The African Family Health Organization, located on Chestnut Street near 44th Street, works with African and Caribbean refugees to connect them with health and social services around the city. AFAHO’s services include ESL courses, case management programs and helping community members set up and go to doctor’s appointments. Kiera Kenney works as the manager of health and social services at AFAHO. She provided her insight on the nonprofit’s initiatives and goals and the state of immigration in Philadelphia.
Talk about about the African Family Health Organization, how it got started and the work you focus on?
The organization was founded several years ago by a woman named Tiguida. She was actually an immigrant herself from Senegal and she knew a woman in the community who ended up passing away in her home alone because she was undocumented. She didn’t know where she could go for care, she was scared. Her medical condition was severe enough that she passed away, so the impetus for the organization was to create a space where our clients could come where they could feel safe and get help regardless of their immigration status and we could just be that support system for the community. Our main mission is to help connect our clients to health and social services and increase health outcomes and social integration.
We have ESL three days a week in three different levels: intermediate, beginner and basic literacy. We also have a maternal and child health program which is helping pregnant women and new moms get access to health education around their pregnancy. We have baby supplies we have a connection for and medical case management. Walking them through their pregnancies, talking to their doctors, making sure they’re thinking about pediatricians and immunizations. One of our biggest programs is the Philadelphia International Women’s Project in partnership with Nationalities Service Center and Drexel Women’s Care Center, an OB-GYN clinic in Center City. That project is focused around women who have been cut – female genital cutting – and we’re providing clinical services and specialized OB-GYN services in addition to case management, support groups and sex therapy groups. Through that program, there’s also a lot of provider education: cultural competency and how to work with women who have been cut in the clinical setting. Then we do outreach sessions in the community, some education around the medical complications of the practice.
We also do family planning counseling. We work with AccessMatters for Title X funding. We’re doing mainly family planning education, helping people understand their options and then helping them get connected to care. We also do workshops in the community around family planning and also preventive healthcare. We put information about PrEP, about STDs, pap smears, men’s health, annual things to get people thinking about it. We also have a nutrition program which is for immigrant youth ages six and seven. It’s like Introduction to Nutrition for little kids. We have a five-week program where everybody meets at one location, they do education, they have snacks, they do a shopping session and a cooking session. We’re trying to integrate African meals and recipes but made healthier.
We also do some health literacy work, which is just helping our clients understand their language access rights and strategies for communicating with providers in clinical settings. We just finished up working with the HealthyWoman Program, which is with the city and health centers around the city to provide breast and cervical cancer screenings. We’ve been helping facilitate with some of our clients to get screened. We do general case management, we were funded to do refugee post-resettlement for awhile and we still do the work although…we’re looking for new funding. Case management is still provided for refugees and non-refugees, it doesn’t matter your status. [We do] healthcare navigation, which includes helping people make appointments, get to the appointments and in the appointment we might help with interpretation.
What are the main demographics you serve here?
African and Caribbean, mostly Afro-Caribbean, meaning Haiti, Jamaica. We don’t really have a lot of Spanish speakers and we do not have staff who speak Spanish. The majority of our clients are African and then Afro-Caribbean. The main languages we’re able to provide at the moment are Haitian-Creole, French, Bambara, Swahili, Arabic, Yoruba, Patois. It depends on the staff we have, but right now that’s what we can provide. Mainly we’re seeing clients who speak those languages and we try to get staff in that are mostly representing the communities that are coming in.
What are the largest populations from African countries living in Philadelphia?
A lot of West Africans, Liberians, Sierra Leone, Mali. Those tend to also be the populations we’re working with. There’s also a large Ethiopian community, a Sudanese community we work with a lot in west and northeast. Those are some of the more predominant ones.
Do most of these populations live around West Philly or are there other neighborhoods that are popular?
For our population that interact with us the most they’re living west and southwest, some in south and also in the northeast we have a large population.
What would you say are the main issues that affect these demographics during the immigration process?
There’s so many. The immigration process itself has gotten a little bit more difficult. We have a lot of clients who have applied last year and they still don’t know what’s going on, so we need to check back with their immigration lawyers. Or they’re applying for asylum or they don’t have status and they’re trying to figure out how they can get status. Immigration issues themselves are very broad and we have an immigration lawyer who comes once a month and consults during free consultations. She once explained to me that immigration law is complicated because its family law plus other dynamics and things to consider that make it very complicated.
Work is an issue, whether or not they have a working permit and can find work. Education, if they can enter into any of the institutions and start to get education if they want it when English proficiency may not be up to par with what institutions need or require. Some clients have never read or written in their own primary language, so that’s another barrier to learning English in general. Healthcare access is a huge issue, there’s stigma, a lot of our clients are not accustomed to preventive care systems. It’s kind of like, “When I’m sick, I go to the doctor,” not, “I’m going to go even when I feel fine.” Getting them into this preventive health care system for screenings is difficult.
Navigating the transportation system is hard for a lot of people depending on where they lived prior. Some people lived in cities but some people lived where there was not the same infrastructure in terms of transportation, which is confusing for a lot of people. Whether or not they have family here or support systems [is an issue]. Their health status, their age impacts how easily they can adjust to the Philadelphia landscape. Childcare is an issue. Everything.
How many people use the services here in a year?
Around 500 between our classes and people who come in, but then also clients we’re reaching outside of the office. A lot of what we’re doing is outreach or meeting people where they are, so they’re not necessarily coming to the office.
Do you help connect with mental health services as well?
Yes, where there are mental health services. That’s a struggle with the city. There’s many efforts to try and bolster the mental health services that are available. A lot of our clients are not requesting them in the traditional sense, but there are some who need it. There are some providers who are accustomed to working with more diverse populations but a lot of providers are not. They don’t even know if they offer language services, even though they’re mandated by law. It’s a struggle for mental health.
What is the dynamic like between immigrant parents and their kids who were born here? What’s it like when the kids try to assimilate more into the community?
This is an issue that a lot of immigrant parents have. You just have youth who are better able to adjust to the environment. They’re learning English quicker, they’re assimilating a little bit easier and they’re trying to become more American in some ways and match their peers in that way to prevent them from being bullied. The parents are trying to preserve their culture and they’re not able to learn English as quickly in a lot of instances. You have this dynamic where the parents are trying to preserve the culture of the kids, the kids are trying to throw away pieces of their parents’ culture. It’s this difficult dynamic and probably a lack of understanding. The kids are also hearing a lot at school. I was just talking to someone who was saying her friend’s child basically thought his mom was dumb because she couldn’t speak English. I guess he heard that in school or somewhere and there’s just this difficult dynamic for parents and kids. [Kids] have their own struggles, they’re trying to make it in life. Parents are trying to do the same thing.
Are there ever kids who know more English than their parents and then are expected to take on more of a role in the family at a young age?
Yeah. That happens often. Kids are not supposed to be used for interpretation and to translate documents, but they are. In the household they are counted on to read. “What does this piece of mail say?” And it could be something very important. Or in school settings, a lot of schools now have BCAs, bicultural assistance. There are schools that have a high density of certain language groups [so] someone is hired to be there and assist with those youth. A lot of schools don’t have that because there’s not a high enough population. So kids are sometimes utilized in different appointments, like in the medical field they’re not supposed to use children but sometimes they do. Their language skills are put to the test in the family.
Is it getting hard to get funding?
I think it’s safe to say yes. There’s funding priorities for different administrations. So if you’re no longer that priority area then funding is being pushed somewhere else. At the same time, I think there are lots of organizations or foundations who are aware of that and are trying to supplement. I know Women’s Way has this emergency fund grant where if you’re not able to do some sort of programming that impacts people that is important they’ll try to give you some money. [There are] other organizations who are interested in helping immigrants. They’re not going to be providing the large-scale funding the government would be providing, but they’re definitely trying to help fill in some of that gap.
What other organizations in the city work with these types of populations?
On the same type of level that we do, I’d say ACANA and Africom. Africom is an umbrella representative agency who represents the interest of a lot of other African and Caribbean focused organizations and businesses. They also have focus areas they work on in health and ACANA has a number of different programs as well.
What issues concerning these demographics would you like to see more of in the media that you feel might be missing?
We would like to see more attention on barriers to care because we’re focused on health and social services. We want to see more work being funded or more emphasis on helping immigrant populations gain access and the different health care needs they have. I don’t think that’s really on a lot of people’s radar. Funding is being cut in a lot of different areas around navigation and things like that. Also, I think there’s a lot of negative stories. I don’t think there are many happy stories. A lot of people contribute to the city. There’s a large immigrant population who started businesses around the city. I don’t think a lot of that gets out there unless you’re already in the community and working with the population. The positive stories of how people are contributing and engaging with each other in really positive ways, I don’t know if that’s getting out there enough.
-Text and images by Laura Smythe.