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Global Health BSc 2018/19 - CDMM2 > Migrant Health - 2.4, 2.5 + 2.13 > Flashcards

Migrant Health - 2.4, 2.5 + 2.13 Flashcards

1
Q

What is the definition of armed conflict?

A

25 battle related deaths in 1 year

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2
Q

What is the definition of war?

A

Major armed conflict with > 1000 battle-related deaths in 1 year

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3
Q

What is the definition of international armed conflict?

A

2 states at war

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4
Q

What is the definition of non international armed conflict?

A

Within a state

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5
Q

Name 4 conflicts in the past year which have caused 10 000 or more deaths

A

War in Afghanistan (1978)
Mexican drug war (2006)
Syrian Civil War (2011)
Iraq conflict (2003)

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6
Q

Who are the most vulnerable in times of conflict?

A

Children - estimated to be 50% of affected population

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7
Q

What effects can conflict have on the health system?

A

Resources: human, infrastructure, supplies, financial

Management + organisation: centralisation, fragmentation, lack of data

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8
Q

How do you measure death?

A

Press reports
Death certificates
Surveys
Eye-witnesses

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9
Q

What are the two laws of war?

A

Jus ad bellum - laws of going to war e.g. UN Charter, treaties etc
Jus in bello - laws during war e.g. International humanitarian Law

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10
Q

What is the UN Security Council made up of?

A

US, UK, France, China and Russia - they won WW2

Any decision must go through all members of the Security Council so all have vetoing power

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11
Q

What is Jus in bello made up of?

A

Law of Geneva - states who you can kill and combatants –> 4 conventions + 3 protocols; all 193 UN member states have signed
Law of Hague - states how you can kill and limits methods: launch of weapons from balloons; asphyxiating poisonous gases; expanding bullets

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12
Q

What are the medical issues in conflict zones?

A 
Humanitarian access
Sexual violence
Banned weapons
Food + medicine
Humanitarian spaces
Attacks on doctors
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13
Q

What happened during the final few months of the Sri Lanka civil war?

A

Government told aid agencies to leave and that ‘safety can’t be guarunteed’

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14
Q

What does medical complicity mean in the context of conflict?

A

Doctors can play a part in the war both good and bad - UN Human Rights Commission issued force feeding as a form of torture
Sexual assault and rape from Oxfam aid workers

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15
Q

What can be done during conflict?

A

Documentation - currently no routine reporting of attacks on medical facilities
Protection - condemnation - speaking out more vigorously
Prevention and punishment - accountability -raising the political cost

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16
Q

Who is responsible for the enforcement of IHL?

A

International Criminal Court but many criticisms

17
Q

How many people are displaced globally?

A

65.3 million refugees, asylum seekers/IDPs = 1 in every 113 people
Highest level ever recorded globally
From Syria, Afghanistan + Iraq

18
Q

What is the journey a migrant would take?

A

Camps/detention centres -> first arrival countries e.g. Turkey, Southern EU -> Transit countries e.g. Greece, France -> Settlement countries (Western Europe)

19
Q

What health care provision is provided in first arrival countries?

A

NGOs and emergency health care only

20
Q

What is the optimal approach for screening TB?

A

Targeted pre-arrival screening for active TB
Post-arrival screening for latent TB in migrants from intermediate-high TB countries
Collaborative TB Strategy for England 2015-2020

21
Q

How do migrants impact the NHS?

A

64% 0-5 years in the UK “New migrants” in A&E
Low numbers registered in GP
30% of NHS workforce is non-British (2014)

22
Q

What legal framework is in place to charge migrants for NHS?

A

2015/16 DoH Consultation on migrant charging - expansion of charging Non-EEA for A&E; NHS prescriptions; primary medical care; NHS dental care; ophthalmic + ambulance services and out-of-hospital care

23
Q

What are the arguments for charging migrants?

A

Can identify undocumented migrants

Deters health tourists

24
Q

What are the arguments against charging migrants?

A

May cost NHS more in the long run: emergency services provided at point of need is exponentially more expensive than prevention/planned care
W/o preventative care, outbreaks can occur
Health professionals acting as ‘border guards’ and going against professional ethics
Increases administrative complexity
Sweden found that providing a range of health services for undocumented migrants is costing less

25
Q

What is a psychiatric disorder?

A

Abnormalities of emotions, behaviour and cognition

Cluster of symptoms + impairment = disorder

26
Q

Name 5 psychiatric disorders that may present from conflict

A

Depression
PTSD
Emotional disorder = depressive +/- anxiety symptoms
Conduct disorder = aggression to people, destructiveness of property, rule violations
Psychosis = experience of delusions

27
Q

What is the prevalence of psychiatric disorders between migrants and non-migrants?

A

Similar

28
Q

Why is the prevalence of psychiatric disorders between migrants and non-migrants similar?

A

Resilient families migrate
Diverse reasons for migrations
Importance of protective factors: reduced intake of alcohol; lower rates of divorce/parental separation; high aspirations of immigrants e.g. education
Generational effects of migrants/duration of settlement

29
Q

Name 2 categories of resettlement stressors

A

Political

Economic

30
Q

What are the political resettlement stressors?

A 
Mobility in new country
Family separation
Poverty
Loose occupation
Exposure to new language
Discrimination/racism
No return to community
31
Q

What are the economic resettlement stressors?

A 
Initial mobility
Family together/may reunite
Poverty typical
Variable;gain skills
Exposure to new language/culture
Discrimination/racism
Ongoing links community
32
Q

What is the definition of an asylum-seeker?

A

Requested international protection + whose claim for refugee status has not yet been determined

33
Q

What is the definition of a migrant?

A

Permission to enter and stay in the UK for an initial period of 5 years; dependants included e.g. children

34
Q

What is the definition of discretionary leave to remain?

A

Not recognised as a refugee or a person who qualifies for humanitarian protection, but temporary permission to stay in the UK

35
Q

What are the reasons for variations in psychosis?

A

Migration effects = adversities/persecution
Socio-economic adversity (poverty, unemployment)
Lone parent households
Social isolation
Low same ethnic group contact
?Early child abuse/neglect
?Bullying

36
Q

How many left behind children are there?

A

Hundreds of millions

In 2010, 61 million left behind in China

37
Q

What are the impacts of parent separation on unaccompanied children?

A

Reported increase risk of anxiety + depressive symptoms
Higher level risk behaviours - antisocial behaviour + alcohol abuse
Poorer educational outcomes

Global Health BSc 2018/19 - CDMM2 (5 decks)

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