Public Health Award Winner Created Ideal Setting for Refugee Care
Feb. 20, 2025, David Mitchell — When Fern Hauck, M.D., M.S., FAAFP, noticed there was a growing number of refugees arriving in Charlottesville, Va., with complex care needs, she didn’t wait around for someone else to address the issue.
Hauck launched the International Family Medicine Clinic in the University of Virginia’s Department of Family Medicine in 2002 after refugees from the former Yugoslavia and Afghanistan arrived in her community. The clinic started small with Hauck and a fellow providing care one day a week. In the two decades since then, the clinic has evolved into daily service that has cared for more than 5,000 people.
The clinic partners with a refugee resettlement agency as well as the local health department, which provides initial health screenings required by the CDC.
“After that, patients come to us and we become their primary care physicians,” Hauck said. “We’re a perfect setting because we take care of whole families, and often refugee families are large. We’re taking care of children, adults, pregnant women and the elderly. It’s great because we can provide care in one clinic and be their medical home.”
In September alone, more than 400 refugees from more than a dozen countries arrived in Virginia, including 215 from Afghanistan. Hauck said the clinic’s patients come from 85 countries and speak 75 languages.
The clinic, which provides in-person, telephonic and virtual interpreter services, provides referrals to other specialties within the health system, including mental health services available in the refugee clinic. The clinic has a nurse care coordinator and a case manager. Initial visits last a full hour, and follow-up visits last 30 minutes.
“You need that time, especially when you’re working with interpreters,” Hauck said. “There’s a certain art and skill to caring for immigrants in general and refugees in particular. In addition to the usual chronic diseases and acute illnesses we see with American patients, they come with a variety of unique illnesses.”
For example, Hauck said UVA’s physicians and trainees have become accustomed to treating latent tuberculosis and helicobacter pylori, the ulcer-causing infection that is common in less-developed countries. Refugees often are behind on immunizations and experience higher rates of malnutrition. Mental health issues are also common.
“There’s a tremendous amount of trauma that refugees have experienced,” she said. “Just the resettlement process itself is quite stressful. Approaching the patients with trauma-informed care is essential. We try to provide full-service care in one location.”
Hauck said the clinic works closely with community agencies to make sure refugees’ needs are met, and it also communicates with schools to identify mental health issues in pediatric patients.
After refugees settle into the community, learn English and have their needs met, they eventually transition to UVA’s regular family medicine clinic, which is in the same location with the same staff.
“For the patients, it’s pretty seamless because it’s happening behind the scenes,” Hauck said. “It works well.”
For her efforts, Hauck was recognized with the AAFP’s 2024 Public Health Award during the Congress of Delegates last September in Phoenix.
Award Deadline Approaching
The AAFP's Public Health Award recognizes important contributions family physicians make to improving community health at the local, state or national levels. The application deadline for the Academy’s 2025 Public Health Award is March 1. The winner will receive paid travel to the Congress of Delegates Oct. 4-6 in Anaheim, Calif., a plaque to display and a chance to share their story with family medicine colleagues!
.“This award really meant a lot to me because it came from the American Academy of Family Physicians,” she said. “When people think about the AAFP, they tend to think of clinical service, but in my mind family medicine is the perfect specialty to think about public and community health. Part of our residency education is to think about not just the patient in front of us but the whole community we care for. It really meant a lot to me to be recognized for the work that I do because my path was very circuitous. Many opportunities came my way, and I was able to take advantage of that.”
After graduating from the Maine-Dartmouth Family Practice Residency in 1981, Hauck spent two years as a Robert Wood Johnson Foundation Family Practice Faculty Development and Research Fellow at Case Western Reserve University in Cleveland. A career in academic medicine awaited, but Hauck had entered medical school with plans to work in global health, so she took a year off to serve as a pediatric ward supervisor at a refugee camp in Thailand.
“Even there I started doing quality improvement projects and little research projects with the hospital epidemiologists,” she said. “That program was all about teaching the local Cambodian residents of the refugee camp how to provide medical care, so it was constant teaching.”
The camp also sparked her interest in public health because it presented challenges related to sanitation, and food and water quality. Returning to the United States, Hauck spent two years in the CDC’s epidemiology training program studying obesity and malnutrition.
She then spent more than a decade in Chicago where founded and chaired the Department of Family Medicine at Loyola University’s Stritch School of Medicine with seed money from a grant from the Health Resources and Services Administration. While there, Hauck was involved in a large research project related to sudden infant death syndrome, a prominent issue on a curriculum vitae with more than 100 peer-reviewed articles.
Hauck was recruited to Virginia in 2000 to lead research activities in the Department of Family Medicine, where she is a professor of family medicine and of public health sciences. She stepped away from direct patient care and precepting last year but remains the director of the international clinic.
More than two decades since leaving Chicago, Hauck’s work on SIDS continues. She’s working with geneticists to study the genetic basis of the syndrome, and she also is involved in work with pediatricians, statisticians and epidemiologists studying educational interventions with parents aimed at reducing sleep-related infant deaths.
“I’ve always been drawn to research and teaching, even in residency,” she said. “I asked to do a research project then, and everyone thought was a little crazy because no one had ever asked to do that before.”