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Approximately 300 refugees from between 20 to 30 different countries resettle in Rhode Island each year. The Refugee Dream Center was founded by one such refugee, Dr. Omar Bah, whose mission was to create a “one-stop-shop” to support all refugee needs. Since its establishment in 2015, the Refugee Dream Center has grown to host 13 different programs that serve 3000 community members. Dr. Bah’s greatest hope for the center is to provide refugees with a welcoming community amidst an unfamiliar country: “a home away from home.” 2
One particularly notable program run by the center is the Health Promotion Program. This program aims to fulfill the diverse healthcare needs of the refugee population in Rhode Island in a cross-disciplinary, holistic manner. According to one study, the rate of inadequate functional health literacy among refugee populations in the US is upwards of 50 percent. Compared to the rest of the population, a study by Ahmad et al. finds that rates of domestic violence among refugee populations have significantly increased. These statistics align with Dr. Bah’s observation that members of the refugee community may face unique challenges in navigating healthcare, including cultural misunderstandings, barriers to health literacy, an increased risk of domestic violence, and mental health concerns associated with trauma.2 The Refugee Dream Center works with partners including the Rhode Island Department of Health, Dorcas International Institute of Rhode Island, ethnic and faith based groups, and Hasbro Children’s Refugee Health clinic to run three programs to combat these issues: the Journey to Health Program, the Home Visit Program and the Clinical Counseling Program.
The Journey to Health Program is designed to educate refugees about the principles of maintaining good physical and mental health through diet and lifestyle habits, with their unique cultural backgrounds in mind. Dr. Bah explains that things that may seem intuitive to someone who has grown up in America might not necessarily be intuitive to refugees who are used to living in a refugee camp. For example, in refugee camps, refugees may live under conditions of starvation for extended periods of time. They are not afforded the luxury of being picky about what they eat. Upon resettling in Rhode Island, refugees are given food stamps, which they can exchange for a variety of food options. To someone who has never had the opportunity of extensive choice in diet before, the diversity of food options in an American grocery store can be overwhelming. Many refugees tend to choose foods that taste good, but are not very healthy. Part of the Journey to Health Program focuses on teaching refugees about the health consequences of a high-sugar diet and educating them about how to select and prepare nutritious foods.
There are also other cultural factors that may prevent refugees from maintaining good health. For example, in some refugee cultures, there is prejudice against preventative healthcare. Thus, many refugees will only seek out healthcare once it is too late, and they are too sick for their ailments to be treated. There is also a similar stigma around mental healthcare. Dr. Bah notes that in some cultures, mental health ailments are viewed as a “curse” rather than a health condition. This view can cause refugees with mental health problems to feel alienated and doubtful of the efficacy of mental health treatments. As a result, the classes that are part of the Journey to Health Program are designed to de-stigmatize routine doctor's visits and preventative physical and mental health practices.
In addition to educating about healthy lifestyle practices, the Refugee Dream Center also provides professional health services through their Clinical Counseling program in partnership with Hasbro Children’s Refugee Health clinic. This program is designed to provide Rhode Island refugees with access to initial overall health assessments, professional mental health counseling services, and referrals to specialty physicians. Dr. Bah explained that this program provides support for some of the main mental and interpersonal health challenges that are particularly prevalent in the refugee population including substance abuse and domestic violence. A meta-analysis by Carerye finds that about half of all female refugees experience domestic violence at some point in their lives. While there is limited research on substance abuse in refugee populations, experts generally acknowledge that rates of substance abuse are often significantly increased among refugee populations.
Dr. Bah explains that these issues can stem from cultural factors. For example, in some cultures with patriarchal customs, the husband is believed to have authority over his wife and is allowed to restrict her freedom in ways that are isolating and detrimental to her mental health. This can create an unhealthy power dynamic in which the husband prevents his wife from learning English or getting a job in order to maintain his power over her. Combined with substance abuse issues, this dynamic is often conducive to perpetuating domestic violence. For complex situations like this, the Refugee Dream Center believes it is important to provide professional counseling services and to apply an integrative solution in which they also work with leaders of spiritual organizations.
Another factor that makes the Clinical Counseling Program unique is its emphasis on trauma-informed care. The Refugee Dream Center works with its partners to provide training on what trauma is and how to be mindful of trauma when assisting refugee populations.
Dr. Omar Bah says that the purpose of these training sessions is to teach people who work with refugees how to serve them “with their trauma histories in mind, in a culturally appropriate way.”
In conjunction with increasing access to professional mental health care, the Refugee Dream Center runs a Home Visit program to promote healthcare in a personal and holistic manner. During visits to refugees’ homes, staff members provide guidance on lifestyle changes to promote better health. For example, a common problem in refugee populations is asthma. Refugees are typically not used to having homes with a kitchen enclosed within the same space where they live because in many refugee camps, the kitchen is a separate, shared, outdoor structure. As a result, refugees may not understand the importance of proper ventilation and cleanliness when cooking. Dr. Bah recalls that he would walk into homes and not be able to breathe because of the smoke, but the refugees living in that space would “say that they [didn’t even] notice.” 9 This constant smoke inhalation is often responsible for bringing about asthma attacks. In addition to teaching refugees about proper ventilation, staff also use home visits to deliver food and other goods including clothes and cleaning supplies. Overall, the visits are a way to increase access to services by removing the cost and time it would take for refugees to come into the physical location of the Refugee Dream Center.
More than 50% of the staff who work for the Refugee Dream Center are refugees themselves. This is one of the many reasons why the Refugee Dream Center is uniquely equipped to work with refugee populations. They understand and appreciate the importance of the diversity and resilience of the refugee population. Refugees have to begin an entirely new life immersed in a society with customs and cultures that are completely foreign to them. The Refugee Dream Center’s Health Promotion Program works to ease the transition into this new life through a personal, holistic approach to improving refugees’ overall physical and mental health.
Writer: Sirena D'Orazio
Researcher: Allison Morales
Editor: Pranav Kota
Editor Soyu Hong
Illustrator: Bath Hernandez
1 “Refugee Assistance Program,” Refugee Assistance Program | RI Department of Human Services, accessed January 20, 2025, https://dhs.ri.gov/programs-and-services/refugee-assistance-program.
2. Allinson Morales and Omar Bah, Interview of Dr. Omar Bah of Refugee Dream Center, other, November 1, 2024.
3 Refugee Dream Center, Refugee Dream Center 2023 Annual Report (Canva, 2024), https://www.canva.com/design/DAF0KD6-Z9w/qFEhL85lvLP0PjyYADPghw/vie w?ut_content=DAF0KD6-Z9w&utm_campaign=designshare&utm_medium=link &utm_soure=editor#1.
4 C. Bouclaous et al., “Health Literacy Levels and Correlates among Refugees in Mount Lebanon,” Public Health 199 (October 2021): 25–31, https://doi.org/10.1016/j.puhe.2021.08.006.
5 Tehmina Sattar, Saeed Ahmad, and Muhammad Asim, “Intimate Partner Violence against Women in Southern Punjab, Pakistan: A Phenomenological Study,” BMC Women’s Health 22, no. 1 (December 8, 2022), https://doi.org/10.1186/s12905-022-02095-0.
6 “Programs & Services,” Refugee Dream Center, December 24, 2024, https://refugeedreamcenter.org/programs-and-services/.
7 Danielle Horyniak et al., “Epidemiology of Substance Use among Forced Migrants: A Global Systematic Review,” PLOS ONE 11, no. 7 (July 13, 2016), https://doi.org/10.1371/journal.pone.0159134.
8 Allinson Morales and Omar Bah, Interview of Dr. Omar Bah of Refugee Dream Center, other, November 1, 2024.