Dental care for refugees Flashcards
Types of migration?
Voluntary
Involuntary (forced displacement)
Types of forcibly displaced people:
- Refugees
- Asylum seekers
- Internally displaced people
Health profile of refugees is very diverse due to conditions they have been subject to, what does this depend on?
- Country of origin
- Transit country
- Destination country
- Return country
What burdens may refugees come with?
- Non communicable diseases e.g. cardiovascular disease, cancer
- Communicable (infectious diseases)
- Mental Health - due to trauma of journey
Main concerns of oral health profile in refugees?
Strong concerns about their children’s oral health in humanitarian settings and its considerable impact on families
Child dental pain has been repeatedly reported to cause considerable distress for refugee parents (and children) and served as a trigger for deeper feelings of anger, frustration and helplessness.
What different types of barriers are there to maintaining good oral health among refugees?
Barriers to healthy diet
Barriers to oral hygiene
Barriers to accessing dental services (e.g. affordability, availability, long waiting time etc.)
What are current approaches to improve refugee oral health in LMICs?
International dental missions:
[extra info]
Example: Miles for Smiles deliver dental care for Syrian refugee children and disadvantaged Lebanese children in Bekaa, Lebanon. Dental care is delivered through a school-based programme providing a preventative and curative care package, twice annually by local and international operational practitioners and academics
Potential future approaches to improve refugee oral health in LMICs?
Many international humanitarian organisations such as the UNICEF and UNHCR started including oral health within their needs assessment and programmes to improve school children’s health
Use of community health care workers?
Limited and inconclusive evidence globally related to public health interventions to improve the oral health of refugees
What is ARAP?
All families and individuals relocated under the ARAP (Afghan Relocations and Assistance Policy - ppl who helped the British forces in Afghanistan by being a translator for e.g. are housed in hotels in the UK) are entitled to access of all NHS health care services
What is the asylum process?
- application
- “screening” i.e. meeting with applicant and immigration officer
- Interview with caseworker, long time until decision is made
- Unaccompanied asylum seeking children will most likely receive ‘discretionary leave to remain’ until the age of 17 1/2. i.e. they can stay until this age and then after that they either get to reapply or are sent back - these children are at increased risk of harm due to poverty and social integration. They are more likely to drop out of school
Barriers in accessing healthcare as refugees and Asylum seekers?
- Lack of awareness of structure and function of the NHS (need to explain this to them)
- Language barriers and inadequate interpreting services being available
- Discrimination
Health challenges of refugees & asylum seekers?
- Untreated communicable diseases e.g. TB , COVID
- Poorly controlled chronic medical conditions
- Poor access to maternity care
- Mental health assessment and specialist support
Barriers to healthcare
- Language and access to interpreters, difficulty obtaining appointments and different expectations of healthcare.
- Inappropriate for family members to interpret
- Mobile population and may need to move locations before they are settled permanently in the host country.
- They may be turned away by front line staff due to lack of awareness on the rights of these vulnerable groups to healthcare.
- Knowledge on maintaining good oral health may be limited and Oral health may not be a priority
- Simple tasks such as reclining the dental chair and using the light to examine a patient can evoke past memories of interrogation, loss of control and subsequent abuse
What can dental teams do?
- Knowledge of service entitlements and willingness to learn about different cultures: sympathetic, personalised approach
- A detailed oral health assessment should be carried out, with emphasis on PREVENTION
- Interpreting services are readily available. It is important that children are not expected to translate for adults
- Be aware of impacts of torture and imprisonment on the provision of dental treatment
- Additional time and resources for oral health care
- Referral to other health and social professionals such as health visitors and school nurses, can provide cohesive efforts to alert teams to children at risk
- Consultation with children and young people and their families in addition to community groups to ensure that services are sensitive to their needs.
