Refugee Relief During COVID-19

April 15, 2020 by Elizabeth Quinn

During the COVID-19 pandemic, athletic trainers have stepped up to help their local health care systems in multiple ways, including screening, telemedicine and infrastructure. NATA will share what athletic trainers everywhere are doing to care for their patients, communities and themselves during this time.

For refugees living through the pandemic, there is a lack of information as well as a delayed or no response as to how to tackle the coronavirus, said Alexandra Nuttall-Smith, ATC, MPT, director of health and wellness of iACT, an Los Angeles-based nonprofit dedicated to providing aid to refugees, and athletic trainer of Darfur United, an iACT program and adult soccer team comprised of refugee players.

“The refugee and displaced communities are being left out of the global response at every level,” she said. “So attention needs to be paid to supporting refugee-led community response. Even refugee communities in the U.S. are using our resources because there isn’t info in their native languages.”

Nuttall-Smith and her coworkers at iACT work together to provide information to refugees to ensure the safety and protection of everyone. Nuttall-Smith explains how she and iACT are changing the situation for refugees during COVID-19.

What is the current COVID-19 situation like in your area and how have you and your patients/athletes been affected?

Los Angeles has been, since March 19, under stay-at-home orders from California Gov. Gavin Newsom. The outpatient physical therapy clinic that I worked at had to close in order to protect our patients and our staff. We are slowly integrating telehealth per California PT guidelines.

For the Darfur United all-refugee men’s soccer team, I have been in contact with all players (in various countries) since the COVID-19 outbreak. The June Confederation of Independent Football Associations 2020 World Football Cup, which the team qualified for, has been postponed to 2021. As soon as the outbreak was escalating in China in January, I wrote a COVID-19 coronavirus emergency action plan for the team and iACT. As ATs, we have to be prepared and informed and then educate the staff, coaches, directors and athletes.

What advice, guidance or instruction have you given your patients and athletes? Are there resources that have been helpful or would be helpful to have in this regard?

All the soccer players on Darfur United are re-settled refugees from the Darfur, Sudan, where a genocide began in 2003 and where violence continues today. Many lived in refugee camps in eastern Chad, Africa, before being resettled in the United States, Sweden and across Europe. As their AT, and with the help of other volunteers, I have to educate myself on the player’s current area of residence, their regulations and recommendations and remain updated on their local, unfolding COVID-19 situation. Each player was initially sent our COVID-19 Facts and Precautions Handout.

In March, with the assistance of Dr. Joshua Scott, primary care sports medicine physician for Cedars Sinai Kerlan Jobe Institute, team physician for LA Galaxy and Darfur United medical advisor, I formalized the Darfur United Symptom/Testing Protocol and Procedures should any players or their families develop COVID-19 symptoms. I also looked up each country and province/state’s online government website, in which every player currently resides, to confirm their particular COVID-19 information hotlines, information links and phone numbers, and local medical testing procedures. With the assistance again from Scott, should any player have any issues, they can contact us immediately, per our COVID-19 EAP.

In addition, each player has now received the Darfur United Staying Healthy During COVID-19 information guide. This document includes suggestions for workouts at home, soccer skills training, stretching programs and mental health/meditation/yoga/mindfulness links. It is updated as Darfur United's refugee players needs surface and are communicated to us. We have also included extra tips on how to disinfect grocery items that are being brought home.

Many players live with their families, and it is important to keep everyone safe and healthy. I used Fédération Internationale de Football Association, World Health Organization, Center for Disease Control and Prevention, The Prehab Guys, F45, Beast Mode Soccer and our local yoga and mindfulness volunteers as valuable resources. It is vital, as ATs, to have a multi-disciplinary medical referral team in place to assist with all aspects of our athletes’ health during this pandemic. Many of our players still have family and friends living in overcrowded refugee camps in Chad with limited-to-no resources, medical support, food or clean water. Therefore, we are encouraging them to share the Darfur United COVID-19 documents with their refugee communities to educate and empower them to reduce the potential of COVID-19 spread.

Why did you get involved with iACT and how have your grown your involvement since COVID-19?

I have been volunteering with iACT and Darfur United since 2012 to address all aspects of refugee athlete health, Refugees United Soccer Academy health (for refugee girls and boys ages 6 to 13 in refugee camps) and non-governmental organization staff health and wellness, including stress reduction, first aid and CPR education. I coordinate free community and local exercise classes for humanitarians and volunteers who are on an extremely limited budget. Many of the EAPs I have previously created for soccer training camps and international games/tournaments have included universal precautions as well as disease and illness prevention and protocols. In my experience, ATs should already have EAPs prepared for medical emergencies, illness and mental health crises.

To further assist with the refugees, the COVID-19 Facts and Precautions document has been translated into many languages, including English, French, Arabic, Kirundi, Swahili, Farsi/Persian, Sorani, Kurmanji, Burmese and Karen, and sent to many refugee communities globally. These translated documents have also been sent and communicated via WhatsApp to refugee community leaders worldwide to share immediately and rapidly within the refugee camps. They are sharing the information with the refugees and other organizations in their region.

What are you doing to take care of yourself and stay connected with your local community, athletic training community, friends and family?

As an AT, I am part of an all-women’s AT Facebook page, which keeps me connected to the profession, and I learn so much from my amazing peer ATs working in so many settings around the country. As a humanitarian, I don’t get paid for any of my work. As in all of our AT settings, burnout needs to be addressed and managed. The refugee athletes, who have endured so much worse than this COVID-19 pandemic, are my inspiration. They fuel my drive to work for them and better their lives. They are truly the titans of peace and hope.

What encouragement would you give your fellow ATs during this time?

Volunteer. As ATs, we have an innate drive to fix things; so, let’s fix it. Even the smallest of gestures will ripple into a huge wave of good. Remember though, we must put on our own oxygen masks first so we have enough to give to others: use telehealth; reach out to the coaches, teams and players who you are used to supporting in person; update EAPs; share your wealth of knowledge online; and empower your athletes to practice self-care and share their knowledge while sheltering at home.

What has been a positive part of this experience for you? Where do you find the bright spot in times like this?

Many refugee communities live in cramped, overcrowded quarters. They have limited resources, minimal information, horrific living conditions and negligible medical care. However, the bright spot is the coming together of humanity, in so many countries and languages, to help those impacted by this crisis. Also, the volunteers who are helping are an inspiration. Even in our own communities, we are seeing volunteers making a difference – bringing supplies to the quarantined elderly, clapping nightly for the frontline workers and staying at home to protect others.