Refugees & asylum seekers

Question 1

Define refugee

Answer 1

Someone:
- Outside their own country
- Unwilling to return
- Well-founded fear of persecution due to race/religion/social group/political opinion

Question 2

Define asylum seeker

Answer 2

Someone:
- Seeking international protection
- Refugee status not yet confirmed

Question 3

Define internally displaced person

Answer 3

Someone:
- Fled home
- Haven’t left country
- Thus can not claim refugee status

Question 4

Pre-arrival factors affecting health (PETS)

Answer 4

• Poor access to healthcare on the journey
• Experiences (conflict/trauma)
• Time in refugee camps/mandatory detention
• Standard of healthcare in home country

Question 5

Post-arrival factors affecting health

Answer 5

• Difficulty accessing Aus healthcare/lack of knowledge of health system
• Language barriers
• Financial barriers
• Problems with health screening
• Forced detention
• Systemic prejudice

Question 6

Processing policies

Answer 6

Offshore detention
- Boat
- Unauthorised asylum seekers
- Never allowed to settle in Australia
- Offered protection

Onshore detention
- Plane
- Authorised refugees
- Eventually settle in Australia

• Aus accepts 18,750/year
• MUST HAVE A VISA
• Those w/o visa are placed indefinitely in mandatory detention

Authorised detention:
- Arrived w plane + visa –> may be placed here
- Applying for bridging visa –> may be placed here
- NOT indefinite

Unauthorised detention:
- Indefinite
- No visa

Question 7

ASK framework to promote refugee health

Answer 7

1. ASK
   - Country of origin
   - Arrival details
   - Languages (interpretors)
   - Occupation
   - Current stressors
   - Priorities
2. Screening
   - Informed consent
   - Country-based screening
   - Risk-based screening
   - General diseases
3. Kindness
   - Longer appointments
   - Consider social issues
   - Health service information access
   - RED CROSS: MEDICAL REIMBURSEMENT

Question 8

Family interpreters

Answer 8

• Medical terminology difficult to interpret
• Soften/delete information
• No confidentiality
• Accuracy difficult to ascertain

Question 9

Key statistics

Answer 9

• 2023 June: 110 million people displaced
• Countries with most refugees: Syria, South Sudan, Venezuela, Afghanistan, Myanmar
• Over 50% refugees = children
• 86% in developing countries
• 13 million more people displaced in 2018 than 2017

Question 10

Screening

Answer 10

All people:
- Hep B
- HIV
- Strongyloides
- Varicella
- Dental/hearing/visual
- NCDs (non-communicable)

Risk-based:
- Rubella (all women of childbearing-age)
- Vitamin B12 deficiency?? (vegans??)
- Vitamin D deficiency

Country-based:
- Malaria
- Schistosoma (blood flukes)
- Hep C

Question 11

Infant mortality rates

Answer 11

Developing countries
- MATERNAL EDUCATION LEVEL!

Question 12

Border Force Act 2015

Answer 12

Health professionals who spoke about abuses in offshore centres were threatened with up to 2 years in prison

Question 13

Medevac Force Act 2019

Answer 13

Critically ill asylum seekers held offshore would be transferred to Australia

• Up to 2 years wait