1. HELEN TOWNSEND MPH RN REFUGEE HEALTH COORDINATOR REFUGEE HEALTH PROGRAM TUBERCULOSIS/REFUGEE HEALTH DIVISION INDIANA STATE DEPARTMENT OF HEALTH Refugees in Indiana

2. Definition of a Refugee

3. UNHCR 2007 STATISTICAL YEARBOOK # of Refugees worldwide in 2007 11.4 million does not include 4.6 million Palestinians counted by another UN agency # of Refugees resettled worldwide in 2007 75,300 (0.7% of total # of refugees) # of Refugees resettled in United States in FY 2007* 48,300 International Statistics *Federal fiscal year (1 Oct 2006-30 Sep 2007)

4. 2004-2006 1232 arrivals* 2007 1533 arrivals* 2008 1552 arrivals* 2009 Arrival #s are expected to follow the trend of the previous two years *This number does not include secondary migrants: refugees who originally settled in another part of the United States, then moved to Indiana after arrival. Refugee Resettlement in Indiana

5. PHOTOS Burmese Refugees in Thailand

6. Photos from Refugee Camp in Thailand

10. PHOTOS AND STORIES Burmese Refugees in Malaysia

11. Kuala Lumpur

14. Malaysian Jungle

15. Iraqi Refugees

16. Iraqi Refugees in Syria

18. Iraqi Refugees in Jordan Zeinab Majid and her husband, a painter, fled Iraq with their two sons, ages 7 and 4, last September after receiving two threats and surviving a bombing.

19. Iraqi Refugees in Jordan Hassan Jabr left his elegant home and garden and his job as a Spanish teacher in Baghdad after one of his sons was kidnapped and killed last year.

20. Medical Screening Overseas  Pre-departure Domestic  30-90 days after US arrival

21. TO IDENTIFY APPLICANTS WITH INADMISSIBLE HEALTH-RELATED CONDITIONS Purpose of the Overseas Refugee Medical Examination

29. TO COLLECT INFORMATION ON IMMIGRANTS AND REFUGEES WHO HAVE MIGRATED TO THE U.S. THEY WERE CLASSIFIED OVERSEAS DURING THE REQUIRED MEDICAL EXAMINATION PROCESS WITH A TB CONDITION. FOLLOW-UP EVALUATION IN THE U.S. WAS RECOMMENDED. Purpose of the TB Follow-up Worksheet

30. 2007 185 arrivals 2008 240 arrivals 130 refugees 110 immigrants TB Class B Arrivals in Indiana

33. 1) TO SCREEN FOR COMMUNICABLE DISEASES OF PUBLIC HEALTH SIGNIFICANCE AND LINK REFUGEES WITH LOCAL TREATMENT SERVICES 2) TO INTRODUCE REFUGEES TO THE U.S. HEALTH CARE SYSTEM 3) TO IDENTIFY REFUGEE POPULATIONS WHO ARRIVE WITH AN INCREASED RISK OF DISEASE Purpose of the Domestic Refugee Medical Screening