Some of them were even unwelcome!

Neighborhood leader Mary Haines nailed it at comment time when she called Mr. Ford’s talk patronizing. I would add that the talk directly contradicted Dave Jordan’s request that people not make testimonials. Or maybe he only meant the questioners, and the speakers were free to display their compassion credentials at length. It also directly contradicted what I thought was the purpose of the meeting: to present facts. Mr. Ford’s talk was pretty much free of relevant facts about the refugee program, though full of historical facts, mostly ones that we already know. 

I do have the satisfaction of having predicted this, in my Monday post on the Delphi technique. The underlying message of Mr. Ford’s talk was, of course, that the refugees are just like our ancestors, and we will be dishonoring their memories and the meaning of America if we don’t welcome the refugees with open arms. I don’t think he persuaded anybody.

It snowed in Hagerstown last night

Whew,  finally a few minutes to report on the snow-job in Hagerstown last night.   O.K. I’ll say it, I’m naive.   I thought the forum would be a good idea to get facts out in the public and thus allow our community to weigh all sides of the issue.   To all of you who warned me that they wouldn’t give us straight answers, I apologize, you were right.   

But, the meeting wasn’t a complete waste.  Judy and I look forward to writing about it for weeks to come.   We will try to keep each post short adding it to a new category called September Forum, so that eventually a newcomer to RRW could follow our whole analysis.

This afternoon I’m commenting on the first, actually funny (sort of funny), non-answer.  Someone more knowledgable than I about refugee resettlement told me that if we asked about the repayment of the airfare loan (refugees fly here on the taxpayer’s dime and are expected to repay the loan) the response would be:  “The repayment rate is better than for student loans.”    Yup, you guessed it!  That is exactly the response we got the first time the question was asked of the US State Dept. representative.

The second time the question was asked the amount of the backlogged unpaid loans was not known (we hear hundreds of millions)  but it was confirmed that the volags can pocket 25% of the loans they can wring out of refugees, and afterall we are told that is the going rate for debt collecting.   Call me crazy, but I get an image of a mobster-minister-type putting the squeeze on some poor soul making $8 an hour who doesn’t even understand English well enough to read his dunning notice.