557 - Understanding the Health Needs of Newly Evacuated Afghan Children

In August 2021, approximately 85,000 Afghan civilians were evacuated emergently from Afghanistan. Half of these evacuees were estimated to be children. Many evacuees required medical care immediately upon arrival to US airports or over the following months while living on military bases awaiting resettlement.  Our healthcare system is located near one of the military bases housing approximately 16,000 evacuees. Due to the extraordinary circumstances of their evacuation and resettlement process, this population had unique clinical and care coordination needs compared to refugees arriving in the US via the traditional resettlement process.

Objective: Our goal was to describe the demographics, health status, medical problems, and healthcare utilization of pediatric Afghan evacuees seeking emergency or subspecialty care in our health care network prior to resettlement.

Design/Methods: This was a retrospective chart review of all pediatric Afghan evacuees presenting for care in our healthcare network between August 2021, when the evacuation began, and February 2022, when the last Afghan families were resettled. Patients were identified by the presence of a specific insurance designation given to Afghan evacuees, the detection of ‘Afghan’ free-text in the chart for patients presenting during this time period, and by demographic information (ex: address on local military base).  The charts were reviewed by a team of clinicians. Data was abstracted into a REDCap database.

Results: We identified 479 children, comprising 680 individual encounters, presenting to care for acute and chronic medical needs. Sixty-five percent of these encounters were to our emergency departments (ED). The most common acute care diagnoses were viral illness, extremity fracture, and skin/soft tissue infections. Many children presented with region-specific illnesses including cutaneous leishmaniasis, hepatitis A, measles, malaria, and extrapulmonary tuberculosis. Fifty-two children (with 205 unique encounters) had complex chronic medical problems (ex: congenital heart disease, epidermolysis bullosa, epilepsy, hemophilia), requiring advanced medical care and care coordination prior to their final resettlement.

Conclusion(s): Due to their precipitous mass evacuation and nontraditional pathway to resettlement, newly arrived Afghan children are a unique cohort with diverse, and occasionally complex, medical needs. Results from this study will inform clinicians caring for Afghan evacuees after their resettlement and those who may have to care for similarly large volumes of children displaced by future humanitarian disasters.