LEARNING OUTCOMES
Describe the differences between the terms internally displaced, refugees, asylum seekers and climate refugees.
Outline the
health and social issues faced by refugees and asylum seekers in the community.
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 asylum seekers globally and in Australia
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.
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. The estimated 9.2 million people of concern to UNHCR in this region, including 4.4 million refugees, 3.3 million internally displaced persons, and 2.3 million
stateless people1 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
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 is 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 activity4.
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 populations5.
REFERENCES:
1. United Nations High
Commissioner for Refugees. 2021. Asia
and the Pacific UNHCR; [cited 2021 May
3]. Available from: https://www.unhcr.org/en-my/asia-and-the-pacific.html 2. 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
3.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.
4. 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
5.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! 