HEALTH Research Institute

A former HEALTH–RCMI Pilot Grant Program awardee and affiliate, Salim is guided by a deeper purpose to shed light on the palpable trauma refugees face on a daily basis.

[HEALTH–RCMI PI: Dr. Ezemenari Obasi] Salim is a UH Associate Professor in the College of Pharmacy, Department of Pharmacological and Pharmaceutical Sciences.

"Syrian refugees bear the brunt of political ambitions of some people. All of a sudden, they find themselves sleeping in cold beds, communal housing,” Salim said. “They’re often stigmatized in displaced communities. These people are civilians, and now they are displaced and uprooted from their homes. I think about this a lot. It affects me as a scientist, and as a global citizen.”

For Salim, 2023 has been marked by a series of important achievements highlighting the plight of refugees, including the publication of two significant papers and the organization of a UH Research Symposium to explore health challenges and disparities among refugee communities.

In Salim’s recent paper in International Journal of Environmental Research and Public Health, she delves into exploring psychological distress and mental health outcomes of Syrian refugees entitled, “Understanding the Mental Health Status of Syrian Refugee and Jordanian Women: Novel Insights and Comparative Study.”

“An area which has always piqued my curiosity—is understanding why some people are susceptible to stress and why some are resilient to stressful stimuli,” Salim said. “Why are some prone to mental health problems while some are not? Why do some people who have had adversity after adversity emerge fierce and resilient, while others come out of similar type of traumatic experience and just crash and cannot cope?”

Salim’s study compares the mental health status of urban Syrian refugee women with local Jordanian women, according to the Afghan Symptom Checklist (ASC). Syrian women scored higher than Jordanian women in the perceived stress scale which measures psychological distress, perceived stress and mental health respectively.

Focusing on the specific breast cancer health disparities of female Syrian refugees, Salim authored a new paper in International Journal of Environmental Research and Public Health entitled, Breast Cancer Beliefs and Screening Practices among Syrian Refugee Women and Jordanian Women.

“The overarching goal is to try to understand the connection between psychological stress and breast cancer,” Salim said. “Does psychological stress play a role in permanent stressors? Are they tumor inducing? There is some correlation between chronic stress and some types of cancers.”

In the breast cancer study of Syrian and Jordanian women, Salim was surprised to find that 98 percent of the women had not received a breast cancer screening yet. The study assessed breast cancer screenings for 138 Syrian refugee women and 160 Jordanian women.

“So, that was an eye-opening thing for us. The one important thing is that the Syrian women in our study sample were less than 40 years of age, and most had never heard of a mammogram,” Salim said. “Obviously, there is a lack of breast cancer screening awareness—not only among the refugee population but in general among Jordanian women. We weren’t expecting to get the data, but that’s the highlight of this."

Salim elaborated that much of the findings were rooted in psychosocial stress that many of the Syrian refugee and Jordanian women face.

“In general, I think they take on a lot on themselves,” Salim said. “They deal with these multigenerational family structure, where they tend to the needs of the elderly members of their family, their children, husband and often unmarried brothers and sisters-in-law. The pressure is to do well in three factors—be this amazing daughter-in-law, be an amazing wife, and then being an awesome mom. Caring for the elderly, caring for brothers and sisters of the husband and caring for the children. The family structure plays a significant role in psychosocial stress. Who cares about health? Breast cancer screening is the last thing on their minds.”

In March 2023, Salim spearheaded the Houston Refugee Health Research Symposium at University of Houston’s MD Anderson Library. Featuring renowned humanitarian and scientist Rana Dajani, Ph.D. as the keynote speaker, the symposium was organized by UH College of Pharmacy and the Institute for Research on Women, Gender & Sexuality. The goal of the symposium was to share new developments and address disparities within the vulnerable refugee groups.

The plight of refugee women weighs heavily on Salim’s heart, and this resonates through her vision for purpose-driven research. Salim is scheduled to travel to Jordan this summer with the goal to establish a research experiential program at the Jordan University of Science and Technology (JUST), Irbid. This program funded by the US-Jordan partnership grant will allow her to expand her refugee work in Jordan.

“I keep thinking about science as a purpose—a purposeful science,” Salim said. “Everything I do in the laboratory setting. I want to see it transformed in the community. I want to work with collaborators who address the root of the problem and have an impact on society by engaging all sectors-basic scientists, health workers, pharmacists, social workers, biostatisticians, entrepreneurs, community leaders. This will take another 20 years, but at least we can begin to address it with a multi-disciplinary approach. Having different stakeholders—this is where I want my science to go.”

—Alison Medley

If you would like more information about this topic, please contact Alison Medley at 713.320.0933 or email aemedle2@central.uh.edu