World Refugee Day

June 20th is World Refugee day, designed to bring attention to the large number of people displaced from their homes by violence. Sadly this day is needed more than ever with the UN Refugee Agency (UNHCR) estimating that there are 21.3 million people worldwide classed as refugees.

 

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Whilst research into the health of this vulnerable population is increasing, as shown in this bibliometric analysis, published in BMC International Health & Human Rights there are still many challenges on how best to reach and treat refugees.  Below we discuss a selection of BMC series research into the health challenges experienced by refugees.

As many refugees have suffered physical or psychological stress it is perhaps unsurprising that mental health conditions are prevalent in the population. In a study published in BMC Psychiatry the prevalence of mental health illness amongst refugees and asylum-seekers in Australia was measured at 50.4%, with approximately a third having had post-traumatic stress disorder (PTSD) symptoms at some point. In a Danish study of refugees it was shown PTSD was sometimes accompanied by secondary psychotic symptoms, likely to be linked to severe interpersonal traumas such as torture and imprisonment.

In this study in BMC Public Health the rates of depressive symptoms in African asylum-seekers and refugees in Hong Kong was examined. Whilst a significant proportion of this population exhibited depressive symptoms those who lived alone were more likely to suffer. In addition those who reported discrimination or difficulties accessing healthcare also had an increased likelihood of experiencing depressive symptoms highlighting the value of social support.

A number of studies have looked at why refugee populations find healthcare difficult to access. Primary healthcare workers (HCWs) are aware of the issues refugees face and in this study, from Switzerland, HCWs identified a lack of adequate financial resources, housing, and access to employment as important factors in creating barriers to accessing healthcare. In addition the HCWs considered that a lack of information about services and a fear of stigmatization were preventing refugees from accessing mental healthcare.

Refugee youth are at elevated risk of mental health and alcohol and other drug problems and this study looking at refugee youths in South Australia highlighted a lack of awareness of services and the fragmented nature of them as causing major barriers to access.

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In addition to mental health conditions there are other areas where refugees are at an increased risk. This study showed that children of North Korean refugees in China had significantly lower vaccination rates compared to Chinese or migrant children. Unvaccinated children are at risk of many preventable infectious diseases such as measles, diphtheria and pertussis.

In this study, published in BMC Pediatrics new immigrant and refugee children arriving in Greece were shown to commonly lack immunization records, have poor dental health and present with elevated blood lead levels. Many of the conditions reported were manageable but if undiagnosed or left untreated, could lead to poor health outcomes.

Doubtless the work discussed in this blog barely scratches the surface of the challenges facing refugee populations across the world. Clearly further research is needed and, even more importantly, concerted action required from governments and NGOs to tackle these issues and improve the lives of some of the world’s most vulnerable people

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