News publications and other organizations are encouraged to reuse Direct Relief-published content for free under a Creative Commons License (Attribution-Non-Commercial-No Derivatives 4.0 International), given the republisher complies with the requirements identified below.

When republishing:

  • Include a byline with the reporter’s name and Direct Relief in the following format: "Author Name, Direct Relief." If attribution in that format is not possible, include the following language at the top of the story: "This story was originally published by Direct Relief."
  • If publishing online, please link to the original URL of the story.
  • Maintain any tagline at the bottom of the story.
  • With Direct Relief's permission, news publications can make changes such as localizing the content for a particular area, using a different headline, or shortening story text. To confirm edits are acceptable, please check with Direct Relief by clicking this link.
  • If new content is added to the original story — for example, a comment from a local official — a note with language to the effect of the following must be included: "Additional reporting by [reporter and organization]."
  • If republished stories are shared on social media, Direct Relief appreciates being tagged in the posts:
    • Twitter (@DirectRelief)
    • Facebook (@DirectRelief)
    • Instagram (@DirectRelief)

Republishing Images:

Unless stated otherwise, images shot by Direct Relief may be republished for non-commercial purposes with proper attribution, given the republisher complies with the requirements identified below.

  • Maintain correct caption information.
  • Credit the photographer and Direct Relief in the caption. For example: "First and Last Name / Direct Relief."
  • Do not digitally alter images.

Direct Relief often contracts with freelance photographers who usually, but not always, allow their work to be published by Direct Relief’s media partners. Contact Direct Relief for permission to use images in which Direct Relief is not credited in the caption by clicking here.

Other Requirements:

  • Do not state or imply that donations to any third-party organization support Direct Relief's work.
  • Republishers may not sell Direct Relief's content.
  • Direct Relief's work is prohibited from populating web pages designed to improve rankings on search engines or solely to gain revenue from network-based advertisements.
  • Advance permission is required to translate Direct Relief's stories into a language different from the original language of publication. To inquire, contact us here.
  • If Direct Relief requests a change to or removal of republished Direct Relief content from a site or on-air, the republisher must comply.

For any additional questions about republishing Direct Relief content, please email the team here.

Improving the Health of African Migrants in the United States: A Story Map

Celia Sawyerr, Direct Relief's University of Michigan Gerald R. Ford School of Public Policy intern, finds community-centered approaches help African patients better manage chronic conditions and improve mental health.



Research conducted by Direct Relief's University of Michigan Gerald R. Ford School of Public Policy intern, Celia Sawyerr, looked at community-based ways to improve African migrant health in the U.S. (Slide by Celia Sawyerr)

Improving the health outcomes of African migrants in the U.S. largely depends on how comfortable they feel seeking out health services.

That was a key finding of research conducted by Direct Relief’s University of Michigan Gerald R. Ford School of Public Policy intern, Celia Sawyerr, who interviewed providers from four federally qualified health centers in Houston, Texas, Washington, D.C., and The Bronx, New York.

African migrants face high rates of chronic disease and mental health issues—similar to other minority populations in the United States—but the obstacles preventing them from accessing medical care vary.

According to providers, food insecurity and a lack of transportation, in addition to histories of trauma, low levels of health literacy, and distrust of western medicine, prevent many from being able to achieve better health outcomes. Overcoming these barriers, according to Sawyerr’s research, requires a culturally sensitive approach.

Click here to explore the story map.

“If you want to be able to impact health outcomes, you have to first be able to connect with the culture, understand the various cultures, and then design your delivery systems around those cultures,” said Dr. Douglas York, the CEO of Union Community Health Center in New York.

At the Bee Busy Wellness Center in Houston, Texas, patients’ inability to purchase healthy food has made it difficult to get their chronic conditions, like diabetes, under control. While some can’t afford to buy healthy food, others don’t have grocery stores in their neighborhoods or within walking distance. Providers also said stress, often related to migratory experiences, hinders patients’ ability to manage their conditions and exacerbates diseases like hypertension.

A map showing Houston/Harris County bus stops layered over areas within a 15-minute walk of each food store. Only stops on the bus system’s periphery, located in neighborhoods where African patients of Bee Busy Wellness Center live, are within a 15-minute walk of this sample of food stores. Click here to explore. (Map by Celia Sawyerr)

In addition to chronic disease management, mental health support is a common need among African patients–many of whom have witnessed violence in their home country and isolation in the states. This often manifests as depression and anxiety.

While stigma around mental health care prevents many from reaching out for help, providers said that normalizing this kind of care increases patient engagement. For example, the Bee Busy Wellness Center saw an uptick in the use of mental health services when therapy was offered through telemedicine, rather than a traditional office setting. “African immigrants utilize the services where they feel most comfortable,” said Norman Mitchell, the CEO of Bee Busy Wellness Center. Telemedicine has also helped expand access to chronic disease care during the pandemic when stay-at-home orders made it difficult for patients to manage their conditions independently.

To address these barriers, Sawyerr offers a range of solutions including installing community fridges in public spaces, van shuttles to grocery stores, and signing people up for federally-subsidized internet to lower the costs of telemedicine. While structural changes are needed, Sawyerr says, they will only go so far.

“To effectively meet the health needs of Sub-Saharan African migrants in the United States, it is imperative that they feel comfortable seeking out care,” she wrote. This requires health care providers to understand the cultural circumstances of their patients and meet them where they’re at. “Health centers that tailor their services to the specific needs of this population will be the most successful in connecting with and improving the well-being of their African patients.”

Sawyerr identifies multicultural events in African migrant neighborhoods that patients could attend to establish broader ties to their communities. (Slide by Celia Sawyerr)

Giving is Good Medicine

You don't have to donate. That's why it's so extraordinary if you do.