In 1989, the king of Bhutan proclaimed its “One Nation, One People” policy. Under law, all citizens of Bhutan, regardless of cultural background or geographic location, were required to dress only in traditional Northern Bhutanese garb and only learn the Northern Bhutanese language of Dzongkha. In the 1990s, hundreds of thousands of ethnically Nepali Southern Bhutanese led public demonstrations against this policy, leading to participants being branded as anti-nationals. Thousands were imprisoned and tortured without formal charges or trial, and many more fled to refugee camps in India and Nepal, with UNHCR camps in Southeast Nepal hosting over 80,000 refugees at times. These individuals, formerly successful farmers and merchants, then lived in these makeshift camps through several unsuccessful repatriation negotiations between Nepal and Bhutan. After decades, they began to resettle in foreign lands, with many moving to the US and thousands settling in Philadelphia, where I have had the privilege of working with them.
Many Americans fondly remember “Tommy the Tooth” – the ever so familiar image of a clean and sparkling white molar reminding children to brush their teeth every day. However, most refugees seldom receive the appropriate education, screening, and care to maintain healthy oral hygiene. This is true not only of the regions refugees flee from, but also of refugee camps, where healthcare generally focuses on addressing acute illness. Bhutanese refugee camps in Nepal were no stranger to this tendency, despite hosting refugees for, sometimes, decades. Between the years of 2009 and 2012, 87% of Bhutanese refugees in Madison County, Wisconsin, who had oral health screenings were referred to a dentist for early caries, urgent dental care, or prevention. In light of such data, this article will seek to further explore the etiology, prevalence, and significance of oral health challenges amongst Bhutanese refugees in North America
Most users find switching between an Apple product and Android product disorienting. The buttons are no longer in the same places, nor do they mean the same thing. Even more disconcerting is the differing built-in automatic functions that each device has. Simply put, the new device is incredibly unfamiliar. Most definitely, this experience of switching smartphones cannot be compared to the experience of refugee resettlement. However, it is a somewhat relatable illustration of the type of discomfort that refugees often face when resettling in the United States of America. As many refugee camps are temporary and ad hoc settlements, they often lack the basic infrastructure that US housing is generally equipped with. UNHCR estimates that 30% of refugee camps lack adequate latrine facilities and waste disposal. Thus even the operation of a toilet, which most of us take for granted, can prove to be a challenge for refugees who have spent decades or their entire lives living in camps.
In addition to this, subpar camp conditions and the lack of preventative health infrastructure in camps encourage the proliferation of many new illnesses and aggravate pre-existing conditions. Lastly, the physical and psychological trauma that is imposed on individuals by the experience of being persecuted and fleeing must be considered in caring for resettled refugees, who must often surmount various language and sociocultural barriers in the US. In this article, I will introduce these challenges in the context of the Bhutanese refugee crisis in order to increase awareness about a population that requires interdisciplinary assistance in order to realize the American dream.