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Reporter chronicles refugees’ challenges in improving oral health in their new home Date: 11/05/18

Jiwon Choi

By Mary Otto

In recent reporting for Minnesota Public Radio, Jiwon Choi explored the oral health challenges faced by refugees arriving in her state. 

In her piece, officials from resettlement agencies described their struggles in meeting the many needs of refugees within a 90-day eligibility window for government assistance. Efforts to find timely dental care for new refugees were complicated by the shortage of dentists willing to accept refugees’ Medicaid coverage, they noted.

And as Choi explained in her story, refugees like Say Paw, a Karen refugee from Myanmar now living in St. Paul, also may have unique oral health burdens linked to the lives they left behind. In the following Q & A, Choi offers insights from her reporting. She also shares advice for journalists who might want to tell a similar story their own community.

Q. What got you started on this story and how did your reporting evolved?

A. I started looking into oral health struggles among refugees when I was in Missouri for graduate school. As part of my reporting project, my team and I produced a radio package about the same topic in Missouri last year, when I figured out that many refugees coming to the U.S. would bring their unique cultural practices, some of which might compromise their oral health. So when I relocated here in Minnesota this summer, I wondered what the situation in this state is like compared to what I witnessed in Missouri.

Because of the demographic difference in refugee communities, most of whom are Somali, Hmong or Ethiopian, they have somewhat similar but culturally different issues with maintaining their dental health. After deciding to delve into the issue, I contacted six refugee resettlement agencies in the state and interviewed directors of a couple of the agencies to develop the story and broaden my knowledge about the topic. Especially the International Institute of Minnesota, a refugee resettlement agency in St. Paul, helped a lot connect me to refugee families to talk with for the story.

Q. What surprised you most as you explored this topic?

A. It was really surprising, and rather shocking, to learn how low the dental health awareness is among refugees, especially parents with kids like Say Paw in the story. She said during the interview that she thinks her teeth are okay and functional, even though she was told by her dentist a couple times already that they need to be pulled out considering their condition. Her teeth, even to me, seemed really discolored and not in good condition, because she has consumed betel nuts for years and she lost several of her front teeth when she was back in Myanmar, due to an accident. Paw said she cares about her kids’ maintaining their teeth clean but for herself, she didn’t seem like she cares as much.

Another thing that surprised me was the low acceptance rate of the state Medicaid. I myself am an immigrant from South Korea, where every person is enrolled in a national health care and can be provided essential medical services at low costs at any medical provider.  I knew how different the health care system is in the United States from the one in my home country, but it was quite surprising that many people who need care can’t get it in time because there are not many clinics and dentists who accept the Medicaid.

Q. What resources turned out to be most valuable as you continued your work?

A. Throughout the reporting process, every source I looked into and talked to was very helpful and knowledgeable. I cannot point to which resources were most valuable but I can certainly share what I did for the story: When I decided to cover the topic, one of the first things I did was to read academic articles and studies that are related to it. I think I at least read hundreds of pages of such studies I found online. While doing the homework, I started reaching out to local refugee assistance agencies, like the International Institute of Minnesota, and other resettlement agencies in the state funded by the federal government. From there, I could learn more about the issue and get much help from the organizations and directors working there.

Q. In the story, you highlighted a number of oral health challenges faced by refugees. They include shortages of Medicaid dental providers, time limits on government resettlement assistance; experiences of poverty and trauma. You also described cultural practices refugees may bring with them from their home countries that can compromise oral health: the use of betel nuts, the removal of baby canine teeth. The online version of your piece was accompanied by a well-referenced graphic that provided readers with more background. Tell us a little more about what you learned about these cultural practices and their impact?

A. Much of the information in the graphics and story came from the academic research I read. I got the idea of making the graphics by getting official data on the demographics of refugees in Minnesota, and then searching for studies about dental health in their countries of origin. For the Karen people’s custom of chewing betel nuts, I was told by a lot of sources during interviews that it’s a problem in the refugee community. Some scientific research results backed up what I heard from dentists and refugee resettlement directors.

Q. For reporters who might want to examine this issue in their own communities, do you some wisdom to share on the best place for them to begin?

A. Try reaching out to the local refugee resettlement agencies if you want to develop your idea and get to know what the real problems are. In my case, for example, I didn’t know about the difficulty of finding dentists and the problem of chewing betel nuts among Karen people before talking to them. The staff at these agencies interact with the new Americans first, they see the struggles they have, and assist them through providing resources that they need. Many of them would welcome you when you express your interest in shedding light on the resettlement struggles.

Q. Do you plan on writing more stories about refugees and the challenges they face?

A. Of course, I do and I will. It might be because of my personal interest as an immigrant from South Korea, but stories like this are the ones I have a passion for pursuing. It’s what has led me to journalism. I’ve always wanted to be a bridge between people and communities around the world by letting those relatively-unknown people’s voices be heard. Through this story, I could make this precious connection to the refugees in Minnesota and I’m hoping it will be a stepping stone for me to develop more stories like this in my future career.

Jiwon Choi is a digital writing and reporting intern at Minnesota Public Radio.