Afghan Clinical Guidance
Center of Excellence in Newcomer Health

In August 2021, over 100,000 Afghan nationals were evacuated from Afghanistan to transit locations overseas and to eight military bases in the U.S. Evacuees included people who worked alongside the U.S. in Afghanistan, as well as other vulnerable groups. Most people were evacuated with their families. As part of Operation Allies Welcome (OAW), evacuees were housed on military bases in temporary, communal living facilities called Safe Havens where they received medical and immigration screening and were processed for relocation and resettlement in communities. Subsequently, the evacuees moved to states across the U.S. where they are receiving domestic health examinations and other health care services.

In March 2022, the OAW shifted to Phase 2 of its response. Afghan arrivals arriving during Phase 2 will be coming from overseas, some with a brief layover at a processing center. These arrivals will be completing their medical examinations overseas prior to entering the U.S and notifications will be sent via EDN.

Brief overview for clinicians caring for Afghan new arrivals

Health screening and care

• CareRef: Clinical Assessment for Refugees
  CareRef is a tool that guides clinicians through conducting a routine post-arrival medical screening of a newly arrived refugee to the U.S. The output of this tool is based on the current CDC Domestic Refugee Screening Guidance. CareRef recommends screening tests and other preventive care based on the demographic and geographic factors that contribute to risk.
• Afghan Evacuees Health Resources
  University of Minnesota and Minnesota Department of Health partnership to develop a coordinated resettlement response to Afghan new arrivals.

CDC guidance for clinicians caring for Afghans

• CDC: Dear colleague letter (March): OAW Phase 2 medical examinations (PDF)
  Update on the Phase 2 Afghan newcomers arriving from overseas and medical examinations; Mar. 28, 2022.
• CDC: Interim Clinical Guidance for Providers Caring for Newcomers from Afghanistan (PDF)
  Update Alert with recommendations for leishmaniasis, lead, and malaria; Dec. 20, 2021.
• CDC: Supplemental Health Recommendations and Considerations for Arrivals from Afghanistan — Multiple Locations, 2021
  Guidance for clinicians seeing Afghan evacuees who did not complete screening at a Safe Haven military base; Sept. 24, 2021.
• CDC: Guidance for Clinicians Caring for Individuals Recently Evacuated from Afghanistan
  Clinicians should be alert for cases of measles, as well as other infectious diseases, including mumps, leishmaniasis, and malaria; Sept. 20, 2021.

Webinars and trainings

• Center of Excellence in Newcomer Health: Webinars
  Webinars on pediatric and adult refugee health; includes “Afghan Culture and Health Screening Considerations.”
• Free Course: Caring for Newly Arrived Afghans
  This four-hour free online course with CME, composed of recorded lectures and interactive lessons, helps prepare providers to serve newly arrived Afghans. Provided by Global Medicine at the University of Minnesota in collaboration with presenters.
• PolicyLab: Refugee Health Care in the United States
  This webinar examines common models of refugee health care and how we can use tools to standardize care for all refugees.

Household health and safety

• Afghan Evacuees Health Resources: Household Health and Safety FAQs for Communities hosting Afghans
  Medical guidance to prepare for and promote household health and safety when hosting Afghan refugee families and individuals.

Health profiles

• Afghan Refugee and Humanitarian Parolee Health Profile
  History, cultural beliefs, health concerns and priorities, health care and access, and more to consider when caring for or assisting Afghan refugees and humanitarian parolees.
• Centers of Excellence in Newcomer Health Colorado Infographics: New Arrival Health Overviews

Translated materials

• CDC's Response to Afghan Evacuees
  Infectious disease resources in Dari and Pashto.
• NRC-RIM: COVID-19 Resources for Afghan New Arrivals
• Centers of Excellence in Newcomer Health Colorado: Translated Materials

Benefits and eligibility

• HHS Office of Refugee Resettlement: Afghan Assistance Resources
  • Benefits for Afghan Humanitarian Parolees (PDF)
  • Benefits for Afghan and Iraqi Special Immigrant Visa (SIV) Holders or SQ/SI Parolees (PDF)
  • Afghan Humanitarian Parolees and Unaccompanied Afghan Minors Eligible for ORR Benefits and Services: Policy Letter 22-01 (PDF)

Other resources

• Cultural Orientation Resource Exchange (CORE): Community Partners and Sponsors
  Introductory information about sponsorship, refugee populations, and resources to use with newcomers.

SIV holders

For general health information on newly arrived SIV holders please see the following publications: 

• Kumar GS, Pezzi C, Wien S, et al. Health of Special Immigrant Visa holders from Iraq and Afghanistan after arrival into the United States using Domestic Medical Examination data, 2014- 2016: A cross-sectional analysis. PLoS Med. 2020;17(3):e1003083. Published 2020 Mar 31.
• Kumar GS, Wien SS, Phares CR, Slim W, Burke HM, Jentes ES. Health profile of adult special immigrant visa holders arriving from Iraq and Afghanistan to the United States, 2009-2017: A cross-sectional analysis. PLoS Med. 2020;17(5):e1003118. Published 2020 May 13. doi:10.1371/journal.pmed.1003118
• Wien SS, Kumar GS, Bilukha OO, Slim W, Burke HM, Jentes ES. Health profile of pediatric Special Immigrant Visa holders arriving from Iraq and Afghanistan to the United States, 2009- 2017: A cross-sectional analysis. PLoS Med. 2020;17(3):e1003069. Published 2020 Mar 17. doi:10.1371/journal.pmed.1003069