Skye Hathaway, Copy Editor
When third-year Doctor of Nursing Practice student Karma Choki left her home country to study nursing in America, she faced many of the same challenges as domestic first-year students.
Incoming college students must make an entirely new group of friends and juggle a rigorous academic schedule, all while adjusting to college life in an unfamiliar environment.
Choki said international students find themselves tackling an entirely different problem: the U.S. healthcare system. Many international students, including Choki, come from countries where universal healthcare is the standard.
“I think if I didn’t work in the healthcare system and didn’t study anything healthcare related, I think it would be really hard for me to fathom,” Choki said.
As Choki began brainstorming ideas for her Doctor of Nursing Practice Project, she felt it was important for U.S. healthcare to be more accessible to international students and immigrants. Shortly after, she created the International Student Health Compass Project, a dedicated support resource to help international students transition to the U.S. healthcare system.
With the help of the Global Education Office, Choki created the ISHC website to provide students with key healthcare information, including their insurance options and where they can receive medical care. She also offers peer navigation support through the website, available by appointment or during drop-in hours.
Julianna Hill, a global learning specialist at GEO, works closely with Choki to hold collaborative workshops with an aim to help international students understand U.S. healthcare. In August, the pair led a workshop for students during open enrollment where Hill helped students enroll in their health insurance. After registering, students were invited to connect with Choki, who answered their healthcare related questions.
GEO holds international student orientations each semester to discuss the unique aspects of international student life with incoming students, Hill said.
“A lot of our international students assume that the hospital is where you need to go, no matter the ailment,” Hill said. “So informing international students of those nuances in our healthcare system is something we strive to do at every international student orientation.”
Amala Kavumkandathil, a second-year Doctor of Integrative Life Sciences student, said she feels that VCU cannot cover all of the necessary health insurance information at its international student orientations. She said that VCU suggested they use United Healthcare, but did not include information about specific packages or other insurance programs.
“Especially when it is something related to mental health services, when you call them they specifically tell you that ‘We don’t accept United,’” Kavumkandathil said. “So, what is the point of then taking something that the university suggests?”
Kavumkandathil said she recently became ill for the first time since moving to the U.S., and felt panic because she was unsure where to go. She assumed that VCU Medical Center was a general hospital, and was surprised when a friend informed her that it was a specialized hospital, not meant for common illnesses.
“I never had to face this experience,” Kavumkandathil said. “Anytime I was sick, I’ll just tell my mom and she’ll take me to her hospital.”
Kavumkandathil is from South India, where its healthcare system is universal, offering a private and government sector to its citizens. The government sector funds government hospitals, which operate similarly to a Patient First in the U.S., minus the cost, according to Kavumkandathil.
While there are various systems arranged by the necessary level of patient care, Kavumkandathil said health insurance is not necessary in South India unless a major surgery is needed.
“The state that I come from is very well known globally for their healthcare,” Kavumkandathil said. “So I literally never had to pay for anything in my life and I came to the U.S. and it was a big shift.”
According to Kavumkandathil, hospitals and private clinics offer walk-in appointments in India. Citizens do not have to wait to see a doctor, and are typically seen within two days if their care is delayed.
“Here I have experienced a delay in getting the health services,” Kavumkandathil said. “There were moments I decided not to pursue some services because the wait time was six months and I had to depend on my pre-med friends for a diagnosis.”
Choki said international students often rely on their support system for healthcare advice, and those who do not have that safety net often turn to the internet. She said students often experience an unspoken fear engaging in healthcare due to cost, causing them to avoid seeing the doctor, even when they are insured.
“My four years of undergraduate, I did not even interact with anything healthcare,” Choki said. “Even if I’m sick, I’ll do something at home, just out of fear that I may not be able to afford it.”
Choki said when international students continue to fear healthcare, they miss out on life-saving screenings, particularly those for reproductive health. She said she feels that reaching international students has become especially important as attitudes against immigrants and international students have changed in the current political landscape.
Choki said she has encountered challenges when performing outreach due to the federal government’s dismantling of diversity, equity and inclusion initiatives. She said targeting her message toward international students is considered discrimination against domestic students, adding an additional barrier to her resources.
According to Choki, she cannot directly say that the resource is only for international students. She said she had to add disclaimers and remove VCU’s school colors from her website, along with slashing the word international.
“There are institutional limits to it, and I feel like it’s very true for any underserved or minority population in this country, where you always have to get creative and do some jokes,” Choki said. “Sometimes the argument doesn’t really make sense, but we also don’t have a lot of control over it.”
Find more information about the International Health Student Compass Project on https://sites.google.com/view/ishcvcugeopilotproject/get-peer-navigation-support.