Pavli, Androula; Maltezou, Helena
The number of migrants and refugees in Europe in the past few years has increased dramatically due to war, violence or prosecutions in their homeland. Migration may affect physical, mental and social health. The objective of this article is to assess migrants and refugees' health problems, and to recommend appropriate interventions. A PubMed search of published articles on health problems of newly arrived migrants and refugees was conducted from 2003 through 2016, focusing on the current refugee crisis in Europe. In addition to communicable diseases, such as respiratory, gastrointestinal and dermatologic infections, non-communicable diseases, including chronic conditions, mental and social problems, account for a significant morbidity burden in newly arrived migrants and refugees. Vaccine-preventable diseases are also of outmost importance. The appropriate management of newly arrived refugees and migrants' health problems is affected by barriers to access to health care including legal, communication, cultural and bureaucratic difficulties. There is diversity and lack of integration regarding health care provision across Europe due to policy differences between health care systems and social services. There is a notable burden of communicable and non-communicable diseases among newly arrived migrants and refugees. Provision of health care at reception and temporary centres should be integrated and provided by a multidisciplinary team Appropriate health care of migrants and refugees could greatly enhance their health and social status which will benefit also the host countries at large. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: firstname.lastname@example.org
Lee, Deborah; Philen, Rossanne; Wang, Zanju; McSpadden, Pamela; Posey, Drew L; Ortega, Luis S; Weinberg, Michelle S; Brown, Clive; Zhou, Weigong; Painter, John A
Approximately 450,000 legal permanent immigrants and 75,000 refugees enter the United States annually after receiving required medical examinations by overseas panel physicians (physicians who follow the CDC medical screening guidelines provided to the U.S. Department of State). CDC has the regulatory responsibility for preventing the introduction, transmission, and spread of communicable diseases into the United States as well as for developing the guidelines, known as technical instructions, for the overseas medical examinations. Other conditions that are not infectious might preclude an immigrant or refugee from entering the United States and also are reported as part of the medical examination. After arrival in the United States, all refugees are recommended to obtain a medical assessment by a health-care provider or a health department within 30 days. In addition, immigrants with certain medical conditions such as noninfectious tuberculosis at the time of the original medical examination are recommended to be evaluated after arrival to ensure that appropriate prevention or treatment measures are instituted. Health departments need timely and accurate notifications of newly arriving immigrants, refugees, and persons with other visa types to facilitate these evaluations. Notifications for all newly arriving refugees (with or without medical conditions) and immigrants with medical conditions are provided by CDC's Electronic Disease Notification (EDN) system. This is the first report describing EDN. This report summarizes notifications by the EDN system during January-December 2009. The EDN system is a centralized electronic reporting system that collects health information on newly arriving refugees and immigrants with Class A and Class B medical conditions. Class A conditions render applicants inadmissible and require a waiver for entry; Class B conditions are admissible but might require treatment or follow-up. Information in the EDN system is used to notify
McNeely, Clea A; Morland, Lyn; Doty, S Benjamin; Meschke, Laurie L; Awad, Summer; Husain, Altaf; Nashwan, Ayat
The US education system must find creative and effective ways to foster the healthy development of the approximately 2 million newly arrived immigrant and refugee adolescents, many of whom contend with language barriers, limited prior education, trauma, and discrimination. We identify research priorities for promoting the school success of these youth. The study used the 4-phase priority-setting method of the Child Health and Nutrition Research Initiative. In the final stage, 132 researchers, service providers, educators, and policymakers based in the United States were asked to rate the importance of 36 research options. The highest priority research options (range 1 to 5) were: evaluating newcomer programs (mean = 4.44, SD = 0.55), identifying how family and community stressors affect newly arrived immigrant and refugee adolescents' functioning in school (mean = 4.40, SD = 0.56), identifying teachers' major stressors in working with this population (mean = 4.36, SD = 0.72), and identifying how to engage immigrant and refugee families in their children's education (mean = 4.35, SD = 0.62). These research priorities emphasize the generation of practical knowledge that could translate to immediate, tangible benefits for schools. Funders, schools, and researchers can use these research priorities to guide research for the highest benefit of schools and the newly arrived immigrant and refugee adolescents they serve. © 2017, American School Health Association.
Full Text Available BACKGROUND: Vitamin B12 deficiency is prevalent in many countries of origin of refugees. Using a threshold of 5% above which a prevalence of low Vitamin B12 is indicative of a population health problem, we hypothesised that Vitamin B12 deficiency exceeds this threshold among newly-arrived refugees resettling in Australia, and is higher among women due to their increased risk of food insecurity. This paper reports Vitamin B12 levels in a large cohort of newly arrived refugees in five Australian states and territories. METHODS: In a cross-sectional descriptive study, we collected Vitamin B12, folate and haematological indices on all refugees (n = 916; response rate 94% of eligible population who had been in Australia for less than one year, and attended one of the collaborating health services between July 2010 and July 2011. RESULTS: 16.5% of participants had Vitamin B12 deficiency (<150 pmol/L. One-third of participants from Iran and Bhutan, and one-quarter of participants from Afghanistan had Vitamin B12 deficiency. Contrary to our hypothesis, low Vitamin B12 levels were more prevalent in males than females. A higher prevalence of low Vitamin B12 was also reported in older age groups in some countries. The sensitivity of macrocytosis in detecting Vitamin B12 deficiency was only 4.6%. CONCLUSION: Vitamin B12 deficiency is an important population health issue in newly-arrived refugees from many countries. All newly-arrived refugees should be tested for Vitamin B12 deficiency. Ongoing research should investigate causes, treatment, and ways to mitigate food insecurity, and the contribution of such measures to enhancing the health of the refugee communities.
Shannon, Patricia J; Wieling, Elizabeth; McCleary, Jennifer Simmelink; Becher, Emily
We explored the mental health effects of war trauma and torture as described by 111 refugees newly arrived in the United States. We used ethnocultural methodologies to inform 13 culture-specific focus groups with refugees from Bhutan (34), Burma (23), Ethiopia (27), and Somalia (27). Contrary to the belief that stigma prevents refugees from discussing mental health distress, participants readily described complex conceptualizations of degrees of mental health distress informed by political context, observation of symptoms, cultural idioms, and functional impairment. Recommendations for health care providers include assessment processes that inquire about symptoms in their political context, the degree of distress as it is culturally conceptualized, and its effect on functioning. Findings confirm the cross-cultural recognition of symptoms associated with posttraumatic stress disorder; however, refugees described significant cultural variation in expressions of distress, indicating the need for more research on culture-bound disorders and idioms of distress. © The Author(s) 2014.
McNeely, Clea A.; Morland, Lyn; Doty, S. Benjamin; Meschke, Laurie L.; Awad, Summer; Husain, Altaf; Nashwan, Ayat
Background: The US education system must find creative and effective ways to foster the healthy development of the approximately 2 million newly arrived immigrant and refugee adolescents, many of whom contend with language barriers, limited prior education, trauma, and discrimination. We identify research priorities for promoting the school…
Sonden, K; Castro, E; Törnnberg, L; Stenstrom, C; Tegnell, A; Farnert, A
Since May 2014, an increase in Plasmodium vivax malaria has been observed in Sweden. As of 31 August 2014, 105 malaria cases have been reported in newly arrived Eritrean refugees, 84 of them P. vivax. The patients were mainly young men and reported migration through Ethiopia and/or Sudan. Severe anaemia and long symptom duration reflect inadequate healthcare during migration. Countries currently hosting Eritrean refugees need to consider P. vivax malaria in this group of migrants.
Redditt, Vanessa J; Janakiram, Praseedha; Graziano, Daniela; Rashid, Meb
To determine the prevalence of selected infectious diseases among newly arrived refugee patients and whether there is variation by key demographic factors. Retrospective chart review. Primary care clinic for refugee patients in Toronto, Ont. A total of 1063 refugee patients rostered at the clinic from December 2011 to June 2014. Demographic information (age, sex, and region of birth); prevalence of HIV, hepatitis B, hepatitis C, Strongyloides, Schistosoma, intestinal parasites, gonorrhea, chlamydia, and syphilis infections; and varicella immune status. The median age of patients was 29 years and 56% were female. Refugees were born in 87 different countries. Approximately 33% of patients were from Africa, 28% were from Europe, 14% were from the Eastern Mediterranean Region, 14% were from Asia, and 8% were from the Americas (excluding 4% born in Canada or the United States). The overall rate of HIV infection was 2%. The prevalence of hepatitis B infection was 4%, with a higher rate among refugees from Asia (12%, P refugees (64%, P refugees from Africa (6%, P = .003). Schistosoma infection was identified in 15% of patients from Africa. Intestinal parasites were identified in 16% of patients who submitted stool samples. Approximately 8% of patients were varicella nonimmune, with higher rates in patients from the Americas (21%, P refugee patients to provide timely preventive and curative care. Our data also point to possible policy and clinical implications, such as targeted screening approaches and improved access to vaccinations and therapeutics. Copyright© the College of Family Physicians of Canada.
Johnston, Vanessa; Smith, Le; Roydhouse, Heather
Accurate data on the health of refugees in primary care is vital to inform clinical practice, monitor disease prevalence, influence policy and promote coordination. We undertook a retrospective clinical audit of newly arrived refugees attending the Darwin refugee primary health service in its first 12 months of operation. Data were collected from the clinic files of refugee patients who attended for their initial health assessment from 1 July 2009 to 30 June 2010 and were analysed descriptively. Among 187 refugees who attended in 2009-2010, ~60% were from Asia and 42% were female. The most common diagnoses confirmed by testing were vitamin D deficiency (23%), hepatitis B carrier status (22%), tuberculosis infection (18%), schistosomiasis (17%) and anaemia (17%). The most common documented health conditions recorded by the GPs were vitamin D deficiency or insufficiency (66%), followed by schistosomiasis (24%) and dental disease (23%). This clinical audit adds to a limited evidence base suggesting a high prevalence of infectious disease, nutrient deficiency and dental disease among refugees arriving to Australia. GPs involved in the care of refugees must be aware of the epidemiology of disease in this group, as some diseases are rare among the general Australian population. Our results also highlight the ongoing need for advocacy to address service constraints such as limited public dental access for this population.
Oda, Anna; Tuck, Andrew; Agic, Branka; Hynie, Michaela; Roche, Brenda; McKenzie, Kwame
Canada welcomed 33 723 Syrian refugees between November 2015 and November 2016. This paper reports the results of a rapid assessment of health care needs and use of health care services among newly arrived Syrian refugees in Toronto. A cross-sectional study was conducted in Toronto among Syrian refugees aged 18 years or more who had been in Canada for 12 months or less. Participants were recruited initially through distribution of flyers in hotels and through direct referrals and communication with community and settlement agency partners, and then through snowball sampling. We collected sociodemographic information and data on self-perceived physical health and mental health, unmet health care needs and use of health care services. A total of 400 Syrian refugees (221 women [55.2%] and 179 men [44.8%]) were enrolled. Of the 400, 209 (52.2%) were privately sponsored refugees, 177 (44.2%) were government-assisted refugees, and 12 (3.0%) were refugees under the Blended Visa Office-Referred Program. They reported high levels of self-perceived physical and mental health. Over 90% of the sample saw a doctor in their first year in Canada, and 79.8% had a family doctor they saw regularly. However, almost half (49.0%) of the respondents reported unmet health care needs, with the 3 most common reasons reported being long wait times, costs associated with services and lack of time to seek health care services. Many factors may explain our respondents' high levels of self-perceived physical and mental health during the first year of resettlement, including initial resettlement support and eligibility for health care under the Interim Federal Health Program. However, newly arrived Syrian refugees report unmet health care needs, which necessitates more comprehensive care and management beyond the initial resettlement support. Copyright 2017, Joule Inc. or its licensors.
Wagner, Julie; Berthold, S Megan; Buckley, Thomas; Kong, Sengly; Kuoch, Theanvy; Scully, Mary
A growing body of literature suggests that cardiometabolic disease generally and type 2 diabetes specifically are problems among refugee groups. This paper reviews rates of cardiometabolic disease and type 2 diabetes among refugees and highlights their unique risk factors including history of malnutrition, psychiatric disorders, psychiatric medications, lifestyle changes toward urbanization and industrialization, social isolation, and a poor profile on the social determinants of health. Promising interventions are presented for preventing and treating diabetes in these groups. Such interventions emphasize well-coordinated medical and mental health care delivered by cross-cultural and multidisciplinary teams including community health workers that are well integrated into the community. Finally, recommendations for service, policy, and research are made. The authors draw on local data and clinical experience of our collective work with Cambodian American refugees whose 30-year trajectory illustrates the consequences of ignoring diabetes and its risk factors in more recent, and soon to be arriving, refugee cohorts.
Baker, Felicity; Jones, Carolyn
This pilot study examined the effects of a short-term music therapy program on the classroom behaviours of newly arrived refugee students who were attending an intensive "English as a Second Language" secondary school. A cross-over design with two five-week intervention periods was employed with group music therapy sessions conducted one…
Bennett, Rachel J.; Brodine, Stephanie; Waalen, Jill; Moser, Kathleen; Rodwell, Timothy C.
Objectives. We determined the prevalence and treatment rates of latent tuberculosis infection (LTBI) in newly arrived refugees in San Diego County, California, and assessed demographic and clinical characteristics associated with these outcomes. Methods. We analyzed data from LTBI screening results of 4280 refugees resettled in San Diego County between January 2010 and October 2012. Using multivariate logistic regression, we calculated the associations between demographic and clinical risk factors and the outcomes of LTBI diagnosis and LTBI treatment initiation. Results. The prevalence of LTBI was highest among refugees from sub-Saharan Africa (43%) and was associated with current smoking and having a clinical comorbidity that increases the risk for active tuberculosis. Although refugees from sub-Saharan Africa had the highest prevalence of infection, they were significantly less likely to initiate treatment than refugees from the Middle East. Refugees with postsecondary education were significantly more likely to initiate LTBI treatment. Conclusions. Public health strategies are needed to increase treatment rates among high-risk refugees with LTBI. Particular attention is required among refugees from sub-Saharan Africa and those with less education. PMID:24524534
Montour, Jessica; Lee, Deborah; Snider, Cathy; Jentes, Emily S; Stauffer, William
The Centers for Disease Control and Prevention recommends that refugees at risk of Loa loa infection be tested for microfilaria before treatment with ivermectin. We report observational results of this approach in African refugees in Texas. Daytime blood smears were performed for microfilaria on at-risk African refugees who arrived in Texas from July 1, 2014 through December 30, 2016. Clinics were asked if there were any adverse events reported among those who received ivermectin. Of the 422 persons screened, 346 (82%) were born in L. loa -endemic countries, with 332 (96%) of these being born in the Democratic Republic of Congo. No smears detected microfilaria, and all received presumptive ivermectin with no reports of significant adverse events. In this investigation, the prevalence of significant microfilarial load in sub-Saharan African refugees appeared to be low, and ivermectin treatment was safe and well tolerated.
Full Text Available Among approximately 163.5 million foreign-born persons admitted to the United States annually, only 500,000 immigrants and refugees are required to undergo overseas tuberculosis (TB screening. It is unclear what extent of the unscreened nonimmigrant visitors contributes to the burden of foreign-born TB in the United States.We defined foreign-born persons within 1 year after arrival in the United States as "newly arrived", and utilized data from U.S. Department of Homeland Security, U.S. Centers for Disease Control and Prevention, and World Health Organization to estimate the incidence of TB among newly arrived foreign-born persons in the United States. During 2001 through 2008, 11,500 TB incident cases, including 291 multidrug-resistant TB incident cases, were estimated to occur among 20,989,738 person-years for the 1,479,542,654 newly arrived foreign-born persons in the United States. Of the 11,500 estimated TB incident cases, 41.6% (4,783 occurred among immigrants and refugees, 36.6% (4,211 among students/exchange visitors and temporary workers, 13.8% (1,589 among tourists and business travelers, and 7.3% (834 among Canadian and Mexican nonimmigrant visitors without an I-94 form (e.g., arrival-departure record. The top 3 newly arrived foreign-born populations with the largest estimated TB incident cases per 100,000 admissions were immigrants and refugees from high-incidence countries (e.g., 2008 WHO-estimated TB incidence rate of ≥100 cases/100,000 population/year; 235.8 cases/100,000 admissions, 95% confidence interval [CI], 228.3 to 243.3, students/exchange visitors and temporary workers from high-incidence countries (60.9 cases/100,000 admissions, 95% CI, 58.5 to 63.3, and immigrants and refugees from medium-incidence countries (e.g., 2008 WHO-estimated TB incidence rate of 15-99 cases/100,000 population/year; 55.2 cases/100,000 admissions, 95% CI, 51.6 to 58.8.Newly arrived nonimmigrant visitors contribute substantially to the burden of
Liu, Yecai; Painter, John A; Posey, Drew L; Cain, Kevin P; Weinberg, Michelle S; Maloney, Susan A; Ortega, Luis S; Cetron, Martin S
Among approximately 163.5 million foreign-born persons admitted to the United States annually, only 500,000 immigrants and refugees are required to undergo overseas tuberculosis (TB) screening. It is unclear what extent of the unscreened nonimmigrant visitors contributes to the burden of foreign-born TB in the United States. We defined foreign-born persons within 1 year after arrival in the United States as "newly arrived", and utilized data from U.S. Department of Homeland Security, U.S. Centers for Disease Control and Prevention, and World Health Organization to estimate the incidence of TB among newly arrived foreign-born persons in the United States. During 2001 through 2008, 11,500 TB incident cases, including 291 multidrug-resistant TB incident cases, were estimated to occur among 20,989,738 person-years for the 1,479,542,654 newly arrived foreign-born persons in the United States. Of the 11,500 estimated TB incident cases, 41.6% (4,783) occurred among immigrants and refugees, 36.6% (4,211) among students/exchange visitors and temporary workers, 13.8% (1,589) among tourists and business travelers, and 7.3% (834) among Canadian and Mexican nonimmigrant visitors without an I-94 form (e.g., arrival-departure record). The top 3 newly arrived foreign-born populations with the largest estimated TB incident cases per 100,000 admissions were immigrants and refugees from high-incidence countries (e.g., 2008 WHO-estimated TB incidence rate of ≥100 cases/100,000 population/year; 235.8 cases/100,000 admissions, 95% confidence interval [CI], 228.3 to 243.3), students/exchange visitors and temporary workers from high-incidence countries (60.9 cases/100,000 admissions, 95% CI, 58.5 to 63.3), and immigrants and refugees from medium-incidence countries (e.g., 2008 WHO-estimated TB incidence rate of 15-99 cases/100,000 population/year; 55.2 cases/100,000 admissions, 95% CI, 51.6 to 58.8). Newly arrived nonimmigrant visitors contribute substantially to the burden of foreign
Master i International Social Welfare and Health Policy The aim of this thesis is to explore how newly arrived immigrants and refugees interpret their opportunities to improve labor market participation through the Introduction Program. The thesis is based on qualitative interviews with six former participants of the program situated in Oslo, Norway. The Introduction Program is an activation program designed to qualify newly arrived immigrants and refugees for economic indep...
Schweitzer, Robert D; Brough, Mark; Vromans, Lyn; Asic-Kobe, Mary
This study documents the mental health status of people from Burmese refugee backgrounds recently arrived in Australia, then examines the contributions of gender, pre-migration and post-migration factors in predicting mental health. Structured interviews, including a demographic questionnaire, the Harvard Trauma Questionnaire, the Post-migration Living Difficulties Checklist and Hopkins Symptom Checklist assessed pre-migration trauma, post-migration living difficulties, depression, anxiety, somatization and traumatization symptoms in a sample of 70 adults across five Burmese ethnic groups. Substantial proportions of participants reported psychological distress in symptomatic ranges including: post-traumatic stress disorder (9%), anxiety (20%) and depression (36%), as well as significant symptoms of somatization (37%). Participants reported multiple and severe pre-migration traumas. Post-migration living difficulties of greatest concern included communication problems and worry about family not in Australia. Gender did not predict mental health. Level of exposure to traumatic events and post-migration living difficulties each made unique and relatively equal contributions to traumatization symptoms. Post-migration living difficulties made unique contributions to depression, anxiety and somatization symptoms. While exposure to traumatic events impacted on participants' mental well-being, post-migration living difficulties had greater salience in predicting mental health outcomes of people from Burmese refugee backgrounds. Reported rates of post-traumatic stress disorder symptoms were consistent with a large review of adults across seven western countries. High levels of somatization point to a nuanced expression of distress. Findings have implications for service provision in terms of implementing appropriate interventions to effectively meet the needs of this newly arrived group in Australia.
Power, David V; Moody, Emily; Trussell, Kristi; O'Fallon, Ann; Chute, Sara; Kyaw, Merdin; Letts, James; Mamo, Blain
Since 2004, Minnesota has seen an influx of refugees from Burma. Many of these newcomers came from the Karen state and spent time in refugee camps in Thailand before resettling in the United States. To better understand the health needs of this population, the authors of this article conducted chart reviews at a St. Paul family medicine clinic that serves a number of Karen refugees and reviewed formal data from the Minnesota Department of Health's Refugee Health Program. Here, they briefly describe this community, the cultural issues that could affect health care providers' ability to care for Karen patients, and the health concerns of these refugees.
van Loenen, Tessa; van den Muijsenbergh, Maria; Hofmeester, Marrigje; Dowrick, Christopher; van Ginneken, Nadja; Mechili, Enkeleint Aggelos; Angelaki, Agapi; Ajdukovic, Dean; Bakic, Helena; Pavlic, Danica Rotar; Zelko, Erika; Hoffmann, Kathryn; Jirovsky, Elena; Mayrhuber, Elisabeth Sophie; Dückers, Michel; Mooren, Trudy; Gouweloos, Juul; Kolozsvári, László; Rurik, Imre; Lionis, Christos
Background: In order to provide effective primary care for refugees and to develop interventions tailored to them, we must know their needs. Little is known of the health needs and experiences of recently arrived refugees and other migrants throughout their journey through Europe. We aimed to gain
Loenen, T. van; Muijsenbergh, M. van den; Hofmeester, M.; Dowrick, C.; Ginneken, N. van; Mechili E.A.; Angelaki, A.; Ajdukovic, D.; Bakic, H.; Pavlick, D.R.; Zelko, E.; Hoffmann, K.; Jirovsky, E.; Mayrhuber, E.S.; Dückers, M.; Mooren, T.; Gouweloos-Trine, J.; Kolozsvári, L.R.; Rurik, I.; Lionis, C.
Background: In order to provide effective primary care for refugees and to develop interventions tailored to them, we must know their needs. Little is known of the health needs and experiences of recently arrived refugees and other migrants throughout their journey through Europe. We aimed to gain
Aucoin, Michael; Weaver, Rob; Thomas, Roger; Jones, Lanice
To determine the 25-hydroxyvitamin D (25[OH]D) serum levels in refugee women of childbearing age and in refugee children; to compare their 25(OH)D levels with the recommended levels in order to determine the prevalence of deficiency; to compare their 25(OH)D levels with those in the general Canadian population in the appropriate age and sex groups; and to investigate the association of vitamin D deficiency with potential risk factors. Cross-sectional chart review. The Calgary Refugee Health Program, an urban family practice that serves newly arrived refugees in Calgary, Alta. A total of 1217 refugee women and children screened between June 2005 and January 2010. Serum 25(OH)D values that were measured during initial screening visits. Overall, 1217 of the 1768 eligible participants (69%) had 25(OH)D laboratory values recorded. The mean concentration of 25(OH)D was 52.0 nmol/L (95% CI 50.6 to 53.3 nmol/L). Using the Institute of Medicine guideline for adequate serum vitamin D levels (>50 nmol/L), 61% of women and 42% of children had lower-than-desirable 25(OH)D levels. Considering the Osteoporosis Canada guidelines, 88% of women and 81% of children had lower-than-desirable 25(OH)D levels (refugees between the ages of 12 and 19 years old had lower mean values of 25(OH)D than male refugees in the same age group did (P=.01). Most refugees had lower-than-desirable vitamin D levels. All age groups studied had lower mean 25(OH)D levels compared with the general Canadian population. Health care providers should be aware of this concern and consider vitamin D supplementation among refugees.
Davidson, N; Skull, S; Chaney, G; Frydenberg, A; Isaacs, D; Kelly, P; Lampropoulos, B; Raman, S; Silove, D; Buttery, J; Smith, M; Steel, Z; Burgner, D
Providing appropriate and responsive care to refugees from diverse backgrounds and with unique health needs is challenging. Refugee children may present with a wide range of conditions, which may be unfamiliar to health professionals in developed countries. Additionally, refugees may experience
Roscoe, Clay; Gilles, Ryan; Reed, Alex J; Messerschmidt, Matt; Kinney, Rebecca
In the United States, vaccines have eliminated wild poliovirus (WPV) infection, though resettling refugees may lack immunity and importation of WPV remains a concern. A cross-sectional survey was performed to determine the prevalence of poliovirus immunity in adult refugees resettling in Boise, Idaho, U.S.A.; immunity was evaluated using two definitions: serotypes 1, 2 and 3 positive, or serotypes 1 and 3 positive. This survey evaluated 795 adult refugees between August 2010 and November 2012. Poliovirus immunity in adults >18 years was 55.3% for serotypes 1, 2 and 3 combined, and 60% for serotypes 1 and 3 only. This study demonstrated a WPV immunity rate of poliovirus immunity in all newly arrived adult refugees, either by expanding pre-departure immunization or by screening for immunity at resettlement and vaccinating when indicated. Copyright © 2015 Elsevier Ltd. All rights reserved.
Board, Amy R; Suzuki, Sumihiro
Previous research has documented that parasite infection may increase vulnerability to TB among certain at risk populations. The purpose of this study was to identify whether an association exists between latent tuberculosis infection (LTBI) and intestinal parasite infection among newly resettled refugees in Texas while controlling for additional effects of region of origin, age and sex. Data for all refugees screened for both TB and intestinal parasites between January 2010 and mid-October 2013 were obtained from the Texas Refugee Health Screening Program and were analyzed using logistic regression. A total of 9860 refugees were included. In multivariable logistic regression analysis, pathogenic and non-pathogenic intestinal parasite infections yielded statistically significant reduced odds of LTBI. However, when individual parasite species were analyzed, hookworm infection indicated statistically significant increased odds of LTBI (OR 1.674, CI: 1.126-2.488). A positive association exists between hookworm infection and LTBI in newly arrived refugees to Texas. More research is needed to assess the nature and extent of these associations. © The Author 2015. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene. All rights reserved. For permissions, please e-mail: email@example.com.
van Loenen, Tessa; van den Muijsenbergh, Maria; Hofmeester, Marrigje; Dowrick, Christopher; van Ginneken, Nadja; Mechili, Enkeleint Aggelos; Angelaki, Agapi; Ajdukovic, Dean; Bakic, Helena; Pavlic, Danica Rotar; Zelko, Erika; Hoffmann, Kathryn; Jirovsky, Elena; Mayrhuber, Elisabeth Sophie; Dückers, Michel; Mooren, Trudy; Gouweloos-Trines, Juul; Kolozsvári, László; Rurik, Imre; Lionis, Christos
In order to provide effective primary care for refugees and to develop interventions tailored to them, we must know their needs. Little is known of the health needs and experiences of recently arrived refugees and other migrants throughout their journey through Europe. We aimed to gain insight into their health needs, barriers in access and wishes regarding primary health care. In the spring of 2016, we conducted a qualitative, comparative case study in seven EU countries in a centre of first arrival, two transit centres, two intermediate-stay centres and two longer-stay centres using a Participatory Learning and Action research methodology. A total of 98 refugees and 25 healthcare workers participated in 43 sessions. Transcripts and sessions reports were coded and thematically analyzed by local researchers using the same format at all sites; data were synthesized and further analyzed by two other researchers independently. The main health problems of the participants related to war and to their harsh journey like common infections and psychological distress. They encountered important barriers in accessing healthcare: time pressure, linguistic and cultural differences and lack of continuity of care. They wish for compassionate, culturally sensitive healthcare workers and for more information on procedures and health promotion. Health of refugees on the move in Europe is jeopardized by their bad living circumstances and barriers in access to healthcare. To address their needs, healthcare workers have to be trained in providing integrated, compassionate and cultural competent healthcare. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Paxton, Georgia A; Sangster, Katrina J; Maxwell, Ellen L; McBride, Catherine R J; Drewe, Ross H
To document the prevalence of nutritional deficiencies, infectious diseases and susceptibility to vaccine preventable diseases in Karen refugees in Australia. Retrospective audit of pathology results. Community based cohort in Melbourne over the period July 2006-October 2009. 1136 Karen refugee children and adults, representing almost complete local area settlement and 48% of total Victorian Karen humanitarian intake for the time period. Prevalence of positive test results for refugee health screening, with breakdown by age group (Karen refugees have high rates of nutritional deficiencies and infectious diseases and may be susceptible to vaccine preventable diseases. These data support the need for post-arrival health screening and accessible, funded catch-up immunisation.
Lim, Rachel; Jarand, Julie; Field, Stephen K; Fisher, Dina
Background . Canadian policy requires refugees with a history of tuberculosis (TB) or abnormal chest radiograph to be screened after arrival for TB. However, Tibetan refugees are indiscriminately screened, regardless of preimmigration assessment. We sought to determine the incidence of latent (LTBI) and active TB, as well as treatment-related outcomes and associations between preimmigration factors and TB infection among Tibetan refugees arriving in Calgary, Alberta. Design . Retrospective cohort study including Tibetan refugees arriving between 2014 and 2016. Associations between preimmigration factors and incidence of latent and active TB were determined using Chi-square tests. Results . Out of 180 subjects, 49 percent had LTBI. LTBI was more common in migrants 30 years of age or older ( P = 0.009). Treatment initiation and completion rates were high at 90 percent and 76 percent, respectively. No associations between preimmigration factors and treatment completion were found. A case of active TB was detected and treated. Conclusion . Within this cohort, the case of active TB would have been detected through the usual postsurveillance process due to a history of TB and abnormal chest radiograph. Forty-nine percent had LTBI, compared to previously quoted rates of 97 percent. Tibetan refugees should be screened for TB in a similar manner to other refugees resettling in Canada.
Coleman, Margaret S; Burke, Heather M; Welstead, Bethany L; Mitchell, Tarissa; Taylor, Eboni M; Shapovalov, Dmitry; Maskery, Brian A; Joo, Heesoo; Weinberg, Michelle
Background On August 24, 2011, 31 US-bound refugees from Kuala Lumpur, Malaysia (KL) arrived in Los Angeles. One of them was diagnosed with measles post-arrival. He exposed others during a flight, and persons in the community while disembarking and seeking medical care. As a result, 9 cases of measles were identified. Methods We estimated costs of response to this outbreak and conducted a comparative cost analysis examining what might have happened had all US-bound refugees been vaccinated before leaving Malaysia. Results State-by-state costs differed and variously included vaccination, hospitalization, medical visits, and contact tracing with costs ranging from $621 to $35,115. The total of domestic and IOM Malaysia reported costs for US-bound refugees were $137,505 [range: $134,531 - $142,777 from a sensitivity analysis]. Had all US-bound refugees been vaccinated while in Malaysia, it would have cost approximately $19,646 and could have prevented 8 measles cases. Conclusion A vaccination program for US-bound refugees, supporting a complete vaccination for US-bound refugees, could improve refugees' health, reduce importations of vaccine-preventable diseases in the United States, and avert measles response activities and costs.
Idemudia, Erhabor Sunday; Williams, John K; Wyatt, Gail E
Zimbabweans are immigrating to South Africa with a commonly cited reason being economic opportunities. Prospects of finding employment may be a significant reason to leave behind family, friends, and community, sources that buffer and offer social support against life's challenges. Currently, there is a dearth of research examining the motivators for Zimbabweans immigrating and the experiences encountered along the way and after arrival in South Africa. Such research is essential as large numbers of Zimbabweans may be at risk for emotional and physical trauma during this process. Two gender specific focus group discussions, each lasting 90-minutes and consisting of homeless Zimbabwean refugees, were conducted in the Limpopo Province of South Africa. A semi-structured interview assessed for experiences in and reasons for leaving Zimbabwe, as well as experiences en-route and within South Africa. Discussions were audio-recorded, transcribed, and analyzed using consensual qualitative research and a constant comparison qualitative method. Three temporal themes were identified and included challenges and trauma experienced in Zimbabwe (pre-migration), during the immigration journey (mid-migration), and upon arrival in South Africa (post-migration). While there were some experiential differences, Zimbabwean men and women shared numerous traumatic commonalities. In addition to the themes, three subthemes contributing to reasons for leaving Zimbabwe, two subthemes of negative and traumatic experiences incurred mid-migration, and two post-migration subthemes of challenges were identified. Despite the difficulties encountered in their homeland, newly arrived Zimbabweans in South Africa may be exchanging old struggles for a new array of foreign and traumatic challenges. Reasons to immigrate and the psychological and physical toll of migration exacted at the individual and community levels are discussed. Recommendations advocating for culturally congruent mental health research
Maximova, Katerina; Krahn, Harvey
This paper sought to examine which pre- and post-migration factors might be associated with changes in refugees' health status. Using linear regression, the associations between pre- and post-migration factors and changes in self-rated mental and physical health status were examined in 525 refugees from the 1998 Settlement Experiences of Refugees in Alberta study. Having spent time in a refugee camp and having held professional/managerial jobs in one's home country were associated with a greater decline in mental health status since arrival in Canada. Having completed a university degree in one's home country was associated with a greater decline in physical health status. Being employed was associated with greater improvements in mental health status. Perceived economic hardship was associated with greater declines in physical health status. A higher number of settlement services received during the first year in Canada was associated with greater improvements in both mental and physical health status. Longer residence in Canada was associated with greater declines in physical health status but not in mental health status. While little can be done to alter refugees' pre-migration experiences, public policies can affect many post-migration experiences in order to mitigate the negative health consequences associated with resettlement. Results of this study point to the need for continued provision of settlement services to assist refugees with job training, labour market access, and credential recognition, as well as counseling for refugees who experienced the trauma of living in a refugee camp.
Hollifield, Michael; Verbillis-Kolp, Sasha; Farmer, Beth; Toolson, Eric C; Woldehaimanot, Tsegaba; Yamazaki, Junko; Holland, Annette; St Clair, Janet; SooHoo, Janet
Screening for emotional distress in newly arrived refugees is not a standard practice due to multiple barriers, one being the absence of a valid screening instrument for multiple refugee populations. The Refugee Health Screener-15 (RHS-15) was empirically developed to be a valid, efficient and effective screener for common mental disorders in refugees. Development followed published methods. Two hundred fifty-one refugees from three countries were screened at their public health visit with a pilot instrument, and 190 were administered diagnostic proxy instruments (DPs). Data analyses using multiple methods selected the best items for classification on DPs. Follow-up clinical service data were obtained. Post hoc analyses of the developed RHS-15 showed good sensitivity(range .81 to .95) and specificity (range .86 to .89) to DP's in two of three ethnic groups. Seventy-four percent of positive cases accepted treatment services. Of those, 79% engaged in treatment, and 92% continued treatment more than 3 months. The RHS-15 is a screener for common mental disorders in newly-arrived refugees in public health. The RHS-15appears to be effective, but further prospective research in a broad range of refugee groups is required to establish generalizability. Strengths, limitations, methods to apply the RHS-15 for optimal performance, and future directions for research and implementation are discussed. Published by Elsevier Inc.
Padovan-Özdemir, Marta; Øland, Trine
the organisations’ websites. Older material has been retrieved from the library collection of education and educational research at Aarhus University, Emdrup, Copenhagen, and from The Collection of Pamphlets and Corporate Publications at the Royal Library, Copenhagen.Articles, announcements, job adds, etc......In the Summer of 2015, in all European welfare nation-states professionals, policy makers, administrators, and civil society organisations were in highest alert over the major refugee arrivals from Afghanistan, Syria, and the African continent. In Denmark, in particular, the government responded...... four major welfare professions; teacher, social educators, nurses, and social workers. The refugee family as a shared object of problematisation and intervention is what binds these professional groups together in the historical educational practices under investigation. For example, professionals...
Darcis, Gilles; Hayette, Marie-Pierre; Bontems, Sebastien; Sauvage, Anne-Sophie; Meuris, Christelle; Van Esbroeck, Marjan; Leonard, Philippe
We report a case of louse-borne relapsing fever (LBRF) in a refugee from Somalia who had arrived in Belgium a few days earlier. He complained of myalgia and secondarily presented fever. Blood smears revealed spirochetes later identified as Borrelia recurrentis. LBRF should be considered in countries hosting refugees, particularly those who transit through endemic regions. © International Society of Travel Medicine, 2016. All rights reserved. Published by Oxford University Press. For permissions, please e-mail: firstname.lastname@example.org.
Erhabor Sunday Idemudia
Full Text Available BACKGROUND: Zimbabweans are immigrating to South Africa with a commonly cited reason being economic opportunities. Prospects of finding employment may be a significant reason to leave behind family, friends, and community, sources that buffer and offer social support against life’s challenges. Currently, there is a dearth of research examining the motivators for Zimbabweans immigrating and the experiences encountered along the way and after arrival in South Africa. Such research is essential as large numbers of Zimbabweans may be at risk for emotional and physical trauma during this process. METHODS: Two gender specific focus group discussions, each lasting 90-minutes and consisting of homeless Zimbabwean refugees, were conducted in the Limpopo Province of South Africa. A semi-structured interview assessed for experiences in and reasons for leaving Zimbabwe, as well as experiences en-route and within South Africa. Discussions were audio-recorded, transcribed, and analyzed using consensual qualitative research and a constant comparison qualitative method. RESULTS: Three temporal themes were identified and included challenges and trauma experienced in Zimbabwe (pre-migration, during the immigration journey (mid-migration, and upon arrival in South Africa (post-migration. While there were some experiential differences, Zimbabwean men and women shared numerous traumatic commonalities. In addition to the themes, three subthemes contributing to reasons for leaving Zimbabwe, two subthemes of negative and traumatic experiences incurred mid-migration, and two post-migration subthemes of challenges were identified. CONCLUSIONS: Despite the difficulties encountered in their homeland, newly arrived Zimbabweans in South Africa may be exchanging old struggles for a new array of foreign and traumatic challenges. Reasons to immigrate and the psychological and physical toll of migration exacted at the individual and community levels are discussed
Svensson, Pia; Carlzén, Katarina; Agardh, Anette
In Sweden, migrants have poorer sexual and reproductive health compared to the general population. Health literacy, in the form of the cognitive and social skills enabling access to health promoting activities, is often poorer among migrants, partly due to language and cultural barriers. Culturally sensitive health education provides a strategy for enhancing health literacy. Since 2012, specially trained civic and health communicators have provided sexual and reproductive health and rights information to newly arrived refugees in Skåne, Sweden. The aim of this study was to explore how information on sexual and reproductive health and rights was perceived by female recipients and whether being exposed to such information contributed to enhanced sexual and reproductive health and rights literacy. Semi-structured in-depth interviews were conducted with nine women and analysed using qualitative content analysis. Two themes emerged: (1) opening the doors to new understandings of sexual and reproductive health and rights and (2) planting the seed for engagement in sexual and reproductive health and rights issues, illustrating how cultural norms influenced perceptions, but also how information opened up opportunities for challenging these norms. Gender-separate groups may facilitate information uptake, while discussion concerning sexual health norms may benefit from taking place in mixed groups.
Bond, Lyndal; Giddens, Anne; Cosentino, Anne; Cook, Margaret; Hoban, Paul; Haynes, Ann; Scaffidi, Louise; Dimovski, Mary; Cini, Eileen; Glover, Sara
Many refugee people and others entering Australia under the Humanitarian Program, have experienced extremely stressful and disrupted lives prior to arrival. A major difficulty experienced by a significant number of refugee young people is their lack of formal education before arrival. It directly affects their ability to start connecting to their new society and constructing a new life. The level of ease with which young people can move into the education and training system and begin to establish a meaningful career pathway has a huge impact on their successful settlement and stable mental health. This paper describes the Changing Cultures Project, a three-year project, which explored models of appropriate and accessible education and training for refugee and newly arrived young people that would enhance their mental health. The Changing Cultures Project was a partnership between the education, health and settlement sectors. This paper describes the program and system response to the health, settlement, education and vocational issues facing refugee young people using a mental health promotion framework and reflective practice. We discuss how the refugee youth programs met a broad range of needs as well as providing language, literacy and basic education to newly arrived young people. While working in an environment of changing policy and public opinion regarding refugee issues, the Project delivered successful outcomes at the program and organisational levels for refugee young people by addressing issues of program development and delivery, organisational development and capacity building and community development and evaluation.
Ghosh, Flora; Juul, Søren
This article is a study of the contrast between the Danish law concerning reduced economic benefits for newly arrived refugees and immigrants (known as Start Help or as introductory benefit) and the idea of recognition as the condition for individual self-realization and justice. Our assumption...
Uptin, Jonnell; Wright, Jan; Harwood, Valerie
Educators in resettlement countries are grappling with ways to adequately engage and meet the needs of newly arrived refugee students. In this article we argue that to fully meet the needs of refugee students a deeper understanding of their educational experience as "a refugee" prior to resettlement is vital. In particular we foreground…
Manchikanti, Prashanti; Cheng, I-Hao; Advocat, Jenny; Russell, Grant
Over 750000 refugees have resettled in Australia since 1945. Despite complex health needs related to prior traumatic experiences and the challenges of resettlement in a foreign country, refugees experience poor access to primary care. Health and settlement service providers describe numerous cultural, communication, financial and health literacy barriers. This study aimed to investigate the acceptability of general practitioner (GP) services and understand what aspects of acceptability are relevant for Afghan refugees in south-eastern Melbourne. Semi-structured interviews were conducted with two Afghan community leaders and 16 Dari- or English-speaking Afghan refugees who accessed GP services. Two distinct narratives emerged - those of recently arrived refugees and established refugees (living in Australia for 3 years or longer). Transecting these narratives, participants indicated the importance of: (1) a preference for detailed clinical assessments, diagnostic investigations and the provision of prescriptions at the first consultation; (2) 'refugee-friendly' staff; and (3) integrated, 'one-stop-shop' GP clinic features. The value of acceptable personal characteristics evolved over time - GP acceptability was less a consideration for recently arrived, compared with more, established refugees. The findings reinforce the importance of tailoring healthcare delivery to the evolving needs and healthcare expectations of newly arrived and established refugees respectively.
Wright, A. Michelle; Dhalimi, Abir; Lumley, Mark A.; Jamil, Hikmet; Pole, Nnamdi; Arnetz, Judith E.; Arnetz, Bengt B.
Previous refugee research has been unable to link pre-displacement trauma with unemployment in the host country. The current study assessed the role of pre-displacement trauma, post-displacement trauma, and the interaction of both trauma types to prospectively examine unemployment in a random sample of newly-arrived Iraqi refugees. Participants (N=286) were interviewed three times over the first two years post-arrival. Refugees were assessed for pre-displacement trauma exposure, post-displacement trauma exposure, a history of unemployment in the country of origin and host country, and symptoms of posttraumatic stress disorder (PTSD) and depression. Analyses found that neither pre-displacement nor post-displacement trauma independently predicted unemployment 2 years post-arrival; however, the interaction of pre and post-displacement trauma predicted 2-year unemployment. Refugees with high levels of both pre and post-displacement trauma had a 91% predicted probability of unemployment, whereas those with low levels of both traumas had a 20% predicted probability. This interaction remained significant after controlling for sociodemographic variables and mental health upon arrival to the U.S. Resettlement agencies and community organizations should consider the interactive effect of encountering additional trauma after escaping the hardships of the refugee's country of origin. PMID:27535348
Linde, Ann C; Sweet, Kristin A; Nelson, Kailey; Mamo, Blain; Chute, Sara M
The Hepatitis Testing and Linkage to Care (HepTLC) initiative promoted viral hepatitis B and hepatitis C screening, posttest counseling, and linkage to care at 34 U.S. sites from 2012 to 2014. Through the HepTLC initiative, the Minnesota Department of Health (MDH) and clinic partners began conducting linkage-to-care activities with hepatitis B-positive refugees in October 2012. This intervention provided culturally appropriate support to link refugees to follow-up care for hepatitis B. MDH refugee health and viral hepatitis surveillance programs, along with clinics that screened newly arrived refugees in Hennepin and Ramsey counties in Minnesota, collaborated on the project, which took place from October 1, 2012, through September 30, 2014. Bilingual care navigators contacted refugees to provide education, make appointments, and arrange transportation. We compared the linkage-to-care rate for participants with the rates for refugees screened the year before project launch using a two-sample test of proportions. In the year preceding the project (October 2011 through September 2012), 87 newly arrived refugees had a positive hepatitis B surface antigen (HBsAg) test. Fifty-six (64%) refugees received follow-up care, 12 (14%) refugees did not receive follow-up care, and 19 (22%) refugees could not be located and had no record of follow-up care. During the project, 174 HBsAg-positive, newly arrived refugees were screened. Of those 174 refugees, 162 (93%) received follow-up care, seven (4%) did not receive follow-up care, and five (3%) could not be located and had no record of follow-up care. The one-year linkage-to-care rate for project participants (93%) was significantly higher than the rate for refugees screened the previous year (64%) (prefugees.
Benson, Jill; Phillips, Christine; Kay, Margaret; Hanifi, Hoda; Giri, Gauri; Leahy, Catherine; Lorimer, Michelle
Many refugees have vitamin B12 (B12) deficiency. It has been assumed that deficiency would be predictable from macrocytosis or symptoms, and borderline levels would improve after a period of resettlement in countries rich with animal-source foods. We explored B12 levels and symptoms soon after the refugees' arrival and 4-8 months after settlement in Australia. Newly arrived refugees aged >18 years (n = 136) were tested for vitamin B12 and haematological indices. They also completed a language-validated questionnaire, which they repeated 4-8 months after arrival. B12 levels were reassessed in patients with levels ≤240 pmol at baseline. We found that 21 participants (15%) had low levels of B12 (≤150 pmol/L) and 65 (48%) had borderline B12 levels (151-240 pmol/L). There was no relationship between B12 level and mean corpuscular volume, ferritin or symptoms. Borderline B12 levels persisted in 64% of participants at follow-up and deficiency developed in 11%. B12 levels cannot be predicted from macrocytosis or symptoms, and may not 'self-correct' after resettlement. Health assessments for newly arrived refugees should include B12 measurement and those with borderline levels should be followed up.
Sweet, Kristin A.; Nelson, Kailey; Mamo, Blain; Chute, Sara M.
Objective The Hepatitis Testing and Linkage to Care (HepTLC) initiative promoted viral hepatitis B and hepatitis C screening, posttest counseling, and linkage to care at 34 U.S. sites from 2012 to 2014. Through the HepTLC initiative, the Minnesota Department of Health (MDH) and clinic partners began conducting linkage-to-care activities with hepatitis B-positive refugees in October 2012. This intervention provided culturally appropriate support to link refugees to follow-up care for hepatitis B. Methods MDH refugee health and viral hepatitis surveillance programs, along with clinics that screened newly arrived refugees in Hennepin and Ramsey counties in Minnesota, collaborated on the project, which took place from October 1, 2012, through September 30, 2014. Bilingual care navigators contacted refugees to provide education, make appointments, and arrange transportation. We compared the linkage-to-care rate for participants with the rates for refugees screened the year before project launch using a two-sample test of proportions. Results In the year preceding the project (October 2011 through September 2012), 87 newly arrived refugees had a positive hepatitis B surface antigen (HBsAg) test. Fifty-six (64%) refugees received follow-up care, 12 (14%) refugees did not receive follow-up care, and 19 (22%) refugees could not be located and had no record of follow-up care. During the project, 174 HBsAg-positive, newly arrived refugees were screened. Of those 174 refugees, 162 (93%) received follow-up care, seven (4%) did not receive follow-up care, and five (3%) could not be located and had no record of follow-up care. The one-year linkage-to-care rate for project participants (93%) was significantly higher than the rate for refugees screened the previous year (64%) (prefugees. PMID:27168670
In the aftermath of large refugee arrivals in 2015, EU regulations and national asylum laws were tightened, especially those regarding reception and accommodation. The current contribution introduces the concept of "campization" to explain the impact of law and policy changes on the socio-spatial configuration and functions of refugee accommodation in European capital regions. Based on qualitative research concerning case studies for Athens, Berlin, and Copenhagen, I argue that refugee accommodation has increasingly been transformed into large, camp-like structures with lowered living standards and a closed character. This is shown by the structural, functional, and socio-spatial characteristics of the accommodation in the three case studies, as well as the political and administrative objectives that determine the campization of accommodation. The contribution lastly highlights changing notions and forms of containment, exclusion, and temporality as part of campization, and links this process to current trends in asylum and urban development.
Bäärnhielm, Sofie; Edlund, Ann-Sofie; Ioannou, Michael; Dahlin, Marie
This study evaluates the outcomes of cross-cultural mental health training given to professionals in health care and refugee reception in Stockholm, Sweden. A mixed method approach, with quantitative data from questionnaires (n = 232) and ten qualitative focus group interviews, was used. After training, the participants reported that the hindering effect of lack of knowledge on their work decreased significantly from 2.81 (SD1.22) before, to 2.29 (SD1.00) (p refugees with mental ill-health. Training resulted in an increased experienced capacity among participants to understand the social vulnerability of newly-arrived refugees with mental distress. However, the lack of collaboration and the structural barriers between the different organisations were not affected.
Brown, Chris; Schale, Codi L.; Nilsson, Johanna E.
Vietnamese immigrant and refugee women (N = 83) were surveyed regarding their mental health, English language proficiency, age of arrival, length of stay, and income. English language proficiency and age of arrival correlated with reduced symptomatology. Moreover, English language proficiency was the sole predictor of somatic distress. (Contains 1…
Breidahl, Karen Nielsen
models have been resilient: Based on an in-depth historical and comparative analysis of labour market activation policies targeting newly arrived immigrants in Sweden, Norway, and Denmark since the early 1990s, the article contributes to the overall question: To what extent do the institutional pathways...... of the Scandinavian welfare states prevail when confronted with newcomers? Activation policies targeting newly arrived immigrants exemplifies how the ambition of states to promote functional, individual autonomy is also an important, ongoing process in diverse policy areas of the welfare state and not restricted...
In global times, when the forced migration of refugees from war-torn countries like Sudan impacts the demography of once ethnically homogenous schooling spaces, I consider the need to better understand the geographical making of racism. This article explores the lived experience of two newly arrived Sudanese students studying at a rural high…
Full Text Available Objective. Tuberculosis control in foreign-born populations is a major public health concern for Australia, Canada, New Zealand, United Kingdom, and the United States, large immigrant- and refugee-receiving countries that comprise the Immigration and Refugee Health Working Group (IRHWG. Identifying and comparing immigration and distribution of foreign-born tuberculosis cases are important for developing targeted and collaborative interventions. Methods. Data stratified by year and country of birth from 2005 to 2009 were received from these five countries. Immigration totals, tuberculosis case totals, and multidrug-resistant tuberculosis (MDR TB case totals from source countries were analyzed and compared to reveal similarities and differences for each member of the group. Results. Between 2005 and 2009, there were a combined 31,785,002 arrivals, 77,905 tuberculosis cases, and 888 MDR TB cases notified at the federal level in the IRHWG countries. India, China, Vietnam, and the Philippines accounted for 41.4% of the total foreign-born tuberculosis cases and 42.7% of the foreign-born MDR tuberculosis cases to IRHWG. Interpretation. Collaborative efforts across a small number of countries have the potential to yield sizeable gains in tuberculosis control for these large immigrant- and refugee-receiving countries.
Zimmerman, M; Bornstein, R; Martinsson, T
The aim of this study was to evaluate the effects of a simplified oral health programme on attitudes to and knowledge of preventive dentistry. The subjects were Chilean refugees and the programme was delivered at one or two sessions in the form of group information/discussion. Because of increasing immigration, Sweden has become a multicultural society. The number of non-Nordic immigrants has doubled in the past decade. The major refugee groups have come from Iran, Chile and Poland. The subjects comprised 193 Chilean refugees: 106 in a single-visit group and 87 in a two-visit group. The oral health programme was completed by 94 and 65 subjects respectively and was evaluated after 6 months. Positive effects were discernible in attitudes to and knowledge of preventive dentistry, particularly with respect to oral hygiene. A key to success may have been group discussion in which the refugees could relate oral health problems to their own ethnic group. This could have an important function in bridging cultural, linguistic and situational barriers. Different forms of outreach programmes for oral health via groups, organisations or authorities in close contact with refugees shortly after arrival in Sweden are proposed. This approach may be particularly effective in a multicultural society and also in the context of the turbulent conditions the newly-arrived refugee experiences.
Tynell, Lena Lyngholt; Wimmelmann, Camilla Lawaetz; Jervelund, Signe Smith
a language school in Copenhagen in 2012 received either a course or written information on the Danish healthcare system and subsequently evaluated this quantitatively. Results: The evaluation revealed a positive appraisal of the course/information provided. Conclusion: In times of austerity, incorporating......Objective: In most European countries, immigrants do not systematically learn about the host countries’ healthcare system when arriving. This study investigated how newly arrived immigrants perceived the information they received about the Danish healthcare system. Method: Immigrants attending...... healthcare information into an already existing language programme may be pertinent for providing immigrants with knowledge on the healthcare system....
In Sweden, tutoring in the mother tongue is a special support measure primarily intended for newly arrived students to facilitate their transition into the Swedish school system. Tutoring is premised on the collaboration between the class teacher, responsible for subject-related expertise, and the tutor, who contributes with knowledge of the…
Schilling, Tobias; Rauscher, Stephan; Menzel, Christian; Reichenauer, Simon; Müller-Schilling, Martina; Schmid, Stephan; Selgrad, Michael
Due to the current geopolitical situation more refugees from crisis countries were and will be treated in Europe. In 2015 the number of displaced people reached an unprecedented level, with more than one million crossing into Europe. The migration itself can impair both mental and physical health. Therefore, the provision of medical care for refugees and migrants is a novel and major challenge for the health care systems in Europe. In this article we describe our experiences and contribution in providing medical care for refugees who have newly arrived in Stuttgart, Baden-Wuerttemberg, Germany. Furthermore, we report our experiences from a tertiary referral University center in Regensburg, Bavaria, Germany. We focus on challenges in both the outpatient and the inpatient setting, with a special focus on intensive care patients. In addition, we provide an overview about the spectrum of diseases in this specific patient cohort.
Lerner, Amy B.
Each year, approximately 100,000 refugees arrive in the United States (Refugee Council USA). Nearly half of these arrivals are children. The number of refugees worldwide has more than sextupled since the 1950s, and according to the United States Committee for Refugees and immigrants (USCRI) this number is expected to continue to grow in coming…
Breidahl, Karen N
Since the late 1990s, a wide range of so-called new civic integration policies aimed at civilizing or disciplining newcomers have been introduced. Consequently, migration scholars have discussed whether a converging restrictive 'civic turn' has taken place in Western Europe or whether national models have been resilient: Based on an in-depth historical and comparative analysis of labour market activation policies targeting newly arrived immigrants in Sweden, Norway, and Denmark since the early 1990s, the article contributes to the overall question: To what extent do the institutional pathways of the Scandinavian welfare states prevail when confronted with newcomers? Activation policies targeting newly arrived immigrants exemplifies how the ambition of states to promote functional, individual autonomy is also an important, ongoing process in diverse policy areas of the welfare state and not restricted to early integration instruments. While the Scandinavian welfare states differ on a number of counts with respect to immigration control, national integration philosophies and citizenship policies, the article outlines how activation policies aimed at newly arrived immigrants share several features. One of the key factors in this turn involves path dependency from, among others, a lengthy tradition for strong state involvement and norms about employment. Another factor in this turn involves transnational policy learning. On some points, national versions of these policies are also found due to country-specific citizenship traditions, integration philosophies and party political constellations.
Fazel, Mina; Garcia, Jo; Stein, Alan
Access to needed mental health services can be particularly difficult for newly arrived refugee and asylum-seeking adolescents, although many attend school. This study examined young refugees' impressions and experience of mental health services integrated within the school system. Semi-structured interviews were conducted with 40 adolescent refugees discharged by three school-based mental health services across the United Kingdom. Two-thirds preferred to be seen at school. Rumination and worry about insecurity in the asylum process had a negative impact particularly on the adolescents' social functioning and ability to focus at school. The important role played by teachers in supporting and mediating contact with mental health services was valued by those interviewed. The study confirms that schools offer an important location for mental health services for adolescent refugees and provide an important portal for integration of services. © The Author(s) 2016.
Padovan-Özdemir, Marta; Øland, Trine
professional journals are included representing four major welfare professions (teachers, social educators, nurses and social workers: Folkeskolen [The Public Community School], Børn & Unge [Children & Adolescents], Sygeplejersken [The Nurse], Socialrådgiveren [The Social Worker]. Included are also two...... four major welfare professions; teacher, social educators, nurses, and social workers. The refugee family as a shared object of problematisation and intervention is what binds these professional groups together in the historical educational practices under investigation. For example, professionals...... express concerns regarding single male refugees (without family), polygamous refugee families, unaccompanied refugee children (broken families), dysfunctional (traumatised) families etc.Analytical questions that reflect a theoretically informed understanding the object of study based on readings...
Hertting, Krister; Karlefors, Inger
Sport is a global phenomenon, which can make sport an important arena for integration into new societies. However, sport is also an expression of national culture and identities. The aim of this study is to explore images and experiences that newly-arrived immigrant children in Sweden have about sport in their country of origin, and challenges that can arise in processes of integration through sport. We asked 20 newly arrived children aged 10 to 13 to make drawings about sporting experiences ...
Frederiksen, Hanne W; Krasnik, Allan; Nørredam, Marie
Quota refugees coming to Denmark are mandated refugee status offshore and approximately 500 quota refugees are resettled annually. Upon arrival to Denmark, quota refugees are received directly in the municipalities and municipal caseworkers therefore have the practical responsibility for their he......Quota refugees coming to Denmark are mandated refugee status offshore and approximately 500 quota refugees are resettled annually. Upon arrival to Denmark, quota refugees are received directly in the municipalities and municipal caseworkers therefore have the practical responsibility...
Conick, John E.
Describes the approach to resettlement for recently arrived refugees implemented within the state of South Carolina. Suggests that non-clustering of refugees leads to quick acculturation if there is wide community support, but that certain services are more readily available when refugees are clustered. (GC)
Watts, Delma-Jean; Friedman, Jennifer F; Vivier, Patrick M; Tompkins, Christine E A; Alario, Anthony J
Refugee children can have significant health problems. Our objective was to describe health status and health care utilization of refugee children after resettlement. A retrospective chart review of refugee children was performed. Initial laboratory data was extracted. Primary care visits, emergency room visits, and subspecialty referrals in the first 15 months from arrival were recorded. The sample included 198 refugees, many with positive initial screening tests. After arrival, 21% had an emergency department visit, 40% had a primary care sick visit, and 71% had a primary care follow-up. Mean number of visits ranged from 0.3 for emergency department to 1.9 for follow-up. Fifty-seven percent were referred to at least one subspecialist. Refugee children had substantial disease burden at arrival. Most had primary care follow-up visits and subspecialty referral after resettlement. These visits were largely for problems identified on initial screening and for general pediatric illnesses.
Refugee camps in Dadaab, Kenya, currently are receiving Somali refugees fleeing famine and armed conflict at a rate of approximately 1,400 refugees per day. New arrivals are at an elevated risk for mortality because of severe famine in Somalia, the dangerous journey, and overcrowding in the camps.
A practice-based dialectic theory of identity was used in this study to explore the cultural-historical context of an urban charter school in which a group of newly arrived Muslim Turk refugee students' academic identities were formed. The school, located in the Southwestern United States, was founded by a global Islamist movement. Ethnographic…
Nelson-Peterman, Jerusha L.; Toof, Robin; Liang, Sidney L.; Grigg-Saito, Dorcas C.
Refugees in the United States have high rates of chronic disease. Both long-term effects of the refugee experience and adjustment to the U.S. health environment may contribute. While there is significant research on health outcomes of newly resettled refugees and long-term mental health experiences of established refugees, there is currently…
Wing Chan, Yu; Gao, Xuesong
The research reported here investigated pre-service English language teachers' perceptions of newly arrived immigrant children from Mainland China in Hong Kong. Seventeen participants, who had at least 10 weeks of experience working with these immigrant children during teaching practicum, participated in focus group discussions and shared their…
Full Text Available Purpose: Our objective was to identify perceived challenges in the provision of health care for refugees from the perspective of medical interpreters, case managers, and pharmacists working with refugee patients in Milwaukee, Wisconsin. Methods: Two 60-minute focus groups were performed exploring challenges in refugee health care using a literature-based semi-structured protocol. Focus groups were transcribed and de-identified prior to independent analysis by two of the investigators. Using a memoing-process qualitative approach, major concepts, cross-cutting themes, and subthemes were established and ultimately developed a narrative. The project protocol was approved as not human subject research by the local institutional review board. Results: Four overarching themes regarding health care for refugee patients were identified: 1 difficulty balancing the dynamic of autonomy versus support for refugees; 2 educational needs of refugee families outpacing available resources; 3 challenges for refugees developing trust; and 4 diversity of cultures, education levels, and experiences among refugee families. Language barriers in accessing health care services and insufficient time to meet educational needs of refugees were major challenges outside of the clinic visit setting. Poor health literacy and difficulties communicating health needs and building trust within the interactive triad of refugee, physician, and interpreter impacted clinic visits. Conclusions: Refugee patients and other participants in refugee care work to navigate a complicated path to equitable health care for a vulnerable population. Continued pursuit of strategies that increase time allocation, education, and support for all parties are needed as we seek to improve health outcomes for newly arrived refugee families.
Full Text Available Refugee-led humanitarian initiatives by ‘established’ Palestinian refugees in response to the arrival of ‘new’ displaced Syrians to Shatila camp raise key questions about the limitations of the humanitarian system and representations of refugees as passive victims.
Peterman, Jerusha Nelson; Wilde, Parke E; Silka, Linda; Bermudez, Odilia I; Rogers, Beatrice Lorge
Resettled refugees have high rates of chronic disease, which may be partially due to persistent food insecurity. This study describes food experiences on arrival in the U.S. and current food security status and examines characteristics related to food insecurity in a well-established refugee community. Focus groups and a survey assessed food security status and personal characteristics of Cambodian women in Lowell, MA, USA. Multivariate logistic regression was used to examine relationships with food insecurity. Current rates of food insecurity are high. In multivariate models, food insecurity was positively associated with being depressed and being widowed, and negatively associated with higher income and acculturation. Early arrivers (1980s) had difficulty in the U.S. food system on arrival, while later arrivers (1990s-2000s) did not. Refugee agencies should consider strategically devoting resources to ensure successful early transition to the U.S. food environment and long-term food security of refugees.
K. Bruce Newbold
Full Text Available Embodying a differential set of skills, refugees experience varying obstacles and reception upon entry into their host country. Starting in 1975, the U.S. received large numbers of refugees from Southeast Asia. Although these arrivals are no longer labeled as ‘refugees’, their initial immigration status raises interesting questions, including whether or not they match the attainment of those who arrived in the U.S. at the same time. Using the 1980 and 1990 Public Use Microdata Files (PUMS, this paper traces the adaptation of post-1975 Southeast Asians within the U.S. through the lens of segmented assimilation. Refugee flows are disaggregated into Sino-Vietnamese, Ethnic-Vietnamese, Hmong, Cambodians, and Laotian identities and contrasted to Chinese immigrants.
Tynell, Lena Lyngholt; Wimmelmann, Camilla Lawaetz; Jervelund, Signe Smith
Objective: In most European countries, immigrants do not systematically learn about the host countries' healthcare system when arriving. This study investigated how newly arrived immigrants perceived the information they received about the Danish healthcare system. Methods: Immigrants attending a language school in Copenhagen in 2012 received…
Lopez, Alexis A.; Turkan, Sultan; Guzman-Orth, Danielle
"Translanguaging" refers to the flexible use of the bilingual repertoire. In this report, we provide a theoretical framework to support the use of translanguaging to assess the academic content knowledge of newly arrived emergent bilingual students. In this report, we argue that translanguaging offers newly arrived emergent bilingual…
Lionis, Christos; Petelos, Elena; Mechili, Enkeleint-Aggelos; Sifaki-Pistolla, Dimitra; Chatzea, Vasiliki-Eirini; Angelaki, Agapi; Rurik, Imre; Pavlic, Danica Rotar; Dowrick, Christopher; Dückers, Michel; Ajdukovic, Dean; Bakic, Helena; Jirovsky, Elena; Mayrhuber, Elisabeth Sophie; van den Muijsenbergh, Maria; Hoffmann, Kathryn
The current political crisis, conflicts and riots in many Middle Eastern and African countries have led to massive migration waves towards Europe. European countries, receiving these migratory waves as first port of entry (POE) over the past few years, were confronted with several challenges as a result of the sheer volume of newly arriving refugees. This humanitarian refugee crisis represents the biggest displacement crisis of a generation. Although the refugee crisis created significant challenges for all national healthcare systems across Europe, limited attention has been given to the role of primary health care (PHC) to facilitate an integrated delivery of care by enhancing care provision to refugees upon arrival, on transit or even for longer periods. Evidence-based interventions, encompassing elements of patient-centredness, shared decision-making and compassionate care, could contribute to the assessment of refugee healthcare needs and to the development and the implementation of training programmes for rapid capacity-building for the needs of these vulnerable groups and in the context of integrated PHC care. This article reports on methods used for enhancing PHC for refugees through rapid capacity-building actions in the context of a structured European project under the auspices of the European Commission and funded under the 3rd Health Programme by the Consumers, Health, Agriculture and Food Executive Agency (CHAFEA). The methods include the assessment of the health needs of all the people reaching Europe during the study period, and the identification, development, and testing of educational tools. The developed tools were evaluated following implementation in selected European primary care settings.
Full Text Available The Irish government makes considerable efforts to resettle Syrian refugees arriving through the UNHCR resettlement process but offers no support to those refugees – some of whom are also from Syria – who individually seek asylum under the international protection system.
Van Os, E.C.C.; Kalverboer, M.E.; Zijlstra, A.E.; Post, W.J.; Knorth, E.J.
Decision-making regarding an asylum request of a minor requires decision-makers to determine the best interests of the child when the minor is relatively unknown. This article presents a systematic review of the existing knowledge of the situation of recently arrived refugee children in the host
Mölsä, Mulki; Kuittinen, Saija; Tiilikainen, Marja; Honkasalo, Marja-Liisa; Punamäki, Raija-Leena
The aim of this study was to examine, first, how past traumatic stress and present acculturation indices, and discrimination are associated with mental health; and, second, whether religiousness can buffer the mental health from negative impacts of war trauma. Participants were 128 older (50-80 years) Somali refugees living in Finland. They reported experiences of war trauma and childhood adversities, and filled-in questionnaires of perceived ethnic discrimination, religiousness (beliefs, attendance, and observance of Islamic faith), and symptoms of posttraumatic stress disorder (PTSD), depressive (BDI-21), psychological distress (GHQ-12), and somatization (SCL-90). Symptom-specific regression models showed that newly arrived refugees with non-permanent legal status and severe exposures to war trauma, childhood adversity, and discrimination endorsed greater PTSD symptoms, while only war trauma and discrimination were associated with depressive symptoms. Results confirmed that high religiousness could play a buffering role among older Somalis, as exposure to severe war trauma was not associated with high levels of PTSD or somatization symptoms among highly religious refugees. Health care should consider both unique past and present vulnerabilities and resources when treating refugees, and everyday discrimination and racism should be regarded as health risks.
Chan, Yiu Man; Chan, Christine Mei-Sheung
The Self-esteem Inventory developed by Coopersmith (1967) was used to measure the self-esteem of 387 Chinese children. The sample included newly arrived mainland Chinese children and Hong Kong children. The results showed significant statistical differences when measuring the self-esteem level associated with the length of their stay in Hong Kong…
Lee, Susan K; Sulaiman-Hill, Cheryl M R; Thompson, Sandra C
Preferences for topics and means of access to health information among newly arrived, culturally and linguistically diverse women in Perth, Western Australia, were explored. A mixed-methods approach was adopted. Qualitative material obtained from focus groups and interviews with 22 service providers and 26 migrant women was used to develop a questionnaire, which was then administered to 268 newly arrived migrant and refugee women from 50 countries. Participants' information and support priorities were ascertained from a ranking exercise conducted in a non-threatening context. Responses of migrant and refugee women were compared quantitatively. Women's top priorities for information and support included employment advice, as well as information regarding mental health issues, women's health, exercise and nutrition, family violence and alcohol and other drug issues. Their preferred methods for receiving information were interactive talks or presentations, with written material support. Audiovisual and Web-based material were also considered useful. There were differences between refugee women's and other migrants' preferences for means of receiving information and topics of most concern. The use of a non-threatening ranking process encouraged women to prioritise sensitive topics, such as family violence, and revealed a need for such topics to be incorporated within general health information presentations. Internet-based technologies are becoming increasingly important methods for disseminating information to migrant women. SO WHAT? Differences between migrant and refugee women's priority health issues and their preferred methods for receiving information highlight the desirability of tailoring information to particular groups. Although advice on employment pathways and mental health concerns were top priorities, the study revealed a need for more discussion on other sensitive topics, such as family violence and alcohol-related issues, and that ideally these should
This paper discusses the role of community, non-government organisations and universities in assisting secondary schools meet the needs of refugee students. On arrival in Australia, many African refugee communities experience high levels of stress particularly in adjusting to their new environment. The parents and students unfamiliarity with the…
Liu, Yecai; Posey, Drew L; Cetron, Martin S; Painter, John A
Before 2007, immigrants and refugees bound for the United States were screened for tuberculosis (TB) by a smear-based algorithm that could not diagnose smear-negative/culture-positive TB. In 2007, the Centers for Disease Control and Prevention implemented a culture-based algorithm. To evaluate the effect of the culture-based algorithm on preventing the importation of TB to the United States by immigrants and refugees from foreign countries. Population-based, cross-sectional study. Panel physician sites for overseas medical examination. Immigrants and refugees with TB. Comparison of the increase of smear-negative/culture-positive TB cases diagnosed overseas among immigrants and refugees by the culture-based algorithm with the decline of reported cases among foreign-born persons within 1 year after arrival in the United States from 2007 to 2012. Of the 3 212 421 arrivals of immigrants and refugees from 2007 to 2012, a total of 1 650 961 (51.4%) were screened by the smear-based algorithm and 1 561 460 (48.6%) were screened by the culture-based algorithm. Among the 4032 TB cases diagnosed by the culture-based algorithm, 2195 (54.4%) were smear-negative/culture-positive. Before implementation (2002 to 2006), the annual number of reported cases among foreign-born persons within 1 year after arrival was relatively constant (range, 1424 to 1626 cases; mean, 1504 cases) but decreased from 1511 to 940 cases during implementation (2007 to 2012). During the same period, the annual number of smear-negative/culture-positive TB cases diagnosed overseas among immigrants and refugees bound for the United States by the culture-based algorithm increased from 4 to 629. This analysis did not control for the decline in new arrivals of nonimmigrant visitors to the United States and the decrease of incidence of TB in their countries of origin. Implementation of the culture-based algorithm may have substantially reduced the incidence of TB among newly arrived, foreign-born persons in
Terhart, Henrike; von Dewitz, Nora
Newly arrived migrant students in German schools are currently the centre of attention. In 2015 and 2016 the incoming number of migrant children and adolescents of school-age has risen. Schools, the education administration as well as politics need to take action with regard to this. In the on-going debate on new immigrant students in school,…
Anne-Marie Bélanger McMurdo
Full Text Available By the end of February 2016, Canada had fulfilled its promise to resettle 25,000 Syrian refugees. However, this initiative has put a considerable strain on the settlement services that refugees receive after arrival, and raises questions about fair treatment for other refugees.
Lisa K. Hartley
Full Text Available While most of the world's refugees reside in developing countries, their arrival to western countries is highly politicised, giving rise to questions about the types of entitlements and rights that should, or should not, be granted. In this study, using a mixed-methods community questionnaire (N = 185, we examined attitudes towards social policies aimed at providing assistance to two categories of new arrivals to Australia: resettled refugees (who arrive via its official refugee resettlement program and asylum seekers (who arrive via boat and then seek refugee status. Social policy attitude was examined as a consequence of feelings of anger, fear, and threat, as well as levels of prejudice. Participants felt significantly higher levels of anger, fear, threat, and prejudice towards asylum seekers compared to resettled refugees. For both resettled refugees and asylum seekers, prejudice was an independent predictor of more restrictive social policy attitudes. For resettled refugees, fear and perceived threat were independent predictors for more restrictive social policy whereas for asylum seekers anger was an independent predictor of restrictive social policy. The qualitative data reinforced the quantitative findings and extended understanding on the appraisals that underpin negative attitudes and emotional responses. Practical implications relating to challenging community attitudes are discussed.
Sypek, Scott A; Benson, Jill; Spanner, Kate A; Williams, Jan L
Many refugee children arriving in Australia have an inaccurately documented date of birth (DOB). A medical assessment of a child's age is often requested when there is a concern that their documented DOB is incorrect. This study's aim was to assess the accuracy a holistic age assessment tool (AAT) in estimating the age of refugee children newly settled in Australia. A holistic AAT that combines medical and non-medical approaches was used to estimate the ages of 60 refugee children with a known DOB. The tool used four components to assess age: an oral narrative, developmental assessment, anthropometric measures and pubertal assessment. Assessors were blinded to the true age of the child. Correlation coefficients for the actual and estimated age were calculated for the tool overall and individual components. The correlation coefficient between the actual and estimated age from the AAT was very strong at 0.9802 (boys 0.9748, girls 0.9876). The oral narrative component of the tool performed best (R = 0.9603). Overall, 86.7% of age estimates were within 1 year of the true age. The range of differences was -1.43 to 3.92 years with a standard deviation of 0.77 years (9.24 months). The AAT is a holistic, simple and safe instrument that can be used to estimate age in refugee children with results comparable with radiological methods currently used. © 2016 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).
In 1945, 423 refugees were admitted because of contagious disease at Malmö Epidemic Hospital. Of these refugees 159 men and 167 women arrived from the German concentration camps in Ravensbrück, Buchenwald, Bergen-Belsen, Neuengamme and others. Others arrived in a boat destined to be sunk when peace came and the crew changed mind, letting the boat board at Malmö harbour. Thus life was saved to more than 95% of its passengers. Of the refugees 31% came from Poland, 24% from Scandinavian countries, 12% from Benelux and 10% from France. Louse-borne typhus was the most frequent diagnosis that occurred in 35%. Other common disorders were diphtheria, scarlet fever, enteric fever and tuberculosis. Almost all prisoners from concentration camps were malnourished and had sustained severe cruelty. Most of them recovered rapidly when given food and vitamins.
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Background: adolescent migrants are in a state of double vulnerability because of their age and migration experience. The purpose of this review was to identify risk and protective factors serving as a base for health promotion of young recent migrants.
Methods: we assessed 95 papers identified through a MEDLINE search. Thirty-five papers were retained for review and analysed within the following themes: general health, mental health, cigarette smoking and sexual health.
Results: young migrants’ health was considered good at arrival, but deteriorated with length of stay due to factors linked to migration. Mental health was determined by pre-migration factors, such as violence, and was strongly related to post-migration factors, such as asylum procedures, discrimination and low socio-economic status. Social support and family cohesion were identified as protective factors. We found a lack in epidemiologic data about tobacco use and sexual health issues. Results from North America indicated less frequent smoking in certain groups of immigrants. Some data suggested more frequent teenage pregnancies and abortions in young refugee women as compared to the host population. We also found some evidence about increased risk of sexually transmitted infections and HIV/AIDS in certain immigrant populations.
Conclusions: migrant adolescents are generally healthy at arrival. The migration process and social inequalities after arrival influence their long-term health. A comprehensive approach to health promotion is necessary, taking into account risk and protective factors. More research is needed, in order to obtain more specific epidemiologic data about adolescent migrants, as well as longitudinal and qualitative data.
Duncan, Geraldine; Shepherd, Madeleine; Symons, Jessica
workforce encounters a multitude of issues when working with newly arrived refugees, including language barriers, client expectations and challenges in developing living skills. Workers reported that accessing refugees' information is time-consuming, and that available resources are fragmented. Refugees expressed frustration at being categorised but acknowledged the efforts of volunteers and caseworkers. Findings and feedback from the literature review, focus groups, consultations with resettlement stakeholders and interviews supported the concept of developing a basic manual and conversation-starter flashcards. The limitations of the developed manual are acknowledged, as is a need for agency specific information on common topics for volunteers, caseworkers and clients, is suggested. Volunteer and caseworker training should be expanded.
Carrico, Ruth M; Goss, Linda; Wiemken, Timothy L; Bosson, Rahel S; Peyrani, Paula; Mattingly, William A; Pauly, Allison; Ford, Rebecca A; Kotey, Stanley; Ramirez, Julio A
During 2016, approximately 140,000 individuals entered the United States as part of the federal government refugee resettlement program and established themselves in communities in virtually every state. No national database regarding refugee health currently exists; therefore, little is known about existing infectious diseases, conditions, and cultural practices that impact successful acculturation. The objective of this report is to identify what is currently known about refugees and circumstances important to infection prevention and control with respect to their roles as new community members, employees, and consumers of health care. Using data from the University of Louisville Global Health Center's Newly Arriving Refugee Surveillance System, health issues affecting refugees from the perspective of a community member, an employee, and a patient were explored. Lack of immunity to vaccine-preventable diseases is the most widespread issue impacting almost every adult, adolescent, and child refugee resettled in Kentucky. Health issues of concern from an infection prevention and control perspective include latent tuberculosis infection, HIV, hepatitis B, hepatitis C, syphilis, and parasites. Other health conditions that may also be important include anemia, obesity, oral health, diabetes, and cardiovascular disease. Refugee resettlement provides motivation for collaborative work among those responsible for infection prevention and control in all settings, their public health partners, and those responsible for and interested in community workforce concerns. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
Mishori, Ranit; Aleinikoff, Shoshana; Davis, Dawn
Since 1975, more than 3 million refugees have settled in the United States, fleeing unrest, conflict, and persecution. Refugees represent diverse ethnic, cultural, religious, socioeconomic, and educational backgrounds. Despite this heterogeneity, there are commonalities in the refugee experience. Before resettlement, all refugees must undergo an overseas medical screening to detect conditions that pose a potential health threat in the United States. On arrival, they should undergo an examination to detect diseases with high prevalence in their country of origin or departure. Refugees have higher rates of chronic pain compared with the general population, and their mental health and wellbeing are strongly influenced by their migration history. Refugees have higher rates of mood disorders, posttraumatic stress disorder, and anxiety than the general population. Some refugees have been tortured, which contributes to poorer health. Chronic noncommunicable diseases, such as diabetes mellitus and hypertension, are also prevalent among refugees. Many refugees may be missing routine immunizations and screenings for cancer and chronic diseases. Attention to reproductive health, oral health, and vision care will help identify and address previously unmet needs. Refugees face barriers to care as a result of cultural, language, and socioeconomic factors.
The pre- and post-displacement factors associated with psychological problems among young refugees are not clear. From the existing research it appears that refugee children and adolescents are vulnerable to the effects of pre-migration exposure to trauma, but the long-term effects of such exposure are mediated by certain risk and protective factors at the individual, family and community level. The aim of the present study was to assess the influence of traumatic experiences before emigration, as well as social life after immigration, on the mental health of young Middle Eastern refugees 8-9 years after immigration into Denmark. The study group comprises 131 young refugees (76 girls and 55 boys; mean age 15.3 years) from 67 families. They were assessed in 2000-2001 as part of a follow-up study of 311 children, who in 1992-1993 were consecutively registered in Denmark as asylum seekers with at least one parent. Predictors of more externalizing behaviour were: witnessing attack on others after arrival, more schools attended, less attending school or work, lower mother's education in the home country and lower age. Predictors of more internalizing behaviour were: numbers of types of traumatic events before arrival, numbers of types of stressful events after arrival, and numbers of types of experiences of discrimination, lower mother's education in the home country, fewer Danish friends, not Muslim or Christian religion, less Danish proficiency and female gender. It is concluded that aspects of social life in Denmark, including mother's education and indicators of adaptation, as well as a stressful life context in exile, including discrimination, predicted psychological problems 8-9 years after arrival, more than traumatic experiences before arrival. Thus, the prevention of psychopathology in young refugees depends to a large extent on the political will to make provision for the necessary changes regarding reception and treatment of refugees.
Newbold, K. Bruce
Full Text Available EnglishEmbodying a differential set of skills, refugees experience varying obstaclesand reception upon entry into their host country. Starting in 1975, the U.S. received large numbers ofrefugees from Southeast Asia. Although these arrivals are no longer labeled as 'refugees', theirinitial immigration status raises interesting questions, including whether or not they match theattainment of those who arrived in the U.S. at the same time. Using the 1980 and 1990 Public UseMicrodata Files (PUMS, this paper traces the adaptation of post-1975 Southeast Asians within the U.S.through the lens of segmented assimilation. Refugee flows are disaggregated into Sino-Vietnamese,Ethnic-Vietnamese, Hmong, Cambodians, and Laotian identities and contrasted to Chineseimmigrants.FrenchPrésentant des compétences différentes, les réfugiés vivent des expériences et des accueils différents à leur arrivée dans leur pays hôte. Depuis 1975, les Etats-Unis ont reçu un grand nombre de réfugiés de l'Asie du Sud-Est. Bien que ces nouveaux arrivants ne soient plus étiquetés de " réfugiés ", leur statut d'immigrant soulève tout de même quelques questions intéressantes, à savoir s'ils obtiennent le même succès que ceux qui sont arrivés aux Etats-Unis au même moment. Ce document retrace, au moyen des fichiers de microdonnées à grande diffusion (FMGD de 1980 et de 1990, l'adaptation des immigrants de l'Asie du Sud-Est arrivés aux Etats-Unis après 1975 du point de vue de l'assimilation segmentée. Les groupes de courants de réfugiés sont divisés en Sino-vietnamiens, Vietnamiens ethniques, Hmong, Cambodgiens et Laotiens et comparés aux immigrants chinois.
Morris, Meghan D; Popper, Steve T; Rodwell, Timothy C; Brodine, Stephanie K; Brouwer, Kimberly C
The majority of refugees spend the greater part of their lives in refugee camps before repatriation or resettlement to a host country. Limited resources and stress during residence in refugee camps can lead to a variety of acute and chronic diseases which often persist upon resettlement. However, for most resettled refugees little is known about their health needs beyond a health assessment completed upon entry. We conducted a qualitative pilot-study in San Diego County, the third largest area in California, USA for resettling refugees, to explore health care access issues of refugees after governmental assistance has ended. A total of 40 guided in-depth interviews were conducted with a targeted sample of informants (health care practitioners, employees of refugee serving organizations, and recent refugee arrivals) familiar with the health needs of refugees. Interviews revealed that the majority of refugees do not regularly access health services. Beyond individual issues, emerging themes indicated that language and communication affect all stages of health care access--from making an appointment to filling out a prescription. Acculturation presented increased stress, isolation, and new responsibilities. Additionally, cultural beliefs about health care directly affected refugees' expectation of care. These barriers contribute to delayed care and may directly influence refugee short- and long-term health. Our findings suggest the need for additional research into contextual factors surrounding health care access barriers, and the best avenues to reduce such barriers and facilitate access to existing services.
Damm, Anna Piil; Rosholm, Michael
We argue that spatial dispersal influences labour market assimilation of refugees through two mechanisms: first, the local job offer arrival rate and, second, place utility. Our partial search model with simultaneous job and residential location search predicts that the reservation wage for local jobs decreases with place utility. We argue that spatial dispersal decreases average place utility of refugees which decreases the transition rate into first job due to large local reservation wages....
Anjum, Tanvir M; Nordqvist, Cecilia; Timpka, Toomas
Little is known about how positive phenomena can support resettlement of refugees in a new country. The aim of this study was to examine the hopeful thinking in a group of West African quota refugees at arrival and after 6 years in Sweden and compare these thoughts to the views of resettlement support professionals. The primary study population comprised 56 adult refugees and 13 resettlement professionals. Qualitative data were collected from the refugees by questionnaires on arrival and 6 years later. Data were collected from the resettlement professionals by interview about 3 years after arrival of the refugees. Snyder's cognitive model of hope was used to inform the comparative data analyses. Hopes regarding education were in focus for the refugees shortly after arrival, but thoughts on family reunion were central later in the resettlement process. During the later stages of the resettlement process, the unresponsiveness of the support organization to the family reunion problem became as issue for the refugees. The professionals reported a complex mix of "silent agency thoughts" underlying the local resettlement process as a contributing reason for this unresponsiveness. Hopes regarding education and family reunion were central in the resettlement of West African refugees in Sweden. These thoughts were not systematically followed up by the support organization; possibly the resources for refugees were not fully released. More studies are needed to further investigate the motivational factors underpinning host community support of refugees' hopes and plans.
Anjum Tanvir M
Full Text Available Abstract Background Little is known about how positive phenomena can support resettlement of refugees in a new country. The aim of this study was to examine the hopeful thinking in a group of West African quota refugees at arrival and after 6 years in Sweden and compare these thoughts to the views of resettlement support professionals. Method The primary study population comprised 56 adult refugees and 13 resettlement professionals. Qualitative data were collected from the refugees by questionnaires on arrival and 6 years later. Data were collected from the resettlement professionals by interview about 3 years after arrival of the refugees. Snyder's cognitive model of hope was used to inform the comparative data analyses. Results Hopes regarding education were in focus for the refugees shortly after arrival, but thoughts on family reunion were central later in the resettlement process. During the later stages of the resettlement process, the unresponsiveness of the support organization to the family reunion problem became as issue for the refugees. The professionals reported a complex mix of "silent agency thoughts" underlying the local resettlement process as a contributing reason for this unresponsiveness. Conclusion Hopes regarding education and family reunion were central in the resettlement of West African refugees in Sweden. These thoughts were not systematically followed up by the support organization; possibly the resources for refugees were not fully released. More studies are needed to further investigate the motivational factors underpinning host community support of refugees' hopes and plans.
Wright, A Michelle; Talia, Yousif R; Aldhalimi, Abir; Broadbridge, Carissa L; Jamil, Hikmet; Lumley, Mark A; Pole, Nnamdi; Arnetz, Bengt B; Arnetz, Judith E
Although kidnapping is common in war-torn countries, there is little research examining its psychological effects. Iraqi refugees (N = 298) were assessed upon arrival to the U.S. and 1 year later. At arrival, refugees were asked about prior trauma exposure, including kidnapping. One year later refugees were assessed for posttraumatic stress disorder (PTSD) and major depression disorder (MDD) using the SCID-I. Individual resilience and narratives of the kidnapping were also assessed. Twenty-six refugees (9 %) reported being kidnapped. Compared to those not kidnapped, those who were had a higher prevalence of PTSD, but not MDD, diagnoses. Analyses examining kidnapping victims revealed that higher resilience was associated with lower rates of PTSD. Narratives of the kidnapping were also discussed. This study suggests kidnapping is associated with PTSD, but not MDD. Additionally, kidnapping victims without PTSD reported higher individual resilience. Future studies should further elucidate risk and resilience mechanisms.
Full Text Available Abstract Background Intergenerational transmission of trauma as a determinant of mental health has been studied in the offspring of Holocaust survivors and combat veterans, and in refugee families. Mainly negative effects on the children are reported, while a few studies also describe resilience and a possible positive transformation process. A longitudinal prospective cohort study of Vietnamese refugees arriving in Norway in 1982 reports a 23 years follow-up, including spouses and children born in Norway, to study the long-term effects of trauma, flight, and exile on the offspring of the refugees. Objectives of the study: 1. To study the association between the psychological distress of Vietnamese refugee parents and their children after 23 years resettlement. 2. To analyse paternal predictors for their children's mental health. Methods Information from one or both parents at arrival in 1982 (T1, at follow-up in 1985 (T2, and 23 years after arrival (T3 was included. The mental health was assessed by the Global Severity Index (GSI of the self-report Symptom Check List-90-R (SCL-90-R for parents (n = 88 and older children (age 19-23 yrs, n = 12, while children aged 4-18 (n = 94 were assessed using the Strengths and Difficulties Questionnaire (SDQ. Results Thirty percent of the families had one parent with a high psychological distress score ("probable caseness" for a mental disorder, while only 4% of the children aged 10 - 23 years were considered as probable cases. In spite of this, there was an association between probable caseness in children and in fathers at T3. A significant negative paternal predictor for the children's mental health at T3 was the father's PTSD at arrival in Norway, while a positive predictor was the father's participation in a Norwegian network three years after arrival. Conclusions Children of refugees cannot be globally considered at risk for mental health problems. However, the preceding PTSD in their fathers may
Lowther, Sara A.; Johnson, Glenise; Hendel-Paterson, Brett; Nelson, Kailey; Mamo, Blain; Krohn, Kristina; Pessoa-Brandão, Luisa; O’Fallon, Ann; Stauffer, William
In 2010, the requirement for human immunodeficiency virus (HIV) testing of adult refugees prior to US resettlement was removed, thus leading to a potential for missed diagnosis. We reviewed refugee health assessment data and medical charts to evaluate the health status of HIV-infected refugees who arrived in Minnesota during 2000–2007, prior to this 2010 policy change. Among 19,292 resettled adults, 174 were HIV-infected; 169 (97%) were African (median age 26.4 (range: 17–76) years). Charts were abstracted for 157 (124 (79%) with ≥1 year of follow-up). At initial presentation, two of 74 (3%) women were pregnant; 27% became pregnant during follow-up. HIV clinical stage varied (59%, asymptomatic; 11%, mild symptoms; 10%, advanced symptoms; 3%, severe symptoms; 17%, unknown); coinfections were common (51 tuberculosis, 13 hepatitis B, 13 parasites, four syphilis). Prior to arrival 4% had received antiretrovirals. Opportunistic infections were diagnosed among 13%; 2% died from AIDS-related causes. Arrival screening may be needed to identify these HIV-infected refugees and prevent HIV-related morbidity and mortality. PMID:23202841
Negligible import of enteric pathogens by newly-arrived asylum seekers and no impact on incidence of notified Salmonella and Shigella infections and outbreaks in Rhineland-Palatinate, Germany, January 2015 to May 2016.
Ehlkes, Lutz; George, Maja; Knautz, Donald; Burckhardt, Florian; Jahn, Klaus; Vogt, Manfred; Zanger, Philipp
IntroductionThe 2015 refugee crisis raised concerns about an import of infectious diseases affecting the German population. Aims: To evaluate public and individual health benefits of stool screening, and explore whether importation of enteric pathogens by newly-arrived asylum seekers impacts on the host population. Methods : We used data from mandatory stool screening to determine the overall, age, sex, and country-specific prevalence of enteric bacteria and helminths. We used surveillance data to assess whether the number of incoming asylum seekers influenced notifications of salmonellosis and shigellosis in Rhineland-Palatinate. Results : Salmonella were found in 0.2% (95% confidence interval (CI) 0.2-0.3%) of 23,410 samples collected from January 2015 to May 2016. Prevalence was highest in children under 5 years (0.8%; 95% CI: 0.5-1.3%). No Shigella or invasive Salmonella spp. were detected. In a subset of 14,511 samples, the prevalence of helminth infestation was 2.4% (95% CI: 2.1-2.6%), with highest proportions detected in adolescents (4.6%; 95% CI 3.8-5.4%) and among Eritreans (9.3%; 95% CI: 7.0-12.0%); in the latter particularly Schistosoma mansoni and Taenia spp. The increase in asylum applications did not increase notifications of salmonellosis and shigellosis. No transmission from asylum seekers to German residents was notified. Conclusion : Public health risk associated with imported enteric pathogens is very low overall. Addressing individual and public health risks, we recommend replacing stool screening of all newly-arrived asylum seekers by a targeted approach, with target groups and approaches being adapted if necessary. Target groups supported by our data are children, adolescents, and Eritreans.
Yun, Katherine; Mohamad, Zeinab; Kiss, Ligia; Annamalai, Aniyizhai; Zimmerman, Cathy
Our goal was to describe the forms of persecution reported by adult refugees in the U.S. and the relationships between persecution and health status among this population. Data were derived from the 2003 New Immigrant Survey, a representative sample of new U.S. lawful permanent residents. Major depression, impairment in daily activities due to pain, poor self-reported health, and declining health were described for refugees who had and had not reported persecution prior to arrival in the U.S. Health status was also examined for refugees who reported different forms of persecution. Half of refugees (46.7 %) in this sample reported that they or an immediate family member had been persecuted. One in three persecuted refugees (31.8 %) reported both incarceration and physical punishment. Major depression, pain-related impairment, poor health, and declining health were twice as common among persecuted refugees than among non persecuted refugees. Notably, despite these adverse experiences, the majority of persecuted refugees did not report poor health outcomes.
Berman, Rachel Stein; Smock, Laura; Bair-Merritt, Megan H; Cochran, Jennifer; Geltman, Paul L
The receipt rate of hepatitis B virus vaccine among adolescents in the United States is high, while the receipt rate of human papillomavirus vaccine is low. Rates have not been closely studied among refugees, whose home countries have high rates of disease caused by these viruses. We examined human papillomavirus and hepatitis B virus immunization rates among 2,269 refugees aged 9 to 26 years who resettled in Massachusetts from 2011 through 2013. This was a secondary analysis of data from their medical screenings. We used binary logistic regression to assess characteristics associated with immunization and bivariate analyses to compare refugee immunization rates with those of the general US population. Forty-five percent of US adolescents aged 13 to 17 years received 1 dose of human papillomavirus vaccine, compared with 68% of similarly aged refugees. Males (adjusted odds ratio [aOR], 0.62; 95% confidence interval [CI], 0.52-0.74), refugees older than 13 years (aOR, 0.74; 95% CI, 0.60-0.93), and refugees not from Sub-Saharan Africa (aOR, 0.74; 95% CI, 0.59-0.92) were less likely to receive human papillomavirus vaccine, while arrivals in 2012 through 2013 were more likely (aOR, 1.6; 95% CI, 1.3-1.9) than those arriving in 2011. Refugees older than 13 years were less likely to receive 2 doses of hepatitis B virus vaccine (aOR, 0.49; 95% CI, 0.37-0.63) than older refugees. Specialized post-arrival health assessment may improve refugees' immunization rates.
There has been a long tradition in the Ottoman Empire and the Turkish Republic of receiving refugees. There were Jewish refugees from the Spanish Inquisition, Hungarians and Poles fleeing revolts in 1848-9, and those of Turkish descent and usually from the Balkans. Concurrent with this trend is the history of refugees and immigrants leaving Turkey, such as many Armenians, Greeks and Jews leaving at the turn of the century, and after 1923 and the Treaty of Lausanne. Little is currently published on the topic. This article defines a refugee; provides an overview of the refugee problems of the 1980's due to Bulgarian, Kurdish, and Turkish refugees; and the legal and political aspects. As a country of origin, there is discussion of the political and economic aspects of Turkish asylum seekers in Europe. The potential refugee flows to and from Turkey are also examined. I) For this study, refugees are victims of political violence and are persecuted for political or religious beliefs, ethnic or racial background, or war. In Turkey, there are national refugees, international refugees outside the Convention, and UNHCR Convention refugees. During the 1980's all 3 groups were arriving: from eastern Europe, Iranian Kurds, Iraqis, and ethnic Turks from Bulgaria and Afghanistan. The Turkish restricted acceptance of the 1951 Convention on Refugees creates serious humanitarian and security consequences for refugees other than those from eastern Europe and of Turkish ethnicity. Political considerations play an important role in treatment where security threats outweigh humanitarian need. The case is given for Kurdish refugees. II) Asylum seekers from Turkey in Western Europe was determined between 1986-90 to be 185,000 from applications. These figures have risen steadily due to the political instability and military activity of areas bordering Iraq and Syria, the Emergency Region. In addition there are economic and employment problems, and there has been a suspension of human
Taking its point of departure in the newly published World Bank Economic Outlook for Jordan (October 2016) the article discusses the recent political and economic realities in Jordan with a focus on the Syrian refugees and the so-called Jordan Compact programme, launched in connection with the co......Taking its point of departure in the newly published World Bank Economic Outlook for Jordan (October 2016) the article discusses the recent political and economic realities in Jordan with a focus on the Syrian refugees and the so-called Jordan Compact programme, launched in connection...... they launched the mentioned programme, according to which 200,000 job opportunities for Syrian refugees would be offered "while they remain in the country, contributing to the Jordanian economy without competing with Jordanians for jobs", as it said in the document. Taking this move Jordan is to some degree...
In 2002, the International Organization for Migration provided pre-arrival cultural orientation training to 905 Vietnamese Montagnard refugees living in a transit processing facility on the outskirts of Phnom Penh. The training was specifically designed to prepare the refugees for third country resettlement to the United States. It provided tools…
Williams, Bhanu; Cassar, Christine; Siggers, Georgie; Taylor, Sebastian
In mid-2015, there were an estimated 20.2 million refugees in the world; over half of them are children. Globally, this is the highest number of refugees moving across borders in 20 years. The rights of refugee children to access healthcare and be free from arbitrary detention are enshrined in law. Unaccompanied asylum-seeking children have a statutory medical assessment, but refugee children arriving with their families do not. Paediatricians assessing both unaccompanied and accompanied refugee children must be alert to the possibilities of nutritional deficiencies, infectious diseases, dental caries and mental health disorders and be aware of the national and international health guidance available for support. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Dorall, R F
This article surveys the arrivals of Muslim refugees from countries in Southeast Asia who have not only come to Malaysia for political refuge, but who have also stayed on, in many instances integrating into the local Muslim community. The author concludes that Burmese, Thai, and Filipino Muslim refugee-cum-migrants, and the estimated 500,000 illegal Indonesian migrant workers in East and Peninsular Malaysia make the presence of economic migrants in Malaysia's towns and rural sectors a far more pressing concern to Malaysians than that posed by the arrival of genuine political refugees. Only the Indonesians present in Malaysia are consistently termed by all parties as illegal migrants and some of them have been subjected to well-publicized deportation by the Malaysian immigration authorities. Sympathy for fellow-Muslims in distress explains Malaysia's open-door policy to Muslim refugees. The Koran specifically enjoins Muslims to assist Muslim refugees who have been persecuted by others. However, the necessity to maintain regional political and military alliances, principally as a bulwark against Communism, and the Malay--Non-Malay, Muslim--Non-Muslim dichotomy in Malaysia which almost evenly divides Malaysia's 16 million population into mutually antagonistic halves, results in any overt public policy in favor of Malays and Muslims to be immediately denounced by the other half of the population as a move against the Non-Malays and Non-Muslims. Without political and media attention, the refugees live wherever they can find work, as do hundreds of thousands of mainly Indonesian illegal migrant workers. They surreptitiously get their children admitted to public schools, and through bribery, can even get Malaysian identification papers. Malaysia is a relatively tranquil haven for Malaysia's Muslim refugees compared to their homelands, but their continued stay remains dependent on the ever-present struggle for more equitable sharing of political and economic power between
Dapunt, J; Kluge, U; Heinz, A
Conflicts and precarious living conditions resulted in the arrival of large numbers of refugees in Europe and especially in Germany. Evidence suggests that immigrant populations are at elevated risk of psychotic disorders. Considering the traumatic pre- and post-migratory adversities refugees may have encountered, people granted refugee status may even be more susceptible to psychosis than non-refugee migrants. The aim of this literature review is to summarise and interpret recent research on the incidence or prevalence of psychotic disorders in refugees, additionally focusing on the aspects of gender and Middle Eastern provenance. A systematic search in PubMed was performed in the time from 20 to 28 May 2016. Relevant literature was limited to articles describing cohort studies conducted in Western industrialised countries. Articles published between 1 June 2006 and 28 May 2016 were analysed. Content relating to psychotic disorders in refugees was reviewed and summarised. The selected studies showed an increased risk of psychotic disorders in refugees compared with both the indigenous population and non-refugee. migrants. The elevated risk was more pronounced in refugee men. A particularly high risk in refugees of Middle Eastern origin could not be inferred. The higher susceptibility to psychotic disorders in refugees emphasises the need for the development and implementation of adequate prevention strategies. Clinicians and people working in a refugee setting should be aware of early signs and symptoms of psychosis. Further research is required to evaluate post-migratory experiences and investigate the population of refugees affected by the current humanitarian crisis.
The number of refugees who have fled across international borders due to conflict and persecution is at the highest level in recorded history. The vast majority of these refugees find exile in low-income countries neighboring their countries of origin. The refugee children who are resettled to North America, Europe, and Australia arrive with…
Wright, A Michelle; Aldhalimi, Abir; Lumley, Mark A; Jamil, Hikmet; Pole, Nnamdi; Arnetz, Judith E; Arnetz, Bengt B
This study examined refugees' resource needs and utilization over time, investigated the relationships between pre-displacement/socio-demographic variables and resource needs and utilization, and explored the role of resource needs and utilization on psychiatric symptom trajectories. Iraqi refugees to the United States (N = 298) were assessed upon arrival and at 1-year intervals for 2 years for socio-demographic variables and pre-displacement trauma experiences, their need for and utilization of 14 different resources, and PTSD and depressive symptoms. Although refugees reported reduction of some needs over time (e.g., need for cash assistance declined from 99 to 71 %), other needs remained high (e.g., 99 % of refugees reported a need for health care at the 2-year interview). Generally, the lowest needs were reported after 2 years, and the highest utilization occurred during the first year post-arrival. Pre-displacement trauma exposure predicted high health care needs but not high health care utilization. Both high need for and use of health care predicted increasing PTSD and depressive symptoms. Specifically, increased use of psychological care across the three measurement waves predicted more PTSD and depression symptoms at the 2-year interview. Differences emerged between need for and actual use of resources, especially for highly trauma-exposed refugees. Resettlement agencies and assistance programs should consider the complex relationships between resource needs, resource utilization, and mental health during the early resettlement period.
O'Laughlin, K N; Kasozi, J; Rabideau, D J; Parker, R A; Mulogo, E; Faustin, Z M; Greenwald, K E; Doraiswamy, S; Walensky, R P; Bassett, I V
Refugees living in Uganda come from HIV-endemic countries, and many remain in refugee settlements for over a decade. Our objective was to evaluate the HIV care cascade in Nakivale Refugee Settlement and to assess correlates of linkage to care. We prospectively enrolled individuals accessing clinic-based HIV testing in Nakivale Refugee Settlement from March 2013 to July 2014. Newly HIV-diagnosed clients were followed for 3 months post-diagnosis. Clients underwent a baseline survey. The following outcomes were obtained from HIV clinic registers in Nakivale: clinic attendance ('linkage to HIV care'), CD4 testing, antiretroviral therapy (ART) eligibility, and ART initiation within 90 days of testing. Descriptive data were reported as frequency with 95% confidence interval (CI) or median with interquartile range (IQR). The impact of baseline variables on linkage to care was assessed with logistic regression models. Of 6850 adult clients tested for HIV, 276 (4%; CI: 3-5%) were diagnosed with HIV infection, 148 (54%; CI: 47-60%) of those were linked to HIV care, 54 (20%; CI: 15-25%) had a CD4 test, 22 (8%; CI: 5-12%) were eligible for ART, and 17 (6%; CI: 3-10%) initiated ART. The proportions of refugees and nationals at each step of the cascade were similar. We identified no significant predictors of linkage to care. Less than a quarter of newly HIV-diagnosed clients completed ART assessment, considerably lower than in other reports from sub-Saharan Africa. Understanding which factors hinder linkage to and engagement in care in the settlement will be important to inform interventions specific for this environment. © 2017 British HIV Association.
Masmas, Tania Nicole; Møller, Eva; Buhmannr, Caecilie; Bunch, Vibeke; Jensen, Jean Hald; Hansen, Trine Nørregård; Jørgensen, Louise Møller; Kjaer, Claes; Mannstaedt, Maiken; Oxholm, Annemette; Skau, Jutta; Theilade, Lotte; Worm, Lise; Ekstrøm, Morten
An unknown number of asylum seekers arriving in Denmark have been exposed to torture or have experienced other traumatising events in their country of origin. The health of traumatised asylum seekers, both physically and mentally, is affected upon arrival to Denmark, and time in asylum centres leads to further deterioration in health. One hundred forty-two (N=142) newly arrived asylum seekers were examined at Center Sandholm by Amnesty International Danish Medical Group from the 1st of September until the 31st of December 2007. The asylum seekers came from 33 different countries, primarily representing Afghanistan, Iraq, Iran, Syria, and Chechnya. Of the asylum seekers, 45 percent had been exposed to torture--approximately one-third within the year of arrival to Denmark. Unsystematic blows, personal threats or threats to family, degrading treatment, isolation, and witnessing torture of others were the main torture methods reported. The majority of the asylum seekers had witnessed armed conflict, persecution, and imprisonment. The study showed that physical symptoms were approximately twice as frequent and psychological symptoms were approximately two to three times as frequent among torture survivors as among non-tortured asylum seekers. However, even the health of non-tortured asylum seekers was affected. Among the torture survivors, 63 percent fulfilled the criteria for post-traumatic stress disorder, and 30-40 percent of the torture survivors were depressed, in anguish, anxious, and tearful in comparison to 5-10 percent of the non-tortured asylum seekers. Further, 42 percent of torture survivors had torture-related scars. Torture survivors amid newly arrived asylum seekers are an extremely vulnerable group, hence examination and inquiry about the torture history is extremely important in order to identify this population to initiate the necessary medical treatment and social assistance. Amnesty International Danish Medical group is currently planning a follow
The massive increase in the number of arriving refugees in Europe in 2015 creates enormous economic and political challenges in the receiving countries. An important concern is that the inflow of refugees increases the support for far-right, nationalist, anti-immigration parties. This paper studies a natural experiment in an Austrian state to identify the causal effect of exposure to refugees in the neighborhood on the support for the far-right Freedom Party of Austria (FPÖ). Before the local...
Sulaiman-Hill, Cheryl Mr; Thompson, Sandra C
As almost half of all refugees currently under United Nations protection are from Afghanistan or Iraq and significant numbers have already been resettled outside the region of origin, it is likely that future research will examine their resettlement needs. A number of methodological challenges confront researchers working with culturally and linguistically diverse groups; however, few detailed articles are available to inform other studies. The aim of this paper is to outline challenges with sampling and recruitment of socially invisible refugee groups, describing the method adopted for a mixed methods exploratory study assessing mental health, subjective wellbeing and resettlement perspectives of Afghan and Kurdish refugees living in New Zealand and Australia. Sampling strategies used in previous studies with similar refugee groups were considered before determining the approach to recruitment A snowball approach was adopted for the study, with multiple entry points into the communities being used to choose as wide a range of people as possible to provide further contacts and reduce selection bias. Census data was used to assess the representativeness of the sample. A sample of 193 former refugee participants was recruited in Christchurch (n = 98) and Perth (n = 95), 47% were of Afghan and 53% Kurdish ethnicity. A good gender balance (males 52%, females 48%) was achieved overall, mainly as a result of the sampling method used. Differences in the demographic composition of groups in each location were observed, especially in relation to the length of time spent in a refugee situation and time since arrival, reflecting variations in national humanitarian quota intakes. Although some measures were problematic, Census data comparison to assess reasonable representativeness of the study sample was generally reassuring. Snowball sampling, with multiple initiation points to reduce selection bias, was necessary to locate and identify participants, provide reassurance and
Thompson Sandra C
Full Text Available Abstract Background As almost half of all refugees currently under United Nations protection are from Afghanistan or Iraq and significant numbers have already been resettled outside the region of origin, it is likely that future research will examine their resettlement needs. A number of methodological challenges confront researchers working with culturally and linguistically diverse groups; however, few detailed articles are available to inform other studies. The aim of this paper is to outline challenges with sampling and recruitment of socially invisible refugee groups, describing the method adopted for a mixed methods exploratory study assessing mental health, subjective wellbeing and resettlement perspectives of Afghan and Kurdish refugees living in New Zealand and Australia. Sampling strategies used in previous studies with similar refugee groups were considered before determining the approach to recruitment Methods A snowball approach was adopted for the study, with multiple entry points into the communities being used to choose as wide a range of people as possible to provide further contacts and reduce selection bias. Census data was used to assess the representativeness of the sample. Results A sample of 193 former refugee participants was recruited in Christchurch (n = 98 and Perth (n = 95, 47% were of Afghan and 53% Kurdish ethnicity. A good gender balance (males 52%, females 48% was achieved overall, mainly as a result of the sampling method used. Differences in the demographic composition of groups in each location were observed, especially in relation to the length of time spent in a refugee situation and time since arrival, reflecting variations in national humanitarian quota intakes. Although some measures were problematic, Census data comparison to assess reasonable representativeness of the study sample was generally reassuring. Conclusions Snowball sampling, with multiple initiation points to reduce selection bias, was
Gammouh, Omar Salem; Al-Smadi, Ahmed Mohammad; Tawalbeh, Loai Issa; Khoury, Laurice Sami
Studying mental and physical health problems in refugees facilitates providing suitable health care, thus improving their quality of life. We studied depression tendency in Syrian refugees in Jordan in the light of chronic diseases and medication availability. Also, depression prevalence and depression comorbidity with chronic diseases were identified. In this multicenter cross-sectional survey, data from Syrian refugees attending Caritas centers in 6 Jordanian cities from November 2013 through June 2014 were analyzed. Participants' demographics, depression, previously diagnosed chronic diseases, and newly diagnosed chronic diseases and the availability of medications were studied. Logistic regression was used to examine predictors for depression. Of 765 refugees who participated, about one-third demonstrated significant depression as measured by the Beck Depression Inventory. Descriptive analyses showed that depression was comorbid in 35% of participants with previously diagnosed chronic diseases and in 40% of participants with newly diagnosed chronic diseases. Newly diagnosed chronic diseases and lack of medications significantly contributed to depression, but the regression model as a whole explained less than 5% of the variance. Because the regression model showed low effect size, we concluded that newly diagnosed chronic diseases and medication shortages could not predict depression in Syrian refugees residing in Jordan. Therefore, further studies of additional factors are recommended. Prompt measures have to be taken to prevent the spread of chronic diseases and improve mental health in this fragile population.
Khan, Fary; Amatya, Bhasker
The current global refugee crisis poses major challenges in providing effective healthcare to refugees, particularly for non-communicable diseases management and disability. This article provides an overview of refugee health and potential challenges from the rehabilitation perspective. A literature search (both academic and grey literature) was conducted using medical and health science electronic databases and internet search engines (2001-2016). Both authors independently selected studies. Due to heterogeneity amongst identified articles, a narrative analysis was performed for best-evidence synthesis to outline the current health and rehabilitation status of refugees and existing gaps in care. Data suggest that infectious diseases requiring treatment in refugees are a minority; whilst non-communicable diseases, musculoskeletal conditions are prevalent. Many refugees arrive with complex health needs. One in 6 refugees have a physical health problem severely affecting their lives and two-thirds experience mental health problems, signifying the important role of rehabilitation. Refugees face continued disadvantage, poverty and dependence due to lack of cohesive support in their new country, which are determinants of both poor physical and mental health. This is compounded by language barriers, impoverishment, and lack of familiarity with the local environment and healthcare system. In Australia, there are concerns about sexual and gender-based violence in off-shore detention camps. Targeted physical and cognitive rehabilitative strategies have much to offer these vulnerable people to allow for improved activity and participation. Strong leadership and effective action from national and international bodies is urgently needed to develop comprehensive rehabilitation-inclusive medical care for refugees.
Essomba, Miquel Àngel
The right to education of children and youth from asylum seeker and refugee families is currently being threatened in Europe. Two factors explain this: the sudden and disorganised arrival of large numbers of asylum seeker families, and the inconsistent integration of those seeking refugee status and those who have gained such status. The actual…
Andresen, Ellen; Bilukha, Oleg O; Menkir, Zeray; Gayford, Megan; Kavosa, Millicent; Wtsadik, Mulugeta; Maina, Gidraf; Gose, Mesfin; Nyagucha, Irene; Shahpar, Cyrus
As a result of armed civil conflict in South Sudan that started in mid-December of 2013, an estimated 1.1 million persons were internally displaced, and approximately 400,000 refugees fled South Sudan to neighboring countries (primarily to Ethiopia, Uganda, Sudan, and Kenya). Refugees from South Sudan arriving in Ethiopia are sheltered in three refugee camps located in Gambella region: Leitchuor, Kule, and Tierkidi. The camps were established during January-May 2014 and have estimated refugee populations of 47,000, 51,000, and 50,000, respectively. Reports from health clinics and humanitarian agencies providing assistance to refugees suggested poor nutritional status of arriving refugees and elevated mortality rates. To assess the nutritional status of refugee children aged 6-59 months and mortality rates (crude [all ages] and aged <5 years), the Administration for Refugee and Returnee Affairs (an Ethiopian government aid agency), the United Nations High Commissioner for Refugees, World Food Programme, and United Nations Children's Fund, in collaboration with CDC, conducted cross-sectional population-representative surveys in Leitchuor, Kule, and Tierkidi camps during June-July 2014. Anthropometric measurements in children were taken using standard procedures, and nutritional status was classified based on 2006 World Health Organization (WHO) growth standards. Hemoglobin was measured using HemoCue Hb 301. Anemia was diagnosed according to WHO thresholds. Retrospective mortality rates in Leitchuor and Kule were measured using a household census method.
Montgomery, Edith; Foldspang, Anders
Aims: The aim of this study was to compare profiles of present mental health and previous exposure to violence among refugee children from the Middle East, whose asylum seeking families either did or did not obtain permission to stay in Denmark. Methods: Shortly after arrival in Denmark, the pare......Aims: The aim of this study was to compare profiles of present mental health and previous exposure to violence among refugee children from the Middle East, whose asylum seeking families either did or did not obtain permission to stay in Denmark. Methods: Shortly after arrival in Denmark...... in a refugee camp, and seven out of 10 had witnessed violence. Half of the children had a tortured parent. Considerably more children of families who did not get a residence permit had lost a parent (30.6% versus 13.7%; P , 0.001). In both groups about two-thirds suffered from anxiety and about 30% from sleep...... exposure to violence and their present mental health. There seems to be good reason to systematically integrate evidence on the children of refugee families in the treatment of applications for permission to stay....
Jazwa, Amelia; Coleman, Margaret S.; Gazmararian, Julie; Wingate, La’Marcus T.; Maskery, Brian; Mitchell, Tarissa; Weinberg, Michelle
Background Refugees are at an increased risk of chronic Hepatitis B Virus (HBV) infection because many of their countries of origin, as well as host countries, have intermediate-to-high prevalence rates. Refugees arriving to the US are also at risk of serious sequelae from chronic HBV infection because they are not routinely screened for the virus overseas or in domestic post-arrival exams, and may live in the US for years without awareness of their infection status. Methods A cohort of 26,548 refugees who arrived in Minnesota and Georgia during 2005–2010 was evaluated to determine the prevalence of chronic HBV infection. This prevalence information was then used in a cost-benefit analysis comparing two variations of a proposed overseas program to prevent or ameliorate the effects of HBV infection, titled ‘Screen, then vaccinate or initiate management’ (SVIM) and ‘Vaccinate only’ (VO). The analyses were performed in 2013. All values were converted to US 2012 dollars. Results The estimated six year period-prevalence of chronic HBV infection was 6.8% in the overall refugee population arriving to Minnesota and Georgia and 7.1% in those ≥ 6 years of age. The SVIM program variation was more cost beneficial than VO. While the up-front costs of SVIM were higher than VO ($154,084 vs. $73,758; n=58,538 refugees), the SVIM proposal displayed a positive net benefit, ranging from $24 million to $130 million after only 5 years since program initiation, depending on domestic post-arrival screening rates in the VO proposal. Conclusions Chronic HBV infection remains an important health problem in refugees resettling to the United States. An overseas screening policy for chronic HBV infection is more cost-beneficial than a ‘Vaccination only’ policy. The major benefit drivers for the screening policy are earlier medical management of chronic HBV infection and averted lost societal contributions from premature death. PMID:25595868
Jazwa, Amelia; Coleman, Margaret S; Gazmararian, Julie; Wingate, La'Marcus T; Maskery, Brian; Mitchell, Tarissa; Weinberg, Michelle
Refugees are at an increased risk of chronic Hepatitis B virus (HBV) infection because many of their countries of origin, as well as host countries, have intermediate-to-high prevalence rates. Refugees arriving to the US are also at risk of serious sequelae from chronic HBV infection because they are not routinely screened for the virus overseas or in domestic post-arrival exams, and may live in the US for years without awareness of their infection status. A cohort of 26,548 refugees who arrived in Minnesota and Georgia during 2005-2010 was evaluated to determine the prevalence of chronic HBV infection. This prevalence information was then used in a cost-benefit analysis comparing two variations of a proposed overseas program to prevent or ameliorate the effects of HBV infection, titled 'Screen, then vaccinate or initiate management' (SVIM) and 'Vaccinate only' (VO). The analyses were performed in 2013. All values were converted to US 2012 dollars. The estimated six year period-prevalence of chronic HBV infection was 6.8% in the overall refugee population arriving to Minnesota and Georgia and 7.1% in those ≥6 years of age. The SVIM program variation was more cost beneficial than VO. While the up-front costs of SVIM were higher than VO ($154,084 vs. $73,758; n=58,538 refugees), the SVIM proposal displayed a positive net benefit, ranging from $24 million to $130 million after only 5 years since program initiation, depending on domestic post-arrival screening rates in the VO proposal. Chronic HBV infection remains an important health problem in refugees resettling to the United States. An overseas screening policy for chronic HBV infection is more cost-beneficial than a 'Vaccination only' policy. The major benefit drivers for the screening policy are earlier medical management of chronic HBV infection and averted lost societal contributions from premature death. Published by Elsevier Ltd.
Wingate, La'Marcus T; Coleman, Margaret S; de la Motte Hurst, Christopher; Semple, Marie; Zhou, Weigong; Cetron, Martin S; Painter, John A
This study explored the effect of screening and treatment of refugees for latent tuberculosis infection (LTBI) before entrance to the United States as a strategy for reducing active tuberculosis (TB). The purpose of this study was to estimate the costs and benefits of LTBI screening and treatment in United States bound refugees prior to arrival. Costs were included for foreign and domestic LTBI screening and treatment and the domestic treatment of active TB. A decision tree with multiple Markov nodes was developed to determine the total costs and number of active TB cases that occurred in refugee populations that tested 55, 35, and 20 % tuberculin skin test positive under two models: no overseas LTBI screening and overseas LTBI screening and treatment. For this analysis, refugees that tested 55, 35, and 20 % tuberculin skin test positive were divided into high, moderate, and low LTBI prevalence categories to denote their prevalence of LTBI relative to other refugee populations. For a hypothetical 1-year cohort of 100,000 refugees arriving in the United States from regions with high, moderate, and low LTBI prevalence, implementation of overseas screening would be expected to prevent 440, 220, and 57 active TB cases in the United States during the first 20 years after arrival. The cost savings associated with treatment of these averted cases would offset the cost of LTBI screening and treatment for refugees from countries with high (net cost-saving: $4.9 million) and moderate (net cost-saving: $1.6 million) LTBI prevalence. For low LTBI prevalence populations, LTBI screening and treatment exceed expected future TB treatment cost savings (net cost of $780,000). Implementing LTBI screening and treatment for United States bound refugees from countries with high or moderate LTBI prevalence would potentially save millions of dollars and contribute to United States TB elimination goals. These estimates are conservative since secondary transmission from tuberculosis cases
Al-Smadi, Ahmed Mohammad; Tawalbeh, Loai Issa; Khoury, Laurice Sami
Introduction Studying mental and physical health problems in refugees facilitates providing suitable health care, thus improving their quality of life. We studied depression tendency in Syrian refugees in Jordan in the light of chronic diseases and medication availability. Also, depression prevalence and depression comorbidity with chronic diseases were identified. Methods In this multicenter cross-sectional survey, data from Syrian refugees attending Caritas centers in 6 Jordanian cities from November 2013 through June 2014 were analyzed. Participants’ demographics, depression, previously diagnosed chronic diseases, and newly diagnosed chronic diseases and the availability of medications were studied. Logistic regression was used to examine predictors for depression. Results Of 765 refugees who participated, about one-third demonstrated significant depression as measured by the Beck Depression Inventory. Descriptive analyses showed that depression was comorbid in 35% of participants with previously diagnosed chronic diseases and in 40% of participants with newly diagnosed chronic diseases. Newly diagnosed chronic diseases and lack of medications significantly contributed to depression, but the regression model as a whole explained less than 5% of the variance. Conclusion Because the regression model showed low effect size, we concluded that newly diagnosed chronic diseases and medication shortages could not predict depression in Syrian refugees residing in Jordan. Therefore, further studies of additional factors are recommended. Prompt measures have to be taken to prevent the spread of chronic diseases and improve mental health in this fragile population. PMID:25633485
Roy, Laura A.
This study examines the linguistic and cultural intersections of recently arrived Somali Bantu refugee students in South Texas through the lens of border theory. The use of Spanish in the homes of refugee families is explored in addition to ways in which an educator used testimonios to honor students' migration experiences. Findings show how…
Clausen, Jens; Heinesen, Eskil; Hummelgaard, Hans
We analyse the effect of active labour-market programmes on the hazard rate into regular employment for newly arrived immigrants using the timing-of-events duration model. We take account of language course participation and progression in destination country language skills. We use rich...... administrative data from Denmark. We find substantial lock-in effects of participation in active labour-market programmes. Post programme effects on the hazard rate to regular employment are significantly positive for wage subsidy programmes, but not for other types of programmes. For language course...... participants, improvement in language proficiency has significant and substantial positive effects on the hazard rate to employment....
Full Text Available This article reflects on the first-hand life experiences of refugees ofEast/Horn of Africa origin on arrival in the UK. The experiences – someof which could be seen as humorous or sad – may be informative andrelevant for other practitioners.
Damm, Anna Piil; Rosholm, Michael
We argue that spatial dispersal influences labour market assimilation of refugees through two mechanisms: first, the local job offer arrival rate and, second, place utility. Our partial search model with simultaneous job and residential location search predicts that the reservation wage for local...... by evaluating the employment effects of the Danish spatial dispersal policy carried out 1986-1998....
Tsai, Lily P; Barr, Jennieffer A; Welch, Anthony
Refugee mothers have fled from their homeland to escape persecutions with their children only to find other threats to their well-being in the new country. Building on previous research, it is known that being a new immigrant is challenging and requires adaptation. The adaptation process, known as acculturation, may not be successful leading to psychological distress. It is also known that a generation gap can occur when children acculturate faster than their parents. What was lacking was understanding about the experiences of single refugee mothers. Interpretative phenomenological study was undertaken to explore the lived experiences of eight Burundian refugee single mothers in Australia. Data were collected by in-depth interviews. Each interviews were transcribed and analyzed using thematic analysis. Findings revealed three themes. First theme 'Traditional mothering practices of Burundian culture' illustrated mothering strategies as practiced prior to their arrival in Australia including mothering with sufficient social support, strong position of parents, and regular use of physical disciplining. Second theme 'Challenges identified after arrival to new country' revealed that mothers felt their children acculturated faster than themselves which led to intergenerational gap. This has also led participants to live in a continuous dilemma, experiencing inner conflicts and struggles associated with their mothering practices, especially when mothers had arrived with a lack of knowledge relating to acceptable mothering practices in a new culture. Final theme, 'Reforming family life in Australia' highlighted the decisions made by single refugee mothers which is to embrace both new and original cultures, leading to successful acculturation. However, lack of appropriate knowledge of acceptable mothering practices led to involvement of legal authorities who threatening to remove children from the mother's care. This has led mothers feeling change of power from 'mother to
Raman, Shanti; Wood, Nicholas; Webber, Murray; Taylor, Kellie-Ann; Isaacs, David
To document the health needs of refugee children accessing comprehensive refugee health services in New South Wales (NSW), to match needs with available services and establish gaps in services. We collated clinical data on all children aged under 14 years attending the three refugee specific clinics seeing children in NSW in 2005. We compared these data to the number of refugee children settling in NSW in 2005. NSW received 1,557 refugee children (vitamin D levels. Most children needed catch up immunisation. Other problems included chronic health, developmental and behavioural problems. Screening tests varied across sites. Follow up was problematic for most. A small proportion of refugee children arriving in NSW have access to comprehensive screening and assessment, in spite of significant health needs. There is variation in screening practices, and follow up is poor. There is a high pick up rate for diseases of personal and public health significance. There is a strong moral and public health imperative to provide appropriately resourced, culturally competent and comprehensive health care to optimise refugee children's wellbeing.
Streitwieser, Bernhard; Brueck, Lukas; Moody, Rachel; Taylor, Margaret
By the close of 2015, roughly 890,000 new refugees had arrived in Germany, more than half fleeing the ongoing Syrian Civil War. While Germany had been accustomed to heavy migration streams since the end of the Second World War, the speed of the refugee influx was unexpected. Federal, state, and municipal governments and German civil society,…
Wanigaratne, Susitha; Cole, Donald C; Bassil, Kate; Hyman, Ilene; Moineddin, Rahim; Urquia, Marcelo L
It is unknown whether the risk of preterm birth (PTB) is elevated for forced (refugee) international migrants and whether prolonged displacement amplifies risk. While voluntary migrants who arrive from a country other than their country of birth (ie, secondary migrants) have favourable birth outcomes compared with those who migrated directly from their country of birth (ie, primary migrants), secondary migration may be detrimental for refugees who experience distinct challenges in transition countries. Our objectives were (1) to determine whether refugee status was associated with PTB and (2) whether the relation between refugee status and PTB differed between secondary and primary migrants. We conducted a retrospective population-based cohort study. Ontario immigration (2002-2010) and hospitalisation data (2002-2010) were linked to estimate adjusted cumulative odds ratios (ACOR) of PTB (22-31, 32-36, 37-41 weeks of gestation), with 95% CIs (95% CI) comparing refugees with non-refugees. We further included a product term between refugee status and secondary migration. Overall, refugees (N=12 913) had 17% greater cumulative odds of short gestation (ACOR=1.17, 95% CI 1.07 to 1.28) compared with non-refugees (N=110 640). Secondary migration modified the association between refugee status and PTB (p=0.007). Secondary refugees had 58% greater cumulative odds of short gestation (ACOR=1.58, 95% CI 1.25 to 2.00) than secondary non-refugees, while primary refugees had 12% greater cumulative odds of short gestation (ACOR=1.12, 95% CI 1.02 to 1.23) than primary non-refugee immigrants. Refugee status, jointly with secondary migration, influences PTB among migrants. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
large numbers of refugees materialized. This plan, tentatively called Operation COMPASSION , envisioned that the refugees would at first be evacuated...Mptg ... —nex,- ■>• -g| ._ *M * UNCLASSIFIED * THIS MIGHT INVOLVE OVERNIGHT HOUSING FOR UP TO SDG TRANSIENT PERSONNEL. b- SUBP1IT...DDD REFUGEES AT FT CHAFFEE AND FT INDIANTOUN GAP UAS ACCOMPLISHED WITH COMPASSION AND EFFICIENCY BY THE ARMY TEAMS- ADDITIONALLY-. THE ORDERLY
St-Martin, Gry; Thusgaard, Mikkel; Simonsen, Hanne Marie
We present three cases of malaria in refugee children newly arrived from Sub-saharan Africa. Only one of the three children had fever and all had high parasite loads (2,5-14% parasitemia). Malaria is an important differential diagnosis in refugees from endemic areas, regardless of whether...
Manhica, Hélio; Gauffin, Karl; Almquist, Ylva B; Rostila, Mikael; Berg, Lisa; Rodríguez García de Cortázar, Ainhoa; Hjern, Anders
Psychological distress and lack of family support may explain the mental health problems that are consistently found in young unaccompanied refugees in Western countries. Given the strong relationship between poor mental health and alcohol misuse, this study investigated hospital admissions due to alcohol related disorders among accompanied and unaccompanied young refugees who settled in Sweden as teenagers. The dataset used in this study was derived from a combination of different registers. Cox regression models were used to estimate the risks of hospital care due to alcohol related disorders in 15,834 accompanied and 4376 unaccompanied young refugees (2005-2012), aged 13 to 19 years old when settling in Sweden and 19 to 32 years old in December 2004. These young refugees were divided into regions with largely similar attitudes toward alcohol: the former Yugoslavian republics, Somalia, and the Middle East. The findings were compared with one million peers in the native Swedish population. Compared to native Swedes, hospital admissions due to alcohol related disorders were less common in young refugees, with a hazard ratio (HR) of 0.65 and 95% confidence interval (CI) between 0.56 and 0.77. These risks were particularly lower among young female refugees. However, there were some differences across the refugee population. For example, the risks were higher in unaccompanied (male) refugees than accompanied ones (HR = 1.49, 95% CI = 1.00-2.19), also when adjusted for age, domicile and income. While the risks were lower in young refugees from Former Yugoslavia and the Middle East relative to native Swedes, independent of their length of residence in Sweden, refugees from Somalia who had lived in Sweden for more than ten years showed increased risks (HR = 2.54, 95% CI = 1.71-3.76), after adjustments of age and domicile. These risks decreased considerably when income was adjusted for. Young refugees have lower risks of alcohol disorders compared with native
On 11 December 2007, the Federal Court allowed Jose Hernandez's application for judicial review of a November 2006 decision by the Refugee Protection Division of the Immigration and Refugee Board, which found that the applicant was neither a Convention refugee nor a person in need of protection. Hernandez had requested that the Board's decision be set aside and the matter referred back to a newly constituted panel of the Board for re-determination.
Hainmueller, Jens; Hangartner, Dominik; Lawrence, Duncan
European governments are struggling with the biggest refugee crisis since World War II, but there exists little evidence regarding how the management of the asylum process affects the subsequent integration of refugees in the host country. We provide new causal evidence about how one central policy parameter, the length of time that refugees wait in limbo for a decision on their asylum claim, affects their subsequent economic integration. Exploiting exogenous variation in wait times and registry panel data covering refugees who applied in Switzerland between 1994 and 2004, we find that one additional year of waiting reduces the subsequent employment rate by 4 to 5 percentage points, a 16 to 23% drop compared to the average rate. This deleterious effect is remarkably stable across different subgroups of refugees stratified by gender, origin, age at arrival, and assigned language region, a pattern consistent with the idea that waiting in limbo dampens refugee employment through psychological discouragement, rather than a skill atrophy mechanism. Overall, our results suggest that marginally reducing the asylum waiting period can help reduce public expenditures and unlock the economic potential of refugees by increasing employment among this vulnerable population.
Hainmueller, Jens; Hangartner, Dominik; Lawrence, Duncan
European governments are struggling with the biggest refugee crisis since World War II, but there exists little evidence regarding how the management of the asylum process affects the subsequent integration of refugees in the host country. We provide new causal evidence about how one central policy parameter, the length of time that refugees wait in limbo for a decision on their asylum claim, affects their subsequent economic integration. Exploiting exogenous variation in wait times and registry panel data covering refugees who applied in Switzerland between 1994 and 2004, we find that one additional year of waiting reduces the subsequent employment rate by 4 to 5 percentage points, a 16 to 23% drop compared to the average rate. This deleterious effect is remarkably stable across different subgroups of refugees stratified by gender, origin, age at arrival, and assigned language region, a pattern consistent with the idea that waiting in limbo dampens refugee employment through psychological discouragement, rather than a skill atrophy mechanism. Overall, our results suggest that marginally reducing the asylum waiting period can help reduce public expenditures and unlock the economic potential of refugees by increasing employment among this vulnerable population. PMID:27493995
Faustine K. Nkulu Kalengayi
Full Text Available Background: Screening newly arrived migrants from countries with high burden of communicable diseases of public health significance is part of the Swedish national strategy against the spread of these diseases. However, little is known about its implementation. Objective: This study aimed at exploring caregivers’ experiences in screening newly arrived migrants to generate knowledge that could inform policy and clinical practice. Design: Using an interpretive description framework, we conducted semistructured interviews between November and December 2011 in four Swedish counties, with 15 purposively selected nurses with experience in screening migrants. Data were analyzed using thematic analysis. Results: Participants described a range of challenges including discordant views between migrants and the nurses about medical screening, inconsistencies in rules and practices, and conflicting policies. Participants indicated that sociocultural differences resulted in divergent expectations with migrants viewing the participants as agents of migration authorities. They also expressed concern over being given a new assignment without training and being expected to share responsibilities with staff from other agencies without adequate coordination. Finally, they indicated that existing policies can be confusing and raise ethical issues. All these were compounded by language barriers, making their work environment extremely complex and stressful. Conclusions: These findings illuminate complex challenges that could limit access to, uptake, and delivery of health screening and undermine public health goals, and highlight the need for a multilevel approach. This entails avoiding the conflation of migration with health issues, harmonizing existing policies to make health care services more accessible and acceptable to migrants, and facilitating health professionals’ work in promoting public health, improving interagency collaboration and the skills of all
Mitchell, Tarissa; Lee, Deborah; Weinberg, Michelle; Phares, Christina; James, Nicola; Amornpaisarnloet, Kittisak; Aumpipat, Lalita; Cooley, Gretchen; Davies, Anita; Tin Shwe, Valerie Daw; Gajdadziev, Vasil; Gorbacheva, Olga; Khwan-Niam, Chutharat; Klosovsky, Alexander; Madilokkowit, Waritorn; Martin, Diana; Htun Myint, Naing Zaw; Yen Nguyen, Thi Ngoc; Nutman, Thomas B; O'Connell, Elise M; Ortega, Luis; Prayadsab, Sugunya; Srimanee, Chetdanai; Supakunatom, Wasant; Vesessmith, Vattanachai; Stauffer, William M
With an unprecedented number of displaced persons worldwide, strategies for improving the health of migrating populations are critical. United States-bound refugees undergo a required overseas medical examination to identify inadmissible conditions (e.g., tuberculosis) 2-6 months before resettlement, but it is limited in scope and may miss important, preventable infectious, chronic, or nutritional causes of morbidity. We sought to evaluate the feasibility and health impact of diagnosis and management of such conditions before travel. We offered voluntary testing for intestinal parasites, anemia, and hepatitis B virus infection, to U.S.-bound refugees from three Thailand-Burma border camps. Treatment and preventive measures (e.g., anemia and parasite treatment, vaccination) were initiated before resettlement. United States refugee health partners received overseas results and provided post-arrival medical examination findings. During July 9, 2012 to November 29, 2013, 2,004 refugees aged 0.5-89 years enrolled. Among 463 participants screened for seven intestinal parasites overseas and after arrival, helminthic infections decreased from 67% to 12%. Among 118 with positive Strongyloides -specific antibody responses, the median fluorescent intensity decreased by an average of 81% after treatment. The prevalence of moderate-to-severe anemia (hemoglobin migration process to improve the health of refugees before resettlement. With more than 250 million migrants globally, this model may offer insights into healthier migration strategies.
Earnest, Jaya; Mansi, Ruth; Bayati, Sara; Earnest, Joel Anthony; Thompson, Sandra C
In Australia, the two major pathways of refugee entry are the United Nations High Commissioner for Refugees resettlement programme and irregular maritime arrivals (IMAs) seeking asylum. The Australian Government's policies towards IMAs since July 2013 are controversial, uncompromising and consistently harsh, with asylum seekers held in detention centres for prolonged periods. Refugees and asylum seekers have distinct and unique stressors that make resettlement difficult. This exploratory study examines resettlement experiences for refugee youth in Western Australia using the psychosocial conceptual framework and qualitative methods. Focus group discussions and key informant interviews were undertaken with verbatim transcripts analysed using thematic analysis to identify themes. Themes documented that language and its impact, and experience with education, health, and social activities, support structures provided to youth and supporting future aspirations as critical to successful resettlement. This exploratory study contributes to developing a broader understanding of the resettlement experiences of refugee youth, drawing on their current and past experiences, cultural differences and mechanisms for coping. Fluency in English language, especially spoken, was a facilitator of successful resettlement. Our results align with previous studies documenting that support programs are vital for successful resettlement. Although faced with immense difficulties refugee youth are resilient, want to succeed and have aspirations for the future. Strategies and recommendations suggested by refugee youth themselves could be used for developing interventions to assist successful resettlement.
This qualitative study examines eight elder women's experiences of resettling with their family and the protective factors that enhanced their resiliency. The implications for social work include the need to assess elder refugees' strengths, resilience, pre-resettlement functioning instead of services that might encourage integration into the dominant culture and community, and that the refugee experience is a lifelong experience that shapes and informs various stages of life.
Full Text Available Abstract Background Psychological distress and lack of family support may explain the mental health problems that are consistently found in young unaccompanied refugees in Western countries. Given the strong relationship between poor mental health and alcohol misuse, this study investigated hospital admissions due to alcohol related disorders among accompanied and unaccompanied young refugees who settled in Sweden as teenagers. Methods The dataset used in this study was derived from a combination of different registers. Cox regression models were used to estimate the risks of hospital care due to alcohol related disorders in 15,834 accompanied and 4376 unaccompanied young refugees (2005–2012, aged 13 to 19 years old when settling in Sweden and 19 to 32 years old in December 2004. These young refugees were divided into regions with largely similar attitudes toward alcohol: the former Yugoslavian republics, Somalia, and the Middle East. The findings were compared with one million peers in the native Swedish population. Results Compared to native Swedes, hospital admissions due to alcohol related disorders were less common in young refugees, with a hazard ratio (HR of 0.65 and 95% confidence interval (CI between 0.56 and 0.77. These risks were particularly lower among young female refugees. However, there were some differences across the refugee population. For example, the risks were higher in unaccompanied (male refugees than accompanied ones (HR = 1.49, 95% CI = 1.00–2.19, also when adjusted for age, domicile and income. While the risks were lower in young refugees from Former Yugoslavia and the Middle East relative to native Swedes, independent of their length of residence in Sweden, refugees from Somalia who had lived in Sweden for more than ten years showed increased risks (HR = 2.54, 95% CI = 1.71–3.76, after adjustments of age and domicile. These risks decreased considerably when income was adjusted for. Conclusion Young
Full Text Available The sharp increase in refugee numbers arriving in the European Union has recently caused major and manifold challenges for the member states and their administrative services. Location based situation reports and maps may support the refugee management from local to European level. The first support is mapping of the geographical distribution of migrating people which needs more or less real time data. The actual data sources are location related observations along the routes of refugees, actual satellite observations and data mining results. These tools and data are used to monitor spatial distributions as well as extrapolate the arrival of refugees for the subsequent weeks. The second support is the short term update of the location of initial registration facilities and first reception facilities, their capacities, and their occupancy. The third management level is the systematic inquiry for unoccupied housing facilities and for empty places within build-up areas. Geo-coded data sets of house numbers have to be cross-referenced with city maps and communal inhabitants address data. The legal aspects of data mining and secured access to personal data are strictly controlled by the administration allowing only limited access and distribution of data and results. However, the paper will not disclose scientific progress in Earth Observation and GIS, but will actually demonstrate an urgently needed new combination of existing methods to support actual needs. The societal benefits of EO/GIS are no longer just potential possibilities, but actual results in real political, administrative and humanitarian day to day reality.
Shakya, Yogendra; Gagnon, Anita J; Cole, Donald C; Rashid, Meb; Blake, Jennifer; Dastoori, Parisa; Moineddin, Rahim; Ray, Joel G; Urquia, Marcelo L
Objectives Immigrants are thought to be healthier than their native-born counterparts, but less is known about the health of refugees or forced migrants. Previous studies often equate refugee status with immigration status or country of birth (COB) and none have compared refugee to non-refugee immigrants from the same COB. Herein, we examined whether: (1) a refugee mother experiences greater odds of adverse maternal and perinatal health outcomes compared with a similar non-refugee mother from the same COB and (2) refugee and non-refugee immigrants differ from Canadian-born mothers for maternal and perinatal outcomes. Design This is a retrospective population-based database study. We implemented two cohort designs: (1) 1:1 matching of refugees to non-refugee immigrants on COB, year and age at arrival (±5 years) and (2) an unmatched design using all data. Setting and participants Refugee immigrant mothers (n=34 233), non-refugee immigrant mothers (n=243 439) and Canadian-born mothers (n=615 394) eligible for universal healthcare insurance who had a hospital birth in Ontario, Canada, between 2002 and 2014. Primary outcomes Numerous adverse maternal and perinatal health outcomes. Results Refugees differed from non-refugee immigrants most notably for HIV, with respective rates of 0.39% and 0.20% and an adjusted OR (AOR) of 1.82 (95% CI 1.19 to 2.79). Other elevated outcomes included caesarean section (AOR 1.04, 95% CI 1.00 to 1.08) and moderate preterm birth (AOR 1.08, 95% CI 0.99 to 1.17). For the majority of outcomes, refugee and non-refugee immigrants experienced similar AORs when compared with Canadian-born mothers. Conclusions Refugee status was associated with a few adverse maternal and perinatal health outcomes, but the associations were not strong except for HIV. The definition of refugee status used herein may not sensitively identify refugees at highest risk. Future research would benefit from further refining refugee status based on migration
Full Text Available As outlined in the Department of Immigration and Border Protection Annual report 2016–17, Australia granted 21 928 humanitarian visas in 2016–17, 13 760 of them offshore. This number will increase in future to a planned offshore program of 18 750 in 2018–19. The report notes that the United Nations High Commissioner for Refugees ranks Australia third for the number of refugees resettled. With such a massive program and commitment by the Australian Government, the need to ensure that health and wellbeing are maintained or gained during the settlement process is paramount. This article outlines how collaboration between like-minded national governments can improve premigration health screening through information sharing, collaborative learning and increased capability in countries of origin to not only screen for illness and disability, but to more effectively put measures in place to address these before, during and after arrival. Australia, Canada, New Zealand, the UK and the US have worked together for more than a decade on migration health screening policies to ensure better management of health needs and successful resettlement. A case study about the Syrian refugee cohort, which began arriving in Australia in late 2015, illustrates how intergovernmental collaboration can improve settlement.
Thiel de Bocanegra, Heike; Carter-Pokras, Olivia; Ingleby, J David; Pottie, Kevin; Tchangalova, Nedelina; Allen, Sophia I; Smith-Gagen, Julie; Hidalgo, Bertha
The cumulative total of persons forced to leave their country for fear of persecution or organized violence reached an unprecedented 24.5 million by the end of 2015. Providing equitable access to appropriate health services for these highly diverse newcomers poses challenges for receiving countries. In this case study, we illustrate the importance of translating epidemiology into policy to address the health needs of refugees by highlighting examples of what works as well as identifying important policy-relevant gaps in knowledge. First, we formed an international working group of epidemiologists and health services researchers to identify available literature on the intersection of epidemiology, policy, and refugee health. Second, we created a synopsis of findings to inform a recommendation for integration of policy and epidemiology to support refugee health in the United States and other high-income receiving countries. Third, we identified eight key areas to guide the involvement of epidemiologists in addressing refugee health concerns. The complexity and uniqueness of refugee health issues, and the need to develop sustainable management information systems, require epidemiologists to expand their repertoire of skills to identify health patterns among arriving refugees, monitor access to appropriately designed health services, address inequities, and communicate with policy makers and multidisciplinary teams. Copyright © 2017. Published by Elsevier Inc.
Media reports, political statements, and social media debates on the refugee/migrant crisis shape the ways in which people and societies respond to those displaced people arriving at their borders world wide. These current events are framed and experienced as a crisis, entering the media, capturing
Tingvold, Laila; Vaage, Aina Basilier; Allen, James; Wentzel-Larsen, Tore; van Ta, Thong; Hauff, Edvard
We investigated acculturative hassles in a community cohort of Vietnamese refugees in Norway (n = 61), exploring cross-sectional data and longitudinal predictors of acculturative hassles using data from their arrival in Norway in 1982 (T1), with follow up in 1985 (T2) and in 2005-2006 (T3). To our knowledge, this is the first longitudinal study of predictors of acculturative hassles in a refugee population. Results indicated that more communication problems and less Norwegian language competence were related to most hassles at T3. Higher psychological distress, lower quality of life, lower self-reported state of health, and less education at T3 were associated with higher levels of hassles at T3. More psychological distress at T2 and less education at arrival (T1) were significant predictors for more acculturative hassles at T3. These data suggest that addressing psychological distress during the early phase in a resettlement country may promote long-term refugee adjustment and, in particular, reduce exposure to acculturative hassles. © The Author(s) 2015.
Full Text Available Members of Congress have introduced numerous pieces of legislation in recent years related to refugees, asylum seekers, and other populations of migrants seeking protection in the United States. These bills were drafted in reaction to dramatic events within the United States, at its borders, and around the world. For example, roughly 400,000 children traveling alone and mothers with children have arrived at the southern US border since 2013, many seeking protection from organized crime, gang violence, and threats of human trafficking. Similarly, more than a million refugees from the Middle East, North Africa, and Asia sought to reach safety on the European continent in 2015 alone. Terrorist attacks fueled attempts to curtail the US commitment to offer protection to those fleeing persecution, even when those attacks had no connection to refugees or only tenuous links. And yet existing US law has been left virtually unchanged throughout this tumultuous period. This article describes the significant attempts to enact legislation related to refugees and international migrants since 2013 and examines the reasons why those attempts have not succeeded. It also describes American attitudes toward refugees and assesses whether those attitudes affected the fate of legislation.
Anna Piil Damm; Michael Rosholm
Spatial dispersal policies may influence labour market integration of refugees through two mechanisms. First, it may affect the local job offer arrival rate, and second, it may affect place utility. We investigate the second mechanism theoretically by formulating a partial search model in which an individual searches simultaneously for a job and for a new residential location. The model predicts that the reservation wage for local jobs is decreasing in place utility. We argue that spatial dis...
Febles, C; Nies, M A; Fanning, K; Tavernier, S S
The recent crisis in the Middle East has prompted the exodus of millions of refugees from the region who are at present seeking shelter across Europe and in the United States. Among the most immediate needs of refugees upon arrival in a host country is health care, and it is one of the most sustained interactions they experience. Home visits are a common form of primary care for refugees. The authors review the literature to identify themes related to challenges and strategies for providing home based primary care to refugees. The literature review was performed by searching cross-disciplinary databases utilizing Onesearch, but focusing primarily on results produced through CINAHL, EBSCOHOST, and Pub Med databases. To maximize the number of studies included, there was no time frame placed upon publication dates of articles within the search. A total of 55 articles were included in this paper.
Jen, K-L Catherine; Zhou, Kequan; Arnetz, Bengt; Jamil, Hikmet
Refugees have typically experienced stress and trauma before entering the US. Stressors and mental health disorders may contribute to obesity. The aim of this study was to investigate changes in the body mass index (BMI) in Iraqi refugees settled in Michigan in relationship to pre- and post-migration stressors and mental health. Anthropometric and demographic data were collected from 290 Iraqi refugees immediately after they arrived in Michigan and one year after settlement. Significant increases were observed in BMI (+0.46 ± 0.09 kg/m(2), p refugees suffering from hypertension (from 9.6 to 13.1%, p migration trauma and social support, were also observed. Linear regression analyses failed to link stressors, well-being, and mental health to changes in BMI. It is likely that acculturation to a new lifestyle, including dietary patterns and physical activity levels, may have contributed to these changes.
Toole, M J; Waldman, R J
The number of refugees and internally displaced persons in need of protection and assistance has increased from 30 million in 1990 to more than 43 million today. War and civil strife have been largely responsible for this epidemic of mass migration that has affected almost every region of the world, including Europe. Since 1990, crude death rates (CDRs) during the early influx of refugees who crossed international borders have been somewhat lower than CDRs reported earlier among Cambodian and Ethiopian refugees. Nevertheless, CDRs among refugees arriving in Ethiopia, Kenya, Nepal, Malawi, and Zimbabwe since 1990 ranged from five to 12 times the baseline CDRs in the countries of origin. Among internally displaced populations in northern Iraq, Somalia, and Sudan, CDRs were extremely high, ranging from 12 to 25 times the baseline CDRs for the nondisplaced. Among both refugees and internally displaced persons, death rates among children less than 5 years of age were far higher than among older children and adults. In Bangladesh, the death rate in female Rohingya refugees was several times higher than in males. Preventable conditions such as diarrheal disease, measles, and acute respiratory infections, exacerbated often by malnutrition, caused most deaths. Although relief programs for refugees have improved since 1990, the situation among the internally displaced may have worsened. The international community should intervene earlier in the evolution of complex disasters involving civil war, human rights abuses, food shortages, and mass displacement. Relief programs need to be based on sound health and nutrition information and should focus on the provision of adequate shelter, food, water, sanitation, and public health programs that prevent mortality from diarrhea, measles, and other communicable diseases, especially among young children and women.
Dara, Masoud; Solovic, Ivan; Sotgiu, Giovanni; D'Ambrosio, Lia; Centis, Rosella; Tran, Richard; Goletti, Delia; Duarte, Raquel; Aliberti, Stefano; de Benedictis, Fernando Maria; Bothamley, Graham; Schaberg, Tom; Abubakar, Ibrahim; Teixeira, Vitor; Ward, Brian; Gratziou, Christina; Migliori, Giovanni Battista
No evidence exists on tuberculosis (TB) and latent TB infection (LTBI) management policies among refugees in European countries.A questionnaire investigating screening and management practices among refugees was sent to 38 national TB programme representatives of low and intermediate TB incidence European countries/territories of the WHO European Region.Out of 36 responding countries, 31 (86.1%) reported screening for active TB, 19 for LTBI, and eight (22.2%) reporting outcomes of LTBI treatment. Screening for TB is based on algorithms including different combinations of symptom-based questionnaires, bacteriology and chest radiography and LTBI screening on different combinations of tuberculin skin test and interferon-γ release assays. In 22 (61.1%) countries, TB and LTBI screening are performed in refugee centres. In 22 (61.1%) countries, TB services are organised in collaboration with the private sector. 27 (75%) countries answered that screening for TB is performed as per national and international guidelines, while 19 (52.7%) gave the same answer with regards to LTBI screening. Infection control measures are inadequate in several of the countries surveyed.There is need for improved coordination of TB screening in Europe to implement the End TB Strategy and achieve TB elimination. Copyright ©ERS 2016.
Goers, Matthew; Ope, Maurice O; Samuels, Aaron; Gitu, Natalia; Akandwanaho, Saul; Nabwami, Gladys; Nyoka, Raymond; Cetron, Martin S; Dalal, Warren; Conroy, Andrea L; Cantey, Paul; John, Chandy; Naoum, Marwan; Weinberg, Michelle; Marano, Nina; Stauffer, William
Approximately 70,000-90,000 refugees are resettled to the United States each year, and during the next 5 years, 50,000 Congolese refugees are expected to arrive in the United States. The International Organization for Migration (IOM) performs refugee medical examinations overseas for the U.S. Refugee Resettlement Program. In 2014, IOM reported that a large number of U.S.-bound Congolese refugees from Uganda had spleens that were enlarged on examination. During two evaluations of refugee populations in western Uganda in March and July 2015, refugees with splenomegaly on physical examination were offered additional assessment and treatment, including abdominal ultrasonography and laboratory testing. Among 987 persons screened, 145 (14.7%) had splenomegaly and received further testing. Among the 145 patients with splenomegaly, 63.4% were aged 5-17 years (median = 14.8 years). There was some evidence of family clustering, with 33 (22.7%) of the 145 cases occurring in families.
Hampel, Annika; Solbach, Philipp; Cornberg, Markus; Schmidt, Reinhold E; Behrens, Georg M N; Jablonka, Alexandra
Currently only vague estimates exist for the seroprevalence and vaccination status for viral hepatitis B (HBV) in refugees arriving in Germany during the current refugee crisis. To assess the prevalence of hepatitis B in refugees arriving in northern Germany in 2015. In a cross-sectional study in 793 patients from all age groups tests for serological markers of hepatitis B virus infection (HBsAg, anti-HBc) and liver enzymes (ALT, AST, bilirubin, γGT, alkaline phosphatase) were performed in August 2015 at six reception centers in northern Germany. In 258 patients anti-HBs antibodies were assessed additionally. Of the tested refugees, 76.7 % were male, the median age was 28.8 ± 11.4 years, and 7.8 % were children under the age of 18. The overall prevalence of HBsAg and total anti-HBc was 2.3 % and 14.0 % respectively (2.5 % and 14.5 % in men; 1.2 % and 13.5 % in women). Prevalence was highest in 35 to 49-year-old patients for HBsAg (3.1 %) and for refugees over 50 years for anti-HBc (38 %). No immunity to Hepatitis B was found in 62 %, 18.6 % had been vaccinated against Hepatitis B, while 50 % of children aged up to 15 years (n = 12) had been vaccinated. Positive predictive values of elevated AST and ALT for detection of HBsAg was 0 and 0.016, respectively. Only two patients with a positive HBsAg had elevated transaminases. This study showed a high prevalence of HBsAg in a German refugee sample in comparison to the general German population. Liver enzymes are not an appropriate tool for screening for hepatitis B virus infection.
Damm, Anna Piil; Rosholm, Michael
Spatial dispersal policies may influence labour market integration of refugees through two mechanisms. First, it may affect the local job offer arrival rate, and second, it may affect place utility. We investigate the second mechanism theoretically by formulating a partial search model in which a...... due to large local reservation wage effects. We investigate both mechanisms empirically and test the predictions of the theoretical model by evaluating the employment effects of the Danish spatial dispersal policy carried out 1986-1998....
O'Mahony, J M; Donnelly, T T
The number of migrants arriving in Canada from non-European countries has grown significantly over the past three decades. How best to assist these escalating numbers of immigrant and refugee women to adapt to their new environment and to cope with postpartum depression (PPD) is a pressing issue for healthcare providers. Evidence has shown that immigrant and refugee women experience difficulties in accessing care and treatment for PPD. This qualitative study was conducted with 30 immigrant and refugee women using in-depth interviews to obtain information about the women's PPD experiences. The primary aim was to explore how cultural, social, political, historical and economic factors intersect with race, gender and class to influence the ways in which immigrant and refugee women seek help to manage PPD. Results reveal that immigrant and refugee women experience many complex gender-related challenges and facilitators in seeking equitable help for PPD treatment and prevention. We will demonstrate that (a) structural barriers and gender roles hinder women's ability to access necessary mental healthcare services and (b) insecure immigration status coupled with emotional and economic dependence may leave women vulnerable and disadvantaged in protecting themselves against PPD. © 2012 John Wiley & Sons Ltd.
This essay attempts to disentangle a debate within the study of refugee crises and their security implications involving 'refugee warriors'. It situates the debate in the context of the Iraqi refugee crisis and its purported and real manifestations in three main host countries: Syria, Jordan and
Minnesota State Dept. of Health, St. Paul. Refugee Education Resource Center.
This is a directory of (print) health education materials for Indochinese refugees, refugee sponsors, and refugee health providers. Materials listed for refugees cover dental health, diseases, family planning, infant and child health, maternal care and pregnancy, legal systems, nutrition, patient instruction, and education. The directory also…
Full Text Available Twenty-three of 26 participants, mainly women from six local agencies involved in the reception of refugees, completed a university course titled “Refugee-related stress and mental health—local cooperation”, which was spread over seven days in 2011. The course was based on evidence and clinical experience and was commissioned to serve as competency training by Stockholm County Council and Södertälje Municipality. It received funding from the Swedish National Board of Health and Welfare. It was a continuation of an earlier one-week full-time university course from 2010 with the same title. As a result of a new law relating to refugee reception, which led to organizational change, the participants requested a continuation of the original course. The learning objectives were met (5.4 on a 6-point scale; 1 = strongly disagree, 6 = strongly agree. The general assessment of the course as a whole by the participants was 5.7 (on a 6-point scale, 1 = very unsatisfied, 6 = very satisfied. The participants thought that their skills had increased, and their perception was that they had significantly better control of their work situation following completion of the course. The most important findings were that participants from different agencies at the local level: (1 perceived that they had developed the sense that there was a local inter-cultural and inter-professional inter-agency collaboration in the reception of newly arrived refugees and (2 will continue efforts to stabilize and develop this together. This method of teaching, in terms of skills training, is not a “quick fix.” It is a process, and it needs support from those in power in order to continue.
Full Text Available Over half of the world’s more than 10 million refugees are inMuslim countries while 9 million of the total of over 26 millionIDPs worldwide are displaced in the Muslim world, including over800,000 newly displaced as a result of the ‘Arab Spring’ uprisings.
Stingl, Markus; Knipper, Michael; Hetzger, Björge; Richards, Jessica; Yazgan, Bülent; Gallhofer, Bernd; Hanewald, Bernd
Although EU member states are obligated to take special account of the situation of particularly vulnerable refugees, appropriate and specific measures to detect affected asylum seekers are not yet available. This study tries to pave the way for the implementation of an adequate instrument which at the same time assesses these needs of suffering people whilst responding to the need for mental health assessments specifically designed for refugees. This was done by testing the implementation of a screening method (Refugee Health Screener RHS-15) for trauma related mental health problems in refugees. Two refugee samples in Germany (differing in arrival time: 126 applicants for asylum residing in the initial reception center and 116 living in long term communal accommodations) were assessed with the culturally sensitive Refugee Health Screener (RHS-15) to detect the incidence of mental health problems amongst them. Test fairness, reasonableness, susceptibility, transparency, acceptance, external design, utility and economy of the instrument were examined to check the applicability of the RHS-15 standardization test. The RHS-15 indicates a good practical feasibility as the examination of the focused psychometric characteristics suggests. It became apparent, that implementing a screening procedure depends on political, legal and medical context factors that need to be considered. 2/3 of the participants had a positive screening result, which needs further diagnostic clarification in a second step. The RHS-15 seems to be practicable, economical, and rapidly deployable for the widespread detection of traumatic disorders in refugees living in Europe. The tool proved useful to aid diagnostic assessments and provide treatment to individuals in need, however the time of examination (resp. the duration of staying in the target land) influences the results.
Yanni, Emad A; Naoum, Marwan; Odeh, Nedal; Han, Pauline; Coleman, Margaret; Burke, Heather
More than 63,000 Iraqi refugees were resettled in the United States from 1994 to 2010. We analyzed data for all US-bound Iraqi refugees screened in International Organization for Migration clinics in Jordan during June 2007-September 2009 (n = 18,990), to describe their health profile before arrival in the United States. Of 14,077 US-bound Iraqi refugees ≥ 15 years of age, one had active TB, 251 had latent TB infection, and 14 had syphilis. No HIV infections were reported. Chronic diseases comorbidities accounted for a large burden of disease in this population: 35% (n = 4,105) of screened Iraqi refugees had at least one of three chronic medical conditions; hypertension, diabetes mellitus, or obesity. State health departments and clinicians who screen refugees need to be aware of the high prevalence of chronic diseases among Iraqi refugees resettled in the United States. These results will help public health specialists develop policies to reduce morbidity and mortality among US-bound Iraqi refugees.
Ng Chok, Harrison; Mannix, Judy; Dickson, Cathy; Wilkes, Lesley
This scoping review presents an exploration of international literature on the factors that impact refugees' personal and professional experiences during their journey to being registered nurses in a new host country. Governments of host countries receiving refugees seek to develop strategies that facilitate the successful resettlement, employment and enculturation of refugees that arrive as skilled professionals. There is a scarcity of studies focussing on issues faced by refugees that are RNs or those pursuing nursing registration and employment in a new host country. This study is relevant for resettlement services, nursing registration authorities and education providers and informs the international nursing workforce. Scoping review. Databases such as MEDLINE, EMBASE, Cochrane Library, CINAHL; Google Scholar; PubMed; Scopus and Web of Science were searched for qualitative studies published up to and including 2017. Articles that did not specify explicitly the participants as registered nurses and/or refugees were excluded. All eligible articles were analysed for collective findings, and impact factors were extracted, synthesised and illustrated diagrammatically. This review explored six eligible articles and six impact factors were identified. The challenging impacts were as follows: loss of control; shock in a new environment and bleak employment prospects. Equally three impact factors: reconciling new reality; establishing a new identity and hope for the future, facilitate positive experiences for nurses in their successful transition into society and the nursing workplace. This scoping review reports the small number of international studies on the experiences of refugees seeking to become registered and employed as registered nurses. The six impact factors identified influence the lives of the nurse participants socio-economically in and out of the workplace. Policymakers, managers and educators providing resettlement, registration and employment services
Sport organisations aim to grow the participation of culturally and linguistically diverse communities, including newly arrived people from refugee backgrounds. Drawing on multi-sited ethnographic research conducted by the author at community sport organisations in the multicultural city of
Namer, Yudit; Razum, Oliver
Refugees and asylum seekers arriving in Europe during the 2015/2016 wave of migration have been exposed to war conditions in their country of origin, survived a dangerous journey, and often struggled with negative reception in transit and host countries. The mental health consequence of such forced migration experiences is named the Ulysses syndrome. Policies regarding the right to residency can play an important role in reducing mental health symptoms. We propose that facilitating a sense of belonging should be seen as one important preventive mental healthcare intervention. A refugee mental health agenda needs to take into account the interplay between refugees' and asylum seekers' mental health, feeling of belonging, and access to healthcare. We urge for policies to restore individuals' dignity, and recognize the right for homecoming to parallel the mythology of Ulysses. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Hartwig, Kari A; Mason, Meghan
Refugees and new immigrants arriving in the United States (U.S.) often encounter a multitude of stressors adjusting to a new country and potentially coping with past traumas. Community gardens have been celebrated for their role in improving physical and emotional health, and in the Twin Cities of Minnesota, have been offered as a resource to immigrants and refugees. The purpose of this study is to present a mixed method evaluation of a refugee gardening project hosted by area churches serving primarily Karen and Bhutanese populations. Quantitative data were obtained from early and late season surveys (44 and 45 % response rates, respectively), and seven focus groups conducted at the end of the season provided qualitative data. Although few gardeners (4 %) identified food insecurity as a problem, 86 % indicated that they received some food subsidy, and 78 % reported vegetable intake increased between the early and late season surveys. Twelve percent of gardeners indicated possible depression using the PHQ-2 scale; in focus groups numerous respondents identified the gardens as a healing space for their depression or anxiety. Refugee gardeners expressed receiving physical and emotional benefits from gardening, including a sense of identity with their former selves. Gardens may serve as a meaningful health promotion intervention for refugees and immigrants adjusting to the complexity of their new lives in the U.S. and coping with past traumas.
facilitating irregular migration grows, unfortunately so too do attempts to exploit migrants and refugees by smugglers, criminal networks, governments, or members of local communities (Gammeltoft-Hansen and Nyberg Sørensen 2013. The “deterrence paradigm” can be understood as a particular instantiation of the global refugee protection regime. It shows how deterrence policies have come to dominate responses to asylum seekers arriving in developed states, and how such policies have continued to develop in response to changes in migration patterns as well as legal impositions. The dominance of the deterrence paradigm also explains the continued reliance on deterrence as a response to the most recent “crisis,” despite continued calls from scholars and civil society for a more protection-oriented and sustainable response. The paper argues that the current “crisis,” more than a crisis in terms of refugee numbers and global protection capacity, should be seen a crisis in terms of the institutionalized responses so far pursued by states. Deterrence policies are being increasingly challenged, both by developments in international law and by less wealthy states left to shoulder the vast majority of the world’s refugees. At the same time, recent events suggest that deterrence policies may not remain an effective tool to prevent secondary movement of refugees in the face of rising global protection needs, while deterrence involves increasing direct and indirect costs for the states involved. The present situation may thus be characterized as, or at least approaching, a period of paradigm crisis, and we may be seeing the beginning of the end for deterrence as a dominant policy paradigm in regard to global refugee policy. In its place, a range of more or less developed alternative policy frameworks are currently competing, though so far none of them appear to have gained sufficient traction to initiate an actual paradigm shift in terms of global refugee policy. Nonetheless
Cook, Tonya L; Shannon, Patricia J; Vinson, Gregory A; Letts, James P; Dwee, Ehtaw
Karen refugees have suffered traumatic experiences that affect their physical and mental health in resettlement. The United States Centers for Disease Control and Prevention recommends assessing traumatic histories and mental health symptoms during initial public health screening. This article reports the traumatic experiences that Karen refugees were able to describe during a short screening and contributes knowledge to existing human rights documentation systems. Four semi-structured and open-ended items asked about lifetime experiences of war trauma and torture. Interviews were completed with adult, Karen refugees during their initial public health screening. Experiences of war trauma and torture were coded using the extensive Human Rights Information and Documentation (HURIDOCS) Micro-thesauri coding system. Additional codes were created to describe experiences not captured by existing codes. Over 85% of 179 Karen people interviewed experienced life-threatening war trauma. All participants who reported war trauma or torture stories were able to describe at least one event. New war trauma codes proposed include: widespread community fear, systematic destruction/burning of house or village, exposure to dead bodies, orphaned in the context of war, injury caused by a landmine, fear of Thai police or deportation from Thailand, and harm or killings in the context of war. New torture codes include: forced portering; forced to be a human landmine sweep; forced to be a soldier, including child soldier; forced contact with a dead body; and removal of the eyes. Karen refugees were able to report traumatic experiences in the context of a brief health screening. The findings confirm existing reports of human rights violations against Karen people and suggest that additional codes be added to the HURIDOCS Micro-thesauri system that is used by torture treatment centers. Understanding the nature of traumatic experiences of this group is important for health providers working
Full Text Available In the wake of the Hungarian Revolution of 1956, close to two hundred thousand Hungarians crossed into Austria. About thirty thousand of these refugees were allowed to enter the United States. Their common experience of living under totalitarian communism and participating or being a witness to the exhilarating thirteen days of the revolution and their sudden, previously unplanned, departure from the homeland gave them a collective identity that was different from the one shared by the people of previous waves of Hungarian influx to the United States. The high educational level of the refugees attained before and after their arrival made their absorption into the mainstream relatively easy. The integration process was facilitated by the shaping of a positive image of the 1956 refugees by the US government and the media. The reestablishment of the communist system in post-1956 Hungary contributed to the perception that, for the refugees in the United States, there was no hope for return to the homeland. This assumption strengthened the attitudes of those who wished to embrace the American melting pot model. Many of the 1956-ers in the United Sates, however, were also comfortable with the notion of ethnic pride and believed in the shaping of a dual national identity.
Rasmussen, Andrew; Crager, Mia; Baser, Ray E; Chu, Tracy; Gany, Francesca
Although refugees are generally thought to be at increased risk for posttraumatic stress disorder (PTSD) and major depressive episode (MDE), few studies have compared onset of PTSD and MDE between refugees and voluntary migrants. Given differences in migration histories, onset should differ pre- and postmigration. The National Latino and Asian American Survey (NLAAS) is a national representative, complex dataset measuring psychiatric morbidity, mental health service use, and migration history among Latino and Asian immigrants to the United States. Of the 3,260 foreign-born participants, 660 were refugees (a weighted proportion of 9.52%). Refugees were more likely to report a history of war-related trauma, but reports of other traumatic events were similar. Premigration onset of PTSD was statistically higher for refugees than voluntary migrants, odds ratio (OR) = 4.86, 95% confidence interval (CI) [2.01, 11.76], where postmigration onset for PTSD was not, OR = 0.61, 95% CI [0.29, 1.28]; a similar pattern was found for MDE, OR = 1.98, 95% CI [1.11, 3.51]; and OR = 1.02, 95% CI [0.65, 1.62], respectively. Although refugees arrive in host countries with more pressing psychiatric needs, onset is comparable over time, suggesting that postmigration refugees and voluntary migrants may be best served by similar programs. Copyright © 2012 International Society for Traumatic Stress Studies.
Taylor, J Edward; Filipski, Mateusz J; Alloush, Mohamad; Gupta, Anubhab; Rojas Valdes, Ruben Irvin; Gonzalez-Estrada, Ernesto
In 2015, the United Nations High Commission for Refugees accommodated over 15 million refugees, mostly in refugee camps in developing countries. The World Food Program provided these refugees with food aid, in cash or in kind. Refugees' impacts on host countries are controversial and little understood. This unique study analyzes the economic impacts of refugees on host-country economies within a 10-km radius of three Congolese refugee camps in Rwanda. Simulations using Monte Carlo methods reveal that cash aid to refugees creates significant positive income spillovers to host-country businesses and households. An additional adult refugee receiving cash aid increases annual real income in the local economy by $205 to $253, significantly more than the $120-$126 in aid each refugee receives. Trade between the local economy and the rest of Rwanda increases by $49 to $55. The impacts are lower for in-kind food aid, a finding relevant to development aid generally.
Atanasoska, Tatjana; Proyer, Michelle
This paper offers first-hand accounts of refugees beyond the age of compulsory education having arrived in Austria during the last five years. Their accounts were collected using qualitative interviews and a visual method to allow for different approaches towards their educational biographies. Nine individual and two group interviews (altogether…
Full Text Available Public and political claims about the employment of people from a refugee background in Australia do not always reflect the research findings in this area. For example, recent claims by a senior Coalition Government Minister about people seeking asylum who arrived to Australia by boat during the previous Labor Government’s terms in office (2007-13 posit that many have limited employment prospects. However, given there is little research or government reporting on the experiences of asylum seekers who arrived during this time, and none that focuses specifically on their employment, there is no evidence to support this. A review of research on the employment experiences of people from a refugee background, and Australian policies, suggests a more nuanced picture. This includes research that found while initially people from a refugee background are more likely to be unemployed, have temporary jobs and lower incomes than other newly arrived immigrants, second-generation refugees have higher levels of labour market participation than the general population. Research also highlights that refugees may experience a range of barriers to accessing employment, including discrimination, and a review of Australian policies indicates these are likely to have exacerbated some of these barriers for asylum seekers who arrived to Australia by boat. In addition, given previous findings that public attitudes can be influenced by representations made in public and political discourses, the public statements of senior Ministers may be further deepening barriers to accessing employment faced by asylum seekers who arrived by boat.
Blitz, Brad K; d'Angelo, Alessio; Kofman, Eleonore; Montagna, Nicola
The arrival of more than one million migrants, many of them refugees, has proved a major test for the European Union. Although international relief and monitoring agencies have been critical of makeshift camps in Calais and Eidomeni where infectious disease and overcrowding present major health risks, few have examined the nature of the official reception system and its impact on health delivery. Drawing upon research findings from an Economic and Social Research Council (ESRC) funded project, this article considers the physical and mental health of asylum-seekers in transit and analyses how the closure of borders has engendered health risks for populations in recognised reception centres in Sicily and in Greece. Data gathered by means of a survey administered in Greece (300) and in Sicily (400), and complemented by in-depth interviews with migrants (45) and key informants (50) including representatives of government offices, humanitarian and relief agencies, NGOs and activist organisations, are presented to offer an analysis of the reception systems in the two frontline states. We note that medical provision varies significantly from one centre to another and that centre managers play a critical role in the transmission of vital information. A key finding is that, given such disparity, the criteria used by the UNHCR to grade health services reception do not address the substantive issue that prevent refugees from accessing health services, even when provided on site. Health provision is not as recorded in UNHCR reporting but rather there are critical gaps between provision, awareness, and access for refugees in reception systems in Sicily and in Greece. This article concludes that there is a great need for more information campaigns to direct refugees to essential services.
Bouhenia, Malika; Farhat, Jihane Ben; Coldiron, Matthew E; Abdallah, Saif; Visentin, Delphine; Neuman, Michaël; Berthelot, Mathilde; Porten, Klaudia; Cohuet, Sandra
In 2015, more than 1 million refugees arrived in Europe. During their travels, refugees often face harsh conditions, violence and torture in transit countries, but there is a lack of quantitative evidence on their experiences. We present the results of a retrospective survey among refugees in the 'Jungle' of Calais, France, to document their health problems and the violence they endured during their journeys. We conducted a cross-sectional population-based survey in November and December 2015. The sample size was set at 402 individuals, and geospatial simple random sampling was used. We collected data on demographics, routes travelled, health status, violence and future plans. Departures from the country of origin increased beginning in September 2015. Sixty-one percent of respondents reported having at least one health problem, especially while in Calais. Overall, 65.6% (95% CI 60.3-70.6) experienced at least one violent event en route; 81.5% of refugees wanted to go to the UK. This first quantitative survey conducted among refugees in Europe provides important socio-demographic data on refugees living in Calais and describes the high rate of violence they encountered during their journeys. Similar documentation should be repeated throughout Europe in order to better respond to the needs of this vulnerable population. © The Author 2017. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.
Kalipeni, E; Oppong, J
Political violence in civil war and ethnic conflicts has generated millions of refugees across the African continent with unbelievable pictures of suffering and unnecessary death. Using a political ecology framework, this paper examines the geographies of exile and refugee movements and the associated implications for re-emerging and newly emerging infectious diseases in great detail. It examines how the political ecologic circumstances underlying the refugee crisis influences health services delivery and the problems of disease and health in refugee camps. It has four main themes, namely, an examination of the geography of the refugee crisis: the disruption of health services due to political ecologic forces that produce refugees; the breeding of disease in refugee camps due to the prevailing desperation and destitution; and the creation of an optimal environment for emergence and spread of disease due to the chaotic nature of war and violence that produces refugees. We argue in this paper that there is great potential of something more virulent than cholera and Ebola emerging and taking a big toll before being identified and controlled. We conclude by noting that once such a disease is out in the public rapid diffusion despite political boundaries is likely, a fact that has a direct bearing on global health. The extensive evidence presented in this paper of the overriding role of political factors in the refugee health problem calls for political reform and peace accords, engagement and empowerment of Pan-African organizations, foreign policy changes by Western governments and greater vigilance of non-governmental organizations (NGOs) in the allocation and distribution of relief aid.
Kim, Seong-Hyeon; Kim, Hee Kyung; Lee, Narae
This study examined the heterogeneity in the Minnesota Multiphasic Personality Inventory-2nd Edition (MMPI-2; Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) profiles of North Korean female refugee population (N = 2,163) using latent profile analysis (LPA). The North Korean female refugee sample arrived at Hanawon, South Korea's resettlement center for North Korean refugees in 2008 and 2009 and took the MMPI-2 as part of an initial psychological screen. The analysis, which included the T scores of the 6 validity scales and the 10 standard clinical scales, identified 4 classes with distinctive psychological features: Class 1 (nonclinical), Class 2 (demoralized), Class 3 (somatized), and Class 4 (detached). The 4 covariates entered into the model (age, education, affiliation with a religion, and the number of forced repatriations) impacted the likelihood of belonging to certain classes. As hypothesized, older age, fewer years of education, and more incidents of forced repatriation predicted higher proneness to psychopathology. However, contrary to our expectation, having a religious faith did not emerge as a salient protective factor. The current LPA results revealed distinct heterogeneous subgroups that previous research on the MMPI and MMPI-2 profiles of refugee populations overlooked with the assumption of a homogeneous sample. Clinical implications for the treatment of North Korean female refugees and the limitations of the study are discussed. (c) 2013 APA, all rights reserved.
Hollifield, Michael; Toolson, Eric C; Verbillis-Kolp, Sasha; Farmer, Beth; Yamazaki, Junko; Woldehaimanot, Tsegaba; Holland, Annette
Screening for emotional distress is important, but not widely available. This study assesses the utility of the Refugee Health Screener 15 (RHS-15) in a public health setting. Refugee Health Screener 15 and diagnostic proxy (DP) instruments assessing anxiety, depression, and posttraumatic stress disorder were administered to refugees from 3 countries at their public health examination. Properties of the RHS-15 and its components were evaluated utilizing appropriate methods. Scale Cronbach α was 0.95, and a factor analysis identified 1 factor accounting for 66% of scale variance. Refugee Health Screener 15 scores and cases discriminated between refugee groups similar to DPs. Refugee Health Screener 15 case sensitivity and specificity to DPs were acceptable (≥0.87/0.77). A shorter, 13-item component had acceptable metric properties. The RHS-15 appears to be a valid screener for emotional distress of refugees. The 13-item scale may be more efficient and as efficacious for case identification. The critical public health need and recommendations for implementation are discussed.
Arsenijević, Jovana; Schillberg, Erin; Ponthieu, Aurelie; Malvisi, Lucio; Ahmed, Waeil A Elrahman; Argenziano, Stefano; Zamatto, Federica; Burroughs, Simon; Severy, Natalie; Hebting, Christophe; de Vingne, Brice; Harries, Anthony D; Zachariah, Rony
Pushed by ongoing conflicts and pulled by the desire for a better life, over one million migrants/refugees transited Balkan countries and arrived in Europe during 2015 and early 2016. To curb this influx, European countries instituted restrictive migration policies often characterized by building of razor-wire border fences and border closures. Among migrants/refugees who received mental health care in Serbia while travelling through Balkan countries to Northern Europe, we assessed the prevalence and patterns of violent events experienced including physical trauma. A mixed methods study among migrants/refugees attending mobile mental health clinics run by Médecins sans Frontières (MSF) between July 2015 and June 2016, in Serbia - a main transit hub to European countries. Clinics were conducted according to MSF guidelines by experienced psychologists who were supported by cultural mediators. The main outcome measures were violent events and associated physical trauma. Of 992 migrants/refugees attending MSF mental health clinics, the majority (72%) were from Syria and Afghanistan and included vulnerable groups (14%) such as unaccompanied minors and pregnant women. The most frequent mental health symptoms/signs were anxiety (29%) and adjustment reactions (26%). Of the 992 migrants/refugees, 270 (27%) had experienced violent events during their journey. Signs of physical trauma due to acts of violence were seen in 223(22%) of the 992 individuals, 144 (65%) being perpetrated by State authorities and involving women (11%) and children (13%). Border closures along the Balkan route were associated with a dramatic decrease in registered migrants/refugee arrivals in Serbia. Conversely, among those that made it across the borders, an increasing linear trend in reported violent events was observed at MSF mental health clinics ( X 2 for linear trend, P European countries were the perpetrators in over half of such events which were associated with border closures. There is "a
Vennskapelig integrering : en studie av krysskulturelle erfaringer med vennskap og integrering, samt en vurdering av nyankomne flyktningers mulighet for anerkjennelse gjennom introduksjonslovens fokus på kvalifisering
Knutsen, Linn Iren Engemyr
Masteroppgave religion REL500 - Universitetet i Agder 2016 This study is a qualitative study focusing on the experience refugee families and Norwegian families derived from a friendship family service during the period 1981 until today. The friendship family service was, and is, a service with the objective to create contact between newly arrived refugees and Norwegians. The study also contains ethical reflections linked to the term qualify and/or qualifying which is used in connection wit...
Dharod, Jigna M.; Croom, Jamar E.; Sady, Christine G.
Objective: To examine the association between food insecurity, dietary intake, and body mass index among Somali refugee women living in the United States. Methods: Cross-sectional study utilizing the snowball sampling method. Results: Most (67%) participants experienced some level of food insecurity, which was common among recent arrivals and…
Hirani, Kajal; Cherian, Sarah; Mutch, Raewyn; Payne, Donald N
Adolescent refugees encounter traumatic stressors and are at risk of developing psychosocial health problems; limited research data exist internationally. This study aims to identify health risk behaviours among adolescent refugees resettling in Western Australia and assess the feasibility of using a standardised adolescent health questionnaire for this purpose. Refugees aged 12 years and above attending a tertiary Refugee Health Service (RHS) were recruited over 12 months. Sociodemographic data were collected. Psychosocial assessments based on the ' H ome, E ducation/Eating, A ctivities, D rugs, S exuality, S uicide/mental health' (HEADSS) framework were undertaken utilising interpreters where required. Health concerns identified were managed through the RHS. A total of 122 adolescents (20 ethnicities) participated; 65% required interpreters. Median age (range) was 14 (12-17) years. Most (80%) had nuclear family separation. Almost half (49%) had a deceased/missing family member. A third (37%) had lived in refugee camps and 20% had experienced closed detention. The median time (range) since arrival in Australia was 11 (2-86) months. Every adolescent had at least one health concern identified during the psychosocial assessment. Frequency of health concerns identified in each domain were 87% for home, 66% for education, 23% for eating, 93% for activities, 5% for drugs, 88% for sexuality and 61% for suicide/mental health. Most adolescents (75%) required intervention, consisting of counselling for health risk behaviours and/or referral to health or community services. It is feasible to use a standardised adolescent health questionnaire to identify health risk behaviours among a cohort of ethnically diverse adolescent refugees. Use of the questionnaire identified a large burden of psychosocial health issues requiring multidisciplinary intervention. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved
Blitz, Brad K.; d’Angelo, Alessio; Kofman, Eleonore; Montagna, Nicola
The arrival of more than one million migrants, many of them refugees, has proved a major test for the European Union. Although international relief and monitoring agencies have been critical of makeshift camps in Calais and Eidomeni where infectious disease and overcrowding present major health risks, few have examined the nature of the official reception system and its impact on health delivery. Drawing upon research findings from an Economic and Social Research Council (ESRC) funded project, this article considers the physical and mental health of asylum–seekers in transit and analyses how the closure of borders has engendered health risks for populations in recognised reception centres in Sicily and in Greece. Data gathered by means of a survey administered in Greece (300) and in Sicily (400), and complemented by in-depth interviews with migrants (45) and key informants (50) including representatives of government offices, humanitarian and relief agencies, NGOs and activist organisations, are presented to offer an analysis of the reception systems in the two frontline states. We note that medical provision varies significantly from one centre to another and that centre managers play a critical role in the transmission of vital information. A key finding is that, given such disparity, the criteria used by the UNHCR to grade health services reception do not address the substantive issue that prevent refugees from accessing health services, even when provided on site. Health provision is not as recorded in UNHCR reporting but rather there are critical gaps between provision, awareness, and access for refugees in reception systems in Sicily and in Greece. This article concludes that there is a great need for more information campaigns to direct refugees to essential services. PMID:29189766
Brad K. Blitz
Full Text Available The arrival of more than one million migrants, many of them refugees, has proved a major test for the European Union. Although international relief and monitoring agencies have been critical of makeshift camps in Calais and Eidomeni where infectious disease and overcrowding present major health risks, few have examined the nature of the official reception system and its impact on health delivery. Drawing upon research findings from an Economic and Social Research Council (ESRC funded project, this article considers the physical and mental health of asylum–seekers in transit and analyses how the closure of borders has engendered health risks for populations in recognised reception centres in Sicily and in Greece. Data gathered by means of a survey administered in Greece (300 and in Sicily (400, and complemented by in-depth interviews with migrants (45 and key informants (50 including representatives of government offices, humanitarian and relief agencies, NGOs and activist organisations, are presented to offer an analysis of the reception systems in the two frontline states. We note that medical provision varies significantly from one centre to another and that centre managers play a critical role in the transmission of vital information. A key finding is that, given such disparity, the criteria used by the UNHCR to grade health services reception do not address the substantive issue that prevent refugees from accessing health services, even when provided on site. Health provision is not as recorded in UNHCR reporting but rather there are critical gaps between provision, awareness, and access for refugees in reception systems in Sicily and in Greece. This article concludes that there is a great need for more information campaigns to direct refugees to essential services.
Full Text Available How does the press in Hungary write about refugees, asylum-seekers and refugee affairs? We sought to answer this question. Articles appearing in 2005 and 2006 in two leading national Hungarian dailies were examined with quantitative content analysis. The results show that the articles analyzed often treat refugee affairs as an “official” political matter. The high proportion of legislation and political positions conveys the image that refugee affairs are a state or intergovernmental matter, an “official”, legal, political issue rather than for example a humanitarian question. Most of the articles published in both papers write about problems and conflicts in connection with refugee affairs. The negative media image has different significance for different topics. We argue that the question of refugee affairs is a topic where the image shown by the media is of great relevance: the media can be a more important source of information on this subject than personal contacts.
Patricia A Ongpin
Full Text Available Studying the impact that a refugee population has on itshost country’s economy is important when assessing anddeveloping government refugee strategies, particularly inprotracted refugee situations.
Lucht, Marianne; Knoke, Gudrun Elke; Mortensen, Karen Rask
and a digital survey with about a 100 respondents – all of them newly arrived refugees in Aalborg. The didactic design with an underlying social constructive knowledge approach and including the smartphone technology WhatsApp, was developed and tested through two interventions with a Danish class at Sprogcenter...
Shawyer, Frances; Enticott, Joanne C; Doherty, Anne R; Block, Andrew A; Cheng, I-Hao; Wahidi, Sayed; Meadows, Graham N
Refugees and asylum seekers have high rates of risk factors for mental disorders. In recent years, Australia has experienced a rapid increase in asylum seeker arrivals, creating new challenges for services in areas with high settlement numbers. This paper describes the design, including analytic framework, of a project set in a refugee health service in the state of Victoria, Australia, as part of their response to meeting the mental health needs of their burgeoning local population of refugees and asylum seekers. In order to assist service planning, the primary aim of this study is to determine: 1) an overall estimate of the prevalence of psychiatric disorders; 2) the specific prevalence of post-traumatic stress disorder 3) the perceived need and unmet need for mental health treatment. The secondary aim of the study is to establish matched risk ratios based on an Australian-born matched comparison group from the 2007 National Survey of Mental Health and Well-Being. A cross-sectional survey is used to estimate the prevalence of psychiatric disorders in refugees and asylum seekers attending a local refugee health service. Measures include the Kessler Psychological Distress Scale-10, the Post-Traumatic Stress Disorder-8, the General-practice User's Perceived-need Inventory together with service utilisation questions from the National Survey of Mental Health and Well-Being. Data collected from refugees and asylum seekers (n = 130) is matched to existing data from Australian-born residents drawn from the 2007 National Survey of Mental Health and Well-Being (n = 520) to produce estimates of the risk ratio. The paper describes a prototype for what is possible within regular services seeking to plan for and deliver high quality mental health care to refugees and asylum seekers. A novel project output will be the development and dissemination of an epidemiological methodology to reliably compare mental health status in a relatively small target sample with a matched
Lamkaddem, M.; Essink-Bot, M.; Gerritsen, A.A.M.; Devillé, W.; Stronks, K.
Introduction: Refugees and asylum seekers are an important group of new immigrants in today’s Europe. Despite recent research efforts information on changes in health upon resettlement is scarce. We analyzed the mechanisms underlying changes in mental and physical health after arrival in The
Thacher, Tom D; Pludowski, Pawel; Shaw, Nick J; Mughal, M Zulf; Munns, Craig F; Högler, Wolfgang
programs that include screening for micronutrient deficiencies, in addition to assessing infections and vaccination programs. Due to their high prevalence of vitamin D deficiency, refugee children of all ages from these ethnic groups should be supplemented with vitamin D, beginning upon arrival.
Mareng, Chuei D.
This reflective study explores refugee students' perceptions of the educational approach used in Kakuma Refugee Camp in Kenya. The study focuses on my personal reflections as a teacher and a student in this camp, and as a refugee. My goal of writing this narrative is to reflect fully on the refugee students' life in a camp and then contribute to…
Full Text Available European Union and its Member States have tried at least at political level to solve the problem of migrants and refugees inflows coming to Europe from the Middle East trough Turkey and Greece. Latest attempts in this regard are represented by the 2015 European Union-Turkey Action Plan and the 2016 Statement of the European Union and Turkey which contained measures aimed to control the irregular migration and human trafficking acts, in accordance with the European Union law and international standards of refugee law. Although the aforementioned acts refer to concrete provisional and extraordinary measures concerning different categories of persons arriving in Greece and applying for asylum and they were actually put in practice by Turkey, their legally binding force is controversial in the context of the recent interpretation of the Court of Justice of the European Union in some similar cases, in which the Court found that the 2016 Statement is not an act concluded by the institutions of the European Union and it is not an agreement legally binding. In other words, it represents a political statement which is excluded from the legality examination of the Court. Although the decision of the Court may be legally correct for procedural reasons, this situation raises questions concerning the commitment of the European Union and its institutions to really analyse and find effective measures regarding persons arriving in the European Union territory and claiming international protection according to international standards. The aim of this paper is to analyse the legal implications of the 2015 Joint Action Plan and the 2016 Statement and their compatibility with the international legal standard of refugees and to show the lack of resilience in adapting to refugee and irregular migration problems, contrary to the European Union values and principles.
Gabriel, Patricia; Kaczorowski, Janusz; Berry, Nicole
Research is needed to understand refugees' health challenges and barriers to accessing health services during settlement. However, there are practical and ethical challenges for engaging refugees as participants. Despite this, there have been no studies to date specifically investigating refugee perspectives on factors affecting engagement in health research. Language-concordant focus groups in British Columbia, Canada, with four government-assisted refugee language groups (Farsi/Dari, Somali, Karen, Arabic) inquired about willingness to participate in health research. Twenty-three variables associated with the willingness of refugees to participate in health research were elicited. Variables related to research design included recruitment strategies, characteristics of the research team members and the nature of the research. Variables related to individual participants included demographic features such as gender and education, attitudes towards research and previous experience with research. This research can be used to increase opportunities for refugees' engagement in research and includes recommendations for subgroups of refugees that may have more difficulties engaging in research.
Nof Nasser Eddin
Full Text Available This article argues that the situation of Palestinian refugees is still relevant till this day. There are around five million refugees living in neighbouring Arab countries, such as Lebanon, Jordan, Syria and Egypt, as well as neighbouring areas in Palestine itself, like the West Bank and Gaza Strip, under very precarious conditions. Their situation is extremely unstable as any changes in the region can influence them directly. The need to address this issue is particularly important because Palestinian refugees (as well as internally displaced Palestinians have been both historically and politically marginalised. In particular, I will argue for a need to gender the debate around the Palestinian refugees, because the distinct experience of women Palestinian refugees has been overlooked within this context. Most literature has focused on the Palestinian refugees as a holistic population, which assumes all refugees share the same struggle. However, understanding the position of women within the context of the refugees and the unique struggles they face is essential to understanding their particular experiences as refugees and in highlighting their differential needs; this is why a feminist perspective is needed within the field of refugee studies. This article is based on a feminist journey drawing on research interviews with female Palestinian refugees in camps in Jordan, and with Syrian Palestinian women in Turkey, Jordan and Europe.
O'Neal, Colleen R.; Gosnell, Nicole M.; Ng, Wai Sheng; Ong, Edward
Given the current refugee crisis, the development of sustainable postconflict refugee education systems and supports is essential. The present study reports Resilient Refugee Education (RRE) intervention effects on refugee teacher confidence and knowledge of classroom management, in addition to refugee teacher self-care in Malaysia. We compared…
Full Text Available Academic discourse tends to view the labor market as a central sphere in the refugee integration process, while other aspects related to the market economy, such as capital accumulation and the purchase of goods, gain less attention if at all. Studying these issues from the perspective of African refugees in Israel enables us to examine alternative means through which the refugee community seeks to integrate into the socio-economic arena in the host culture by adopting popular consumption patterns. The study explores consumer culture among refugees as a means through which they borrow, adopt and translate what they perceive to be the attributes of the desired lifestyle in the host country. Based on ethnographic work, the study examines the ways in which consumption practices form a socio-cultural bridge to blur social boundaries between refugees and Western society. By adopting commodity and consumption patterns, African refugees seek to become a part of the Israeli collective and distance themselves from the monolithic identity of alien-African-refugees.
Al-qudsi, S S
Relying on demographic and labor surveys which the Palestinian Central Bureau of Statistics collected in 1995, this article investigates the profile of West Bank and Gaza refugees. Refugees are better educated and have higher fertility than non-refugee Palestinians, but the difference is small. However, they have a significantly lower participation rate, a higher unemployment rate and a higher incidence of arrests and work stoppage than the corresponding rates among non-refugee Palestinians. A smaller proportion of Palestinians commute to work into the Israeli labor market and refugees earn lower wages than nonrefugees. Returns to investment in education are small for both groups. High fertility among refugees imposes a future challenge for policy makers in terms of resources required for the provision of appropriate education and health facilities. Employing future labor market entrants is another serious policy challenge.
Presswell, N J
Family planning services were introduced in Vietnam by the Americans about 20 years ago, but on a limited basis. Many of the Vietnamese refugee women have had no contact with such services. Abortion was illegal until 1975 in South Vietnam, but since the takeover, abortion clinics have been available as part of the public hospital system. Family planning was available in some of the refugee camps. Most of the Vietnam refugees fled their country by boat. Before their acceptance by Australia, the Vietnamese refugees have health checks by the Australian Commonwealth Health Department in the country of transit. Shortly after their arrival in Australia, health screening is done by the State Health Department. The majority of refugees are accommodated in migrant hostels for the 1st 3-12 months. Family planning is incorporated into Eastbridge Hostel's orientation program. During participation in some family planning discussion groups with the Indochinese refugees, it was observed that the women were particularly shy and hesitant to talk about sexual concerns in a large group or in mixed company. As personal matters are dealt with in the family, it is preferable to have a female as a discussion leader and interpreter. Visual aids such as a display of contraceptive devices, a model showing female anatomy and a family planning film for non-English speaking migrants are particularly useful. As a female doctor using a female interpreter the aim was to provide an accessible service for Indochinese women with family planning inquiries or gynecological problems. It is important that the interpreter is present in the consulting room. Nonverbal cues are most important and particular attention should be paid to establishing eye contact with the patient. Simple miming techniques or the use of diagrams may be helpful in reinforcing the work of the interpreter. When listening to the patient, it is useful to look and listen for nonverbal cues from them. Between February 1980 and May 1981
Full Text Available Seeking asylum is a human right, enshrined in the Universal Declaration of Human Rights. The 1951 Convention relating to the Status of Refugees (“Refugee Convention” and its 1967 Protocol relating to the Status of Refugees (“1967 Protocol” prohibit the United States from returning refugees to persecution, and the 1980 Refugee Act set up a formal process for applying for asylum in the United States. However, the Illegal Immigration Reform and Immigrant Responsibility Act of 1996 (IIRIRA created a barrage of new barriers to asylum. These impediments have blocked many refugees from accessing asylum in the United States and inserted additional layers of technicalities, screening, and processing, undermining the effectiveness of the US asylum system. The barriers imposed by IIRIRA are significant. They include a filing deadline on asylum applications, which prevents genuine refugees from receiving asylum if they cannot prove they have filed the application within one year of arriving in the United States. IIRIRA also established summary deportation procedures, including “expedited removal” and “reinstatement of removal,” which block asylum seekers from even applying for asylum or accessing an immigration court removal hearing, unless they first pass through a screening process. Finally, IIRIRA imposed “mandatory detention” on certain immigrants, including asylum seekers who are placed in expedited removal proceedings upon their arrival at a US port of entry. Each of these provisions imposed new processes and procedures that have contributed to an increasingly ineffective immigration system. The current backlog in the immigration courts has reached a record high, surpassing half a million cases, while the backlog of affirmative asylum cases before the Asylum Division of US Citizenship and Immigration Services (USCIS has increased by a factor of six [check] in just three years. Backlogs, which lead to long delays in adjudication
Norredam, Marie; Agyemang, Charles; Hoejbjerg Hansen, Oluf K; Petersen, Jørgen H; Byberg, Stine; Krasnik, Allan; Kunst, Anton E
The 'healthy migrant effect' (HME) hypothesis postulates that health selection has a positive effect on migrants' health outcomes, especially in the first years after migration. We examined the potential role of the HME by assessing the association between residence duration and disease occurrence. We performed a historical prospective cohort study. We included migrants who obtained residence permits in Denmark between 1 January 1993 and 31 December 2010 (n = 114,331). Occurrence of severe conditions was identified through linkage to the Danish National Patient Register. Hazard Ratios (HRs) were modelled for disease incidence by residence duration since arrival (0-5 years; 0-10 years; 0-18 years) adjusting for age and sex. Compared with Danish-born individuals, refugees and family reunited immigrants had lower HRs of stroke and breast cancer within 5 years after arrival; however, HRs increased at longer follow-up. For example, HRs of stroke among refugees increased from 0.77 (95% CI: 0.66; 0.91) to 0.96 (95% CI: 0.88; 1.05). For ischaemic heart disease (IHD) and diabetes, refugees and family reunited migrants had higher HRs within 5 years after arrival, and most HRs had increased by end of follow-up. For example, HRs of IHD among family reunited migrants increased from 1.29 (95% CI: 1.17; 1.42) to 1.43 (95% CI: 1.39; 1.52). In contrast, HRs for TB and HIV/AIDS showed a consistent decrease over time. Our analyses of the effect of duration of residence on disease occurrence among migrants imply that, when explaining migrants' advantageous health outcomes, the ruling theory of the HME should be used with caution, and other explanatory models should be included. © 2014 John Wiley & Sons Ltd.
Del Pinto, R; Pietropaoli, D; Russomando, U; Evangelista, P; Ferri, C
The recent sociopolitical events in the Mediterranean and Middle Eastern areas have significantly impacted international migration flows. As disease prevalence and type are different among western and Afro-Asian countries, physicians dealing with refugees should be aware of their specific health needs. We aimed at evaluating the health status and disease history of refugees at their arrival in the urban area of L'Aquila (Italy). This is a monocentric cross-sectional study. Refugees hosted at the local reception center in L'Aquila (Italy) between July 2014 and December 2014 were cross-sectionally evaluated for anamnestic, clinical, and laboratory features. A subset of randomly selected participants underwent further assessments (screening for tuberculosis, hepatitis B/C, human immunodeficiency virus, syphilis; ambulatory blood pressure measurement [ABPM]) to better define their health status. Ninety-three adult male refugees (27.34 ± 7.41 years) from Africa (76%) and Asia (24%) were enrolled. Overall, the most prevalent diseases according to the International Statistical Classification of Diseases and Related Health Problems 10th revision affected the digestive tract (15.6%) and musculoskeletal apparatus (14.4%). The analysis by continent of origin did not show significant differences in the distribution of diseases, although a trend toward some differences was observed. African refugees had a significantly greater prevalence of viral hepatitis (hepatitis B virus, P = 0.004; hepatitis C virus, P = 0.007) compared with Asians. Hypertension, as detected by ABPM, was uncommon. No written vaccination history was available. Health issues of our sample of Afro-Asian refugees span both non-communicable and communicable diseases, requiring attention for the safety of the individual and the community. National health systems should provide adequate information and shared guidelines for health professionals regarding identification and management of refugees' health
LeMaster, Joseph W; Broadbridge, Carissa L; Lumley, Mark A; Arnetz, Judith E; Arfken, Cynthia; Fetters, Michael D; Jamil, Hikmet; Pole, Nnamdi; Arnetz, Bengt B
Refugees frequently experience symptoms of posttraumatic stress and depression, which impede their acculturation in the new host country where they are resettling. There are few longitudinal studies investigating predictors of mental health and acculturation during the early postmigration period. We conducted a longitudinal study of 298 Iraqi refugees, assessing them upon arrival to the U.S. and 1 year after migration. Premigration trauma was associated with increased PTSD and depressive symptoms at baseline, and with decreased acculturation 1 year later. Resilience was associated with depressive symptoms at 1-year follow-up, but not with other resettlement outcomes (PTSD symptoms, English-language skills, or acculturation). PTSD and depressive symptoms at baseline predicted the same symptoms at 1-year follow-up, but not any other resettlement outcomes. The number of chronic diseases at baseline predicted worse PTSD and depressive symptoms, acculturation, and English language skills at 1-year follow up. Postmigratory exposure to daily stressors and less social support predicted worse 1-year outcomes. Results suggest that interventions that aim to improve mental health and promote acculturation among refugees should assess their history of trauma, chronic disorders, and psychological symptoms soon after migration, and promptly provide opportunities for social support. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Canzi, Elena; Rosnati, Rosa; Miller, Laurie C
Following initial adversities, most internationally adopted children arrive with significant growth delays. Post-placement recovery has been widely documented, but research about risk or protective factors is still limited. Even less is known about the relationship between growth recovery and the quality of the family environment. 28 children in 26 adoptive families were involved in this longitudinal study. A comprehensive evaluation (including anthropometry, cognitive assessment [using the Leiter International Performance Scale-Revised], and completion by both parents of the Parenting Stress Index - Short Form) was done at arrival of the child, and 1 year later. Results evidenced that on arrival nearly half of children had growth measurements in the normal range. All the children showed a significant recovery in height and weight at 6 and 12 months post-placement. Initial and follow up growth measurements correlated strongly. Growth recovery was related to the age of the child at adoption, the proportion of time the child had resided in institutional care, as well as parenting stress. Results suggested that the higher the parenting stress experienced the less improvements occurred in children: for mothers for height and weight, for fathers for all the growth indicators. Results suggested the critical importance of family factor in influencing children's growth recovery.
de Sherbinin, Michael J., Ed.
This report presents an update and analysis of refugee and/or resettlement situations in Africa, Asia, the Middle East, Europe and Canada, and Latin America. Described are activities undertaken by the following refugee organizations: (1) the Office of United Nations High Commissioner for Refugees (UNHCR); (2) the Intergovernmental Committee for…
Sijbrandij, Marit; Acarturk, Ceren; Bird, Martha; Bryant, Richard A; Burchert, Sebastian; Carswell, Kenneth; de Jong, Joop; Dinesen, Cecilie; Dawson, Katie S; El Chammay, Rabih; van Ittersum, Linde; Jordans, Mark; Knaevelsrud, Christine; McDaid, David; Miller, Kenneth; Morina, Naser; Park, A-La; Roberts, Bayard; van Son, Yvette; Sondorp, Egbert; Pfaltz, Monique C; Ruttenberg, Leontien; Schick, Matthis; Schnyder, Ulrich; van Ommeren, Mark; Ventevogel, Peter; Weissbecker, Inka; Weitz, Erica; Wiedemann, Nana; Whitney, Claire; Cuijpers, Pim
The crisis in Syria has resulted in vast numbers of refugees seeking asylum in Syria's neighbouring countries as well as in Europe. Refugees are at considerable risk of developing common mental disorders, including depression, anxiety, and posttraumatic stress disorder (PTSD). Most refugees do not have access to mental health services for these problems because of multiple barriers in national and refugee specific health systems, including limited availability of mental health professionals. To counter some of challenges arising from limited mental health system capacity the World Health Organization (WHO) has developed a range of scalable psychological interventions aimed at reducing psychological distress and improving functioning in people living in communities affected by adversity. These interventions, including Problem Management Plus (PM+) and its variants, are intended to be delivered through individual or group face-to-face or smartphone formats by lay, non-professional people who have not received specialized mental health training, We provide an evidence-based rationale for the use of the scalable PM+ oriented programmes being adapted for Syrian refugees and provide information on the newly launched STRENGTHS programme for adapting, testing and scaling up of PM+ in various modalities in both neighbouring and European countries hosting Syrian refugees.
Miranda, Chandler P.
The 2016 presidential election was dominated by anti-immigrant rhetoric where truths counted for less than bombast, obscuring the fact that the majority of refugees and immigrants are women and children. This article describes how teachers and students in a school for newly arrived immigrants are adapting to the reality of the new administration.
Hollander, Anna-Clara; Dal, Henrik; Lewis, Glyn; Magnusson, Cecilia; Kirkbride, James B; Dalman, Christina
To determine whether refugees are at elevated risk of schizophrenia and other non-affective psychotic disorders, relative to non-refugee migrants from similar regions of origin and the Swedish-born population. Cohort study of people living in Sweden, born after 1 January 1984 and followed from their 14th birthday or arrival in Sweden, if later, until diagnosis of a non-affective psychotic disorder, emigration, death, or 31 December 2011. Linked Swedish national register data. 1,347,790 people, including people born in Sweden to two Swedish-born parents (1,191,004; 88.4%), refugees (24,123; 1.8%), and non-refugee migrants (132,663; 9.8%) from four major refugee generating regions: the Middle East and north Africa, sub-Saharan Africa, Asia, and Eastern Europe and Russia. Cox regression analysis was used to estimate adjusted hazard ratios for non-affective psychotic disorders by refugee status and region of origin, controlling for age at risk, sex, disposable income, and population density. 3704 cases of non-affective psychotic disorder were identified during 8.9 million person years of follow-up. The crude incidence rate was 38.5 (95% confidence interval 37.2 to 39.9) per 100,000 person years in the Swedish-born population, 80.4 (72.7 to 88.9) per 100,000 person years in non-refugee migrants, and 126.4 (103.1 to 154.8) per 100,000 person years in refugees. Refugees were at increased risk of psychosis compared with both the Swedish-born population (adjusted hazard ratio 2.9, 95% confidence interval 2.3 to 3.6) and non-refugee migrants (1.7, 1.3 to 2.1) after adjustment for confounders. The increased rate in refugees compared with non-refugee migrants was more pronounced in men (likelihood ratio test for interaction χ(2) (df=2) z=13.5; P=0.001) and was present for refugees from all regions except sub-Saharan Africa. Both refugees and non-refugee migrants from sub-Saharan Africa had similarly high rates relative to the Swedish-born population. Refugees face an
Dal, Henrik; Lewis, Glyn; Magnusson, Cecilia; Kirkbride, James B; Dalman, Christina
Objective To determine whether refugees are at elevated risk of schizophrenia and other non-affective psychotic disorders, relative to non-refugee migrants from similar regions of origin and the Swedish-born population. Design Cohort study of people living in Sweden, born after 1 January 1984 and followed from their 14th birthday or arrival in Sweden, if later, until diagnosis of a non-affective psychotic disorder, emigration, death, or 31 December 2011. Setting Linked Swedish national register data. Participants 1 347 790 people, including people born in Sweden to two Swedish-born parents (1 191 004; 88.4%), refugees (24 123; 1.8%), and non-refugee migrants (132 663; 9.8%) from four major refugee generating regions: the Middle East and north Africa, sub-Saharan Africa, Asia, and Eastern Europe and Russia. Main outcome measures Cox regression analysis was used to estimate adjusted hazard ratios for non-affective psychotic disorders by refugee status and region of origin, controlling for age at risk, sex, disposable income, and population density. Results 3704 cases of non-affective psychotic disorder were identified during 8.9 million person years of follow-up. The crude incidence rate was 38.5 (95% confidence interval 37.2 to 39.9) per 100 000 person years in the Swedish-born population, 80.4 (72.7 to 88.9) per 100 000 person years in non-refugee migrants, and 126.4 (103.1 to 154.8) per 100 000 person years in refugees. Refugees were at increased risk of psychosis compared with both the Swedish-born population (adjusted hazard ratio 2.9, 95% confidence interval 2.3 to 3.6) and non-refugee migrants (1.7, 1.3 to 2.1) after adjustment for confounders. The increased rate in refugees compared with non-refugee migrants was more pronounced in men (likelihood ratio test for interaction χ2 (df=2) z=13.5; P=0.001) and was present for refugees from all regions except sub-Saharan Africa. Both refugees and non-refugee migrants from sub-Saharan Africa had similarly high
Full Text Available Abstract Background Being an immigrant in a high-income country is a risk factor for severe mental ill health. Studies on mental ill health among immigrants have found significant differences in mental health outcome between immigrants from high income countries and low-income countries. Being an asylum seeker or a refugee is also associated with mental ill health. This study aimed to assess if there is a difference in mental ill health problems between male and female refugee and non-refugee immigrants from six low-income countries in Sweden. Methods A cross-sectional, population-based study design was used comparing refugees with non-refugees. The study size was determined by the number of persons in Sweden fulfilling the inclusion criteria at the time of the study during 2006. Outcome: Mental ill health, as measured with the proxy variable psychotropic drugs purchased. Refugee/Non-refugee: Sweden grants asylum to refugees according to the Geneva Convention and those with a well-grounded fear of death penalty, torture or who need protection due to an internal or external armed conflict or an environmental disaster. The non-refugees were all family members of those granted asylum in Sweden. Covariates: Gender and origin. Potential confounders: Age, marital status, education and duration of stay in Sweden. Background variables were analysed using chi square tests. The association between outcome, exposure and possible confounders was analysed using logistic regression analyses. Multiple logistic regression analysis was used to adjust for potential confounders. Results The study population comprised 43,168 refugees and non-refugees, of whom 20,940 (48.5% were women and 24,403 (56.5% were refugees. Gender, age, origin, marital status and education were all associated with the outcome. For female, but not male, refugees there was a significantly higher likelihood of purchasing psychotropic drugs than non-refugees (OR = 1.27, 95% CI = 1.15 - 1
Hollander, Anna-Clara; Bruce, Daniel; Burström, Bo; Ekblad, Solvig
Being an immigrant in a high-income country is a risk factor for severe mental ill health. Studies on mental ill health among immigrants have found significant differences in mental health outcome between immigrants from high income countries and low-income countries. Being an asylum seeker or a refugee is also associated with mental ill health. This study aimed to assess if there is a difference in mental ill health problems between male and female refugee and non-refugee immigrants from six low-income countries in Sweden. A cross-sectional, population-based study design was used comparing refugees with non-refugees. The study size was determined by the number of persons in Sweden fulfilling the inclusion criteria at the time of the study during 2006. Mental ill health, as measured with the proxy variable psychotropic drugs purchased. Refugee/Non-refugee: Sweden grants asylum to refugees according to the Geneva Convention and those with a well-grounded fear of death penalty, torture or who need protection due to an internal or external armed conflict or an environmental disaster. The non-refugees were all family members of those granted asylum in Sweden. Covariates: Gender and origin. Potential confounders: Age, marital status, education and duration of stay in Sweden. Background variables were analysed using chi square tests. The association between outcome, exposure and possible confounders was analysed using logistic regression analyses. Multiple logistic regression analysis was used to adjust for potential confounders. The study population comprised 43,168 refugees and non-refugees, of whom 20,940 (48.5%) were women and 24,403 (56.5%) were refugees. Gender, age, origin, marital status and education were all associated with the outcome. For female, but not male, refugees there was a significantly higher likelihood of purchasing psychotropic drugs than non-refugees (OR = 1.27, 95% CI = 1.15-1.40). Female refugees from low-income countries seem to be a risk group
Boright, Lucinda L.
The Khmer are the predominant ethnic group of Cambodia, yet they have suffered genocide in their own homeland. The English language is the primary social barrier confronted by Cambodian refugees to the United States, since there are no similarities between English and Khmer alphabets and tenses. Refugees who arrrived in 1975 tended to be educated,…
Full Text Available Buddhist Monks in Vietnam struggle with cultural preservation differently from a monk in the U.S. where the forces of acculturation for new arrivals, often refugees, are extraordinarily overwhelming. The author provides a case study examining how Buddhist leaders engage in cultural preservation and community building in the American South. Fusing ideas of Engaged Buddhism and community building, the author will demonstrate how a Buddhist monk is able to navigate the broader American culture and assist Vietnamese immigrants and refugees to acculturate, while maintaining their own cultural heritage, beliefs and religious traditions; ultimately building a viable and sustainable Buddhist community that contributes greatly to its new host community.
... October 8, 2010 Fiscal Year 2011 Refugee Admissions Numbers and Authorizations of In-Country Refugee... Determination Pursuant to Section 2(b)(2) of the Migration and Refugee Assistance Act, as Amended Memorandum for... refugees to the United States during Fiscal Year (FY) 2011 is justified by humanitarian concerns or is...
The Ryerson University Refugee Resettlement Project (RRP), a decade-long study of 1348 Southeast Asian refugees who came to Canada between 1979 and 1981, is one of the largest, most comprehensive and longest-lived investigations of refugee resettlement ever carried out. Knowledge gleaned from the RRP about research methodology, about the resettlement experience, about the social costs of resettling refugees, about factors that promote or hinder integration, about risk and protective factors for refugee mental health, and about the refugees' consumption of mental health and social services is summarized in the form of 18 "Lessons." The lessons are offered in order to encourage and stimulate further research, as well to suggest policy and practice innovations that could help make resettlement easier, less costly, more effective, and more humane.
Pastoor, Lutine de Wal
This article explores unaccompanied young refugees' participation in various learning contexts beyond school. Drawing from a qualitative study based on interviews with unaccompanied young refugees, educators and social workers in Norway, the findings emphasise the need for a holistic approach to refugee education in and across contexts of…
The juridical problems in regard to the concepts of refugee, expulsion, and migration are complicated. If one speaks about migration in Europe, one must 1st distinguish between Eastern and Western Europe. In the communist states of Eastern Europe the refugee problem does not exist officially, with the only existing refugee problem in Yugoslavia, which has signed and ratified the Geneva Refugee Convention of 1951. In the other East European states the right to asylum exists, but refugees are granted asylum only if they are persecuted in their country of origin for their communist ideas and activities. In speaking of migration, one must distinguish between migration, forced migration, mass migration, emigration, immigration, the shift of populations, and refugees. In the communist countries of Eastern Europe the right to emigration is not respected, although certain exceptions, as in Poland or Yugoslavia do exist. Generally, in the communist states emigration is not allowed and illegal emigration is punished as "Flight from the Republic." With a few exceptions, political and other persecutions are no longer so typical within Europe. In the last decades, the refugee problem has changed to other continents: Afghanistan/Pakistan, Iran, Sri Lanka, East Timor, Lebanon, Palestine, Sudan, Tchad, Ethiopia, Eritrea, and Angola. The refugee problem in Europe consists mainly in the large afflux of refugees coming from places with other cultural (and religious) attributes. The Islamic immigrants declare themselves regularly as political refugees and hope to be acknowledged as such by the receiving state. The fear of the governments and populations of the receiving countries is that it would not be possible to assimilate such aliens who do not belong to the Christian culture of Europe. Formerly, refugees came mostly from the Christian countries of Eastern Europe with the same race identity and the same religion. For years now, more and more foreign workers are a kind of migrant
White, Justin S; Hamad, Rita; Li, Xinjun; Basu, Sanjay; Ohlsson, Henrik; Sundquist, Jan; Sundquist, Kristina
Although studies have shown associations between neighbourhood quality and chronic disease outcomes, such associations are potentially confounded by the selection of different types of people into different neighbourhood environments. We sought to identify the causal effects of neighbourhood deprivation on type 2 diabetes risk, by comparing refugees in Sweden who were actively dispersed by government policy to low-deprivation, moderate-deprivation, or high-deprivation neighbourhoods. In this quasi-experimental study, we analysed national register data for refugees who arrived in Sweden aged 25-50 years, at a time when the government policy involved quasi-random dispersal of refugees to neighbourhoods with different levels of poverty and unemployment, schooling, and social welfare participation. Individuals in our sample were assigned to a neighbourhood categorised as high deprivation (≥1 SD above the mean), moderate deprivation (within 1 SD of the mean), or low deprivation (≥1 SD below the mean). The primary outcome was new diagnosis of type 2 diabetes between Jan 1, 2002, and Dec 31, 2010. We used multivariate logistic and linear regressions to assess the effects of neighbourhood deprivation on diabetes risk, controlling for potential confounders affecting neighbourhood assignment and assessing effects of cumulative exposure to different neighbourhood conditions. We included data for 61 386 refugees who arrived in Sweden during 1987-91 and who were assigned to one of 4833 neighbourhoods. Being assigned to an area deemed high deprivation versus low deprivation was associated with an increased risk of diabetes (odds ratio [OR] 1·22, 95% CI 1·07-1·38; p=0·001). In analyses that included fixed effects for assigned municipality, the increased diabetes risk was estimated to be 0·85 percentage points (95% CI -0·030 to 1·728; p=0·058). Neighbourhood effects grew over time such that 5 years of additional exposure to high-deprivation versus low
This article looks at Britain's response to the World Refugee Year (1959-60), and in particular the government's decision to allow entry to refugees with tuberculosis and other chronic illnesses. In doing so, it broke the practice established by the 1920 Aliens' Order which had barred entry to immigrants with a range of medical conditions. This article uses the entry of these sick refugees as an opportunity to explore whether government policy represented as much of a shift in attitude and practice as contemporary accounts suggested. It argues for the importance of setting the reception of tubercular and other 'disabled' refugees in 1959-61 in its very particular historical context, showing it was a case less of the government thinking differently about refugees, and more of how, in a post-Suez context, the government felt obliged to take into account international and public opinion. The work builds on and adds to the growing literature surrounding refugees and disease. It also places the episode within the specificity of the post-war changing epidemiological climate; the creation of the National Health Service; and the welfare state more broadly. In looking at the role of refugee organizations in the Year, the article also contributes to debates over the place of voluntary agencies within British society.
Montgomery, Edith; Foldspang, Anders
Aims: The aim of this study was to compare profiles of present mental health and previous exposure to violence among refugee children from the Middle East, whose asylum seeking families either did or did not obtain permission to stay in Denmark. Methods: Shortly after arrival in Denmark......, the parents of 311 Middle-Eastern children answered a structured interview on their children’s exposure to organized violence and their mental health. The families were followed-up as concerns receipt of a residence permit. Results: At arrival in Denmark, the children’s patterns of previous exposure...... to violence and present mental health was generally similar irrespective of the family getting a residence permit, as was the case for 90 families (60.4%) with 190 children (61.1%). In both groups an overwhelming majority, eight to nine out of 10 children, had been exposed to conditions of war and had stayed...
Straiton, Melanie L; Reneflot, Anne; Diaz, Esperanza
High rates of mental health problems are consistently found among immigrants from refugee generating countries. While refugees and their family members may have experienced similar traumas, refugees are more likely to have undergone a stressful asylum period. This study aims to determine whether their mental health differs. Using national registry data, refugees and non-refugees from the same countries were compared on primary healthcare service use for mental health problems and purchase of psychotropic medicine. Refugees had higher odds of using primary health care services than non-refugees. Refugee women were more likely to purchase psychotropic medicine than non-refugee women. Refugee men were more likely to purchase anti-depressants. The findings suggest that refugees have poorer mental health than non-refugees. This may be due to a combination of greater pre-migration trauma and post-migration stressors such as enduring a difficult asylum period.
Full Text Available Last year, Greece became the epicenter of attention not only for the newly elected SYRIZA government and the negotiations for a bail-out with creditors, but also for its role as the main border-crossing point for hundreds of thousands of refugees, coming from war zones in order to continue their journey towards central and northern Europe. The country, located ‘on the doorstep of Europe’, is on the frontline of Europe’s biggest immigration crisis since the Second World War. It is thus a ‘frontier’ state between European Union states and the various countries which refugees or immigrants leave to seek asylum and/or a viable livelihood elsewhere. Hundreds of people are attempting the short but dangerous crossing from Turkey to the Greek islands in unseaworthy, overcrowded vessels that often founder and capsize.
Mateen, Farrah J; Carone, Marco; Nyce, Sayre; Ghosn, Jad; Mutuerandu, Timothy; Al-Saedy, Huda; Lowenstein, Daniel H; Burnham, Gilbert
The United Nations High Commissioner for Refugees (UNHCR) recognizes 43.7 million forcibly displaced persons and asylum seekers due to conflict and persecution worldwide. Neurological disorders have rarely been described in displaced persons but likely pose a significant burden of disease. We describe the disease spectrum and health service utilization of Iraqi refugees and asylum seekers with neurological disorders using an information system developed by the UNHCR. Neurological disorders were actively monitored among the 7,642 UNHCR-registered Iraqi refugees and asylum seekers who received health and humanitarian assistance using a pilot, centralized, database called the Refugee Assistance Information System (RAIS) in the Kingdom of Jordan in 2010. There were 122 neurological diagnoses reported in 1,328 refugees (mean age 41 years, 49% female, 10% disabled, 43% with pending resettlement applications) in 2,659 health visits, accounting for 17% of all refugees who sought health assistance in RAIS. Referral to a neurologist occurred in 178 cases (13.4%). The most frequent ICD-10 neurological diagnoses were dorsalgia (back pain) (29.7% of individuals with neurological disorders), headache (13.1%), and epilepsy (12.6%). Approximately 1 in 20 Iraqi refugees with a neurological diagnosis self-reported a history of torture, which was higher than Iraqi refugees without a history of torture [66/1,328 versus 196/6,314, odds ratio (OR) = 1.63, 95% confidence interval (CI) 1.21-2.18]. Neurological disease affects a high proportion of Iraqi refugees, including victims of torture and the disabled. Refugees require dedicated care for treatment of neurological disease with a focus on pain disorders and epilepsy.
Kerim Hakan Altintas
Full Text Available United Nations Convention Relating to the Status of Refugees (1951 defines refugee as "A person who owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his nationality and is unable or, owing to such fear, is unwilling to avail himself of the protection of that country; or who, not having a nationality and being outside the country of his former habitual residence as a result of such events, is unable or, owing to such fear, is unwilling to return to it. Factors such as difficult living conditions, housing problems, nutritional problems, poor access to health and social services and violence cause refugees and asylum seekers to be among the most vulnerable groups with respect to health. Although some variations exist between countries, health care services for refugees and asylum seekers are insufficient throughout the world. They encounter significant problems with counseling services, primary health care and preventive services as well as diagnosis and treatment options and access to essential medicines. In spite of legal improvements, issues concerning refugees and asylum seekers have been and will continue to be significant challenges as a consequence of increasing inequalities, conflicts and climate changes both in Turkey and the world. Therefore, governments, non-governmental organizations and universities need to scale up their efforts both at the country and global level, for refugees to benefit from services related to nutrition, housing and health care until their final destinations are determined. [TAF Prev Med Bull 2010; 9(1.000: 55-62
• the adoption of coherent strategies, involving all sectors, to address large movements of refugees. This paper draws heavily, albeit not exclusively, from a series of papers published as a special collection in the Journal on Migration and Human Security on strengthening the global system of refugee protection.  Rethinking the Global Refugee Protection System, Journal on Migration and Human Security, Center for Migration Studies, 2016-2017. See http://cmsny.org/cms_research/refugeeproject/.
Large numbers of refugee children are arriving in high-income countries. The evidence to date suggests that they have mental health needs that are higher than for the general population and that these are exacerbated by the numbers of traumatic events they have experienced and the post-migration stressors they continue to be exposed to. The importance of a thorough and thoughtful assessment is discussed. Treatments of note are described for post-traumatic stress disorder, family functioning, general mental health problems and school environments. Future opportunities to operationalise outcome measures, develop multimodal interventions and utilise implementation science methodology are considered.
Salas-Wright, Christopher P; Vaughn, Michael G
Few, if any, studies have systematically examined the link between nativity and substance use disorders (SUD) among refugees using national samples. As such, it remains uncertain if the "immigrant paradox" for substance use can be extended to include refugees in the United States. Employing data from the National Epidemiologic Survey on Alcohol and Related Conditions, we examine the lifetime prevalence of SUDs among refugees (n=428) in contrast with non-refugee immigrants (n=4955) and native-born Americans (n=29,267). We also examine the impact of gender and refugee duration on the relationship between nativity, refugee status, and SUDs. Refugees were between 3 and 6 times less likely than native-born Americans meet criteria for all SUDs examined, and significantly less likely than non-refugee immigrants to meet criteria for alcohol (AOR=0.44, 95% CI=0.41-0.47), cocaine (AOR=0.54, 95% CI=0.50-0.59), hallucinogen (AOR=0.66, 95% CI=0.58-0.74), and opioid/heroin (AOR=0.62, 95% CI=0.58-0.66) use disorders. The refugee-SUD link was significantly moderated by gender. Duration as a refugee was associated with increased risk for alcohol use disorder and decreased risk of cannabis and illicit drug use disorders. Study findings provide evidence in support of a "refugee paradox" for SUDs among adults in the United States. Refugees are substantially less likely than native-born Americans to meet criteria for all SUDs examined and, albeit with weaker effects, significantly less likely than non-refugee immigrants to meet criteria for a variety of SUDs. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
O'Laughlin, Kelli N; Rouhani, Shada A; Kasozi, Julius; Greenwald, Kelsy E; Perkons, Nicholas R; Faustin, Zikama M; Bassett, Ingrid V; Ware, Norma C
Refugees living with HIV in sub-Saharan Africa suffer unique hardships that may increase their vulnerability to interruptions in antiretroviral therapy (ART). To investigate refugees' experiences adhering to ART, we conducted inperson interviews with refugees on ART ( n = 73) and HIV clinic staff ( n = 4) in Nakivale Refugee Settlement in southwest Uganda from March to July 2011. Three analysts used a conventional content analysis approach to evaluate these data. Refugees described profound motivation to adhere to ART and employed adherence strategies to facilitate success despite the austere setting. However, refugees spoke of specific hardships living in Nakivale that served as barriers to ART adherence, including difficulty accessing clinic when ill, food insecurity, drug stockouts, and violence and unrest in the settlement. For some refugees, need for ART inextricably linked them to the HIV clinic and prevented them from transitioning permanently away from the settlement. By learning about refugees' experiences we can design informed interventions to enhance ART adherence, thus minimizing morbidity and mortality, preventing transmission of HIV, and supporting refugees' abilities to move freely toward repatriation, resettlement or integration in their host country.
... 3 The President 1 2010-01-01 2010-01-01 false Fiscal Year 2010 Refugee Admissions Numbers and Authorizations of In-country Refugee Status Pursuant to Sections 207 and 101(A)(42), Respectively, of the Immigration and Nationality Act, and Determination Pursuant to Section 2(B)(2) of the Migration and Refugee...
Full Text Available Public diplomacy is described as a new form of relations and communications between countries and societies in the field of international relations with the process of globalisation. The subject of refugees shown among the priority issues can be solved through international cooperation and solidarity with its results affecting all countries and societies, that’s why becoming part of public diplomacy. Asylum seekers and refugee rights are guaranteed by the Universal Declaration of Human Rights and considered to be an area that the international community needs to take the roles and share responsibilities. In this aspect, it is shown as global responsibilities and part of the humanitarian sensibility of countries and societies. In one hand, asylum seekers and refugees are considered to be the subject of the problem and crisis, on the other hand, due to contributing to the human and cultural interaction between the different communities, these are specified as part of public diplomacy. This article discusses the relationship between public diplomacy and refugees relations which provides the interaction between countries and effects the prestige and perception of them. In the study, to reveal the reflections of Turkey’s Refugees Relations on the International Media, three highest-circulation newspapers (“The Guardian”, “Le Monde”, “Der Spiegel” will be choosen from three important EU countries (United Kingdom, France, Germany. These newspapers’ headlines and news content which related to Turkey and Syrian refugees are going to be analized on three-month period. As a result, Turkish public diplomacy and refugee relations and its implications on the international media in the context of Syrian refugees will be evaluated and some recommendations for the future of Turkish public diplomacy and refugee relations will be provided.
Today, there are about 14 million refugees worldwide. The United Nations' High Commissioner for Refugees supports them with legal aid, food supplies, housing and preventive health measures, and also tries to find a permanent residence for the refugees. In recent years, there has been increasing awareness about the great number of internally displaced persons in many countries, and of the extent of economic migration. The fear that immigrants may be a threat to the public health, especially as regards import of infectious diseases such as HIV, hepatitis B and tuberculosis, is diminishing. The cultural aspects of health care among immigrants require increased attention, both from the immigrants themselves, and the countries to which they immigrate.
Refugees in Africa are forced to fl ee their homelands because of ongoing conflicts, persecution and humanitarian crises in their countries. Refugees constitute one of Africa's most complex challenges, and in many regions protracted refugee situations (PRSs) have developed. This means that refugees have lived in host ...
Essed, P.; Frerks, G.; Schrijvers, J.; Ph. Essed,; G. Frerks,; J. Schrijvers,
Refugees and the Transformation of Societies is about cultures and societies in change, in the process of producing, refusing or receiving refugees. It explores experiences, interpretations and practices of 'refugees', 'internally displaced' and 'returnees' in or emerging from societies in violent
Correa-Velez, Ignacio; Gifford, Sandra M; McMichael, Celia
This short report assesses the predictors of subjective health and happiness among a cohort of refugee youth over their first eight years in Australia. Five waves of data collection were conducted between 2004 (n = 120) and 2012-13 (n = 51) using mixed methods. Previous schooling, self-esteem, moving house in the previous year, a supportive social environment, stronger ethnic identity and perceived discrimination were significant predictors of wellbeing after adjusting for demographic and pre-migration factors. When compared with a previous analysis of this cohort over their first three years of settlement, experiences of social exclusion still have a significant impact on wellbeing eight years after arriving in Australia. This study contributes to mounting evidence in support of policies that discourage discrimination and promote social inclusion and cultural diversity and which underpin the wellbeing of resettled refugee youth. Copyright © 2015 Elsevier Ltd. All rights reserved.
Abu Jarour, Safa'a; Krasnova, Hanna; Wenninger, Helena
, especially smartphones, is an important distinction of the current refugees’ crisis. ICT may support integrative efforts undertaken by local authorities and other stakeholders. Nonetheless, the question how ICTs can be applied to support refugees and how detrimental effects for them and the hosting societies...... of ICT use by refugees on an operational level, and how ICT systems should be designed and culturally adapted.......Spurred by the military conflicts, refugees’ crisis has swept Europe by surprise. With a challenge of integrating refugees into hosting societies comes the question about the role that ICTs could play in the ongoing integration efforts. Indeed, unprecedented reliance of refugees on technology...
Arnetz, Bengt B; Broadbridge, Carissa L; Jamil, Hikmet; Lumley, Mark A; Pole, Nnamdi; Barkho, Evone; Fakhouri, Monty; Talia, Yousif Rofa; Arnetz, Judith E
Trauma exposure contributes to poor mental health among refugees, and exposure often is measured using a cumulative index of items from the Harvard Trauma Questionnaire (HTQ). Few studies, however, have asked whether trauma subtypes derived from the HTQ could be superior to this cumulative index in predicting mental health outcomes. A community sample of recently arrived Iraqi refugees (N = 298) completed the HTQ and measures of posttraumatic stress disorder (PTSD) and depression symptoms. Principal components analysis of HTQ items revealed a 5-component subtype model of trauma that accounted for more item variance than a 1-component solution. These trauma subtypes also accounted for more variance in PTSD and depression symptoms (12 and 10%, respectively) than did the cumulative trauma index (7 and 3%, respectively). Trauma subtypes provided more information than cumulative trauma in the prediction of negative mental health outcomes. Therefore, use of these subtypes may enhance the utility of the HTQ when assessing at-risk populations.
Arnetz, Bengt B.; Broadbridge, Carissa L.; Jamil, Hikmet; Lumley, Mark A.; Pole, Nnamdi; Barkho, Evone; Fakhouri, Monty; Talia, Yousif Rofa; Arnetz, Judith E.
Background Trauma exposure contributes to poor mental health among refugees, and exposure often is measured using a cumulative index of items from the Harvard Trauma Questionnaire (HTQ). Few studies, however, have asked whether trauma subtypes derived from the HTQ could be superior to this cumulative index in predicting mental health outcomes. Methods A community sample of recently arrived Iraqi refugees (N = 298) completed the HTQ and measures of posttraumatic stress disorder (PTSD) and depression symptoms. Results Principal components analysis of HTQ items revealed a 5-component subtype model of trauma that accounted for more item variance than a 1-component solution. These trauma subtypes also accounted for more variance in PTSD and depression symptoms (12% and 10%, respectively) than did the cumulative trauma index (7% and 3%, respectively). Discussion Trauma subtypes provided more information than cumulative trauma in the prediction of negative mental health outcomes. Therefore, use of these subtypes may enhance the utility of the HTQ when assessing at-risk populations. PMID:24549491
... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Derivatives of refugees. 207.7 Section 207... REFUGEES § 207.7 Derivatives of refugees. (a) Eligibility. A spouse, as defined in section 101(a)(35) of..., shall be granted refugee status if accompanying or following-to-join the principal alien. An...
... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Termination of refugee status. 207.9... REFUGEES § 207.9 Termination of refugee status. The refugee status of any alien (and of the spouse or child... district director in whose district the alien is found if the alien was not a refugee within the meaning of...
Full Text Available Interviews with both refugees and organizational staff in two nonprofit refugee resettlement organizations in the United States reveal the ways in which knowledge(s and expertise are crafted, threatened, and understood in refugee organizations. Refugee-participants described the need for knowledgeable communication, barriers to the communication of knowledge, and processes of negotiating whose expertise is involved. Organizational staff participants described the duty of communicating expert knowledge, the limits of knowledge as expertise, and alternative communications of expertise. These tensions surrounding “knowing” in refugee resettlement organizations highlights the need for a more complex theoretical understanding of the processes of knowing present in refugee resettlement. These tensions also suggest areas in which refugee resettlement agencies and other nonprofit staff can make on-the-ground changes to better facilitate refugee resettlement processes.
Akinyemi, O O; Atilola, O; Soyannwo, T
Among the serious mental health problems that may be associated with being a refugee is suicidal behavior. This study aimed to assess the prevalence and correlates of suicidal ideation among African refugees in Oru-Ijebu Nigeria. Suicidal ideation was assessed using appropriate section in the Mini-International Neuropsychiatric Interview while the brief version of the WHO Quality of Life was used to assess quality of life as a clinical variable. Study involved 444 refugees and 527 non-refugee member of host community. Result showed that the prevalence of suicidal ideation was significantly higher among the refugees than the non-refugee comparison group (27.3% vs. 17.3%; prefugees compared with their non-refugee members of same community. Quality of life was the only factor independently associated with suicidal ideations among refugees. In conclusion, the study shows that the prevalence of suicidal ideation is significantly higher among the refugees than the non-refugee members of the host community and calls for innovative ways of extending mental health services to refugees at the study site. Copyright © 2015 Elsevier B.V. All rights reserved.
Full Text Available Ever since 2015, Europe has seen the number of asylum seekers increased as a consequence of the situation in the Middle East. The situation, now known as “the refugee crisis”, has had major repercussions on the political and social European landscape. From a legal perspective, the unwillingness of European states to welcome refugees led part of the legal community to talk about the failure of international refugee law. This paper aims to challenge such statement by critically analysing one UNHCR’s artistic project implemented in a refugee camp. By looking specifically at the project “Exile Voices” and the subsequent photo exhibition that took place in Paris in 2015, it argues that that international refugee law has not failed in dealing with the refugee crisis. Rather, the crisis revealed the limits of the international and European legal frameworks subsumed within the concept of the Nation-State. Despite the increasing internationalization of governance through the multiplication of regulatory tools in a growing number of areas, domestic interests still prevail over international legal obligations because of the Nation-States struggle for power. Drawing on the work done by scholars in the fields of legal aesthetic and legal iconology, I will explain how visual arts are being enrolled by international law in order to bypass those limits and in fact, act as a technique of legal authorization.
Against the background of the changing situation in Afghanistan, the United Nations High Commissioner for Refugees (UNHCR) requested NIDI in the beginning of 2002 to conduct a rapid survey among Afghan refugees living in Pakistan. It's purpose was to assess the demographic and socio-economic
McBride, Jacquie; Russo, Alana; Block, Andrew
Asylum seekers and refugees experience a range of barriers to health service access and competent use. The Refugee Health Nurse Liaison initiative was piloted at a hospital in a high-settlement region of Victoria, Australia. This initiative aimed to build capacity within the health sector to more effectively respond to the needs of asylum seekers and refugees. A mixed-methods evaluation was undertaken to: describe issues encountered by asylum seekers and refugees within the hospital setting; capture the nature of the Refugee Health Nurse Liaison position; and document key outputs. Throughout the pilot period, 946 patients were referred to the role, of which 99% received an assessment of physical, mental, and social health. Refugee Health Nurse Liaisons effectively provided clinical support, advocacy, education, referrals, and both formal and informal capacity building. Learnings from this model are transferable to services in high-settlement regions, and could have application in improving patient care more broadly.
Djuraskovic, Ivana; Arthur, Nancy
Although the displacement of people from their home countries is of growing concern, little attention has been paid to refugees in the counselling literature. Experiences of refugees are more complex and difficult than those of voluntary immigrants because refugees are typically pushed out of their countries. Using heuristic inquiry, four main…
Full Text Available Abstract Background Comparisons between refugees receiving health care in settlement-based facilities and persons living in host communities have found that refugees have better health outcomes. However, data that compares utilization of health services between refugees and the host population, and across refugee settlements, countries and regions is limited. The paper will address this information gap. The analysis in this paper uses data from the United Nations High Commissioner of Refugees (UNHCR Health Information System (HIS. Methods Data about settlement populations and the use of outpatient health services were exported from the UNHCR health information system database. Tableau Desktop was used to explore the data. STATA was used for data cleaning and statistical analysis. Differences in various indicators of the use of health services by region, gender, age groups, and status (host national vs. refugee population were analyzed for statistical significance using generalized estimating equation models that adjusted for correlated data within refugee settlements over time. Results Eighty-one refugee settlements were included in this study and an average population of 1.53 million refugees was receiving outpatient health services between 2008 and 2009. The crude utilization rate among refugees is 2.2 visits per person per year across all settlements. The refugee utilization rate in Asia (3.5 was higher than in Africa on average (1.8. Among refugees, females have a statistically significant higher utilization rate than males (2.4 visits per person per year vs. 2.1. The proportion of new outpatient attributable to refugees is higher than that attributable to host nationals. In the Asian settlements, only 2% outpatient visits, on average, were attributable to host community members. By contrast, in Africa, the proportion of new outpatient (OPD visits by host nationals was 21% on average; in many Ugandan settlements, the proportion of outpatient
Weiss, William M; Vu, Alexander; Tappis, Hannah; Meyer, Sarah; Haskew, Christopher; Spiegel, Paul
Comparisons between refugees receiving health care in settlement-based facilities and persons living in host communities have found that refugees have better health outcomes. However, data that compares utilization of health services between refugees and the host population, and across refugee settlements, countries and regions is limited. The paper will address this information gap. The analysis in this paper uses data from the United Nations High Commissioner of Refugees (UNHCR) Health Information System (HIS). Data about settlement populations and the use of outpatient health services were exported from the UNHCR health information system database. Tableau Desktop was used to explore the data. STATA was used for data cleaning and statistical analysis. Differences in various indicators of the use of health services by region, gender, age groups, and status (host national vs. refugee population) were analyzed for statistical significance using generalized estimating equation models that adjusted for correlated data within refugee settlements over time. Eighty-one refugee settlements were included in this study and an average population of 1.53 million refugees was receiving outpatient health services between 2008 and 2009. The crude utilization rate among refugees is 2.2 visits per person per year across all settlements. The refugee utilization rate in Asia (3.5) was higher than in Africa on average (1.8). Among refugees, females have a statistically significant higher utilization rate than males (2.4 visits per person per year vs. 2.1). The proportion of new outpatient attributable to refugees is higher than that attributable to host nationals. In the Asian settlements, only 2% outpatient visits, on average, were attributable to host community members. By contrast, in Africa, the proportion of new outpatient (OPD) visits by host nationals was 21% on average; in many Ugandan settlements, the proportion of outpatient visits attributable to host community members
Background Comparisons between refugees receiving health care in settlement-based facilities and persons living in host communities have found that refugees have better health outcomes. However, data that compares utilization of health services between refugees and the host population, and across refugee settlements, countries and regions is limited. The paper will address this information gap. The analysis in this paper uses data from the United Nations High Commissioner of Refugees (UNHCR) Health Information System (HIS). Methods Data about settlement populations and the use of outpatient health services were exported from the UNHCR health information system database. Tableau Desktop was used to explore the data. STATA was used for data cleaning and statistical analysis. Differences in various indicators of the use of health services by region, gender, age groups, and status (host national vs. refugee population) were analyzed for statistical significance using generalized estimating equation models that adjusted for correlated data within refugee settlements over time. Results Eighty-one refugee settlements were included in this study and an average population of 1.53 million refugees was receiving outpatient health services between 2008 and 2009. The crude utilization rate among refugees is 2.2 visits per person per year across all settlements. The refugee utilization rate in Asia (3.5) was higher than in Africa on average (1.8). Among refugees, females have a statistically significant higher utilization rate than males (2.4 visits per person per year vs. 2.1). The proportion of new outpatient attributable to refugees is higher than that attributable to host nationals. In the Asian settlements, only 2% outpatient visits, on average, were attributable to host community members. By contrast, in Africa, the proportion of new outpatient (OPD) visits by host nationals was 21% on average; in many Ugandan settlements, the proportion of outpatient visits attributable
Nath, Lopita; Grote-Garcia, Stephanie
The U.S. Refugee Resettlement Program offers a quick path to permanent residency and adjustment to the United States, with the major objectives of economic success, community involvement, and local integration. The success of the program partly depends on the response of the American community towards refugees. Using the foundational idea that…
Griswold, Kim S
Cultural awareness training is an increasingly important priority within medical curricula. This article describes an academic family practice-community partnership focusing on health care needs of refugees that became the model for a medical school selective on cultural sensitivity training. The monthly Refugee Health Night program featured dinner with preceptors and patients, international sessions on special medical needs of refugees, and actual clinical encounters with patients. Students were not expected to become culturally competent experts but, rather, health care providers sensitive to and appreciative of cultural context, experience, and expectations. We worked with students to develop sensitive methods of inquiry about mental health, especially around issues of war and torture. We used problem-based cases to emphasize primary care continuity and the benefit of establishing trust over time. Over 2 years, 50 students and nearly 300 refugees (more than 73 families) participated. Students reported that their interactions with the refugees provided positive learning experiences, including expanded knowledge of diverse cultures and enhanced skills for overcoming communication barriers. Patients of refugee status were able to have emergent health care needs met in a timely fashion. Providing health care for refugee individuals and families presents many challenges as well as extraordinary opportunities for patients and practitioners to learn from one another.
Thela, Lindokuhle; Tomita, Andrew; Maharaj, Varsha; Mhlongo, Mpho; Burns, Jonathan K
There are few studies on the role of migration within sub-Saharan Africa and its relation to the development of mental illness. We investigated post-resettlement adaptation and mental health challenges of African refugees/migrants in Durban, South Africa. We interviewed 335 African help-seeking refugees/migrants for anxiety, depression (25-item Hopkins Symptom Checklist) and post-traumatic stress symptoms (30-item Harvard Trauma Questionnaire). Socio-demographic and migration history, focusing on post-migration circumstances and experiences of discrimination in the host country, were obtained. Association between migration and post-settlement factors and mental health outcomes were assessed using adjusted logistic regression models. Prevalence of mental distress was high: 49.4% anxiety, 54.6% depression and 24.9% post-traumatic stress symptoms. After adjustment for family separation since migration, recent arrival in South Africa was associated with increased risk for depression (aOR = 4.0, 95% CI:1.3-11.8) and post-traumatic stress (aOR = 5.2, 95% CI:1.7-15.9), while in unadjusted models, older age on arrival was associated with anxiety (aOR = 5.3, 95% CI:1.4-19.8) and depression (aOR = 6.2, 95% CI:1.6-24.3). History of family separation since migration was independently associated with depression and post-traumatic stress in all models. Discriminatory experiences since migration was also an independent risk factor for all three mental health outcomes. Finally, being divorced/widowed was associated with an increased risk for post-traumatic stress, while higher income earners were protected against post-traumatic symptoms, even after adjustment. Refugees/migrants in South Africa show a significant burden of mental distress that is linked to challenges of adjustment in an often hostile context. Services addressing these and other health-related, social-economic needs should be developed as a priority.
Problem Statement: Historically, Turkey is an immigrant country. It has experienced various migration waves from Asia, Awrupa and Africa. Recently, Turkey has confronted a huge wave of migration. Turkey tries to meet many needs besides the educational needs of refugees, but there is not enough study on refugees in the field of educational sciences…
Adams, Jo Hunter; Young, Samorga; Laird, Lance D; Geltman, Paul L; Cochran, Jennifer J; Hassan, Ahmed; Egal, Fadumo; Paasche-Orlow, Michael K; Barnes, Linda L
Oral health disparities related to socioeconomic status have been well described in the U.S., but oral health among refugee groups has not been well characterized. This article examines oral health among Somali refugees in Massachusetts. Eighty-three (83) participants were purposively selected for an in-depth, open-ended interview related to oral health. Older individuals associated use of the stick brush with the Islamic practice of cleansing before prayer. When unable to find stick brushes in the U.S., many adopted the Western toothbrush. Parents expressed concern that their children had adopted U.S. practices of brushing with a toothbrush only once or twice a day. Somali oral health practices have changed following arrival to the U.S., but the underlying model for oral health care remains rooted in Islam. By acknowledging the value of traditional practices, dentists may communicate the value of Western preventive and restorative dentistry, and recommend approaches to integrating the two.
Ekmekci, Perihan Elif
This paper discusses the crucial effects of Turkish health and migration laws on Syrian refugees' access to public health services and social determinants of health. Key aspects of current Turkish laws affect the health of both refugees and Turkish citizens in many ways. The huge influx of refugees is increasing communicable disease risks, overcrowding hospitals, and more generally straining financial and health resources. Turkey's United Nations membership and its candidacy for European Union (EU) have led to increased alignment of Turkey's refugee and migration policies with international law. Major differences remain, however, and Turkey's remaining noncompliance with international refugee laws is a major force driving Syrian refugee's flight to EU countries, as refugees desperately seek the right to better health and social services.
Friends of the Earth Australia is commemorating World Refugee Day in 2005 by publishing a 'Citizens Guide to Climate Refugees'. This publication gives the basic facts on climate change, greenhouse gas emissions; why people could become climate refugees, how many and where are they likely to come from; and what can be done about it
Rousseau, Cécile; Benoit, Maryse; Gauthier, Marie-France; Lacroix, Louise; Alain, Néomée; Rojas, Musuk Viger; Moran, Alejandro; Bourassa, Dominique
This evaluative study assesses the effects of a school drama therapy program for immigrant and refugee adolescents designed to prevent emotional and behavioral problems and to enhance school performance. The 9-week program involved 136 newcomers, aged 12 to 18, attending integration classes in a multiethnic school. Pretest and posttest data were collected from the students and their teachers. The self-report and teacher's forms of the Strengths and Difficulties Questionnaire were used to assess emotional and behavioral symptoms. At the end of the program, although there were no reported improvement in self-esteem or emotional and behavioral symptoms, the adolescents in the experimental group reported lower mean levels of impairment by symptoms than those in the control group, when baseline data were controlled for. Their performance in mathematics also increased significantly compared to that of their control peers. The findings suggest that the workshops may have an impact on social adjustment of recently arrived immigrants and refugees. This drama therapy program appears to be a promising way of working preventively and in a nonstigmatizing manner with adolescents who have been exposed to diverse forms of adversity, among which are war and violence.
Ben Farhat, Jihane; Blanchet, Karl; Juul Bjertrup, Pia; Veizis, Apostolos; Perrin, Clément; Coulborn, Rebecca M; Mayaud, Philippe; Cohuet, Sandra
Since 2015, Europe has been facing an unprecedented arrival of refugees and migrants: more than one million people entered via land and sea routes. During their travels, refugees and migrants often face harsh conditions, forced detention, and violence in transit countries. However, there is a lack of epidemiological quantitative evidence on their experiences and the mental health problems they face during their displacement. We aimed to document the types of violence experienced by migrants and refugees during their journey and while settled in Greece, and to measure the prevalence of anxiety disorders and access to legal information and procedures. We conducted a cross-sectional population-based quantitative survey combined with an explanatory qualitative study in eight sites (representing the range of settlements) in Greece during winter 2016/17. The survey consisted of a structured questionnaire on experience of violence and an interviewer-administered anxiety disorder screening tool (Refugee Health Screener). In total, 1293 refugees were included, of whom 728 were Syrians (41.3% females) of median age 18 years (interquartile range 7-30). Depending on the site, between 31% and 77.5% reported having experienced at least one violent event in Syria, 24.8-57.5% during the journey to Greece, and 5-8% in their Greek settlement. Over 75% (up to 92%) of respondents ≥15 years screened positive for anxiety disorder, which warranted referral for mental health evaluation, which was only accepted by 69-82% of participants. Access to legal information and assistance about asylum procedures were considered poor to non-existent for the majority, and the uncertainty of their status exacerbated their anxiety. This survey, conducted during a mass refugee crisis in a European Community country, provides important data on experiences in different refugee settings and reports the high levels of violence experienced by Syrian refugees during their journeys, the high prevalence of
Abu-Madi, Marawan A; Behnke, Jerzy M; Ismail, Ahmed; Boughattas, Sonia
In the last decades, the enormous influx of immigrants to industrialized countries has led to outbreaks of parasitic diseases, with enteric infections being amongst the most frequently encountered. In its strategy to control such infection, Qatar has established the Pre-Employment Certificate (PEC) program which requires medical inspection before arrival in Qatar and which is mandatory for immigrant workers travelling to the country. To assess the reliability of the PEC, we conducted a survey of intestinal parasites, based on examination of stool samples provided by immigrant workers (n = 2,486) recently arrived in Qatar. Overall prevalence of helminths was 7.0% and that of protozoa was 11.7%. Prevalence of combined helminths was highest among the western Asians and the highest prevalence of combined protozoan parasites was among workers from North to Saharan Africa. Analysis of temporal changes showed an increasing trend of protozoan infections over the investigated 3 years. A major contribution to this temporal change in prevalence came from Blastocystis hominis as well as from other protozoan species: Giardia duodenalis and Endolimax nana. Analysis of the temporal trend in species richness of the protozoan species showed a significant increase in the mean number of species harboured per subject across this period. The increase of protozoan infections over recent years raises some concerns. It suggests that screening protocols for applicants for visas/work permits needs to be revised giving more careful attention to the intestinal protozoan infections that potential immigrants may harbor.
The Fourth World Conference on Women in Beijing 1995 presented a global Platform for Action on the consequences of conflict and violence for women. The UN High Commission for Refugees (UNHCR) was given the task of providing international protection and seeking solutions for refugees. Refugees included those who had fled their country, returnees who had come home but were not fully reintegrated and civilians displaced inside their own country. Demographic data was designed for appropriate protection and assistance programs that could be implemented at the outset of any humanitarian crisis. The sample covered Yugoslavian refugees, 64% of whom were female, and Somali women in northern Kenya aged 19-44 years. In humanitarian crises the focus has been on providing basic health care and meeting urgent needs; however, reproductive health has been ignored. Thus, since women have been dynamic actors of change, efforts should be redoubled to ensure that women have access to food, education, health and basic material needs, which would result in the improvement of the health of the whole refugee population.
Chang, Alicia H.; Perry, Sharon; Du, Jenny N. T.; Agunbiade, Abdulkareem; Polesky, Andrea; Parsonnet, Julie
Beginning in 2005, the Centers for Disease Control and Prevention (CDC) expanded the overseas presumptive treatment of intestinal parasites with albendazole to include refugees from the Middle East. We surveyed the prevalence of helminths and protozoa in recent Middle Eastern refugees (2008–2010) in comparison with refugees from other geographical regions and from a previous survey (2001–2004) in Santa Clara County, California. Based on stool microscopy, helminth infections decreased, particularly in Middle Eastern refugees (0.1% versus 2.3% 2001–2004, P = 0.01). Among all refugees, Giardia intestinalis was the most common protozoan found. Protozoa infections also decreased somewhat in Middle Eastern refugees (7.2%, 2008–2010 versus 12.9%, 2001–2004, P = 0.08). Serology for Strongyloides stercoralis and Schistosoma spp. identified more infected individuals than stool exams. Helminth infections are increasingly rare in refugees to Northern California. Routine screening stool microscopy may be unnecessary in all refugees. PMID:23149583
Almontaser, Esmihan; Baumann, Steven L
The civil war in Syria that began in 2011 has displaced millions of Syrians of all ages. While the number that have arrived in the United States is small in comparison to many other countries, it is important that nurses and other healthcare workers here understand that many of them have faced considerable trauma and endured stresses. Most of them are Muslims. Muslims in the United States and elsewhere represent a heterogeneous group of people with a long intellectual and cultural history. Islamic cultural patterns do pose unique barriers to a primarily Anglo-Saxon medical system that medical practitioners need to consider in order to avoid misunderstanding and provide culturally sensitive care. The authors discuss the Syrian refugee crisis and the experience of being a Muslim or Arab American patient in U.S. healthcare settings.
... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Control over approved refugee numbers. 207... ADMISSION OF REFUGEES § 207.6 Control over approved refugee numbers. Current numerical accounting of approved refugees is maintained for each special group designated by the President. As refugee status is...
Farkas, Livia J.
Describes the Refugee Data Center (RDC) (New York City), a hub for linking refugees with voluntary resettlement agencies. The RDC maintains a database on refugees as they progress toward final resettlement in the United States. At present, RDC files include refugees from Asia, Africa, Europe, and Latin America. (SLD)
Sabrina J. Stotz
Full Text Available Background: The relationships between traumatic stress and self-conscious emotions, such as shame and guilt, remain to be fully explored, especially in refugees, who frequently are exposed to a multitude of stressors. Objective: The aim of the present study was to investigate shame and guilt in refugee minors and to assess to what extent a greater cumulative exposure to traumatic stressors would result not only in more severe posttraumatic stress disorder (PTSD symptoms but also in higher levels of shame and guilt. Methods: Thirty-two male refugee minors, who were all below the age of 18 when they sought asylum in Germany, agreed to participate. At the time of the assessment, the age ranged from 11 to 20 years. Eighteen refugees had arrived without relatives in their host country (“unaccompanied minors”. In structured diagnostic interviews, a PTSD diagnosis was established using the UCLA PTSD Index. Posttraumatic guilt was assessed by means of the Trauma-related Guilt Inventory, and the Shame Variability Questionnaire was used to record the intensity, duration, and frequency of shame episodes. Results: Feelings of guilt and shame as well as trauma symptoms were all associated with the number of traumatic event types subjects had experienced. Posttraumatic guilt and shame were both correlated with PTSD symptom severity. Conclusions: The findings indicate that cumulative stress such as exposure to multiple traumatic events poses a risk factor for the mental health including greater suffering and functional impairment due to shame and guilt.
Stotz, Sabrina J.; Elbert, Thomas; Müller, Veronika; Schauer, Maggie
Background The relationships between traumatic stress and self-conscious emotions, such as shame and guilt, remain to be fully explored, especially in refugees, who frequently are exposed to a multitude of stressors. Objective The aim of the present study was to investigate shame and guilt in refugee minors and to assess to what extent a greater cumulative exposure to traumatic stressors would result not only in more severe posttraumatic stress disorder (PTSD) symptoms but also in higher levels of shame and guilt. Methods Thirty-two male refugee minors, who were all below the age of 18 when they sought asylum in Germany, agreed to participate. At the time of the assessment, the age ranged from 11 to 20 years. Eighteen refugees had arrived without relatives in their host country (“unaccompanied minors”). In structured diagnostic interviews, a PTSD diagnosis was established using the UCLA PTSD Index. Posttraumatic guilt was assessed by means of the Trauma-related Guilt Inventory, and the Shame Variability Questionnaire was used to record the intensity, duration, and frequency of shame episodes. Results Feelings of guilt and shame as well as trauma symptoms were all associated with the number of traumatic event types subjects had experienced. Posttraumatic guilt and shame were both correlated with PTSD symptom severity. Conclusions The findings indicate that cumulative stress such as exposure to multiple traumatic events poses a risk factor for the mental health including greater suffering and functional impairment due to shame and guilt. PMID:26105045
Dourgnon, Paul; Kassar, Hassène
In recent years, North African (NA) countries ceased to be emigration-only countries and are now on the verge of becoming immigration as well as transit countries for economic migrants and refugees. Contextual as well as structural long-term factors are driving these changes. The ongoing crises in Africa and the Middle East are prompting strong outflows of refugees, which are likely to induce NA countries to share some common public policy and public health concerns with European countries in a near future. This article highlights some aspects of these changes, from the study of the consequences of the 2011 Libyan crisis in Tunisia. It addresses individual trajectories and health concerns of refugees in and out North Africa from a study of the Choucha camp in Tunisia. The camp opened to immigrants from Libya during the 2011 crisis and accommodated the bulk of the refugees flow to Tunisia until July 2012. The study includes a monographic approach and a qualitative survey in the Choucha camp refugees. We describe the crisis history and the health response with a focus on the camp. We then address refugees' trajectories, and health needs and concerns from the interviews we collected in the camp in April 2012. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.
Marano, Nina; Wojno, Abbey E; Stauffer, William M; Weinberg, Michelle; Klosovsky, Alexander; Ballew, J Daniel; Shetty, Sharmila; Cookson, Susan; Walker, Patricia; Cetron, Martin S
The current global refugee crisis involves 65.3 million persons who have been displaced from their homes or countries of origin. While escaping immediate harm may be their first priority, displaced people go on to face numerous health risks, including trauma and injuries, malnutrition, infectious diseases, exacerbation of existing chronic diseases, and mental health conditions. This crisis highlights the importance of building capacity among health-care providers, scientists, and laboratorians to understand and respond to the health needs of refugees. The November 2016 American Society of Tropical Medicine and Hygiene (ASTMH) conference in Atlanta will feature an interactive exhibit entitled "The Refugee Journey to Wellbeing" and three symposia about refugee health. The symposia will focus on tropical disease challenges in refugee populations, careers in refugee health, and recent experiences of governmental agencies and nongovernmental organizations in responding to the global refugee crisis. We invite ASTMH attendees to attend the exhibit and symposia and consider contributions they could make to improve refugee health through tropical disease research or clinical endeavors. © The American Society of Tropical Medicine and Hygiene.
Steel, Zachary; Momartin, Shakeh; Silove, Derrick; Coello, Marianio; Aroche, Jorge; Tay, Kuo Wei
Australia has been at the forefront of implementing immigration policies that aim to limit the flow of asylum seekers over recent decades. Two controversial polices have been the use of immigration detention for unauthorized arrivals and the issuing of temporary protection visas (TPVs) for refugees who arrived without valid visas. We conducted a longitudinal survey over 2 years commencing in 2003 of 104 consecutive refugees from Iran and Afghanistan attending a state-wide early intervention program in New South Wales. The sample included those released from immigration detention on TPVs (n = 47) and others granted permanent protection visas prior to entering Australia (PPVs, n = 57). Psychological symptoms were assessed at baseline and follow-up by the Harvard Trauma Questionnaire (HTQ), the Hopkins symptom checklist-25 (HSCL), the GHQ-30 and the Penn State Worry Questionnaires (PSWQ). English language competency, daily living difficulties and coping-related activities were also assessed. The results indicated that TPVs had higher baseline scores than PPVs on the HTQ PTSD scale, the HSCL scales, and the GHQ. ANCOVA models adjusting for baseline symptom scores indicated an increase in anxiety, depression and overall distress for TPVs whereas PPVs showed improvement over time. PTSD remained high at follow-up for TPVs and low amongst PPVs with no significant change over time. The TPVs showed a significant increase in worry at follow-up. TPVs showed no improvement in their English language skills and became increasingly socially withdrawn whereas PPVs exhibited substantial language improvements and became more socially engaged. TPV holders also reported persistently higher levels of distress in relation to a wide range of post-migration living difficulties whereas PPVs reported few problems in meeting these resettlement challenges. The data suggest a pattern of growing mental distress, ongoing resettlement difficulties, social isolation, and difficulty in the
Morina, Naser; Schnyder, Ulrich; Schick, Matthis; Nickerson, Angela; Bryant, Richard A
Refugees can suffer many experiences that threaten their trust in others. Although models of refugee mental health have postulated that attachment securities may be damaged by refugee experiences, this has yet to be empirically tested. This study aimed to understand the relationship between the nature of traumatic experiences sustained by refugees and attachment styles. In a cross-sectional study, treatment-seeking refugees (N = 134) were assessed for traumatic exposure using the Harvard Trauma Questionnaire and Posttraumatic Diagnostic Scale. Attachment style was assessed using the Experiences in Close Relationship Scale. Whereas gender and severity of interpersonal traumatic events predicted avoidant attachment style (accounting for 11% of the variance), neither these factors nor non-interpersonal trauma predicted anxious attachment. Exposure to interpersonal traumatic events, including torture, is associated with enduring avoidant attachment tendencies in refugees. This finding accords with attachment theories that prior adverse interpersonal experiences can undermine secure attachment systems, and may promote avoidance of attachment seeking. This finding may point to an important process maintaining poor psychological health in refugees affected by interpersonal trauma. © The Royal Australian and New Zealand College of Psychiatrists 2016.
Milton, Abul Hasnat; Rahman, Mijanur; Hussain, Sumaira; Jindal, Charulata; Choudhury, Sushmita; Akter, Shahnaz; Ferdousi, Shahana; Mouly, Tafzila Akter; Hall, John; Efird, Jimmy T
The Rohingya people are one of the most ill-treated and persecuted refugee groups in the world, having lived in a realm of statelessness for over six generations, and who are still doing so. In recent years, more than 500,000 Rohingyas fled from Myanmar (Burma) to neighboring countries. This article addresses the Rohingya refugee crisis in Bangladesh, with special emphasis on the living conditions of this vulnerable population. We reviewed several documents on Rohingya refugees, visited a registered refugee camp (Teknaf), collected case reports, and conducted a series of meetings with stakeholders in the Cox's Bazar district of Bangladesh. A total of 33,131 registered Rohingya refugees are living in two registered camps in Cox's Bazar, and up to 80,000 additional refugees are housed in nearby makeshift camps. Overall, the living conditions of Rohingya refugees inside the overcrowded camps remain dismal. Mental health is poor, proper hygiene conditions are lacking, malnutrition is endemic, and physical/sexual abuse is high. A concerted diplomatic effort involving Bangladesh and Myanmar, and international mediators such as the Organization of Islamic Countries and the United Nations, is urgently required to effectively address this complex situation.
Environmental refugees are people who can no longer gain a secure livelihood in their homelands because of drought, soil erosion, desertification, and other environmental problems, aggravated by pressures of population and poverty. All have abandoned their homelands with little hope of returning, looking elsewhere even though it may be hazardous. This paper presents some key findings from a Climate Institute three-year research project into these refugees. One person in 200 worldwide is an environmental refugee. More than 30 countries in sub-Saharan Africa have generated more than 100,000 refugees each; of these, 15 countries have generated at least one million each or have a population where one person in ten is a refugee. While the population of environmental refugees is already enormous, their numbers may swell dramatically with the projected global warming of the planet and other environmental pressures. They have already shown the largest proportional increase among all refugees in recent years. Few countries, however, have mobilized the institutional structures and support resources needed to cope with the fast-gathering crisis. If we do not deal with the problem in the short term, it will only become more severe and costly in the long term.
The article discusses the cooperation between the EU and Lebanon with a focus on the newly launched EU-Lebanon Partnership Compact, based on a decision by the EU-Lebanon Association Council of 11 November 2016. The Compact describes the suggested (and partly mutual) commitments by the EU...... and Lebanon aiming at securing the stabilization of Lebanon in general, but also measures attempting to “provide an appropriate and safe environment for refugees and displaced persons from Syria during their temporary stay in Lebanon.”2 An important discussion in connection with that is the question of easing...... the refugees’ controlled access to the Lebanese labour market – obviously a controversial issue. The article concludes that the main EU interests are twofold. Firstly, it is about avoiding destabilization of Lebanon by supporting the integration of refugees in the Lebanese society. Secondly, the reputation...
Buddhist Monks in Vietnam struggle with cultural preservation differently from a monk in the U.S. where the forces of acculturation for new arrivals, often refugees, are extraordinarily overwhelming. The author provides a case study examining how Buddhist leaders engage in cultural preservation and community building in the American South. Fusing ideas of Engaged Buddhism and community building, the author will demonstrate how a Buddhist monk is able to navigate the broader American culture a...
Cookson, Susan T; Abaza, Hiba; Clarke, Kevin R; Burton, Ann; Sabrah, Nadia A; Rumman, Khaled A; Odeh, Nedal; Naoum, Marwan
By the summer of 2014, the Syrian crisis resulted in a regional humanitarian emergency with 2.9 million refugees, including 608,000 in Jordan. These refugees access United Nations High Commissioner for Refugees (UNHCR)-sponsored clinics or Jordan Ministry of Health clinics, including tuberculosis diagnosis and treatment. Tuberculosis care in Syria has deteriorated with destroyed health infrastructure and drug supply chain. Syrian refugees may have undiagnosed tuberculosis; therefore, the UNHCR, the International Organization for Migration (IOM), the National Tuberculosis Program (NTP), and the Centers for Disease Control and Prevention developed the Public Health Strategy for Tuberculosis among Syrian Refugees in Jordan. This case study presents that strategy, its impact, and recommendations for other neighboring countries. UNHCR determined that World Health Organization (WHO) criteria for implementing a tuberculosis program in an emergency were met for the Syrian refugees in Jordan. Jordan NTP assessed their tuberculosis program and found that access to Syrian refugees was the one component of their program missing. Therefore, a strategy for tuberculosis control among Syrian refugees was developed. Since that development through work with IOM, UNHCR, and NTP, tuberculosis case detection among Syrian refugees is almost 40 % greater (74 cases/12 months or 1.01/100,000 monthly through June 2014 vs. 56 cases/16 months or 0.73/100,000 monthly through June 2013) using estimated population figures; more than two fold the 2012 Jordan tuberculosis incidence. Additionally, the WHO objective of curing ≥85 % of newly identified infectious tuberculosis cases was met among Syrian refugees. Tuberculosis (TB) rates among displaced persons are high, but increased detection is possible. High TB rates were found among Syrian refugees through active screening and will probably persist as the Syrian crisis continues. Active screening can detect tuberculosis early and reduce risk
Carone, Marco; Al-Saedy, Huda; Nyce, Sayre; Ghosn, Jad; Mutuerandu, Timothy; Black, Robert E
Abstract Objective To determine the range and burden of health services utilization among Iraqi refugees receiving health assistance in Jordan, a country of first asylum. Methods Medical conditions, diagnosed in accordance with the tenth revision of the International classification of diseases, were actively monitored from 1January to 31December 2010 using a pilot centralized database in Jordan called the Refugee Assistance Information System. Findings There were 27 166 medical visits by 7642 Iraqi refugees (mean age: 37.4 years; 49% male; 70% from Baghdad; 6% disabled; 3% with a history of torture). Chronic diseases were common, including essential hypertension (22% of refugees), visual disturbances (12%), joint disorders (11%) and type II diabetes mellitus (11%). The most common reasons for seeking acute care were upper respiratory tract infection (11%), supervision of normal pregnancy (4%) and urinary disorders (3%). The conditions requiring the highest number of visits per refugee were cerebrovascular disease (1.46 visits), senile cataract (1.46) and glaucoma (1.44). Sponsored care included 31 747 referrals or consultations to a specialty service, 18 432 drug dispensations, 2307 laboratory studies and 1090 X-rays. The specialties most commonly required were ophthalmology, dentistry, gynaecology and orthopaedic surgery. Conclusion Iraqi refugees in countries of first asylum and resettlement require targeted health services, health education and sustainable prevention and control strategies for predominantly chronic diseases. PMID:22690034
Mateen, Farrah J; Carone, Marco; Al-Saedy, Huda; Nyce, Sayre; Ghosn, Jad; Mutuerandu, Timothy; Black, Robert E
To determine the range and burden of health services utilization among Iraqi refugees receiving health assistance in Jordan, a country of first asylum. Medical conditions, diagnosed in accordance with the tenth revision of the International classification of diseases, were actively monitored from 1 January to 31 December 2010 using a pilot centralized database in Jordan called the Refugee Assistance Information System. There were 27 166 medical visits by 7642 Iraqi refugees (mean age: 37.4 years; 49% male; 70% from Baghdad; 6% disabled; 3% with a history of torture). Chronic diseases were common, including essential hypertension (22% of refugees), visual disturbances (12%), joint disorders (11%) and type II diabetes mellitus (11%). The most common reasons for seeking acute care were upper respiratory tract infection (11%), supervision of normal pregnancy (4%) and urinary disorders (3%). The conditions requiring the highest number of visits per refugee were cerebrovascular disease (1.46 visits), senile cataract (1.46) and glaucoma (1.44). Sponsored care included 31 747 referrals or consultations to a specialty service, 18 432 drug dispensations, 2307 laboratory studies and 1090 X-rays. The specialties most commonly required were ophthalmology, dentistry, gynaecology and orthopaedic surgery. Iraqi refugees in countries of first asylum and resettlement require targeted health services, health education and sustainable prevention and control strategies for predominantly chronic diseases.
Meinel, D M; Kuehl, R; Zbinden, R; Boskova, V; Garzoni, C; Fadini, D; Dolina, M; Blümel, B; Weibel, T; Tschudin-Sutter, S; Widmer, A F; Bielicki, J A; Dierig, A; Heininger, U; Konrad, R; Berger, A; Hinic, V; Goldenberger, D; Blaich, A; Stadler, T; Battegay, M; Sing, A; Egli, A
Toxigenic Corynebacterium diphtheriae is an important and potentially fatal threat to patients and public health. During the current dramatic influx of refugees into Europe, our objective was to use whole genome sequencing for the characterization of a suspected outbreak of C. diphtheriae wound infections among refugees. After conventional culture, we identified C. diphtheriae using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) and investigated toxigenicity by PCR. Whole genome sequencing was performed on a MiSeq Illumina with >70×coverage, 2×250 bp read length, and mapping against a reference genome. Twenty cases of cutaneous C. diphtheriae in refugees from East African countries and Syria identified between April and August 2015 were included. Patients presented with wound infections shortly after arrival in Switzerland and Germany. Toxin production was detected in 9/20 (45%) isolates. Whole genome sequencing-based typing revealed relatedness between isolates using neighbour-joining algorithms. We detected three separate clusters among epidemiologically related refugees. Although the isolates within a cluster showed strong relatedness, isolates differed by >50 nucleotide polymorphisms. Toxigenic C. diphtheriae associated wound infections are currently observed more frequently in Europe, due to refugees travelling under poor hygienic conditions. Close genetic relatedness of C. diphtheriae isolates from 20 refugees with wound infections indicates likely transmission between patients. However, the diversity within each cluster and phylogenetic time-tree analysis suggest that transmissions happened several months ago, most likely outside Europe. Whole genome sequencing offers the potential to describe outbreaks at very high resolution and is a helpful tool in infection tracking and identification of transmission routes. Copyright Â© 2016. Published by Elsevier Ltd.
The purpose of the thesis is to look at the reality of an Italian-speaking refugee during the First World War, when people were forced to evacuate the Trentino region and were moved within the Austro-Hungarian Empire. The thesis will look closely at the diary of an Italian-speaking refugee, starting with his evacuation from Trentino and continuing to his arrival and permanence in the northern Bohemian city of Jablonné v Podještědí. The paper will also explore the internal migration movements ...
Unprecedented numbers of adult refugee learners are entering ESL classes, many of whom escaped war-torn countries and endured long stays in refugee camps. Research in public health and psychology has documented high levels of depression, anxiety, and posttraumatic stress disorder in refugee populations. Drawing on ethnographic research with Laotian refugee women who experienced pre-settlement trauma during the Vietnam War and interviews with bilingual mental health professionals, this article...
Hazou, Rand T.
In September 2015, and in response to the Syrian refugee crisis, there were widespread calls in New Zealand urging the Government to raise its annual Refugee Quota. Maori Party co-leader Marama Fox argued that New Zealand could afford to take on more refugees as part of its global citizenship and suggested that New Zealand's policy might be shaped…
Full Text Available This article explores the different labels under which refugees in Dar es Salaam may be categorised. It identifies and profiles differentgroups of urban refugee in Dar es Salaam and considers some common assumptions about urban refugees.
Kübra Güran Yiğitbaşı
Full Text Available Media allows us to witness to the moments – to the wars in which humanity remains most embarrassed, most vulnerable and most desperate - today via the latest technologies. It is known that the Gulf War was a turning point in media’s illustration of a war, meaning that its representation of actual war footage as a cinematography to the audience in a way never seen before. The point where we have arrived at today seems that it has gone beyond watching the war in our safe places by feeling as if we were directly involved in it. Media receivers/target audiences are now facing the witnessing and being aware of the incidents that all civilians –especially the most affected ones, children, women and elderly people- experienced. This situation brings along the demands of societies who are willing to take responsibilities and initiatives about the events they witnessed, besides the countries and the governments. In this study, the extent to which Multeci-Der as a non-governmental organization that works for refugee problems can represent itself in the media is analyzed by content analysis and discourse analysis methods. In what extent the association is represented and with what types of news it is represented is considered significant, since it shows Multeci-Der’s contributions for creating an agenda on the subject. With reference to the ongoing war in Syria since 2011, the media news regarding Syrian refugees have been analyzed over Multeci-Der, which was established as a non-governmental organization in order to work for refugees. As a result, it is seen that the national press reserves a limited attention about the association’s activities and statements, and the news of local press seem to be far from creating an agenda and public opinion throughout the country.
Mohammadzadeh, Zahra; Jung, Felicitas; Lelgemann, Monika
The Bremen model recognizes that refugee health care has to go beyond merely checking for the prevalence of contagious diseases. Elementary health care offered in the reception centre and transitory facilities is based on voluntary acceptance by the refugees. At the same time, legal requirements for the medical reception of refugees are observed. In addition, doctors performing the initial medical examination are enabled to cover acute care on the spot. During the preliminary phase of immigration refugees are allowed to see a doctor in their facility repeatedly. After a certain time, they are provided with a health card permitting limited access to regular care outside of their facility. The current rise of refugee numbers affects the situation of Bremen health care for adult as well as juvenile refugees. In spite of the increase, health care standards are maintained by means of the health card. From 2011 to 2014, "Factors influencing health status and contact with health services" averaged 29.6 % in the health check data. Diseases of the respiratory system (18.1 %) and "symptoms, signs and abnormal findings not elsewhere classified" (16.9 %) ranked second and third, respectively. Diseases of the digestive system (6.1 %) of the musculoskeletal system (6 %) and of the skin and subcutaneous tissue (3.6 %) followed. Infectious diseases such as HIV infections, hepatitis or tuberculosis were seldom.
Full Text Available In 2013, the Center for Migration Studies of New York (CMS initiated a project to bring concentrated academic and policy attention to the US refugee protection system, broadly understood to encompass refugees, asylum seekers and refugee-like populations in need of protection. The initiative gave rise to a series of papers published in 2014 and 2015, which CMS is releasing as a special collection in its Journal on Migration and Human Security on the 35th anniversary of the Refugee Act of 1980. This introductory essay situates the papers in the collection within a broader discussion of state compliance with international law, impediments to protection, US protection programs, vulnerable populations, and due process concerns. The essay sets forth extensive policy recommendations to strengthen the system drawn from the papers, legislative proposals, and other sources.
... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Adjustment of status of refugees. 209.1... STATUS OF REFUGEES AND ALIENS GRANTED ASYLUM § 209.1 Adjustment of status of refugees. The provisions of this section shall provide the sole and exclusive procedure for adjustment of status by a refugee...
Full Text Available While the Syrian refugees crisis has increasingly continued its effect in both Turkey and other neighboring countries and European countries for more than five years, refugees do not adapt themselves to society in country of asylum, and are exposed to social exclusion. The purpose of the study is to explore social representations of social media users toward Syrian refugees in Turkey with a qualitative approach; because social representations may indicate the problems in the integration process of Syrian refugees and Turkish society, and the reasons of social exclusion toward Syrian refugees. Accordingly 98 entries, which were taken from frequently used social dictionaries in Turkey, were evaluated by researchers and seven thematic units were formed. Thematic units reflect (i perceived negative features of Syrian refugees, (ii perceived threats in Turkey due to Syrian refugees, (iii criticisms toward Syrian refugees policy of Turkish government, (iv positive attitudes toward Syrian refugees, (v perceived political importance of Syrian refugees, (vi proposed solutions toward perceived Syrian refugees problem, and (vii other criticisms toward Syrian refugees issue. Findings provide useful information which can be used to enable the social adaptation of Syrian refugees into Turkish society
Sawyer, Kem Knapp
Millions of people around the world have lost the freedom to remain in their homes or choose where they want to live. In fact, 1 in every 125 people in this world is a refugee. For many refugees, finding a new home is a long, tedious, and painful process. Many host countries that receive refugees suffer from overpopulation, housing shortages, and…
Using a longitudinal dataset from the years 1995 and 2000, respectively, this study examines whether migration within the host country of Sweden generates higher total annual income for (two-earner) immigrant families. The empirical findings indicate that internal migration generates a positive outcome in terms of higher family income for newly arrived refugee-immigrant families. Further, with the length of residence in the host country, the monetary gain accruing from internal migration decr...
Kruse, Johannes; Joksimovic, Ljiljana; Cavka, Majda; Wöller, Wolfgang; Schmitz, Norbert
The aim of this study is to evaluate the effects of a trauma-focused psychotherapy upon war refugees from Bosnia. Seventy refugees who met the criteria for posttraumatic stress disorder (PTSD) and somatoform disorders were included. The first 35 refugees were offered psychotherapy and the following 35 refugees received usual care. Outcome variables were changes in self-reported PTSD symptoms, psychological symptoms, and health status. At 12-month follow-up, participants in the intervention group reported significantly lower scores on the PTSD scale and the measure of psychological symptoms than the comparison group participants. Our results suggest that psychotherapy reduces symptoms of PTSD and somatoform disorders among war refugees even in the presence of insecure residence status.
Full Text Available Between 2011 and 2015, Lebanon received over one million Syrian refugees. There is no country in the world that has taken in as many refugees in proportion to its size: by 2015, one in four of its residents was a refugee from Syria. Already beset, prior to the Syrian crisis, by political divisions, insecure borders, severely strained infrastructure, and over-stretched public services, the mass influx of refugees further taxed the country. That Lebanon withstood what is often characterized as an existential threat is primarily due to the remarkable resilience of the Lebanese people. It is also due to the unprecedented levels of humanitarian funding that the international community provided to support refugees and the communities that hosted them. UN, international, and national partners scaled up more than a hundred-fold to meet ever-burgeoning needs and creatively endeavored to meet challenges on the ground. And while the refugee response was not perfect, and funding fell well below needs, thousands of lives were saved, protection was extended, essential services were provided, and efforts were made to improve through education the future prospects of the close to half-a-million refugee children residing in Lebanon. This paper examines what worked well and where the refugee response stumbled, focusing on areas where improved efforts in planning, delivery, coordination, innovation, funding, and partnerships can enhance future emergency responses.
Full Text Available This study attempted to find a correlation between the trauma of family members of war and exile, and the characteristics of family functioning and lasted from 1992-1995. The term “family resilience” refers to the processes of adaptation and coping in the family as a functional unit. This paper presents a study of refugee families from Bosnia, who lived in refugee camps in Macedonia during the war of 1992- 1995. Data were obtained by interviews, observations, and a number of psychological instruments especially for children and parents, which measured the effects of psychological stress and family relationships. Based on the results obtained by quantitative and qualitative analysis, and application of theoretical models of systemic theory and family therapy, existence for four types of refugee families has been found and described, depending on the structure and the level of functionality.
Full Text Available In the context of protracted refugee situations, there has been a revival in concern among policymakers to transcend the so-called humanitarian-development divide and create greater opportunities for self-reliance. Yet, these discussions too often neglect an analytical focus on refugees’ own economic lives, and their own interactions with markets.Despite a growing literature on the economic lives of refugees, much of that work has lacked theory or data. The work that has been quantitative has generally focused on the economic impact of refugees on host countries rather than explaining variation in economic outcomes for refugees. In order to explain variation in economic outcomes for refugees, this paper asks three questions about the economic lives of refugees: 1 what makes the economic lives of refugees distinctive from other populations; 2 what explains variation in refugees’ income levels; and 3 what role does entrepreneurship play in shaping refugees’ economic outcomes?In order to answer these questions, the paper draws upon extensive qualitative and quantitative research conducted in Uganda by the Humanitarian Innovation Project at Oxford University. The quantitative data set is based on a survey of 2,213 refugees in three types of contexts: urban (Kampala, protracted camps (Nakivale and Kyangwali settlements, and emergency camps (Rwamwanja. It supplements this with qualitative research from other parts of Africa and the Middle East. The economic lives of refugees are argued to be distinctive not because refugees are any different qua human beings but because they often occupy a distinctive institutional space. Following new institutional economics, the paper argues that “refugee economies” represent a distinctive analytical space insofar as refugees face different formal and informal institutional barriers and distortions in their economic lives compared to nationals or other migrants. Even within the same country, refugees
Ankara : Bilkent University Institute of Economics and Social Science, 1999. Thesis (Master's) -- Bilkent University, 1999. Includes bibliographical references. During tlie recent years, the world has experienced severe human rights abuses and many conflicts that turned into violence, which consequently produced massive refugee flows. As the numbers increased to crisis levels, the international community started to adopt a new approach to refugee issues. Today, refugees are ...
Although there is substantial research on the psychological wellbeing of refugees in psychology, especially in acculturation research, there is very little research assessing refugees' objective conditions of living. This study aims to bridge this gap by assessing the perceived satisfaction of Somali refugees' objective elements ...
Full Text Available When citizens lose faith in their government’s refugee policies, there arises the potential for an anti-immigration backlash, as several European countries have recently discovered. Canada has yet to see that happen, but it has for too long been muddling along with a refugee-processing system that is seriously flawed. Refugees go unprocessed for years, and in the meantime end up living, working and laying down roots. Often that only increases the chances they will end up staying even if they might have otherwise been rejected. It may even lead to increases in questionable refugee claims, as people realize they can work and make money in Canada for years before their case is even heard. The Canadian government has committed to increasing refugee numbers. The United Nations High Commissioner for Refugees has designated Canada as the primary destination for hard-to-settle refugees. The diversity of source countries is increasing, resulting in more refugees who are illiterate in both English and French. More refugees will struggle to adapt to life in Canada. Taken together, it is possible that without fixing the problems in the system, public dissatisfaction could rise as Canadians lose faith that their refugee system is under control, and that could undermine their faith in the entire immigration system. The biggest flaw in the refugee system traces back to the government’s overreaction to the Singh decision. The Supreme Court ordered that all rejected refugees had a right to an in-person appeal, but the federal government went much further and gave every refugee an in-person hearing. That system has left Canada with a backlog, as of last year, of 34,000 cases. In most every other country, initial refugee screenings are conducted by public servants working for the immigration agency, which here would be Immigration, Refugees and Citizenship Canada, as opposed to the staff of the Immigration and Refugee Board. Canada could do a much better job
Nyangoma, E N; Olson, C K; Painter, J A; Posey, D L; Stauffer, W M; Naughton, M; Zhou, W; Kamb, M; Benoit, S R
U.S. immigration regulations require clinical and serologic screening for syphilis for all U.S.-bound refugees 15 years of age and older. We reviewed syphilis screening results for all U.S.-bound refugees from January 1, 2009 through December 31, 2013. We calculated age-adjusted prevalence by region and nationality and assessed factors associated with syphilis seropositivity using multivariable log binomial regression models. Among 233,446 refugees, we identified 874 syphilis cases (373 cases per 100,000 refugees). The highest overall age-adjusted prevalence rates of syphilis seropositivity were observed among refugees from Africa (1340 cases per 100,000), followed by East Asia and the Pacific (397 cases per 100,000). In most regions, male sex, increasing age, and living in non-refugee camp settings were associated with syphilis seropositivity. Future analysis of test results, stage of infection, and treatment delivery overseas is warranted in order to determine the extent of transmission risk and benefits of the screening program.
Marshall, Grant N; Schell, Terry L; Wong, Eunice C; Berthold, S Megan; Hambarsoomian, Katrin; Elliott, Marc N; Bardenheier, Barbara H; Gregg, Edward W
To determine rates of diabetes, hypertension, and hyperlipidemia in Cambodian refugees, and to assess the proportion whose conditions are satisfactorily managed in comparison to the general population. Self-report and laboratory/physical health assessment data obtained from a household probability sample of U.S.-residing Cambodian refugees (N = 331) in 2010-2011 were compared to a probability sample of the adult U.S. population (N = 6,360) from the 2009-2010 National Health and Nutrition Examination Survey. Prevalence of diabetes, hypertension and hyperlipidemia in Cambodian refugees greatly exceeded rates found in the age- and gender-adjusted U.S. Cambodian refugees with diagnosed hypertension or hyperlipidemia were less likely than their counterparts in the general U.S. population to have blood pressure and total cholesterol within recommended levels. Increased attention should be paid to prevention and management of diabetes and cardiovascular disease risk factors in the Cambodian refugee community. Research is needed to determine whether this pattern extends to other refugee groups.
Sangalang, Cindy C; Vang, Cindy
Although a robust literature describes the intergenerational effects of traumatic experiences in various populations, evidence specific to refugee families is scattered and contains wide variations in approaches for examining intergenerational trauma. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, the purpose of this systematic review was to describe the methodologies and findings of peer-reviewed literature regarding intergenerational trauma in refugee families. In doing so we aimed to critically examine how existing literature characterizes refugee trauma, its long-term effects on descendants, and psychosocial processes of transmission in order to provide recommendations for future research. The results highlight populations upon which current evidence is based, conceptualizations of refugee trauma, effects of parental trauma transmission on descendants' health and well-being, and mechanisms of transmission and underlying meanings attributed to parental trauma in refugee families. Greater methodological rigor and consistency in future evidence-based research is needed to inform supportive systems that promote the health and well-being of refugees and their descendants.
Murray, John S
The purpose of this article was to describe the phenomenon of toxic stress and its impact on the physical and mental health of child refugees. Almost two decades ago, researchers found that recurring adverse childhood events (ACEs; e.g., physical, psychological, and sexual abuse, neglect, and household dysfunction such as substance abuse, mental illness, and criminal behavior) were associated with a significant increase in serious illnesses during adulthood. Illnesses include heart, lung, and liver disease, cancer, and bone fractures. The scientists reported that experiencing four or more ACEs during childhood significantly increases the risk for toxic stress. Toxic stress is defined as the exposure to extreme, frequent, and persistent adverse events without the presence of a supportive caretaker. There is a paucity of literature related to toxic stress and child refugees. However, it has been clearly established that the prolonged brutal and traumatizing war in Syria is having a profound impact on the physical and mental health of child refugees at a distressing rate. Prevention of toxic stress should be a primary goal of all pediatric healthcare professionals working with child refugees. While this seems daunting given the population, and the seemingly insurmountable stressors they experience, some basic interventions should be considered. Providing basic anticipatory guidance to parents and caregivers of child refugees, to encourage positive parenting and strengthening support networks, will be highly effective in developing the requisite buffers that mitigate the effects of stress and avoid toxic stress. Efforts should also be focused on addressing caregiver stress and improving their ability to provide safe, reliable, and nurturing care that will help to mitigate any stress response experienced by a child. It is critical that greater awareness be placed on the effects of toxic stress on child refugees who are exposed to significant adverse events early in life
Gangamma, Rashmi; Shipman, Daran
In this article, we discuss incorporating the transnational intersectionality framework in family therapy with resettled refugees. Transnational intersectionality is an extension of the framework of intersectionality which helps to better understand complexities of power and oppression across national contexts and their influence on refugees' lives. Adopting this framework alerts family therapists to: (a) develop critical awareness of refugee's transnational contexts; (b) understand differences in experiences of social identities across contexts; (c) acknowledge postmigration factors of oppression affecting resettlement; and (d) critically reflect upon therapist-interpreter-client intersectionalities. This shifts our conceptualization of therapy with refugees to actively consider transnational contexts which refugees uniquely occupy. We describe the framework and provide two case illustrations to highlight its usefulness. © 2017 American Association for Marriage and Family Therapy.
McCleary, Jennifer S; Shannon, Patricia J; Cook, Tonya L
An emerging body of literature identifies substance use as a growing concern among refugees resettling in the United States. Like immigrants, refugees may face cultural, linguistic, or systems barriers to connecting with mainstream substance use treatment programs, which may be compounded by refugees' unique experiences with exposure to trauma, displacement in refugee camps, and resettlement. This qualitative study explores factors that support and prevent refugees from connecting with chemical health treatment. Fifteen participants who identified as social service or public health professionals who work with refugees responded to an online, semistructured survey about their experiences referring refugees to substance use treatment. Resulting data was analyzed using thematic analysis. Themes emerged identifying a lack of culturally informed treatment models, policy issues, and client characteristics such as motivation and past trauma as barriers to engaging with treatment. Ongoing case management and coordination were identified as important to successful linkage. Findings from this study contribute to a better understanding of how to support refugees seeking substance use treatment and suggest that developing trauma informed, culturally relevant models of treatment that are integrated with primary health care and geographically accessible may enhance treatment linkage.
Kronick, Rachel; Rousseau, Cécile; Cleveland, Janet
Asylum seeking children arriving in Canada regularly face incarceration in medium-security-style immigration detention centres. Research demonstrates the human cost of detaining migrant children and families and the psychiatric burden linked with such imprisonment. This study aims to understand the lived experiences of children aged 3-13 held in detention. Informed by a qualitative methodology of narrative inquiry, child participants created worlds in the sand and generated stories to express their subjective experience. Results suggest that children's sandplay confirms the traumatic nature of immigration detention while also revealing children's sometimes conflicting understanding of the meaning of detention and their own migration. The results are contextualized by a description of detention conditions and the psychiatric symptoms associated with immigration incarceration. The study highlights the need for more research examining the impact of immigration detention on children's mental health, while also underlining how refugee children's voices provide important direction for policy change.
Rosholm, Michael; Vejlin, Rune Majlund
We estimate the effect of lowering income transfers to refugee immigrants in Denmark - labeled start-help - using a competing risk framework. Refugee immigrants obtaining residence permit before July 2002 received larger income transfers than those who obtained their residence permit later...
After the so-called refugee crisis of 2015-2016 European reactions to foreigners had come to the fore and we are seeing xenophobic political and populist movements become increasingly mainstream. The massive rejection of refugees/asylum seekers taking place has made their conditions before, during and after flight, increasingly difficult and dangerous. This paper relates current xenophobia to historical attitudinal trends in Europe regarding Islam, and claims that a much more basic conflict is at work: the one between anti-modernism/traditionalism and modernism/globalization. Narratives on refugees often relate them to both the foreign (Islam) and to "trauma". In an environment of insecurity and collective anxiety, refugees may represent something alien and frightening but also fascinating. I will argue that current concepts and theories about "trauma" or "the person with trauma" are insufficient to understand the complexity of the refugee predicament. Due to individual and collective countertransference reactions, the word "trauma" tends to lose its theoretical anchoring and becomes an object of projection for un-nameable anxieties. This disturbs relations to refugees at both societal and clinical levels and lays the groundwork for the poor conditions that they are currently experiencing. Historically, attitudes towards refugees fall somewhere along a continuum between compassion and rejection/dehumanization. At the moment, they seem much closer to the latter. I would argue that today's xenophobia and/or xeno-racism reflect the fact that, both for individuals and for society, refugees have come to represent the Freudian Uncanny/das Unheimliche.
Full Text Available Considering the recent mass movement of people fleeing war and oppression, an analysis of changes in migration, in particular an analysis of the final destination refugees choose, seems to be of utmost importance. Many international organisations like UNHCR (the United Nations High Commissioner for Refugees or EuroStat gather and provide information on the number of refugees and the routes they follow. What is also needed to study the state of affairs closely is a visual form presenting the rapidly changing situation. An analysis of the problem together with up-to-date statistical data presented in the visual form of a map is essential. This article describes methods of preparing such interactive maps displaying movement of refugees in European Union countries. Those maps would show changes taking place throughout recent years but also the dynamics of the development of the refugee crisis in Europe. The ArcGIS software was applied to make the map accessible on the Internet. Additionally, online sources and newspaper articles were used to present the movement of migrants. The interactive map makes it possible to watch spatial data with an opportunity to navigate within the map window. Because of that it is a clear and convenient tool to visualise such processes as refugee migration in Europe.
Calka, Beata; Cahan, Bruce
Considering the recent mass movement of people fleeing war and oppression, an analysis of changes in migration, in particular an analysis of the final destination refugees choose, seems to be of utmost importance. Many international organisations like UNHCR (the United Nations High Commissioner for Refugees) or EuroStat gather and provide information on the number of refugees and the routes they follow. What is also needed to study the state of affairs closely is a visual form presenting the rapidly changing situation. An analysis of the problem together with up-to-date statistical data presented in the visual form of a map is essential. This article describes methods of preparing such interactive maps displaying movement of refugees in European Union countries. Those maps would show changes taking place throughout recent years but also the dynamics of the development of the refugee crisis in Europe. The ArcGIS software was applied to make the map accessible on the Internet. Additionally, online sources and newspaper articles were used to present the movement of migrants. The interactive map makes it possible to watch spatial data with an opportunity to navigate within the map window. Because of that it is a clear and convenient tool to visualise such processes as refugee migration in Europe.
De Filippis, L G; Trombetta, I; Novella, T; Alampi, M
The objective of the research is to determine 25[OH]D serum levels in refugees in Italy. In the following research we have taken into consideration the results of the monitoring of Vitamin D levels in 46 refugees of the Italian Service for protection of refugees and asylum seekers (SPRAR) system. The indicator of overall vitamin D status used was the circulating serum level of 25(OH)D. Data was analyzed using Microsoft Excel. In the refugees tested, the mean level of 25(OH)D resulted 9.18 ng/mL. The standard deviation was 4.8, with a minimal level of 4.3 and a maximum of 27.4. This figure indicates a clear condition of hypovitaminosis in refugees. While it is general assumption that migratory phenomena may induce the spread of tropical or infectious diseases, widely attested literature demonstrates how chronic pathologies and diseases related to altered lifestyles are the most relevant for Italian case records. Indeed, among the aforementioned diseases, Vitamin D deficiency so far lacks acknowledgement at a national level. Considering the results of lower-than-desirable vitamin D levels found in refugees in Italy, it is necessary to take this parameter into consideration when analyzing individuals who have faced migratory phenomena in order to mitigate the effects of hypovitaminosis D.
Full Text Available The strategies of Yemeni refugees in Somalia are extensively based on the social networks and cultural linkages that exist between the Horn of Africa and Yemen. Meanwhile, Somali refugees returning from Yemen need to find safer areas within Somalia.
Alfadhli, Khalifah; Drury, John
As the years of displacement accumulate, the burden of secondary stressors (i.e., stressors not directly related to war) increase on the shoulders of millions of refugees, who do not have the option of either returning home due to war or having a sustainable livelihood in the host countries. This paper aims to shed light on the overlooked importance of secondary stressors among refugees of conflict in developing countries; it will do this by highlighting the experience of Syrian refugees in Jordan, and developing a typology of these stressors. We approached this issue using two levels of exploration. In study 1, we used participant observation and 15 in-depth interviews in Irbid, Jordan. Data were analysed qualitatively using thematic analysis to explore the different types of stressors. In study 2, a questionnaire survey among Syrian refugees in Jordan (n = 305) was used to collect data about a wide range of stressors. Responses were subjected to factor analysis to examine the extent to which the stressors could be organized into different factors. The thematic analysis suggested three different types of secondary stressors: financial (money related), environmental (exile structures and feelings created by it), and social (directly related to social relations). The factor analysis of the survey data produced a similar typology, where secondary stressors were found to be grouped into four main factors (financial, services, safety, and relations with out-groups). The final result is a typology of 33 secondary stressors organised in three main themes. Syrian refugees in Jordan suffer the most from financial stressors, due to loss of income and high living expenses. Environmental stressors arise from exile and are either circumstantial (e.g., services and legal requirements) or created by this environment (e.g., instability and lack of familiarity). Social stressors were observed among a considerable section of refugees, varying from stressors due to being targeted as
Full Text Available The current state of forced displacement today, with record numbers and rising levels of need, poses challenges of a scope and complexity that we have not had to face since the Second World War. Yet, if we make every effort to place refugee protection at the heart of our response, these challenges are not insurmountable. The international refugee regime provides us with tried and tested tools to address them. What is needed now is to put our collective resources and capacities to their most effective use. We are already seeing this in the recent move towards creating a proposed Global Compact on Responsibility Sharing for Refugees, as set out in the UN secretary-general’s report, In Safety and Dignity: Addressing Large Movements of Refugees and Migrants. We are also seeing this with innovative directions in protection, assistance, and solutions for refugees that are helping us to operationalize long-standing principles of protection, transforming them into tangible results for refugees. New forms of group determination, combined with community-based protection and other measures, can help to ensure an appropriate legal status while at the same time identifying specific protection needs. Protection strategies can inform frameworks for governing migration and meeting the needs of the most vulnerable migrants. The integration of services to refugees within national systems and the expansion of cash-based programming can meet essential needs for assistance more effectively. Finally, the humanitarian-development nexus, the progressive realization of rights — including the right to work, and the creation of complementary pathways for admission — can provide the building blocks for achieving longer-term solutions, which remain, as ever, the ultimate aspiration of the international refugee protection regime.Volker Türk is the Assistant High Commissioner for Protection, United Nations High Commissioner for Refugees (UNHCR.
Gilberto M A Rodrigues
Full Text Available Brazil’s humanitarian visa programme for Syrian refugees and its efforts to recognise their qualifications could offer lessons for refugee protection and integration across the region.
Johnson, Jennifer Leigh; Beard, Joyce; Evans, Dena
Annually, over 80,000 refugees enter the United States as a result of political or religious persecution. Of these, approximately 35% to 40% are children and adolescents. Refugees are faced with challenges associated with living conditions, cultural and social norms, and socioeconomic status due to problems occurring in their homelands. These challenges include but are not limited to malnutrition, communicable disease, questionable immunization status, lack of formal education, sexual abuse, violence, torture, human trafficking, homelessness, poverty, and a lack of access to health care. Moreover, the psychological impact of relocation and the stress of acculturation may perpetuate many of these existing challenges, particularly for refugee youth, with limited or underdeveloped coping skills. School nurses are uniquely poised to support refugee youth in the transition process, improve overall health, and facilitate access to primary health services. The purpose of this article is to provide an overview of the unique refugee experience, examine the key health care needs of the population, and present school nurses with timely and relevant resources to assist in caring for refugee youth.
Barghadouch, Amina; Kristiansen, Maria; Jervelund, Signe Smith; Hjern, Anders; Montgomery, Edith; Norredam, Marie
Studies show a high level of mental health problems among refugee children. This study examined whether a subset of refugee children living in Denmark accessed psychiatric healthcare services more than those born in the country. This study compared 24,427 refugee children from Asia, The Middle East, Sub-Saharan Africa and former Yugoslavia, who obtained residency in Denmark between 1 January 1993 and 31 December 2010 with 146,562 Danish-born children, matched 1:6 on age and sex. The study looked at contacts with psychiatric hospitals as well as psychologists and psychiatrists in private practice. Between 1 January 1996 and 30 June 2012, 3.5 % of the refugee children accessed psychiatric healthcare services compared to 7.7 % of the Danish-born children. The rate ratio of having any first-time psychiatric contact was 0.42 (95 % CI 0.40-0.45) among refugee boys and 0.35 (95 % CI 0.33-0.37) among refugee girls, compared to Danish-born children. Figures were similar for those accessing private psychologists or psychiatrists, emergency room, inpatient and outpatient services. Refugee children used fewer psychiatric healthcare services than Danish-born children. This may indicate that refugee children experience barriers in accessing psychiatric healthcare systems and do not receive adequate assessment of their mental health and subsequent referral to specialist services.
The United Nations High Commissioner for Refugees (UNHCR) has helped 3.69 million Afghan refugees return to Afghanistan since March 2002, marking the largest assisted return operation in its history...
Boyd, T. (ed.)
Friends of the Earth Australia is commemorating World Refugee Day in 2005 by publishing a 'Citizens Guide to Climate Refugees'. This publication gives the basic facts on climate change, greenhouse gas emissions; why people could become climate refugees, how many and where are they likely to come from; and what can be done about it.
Milton, Abul Hasnat; Rahman, Mijanur; Hussain, Sumaira; Jindal, Charulata; Choudhury, Sushmita; Akter, Shahnaz; Ferdousi, Shahana; Mouly, Tafzila Akter; Hall, John; Efird, Jimmy T.
The Rohingya people are one of the most ill-treated and persecuted refugee groups in the world, having lived in a realm of statelessness for over six generations, and who are still doing so. In recent years, more than 500,000 Rohingyas fled from Myanmar (Burma) to neighboring countries. This article addresses the Rohingya refugee crisis in Bangladesh, with special emphasis on the living conditions of this vulnerable population. We reviewed several documents on Rohingya refugees, visited a reg...
Full Text Available Screening is one possible tool for monitoring infectious diseases among migrants. However, there is limited information on screening programmes targeted for newly arrived migrants in EU/EEA countries. Our aim was to investigate the implementation, practices and usefulness of these programmes. We conducted a survey among country experts from EU/EEA countries and Switzerland, asking whether their countries had implemented screening programmes. We also estimated the association between the implementation of these programmes and the rate of asylum-seekers in the population. Of the countries, 16 (59% had implemented screening programmes and 15 (56% had national guidelines. The rate of asylum-seekers was associated with implementation of screening programmes (p = 0.014. Screening was performed most often for tuberculosis; most commonly on holding level, and was targeted to specific migrant groups in over half of the countries performing screening. Twenty-five of all the country experts (96% considered screening among migrants useful, and 24 (92% would welcome EU level guidelines for screening. The implementation of screening programmes varied, and the practices were different among countries. Our survey suggests, that establishing EU level guidelines for screening would be useful, although they would have to take into account differences between individual countries.
F. Jackie June ter Heide
Full Text Available Background: Asylum seekers and refugees have been claimed to be at increased risk of developing complex posttraumatic stress disorder (complex PTSD. Consequently, it has been recommended that refugees be treated with present-centred or phased treatment rather than stand-alone trauma-focused treatment. This recommendation has contributed to a clinical practice of delaying or waiving trauma-focused treatment in refugees with PTSD. Objective: The aim of this debate piece is to defend two theses: (1 that complex trauma leads to complex PTSD in a minority of refugees only and (2 that trauma-focused treatment should be offered to all refugees who seek treatment for PTSD. Methods: The first thesis is defended by comparing data on the prevalence of complex PTSD in refugees to those in other trauma-exposed populations, using studies derived from a systematic review. The second thesis is defended using conclusions of systematic reviews and a meta-analysis of the efficacy of psychotherapeutic treatment in refugees. Results: Research shows that refugees are more likely to meet a regular PTSD diagnosis or no diagnosis than a complex PTSD diagnosis and that prevalence of complex PTSD in refugees is relatively low compared to that in survivors of childhood trauma. Effect sizes for trauma-focused treatment in refugees, especially narrative exposure therapy (NET and culturally adapted cognitive-behaviour therapy (CA-CBT, have consistently been found to be high. Conclusions: Complex PTSD in refugees should not be assumed to be present on the basis of complex traumatic experiences but should be carefully diagnosed using a validated interview. In line with treatment guidelines for PTSD, a course of trauma-focused treatment should be offered to all refugees seeking treatment for PTSD, including asylum seekers.
Hurley, Jennifer J.; Medici, Andrea; Stewart, Emily; Cohen, Zachary
According to the United Nations High Commission for Refugees, the number of refugees worldwide was 10.5 million in 2009 and this number continues to grow (United Nations Refugee Agency, 2010). There is a shortage of evidence based practices and information regarding the state of service provision for young refugee children and their families in…
Full Text Available Unprecedented numbers of adult refugee learners are entering ESL classes, many of whom escaped war-torn countries and endured long stays in refugee camps. Research in public health and psychology has documented high levels of depression, anxiety, and posttraumatic stress disorder in refugee populations. Drawing on ethnographic research with Laotian refugee women who experienced pre-settlement trauma during the Vietnam War and interviews with bilingual mental health professionals, this article examines current second language acquisition theories to consider how they elucidate the effect of trauma on second language learning. The article offers cross-cultural perspectives about the impact of trauma and recommendations for working with adult refugee learners who have experienced trauma. Research findings have implications for ESL instructors and second language researchers concerned with the impact of pre-resettlement experiences on second language acquisition and implications for classroom instruction.
Weine, Stevan Merrill
In refugee resettlement, positive psychosocial outcomes for youth and adults depend to a great extent on their families. Yet refugee families find few empirically based services geared toward them. Preventive mental health interventions that aim to stop, lessen, or delay possible negative individual mental health and behavioral sequelae through improving family and community protective resources in resettled refugee families are needed. This paper describes 8 characteristics that preventive mental health interventions should address to meet the needs of refugee families, including: Feasibility, Acceptability, Culturally Tailored, Multilevel, Time Focused, Prosaicness, Effectiveness, and Adaptability. To address these 8 characteristics in the complex environment of refugee resettlement requires modifying the process of developmental research through incorporating innovative mental health services research strategies, including: resilience framework, community collaboration, mixed methods with focused ethnography, and the comprehensive dynamic trial. A preventive intervention development cycle for refugee families is proposed based on a program of research on refugees and migrants using these services research strategies. Furthering preventive mental health for refugee families also requires new policy directives, multisystemic partnerships, and research training. 2011 © FPI, Inc.
Full Text Available As of March 2016, 4.8 million Syrian refugees were scattered in two dozen countries by the civil war. Refugee smuggling has been a major catalyst of human trafficking in the Middle East and Europe migrant crises. Data on the extent to which smuggling devolved into trafficking in this refugee wave is, however, scarce. This article investigates how Syrian refugees interact with smugglers, shedding light on how human smuggling and human trafficking interrelated on the Balkan Route. I rely on original evidence from in-depth interviews (n = 123 and surveys (n = 100 with Syrian refugees in Jordan, Turkey, Greece, Serbia, and Germany; as well as ethnographic observations in thirty-five refugee camps or other sites in these countries. I argue that most smugglers functioned as guides, informants, and allies in understudied ways—thus refugee perceptions diverge dramatically from government policy assumptions. I conclude with a recommendation for a targeted advice policy that would acknowledge the reality of migrant-smuggler relations, and more effectively curb trafficking instead of endangering refugees.
Erim, Yesim; Morawa, Eva
In view of the growing proportion of immigrants and refugees in the population of Germany the knowledge on the influence of culture and migration on identity, and mental health presents a substantial basis for effective therapy. This article addresses important topics of psychotherapy with immigrants in general and with refugees in particular. Following issues selected according to their relevance and actuality are highlighted: definition of persons with migration background, migrants and refugees, facts on immigration to Germany, main results and theories on mental health of immigrants, social psychological aspects of intercultural psychotherapy (individualism vs. collectivism, stereotypes, discrimination etc.), psychosomatic diagnostics in intercultural context, diversity management in institutions, language and use of translators, living conditions of immigrants - stress and protective factors in immigrant mental health, post traumatic stress disorders among refugees: their prevalence, risk factors, diagnostics, course, multimodal psychosocial interventions in consulting centers, trauma focused interventions, trauma pedagogics, education and prevention of the volunteers. © Georg Thieme Verlag KG Stuttgart · New York.
Full Text Available UNHCR supports local integration as one possiblesolution for refugees who cannot return home. Experiencein Mexico, Uganda and Zambia indicates that integrationcan benefi t refugee-hosting communities as well asrefugees.
Drennan, Vari M; Joseph, Judy
This paper reports on the perceptions of experienced health visitors working with refugee families in Inner London. Women who are refugees and asylum seekers in the United Kingdom are more likely to experience depression than either non-refugee women or male asylum seekers. Health visitors provide a universal public health service to all women on the birth of a child, or with children aged under five, and as such are well placed to identify emotional and mental health problems of women who are refugees. Despite successive waves of refugees to the United Kingdom in the 20th century, there are no empirical studies of health visiting practice with this vulnerable group. There is also no body of evidence to inform the practice of health visitors new to working with asylum seekers and refugees. An exploratory study was undertaken in Inner London in 2001. Semi-structured interviews were conducted with a purposive sample of 13 health visitors experienced in working with women and families who are refugees. A range of structural challenges was identified that mediated against the development of a health-promoting relationship between health visitors and refugee women. With refugee families, who were living in temporary accommodation, health visitors were prioritizing basic needs that had to be addressed: in addition, they prioritized the needs of children before those of women. Health visitors were aware of the emotional needs of women and had strategies for addressing these with women in more settled circumstances. Health visitors considered themselves ill-prepared to deal with the complexities of working with women in these situations. This study identifies issues for further exploration, not least from the perspective of refugee women receiving health visiting services. Health visitors in countries receiving refugee women are framing their work with these women in ways that reflect Maslow's theory of a hierarchy of needs. This study suggests ways that public health
L.G. De Filippis
Full Text Available The objective of the research is to determine 25[OH]D serum levels in refugees in Italy. In the following research we have taken into consideration the results of the monitoring of Vitamin D levels in 46 refugees of the Italian Service for protection of refugees and asylum seekers (SPRAR system. The indicator of overall vitamin D status used was the circulating serum level of 25(OHD. Data was analyzed using Microsoft Excel. In the refugees tested, the mean level of 25(OHD resulted 9.18 ng/mL. The standard deviation was 4.8, with a minimal level of 4.3 and a maximum of 27.4. This figure indicates a clear condition of hypovitaminosis in refugees. While it is general assumption that migratory phenomena may induce the spread of tropical or infectious diseases, widely attested literature demonstrates how chronic pathologies and diseases related to altered lifestyles are the most relevant for Italian case records. Indeed, among the aforementioned diseases, Vitamin D deficiency so far lacks acknowledgement at a national level. Considering the results of lower-than-desirable vitamin D levels found in refugees in Italy, it is necessary to take this parameter into consideration when analyzing individuals who have faced migratory phenomena in order to mitigate the effects of hypovitaminosis D.
De Haene, L.; Dalgård, Nina Thorup; Montgomery, E.
J Trauma Stress. 2013 Jun;26(3):413-7. doi: 10.1002/jts.21820. Attachment narratives in refugee children: interrater reliability and qualitative analysis in pilot findings from a two-site study.......J Trauma Stress. 2013 Jun;26(3):413-7. doi: 10.1002/jts.21820. Attachment narratives in refugee children: interrater reliability and qualitative analysis in pilot findings from a two-site study....
Full Text Available Abstract Background There are growing numbers of refugees throughout the world. Refugee health is a relatively unstudied and rarely taught component of medical education. In response to this need, a Refugee Health Elective was begun. Medical student perceptions toward cultural aspects of medicine and refugee health before and after participation in the elective were measured. Methods Preliminary questionnaires were given to all preclinical students at the academic year commencement with follow-up questionnaires at the refugee elective's conclusion. Both questionnaires examined students' comfort in interacting with patients and familiarity with refugee medical issues, alternative medical practices, and social hindrances to medical care. The preliminary answers served as a control and follow-up questionnaire data were separated into participant/non-participant categories. All preclinical medical students at two Midwestern medical schools were provided the opportunity to participate in the Refugee Health Elective and surveys. The 3 data groups were compared using unadjusted and adjusted analysis techniques with the Kruskall-Wallis, Bonferroni and ANCOVA adjustment. P-values Results 408 and 403 students filled out the preliminary and follow-up questionnaires, respectfully, 42 of whom participated in the elective. Students considering themselves minorities or multilingual were more likely to participate. Elective participants were more likely to be able to recognize the medical/mental health issues common to refugees, to feel comfortable interacting with foreign-born patients, and to identify cultural differences in understanding medical/mental health conditions, after adjusting for minority or multilingual status. Conclusion As medical schools integrate a more multicultural curriculum, a Refugee Health Elective for preclinical students can enhance awareness and promote change in attitude toward medical/mental health issues common to refugees. This
Full Text Available Towards the end of the eighties and the beginning of the nineties the Balkan region was characterized by intensive migration of the population and the huge number of refugees. In the most dramatic conditions, in the most dramatic form and in a much larger number, the migration on the Balkans reach its peak in the former Yugoslavia. Forced and voluntary ethnocentric migrations was caused by disintegration of the former Yugoslavia, the civil war, 'ethnic cleansing' and the creation of new etno-national states. According to UNHCR data from 1995, the number of refugees in the former Yugoslavia are estimated about 3 million. According to the same source, over 620 thousand refugees were registered in Serbia, out of which about 43% from Bosnia-Herzegovina. This paper is based on two basic data sources: the census on refugees and on the survey. The paper focus on analysis of demographic and socio-economic characteristics of refugee's population: number, ethnic structure (mostly Bosnian Serbs, age structure, marriage structure, educational level, economic activity and occupation, type of accommodation, etc. The paper also explores three possible solutions of the refugee's problem: repatriation, local reintegration and emigration to abroad. The economic and social status of the refugees is very difficult and its solution requires considerable effort, as well as the assistance of the international community. According to UNHCR data from 2009, in Serbia has registered 97 thousand refugees and Serbia was the first country in Europe and the fifth country in the world with long-term refugee crisis.
Zhang, Ying; Ornelas, India J; Do, H Hoai; Magarati, Maya; Jackson, J Carey; Taylor, Victoria M
Many refugees in the United States emigrated from countries where the incidence of cervical cancer is high. Refugee women are unlikely to have been screened for cervical cancer prior to resettlement in the U.S. National organizations recommend cervical cancer screening for refugee women soon after resettlement. We sought to identify health and social service providers' perspectives on promoting cervical cancer screening in order to inform the development of effective programs to increase screening among recently resettled refugees. This study consisted of 21 in-depth key informant interviews with staff from voluntary refugee resettlement agencies, community based organizations, and healthcare clinics serving refugees in King County, Washington. Interview transcripts were analyzed to identify themes. We identified the following themes: (1) refugee women are unfamiliar with preventive care and cancer screening; (2) providers have concerns about the timing of cervical cancer education and screening; (3) linguistic and cultural barriers impact screening uptake; (4) provider factors and clinic systems facilitate promotion of screening; and (5) strategies for educating refugee women about screening. Our findings suggest that refugee women are in need of health education on cervical cancer screening during early resettlement. Frequent messaging about screening could help ensure that women receive screening within the early resettlement period. Health education videos may be effective for providing simple, low literacy messages in women's native languages. Appointments with female clinicians and interpreters, as well as clinic systems that remind clinicians to offer screening at each appointment could increase screening among refugee women.
Full Text Available The article describes the process of the development of Ukrainian legislation on refugees, the relevant administrative institutes and the decision-making process on the applications for refugee status in Ukraine. The article also analyzes the dynamics of applying for refugee status to the migration services of Ukraine and illustrates the national, gender and education structure of refugee community. The conclusion states that during the years of independence Ukraine has changed from a transit state, supplying refugees for the West, to the state giving asylum on its territory.
Mattenschlager, Andreas; Nahler, Stefanie; Reisinger, Regine
Unseen Suffering - Therapy for Traumatized Refugee Children In March 2015 the psychological counselling service (Psychologische Familien- und Lebensberatung) of Caritas Ulm initiated a psychotherapy project for traumatized minor refugees. Besides individual and group therapy, networking and qualification of qualified personnel and volunteers, in autumn 2015 we started offering our services on-site in a large collective accommodation for asylum seekers in Ulm. This was mainly because - in contrast to unaccompanied, mostly adolescent, minor refugees - our services appeared to reach children only by chance. In our opinion this is mostly due to the fact that children's suffering is often far less noticed. This paper describes our first year's project work, followed by reports on the use of psychodrama groups with refugee children and on the therapeutic work in a collective accommodation for asylum seekers.
Full Text Available Unprecedented numbers of adult refugee learners are entering ESL classes, many of whom escaped war-torn countries and endured long stays in refugee camps. Research in public health and psychology has documented high levels of depression, anxiety, and posttraumatic stress disorder in refugee populations. Drawing on ethnographic research with Laotian refugee women who experienced pre-settlement trauma during the Vietnam War and interviews with bilingual mental health professionals, this article examines current second language acquisition theories to consider how they elucidate the effect of trauma on second language learning. The article offers cross-cultural perspectives about the impact of trauma on learning and recommendations for working with adult refugee learners who have experienced trauma. Findings have implications for ESL instructors and second language researchers concerned with the impact of pre- settlement experiences on second language acquisition and implications for classroom instruction.
Rooij, de L.L.; Wascher, D.M.; Paulissen, M.P.C.P.
This report’s main focus is on the phenomenon of refugee camps as one of the most visible and spatially explicit results of refuge and migration movements at the global scale. Given the steadily growing numbers of people on the move and staying in temporary homes and settlements, refugee camps must
... 45 Public Welfare 2 2010-10-01 2010-10-01 false Counting time-eligibility of refugees. 400.220 Section 400.220 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM...
... 45 Public Welfare 2 2010-10-01 2010-10-01 false Emergency cash assistance to refugees. 400.52 Section 400.52 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM...
... October 2, 2013 Refugee Admissions for Fiscal Year 2014 Memorandum for the Secretary of State In... authorize the following actions: The admission of up to 70,000 refugees to the United States during fiscal... with Federal refugee resettlement assistance under the Amerasian immigrant admissions program, as...
Objectives: To determine the prevalence and causes of the blindness and ocular morbidity amongst Sudanese refugees; to prioritise and provide eye care services to the refugees and; to device administrative strategies and logistics of prevention and control of blinding diseases among the refugees. Design: A mobile ...
Roberts, Bayard; Murphy, Adrianna; McKee, Martin
The European response to the refugee crisis has been lamentable. A preoccupation with numbers has, too often, ignored how each refugee is an individual, many of whom have experienced the most appalling conditions in their countries of origin and in transit. These stories are only rarely heard, when the cameras are there to capture the tragedies. In this commentary we review the challenges of responding to the health needs of refugees, including examples of best practice, but above all call for a concerted political response that will both reduce the pressure on refugees to flee conflict-afflicted countries and recognize their contribution if they do come to Europe.
Becker, G; Beyene, Y; Ken, P
Massive disruptions to a way of life, such as those brought on by widespread violence, terror, and genocide, disorder the body as well as the social order. When they flee their homelands, refugees bring their experiences of violence and terror with them. Drawing on an ethnographic study of 40 Cambodian refugees between the ages of 50 and 79 who suffered from one or more chronic illnesses, we explore how refugees who live with chronic illnesses and are dependent on government support were affected by the threat of welfare reform. When welfare reform threatened to cut Cambodian refugees' income, it posed a new crisis for those who were chronically in limbo and placed further constraints on their lives. Through their narratives, Cambodian refugees enacted their bodily distress and resisted the threat of welfare reform. The story of threatened welfare reform in the U.S. and its possible consequences for refugees is a story of quixotic U.S. politics, policies and antidotes for refugeeism gone awry.
Gabiella, D.; Putri, R. A. A. K.
Indonesia is home to 13,829 refugees and asylum seekers by the end of January 2017. In general, the number could be dichotomized into two categories: camp-based refugees and urban refugees. There are approximately 70.83% of urban refugees living in several cities across the country. The existence of refugees in urban environments has been considered as either bringing promise or peril to urban development. Makassar is one among the most populated cities by refugees in Indonesia. In the middle of the inadequacy of legal framework at the national level, the Makassar City Government initiated a policy to address the issues of refugees staying in the city specifically. In 2005, the Mayor of Makassar signed a Memorandum of Understanding with International Organization for Migration (IOM) to accommodate the needs for funding allocated from Regional Budget that could not be dispensed due to the absence of legal basis. The city also constituted a Joint Committee Monitoring (JCM), which comprises of various government agencies, to support the Immigration Office in monitoring the refugees. These initiatives allow refugees to access basic services that are not made available to them in other cities. Against this backdrop, this paper mainly discusses the initiatives and refugee policy of Makassar City Government, which had emulated the national government’s policy to refugee management before the recently signed Presidential Decree No. 25 / 2016. It argues that the proactive and relatively integrative approach of the City Government alongside the social inclusion by the local community have contributed positively to the livelihoods of urban refugees in Makassar.
Pascucci-Cahen, Ludivine; Groell, Jérôme
However improbable, large radioactive releases from a nuclear power plant would entail major consequences for the surrounding population. In Fukushima, 80,000 people had to evacuate the most contaminated areas around the NPP for a prolonged period of time. These people have been called “nuclear refugees”. The paper first argues that the number of nuclear refugees is a better measure of the severity of radiological consequences than the number of fatalities, although the latter is widely used to assess other catastrophic events such as earthquakes or tsunami. It is a valuable partial indicator in the context of comprehensive studies of overall consequences. Section 2 makes a clear distinction between long-term relocation and emergency evacuation and proposes a method to estimate the number of refugees. Section 3 examines the distribution of nuclear refugees with respect to weather and release site. The distribution is asymmetric and fat-tailed: unfavorable weather can lead to the contamination of large areas of land; large cities have in turn a higher probability of being contaminated. - Highlights: • Number of refugees is a good indicator of the severity of radiological consequences. • It is a better measure of the long-term consequences than the number of fatalities. • A representative meteorological sample should be sufficiently large. • The number of refugees highly depends on the release site in a country like France.
Gardiner, Joanne; Walker, Kate
The physical and psychosocial effects of trauma in refugees are wide ranging and long lasting. They can affect symptom presentation, the patient-doctor relationship and management of refugee victims of trauma. This article discusses how refugees survivors of trauma may present to the general practitioner and gives an approach to psychological assessment and management. A strong therapeutic relationship built by patient led, sensitive assessment over time is the foundation to care. A management framework based on trauma recovery stages and adapted for general practice, is presented.
Lee, Yu Jin; Jun, Jin Yong; Park, Juhyun; Kim, Soohyun; Gwak, Ah Reum; Lee, So Hee; Yoo, So Young; Kim, Seog Ju
We investigated the performance of North Korean refugees on attention tasks, and the relationship between that performance and psychiatric symptoms. Sustained and divided attention was assessed using the computerized Comprehensive Attention Test in North Korean refugees and in South Koreans. All participants also completed the Beck Depression Inventory, the Beck Anxiety Inventory, the Impact of Event Scale-Revised and the Dissociative Experiences Scale-II (DES-II). The North Korean refugees showed slower reaction times (RTs) on the visual sustained attention task compared to the South Koreans after controlling for age and sex. North Korean refugees had a greater number of omission errors (OEs) on the divided attention task and a higher standard deviation (SD) of RT. Total DES-II scores of the North Korean refugees were associated with the number of OEs and the SD of RT on the sustained attention task, and with the number of OEs on the divided attention task. North Korean refugees showed poorer performance on computerized attention tasks. In addition, attention deficit among North Korean refugees was associated with their dissociative experiences. Our results suggest that refugees may have attention deficits, which may be related to their psychiatric symptoms, particularly dissociation.
Haagen, Joris F G; Ter Heide, F Jackie June; Mooren, Trudy M; Knipscheer, Jeroen W; Kleber, Rolf J
OBJECTIVES: Given the recent peak in refugee numbers and refugees' high odds of developing post-traumatic stress disorder (PTSD), finding ways to alleviate PTSD in refugees is of vital importance. However, there are major differences in PTSD treatment response between refugees, the determinants of
Norredam, Marie; Olsbjerg, Maja; Petersen, Jorgen H; Juel, Knud; Krasnik, Allan
Comparisons of mortality patterns between different migrant groups, and between migrants and natives, are relevant to understanding, and ultimately reducing, inequalities in health. To date, European studies on migrants' mortality patterns are scarce and are based solely on country of birth, rather than migrant status. However, mortality patterns may be affected by implications in relation to migrant status, such as health hazards related to life circumstances before and during migration, and factors related to ethnic origin. Consequently, we investigated differences in both all-cause and cause-specific mortality from cancer and cardiovascular disease among refugees and immigrants, compared with the mortality among native Danes. A register-based, historical prospective cohort design. All refugees (n = 29,139) and family-reunited immigrants (n = 27,134) who, between 1 January 1993 and 31 December 1999, were granted right of residence in Denmark were included and matched 1:4 on age and sex with native Danes. To identify deaths, civil registration numbers were cross-linked to the Register of Causes of Death (01.01.1994-31.12.2007) and the Danish Civil Registration System (01.01.1994-31.12.2008). Mortality rate ratios were estimated separately for men and women by migrant status and region of birth, adjusting for age and income and using a Cox regression model, after a median follow-up of 10-13 years after arrival. Compared with native Danes, all-cause mortality was significantly lower among female (RR = 0.78; 95%CI: 0.71;0.85) and male (RR = 0.64; 95%CI: 0.59-0.69;) refugees. The rates were also significantly lower for immigrants: women (RR = 0.44; 95%CI: 0.38;0.51) and men (RR = 0.43; 95%CI: 0.37;0.51). Both migrant groups also had lower cause-specific mortality from cancer and cardiovascular diseases. For both all-cause and cause-specific mortality, immigrants generally had lower mortality than refugees, and differences were observed according to ethnic origin
STATES REFUGEE ADMISSIONS PROGRAM FLOWCHART ...the American public’s concerns. 50 APPENDIX A UNITED STATES REFUGEE ADMISSIONS PROGRAM FLOWCHART Source: US Citizenship and Immigration...TITLE AND SUBTITLE Refugee Status Required for Resettlement in the United States 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT
It is widely held that the current refugee Convention is inadequate with respect to its specification of who counts as a refugee and in its assignment of responsibility concerning refugees to states. At the same time, there is substantial agreement among scholars that the negotiation of a new
This paper is the first attempt to explore digital literacy in the specific context of the Palestinian refugee community in the Middle East by looking at the cultural specificity of digital literacy theorising and practice, by analysing current digital education policy in the countries hosting the Palestinian refugee community and by documenting…
Osman, Mohamud; Hornblow, Andrew; Macleod, Sandy; Coope, Pat
This study investigated how former refugees now living in Christchurch (Canterbury Province, New Zealand) communities coped after the 4 September 2010 and subsequent earthquakes. A systematic sample of one in three former refugees from five ethnic groupings (Afghanistan, Kurdistan, Ethiopia, Somalia and Bhutan) was selected from a list of 317 refugees provided by the Canterbury Refugee Council and invited to participate in the study. Seventy-two out of 105 potential participants completed a 26 item questionnaire regarding the impact of the quakes, their concerns and anxieties, coping strategies and social supports. The methodology was complicated by ongoing aftershocks, particularly that of 22 February 2011. Three-quarters of participants reported that they had coped well, spirituality and religious practice being an important support for many, despite less then 20% receiving support from mainstream agencies. Most participants (72%) had not experienced a traumatic event or natural disaster before. Older participants and married couples with children were more likely to worry about the earthquakes and their impact than single individuals. There was a significant difference in the level of anxiety between males and females. Those who completed the questionnaire after the 22 February 2011 quake were more worried overall than those interviewed before this. Overall, the former refugees reported they had coped well despite most of them not experiencing an earthquake before and few receiving support from statutory relief agencies. More engagement from local services is needed in order to build trust and cooperation between the refugee and local communities.
... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Adjustment of status of refugees. 1209.1... IMMIGRATION REGULATIONS ADJUSTMENT OF STATUS OF REFUGEES AND ALIENS GRANTED ASYLUM § 1209.1 Adjustment of status of refugees. The provisions of this section shall provide the sole and exclusive procedure for...
Palestinian refugees remain the largest single national group of refugees whose status has yet to be settled 60 years after the creation of the problem. Despite great interest in the subject, there are no graduate programs in Palestine that provide students with solid academic training in refugee and forced migration studies.
Full Text Available This paper makes the case that refugee protection and national security should be viewed as complementary, not conflicting state goals. It argues that refugee protection can further the security of refugees, affected states, and the international community. Refugees and international migrants can also advance national security by contributing to a state’s economic vitality, military strength, diplomatic standing, and civic values. The paper identifies several strategies that would, if implemented, promote both security and refugee protection. It also outlines additional steps that the US Congress should take to enhance US refugee protection policies and security. Finally, it argues for the efficacy of political engagement in support of pro-protection, pro-security policies, and against the assumption that political populism will invariably impede support for refugee protection.
O'Neal, Colleen; Atapattu, Ranga; Jegathesan, Anasuya; Clement, Jennifer; Ong, Edward; Ganesan, Asha
Access to Malaysian government schools is prohibited for refugee children, and hidden refugee schools only reach a minority of Burmese students in Malaysia. This study used a participatory culture-specific consultation (PCSC) approach to examine the perspectives of Burmese refugee teachers on Burmese refugee student socioemotional issues and…
Since the middle of 2015, the European community has been struggling to find political solutions to what has come to be known as ‘the refugee crisis’. As tens of thousands of refugees from primarily Syria began crossing the Mediterranean Sea and entering Europe at either Lespos or Lampedusa......, Reiner Keller, Norman Fairclough, Niklas Luhmann and Zygmunt Bauman, this article will describe the formation of the discourse and the constitution of the dispositif on the refugee crisis, in order to uncover the mechanisms and procedures regulating the handling of the crisis in Denmark, that seemed...
Since the middle of 2015, the European community has been struggling to find political solutions to what has come to be known as ‘the refugee crisis’. As tens of thousands of refugees from primarily Syria began crossing the Mediterranean Sea and entering Europe at either Lespos or Lampedusa......, Reiner Keller, Norman Fairclough, Niklas Luhmann and Zygmunt Bauman, this article will describe the formation of the discourse and the constitution of the dispositif on the refugee crisis, in order to uncover the mechanisms and procedures regulating the handling of the crisis in Denmark, that seemed...
New Keywords Collective
Full Text Available The article highlights the fundamentally misleading and unstable nature of the distinctions between the terms ”refugees”, “asylum-seekers”, and “migrants”, all of whom experience the precariousness produced by the EU’s exclusionary politics on asylum – due to juridical instability and geographical hyper-mobility of migrants subjects. The “hotspot” system, first launched in May 2015, represents the restructuring of mechanisms of capture and identification in response to the migration “turmoil” at the external frontiers of Europe. On the other hand, transit zones such as the Eidomeni camp at the Greek-Macedonian border or the makeshift self-organized refugee / migrant camp at Calais operate informally as de facto “hotspots.” What is commonly called “the migrant crisis” or “the refugee crisis” actually reflects the frantic attempt by the EU and European nation-states to control, contain, and govern people’s (“unauthorized” transnational and inter-continental movements. Naming it a “refugee/migrant crisis” appears to be a device for the authorization of exceptional or “emergency” governmental measures – and then their normalization. The very terms “migrant crisis” and “refugee crisis” tend to personalize “crisis” and relocate “crisis” in the body and person of the figurative migrant / refugee, as if s/he is the carrier of a disease called “crisis,” and thus carries the contagion of “crisis” wherever she may go. The article calls for attention to the new spaces of “transit” opened up by the migrants and refugees themselves, and consequently the ways in which these “irregular” human mobilities have scrambled and re-shuffled the social and political geography of “Europe.”
Full Text Available Being a non-party to the 1951 Convention relating to the Status of Refugees (“1951 Refugee Convention” and 1967 Protocol relating to the Status of Refugees (“1967 Protocol”, Indonesia does not have legal obligations to provide permanent resettlement for asylum seeker and/or refugee. However, as a transit country for those seeking shelter in Australia, Indonesia undergoes a myriad of issues resulting from illegal entrance by asylum seeker and/or refugee. Besides having neither legal framework nor domestic mechanism to handle asylum seekers and/or refugee, Indonesia’s immigration law identifies every foreigner including asylum seeker and refugee who unlawfully enter Indonesia’s territory into the same box as illegal migrant. It then leads to the arrest of asylum seeker and/or refugee to be put in an over-capacity detention center or other places. This paper will analyze various issues related to asylum seeker and refugee in Indonesia and to weigh whether it is indispensable for Indonesia to accede to the 1951 Refugee Convention and its 1967 Protocol.
... April 3, 2012 Unexpected Urgent Refugee and Migration Needs Memorandum for the Secretary of State By the... 2(c)(1) of the Migration and Refugee Assistance Act of 1962 (the ``Act''), as amended, (22 U.S.C... United States Emergency Refugee and Migration Assistance Fund, for the purpose of meeting unexpected and...
Jablonka, Alexandra; Behrens, Georg M N; Stange, Marcus; Dopfer, Christian; Grote, Ulrike; Hansen, Gesine; Schmidt, Reinhold Ernst; Happle, Christine
Current political crises in the Middle East and economic discrepancies led millions of people to leave their home countries and to flee to Western Europe. This development raises unexpected challenges for receiving health care systems. Although pan-European initiatives strive for updated and optimized vaccination strategies, little data on immunity against vaccine-preventable diseases in the current refugee population exist. We quantified serum IgG against tetanus and diphtheria (TD) in n = 678 refugees currently seeking shelter in six German refugee centers. Reflecting current migration statistics in Europe, the median age within the cohort was 26 years, with only 23.9 % of female subjects. Insufficient IgG levels without long-term protection against tetanus were found in 56.3 % of all refugees. 76.1 % of refugees had no long-term protection against diphtheria. 47.7 % of subjects needed immediate vaccination against tetanus, and 47.7 % against diphtheria. For both diseases, an age-dependent decline in protective immunity occurred. We observed a considerably low rate of tetanus-protected refugees, and the frequency of diphtheria-immune refugees was far from sufficient to provide herd immunity. These findings strongly support recent intentions to implement and enforce stringent guidelines for refugee vaccination in the current crisis.
Full Text Available Abstract Background The aim of this study was to establish the prevalence of posttraumatic stress disorder (PTSD and depression among Rwandese and Somali refugees resident in a Ugandan refugee settlement, as a measure of the mental health consequences of armed conflict, as well as to inform a subsequent mental health outreach program. The study population comprised a sample from 14400 (n = 519 Somali and n = 906 Rwandese refugees resident in Nakivale refugee settlement in South Western Uganda during the year 2003. Methods The Posttraumatic Diagnostic Scale (PDS and the Hopkins Symptom Checklist 25 were used to screen for posttraumatic stress disorder and depression. Results Thirty two percent of the Rwandese and 48.1% of the Somali refugees were found to suffer from PTSD. The Somalis refugees had a mean of 11.95 (SD = 6.17 separate traumatic event types while the Rwandese had 8.86 (SD = 5.05. The Somalis scored a mean sum score of 21.17 (SD = 16.19 on the PDS while the Rwandese had a mean sum score of 10.05 (SD = 9.7. Conclusion Mental health consequences of conflict remain long after the events are over, and therefore mental health intervention is as urgent for post-conflict migrant populations as physical health and other emergency interventions. A mental health outreach program was initiated based on this study.
MacMillan, Kelli K; Ohan, Jeneva; Cherian, Sarah; Mutch, Raewyn C
Play is vital to children's development, health and resilience. Play modulates cognitive, emotional and social well-being. Children constitute approximately half of all humanitarian refugee entrants resettled in Australia. Refugee children are commonly victims and witnesses of war and persecution, living across resource-poor environs during transit. Little is known about the effects of refugee migration on play. This study explores how refugee children engaged in play pre-migration (in their home country) and post-migration (Australia). Refugee children attending the Refugee Health Clinic of a tertiary children's hospital were invited to complete a qualitative descriptive study of play. The children were asked to draw how they played pre- and post-migration. Drawings were analysed for (i) the presence of play; (ii) location of play; and (iii) drawing detail. Nineteen refugee children were recruited (mean age 8.5 years ± standard deviation 6.4 months). Significantly fewer children drew play pre- versus post-migration (11/19, 58% vs. 18/19, 95% P migration (pre: 2/8, 25% vs. post: 7/8, 87%, P = 0.06), trending to significance. Of those children who drew play, almost all drew playing outside (pre-migration: 10/11, 90.9%; post-migration: 17/18, 94.4%). Drawings showed equivalent detail pre- and post-migration. Resettled refugee children, especially girls, demonstrated limited play pre-migration, with higher levels of engagement post-resettlement. Facilitating opportunities for variety of play may strengthen positive resettlement outcomes for children and parents. Larger longitudinal studies examining play in refugee children and associations with physical, development and psychological well-being are warranted. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).
"It could happen to anybody", observed one nine-year-old child when her teacher read a book in class about refugees. Fiction provides the perfect conduit for the experiences of refugees so that young refugee students feel their experiences are validated, and their peers come to understand their situation. In this book, Julia Hope…
Felder, M.; Minca, C.; Ong, C.E.
Through analysing the correspondence between key refugee camp commanders based at Amsterdam's Lloyd Hotel and different authorities involved in Dutch refugee matters, this paper examines how "the Dutch state" responded to German-Jewish refugees fleeing Nazi Germany in the prelude to World War II.
Hermans, Maaike P J; Kooistra, Jelmer; Cannegieter, Suzanne C; Rosendaal, Frits R; Mook-Kanamori, Dennis O; Nemeth, Banne
To assess current medical problems at two Greek refugee sites at Lesbos island (Camp Moria and Caritas hotel), to explore which care is needed and to assess how the provided healthcare can be improved. In this dynamic cohort study all consecutive patients who visited doctors from the Boat Refugee Foundation were included. Treatment Rates (TR) with 95% Confidence Intervals (95% CI) were calculated for all major health issues. Additionally, the provided health care was evaluated using the SPHERE project standards. During the observation period of 30 March 2016 to 15 May 2016, 2291 persons were followed for a total of 289 person years (py). The median age of patients was 23.0 (IQR 8-38) years, 30.0% was aged refugee crisis. There is an urgent need for mental and dental healthcare. Furthermore, it is crucial that vaccination programs are initiated and "hotspot" camps should transform in camps designed for long-stay situations.
Differences in tobacco smoking prevalence and frequency between adolescent Palestine refugee and non-refugee populations in Jordan, Lebanon, Syria, and the West Bank: cross-sectional analysis of the Global Youth Tobacco Survey.
Jawad, Mohammed; Khader, Ali; Millett, Christopher
Evidence is conflicting as to the whether tobacco smoking prevalence is higher in refugee than non-refugee populations. The aim of this study was to compare the prevalence and frequency of tobacco smoking in Palestine refugee and non-refugee adolescent populations in the Middle East. We conducted a cross-sectional analysis of the Global Youth Tobacco Survey (GYTS) conducted in Jordan, Lebanon, Syria, and the West Bank among adolescent Palestine refugees and non-refugees. Age- and sex-adjusted regression models assessed the association between refugee status and current (past-30 day) tobacco use prevalence and frequency. Prevalence estimates for current tobacco smoking were similar between Palestine refugee and non-refugee groups in Jordan (26.7 % vs. 24.0 %), Lebanon (39.4 % vs. 38.5 %), and the West Bank (39.5 % vs. 38.4 %). In Syria, Palestine refugees had nearly twice the odds of current tobacco smoking compared to non-refugees (23.2 % vs. 36.6 %, AOR 1.96, 95 % CI 1.46-2.62). Palestine refugees consumed more cigarettes per month than non-refugees in Lebanon (β 0.57, 95 % CI 0.17-0.97) and Palestine refugees consumed more waterpipe tobacco per month than non-refugees in Syria (β 0.40, 95 % CI 0.19-0.61) and the West Bank (β 0.42, 95 % CI 0.21-0.64). Current tobacco smoking prevalence is in excess of 20 % in both adolescent Palestine refugee and non-refugee populations in Middle Eastern countries, however Palestine refugees may smoke tobacco more frequently than non-refugees. Comparison of simple prevalence estimates may therefore mask important differences in tobacco use patterns within population groups.
Lindert, Jutta; von Ehrenstein, Ondine S; Wehrwein, Annette; Brähler, Elmar; Schäfer, Ingo
Anxiety, depression and posttraumatic stress disorder are the main psychopathological symptoms shown by refugees. We conducted a systematic review. First, we identified key-words for a systematic search in PUBMED. We included original articles since 2009 with 1) a non-clinical sample of refugees, 2) refugees living at maximum 5 years in the host country, 4) with the outcomes anxiety, depression, and PTSD and 5) a sample with >100 participants. Then we read titles, abstracts and fulltexts. We identified 1 877 studies. Based on this screening procedure, we included in our review 15 studies. 52% of the refugees are from Africa (Somalia, Congo, Rwanda, Liberia, Sierra-Leon and Togo), 33% from Asia (Syria, Bhutan, Vietnam, Cambodia, Iraq) and 16% are from more than one continent. In those studies n=6 769 refugees participated in the studies. The number of participants varied from n=117 to n=1,422 (Median: n=366 refugees). Prevalence rates for PTBS varied from 5-71% (mean prevalence rate: 32%) rates for depression varied from 11-54% (mean prevalence rate: 35%). Sensitivity analyses suggest that refugees, which come from countries with intense human rights violations according to the Political Terror Scale, have an increased rate of psychopathological symptoms. Heterogeneity of prevalence rate is related both 1) to methodological and 2) to difference in the refugee populations according to the human rights violations in the countries of origin of refugees. It is necessary to include further databases in a systematic review. There is an urgent need for representative studies on refugees needs for psychosocial and medical care, especially for those refugees coming from countries with intense human rights violations. Psychosocial and medical services for these refugees are urgently needed to enhance and enable a perspective in the host country Germany. © Georg Thieme Verlag KG Stuttgart · New York.
van Prooijen, Jan-Willem; Krouwel, André P. M.; Emmer, Julia
The 2016 European Union (EU) refugee crisis exposed a fundamental distinction in political attitudes between the political left and right. Previous findings suggest, however, that besides political orientation, ideological strength (i.e., political extremism) is also relevant to understand such distinctive attitudes. Our study reveals that the political right is more anxious, and the political left experiences more self-efficacy, about the refugee crisis. At the same time, the political extremes—at both sides of the spectrum—are more likely than moderates to believe that the solution to this societal problem is simple. Furthermore, both extremes experience more judgmental certainty about their domain-specific knowledge of the refugee crisis, independent of their actual knowledge. Finally, belief in simple solutions mediated the relationship between ideology and judgmental certainty, but only among political extremists. We conclude that both ideological orientation and strength matter to understand citizens’ reactions to the refugee crisis. PMID:29593852
Damm, Anna Piil
This paper investigates whether the Danish Dispersal Policy on new refugee immigrants carried out from 1986 to 1998 can be regarded as a natural experiment. Were refugees randomly assigned to a location? The main findings are as follows. First, around 90% of new refugees were assigned to a location....... Second, the dispersal policy successfully distributed new refugees equally across locations relative to the number of inhabitants in a location. Third, the actual settlement may have been influenced by six refugee characteristics. I conclude that the initial location of new refugees 1986-1998 may...
Barghadouch, Amina; Kristiansen, Maria; Jervelund, Signe Smith
and psychiatrists in private practice. Results: Between 1 January 1996 and 30 June 2012, 3.5 % of the refugee children accessed psychiatric healthcare services compared to 7.7 % of the Danish-born children. The rate ratio of having any first-time psychiatric contact was 0.42 (95 % CI 0.40–0.45) among refugee boys...... and 0.35 (95 % CI 0.33–0.37) among refugee girls, compared to Danish-born children. Figures were similar for those accessing private psychologists or psychiatrists, emergency room, inpatient and outpatient services. Conclusions: Refugee children used fewer psychiatric healthcare services than Danish...
With the break of the civil war in Syria, many Syrians have been displaced either internally or as refugees. Turkey, one of the leading host of Syrian refugees, has made changes to the policies to accommodate the needs of Syrians. Education is one of the most prominent needs of displaced refugee children. While 80 percent of refugee children…
Palestinian Refugees : Challenges of Repatriation and Development. Couverture du livre Palestinian Refugees : Challenges of Repatriation and Development. Directeur(s):. Rex Brynen et Roula El-Rifai. Maison(s) d'édition: I.B. Tauris, CRDI. 14 avril 2007. ISBN : 9781845113117. 224 pages. e-ISBN : 9781552502310.
[Recommendations for the diagnosis and prevention of infectious diseases in pediatric and adolescent refugees in Germany : Statement of the German Society of Pediatric Infectious Diseases, the Society of Tropical Pediatrics and International Child Health, and the Professional Association of Pediatricians].
Pfeil, J; Kobbe, R; Trapp, S; Kitz, C; Hufnagel, M
Child and adolescent refugees in Germany represent a particularly vulnerable social group and treating infectious diseases forms a crucial part of providing their medical care. From an infectious diseases perspective, refugees themselves, as a result of their difficult personal circumstances, are the ones at highest risk. Even in crisis situations, medical practitioners are medically and ethically obliged to provide a high standard of care. The guidelines presented here propose recommendations for diagnosing and preventing infectious diseases among refugees under 18 in Germany. The guidelines are intended to assist in optimizing vaccine protection and treatment of diseases while taking into consideration factors such as refugees' challenging living conditions, cultural differences and potential language barriers.Upon refugees' arrival at the first housing sites, it is recommended that a basic clinical screening (and not just a brief visual inspection) be provided in order to identify and initiate treatment for acute medical problems and potentially contagious diseases (including tuberculosis), as well as to close gaps in vaccination coverage. Documentation of the clinical findings is critical, both to avoid redundant investigations and to optimize individual medical care. For this, an effective communication system must be established.Once refugees have been transferred into their destination community, outpatient and inpatient care providers should collaborate to bring refugees up-to-date with all vaccines recommended by STIKO (German Standing Committee on Vaccination). The same high standard of medical care should be delivered to refugees as would be to the general population. Due to the high prevalence of multi-resistant organisms (MRO) in the refugees' countries of origin, MRO screening is recommended for most patients receiving inpatient care.
Omar Ahmad Kachkar
Full Text Available Purpose - This paper aims to propose cash waqf (endowment to develop a conceptual model that can be utilised to extend microfinance for refugees. Design/methodology/approach - Qualitative method is used in this research. An extensive review of the literature has been conducted. Latest literature on refugees, microfinance has been critically examined beside the current cash waqf models. Findings - Empirical studies have shown that many refugees are equipped with marketable skills and talents that can be utilised to improve their socio-economic situations. The proposed model – cash waqf refugee microfinance fund (CWRMF – is structured to extend microfinance to potential refugee micro entrepreneurs. To address the lack of collateral, which is a requirement to gain any microfinance, CWRMF has been incorporated with a takaful unit (cooperation by which refugees may guarantee each other. Additionally, the model has also been structured to address the challenge of sustainability of the institution that would provide microfinance. Hence, a reserve fund has also been integrated into the model. Practical implications - CWRMF represents a potential model to be implemented by humanitarian non-governmental organisations (NGOs and aid agencies to support livelihood of refugees in particular for Muslim refugees. Positive outcome is expected from the implementation of this model. This is because of the various advantages of microfinance programs not only on refugees but also on concerned NGOs, host populations and donor parties. Additionally, this paper is a set of primarily thoughts aims to open the door wider for more researchers to explore the potential of cash waqf as one of the instruments to finance refugee microenterprises and business activities. Originality/value - Recently cash waqf has been into several models for socio-economic development and poverty alleviation. This paper is proposing cash waqf as a source for a microfinance fund that can
Department of Population & Health, University of Cape Coast, Cape Coast Tel.: 0244 978 .... the goals, resources and livelihood plans of refugees are influenced by their desire to survive .... The selection process for the host population was.
Kim, Eunyoung; Yun, Minwoo; Jun, Jin Yong; Park, Woong-Sub
Many studies on refugees suggested that refugees' traumatic events associated with post-traumatic stress disorder (PTSD). However, it is unknown whether refugees' PTSD was caused by their negative experience before or after the entry of their destination country. Thus, a separation of refugees' pre-migration from their post-migration experience is particularly important in understanding the causal impact of trauma. Using a sample from North Korean refugees, this study investigates the prevalence of PTSD symptoms, the impact of tortured trauma, repatriation experiences, on PTSD among North Korean refugees (n = 698). We found that North Korean refugees in our sample (a) demonstrated a high rate of current probable PTSD; (b) were demonstrated a higher frequency of repatriation experiences with a greater risk for PTSD symptoms. The findings suggest that particular types of trauma for populations with particular socio-demographic characteristics may be at a greater risk of PTSD.
de Smalen, Allard Willem; Ghorab, Hatem; Abd El Ghany, Moataz; Hill-Cawthorne, Grant A
There is a large increase in the numbers of refugees and asylum seekers worldwide and a lack of data on the carriage of antimicrobial resistance in refugee/asylum seeking groups. This article aims to identify the impact of refugees and asylum seekers on the acquisition and transmission of antimicrobial resistance (AMR) through a literature search. The databases Embase, Medline, Pubmed, and Web of Science Core Collection were utilised and covered all articles before the 1st of October 2016. In total, 577 articles were identified, and studies were eligible if they met the selection criteria, including observational study design, English language, and AMR strains reported in absolute numbers. In total, 17 articles met the criteria, the majority were from the European region. Articles fitting the selection criteria exclusively reported AMR in bacterial species including Mycobacterium tuberculosis, Escherichia coli, Klebsiella pneumonia, K. oxytoca, Shigella spp., Staphylococcus aureus, Enterococcus faecium, and Acinetobacter baumannii. The analyses indicated that a high percentage of AMR strains, have been circulating among refugees and asylum seekers. The displacement of refugees and asylum seekers seem to play a key role in the transmission of AMR. Therefore, improved AMR control measures are essential. A knowledge gap was identified; further research is strongly recommended. Copyright © 2016 Elsevier Ltd. All rights reserved.
Maltezou, Helena C; Theodoridou, Maria; Daikos, George L
In the past few years, Europe has experienced an enormous influx of refugees and migrants owing to the ongoing civil war in Syria as well as conflicts, violence and instability in other Asian and African countries. Available data suggest that refugees carry a significant burden of multidrug-resistant (MDR) organisms, which is attributed to the rising antimicrobial resistance (AMR) rates in their countries of origin, both in healthcare settings and in the community. Transmission of MDR pathogens among refugees is facilitated by the collapsed housing, hygiene and healthcare infrastructures in several communities as well as poor hygiene conditions during their trip to destination countries. These findings highlight the fact that refugees may serve as vehicles of AMR mechanisms from their countries of origin along the immigration route. Following risk assessment, routine microbiological screening for MDR organism carriage of refugees and migrants as well as effective infection control measures should be considered upon admission. This will on the one hand address the possibility of dissemination of novel AMR mechanisms in non- or low-endemic countries and on the other will ensure safety for all patients. Copyright © 2017 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.
Sadarangani, Tina R; Jun, Jin
Newcomer elderly immigrants, defined as adults older than the age of 65 who have arrived in the United States in the last 10 years, represent a growing sector of the American population. Newcomers who experience limited English proficiency, financial strain, and acculturative stress are at considerable risk of developing poor health outcomes. Nursing's focus on healthy aging and aging in place has largely ignored the experiences of these older adults, who are said to be "aging out of place." This concept analysis uses Rodgers's evolutionary method to define "aging out of place" and illustrates why existing theories of elderly migration do not necessarily apply to this population. The challenge for nurses is incorporating the family, with whom conflict may arise, into the care of these elders. Community-based strategies that enable social integration and create a greater division of labor in the care of newcomer elders are called for. © The Author(s) 2014.
A. Paz Alencar (Amanda)
textabstractThe refugee crisis has spurred the rapid development of creative technology and social media applications to tackle the problem of refugee integration in Europe. In this article, a qualitative study with 18 refugees from Syria, Eritrea and Afghanistan is presented in order to investigate
... 45 Public Welfare 2 2010-10-01 2010-10-01 false Requirements for documentation of refugee status. 400.43 Section 400.43 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE...
Demirci, Hakan; Yildirim Topak, Nevruz; Ocakoglu, Gokhan; Karakulak Gomleksiz, Mehtap; Ustunyurt, Emin; Ulku Turker, Ayse
To compare the birth characteristics of Syrian refugees with those of Turkish citizens. In a retrospective study, data were obtained for singleton live births that occurred at a hospital in Bursa, Turkey, between June 1 and December 31, 2015. All Syrian refugees were eligible for inclusion; one Turkish citizen was included for each refugee. Overall, 545 Syrian refugees and 545 Turkish citizens were included. Cesarean delivery was undertaken for 176 (32.3%) Syrians and 235 (43.1%) Turks (PSyrian refugees (3110 g, range 540-4790; PSyrian refugees (PSyrians (P=0.014). Cesarean delivery is more common among pregnant Turkish citizens than among Syrian refugees. Other notable differences between the groups were recorded. © 2016 International Federation of Gynecology and Obstetrics.
Lergetporer, Philipp; Piopiunik, Marc; Simon, Lisa
In recent years, Europe has experienced an unprecedented influx of refugees. While natives’ attitudes toward refugees are decisive for the political feasibility of asylum policies, little is known about how these attitudes are shaped by refugees’ characteristics. We conducted survey experiments with more than 5,000 university students in Germany in which we exogenously shifted participants’ beliefs about refugees’ education level through information provision. Consistent with economic theory,...
Muller, Julia; Karl, Anke; Denke, Claudia; Mathier, Fabienne; Dittmann, Jennifer; Rohleder, Nicolas; Knaevelsrud, Christine
Chronic pain (CP) and posttraumatic stress disorder (PTSD) are both frequent and often comorbid in refugees. To date, few controlled trials have studied the efficacy of treatments targeting this comorbidity; no treatment guidelines yet exist. The authors examined the feasibility and efficacy of short-term cognitive behavioural biofeedback (BF) addressing CP in traumatised refugees. The sample comprised 11 severely traumatised refugees with CP and PTSD (mean age = 36 years, SD = 6), who underwent assessment with the Mini International Neuropsychiatric Interview, Posttraumatic Diagnostic Scale, Pain Disability Index, and Visual Rating Scale. Additionally, coping with pain and psychotherapy tolerance were assessed. Acceptance of BF was high. Pre-post effects were small to medium for increased pain management and associated heart rate reactivity but large for coping with pain. The results encourage further research to confirm whether BF is indicated as a treatment component, but not a stand-alone treatment, for traumatised refugees with comorbid CP and PTSD.
Full Text Available Refugee youth unemployment has been linked to increased risk of extremism and/or exploitation. Research indicates, however, that unemployment is just one of many factors triggering frustration among young refugees.
... 45 Public Welfare 2 2010-10-01 2010-10-01 false Child welfare services for refugee children. 400... RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Child Welfare Services § 400.112 Child welfare services for refugee children. (a) In...
Tubergen, F.A. van
Little is known about the language acquisition of refugees in Western countries. This study examines how pre- and post-migration characteristics of refugees are related to their second language proficiency. Data are from a survey of 3,500 refugees, who were born in Afghanistan, Iran, Iraq, former
"The humanitarian policy that the Canadian government implemented in response to the 1989 Tiananmen Square crackdown changed a migration system primarily based on personal networks into a brain drain. Post-Tiananmen mainland Chinese immigrants (MCIs) were better educated than those arriving in Canada previously. Among the post-Tiananmen MCIs, those who landed under the policy were better educated than those landing in other categories. The analysis suggests that post-Tiananmen MCIs represented a brain-drain rather than a refugee flow, that the humanitarian policy implicitly contained ideological and human capital concerns in addition to humanitarian concerns, and that Canada benefited from the policy by obtaining human capital as well as satisfying its humanitarian obligations and ideological aspirations." excerpt
Child Soldiers as Refugees in Germany How do former child soldiers cope with their potentially traumatic experiences, and how do the living conditions as refugees influence these coping processes? A dissertation at the faculty of human and social sciences at the University of Wuppertal, based on biographical-narrative interviews with 15 young refugees from six African countries, describes the characteristics of the traumatic sequences in the countries of origin and in exile, and elaborates typical coping processes. In order to survive a situation of absolute subjection within armed groups, children develop forms of adequate adaptation to the context like regulation and detachment of emotions e.g. with the use of drugs, assimilation to an idea of "hard masculinity" etc. They become victims, witnesses and often perpetrators of extreme violence (man-made-disaster), respectively traumatic processes can be seen in all sequences. After leaving the armed groups there is no way back into the families and communities destroyed by armed conflict, so they become refugees. In Germany, they are subjected to a bureaucratic and excluding asylum system, in which decisions on all relevant areas of life (age determination, place and right of residence, form of accommodation, access to education, etc.) are imposed on them. Especially the insecure right of residence and the living conditions in refugee camps are severe risk factors, impeding stabilization. Social support, e. g. by competent professionals, access to trauma- and culture-sensitive psychotherapy, societal inclusion, but also personal resilience are essential for coping with trauma and developing new future perspectives.
Haagen, Joris F G; Ter Heide, F Jackie June; Mooren, Trudy M; Knipscheer, Jeroen W; Kleber, Rolf J
Given the recent peak in refugee numbers and refugees' high odds of developing post-traumatic stress disorder (PTSD), finding ways to alleviate PTSD in refugees is of vital importance. However, there are major differences in PTSD treatment response between refugees, the determinants of which are largely unknown. This study aimed at improving PTSD treatment for adult refugees by identifying PTSD treatment response predictors. A prospective longitudinal multilevel modelling design was used to predict PTSD severity scores over time. We analysed data from a randomized controlled trial with pre-, post-, and follow-up measurements of the safety and efficacy of eye movement desensitization and reprocessing and stabilization in asylum seekers and refugees suffering from PTSD. Lack of refugee status, comorbid depression, demographic, trauma-related and treatment-related variables were analysed as potential predictors of PTSD treatment outcome. Treatment outcome data from 72 participants were used. The presence (B = 6.5, p = .03) and severity (B = 6.3, p disorder predicted poor treatment response and explained 39% of the variance between individuals. Refugee patients who suffer from PTSD and severe comorbid depression benefit less from treatment aimed at alleviating PTSD. Results highlight the need for treatment adaptations for PTSD and comorbid severe depression in traumatized refugees, including testing whether initial targeting of severe depressive symptoms increases PTSD treatment effectiveness. There are differences in post-traumatic stress disorder (PTSD) treatment response between traumatized refugees. Comorbid depressive disorder and depression severity predict poor PTSD response. Refugees with PTSD and severe depression may not benefit from PTSD treatment. Targeting comorbid severe depression before PTSD treatment is warranted. This study did not correct for multiple hypothesis testing. Comorbid depression may differentially impact alternative PTSD treatments
Duzkoylu, Yigit; Basceken, Salim Ilksen; Kesilmez, Emrullah Cem
Hundreds of thousands of people have fled to Turkey since the civil war started in Syria in 2011. Refugees and local residents have been facing various challenges such as sociocultural and economic ones and access to health services. Trauma exposure is one of the most important and underestimated health problems of refugees settling in camps. We aimed to evaluate refugee admissions to emergency department because of trauma in means of demographics of patients and mechanism of trauma and compare the results with the local population. Retrospective evaluation of results and comparison with the results of local population. We determined that the ratio of emergency admission of refugee patients because of trauma was significantly higher than the local population for most types of trauma. Further studies with more refugee participants are needed to fully understand the underlying reasons for this high ratio to protect refugees as well as for planning to take caution to attenuate the burden on healthcare systems.
Full Text Available Background. Hundreds of thousands of people have fled to Turkey since the civil war started in Syria in 2011. Refugees and local residents have been facing various challenges such as sociocultural and economic ones and access to health services. Trauma exposure is one of the most important and underestimated health problems of refugees settling in camps. Aims. We aimed to evaluate refugee admissions to emergency department because of trauma in means of demographics of patients and mechanism of trauma and compare the results with the local population. Methods. Retrospective evaluation of results and comparison with the results of local population. Results. We determined that the ratio of emergency admission of refugee patients because of trauma was significantly higher than the local population for most types of trauma. Conclusion. Further studies with more refugee participants are needed to fully understand the underlying reasons for this high ratio to protect refugees as well as for planning to take caution to attenuate the burden on healthcare systems.
Basceken, Salim Ilksen; Kesilmez, Emrullah Cem
Background Hundreds of thousands of people have fled to Turkey since the civil war started in Syria in 2011. Refugees and local residents have been facing various challenges such as sociocultural and economic ones and access to health services. Trauma exposure is one of the most important and underestimated health problems of refugees settling in camps. Aims We aimed to evaluate refugee admissions to emergency department because of trauma in means of demographics of patients and mechanism of trauma and compare the results with the local population. Methods Retrospective evaluation of results and comparison with the results of local population. Results We determined that the ratio of emergency admission of refugee patients because of trauma was significantly higher than the local population for most types of trauma. Conclusion Further studies with more refugee participants are needed to fully understand the underlying reasons for this high ratio to protect refugees as well as for planning to take caution to attenuate the burden on healthcare systems. PMID:28694829
Mikal, Jude P; Woodfield, Braden
Post-migration stressors represent significant obstacle to refugee adjustment, and continued exposure to post-migration stressors can negatively affect mental and physical health. Communities of support maintained over the Internet may provide a sense of constancy and reliability that may insulate against the negative effects of stress. We conducted five focus group interviews with Iraqi and Sudanese refugees to understand how refugees use the Internet to access support in their daily lives. Four trends were observed: (a) Internet use was related to culture of origin, (b) refugees were reluctant to explore online, (c) children served as brokers of online knowledge, and (d) limited Internet access is associated with increased time and financial obligations. This study aims to contribute to theory on Internet-mediated social support and to refugee health by creating smoother pathways to self-sufficiency and allowing refugees to exhibit agency in constructing and maintaining online networks of support. © The Author(s) 2015.
developments in communications technologies and the Internet and the proliferation of websites such as the CARFMS – Online Research and Teaching Tool and Practitioners Forum (ORTT & PF) and the Refugee Research Network (RRN), as examples, have contributed to the accessibility of information, knowledge......IASFM 14: Contested Spaces and Cartographic Challenges Kolkata, India, January 6-9, 2013 ABSTRACT for a Roundtable on the topic of Refugee and Forced Migration Studies Online: Harnessing “the Cloud” for Knowledge Generation, Instruction, and Mobilization With the advent of the Internet...... and the proliferation of websites and online instruments on refugee and forced migration studies the nature of research and information gathering, analysis, and dissemination, along with advocacy, has altered fundamentally both in its range, depth and scope. This Roundtable will seek to review how the latest...
Therefore, this paper provides an overview of the social work practice with refugees. ... Legal statutes that govern refugee protection in Zimbabwe .... More often than not, unaccompanied minors have been forced out of school at a tender age because of the war .... of this strategy is to achieve gender and age equality.
Full Text Available Background: Iran has received Afghan refugees for many years. Few studies have been done to assess psychiatric morbidity among Afghan refugees in Iran, especially those who are resettled in camps. This study has been designed to determine the prevalence of mental health problems and the associated demographic factors, in Afghan refugees resettled in Dalakee refugee camp of Bushehr Province, in 2005. Methods: In this cross-sectional survey, a Persian version of the General Health Questionnaire (GHQ-28 was administered to 321 resettled Afghan refugees with the minimum age of 15 years old who were randomly selected among 2200 residents of Dalakee refugee camp in Bushehr Province. Results: Among mental health subscales, the prevalence of social dysfunction, psychosomatic problem, anxiety and depression in the studied population were 80.1%, 48.9%, 39.3% and 22.1%, respectively. The total prevalence of mental health disorders in this camp was 88.5%. Male gender, living with more than eight persons per house, and being age ten or under at migration time were associated with higher level of social dysfunction. Higher rate of psychosomatic problem was associated with unemployment, being born in Iran, being age ten or under at migration time, and having no entertaining programs. Having 1-3 children, living with more than eight persons per house, and positive history of chronic disease were associated with higher level of anxiety. Having no entertaining programs, and family members' death during migration were associated with higher level of depression. Conclusion: Mental health problems related to immigration and living in camps, are common among Afghan refugees.
The unprecedented global refugee crisis and the accompanying political discourse places added pressures on teachers working with children who are refugees in resettling countries. Given the increased chances of having a refugee child in one's classroom, it is critical to explore how interculturally sensitive teachers are and if working with…
Brooker, Abi; Lawrence, Jeanette; Dodds, Agnes
Digital media are beneficial for research of complex refugee issues, as they allow refugees to express their personal experiences of complex issues in ways that are not restricted by language barriers or limited in authenticity, while also offering researchers a way to systematically compare refugees' varied experiences. We used a computerised…
Palic, Sabina; Carlsson, Jessica; Armour, Cherie; Elklit, Ask
Dissociative experiences are common in traumatized individuals, and can sometimes be mistaken for psychosis. It is difficult to identify pathological dissociation in the treatment of traumatized refugees, because there is a lack of systematic clinical descriptions of dissociative phenomena in refugees. Furthermore, we are currently unaware of how dissociation measures perform in this clinical group. To describe the phenomenology of dissociative symptoms in Bosnian treatment-seeking refugees in Denmark. As a part of a larger study, dissociation was assessed systematically in 86 Bosnian treatment-seeking refugees using a semi-structured clinical interview (Structured Interview for Disorders of Extreme Stress-dissociation subscale; SIDES-D) and a self-report scale (Dissociative Experiences Scale; DES). The SIDES-D indicated twice as high prevalence of pathological dissociation as the DES. According to the DES, 30% of the refugees had pathological dissociation 15 years after their resettlement. On the SIDES-D, depersonalization and derealization experiences were the most common. Also, questions about depersonalization and derealization at times elicited reporting of visual and perceptual hallucinations, which were unrelated to traumatic re-experiencing. Questions about personality alteration elicited spontaneous reports of a phenomenon of "split" pre- and post-war identity in the refugee group. Whether this in fact is a dissociative phenomenon, characteristic of severe traumatization in adulthood, needs further examination. Knowledge of dissociative symptoms in traumatized refugees is important in clinical settings to prevent misclassification and to better target psychotherapeutic interventions. Much development in the measurement of dissociation in refugees is needed.
Shannon, Patricia J
About 45.2 million people were displaced from their homes in 2012 due to persecution, political conflict, generalized violence and human rights violations. Refugees who endure violence are at increased risk of developing chronic psychiatric disorders such as posttraumatic stress disorder and major depression. The primary care visit may be the first opportunity to detect the devastating psychological effects of trauma. Physicians and refugees have identified communication barriers that inhibit discussions about mental health. In this study, refugees offer advice to physicians about how to assess the mental health effects of trauma. Ethnocultural methodology informed 13 focus groups with 111 refugees from Burma, Bhutan, Somali and Ethiopia. Refugees responded to questions concerning how physicians should ask about mental health in acceptable ways. Focus groups were recorded, transcribed and analyzed using thematic categorization informed by Spradley's Developmental Research Sequence. Refugees recommended that physicians should take the time to make refugees comfortable, initiate direct conversations about mental health, inquire about the historical context of symptoms and provide psychoeducation about mental health and healing. Physicians may require specialized training to learn how to initiate conversations about mental health and provide direct education and appropriate mental health referrals in a brief medical appointment. To assist with making appropriate referrals, physicians may also benefit from education about evidence-based practices for treating symptoms of refugee trauma. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: email@example.com.
The Soviet repression of the Hungarian uprising in 1956 caused an exodus of 200,000 refugees. Most of the refugees fled to Austria. Austria immediately called on states to help both financially and by physically sharing the refugees by means of resettlement. As a result, most of the refugees were
Benoit, Stephen R; Gregg, Edward W; Zhou, Weigong; Painter, John A
We reported diabetes prevalence among all US-bound adult refugees and assessed factors associated with disease. We analyzed overseas medical evaluations of US-bound refugees from 2009 through 2014 by using CDC's Electronic Disease Notification System. We identified refugees with diabetes by searching for diabetes-related keywords and medications in examination forms with text-parsing techniques. Age-adjusted prevalence rates were reported and factors associated with diabetes were assessed by using logistic regression. Of 248,850 refugees aged ≥18 years examined over 5 years, 5767 (2.3 %) had diabetes. Iraqis had the highest crude (5.1 %) and age-adjusted (8.9 %) prevalence of disease. Higher age group and body mass index were associated with diabetes in all regions. Diabetes prevalence varied by refugee nationality. Although the absolute rates were lower than rates in the United States, the prevalence is still concerning given the younger age of the population and their need for health services upon resettlement.
Full Text Available Abstract Background Providing reproductive and sexual health services is an important and challenging aspect of caring for displaced populations, and preventive and curative sexual health services may play a role in reducing HIV transmission in complex emergencies. From 1995, the non-governmental "Reproductive Health Group" (RHG worked amongst refugees displaced by conflicts in Sierra Leone and Liberia (1989–2004. RHG recruited refugee nurses and midwives to provide reproductive and sexual health services for refugees in the Forest Region of Guinea, and trained refugee women as lay health workers. A cross-sectional survey was conducted in 1999 to assess sexual health needs, knowledge and practices among refugees, and the potential impact of RHG's work. Methods Trained interviewers administered a questionnaire on self-reported STI symptoms, and sexual health knowledge, attitudes and practices to 445 men and 444 women selected through multistage stratified cluster sampling. Chi-squared tests were used where appropriate. Multivariable logistic regression with robust standard errors (to adjust for the cluster sampling design was used to assess if factors such as source of information about sexually transmitted infections (STIs was associated with better knowledge. Results 30% of women and 24% of men reported at least one episode of genital discharge and/or genital ulceration within the past 12 months. Only 25% correctly named all key symptoms of STIs in both sexes. Inappropriate beliefs (e.g. that swallowing tablets before sex, avoiding public toilets, and/or washing their genitals after sex protected against STIs were prevalent. Respondents citing RHG facilitators as their information source were more likely to respond correctly about STIs; RHG facilitators were more frequently cited than non-healthcare information sources in men who correctly named the key STI symptoms (odds ratio (OR = 5.2, 95% confidence interval (CI 1.9–13.9, and in men and
Rhie, Ann Y.
Approved for public release, distribution unlimited The specter of refugees is inextricably linked to a state's national security interests. Mass movements of refugees across international borders cannot possibly be absorbed without incurring political. social and economic costs to the receiving state. To contribute to regional stability and international peace. the United States must be Vigilaint to the dangers and tensions inherent in the international problem of refugees. Nowhere have t...
The purpose of this study is to analyse the educational policies for Syrian school-aged refugees in Turkey. In this study, we identified the policy priorities for refugees by first examining the theoretical approaches to refugee education and the common problems observed for refugee education in different countries. Using this framework, we…
Oxfam America, Boston, MA.
Definitions, statistics, and problems of world refugees are presented in this document for high school global education classes. Although various agencies have determined different definitions of the term, the authors consider as refugees all those forced to flee their native land in order to survive. For most refugees the attraction of a higher…
Conflict and displacement are increasingly protracted, requiring rethinking of refugee education as a long-term endeavour, connected not only to the idea of return but to the ongoing nature of exile. In this essay, I examine how refugees conceptualize education and its role in creating certainty and mending the disjunctures of their trajectories…
Handlos, Line Neerup; Olwig, Karen Fog; Bygbjerg, Ib Christian
Elderly migrants constitute a considerable share of global return migration; nevertheless, literature on the health aspects of the return migration among these migrants is still scarce. This study explores the significance of return migration among elderly, chronically ill Bosnian refugees from...... Denmark and the role of health issues in their decision to return. It is based on semi-structured interviews with 33 elderly, chronically ill Bosnian refugees who have moved back to Bosnia and Herzegovina, and 10 elderly, chronically ill Bosnian refugees who have remained in Denmark. The interviews show...
van Tubergen, Frank
Little is known about the language acquisition of refugees in Western countries. This study examines how pre- and post-migration characteristics of refugees are related to their second language proficiency. Data are from a survey of 3,500 refugees, who were born in Afghanistan, Iran, Iraq, former Yugoslavia and Somalia, and who resided in the…
Full Text Available Recent studies have emphasized the influence of resettlement factors on the mental health of refugees resettling in developed countries. However, little research has addressed gender differences in the nature and influence of resettlement stressors and sources of resilience. We address this gap in knowledge by investigating how gender moderates and mediates the influence of several sources of distress and resilience among 259 Afghan refugees residing in Northern California (USA. Gender moderated the effects of four factors on levels of distress. Intimate and extended family ties have little correlation with men’s distress levels, but are strongly associated with lower distress for women. English ability is positively associated with lower distress for women, but not men. In terms of gender ideology, traditionally oriented women and egalitarian men have lower levels of distress. And experiencing greater dissonant acculturation increases distress for men, but not women. The influence of gender interaction terms is substantial and patterns may reflect difficulty adapting to a different gender order. Future studies of similar populations should investigate gender differences in sources of distress and resilience, and efforts to assist new arrivals might inform them of changes in gender roles they may experience, and facilitate opportunities to renegotiate gender roles.
Stempel, Carl; Sami, Nilofar; Koga, Patrick Marius; Alemi, Qais; Smith, Valerie; Shirazi, Aida
Recent studies have emphasized the influence of resettlement factors on the mental health of refugees resettling in developed countries. However, little research has addressed gender differences in the nature and influence of resettlement stressors and sources of resilience. We address this gap in knowledge by investigating how gender moderates and mediates the influence of several sources of distress and resilience among 259 Afghan refugees residing in Northern California (USA). Gender moderated the effects of four factors on levels of distress. Intimate and extended family ties have little correlation with men's distress levels, but are strongly associated with lower distress for women. English ability is positively associated with lower distress for women, but not men. In terms of gender ideology, traditionally oriented women and egalitarian men have lower levels of distress. And experiencing greater dissonant acculturation increases distress for men, but not women. The influence of gender interaction terms is substantial and patterns may reflect difficulty adapting to a different gender order. Future studies of similar populations should investigate gender differences in sources of distress and resilience, and efforts to assist new arrivals might inform them of changes in gender roles they may experience, and facilitate opportunities to renegotiate gender roles.
Graham, Belinda; Herlihy, Jane; Brewin, Chris R
Studies in western samples have shown that post-traumatic stress disorder (PTSD) and depression are associated with overgeneral autobiographical memory retrieval. This study assesses whether this association extends to asylum seekers and refugees from diverse cultural backgrounds. We discuss implications for those providing testimony of their experiences when seeking asylum. 38 asylum seekers and refugees were recruited through clinics and community groups. Clinical interviews assessed PTSD and depression and participants completed a test of autobiographical memory specificity. When accounting for omissions, participants with PTSD and depression recalled a lower proportion of specific memories. Those with PTSD also failed more frequently to report any memory. The sample did not permit separate evaluation of the effects of PTSD and depression on specificity. Lower memory specificity observed in people experiencing PTSD and depression in western populations extends to asylum seekers and refugees from diverse cultural backgrounds. This study adds to the literature suggesting that being recognised as a refugee fleeing persecution is more difficult for those with post-traumatic symptoms and depression. Copyright © 2014 Elsevier Ltd. All rights reserved.
Al-Nuaimi, Saleem; Aldandashi, Samer; Easa, Abdul Kadir Saed; Saqqur, Maher
To the best of our knowledge, the mental health status of physically injured Syrian refugees has not yet been investigated. The aim of this study was to examine the prevalence of psychiatric morbidity among physically injured Syrian refugees in Turkey receiving treatment at the main rehabilitation centre near the Syrian border. This is a cross sectional study. Information was collected from consenting injured Syrian refugees at Dar-el-Shefa'a Hospital in Reyhanlı (Turkey) during a one week period in December 2012 and another one week period in August 2013. A clinical psychiatric interview was conducted to determine a diagnosis according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM) IV-TR. A total of 40 refugees consented and completed a clinical psychiatric interview. All refugees in this study did not have a significant past psychiatric history. The most prevalent current diagnosis was major depressive disorder (22.5%), adjustment disorder (20%), and post-traumatic stress disorder (15%). Five (12.5%) patients had no evidence of a psychiatric disorder. The prevalence of psychiatric morbidity among injured Syrian refugees in our study was extremely high. This may help guide the treatment and management of this select population. This study had a low number of participants. The method of assessment was not standardized with a validated tool. This study may help guide the treatment and management of this select population, both in neighbouring countries and as resettled refugees in Western host countries. Copyright © 2017 Elsevier Inc. All rights reserved.
LeBrun, Annie; Hassan, Ghayda; Boivin, Mylène; Fraser, Sarah-Louise; Dufour, Sarah; Lavergne, Chantal
Study results on child maltreatment based on general population samples cannot be extrapolated with confidence to vulnerable immigrant or refugee families because of the specific characteristics and needs of these families. The aims of this paper are 1) to conduct an evidence review of the prevalence, risk factors and protective factors for child maltreatment in immigrant and refugee populations, and 2) to integrate the evidence in an analytical ecosystemic framework that would guide future research. We used a 14-step process based on guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Canadian Collaboration for Immigrant and Refugee Health. We searched major databases from "the oldest date available to July 2014". The eligibility criteria for paper selection included qualitative or quantitative methodologies; papers written in English or French; papers that describe, assess or review prevalence, risk and protection factors for child maltreatment; and a studied population of immigrants or refugees. Twenty-four articles met the criteria for eligibility. The results do not provide evidence that immigrant or refugee children are at higher risk of child maltreatment. However, recently settled immigrants and refugees experience specific risk factors related to their immigration status and to the challenges of settlement in a new country, which may result in high risk of maltreatment. Future research must incorporate more immigrant and refugee samples as well as examine, within an ecosystemic framework, the interaction between migratory and cultural factors with regard to the prevalence, consequences and treatment of child maltreatment for the targeted groups.
Jennifer Anne Simmelink
Full Text Available This exploratory study examines the mental health knowledge and training needs of refugee-serving community based organizations in a Midwestern state. A survey was administered to 31 staff members at 27 community based organizations (CBOs to assess the ability of staff to recognize and screen for mental health symptoms that may interfere with successful resettlement. Of the 31 respondents 93.5% (n=29 see refugees with mental health issues and 48.4% (n=15 assess refugees for mental health symptoms – primarily through informal assessment. Mainstream organizations were more likely than ethnic organizations to have received training related to the mental health needs of refugees. Results indicate that while refugee led CBOs recognize mental health symptoms of refugees they may be less likely to assess mental health symptoms and refer for treatment. Policy recommendations for improving CBO services to refugees are offered.
Draminsky Petersen, Hans; Christensen, Maria Elisabeth; Kastrup, Marianne
General health assessment of refugees claiming to have been previously exposed to torture takes place in a psychological atmosphere affected by the difficult situation of the refugee. Thirty-one refugees, mainly from the Middle East and Africa, were assessed as regards their physical and mental...... (P general) health. Reliability was moderate with respect to clinical observation during interview....
In March 2007, the European Council on Refugees and Exiles (ECRE) launched updated Guidelines on the Treatment of Chechen Internally Displaced Persons (IDPs), Asylum Seekers and Refugees in Europe. This article analyses the treatment of Chechen IDPs, asylum seekers and refugees in Europe, concentrating on these groups of people from the Chechen Republic outside of the Russian Federation.
Mackrill, Thomas Edward
This article presents an empirical analysis that is part of a practice research project carried out at a Danish Red Cross refugee centre in Copenhagen. It focuses on the relation between the individual refugee and the receiving institution. It points out how the organizational structure...... of a particular refugee centre enables discord between refugees and centre workers as well as among the centre staff. It analyses some of the dynamics of the conflicts that are facilitated by the structure...
Scott, Kevin C; Taylor, Eboni M; Mamo, Blain; Herr, Nathaniel D; Cronkright, Peter J; Yun, Katherine; Altshuler, Marc; Shetty, Sharmila
Globally, more than two billion persons have been infected at some time with the hepatitis B virus (HBV), and approximately 3.5 million refugees have chronic HBV infection. The endemicity of HBV varies by region. Because chronic hepatitis B is infectious and persons with chronic infection benefit from treatment, CDC recommends screening for HBV among all refugees who originate in countries where the prevalence of hepatitis B surface antigen (HBsAg; a marker for acute or chronic infection) is ≥2% or who are at risk for HBV because of personal characteristics such as injection drug use or household contact with an individual with HBV infection. Currently, almost all refugees are routinely screened for hepatitis B. However, prevalence rates of HBV infection in refugee populations recently resettled in the United States have not been determined. A multisite, retrospective study was performed to evaluate the prevalence of past HBV infection, current infection, and immunity among refugees resettled in the United States; to better characterize the burden of hepatitis B in this population; and to inform screening recommendations. The study incorporated surveillance data from a large state refugee health program and chart reviews from three U.S. sites that conduct medical screenings of refugees. The prevalence of HBV infection (current or past as determined by available titer levels) varied among refugees originating in different countries and was higher among Burmese refugees than among refugees from Bhutan or Iraq. Current or past HBV infection was also higher among adults (aged >18 years) and male refugees. These data might help inform planning by states and resettlement agencies, as well as screening decisions by health care providers.
Comeau, Mary T.
Two papers explore racial ideology and policy toward immigrants and refugees in the United States. The first paper, "Race Theory Paradigms and Immigrant/Refugee Identity and Incorporation," asserts that the United States is a race-based society in which newcomers to the country have a racial identity imposed upon them. A review of the…
Sastre, Lauren; Haldeman, Lauren
INTRODUCTION In 2012, North Carolina ranked in the top ten states in refugee resettlement, with central Guilford County one of the most diverse in the southeast. OBJECTIVE Examine the local resettlement environmental, nutrition and health barriers and needs of refugees in Guilford County, as perceived by individuals providing services to them. METHODS Participants (n = 40) included: medical and social service providers, educators, faith-based volunteers, resettlement agency caseworkers and liaisons to a variety of refugee communities. Guided semistructured interviews were audio-recorded and transcribed verbatim. Themes were identified using deductive content analysis and categorized by frequency of reporting by participants. RESULTS Perceptions were consistent across participants regarding a diverse local refugee population. Resettlement housing was observed to be in poor condition, located in areas of poverty with transportation barriers. However, refugees rarely relocated, due to strong community relationships and support. Perceived dietary risks included: difficulties budgeting and maintaining food assistance, hoarding food, high consumption of sodas and sweets, misperceptions regarding US products (e.g., perceived need for infant formula), and limited health knowledge. Respondents observed that most refugees preferred "fresh" foods, and had strong agricultural skills but lacked green space. Major barriers to health care reported were: poverty, short duration of initial Medicaid coverage, and language (both lack of interpretation services and translated materials). Providers consistently observed type 2 diabetes, weight gain and dental problems across refugee groups. CONCLUSIONS Direct service providers' experiences and observations working with a diverse resettlement population provide unique insight into consistent barriers to achieving good health that confront refugees. While refugees face many barriers, groups often have impressive strengths, such as
... and concealment that are associated with numerous capacity challenges in access and utilisation of the available services. The extreme conditions that refugees go through during displacement, flight and resettlement tend to exacerbate and sustain GBV. Keywords: Experiences, Gender Based Violence, Refugee Camps ...
Refugee learners face traumatising post-migration experiences in South Africa. Their resilience is tested in all spheres – communities which they settle, schools they go to and places they try to get social services. The purpose of this study is to explore post-migration experiences which gave rise to resilience among ...
Shapiro, Ditte Krogh
Fleeing civil war involves managing life threatening events and multiple disruptions of everyday life. The theoretical potentials of analysing the recreation of everyday family life among Syrian refugees in Denmark is explored based on conceptualizations that emphasize the collective agency...... of family members in social historical contexts. Studying the multiple perspectives of family members shows how social support conceptualized as care practises is conflictual in the changing everyday family practices that are transformed by policy. The purpose of studying how families manage to flee civil...... war and struggle to recreate an everyday life in exile is to contribute with contextualization and expansion of mainstream understandings of family life, suffering, and resilience in refugee family trajectories in multiple contexts....
Dao, Tam K; Poritz, Julia M P; Moody, Rachel P; Szeto, Kim
The Posttraumatic Stress Disorder Interview for Vietnamese Refugees (PTSD-IVR) was created specifically to assess for the presence of current and lifetime history of premigration, migration, encampment, and postmigration traumas in Vietnamese refugees. The purpose of the present study was to describe the development of and investigate the interrater and test-retest reliability of the PTSD-IVR and its validity in relation to the diagnoses obtained from the Longitudinal, Expert, and All Data (LEAD; Spitzer, 1983) standard. Clinicians conducted the diagnosis process with 127 Vietnamese refugees using the LEAD standard and the PTSD-IVR. Assessment of the reliability and validity of the PTSD-IVR yielded good to excellent AUC (area under the receiver operating characteristic curve; .86, .87) and κ values (.66, .74) indicating the reliability of the PTSD-IVR and the agreement between the LEAD procedure and the PTSD-IVR. The results of the present study suggest that the PTSD-IVR performs successfully as a diagnostic instrument specifically created for Vietnamese refugees in their native language. Copyright © 2012 International Society for Traumatic Stress Studies.
Full Text Available A major challenge facing many countries around the world is how to sustainably address the issues of increased numbers of refugee migrants. The refugee migrant “issue” is often heavily political as a high density of migrants in local areas impacts communities (e.g., disrupting local employment, service and culture. Different migrants come with different “baggage” and needs which can be a significant draw on the hosting communities’ resources. This paper argues that sustainable long-term solutions to refugee migrants will require a rethink to the existing dominant models of containment and charity. The paper draws upon insights from a study of a large refugee camp in Jordan over a three-and-a-half-year period, and historical cases of refugee migration. The paper presents a sustainable model that develops long-term capability for the various stakeholder groups.
... Information Collection: Refugee Biographic Data ACTION: Notice of request for public comments. SUMMARY: The... of 1995. Title of Information Collection: Refugee Biographic Data. OMB Control Number: 1405-0102..., Refugees, and Migration, PRM/A. Form Number: N/A. Respondents: Refugee applicants for the U.S. Resettlement...
Weinstein, Netta; Khabbaz, Farah; Legate, Nicole
Becoming a refugee is a potent risk factor for indicators of psychological distress such as depression, generalized stress, and posttraumatic stress disorder (PTSD), though research into this vulnerable population has been scant, with even less work focusing on interventions. The current study applied principles from self-determination theory (SDT; Ryan & Deci, 2000) to develop and test an intervention aimed at increasing need-satisfying experiences in refugees of Syrian civil unrest. Forty-one refugees who fled Syria during the past 24 months and resettled in Jordan participated in the study and were randomly assigned to receive the intervention or a neutral comparison. The 1-week-long intervention alleviated some of the need frustration likely associated with refugee status, a major aim of the intervention, and also lowered refugees' self-reported symptoms of depression and generalized stress as compared to the comparison condition, though it did not reduce symptoms of PTSD. Discussion focuses on how these findings speak to the universal importance of need satisfaction for mental health, and how need-satisfying experiences can help buffer against the profound stress of being a refugee. Avenues for longer-term or more intensive interventions that may target more severe outcomes of refugee experiences, such as PTSD symptoms, are also discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).
Evidence from countries such as Rwanda, Bosnia, and Sierra Leone links war and forced migration to the spread of HIV. In complex emergencies such as war, the social cohesion characteristic of stable societies is disrupted and families are dispersed, thereby increasing people's vulnerability. An estimated 30,000-40,000 women were raped during the war in Bosnia. In refugee camps, women may be forced to trade sex for food and protection for themselves and their children. Even when refugees are integrated into receiving communities, they remain vulnerable to sexual exploitation. Medical practitioners in refugee settings tend to emphasize diseases such as diarrhea, malaria, and respiratory illnesses. After a complex emergency, when a minimum range of health services is being re-established, HIV prevention is often considered a secondary issue. The International Federation of the Red Cross has advocated meeting the sexual health needs of refugees during the first 6 weeks of an emergency situation. The Federation provides condoms to refugees in transit and assistance to rape victims. The United Nations High Commission on Refugees ensures that refugee camps provide HIV/AIDS information, access to condoms, screening of donated blood, and observance of universal medical precautions.
Meredith, William H.; Cramer, Sheran L.
This report summarizes the response of 80 sponsors of Indochinese refugees in Nebraska to a survey designed to explore their sponsorship experience. Problem solving areas for sponsors and refugees are named as: acculturation, emotional adjustments, communication, health, housing, transportation, employment, and legal, financial and consumer…
Resettlement to third countries is regarded as a durable solution to refugee crises. In Kakuma refugee camp in north-west Kenya, seeking a better life in industrialized countries has become a preoccupation for many refugees. In this article the effects of the practice of third country resettlement
Akokpari, J K
Migration and refugee movements could significantly decline in sub-Saharan African countries. However, countries must redistribute meager resources equitably and engage in environmental protection. Refugee and migrant populations have increased in sub-Saharan Africa during 1969-95, from 700,000 to 6.8 million. This study examined the causes of migration and the implications for host countries. Doornbos (1990) identifies the root problem as the partisan nature of African politics and the incapacity to manage ecological degradation. The African state is wholly or partially responsible for the creation of conflicts. Examples abound in Zaire, South Africa, Sudan, Rwanda, Burundi, Somalia, Ethiopia, Liberia, Congo, and Chad. State partisanship is also evident in Angola, Mozambique, Uganda, and Sierra Leone. An estimated 10 million Africans, in 1985, left their homes due to wars, government repression, or the inability of land to support them. In 1994, USAID estimated that 11.6 million Africans in 10 countries were threatened by famine from drought. Environmental degradation has generated conflicts. Africa's marginalized economy results in recession, unemployment, inflation, and distributional conflicts. Democratization has brought conflicts between the state, civil society, and exiles. Refugees face homelessness, poverty, emotional distress, inadequate food, and disease. Host countries face security threats, pressure on limited resources, rebellions from refugees and their involvement with foreign mercenaries, local conflicts between native and refugee populations, and environmental degradation from refugees.
Full Text Available The Syrian civil war resulted in mass migration out of Syria into the neighboring countries. Turkey has received the greatest number of refugees from Syria. The Syrian refugees mostly initially settled in refugee camps in Southeastern Turkey. As the Syrian conflict intensified and lengthened, the number of Syrian refugees in Turkey increased and the Syrian population started to reside in the neighboring provinces and started to have important effects on the local economy. In 2016, Syrian refugees were allowed to receive work permits and they became more dispersed geographically. This paper investigates the impact of Syrian refugees on regional labour markets. Panel data for the years 2004 through 2016 is utilized for 26 regions in Turkey. Syrian refugees are found to increase unemployment and decrease informal and formal employment.
Rolf Heuer, Director-General,
Dear Colleagues, In response to the current refugee and migration crisis, we are starting a collection today and we are calling on your generosity. The funds will be forwarded to the International Federation of Red Cross and Red Crescent Societies to respond to the humanitarian needs of the refugees and migrants, providing immediate and longer-term relief, including emergency medical care and basic health services, psychological support, temporary shelter, distribution of food & water and other urgently needed items. We hope that your contributions to the above-mentioned appeal will not prevent you from sparing a thought for them and doing whatever you can to help them. Bank account details for donations: Bank account holder: Association du personnel CERN - 1211 GENEVE 23 Account number: 279-HU106832.1 IBAN: CH85 0027 9279 HU10 6832 1 BIC: UBSWCHZH80A Please mention: Refugee and Migration Crisis
Costello, Cathryn; Groenendijk, Kees; Storgaard, Louise Halleskov
The issue paper examines family reuni cation for refugees as a pressing human rights issue. Without it, refugees are denied their right to respect for family life, have vastly diminished integration prospects and endure great additional unnecessary suffering, as do their family members....... The Commissioner for Human Rights calls on all Council of Europe member states to uphold their human rights obligations and ensure the practical e ectiveness of the right to family reunification for refugees and other international protection bene ciaries. To do so, states should (re)examine their laws, policies...... and practices relating to family reunification for refugees. The issue paper contains 36 recommendations to that end...
McBride, Jacquie; Block, Andrew; Russo, Alana
Asylum seekers and refugees generally have poorer health than the broader Australian population. However, these groups experience a range of barriers to accessing universal health services. Generalist and specialist refugee health services have been established in Australia to improve the health of humanitarian migrant groups. This article describes a refugee health service established in a high-settlement region of Melbourne, Australia, and explores clients' experiences with the service. Client feedback was captured through interviews (n=18) and surveys (n=159). Participants reported high levels of satisfaction with the service, and highlighted the value in having trusting relationships with staff, access to bicultural workers, onsite interpreting services and integrated care. The findings indicate that it is possible to engage asylum seekers and refugees through healthcare delivery that is responsive to the unique needs of this priority population.
Diniz R. Soares
Full Text Available The current global escalation of refugees and involuntary migration, due to the effects of war and world disasters, makes it imperative to devise an effective approach to care for refugees. This article, therefore examines the problem of displacement from the perspective of missio Dei. It presents God’s active involvement in his creation, recreating it and providing particular care for the vulnerable and refugees.
Karam, Fares J.
The United States is the biggest resettlement country of refugees referred by the United Nations High Commissioner for Refugees; however, educational resettlement efforts have been unsuccessful in responding to the needs of refugee students, and educational research has thus far presented a deficit-oriented narrative that ignores the skills and…
This dissertation explores the creation and development of a community based language and health program for Iraqi refugees. The need for the program is contextualized by international, national and local policies of refugee resettlement, policies for language and education, and the interpretation of these policies on the ground. Ideologies…
Khattab, Lana; Butti, Chiara; Slavova, Ilina
, they demonstrate that refugee children are not mere opaque figures on whom we project our insecurities. Instead, they embody potentials and opportunities for progress that we need to nurture, as young refugees fi nd themselves compelled to both negotiate the practical realities of a life in exile, and situate...
Fong, Rowena; Busch, Noel Bridget; Armour, Marilyn; Heffron, Laurie Cook; Chanmugam, Amy
This study examined the successes and challenges of refugee entrepreneurs by interviewing 50 refugees, service providers, and technical assistance providers. Qualitative data analyses revealed that successes and challenges occurred both at the individual and family levels as well as at the community and agency levels. The findings underscore the…
Bronstein, Israel; Montgomery, Paul
Nearly one-quarter of the refugees worldwide are children. There have been numerous studies reporting their levels of psychological distress. The aim of this paper is to review systematically and synthesize the epidemiological research concerning the mental health of refugee children residing in Western countries. A Cochrane Collaboration style…
Walker-Dalhouse, Doris; Dalhouse, A. Derick
Refugee families in the United States face numerous challenges in becoming acculturated. School-age children of refugees face the additional challenges of acquiring academic language and meeting school expectations for behavior and social interactions while attempting to navigate the school curriculum. This case study examines the school and home…
The main purpose of the current study is to discuss the obligations of States towards refugees under international law, and to argue that States have obligations towards refugees regardless of the ratification of the Geneva Convention....
Full Text Available Many Syrians, even when they have not been individually singled out, meet the refugee criteria on the grounds of being at risk of persecution because of a perceived association, in the broadest sense, with one of the parties to the conflict.
study focuses on gatekeeping mechanisms for refugees trying to access the Danish job market, specifically during the process of transitioning from the job-training programme to a real job in the same organisation. Based on ethnographic observations and interviews with refugees, their Danish colleagues......, and the organisational gatekeepers (managers and HR representatives), the project investigates the following research question: How do discourses about Danish language competences and Danish cultural competences influence the refugees’ opportunities for gaining employment? The analysis focuses on how different...
Ruth Hoogland DeHoog
Full Text Available The U.S. refugee program is implemented almost entirely through national and local nonprofit and faith-based organizations that are highly dependent upon limited government funding and uneven refugee flows. This paper reports on a study of a large North Carolina nonprofit agency that closed down its longstanding refugee resettlement office in Greensboro in 2010. The research questions addressed are: What were the reasons given for the closing according to different participants? What were the consequences of this shutdown? This study helps to illuminate not only the organizational dynamics within a large, multi-service agency, but it also exemplifies the challenges faced in refugee resettlement services. The research is based on formal interviews with employees, agency executives, former employees, and representatives of the agency's national office that has a contract with the U.S. State Department to resettle refugees in North and South Carolina. The issues of leadership, financial management, and organizational culture are central to understanding why Lutheran Family Services in the Carolinas closed one of its key refugee resettlement offices. While the effects on the local community of volunteers, community agencies, and refugees are still unfolding, this closure had a profound impact on how the community viewed itself, as well as on the agency’s reputation.
The city of Ghent (BE) has been awarded an URBACT Good Practice for its policy towards refugees that fled wars and conflicts to find a new home in Belgium. This Good Practice, called “Refugee Solidarity” has been managed through the Refugee Task Force (link is external) set up in Ghent in August 2015, an innovative action recognized for its quality and success factors at European level. Peer reviewed
Kane, Jeremy C; Ventevogel, Peter; Spiegel, Paul; Bass, Judith K; van Ommeren, Mark; Tol, Wietse A
Population-based epidemiological research has established that refugees in low- and middle-income countries (LMIC) are at increased risk for a range of mental, neurological and substance use (MNS) problems. Improved knowledge of rates for MNS problems that are treated in refugee camp primary care settings is needed to identify service gaps and inform resource allocation. This study estimates contact coverage of MNS services in refugee camps by presenting rates of visits to camp primary care centers for treatment of MNS problems utilizing surveillance data from the Health Information System (HIS) of the United Nations High Commissioner for Refugees. Data were collected between January 2009 and March 2013 from 90 refugee camps across 15 LMIC. Visits to primary care settings were recorded for seven MNS categories: epilepsy/seizure; alcohol/substance use; mental retardation/intellectual disability; psychotic disorder; emotional disorder; medically unexplained somatic complaint; and other psychological complaint. The proportion of MNS visits attributable to each of the seven categories is presented by country, sex and age group. The data were combined with camp population data to generate rates of MNS visits per 1,000 persons per month, an estimate of contact coverage. Rates of visits for MNS problems ranged widely across countries, from 0.24 per 1,000 persons per month in Zambia to 23.69 in Liberia. Rates of visits for epilepsy were higher than any of the other MNS categories in nine of fifteen countries. The largest proportion of MNS visits overall was attributable to epilepsy/seizure (46.91% male/35.13% female) and psychotic disorders (25.88% male/19.98% female). Among children under five, epilepsy/seizure (82.74% male/82.29% female) also accounted for the largest proportion of MNS visits. Refugee health systems must be prepared to manage severe neuropsychiatric disorders in addition to mental conditions associated with stress. Relatively low rates of emotional and
Abkhezr, Peyman; McMahon, Mary
For people with refugee backgrounds, pursuing a meaningful career in their country of resettlement is important for their successful integration. However, for many, achieving this is a challenging process. Career counsellors may have a role to play in facilitating the transition and integration of people with refugee backgrounds, and narrative…
Rogge, John R.
A significant component of modern migrants are refugees or displaced persons. Historically, most involuntary migrants readily found permanent asylum in the traditional immigrant receiving countries of the New World. This situation is changing. Source areas of refugees have shifted from the European arena to the Third World, and the causes of…
Petersen, H D; Lykke, J; Hougen, H P
To describe exposure to human rights violations among refugees from rural Burma; to compare exposure experienced by an ethnic Burmese minority group, the Shans, with that of the rest of the study population; and to compare exposure of those who had fled Burma recently with that of refugees who ha...
Bettmann, Joanna E; Penney, Deb; Clarkson Freeman, Pamela; Lecy, Natalie
Nearly 13% of the U.S. population is comprised of foreign-born individuals, with Somalis constituting one of the largest resettled groups. Research suggests that, among Somali refugees, rates of mental illness are high. Yet research shows Somalis underutilize mental health services. Understanding their perceptions of mental illness and its cures may help practitioners to design more effective treatments for this population. Thus, this pilot study investigated Somali refugees' perceptions of mental illness and its treatments. Using purposive sampling, this qualitative study interviewed 20 Somali refugees using a semi-structured interview guide. Qualitative analysis yielded participants' perceptions of mental illness through their descriptions of physical symptoms accompanying mental illness, the stigma of mental illness, causes of mental illness, medical and non-medical treatments for mental illness, spirit possession causing mental illness, and the Qur'an as treatment for mental illness. Such information may help practitioners in the United States approach Somali clients in the most culturally coherent manner.
Nam, Boyoung; Kim, Jae Yop; DeVylder, Jordan E; Song, Ahyoung
North Korean refugees in South Korea are at high risk of depression, but there are few studies exploring protective factors in this population. We hypothesized that family functioning (family adaptability and cohesion) and resilience would protect North Korean refugees from developing depressive symptoms. A subsample of 304 adult North Korean refugees drawn from the cross-sectional 2010 Nationwide Survey of Domestic Violence in South Korea was analyzed. Approximately 44% of respondents were identified as having depression, using scores on the Center for Epidemiological Studies Depression scale. In models capturing the full spectrum of depressive symptoms (continuous), family cohesion was significantly associated with depression, and the relationship was partially mediated by resilience. In models predicting clinical depression (dichotomous), resilience fully mediated the relationship between family cohesion and clinical depression. In contrast, family adaptability was not associated with depression or resilience in this sample. These findings suggest that assessing and enhancing family cohesion and resilience may be essential for professionals working with refugees, and that refugees without family support may be at particularly high risk for depression. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.
Alipui, Nicholas; Gerke, Nicole
We are currently facing one of the largest and most complex refugee crises in modern times. Conflict and natural disasters have resulted in 22.5 million refugees worldwide, more than half are children. As the world struggles to respond to this massive displacement of people, how is this affecting child refugees' development and what is being done about it? In this commentary, we explore answers to these central questions. First, we review the situation of child refugees in numbers, exploring their geographic concentration. Second, we review child refugees' access to basic services, including early childhood development, with a special emphasis on community-based programs and initiatives that have proven to be particularly effective in addressing the needs of resettled child refugees. We find in particular that early childhood development activities in emergency contexts have seen remarkable improvements with critical benefits for the development of the youngest child refugees. Our aim is to bring attention to the particular difficulties child refugees must endure and to highlight those practices and approaches that are helping child refugees reach their full potential. © 2018 Wiley Periodicals, Inc.
Full Text Available The European Union (EU is under severe pressure, due to the multiple crises it has to manage. Among them, the refugee crisis is remarkable, since it is shaking both the individual member states and the EU as a whole. The media coverage of the refugee crisis is important because the media still are the main source of information concerning distant issues (the refugee crisis included, and as such it facilitates people’s access to social reality. Using the perspective of agenda-setting and the conceptual background of framing theory, we aim to (1 identify the most prominent frames online media employ with reference to the refugee crisis, and (2 reveal the tone of voice online media use when portraying issues related to this crisis. To achieve these two goals, we content analyzed 1493 online news articles, published between April 15, 2015 and February 29, 2016. Main findings show that online media outlets mainly refer to the refugee crisis in terms of responsibility and conflict, in this order of prominence. At the same time, online media portals prefer using a reasonably balanced viewpoint when portraying the refugees, and a slightly negative one in terms of attitudes towards the European Union.
Bilukha, Oleg O; Jayasekaran, Douglas; Burton, Ann; Faender, Gabriele; King'ori, James; Amiri, Mohammad; Jessen, Dorte; Leidman, Eva
As a result of civil war, an estimated 2.8 million refugees have fled Syria and reside in neighboring countries, mainly Lebanon, Turkey, Jordan, and Iraq. The largest Syrian refugee camp in the region is Zaatari camp in Jordan, with approximately 79,000 refugees; another estimated 500,000 Syrian refugees live in Jordanian cities, towns, and villages, mostly in the capital (Amman) and in four northern governorates (Irbid, Mafraq, Jarash, and Zarqa). Although all registered refugees in Jordan receive food vouchers from the World Food Programme (WFP) and vulnerable refugees receive cash assistance from the United Nations High Commissioner for Refugees (UNHCR) and nongovernmental organizations, the nutritional status of some refugees might be compromised because of dislocation, lack of income, and limited access to nutritious foods. To assess the nutritional status of Syrian refugees, UNHCR, WFP, the United Nations Children's Fund (UNICEF), Medair International (a nongovernmental organization), and CDC, in collaboration with the United Nations Population Fund and the World Health Organization (WHO), conducted cross-sectional, population-representative cluster surveys in Zaatari camp and among refugees residing in the host community. The surveys were conducted during April-May 2014 with the principal objective of assessing nutritional status of refugee children aged 6-59 months and nonpregnant women of reproductive age (15-49 years). Preliminary findings indicated a high prevalence of anemia in Zaatari camp among both children and women (48.4% and 44.8%, respectively). Nutrition policies aimed at ensuring optimal child and maternal micronutrient status and addressing the underlying risk factors for anemia are likely to result in improved health outcomes and a reduction in anemia.
El Hassan bin Talal
Full Text Available There is new thinking – which should be embraced by European leaders – on how to promote long-term responses to the Syrian refugee crisis that protect and uphold human dignity, and that constitute more sustainable and beneficial solutions in refugee-receiving states in the West Asia-North Africa region.
Doocy, Shannon; Lyles, Emily; Akhu-Zaheya, Laila; Burton, Ann; Burnham, Gilbert
The influx of Syrian refugees into Jordan presents an immense burden to the Jordanian health system. Changing lifestyles and aging populations are shifting the global disease burden towards increased non-infectious diseases including chronic conditions, co-morbidities, and injuries which are more complicated and costly to manage. The strain placed on health systems threatens the ability to ensure the health needs of both refugees and host country populations are adequately addressed. In light of the increasing challenges facing host governments and humanitarian actors to meet health needs of Syrian refugees and affected host communities, this study was undertaken to assess utilization of health services among Syrian refugees in non-camp settings. A survey of Syrian refugees in Jordan was undertaken in June 2014 to characterize health seeking behaviors and issues related to accessing care. A cluster design with probability proportional to size sampling was used to attain a nationally representative sample of 1550 non-camp Syrian refugee households. Differences in household characteristics by geographic region, facility type, and sector utilized were examined using chi-square and t-test methods. Care-seeking was high with 86.1 % of households reporting an adult sought medical care the last time it was needed. Approximately half (51.5 %) of services were sought from public sector facilities, 38.7 % in private facilities, and 9.8 % in charity/NGO facilities. Among adult care seekers, 87.4 % were prescribed medication during the most recent visit, 89.8 % of which obtained the medication. Overall, 51.8 % of households reported out-of-pocket expenditures for the consultation or medications at the most recent visit (mean US$39.9, median US$4.2). Despite high levels of care-seeking, cost was an important barrier to health service access for Syrian refugees in Jordan. The cessation of free access to health care since the time of the survey is likely to have worsened
Higher education (HE) is one of the routes that refugees who come to the UK from professional and highly educated backgrounds can re-establish their lives and professional identities. This research follows up a group of such refugees who were on a programme designed to support refugees gain access to HE or appropriate employment. The findings…
Crea, Thomas M.; McFarland, Mary
Refugees experience limited access to adequate education at all levels, but opportunities for higher education are especially lacking. Yet, evidence suggests that education plays an important protective role in helping refugee individuals and communities cope with their daily existence during protracted waiting periods, and the United Nations refugee agency (UNHCR) recently recognised tertiary education as a basic human right. The purpose of this paper is to present findings from the evaluation of a pilot programme, Jesuit Commons: Higher Education at the Margins (JC:HEM), which initially provided higher education to refugees in Kakuma Camp, Kenya and Dzaleka Camp, Malawi; and to urban refugees in Amman, Jordan. The authors of this note review the progress made towards the pilot objectives, as well as student feedback on the benefits and challenges of higher education for refugees and others living at the margins. The refugees interviewed in this study expressed feelings of empowerment, related to their expanded worldview as well as to a specific set of skills obtained through their participation in the programme. Interviewees also noted a number of limitations specific to the context of their living conditions. Particularly in refugee camps, students expressed concerns about what would happen after their having completed their course. The general outcome of the pilot phase, which ended in 2014, was that the programme addresses a critical need and that it should be continued, albeit with key modifications in its design and delivery. Key areas for future growth of the programme include curriculum transformation, integrated service delivery and university engagement.
Koers-Stuiver, Dieke Marlies; Groen, Arend J.; Englis-Englis, Paula Danskin
INTRODUCTION Across the world millions of people have been forced from their homes due to conflicts, oppression, natural disasters and demographic revolutions. Refugees face many problems when moving to a new country including language, legal and cultural barriers. Almost none of them have a strong
This article summarizes some of the findings and recommendations of a research project focusing on the nature and needs of refugee students in Canadian schools. The school performance of refugee students is examined under the following headings: immigration regulations; initial identification, assessment, placement and monitoring; unaccompanied youngsters; "at risk" students; academic needs; the conflict of cultures. In particular, the article discusses the changing role of the school in the light of recent immigration trends. Many of the findings are applicable to other national settings.
Angenendt, Steffen; Kipp, David; Koch, Anne
In June 2016, the United Nations High Commissioner for Refugees (UNHCR) presented his latest annual report on the situation of refugees and displaced persons around the world. Once again, this account documents new record levels in refugee numbers, both in industrialised and in developing countries. For governments and aid organisations, these statistics constitute an important basis for addressing displacement-related challenges in a more effective manner. However, the data provided by UNHCR...
Caron, Rosemary M; Tshabangu-Soko, Thandi; Finefrock, Krysten
Despite the gradual decrease in childhood lead poisoning in the United States, the risk for lead poisoning among African refugee children who resettle in the United States remains elevated. Communication methods implemented by resettlement agencies in the public health system for preventing childhood lead poisoning in this at-risk population warrant further investigation. We utilized structured interviews with key stakeholders (resettlement agencies, social service agencies developed by African refugees and resettled Somali refugees) involved in the refugee resettlement process to (1) describe the agency's role in the refugee resettlement process; (2) examine communication methods utilized and barriers experienced by the public health system in reference to childhood lead poisoning; (3) describe the refugee population's perception of childhood lead poisoning; (4) examine general challenges experienced by the public health system and the refugee population during the resettlement process; and (5) describe stakeholders' recommendations to improve health communication efforts. Based on our findings, we propose that communities are important determinants in health-related problems for refugee populations. Each community has its own environment and public health system that interacts with each other to influence health risks and risk perceptions of its populations. We advocate that understanding a community's ecology and implementing a culture-centered approach is essential for the public health system to help educate and prevent communication inequalities and health disparities among an at-risk African refugee population. This action can reduce a population's resistance to communication and help build a community's capacity to address a persistent public health problem, such as childhood lead poisoning.
Full Text Available This essay aims to understand how refugees present a problem for liberal nation-states. The point of departure is Arendt’s The Origins of Totalitarianism where she argues that the continual existence of refugees within liberal nation-states threatens to break down the principle of equality before the law thereby enabling the rise of police-states and totalitarianism. In light of this diagnosis, three of Arendt’s philosophical heirs—Giorgio Agamben, Seyla Benhabib and Peg Birmingham—argue that it is necessary to think political membership in different and broader terms than national citizenship if we are to avoid a new rise of totalitarianism.
... few of them involved in self-help projects to supplement refugees needs. The paper then concludes that the refugees need additional assistance in terms of empowerment that will pave for integration and full adaptive style. Key words: Refugees, Survival Strategy, Displacement, Resettlement, Rehabilitation, Integration ...
De Haene, Lucia; Rober, Peter; Adriaenssens, Peter; Verschueren, Karine
In this article, we reflect on our evolving ideas regarding a dialogical approach to refugee care. Broadening the predominant phased trauma care model and its engaging of directive expertise in symptom reduction, meaning making, and rebuilding connectedness, these developing dialogical notions involve the negotiation of silencing and disclosure, meaning and absurdity, hope and hopelessness in a therapeutic dialogue that accepts its encounter of cultural and social difference. In locating therapeutic practice within these divergent approaches, we argue an orientation on collaborative dialogue may operate together with notions from the phased trauma care model as heuristic background in engaging a polyphonic understanding of coping with individual and family sequelae of forced displacement. This locating of therapeutic practice, as informed by each perspective, invites us to remain present to fragments of therapeutic positioning that resonate power imbalance or appropriation in a therapeutic encounter imbued with a social context that silences refugees' suffering. In a clinical case analysis, we further explore these relational complexities of negotiating directive expertise and collaborative dialogue in the therapeutic encounter with refugee clients. © FPI, Inc.
Xin, Huaibo; Aronson, Robert E; Lovelace, Kay A; Strack, Robert W; Villalba, José A
Study findings suggest that refugees are more vulnerable than the general population to mental disorders from disasters. This pilot study explored the nature of Vietnamese refugees' resilience to a potential natural disaster as a first step toward improving their disaster mental health. Interviews were conducted with 20 ethnic Vietnamese and Montagnard adult refugees using a semistructured interview guide. Factors in resilience at both individual and family levels were examined. Our results indicated that these refugees had positive personalities and strong family cohesion. However, although a majority of the participants had experienced natural disasters, they lacked knowledge and specific strategies to cope with these events. The individual participants and their families lacked sufficient information, financial resources, emergency supplies, or social support for a natural disaster. Enhancing refugees' current strengths in responding to disasters, delivering them tailored emergency training, strengthening relationships between refugee service providers and refugee communities, and advocating for refugees' socioeconomic capacity building should be considered.
Ruiz, Melissa; Kabler, Brenda; Sugarman, Melissa
Refugee and immigrant children constitute one of the fastest growing groups in the United States, with numbers increasing to an estimated 9 million children by the end of 2010. The Upper Darby School District, located in the southeast corner of Pennsylvania, has witnessed the rapid growth of a diverse immigrant and refugee population during the…
Full Text Available The effects of displacement on culture can have significant impacts on the psychological and physical welfare of individual refugees and onthe social dynamics within a refugee population.
Altıner, Ali Osman; Yeşil, Sıdıka Tekeli
Introduction Many Syrians have left their country and migrated to other countries since March 2011, due to the civil war. As of March 2016, a total of 2,747,946 Syrian refugees had immigrated to Turkey. Some Syrian refugees have been living in camps, while 2,475,134 have been living in metropolitan areas, such as Ankara. Study Objective This study investigated Emergency Medical Service (EMS) utilization among Syrian refugees residing in Ankara. This study was a descriptive, cross-sectional database analysis using data obtained from the Department of EMS of the Ankara Provincial Health Directorate. Five stations in the Altındağ region of Ankara responded to 42% of all calls from Syrian refugees. Prehospital EMS in Ankara have been used mostly by Syrian refugees younger than 18-years-old. Study findings also suggest that medical staff in regions where Syrian refugees are likely to be treated should be supported and provided with the ability to overcome language barriers and cultural differences. Altıner AO , Tekeli Yeşil S . Emergency Medical Service (EMS) utilization by Syrian refugees residing in Ankara, Turkey. Prehosp Disaster Med. 2018;33(2):160-164.
The twentieth century witnessed major waves of emigration, exile and taking refuge abroad. In this paper, a review of the psychiatric literature published between 1990 and 2000 in English and Turkish is presented. Although refugees are considered to differ from economic migrants in a number of respects, they both experience culture and language change and may experience family disruption, social isolation, and hostility from the population of the host country. Accordingly, all refugees and immigrants go through stages of resettlement and need to integrate their past cultural experiences into their new life and culture. The process of integration depends on the subjects' age, mental integrity, and on the conditions he/she lives in. Research indicates that children acculturate more quickly and learn language faster than elders; but they may suffer from role reversal when they are expected to be linguistic and cultural translators for their parents. Young adults at the stage of identity formation can be cut off and feel alienated. Elderly persons have a higher risk of culture shock as they leave behind more memories and connections. These trigger different types of anxieties. The literature shows high levels of acculturative distress, and psychiatric disorders such as post-traumatic stress disorder, anxiety and depression, and refugees are considered to be at risk for suicidal behavior. The complex social and psychological needs of refugee and immigrant families place demands on special services for children, adolescents and adults.
James C. Simeon
The unprecedented current “refugee crisis,” with its 65 million plus uprooted people, demands a new protection orientation and framework for refugees and other forced migrants that are focused on the “root causes” of refugeehood, non-international protracted armed conflict or civil war. It is argued that four essential reforms are required to the international refugee protection system to respond to the “root causes” of refugees in the world today. The first calls for broadening the definitio...
Ross, Tara W.
A global refugee crisis necessitates an understanding of policymaking governing the resettlement of refugees in the United States. Resettling more refugees than all other countries combined, the United States emphasizes rapid employment over post-secondary education for adult resettled refugees in order to compel their self-sufficiency. However,…
Sonne, Charlotte Kærgaard; Mortensen, Erik Lykke; Carlsson, Jessica
outcome. Objective The objective of the study was to examine possible psychosocial predictors of treatment outcome for trauma-affected refugees. Method The participants were 195 adult refugees with posttraumatic stress disorder (PTSD) who were enrolled in a 6- to 7-month treatment programme...
Improving early childhood development and well-being in refugee and other marginalized countries. Early childhood development research has traditionally focused on single-intervention initiatives and non-refugee populations. This project will generate evidence to support effective, integrated and scalable early childhood ...
Palmer, Jennifer J; Robert, Okello; Kansiime, Freddie
Ensuring equity between forcibly-displaced and host area populations is a key challenge for global elimination programmes. We studied Uganda's response to the recent refugee influx from South Sudan to identify key governance and operational lessons for national sleeping sickness programmes working with displaced populations today. A refugee policy which favours integration of primary healthcare services for refugee and host populations and the availability of rapid diagnostic tests (RDTs) to detect sleeping sickness at this health system level makes Uganda well-placed to include refugees in sleeping sickness surveillance. Using ethnographic observations of coordination meetings, review of programme data, interviews with sleeping sickness and refugee authorities and group discussions with health staff and refugees (2013-2016), we nevertheless identified some key challenges to equitably integrating refugees into government sleeping sickness surveillance. Despite fears that refugees were at risk of disease and posed a threat to elimination, six months into the response, programme coordinators progressed to a sentinel surveillance strategy in districts hosting the highest concentrations of refugees. This meant that RDTs, the programme's primary surveillance tool, were removed from most refugee-serving facilities, exacerbating existing inequitable access to surveillance and leading refugees to claim that their access to sleeping sickness tests had been better in South Sudan. This was not intentionally done to exclude refugees from care, rather, four key governance challenges made it difficult for the programme to recognise and correct inequities affecting refugees: (a) perceived donor pressure to reduce the sleeping sickness programme's scope without clear international elimination guidance on surveillance quality; (b) a problematic history of programme relations with refugee-hosting districts which strained supervision of surveillance quality; (c) difficulties that
Linck, Raney; Osman, Munira
The refugee crisis is an urgent global health issue; the number of displaced people has escalated to its worst point in recorded history. To explore the refugee phenomenon as a social determinant of health, this article examines the experience of Somali refugees in Minnesota. Health care barriers unique to refugees are explored through the firstperson perspective of one Somali woman who ultimately became a nurse.
In 2016, the Ministry of Justice and Public Security highlighted the importance of refugee participation in labor in several reports. The ministry stresses the dependency of the Norwegian welfare model on high tax revenue, and argues that it is very important for adult refugees to work. In order to increase employment rates among the refugee population, and decrease number of dependents on social benefits, the Introduction Program was implemented in 2006. This was followed by the tightening o...
Pandya, Samta P
This article reports on a pre- and post-test experimental study with 4504 refugees in 38 camps across nine destination countries. The aim was to examine the role of spirituality and a specially designed spiritual education programme in promoting mental health of refugees. A pre- and post-test experimental design has been used with three scales to examine the outcome measures: (1) the trauma screening questionnaire (2) life orientation test-revised and (3) mental health inventory-38. Results showed that compared with pre-test scores, the average post-test scores of the refugees on the trauma questionnaire were lower, and higher on optimism measure, and mental health inventory. Voluntary participation, full attendance and self-practice willingness were favourable predictors of refugee mental health. Hierarchical regression model showed that self-practice willingness was the most important predictor of positive mental health of refugees. Findings make a case for interventions for refugees grounded in cultural competency and spirituality.
Damm, Anna Piil; Rosholm, Michael
Refugees subjected to a spatial dispersal tend to be assigned to a location outside the immigrant-dense cities. We argue that such locations are associated with low place utility. Our partial equilibrium search model with simultaneous job and residential location search predicts that the reservat......Refugees subjected to a spatial dispersal tend to be assigned to a location outside the immigrant-dense cities. We argue that such locations are associated with low place utility. Our partial equilibrium search model with simultaneous job and residential location search predicts...... that the reservation wage for local jobs decreases with place utility. We test the theoretical prediction by estimating the effects of characteristics of the location of assignment on the transition rate into the first job. Our sample is male refugees aged 30-59 who were subjected to the Danish spatial dispersal...
Wiesmüller, G A; Dötsch, J; Weiß, M; Wiater, A; Fätkenheuer, G; Nitschke, H; Bunte, A
The Cologne statement resulted from both regional and nationwide controversial discussions about meaning and purpose of an initial examination for infectious diseases of refugees with respect to limited time, personnel and financial resources. Refugees per se are no increased infection risk factors for the general population as well as aiders, when the aiders comply with general hygiene rules and are vaccinated according to the recommendations of the German Standing Committee on Vaccination (STIKO). This is supported by our own data. Based on individual medical history, refugees need medical care, which is offered purposeful, economic, humanitarian and ethical. In addition to medical confidentiality, the reporting obligation according § 34 Infection Protection Act (IPA) and the examination concerning infectious pulmonary tuberculosis according to § 36 (4) IPA must be considered. © Georg Thieme Verlag KG Stuttgart · New York.
... March 7, 2011 Unexpected Urgent Refugee and Migration Needs Related to Libya Memorandum for the... States, including section 2(c)(1) of the Migration and Refugee Assistance Act of 1962 (the ``Act''), as... million from the United States Emergency Refugee and Migration Assistance Fund, for the purpose of meeting...
Education is often prioritised by refugee children and families, as well as by their political representatives and international actors alike. This article explores the specificities of the Sahrawi refugee education system, focusing in particular on the nature, motivations and implications of Sahrawi refugee youths' educational migration to Cuba…
The recognition of the international scope and nature of the problem of refugees, which induced the establishment of UNHCR and the adoption of the 1951 Convention relating to the Status of Refugees, did not result in shared responsibility for the protection of refugees but rather in a strict
Sethi, Stephen; Jonsson, Rebecka; Skaff, Rony; Tyler, Frank
ABSTRACT In the sixth year of the Syrian conflict, 11 million people have been displaced, including more than 1.1 million seeking refuge in Lebanon. Prior to the crisis, noncommunicable diseases (NCDs) accounted for 80% of all deaths in Syria, and the underlying health behaviors such as tobacco use, obesity, and physical inactivity are still prevalent among Syrian refugees in Lebanon. Humanitarian agencies initially responded to the acute health care needs of refugees by delivering services to informal settlements via mobile medical clinics. As the crisis has become more protracted, humanitarian response plans have shifted their focus to strengthening local health systems in order to better address the needs of both the host and refugee populations. To that end, we identified gaps in care for NCDs and launched a program to deliver chronic disease care for refugees. Based on a participatory needs assessment and community surveys, and building on the success of community health programs in other contexts, we developed a network of 500 refugee outreach volunteers who are supported with training, supervision, and materials to facilitate health promotion and disease control for community members, target NCDs and other priority conditions, and make referrals to a primary health care center for subsidized care. This model demonstrates that volunteer refugee health workers can implement community-based primary health activities in a complex humanitarian emergency. PMID:28928227
Sethi, Stephen; Jonsson, Rebecka; Skaff, Rony; Tyler, Frank
In the sixth year of the Syrian conflict, 11 million people have been displaced, including more than 1.1 million seeking refuge in Lebanon. Prior to the crisis, noncommunicable diseases (NCDs) accounted for 80% of all deaths in Syria, and the underlying health behaviors such as tobacco use, obesity, and physical inactivity are still prevalent among Syrian refugees in Lebanon. Humanitarian agencies initially responded to the acute health care needs of refugees by delivering services to informal settlements via mobile medical clinics. As the crisis has become more protracted, humanitarian response plans have shifted their focus to strengthening local health systems in order to better address the needs of both the host and refugee populations. To that end, we identified gaps in care for NCDs and launched a program to deliver chronic disease care for refugees. Based on a participatory needs assessment and community surveys, and building on the success of community health programs in other contexts, we developed a network of 500 refugee outreach volunteers who are supported with training, supervision, and materials to facilitate health promotion and disease control for community members, target NCDs and other priority conditions, and make referrals to a primary health care center for subsidized care. This model demonstrates that volunteer refugee health workers can implement community-based primary health activities in a complex humanitarian emergency. © Sethi et al.
Elsouhag, D; Arnetz, B; Jamil, H; Lumley, M A; Broadbridge, C L; Arnetz, J
Arab migrants-both immigrants and refugees-are exposed to pre- and post- migration stressors increasing their risk for health problems. Little is known, however, about rates of, or factors associated with, healthcare utilization among these two groups. A sample of 590 participants were interviewed approximately 1 year post-migration to the United States. Factors associated with healthcare utilization, including active and passive coping strategies, were examined using logistic regressions. Compared to national healthcare utilization data, immigrants had significantly lower, and refugees had significantly higher rates of healthcare utilization. Being a refugee, being married, and having health insurance were significantly associated with medical service utilization. Among refugees, less use of psychological services was associated with the use of medications and having problem-focused (active) strategies for dealing with stress. Healthcare utilization was significantly higher among refugees, who also reported a greater need for services than did immigrants.
Spencer, James H; Le, Thao N
To assess the effects of parents' experience of traumatic events on violence among Southeast Asian and Chinese youth. The study examines independent effects of parents' refugee camp experiences and immigration stress on serious or family/partner violence among youth. Findings contribute evidence on the intergenerational effects of community-level trauma that can help policy makers better integrate family and community strategies to reduce youth violence. Obtained cross-sectional, face-to-face interview data including peer delinquency, parental engagement, parental discipline, serious violence, and family/partner violence from a sample of 329 Chinese and Southeast Asian adolescents. Measures of socioeconomic status, refugee status, and immigration stressors were collected from their respective parents. Data were analyzed using LISREL 8.54 for structural equation modeling. Findings show that parents' refugee status facilitated serious violence, and was fully mediated by peer delinquency and parental engagement, but for Vietnamese only. Parents' refugee status was also significantly related to family/partner violence, and mediated by peer delinquency. This relationship was not observed among the other Asian ethnic groups. The immigration stress variable had no significant effects on either serious violence or family/partner violence. Refugee communities may not transform easily into stereotypical immigrant Asian communities characterized by little youth violence. Results suggest that the refugee process, as experienced second-hand through the children of refugees, has a strong effect on externally oriented violence (serious violence) and on family/partner violence for particular subgroups. Therefore, community-oriented policy makers should join social workers in developing programs to address youth violence in Southeast Asian families and communities. Findings have implications for other forms of community trauma such as natural disasters.
Full Text Available The international law of armed conflicts provides a legal protection to refugees if they find themselves in the territory of warring parties. Refugees are regarded as protected persons, particularly in international armed conflicts. Refugees are people forced to leave their country to find a shelter in a foreign country as a result of political events or the treat of prosecution. The legal status of refugees was regulated first by Convention relating to the Status of Refugees of 1951. The legal status of refugees in armed conflicts was regulated by Geneva Convention relating to Protection of Civilian Persons in Time of War of 1949 and by Protocol I of 1977. Both acts regulate the status of refugees who, at the moment of the beginning of hostile activities find themselves in the territory of one party to the conflict i.e., the occupied territory. So it is therefore about foreigners who have been granted a refugee status before the start of the conflict. According to the same Convention, party to the conflict, at which territory the refugees find themselves in, cannot consider them, neither treat them as foreigners nor hostile citizens, just because they belong to a hostile state. Protocol I, expended the protection of refugees in the way it is regulated, that the persons treated like refugees or stateless persons, before the start of hostilities, would be under the protection of provisions of IV Geneva Convention in all circumstances and without any adverse distinction. We should particularly emphasize the right of refugees, not to be driven out to the country where their lives or freedom could be endangered because of their belonging to a group or because of their political opinion.
Zayas, Luis H.
Aggressive immigration enforcement hurts the very youngest children. Refugee and U.S.-born children of undocumented immigrants experience many childhood adversities, compromising their development and health. Refugee children flee traumatizing violence in their home countries, face grueling migrations, and are harmed further by being held in…
Jensen, Iben; Andersen, Vibeke
In general, integration is hampered if refugees do not have a sufficient educational background to enter the labor market. However, it is estimated by Danish authorities that around 13% of the refugees have a professional background in medicine, technical domains or engineering (The ministry of I...
Mohammad Mehedy Hassan
Full Text Available Following a targeted campaign of violence by Myanmar military, police, and local militias, more than half a million Rohingya refugees have fled to neighboring Bangladesh since August 2017, joining thousands of others living in overcrowded settlement camps in Teknaf. To accommodate this mass influx of refugees, forestland is razed to build spontaneous settlements, resulting in an enormous threat to wildlife habitats, biodiversity, and entire ecosystems in the region. Although reports indicate that this rapid and vast expansion of refugee camps in Teknaf is causing large scale environmental destruction and degradation of forestlands, no study to date has quantified the camp expansion extent or forest cover loss. Using remotely sensed Sentinel-2A and -2B imagery and a random forest (RF machine learning algorithm with ground observation data, we quantified the territorial expansion of refugee settlements and resulting degradation of the ecological resources surrounding the three largest concentrations of refugee camps—Kutupalong–Balukhali, Nayapara–Leda and Unchiprang—that developed between pre- and post-August of 2017. Employing RF as an image classification approach for this study with a cross-validation technique, we obtained a high overall classification accuracy of 94.53% and 95.14% for 2016 and 2017 land cover maps, respectively, with overall Kappa statistics of 0.93 and 0.94. The producer and user accuracy for forest cover ranged between 92.98–98.21% and 96.49–92.98%, respectively. Results derived from the thematic maps indicate a substantial expansion of refugee settlements in the three refugee camp study sites, with an increase of 175 to 1530 hectares between 2016 and 2017, and a net growth rate of 774%. The greatest camp expansion is observed in the Kutupalong–Balukhali site, growing from 146 ha to 1365 ha with a net increase of 1219 ha (total growth rate of 835% in the same time period. While the refugee camps’ occupancy
Full Text Available Aim/Purpose: The research investigates the impact of Information and Communication Technologies (ICT on Iranian refugees’ settlement in Australia. Background: The study identifies the issues of settlement, such as language, cultural and social differences. Methodology: The Multi-Sited Ethnography (MSE, which is a qualitative methodology, has been used with a thematic analysis drawing on a series of semi-structured interviews with two groups of participants (51 Iranian refugees and 55 people with a role in assisting refugees. Contribution: The research findings may enable the creation of a model for use by the Aus-tralian Government with Iranian refugees. Findings: The findings show the vital role ICT play in refugees’ ongoing day-to-day life towards settlement. Recommendations for Practitioners: The results from this paper could be generalised to other groups of refugees in Australia and also could be used for Iranian refugees in other countries. Recommendation for Researchers: Researchers may use a similar study for refugees of different backgrounds in Australia and around the world. Impact on Society: ICT may assist refugees to become less isolated, less marginalized and part of mainstream society. Future Research: Future research could look into the digital divide between refugees in Australia and main stream Australians.
Chemali, Zeina; Borba, Christina P C; Johnson, Kelsey; Khair, Sama; Fricchione, Gregory L
Currently, over 1 million Syrian and Palestinian refugees have fled Syria to take refuge in Lebanon. Among this vulnerable population, elder refugees warrant particular concern, as they shoulder a host of additional health and safety issues that require additional resources. However, the specific needs of elder refugees are often overlooked, especially during times of crisis. Our study used a semi-structured interview to survey the needs of elder refugees and understand their perceived support from Lebanese fieldworkers. Results indicate a high prevalence of depression and cognitive deficits in elder refugees, who expressed concerns surrounding illness, loneliness, war, and instability. Elders highlighted the importance of family connectedness in fostering security and normalcy and in building resilience during times of conflict. Elders spoke of their role akin that of the social workers with whom they interacted, in that they acted as a source of emotional support for their communities. Overall, this study clarifies steps to be taken to increase well-being in elder refugee populations and urges the response of humanitarian organisations to strengthen psychological support structures within refugee encampments.
Bellamy, Kim; Ostini, Remo; Martini, Nataly; Kairuz, Therese
The aim of this study was to explore the barriers to accessing medicines and pharmacy services among refugees in Queensland, Australia, from the perspectives of resettled African refugees. A generic qualitative approach was used in this study. Resettled African refugees were recruited via a purposive snowball sampling method. The researcher collected data from different African refugee communities, specifically those from Sudanese, Congolese and Somalian communities. Participants were invited by a community health leader to participate in the study; a community health leader is a trained member of the refugee community who acts as a 'health information conduit' between refugees and the health system. Invitations were done either face-to-face, telephonically or by email. The focus groups were digitally recorded in English and transcribed verbatim by the researcher. Transcripts were entered into NVIVO© 11 and the data were analysed using inductive thematic analysis. Four focus groups were conducted between October and November 2014 in the city of Brisbane with African refugees, one with five Somali refugees, one with five Congolese refugees, one with three refugee community health leaders from South Sudan, Liberia and Eritrea and one with three refugee community health leaders from Uganda, Burundi and South Sudan. Eleven sub-themes emerged through the coding process, which resulted in four overarching themes: health system differences, navigating the Australian health system, communication barriers and health care-seeking behaviour. With regard to accessing medicines and pharmacy services, this study has shown that there is a gap between resettled refugees' expectations of health services and the reality of the Australian health system. Access barriers identified included language barriers, issues with the Translating and Interpreter Service, a lack of professional communication and cultural beliefs affecting health care-seeking behaviour. This exploratory study has
Full Text Available The images picturing the refugee crisis are heavily emotion-laden and the picture of the dead boy Aylan on the beach is such an example. Besides newspapers where pictures of refugees have been used to stir the readers’ attention, debating platforms have used visual images to initiate debates with the EU citizens about Europe’s refugee crisis. Designed on a ‘bottom-up approach’, the ‘Debating Europe’ platform empowers citizens by encouraging a dialogue between Europe’s policymakers and experts, on the one hand, and citizens, on the other hand. Each debate embeds an issue to be addressed and visual images which may serve as incentives for a vivid debate. The selection of these visuals plays a significant role in the representation of a particular issue. The sample used for this qualitative analysis consists of the visual images (photographs and infographics of nine debates on Europe’s refugee crisis (2013-2015. Since Europe’s refugee crisis is both about attributing responsibility and human interest, we will provide an integrated visual framework for our analysis. Using a qualitative content analysis of the visual images depicting the refugee crisis we want to identify (1 the types and the salience of the participants depicted, (2 the communication strategies and the (rebordering issues used to (delegitimate these represented participants, (3 the types of emotions used by the ‘Debating Europe’ platform to visually frame the refugee crisis.