Sheeba Shafaq carries the memory with her everywhere. She was 13 when she witnessed her aunt die from bleeding out while giving birth. No one in the village was able to help her. Shafaq vowed that day to spare other Afghan mothers the same fate and, after she completed medical school, she began to work for a local obstetrics and gynecology office.
“For the first few weeks, it was so hard because every patient I would see, it was like PTSD remembering what happened to my aunt,” said Shafaq. But she persisted, becoming one of the few female doctors in Afghanistan who advocated for better maternal and reproductive health care. Shafaq volunteered with nonprofits and made trips to hard-to-reach villages where she provided emergency care and guidance on contraception and women’s health ― a move that was not welcomed by the men in charge.
In addition to providing critical medical care, Shafaq organized and participated in women’s rights protests, outraged by the 2015 death of Farkhunda Malikzada, a young Afghan woman who was fatally beaten while hundreds watched.
But Shafaq’s activism subsequently made her a target. When she heard about an exchange program in America, she jumped at the chance and was later granted refugee status. She found herself in a new country, alone and with no help. So she wanted to turn to what she knew best: working in medicine.
Shafaq is one of the thousands of foreign-born health care workers in the United States providing critical care during the coronavirus pandemic. Foreign-born workers make up approximately 17% of the American health care and social services sector, according to the Migration Policy Institute. At least 29% of American physicians were born outside the United States, as were an additional 38% of nursing assistants and home health aides. Nearly 16% of American based registered nurses and medical assistants were also all born outside the country.
And now, many of the nearly 3 million foreign-born professionals in the American health care and social services industries are currently on the front lines of the coronavirus pandemic. Yet health care professionals from abroad face a slew of challenges if they want to work in their field once they come to the U.S. — including language barriers, financial costs, immigration issues and being shut out of residency programs because American institutions don’t efficiently transfer education credentials from other countries. Last week, the Trump administration announced it would ease some immigration rules to allow for more foreign doctors to practice in crisis areas, especially in rural areas where they are needed most. States like New York and New Jersey have also eased some of its licensing requirements to allow for foreign medical graduates to contribute to the coronavirus response.
Earlier this year, the International Rescue Committee launched its Refugees Rescue program, which helps immigrants and refugees who are not accredited in the U.S. but have medical degrees find work volunteering or working in the fight against the coronavirus. More than 400 refugees signed up for the program in the last two weeks.
Even though Shafaq was a licensed physician in Afghanistan, she was not able to work as a doctor when she arrived in the U.S. without going back to medical school. She completed a medical assistant degree in 2019 and then in March was hired by the Elica Health Centers in Sacramento, California. Now she works 12-hour days screening and testing potential COVID-19 patients.
“We can take a lot — a lot of stress and a lot of work and we don’t complain. Maybe it’s in our system. We have been built to just cope and get through,” said Shafaq.
Also in Sacramento, Sayed Ahmadi had been working as a medical assistant in the U.S. for less than a year before the pandemic hit. But he knew how to operate under pressure and felt equipped to deal with the influx of patients at his clinic.
Born and raised in Afghanistan, Ahmadi graduated with a medical degree and worked as a physician for several hospitals before joining the U.S. Army in Afghanistan in June 2008 where he treated American and Afghan soldiers during the invasion. Ahmadi spent nearly eight years working alongside American forces. But when he was no longer needed, he knew it would be dangerous for him to stay in the country. In 2015, he fled to America with his wife and children.
Once in the U.S., he applied to several medical schools and programs with his Afghan degree and experience but was rejected. He was defeated and worried his skills would go to waste until a community of immigrant health care workers pointed him to the IRC’s services.
“People completely forget the skills, the talents, the energy and the diversity that refugees bring to America,” said Hans Van de Weerd, the senior director of resettlement, asylum and integration at IRC.
“We should really think about refugee and immigrant populations in terms of the contributions they make to the country, the solutions that they have for the challenges of the country, rather than perceiving refugees as people that come and take things from us,” he said.
Ahmadi said that his work dealing with trauma patients in the intensive care unit back in Afghanistan has given him a leg up treating COVID-19 patients in his capacity as a medical assistant. He knows how to work a ventilator, intubate a patient, and work with few resources while many of his counterparts do not.
Ahmadi and Shafaq are fortunate that they have found a way to work in their chosen fields, but many others in their position aren’t as lucky. Over 260,000 immigrants and refugees in the U.S. hold health care degrees but are not working in jobs commensurate with their education. Experts like Julia Gelatt, a senior policy analyst at the Migration Policy Institute, argue that there is more the U.S can do to make it possible for immigrants and refugees to put their expertise and training to use.
“We’re lucky as the United States to have people who want to come here and to contribute those talents to the United States, but we’re not always doing the best job at making it possible for people to come and then to use their training to contribute to the country,” said Gelatt.
Despite not being able to work as a physician in the U.S., Shafaq said she is grateful for the opportunity to at least be in medicine.
Earlier this month, she quarantined at home for two weeks after displaying coronavirus-like symptoms. She knows it’s possible that she could contract the virus from the dozens of patients that she sees on a weekly basis — but she’s not too worried.
Being quarantined, though, did eerily remind Shafaq of when she was forced to stay at home as a young girl during Taliban rule. At the time, girls were prohibited from receiving an education, but her mother secretly homeschooled her using her brothers’ textbooks and homework until the regime collapsed and schools reopened.
At least this time, she was able to go back to work after two weeks.
“I never imagined it would be this hard to be able to bring stability to your life when you move to a new country,” she said.
But, she added, her experiences have made her stronger and more than capable of battling the pandemic as a health care worker.
“If it wasn’t for all those hardships, I wouldn’t have been able to get through everything that I’ve been through,” said Shafaq.
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