Tragedy strikes for Bhutanese refugee facing mounting medical bills

by Jordan Green

Depression over mounting medical bills, along with isolation and lack of employment, leads a Bhutanese refugee to take his own life.

For many immigrants and refugees, the United States represents the promise of new opportunity, but for others — particularly members of older generations, who struggle against isolation and language barriers — the transition of starting a new life can go terribly wrong.

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It did for Nar Bahadur DarJee, a 52-year-old Bhutanese refugee who took his life by hanging in High Point on March 29. DarJee had worked as a tailor in a refugee camp in Nepal, but after his initial relocation to Denver he found himself unable to obtain employment. He recently moved to High Point to be closer to his family. After a hospitalization for a serious illness, he became depressed as his medical bills mounted to a total of $340,000 and he saw no prospect of settling the debt.

DarJee had been talking about suicide in the weeks leading up to his death, said Neeru Ranapahelee, his niece. Misinformed acquaintances had told her uncle that if he didn’t pay the bill, the police would come and arrest him, she said.

“We tried to convince him that it was not so,” Ranapahelee said. “I planned to come to talk to him. When I got to work I got the text. I had planned to come on Monday, but he did that on Sunday.”

Dev Bhandari, a shopkeeper who serves as vice president of the Society of Bhutanese in High Point, believes that DarJee’s death might have been prevented with greater awareness of depression in the Bhutanese community, and better access to resources.

Cultural misunderstandings arise from differences between the two cultures, Bhandari said. For example, in Bhutanese society when a person dies their debt transfers to their children. Since neither DarJee nor his wife were working, Bhandari said he believes DarJee’s depression was aggravated by a sense of dependency on his eldest son, who is employed.

Bhim DarJee, Nar’s eldest son, was a picture of stoic grief, bouncing his leg and occasionally checking a smartphone, as his cousin described his family’s ordeal in the living room of the family’s house off Nathan Hunt Drive. Noting that the DarJees had been turned down for Medicaid and food stamps, Ranapahelee said she believes the government penalized the family for their son’s income.

“I don’t think it’s fair,” she said. “In our society the children stay with the parents until they get married. He did the best he could for them.”

Nar DarJee’s wife also seemed to be taking her husband’s death hard. Throughout the visit, she squatted silently against a wall in the living room. Bhandari said she hadn’t eaten for a couple days.

Bhandari believes that the denial of benefits might have resulted from a misunderstanding arising from poor translation services. He volunteers as an interpreter to members of the Bhutanese refugee community who are dealing with social services and insurance matters. Prior to DarJee’s death he hadn’t been aware that the family was dealing with health and financial challenges because they are relatively new to High Point. He hopes that more Bhutanese refugees in High Point will learn about his organization and reach out when they need help.

“There are two different dialects in our language and sometimes that they’ll use translators over the phone who don’t understand what the person is saying,” Bhandari said. “And you know, some of the elderly people in our society don’t even know how to hold a phone. If someone like me can go with them in person and is willing to interpret, that would be much more effective because we know exactly what they need.”

To promote awareness about depression within the Bhutanese refugee community and to link residents with resources, Bhandari is working with High Point Human Relations Director Al Heggins to organize a mass meeting. The event is scheduled for May 8, but they’re still working to secure a venue.

“This is not just in High Point,” Bhandari said. “This is happening in all Bhutanese refugee communities around the country. The young people get the education, but the older people have the same problems of depression, isolation and language barriers. They need our help.”

A 2013 report by the Centers for Disease Control and Prevention, or CDC, recorded 16 suicides among 57,000 Bhutanese refugees who had resettled in the United States between February 2009 and February 2012. The annual suicide rate of 21.5 per 100,000 people for Bhutanese refugees in the United States was higher than the global rate 16.0 per 100,000 people and for US residents of 12.4 per 100,000, but comparable to the prearrival suicide rate in Bhutanese refugee camps in Nepal.

CDC researchers who interviewed Bhutanese refugees found a significant linkage between people who reported thoughts of suicide and mental health disorders, such as anxiety and depression, along with post-migration difficulties like family conflict and inability to find work. The report highlighted a need for the “development of culturally appropriate community-based interventions for suicide prevention and standard procedures for monitoring and reporting suicides and suicide attempts in the Bhutanese refugee population.”

Bhandari said the Society of Bhutanese in High Point raised $600 to cover the cost of DarJee’s funeral. But Bhandari said he is still worried about the family.

“His spouse is stressed about the financial situation,” Bhandari said. “We are really working hard to raise money to get them counseling. They were able to make payments to the funeral home, but his son still had to take out loans. We don’t want the same thing to happen again in this family, so we’re trying to help them pay the bills. Everybody’s life is precious.”

Anyone who is interested in assisting the DarJee family may send checks to the Society of Bhutanese in High Point at 4403 Gower Court, High Point, NC 27265.