Vesna Sin, a Bosnian refugee living in Utica, NY, stated, "I am very satisfied with the medical staff  I have encountered in the United States. I truly believe that 99.9% of the people who become doctors and nurses do so because they love people, love their job, and really want to make a difference." The refugees we interviewed are appreciative of the health care options and staff available to them in Utica, NY.  Vesna pointed out that, "It is the doctor’s job to be as prepared as possible when dealing with patients, and this includes knowing a little about them." This Bosnian refugee, who has been living in the United States for two and a half years, pointed out that, unintentionally,  questions or gestures can be hurtful and get in the way of  good doctor/nurse/patient  relationships. If a patient is offended, due to embarrassing or hurtful questions or interactions, s/he is less likely to confide in the doctor.  These potentially embarrassing or hurtful questions often have to do with hygiene and religion.  A few minutes of research could go a long way towards improving relations between doctor and patient.   The refugees noted that they are more likely to utilize health care facilities when they feel comfortable with their nurses and doctors (interview with Vesna Sin).

Many of the Bosnians who have recently entered the United States are from rural areas.  Lidija Hamzic noted that these new Utica residents are similar to people from rural areas all over the world, meaning that most are uneducated and poor.  Therefore, health care is not a top priority.  Keeping this in mind, it is important to know where the population originated, because their concepts of health and the need to utilize health care may differ.  On the other hand, many of the refugees who reside in Utica (especially the first people to enter) are from city environments and are well- educated.  Therefore, while earlier settlers do recognize the importance of receiving the proper medical attention and are thankful for options that are available in the United States, one must note that newer arrivals to the area do not necessarily share these sentiments (interview with Lidija Hamzic).

Hesitations and Barriers to Health Care Utilization

* Medicaid is health insurance provided by the government.  Most Bosnians feel it is shameful and are extremely embarrassed if and when they must be a Medicaid user.  This in turn makes them more hesitant to go to the doctor because they are reluctant even to hand over their insurance card to the receptionist. Like others in American society, Bosnians would rather be on health insurance through their employment.  However, many are unable to find suitable jobs, especially when first entering the United States.  Health care providers should be aware of the possible embarrassment that is present for their patients and work hard to make them feel comfortable. 

* Insurance in general can be confusing for a newcomer to this country, notably our HMO-structured system of care.  Everyone should be patient and never assume that the client understands this foreign system, especially if they do not speak English.

* The Lack of Specialists such as Psychiatrists or Podiatrists, to name a few, that will accept Medicaid can be a problem for Bosnian refugees in Utica.  They often must travel to Cooperstown or Syracuse to find proper medical attention.  This is difficult because many new immigrants do not own vehicles or have the funds to travel far from home.  In such cases, the primary care physician of a person covered by Medicaid should assist the refugee in finding specialists for their physical and psychological health in close proximity to Utica.