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Highlights

GAO was asked to evaluate both the medical procedures which were used to screen Indochinese refugees overseas and the followup procedures which were practiced in the United States to determine if those procedures were adequate for protecting the public health.

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Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Justice The Attorney General should: (1) not admit refugees into the United States until they have received a thorough medical examination to diagnose health conditions specified in the Immigration and Nationality Act; (2) require that the results of medical examinations be used in making final determinations concerning the eligibility of refugees for admission; (3) not admit refugees with active tuberculosis, infectious leprosy, amebiasis, giardiasis, and malaria until treatment for these diseases has been completed, unless compelling reasons exist to justify a medical waiver.
Closed - Implemented
Please call 202/512-6100 for information.
Department of Health and Human Services The Secretary, HHS, and the Secretary of State should require that the results of overseas medical examinations be provided to Immigration and Naturalization Service (INS) officials for use in the final INS determinations of eligibility of refugees for entry into the United States.
Closed - Implemented
Please call 202/512-6100 for information..
Department of State The Secretary, HHS, and the Secretary of State should require that the results of overseas medical examinations be provided to Immigration and Naturalization Service (INS) officials for use in the final INS determinations of eligibility of refugees for entry into the United States.
Closed - Implemented
Please call 202/512-6100 for information.
Department of Health and Human Services The Secretary, HHS, and the Secretary of State should ensure that medical records are developed and maintained while refugees in overseas camps are under the care of the United Nations High Commissioner for Refugees and are transferred to the overseas physicians before they perform the medical admissions examinations.
Closed - Implemented
Please call 202/512-6100 for information.
Department of State The Secretary, HHS, and the Secretary of State should ensure that medical records are developed and maintained while refugees in overseas camps are under the care of the United Nations High Commissioner for Refugees and are transferred to the overseas physicians before they perform the medical admissions examinations.
Closed - Implemented
Please call 202/512-6100 for information.
Department of Health and Human Services The Secretary, HHS, should transmit to the State or local health department at the refugee's destination all pertinent medical information available on the refugee.
Closed - Implemented
Please call 202/512-6100 for information.
Department of Health and Human Services The Secretary, HHS, should require that treatment be initiated and completed in Southeast Asia for refugees with active tuberculosis, malaria, amebiasis, or giardiasis before they are cleared to enter the United States. In the case of leprosy, the treatment should be sufficient to render the patient noninfectious.
Closed - Implemented
Please call 202/512-6100 for information.
Department of Health and Human Services The Secretary, HHS, should require that all refugees under age 15 be tested for tuberculosis because of the high incidence of tuberculosis in refugees under age 15 and the significant number of cases undetected overseas in this group.
Closed - Implemented
Please call 202/512-6100 for information.
Department of Health and Human Services The Secretary, HHS, should arrange with the Secretary of State to change the procedures for giving overseas medical examinations to Indochinese refugees destined for the United States and request that a medical history and examination for each refugee be performed by a physician using medical procedures commonly used in the United States. This examination should include: (1) an examination for diseases commonly found in Southeast Asia, including tuberculosis, leprosy, parasites, hepatitis B, and malaria; the examination for tuberculosis should include analyses of sputum cultures to further verify the presence or absence of the disease; (2) an evaluation for mental illness; and (3) an examination of body systems to help the physician determine if the refugee is suffering from a health problem which may affect his or her ability to earn a living in the United States.
Closed - Implemented
Please call 202/512-6100 for information.

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