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HKS


LEARNING OUTCOMES

By the end of this lecture students should be able to:

  • Distinguish the differences between the terms internally displaced, refugees, asylum seekers and climate refugees.
  • Identify the health risks faced by refugees and asylum seekers in the different phases of their mobility.
  • Describe the impact of detention on the health of asylum seekers and refugees through a trauma-informed lens.
  • Recognize the importance of cultural security and safe communication skills in building trust with refugee patients.
  • Locate the appropriate clinical resources available in refugee and asylum seeker health in Australia.
  • Demonstrate an introductory understanding of the current political environment regarding the entry of refugees and asylum seekers globally and in Australia

RESOURCES


E-Book: Dr. Sharuna's E Book_Refugee and Asylum Seeker Health 2026

Required Reading:
Further Reading:

For a trauma-informed approach to providing care for refugees, see Compassionate Connections - A Trauma-Informed Approach to Community Engagement
Dear Students,

The issue of refugee and asylum seeker health is close to my heart. You can find information on my work with refugees here at the website of
Health Equity Initiatives , or here.

Do also check out Ref-Up, the JCSMHS MUMedS initiative on refugee health. They have been doing some fabulous work which may be of interest to you. You can reach out to Ref-Up @ refupmum@gmail.com.


ForceD migration and health



Kalhh on Pixabay


The number of the world’s refugees has more than doubled in the last ten years. The Asia-Pacific region is home to the world’s largest forced migration populations where the protection environment remains fragile with very few countries being a State party to the 1951 Convention relating to the Status of Refugees and its 1967 Protocol. Refugee populations in the region have been fleeing massive human rights violations, poverty, and inter-communal clashes as in the case of the Rohingyas in Rakhine state in Burma.  Yet, in the absence of durable solutions and increasing implementation of punitive migration regimes of deterrence in Asia, persons in need of international protection continue to risk dangerous journeys through treacherous waters, being smuggled, and vulnerable to human trafficking. 

 

Often, countries of first asylum are countries of transit for refugees because they fail to offer effective protection. The lack of legal protection and the lack of recognition of the right to asylum in these countries creates tremendous 

challenges for asylum seekers including inadequate access to basic necessities and health care, harassment by enforcement authorities including risks of arrest  and detention, and the risk of refoulement (the forcible return of refugees or asylum seekers to a country where they are liable to be subjected to persecution, contrary to international customary law) Mandatory detention of asylum seekers including incarceration in immigration detention centres, has been associated with adverse mental health and psychosocial impacts on adults, families and children2.

But this precarity is not unique to refugees alone. With 86% of refugees being hosted in countries of the Global South, conflicts and humanitarian crises also have an impact on countries hosting refugees. A case in point was the Syrian crisis which has had a retrograde impact on the economies of Jordan and Lebanon,  in terms of strained public finances, service delivery, and rising poverty and unemployment associated with the massive refugee flows and disruption to trade and economic activity3.


Thus, it can be said that the protection challenges of persons in need of international protection in countries of asylum and in transit are accompanied by risks to their health and human security; as well as global health challenges that present a complex mix of clinical, public health, humanitarian, ethical, political, and financial issues for states, health practitioners, and community-based organizations assisting these populations4.

 

REFERENCES:

1. Allotey P, Verghis S. Forced migration and health. In: Quah SR, Cockerham WC, editors.              The International Encyclopedia of Public Health, 2nd edition. 3: Oxford: Academic Press;            2017. p. 174 - 82. DOI:10.1093/oxfordhb/9780199652433.013.0041
2.Silove D, Austin P, Steel Z. No refuge from terror: the impact of detention on the mental                health of trauma-affected refugees seeking asylum in Australia. Transcult Psychiatry.                2007;44(3):359-93.
3. Verghis S and Balasundaram. Urban refugees: The hidden population. In Allotey P, Reidpath      D, editors. The health of refugees. Oxford: Oxford University Press; 2019. p. 128-66. DOI:            10.1093/oso/9780198814733.001.0001 
4.Reynolds PN, Turnidge JD, Gottlieb T, Moore MJ. Cross-border patients with tuberculosis.          Medical Journal of Australia. 2011 Nov 7;9:523-4.


Let’s start this lecture by getting to know who refugees and asylum seekers are.


Now that we have examined the context of refugee life in camp and urban settings, let us explore the health risks that refugees are exposed to in the different phases of their mobility.


In this segment, we focus on the protection environment for refugees in Malaysia and their access to health care.


And that brings us to the big question: what are the implications for clinical practice for you as doctors in training? This video explores some key issues related to understanding refugee patients as persons and what patient-centered care means in their context.


DROP YOUR QUESTION

We welcome you now to drop your questions in the google form below. We will either address your query during the tutorial or communicate via email. 


TOGGLE TIME

As always, here are some questions to toggle your memory. 😊

See you at the tutorial! 🌿