Iran's religious and political conflicts may seem a world away. Yet Stanislaus County's Refugee Health Program is doing triage for a growing number of those refugees.

The staff treats people for parasites from contaminated water or food, or for tuberculosis that may have been spread in crowded refugee camps.

A nurse practitioner gives health screenings to uncover physical, emotional and mental ailments, and most cases are referred elsewhere for treatment. One man allegedly had been beaten and held for questioning for two days in Tehran after joining other Christians at an Easter gathering on a Muslim holy day, said a community health worker serving as an interpreter.

Those kinds of cases have been growing.

"When the influx started coming, it was like the plane unloaded," said the program's refugee coordinator, Roselyn Cunningham, a registered nurse.

The staff has examined 218 refugees since last fall -- the first half of the fiscal year that began in October. That was double the number examined for all of 1998. In fiscal year 1999, the staff examined 152 people and had a backlog of 101 more cases.

Nearly all the refugees coming to this county in the last two years have been Christian Assyrians from Iran. A handful of refugees are from Iraq, the Ukraine and India.

County health workers have no idea why they've seen such a surge in clients. But a staff member at the office of the United Nations High Commissioner for Refugees said the number of refugees from Iran and Iraq increased in the United States after nongovernmental organizations lobbied the federal government.

The State Department raised the ceiling on those two countries from 4,000 refugees in fiscal year 1998 to 8,000 in 1999, and to 10,000 for the current year, said Kearn Schemm, program officer at the department's Bureau of Population, Refugees and Migration in charge of Neareast and South Asian Refugees.

"I don't think there's been some huge change in Iran, or even Iraq. The numbers (leaving) have been steady," said Kim Hamilton, a resettlement counselor for the U.N. commissioner's office

The state department processed 2,840 Iranian refugees from October to April. The previous year, the department processed 1,533 Iranians, he said.

The refugees are coming to Stanislaus County to join family in the growing Assyrian communities in Turlock, Modesto and Ceres, said Peter Kucher, who resettles families in the Modesto area for New York-based World Relief. He has helped about 20 families so far this year, compared with about five for the same time period last year.

Previously, the county's Refugee Health Program staff was able to schedule exams for people within a week after a resettlement agency notified the county they had arrived in the United States. Now, refugees are lucky to get in for their first exam within a month.

The program's hours and staff were expanded this year after it got a $140,000 grant from the California State Refugee Health Program. Twelve hours per week were added, for a total of 20, and two more people were hired, Cunningham said.

"Everybody who is in the state department has been aware religious minorities in Iran have been persecuted," said Don Climent, the regional director for International Rescue Committee, an agency that provides resettlement services. "What's changed is, this year, the state department is paying more attention to their plight and is processing them."

Bee staff writer Suzanne Hurt can be reached at 578-2321 or shurt@modbee.com.

Reprinted by permission of Modesto Bee.