Refugee Health
Sue Willey & Gayle Comyn
Greater Dandenong Community
Health Service
Definition of a Refugee
…owing to 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.
Australia’s Response
Signatory to the UN 1951 Convention relating to the
Status of Refugees
Approx. 13,000 refugees per year plus 500 Iraqi
refugees this financial year = 13,500
Approx. 5,000 refugees settle in Victoria per annum
…. and of those approx.
750 settle in City of Greater Dandenong per annum
(has been up to 1,000 refugees to CoGD per annum)
Refugee settlement in top 10 Local Government areas 2002 – 2007 (DIAC settlement data
Refugee
settlement inintop
1010
Local
Government
Refugee
settlement
top
Local
Government
2007
areas2002
2002 –
– 2007
settlement
datadata
2007)2007)
areas
2007 (DIAC
(DIAC
settlement
Greater Dandenong (C) 24.9%
Brimbank (C)
13.5%
Hume (C)
10.2%
Casey (C)
6.5%
Maribyrnong (C)
5.8%
Wyndham (C)
4.2%
Darebin (C)
3.2%
Whittlesea (C)
3.2%
Moreland (C)
2.6%
Maroondah (C)
2.5%
Others
23.3%
Total:
100.0%
Expected Humanitarian Entrants (Vic) May 2009
Country of Birth (top 5)
Iraq
Burma (Thailand)
Afghanistan
Sudan
Somalia
Ethnicities (top 10)
Iraq – Iraqi
Chaldean
Burma - Karen
Chin
Afghanistan - Hazara
Sudan – Dinka
Bari
Somalia
Ethiopian
African
Humanitarian Visa Categories
200
Refugee
201
In-Country Special Humanitarian
202
Global Special Humanitarian
203
Emergency Rescue
204
Women at Risk
866
Permanent Protection Visa
Integrated Humanitarian Settlement Strategy
(IHSS)
• Consortium of settlement agencies
AMES (Adult Migrant Education Scheme)
Foundation House (VFST)
Springvale Community Aid & Advice Bureau
Redback Services
Brotherhood of St. Laurence
• Assistance for the first 6 months after arrival
• May then be referred other agencies
Migrant Resource Centre; New Hope Foundation
Asylum Seekers
• Amongst the most disadvantage people living in
Victoria
• Have supporting documentation from either the Red
Cross or the Asylum Seekers Resource Centre
• Bridging Visa ‘E’
• Have access to DHS services such as
Hospitals
Ambulance for emergency situations
Community Health Services
Dental Health Services
Immunisation
Disability Aids and Equipment Program
http://www.dhs.vic.gov.au/multicultural/downloads/asylum-seeker-access-to-dhsservices.pdf
Background to Refugee Health Nurse Initiative
People from a refugee background have
• come from countries that
- are of a lower level of socio-economic
development than Australia and
- have minimal coordination of health care
systems
• witnessed or survived significant violence and human
rights violations
• higher levels of physical and psychological health
problems than migrants and people born in
Australia
Background to Refugee Health
Nurse Initiative
Victorian State Government Initiative
• to optimise the long-term
health of refugees
community members
• nurses placed in high
settlement areas in the
Community Health Service
• able to promote accessible
and culturally appropriate
health care services
• develop relationships with
other community based
agencies
Aims of the RHN Program
Increase refugee access to primary health
services.
Improve the response of health services to
refugees’ needs.
Enable individuals, families and refugee
communities to improve their health and
wellbeing.
Refugee Health Clinics with a Refugee Health Nurse in
Greater Dandenong
Greater Dandenong
Community Health Service
Dandenong Hospital
55 Buckingham Ave, Springvale 3171
PH: 8558 9000
Refugee Health Clinic – Outpatients Department
Monday 1.30pm – 5pm
Support for GPs with managing complex medical issues
• Infectious Diseases Specialists
• Paediatricians
• Refugee Health Nurses
• Community Development Worker
Two Weekly Clinics
• Refugee Health Nurses
• Community Health Nurse
• Interpreters available
• Drop-In
• Appointments available
• Internal & External referral as required
Refugee Immunisation Clinic
• Wednesday 9am – 12noon
• Catch-up immunisation for adults and children
M.Y. Health Clinic
• Thursday 9am – 12noon
• General health assessment / needs
• Pap Smears
• Family Planning
• For all the family
David St, Dandenong 3175
Other services available
• GP Asylum Seeker Clinic (fortnightly)
• Dietitian (monthly)
• Centrelink (monthly)
• Immunisation
Require GP referral
Interpreters available
Appointment only
Reminder call made the week before appointment
Refugee Health & Wellbeing Action Plan
2008 – 2010
Highlights the need for flexible; culturally appropriate access to
health services & service delivery
•
*3 Strategic Priorities*
• Provide timely and accessible
services for newly arrived refugees
• Build the capacity and expertise of
mainstream and specialist services
and health care practitioners in the
area of refugee health care
• Support and strengthen the ability
of individuals, families and refugee
communities to improve their
health & wellbeing
Accessible from
www.dhs.vic.gov.au/multicultural
Interpreters
• Use frequently
• Imperative
• Best if able to get on-site
• Telephone Interpreting Services
• Some languages very difficult to get interpreters
• Try to book in advance to ensure availability
• Be mindful of issues that can relate to small
communities and gender difference
• Do not rely on family members particularly children to
interpret
Southern Health Interpreting Guideline available on the intranet
(Allied Health – Clinical Protocols & Guidelines)
Barriers / Difficulties / Issues for Refugees
• Housing – overcrowding; lack of affordable rentals
• Language Barriers
• Education – learning English
• Child care
• Transport
• Delay in receiving Centrelink income
• Delay with obtaining Medicare number
• Linking to other services; knowing where to go;
uncertainty
Barriers / Difficulties / Issues for Refugees
• Competing demands with settlement
• Australian Health system
• Access to health services
• Complex medical conditions
• Mental health and well-being
• Physical health
• Social issues – relationships; differences in Aust
• Medication – cost
• Inadequate Immunisation
• Interpreters
• Separation from family / children
How can you help?
• Developing awareness and understanding of the
refugee experience and CALD issues
• Take time to explain - sometimes explanations need
to occur more than once
• Easy English when explaining
• Building a trusting relationship with people from a
refugee background imperative
• Only make promises you can keep
• Recognise there will be many many other social and
health issues for this person
• Ask what other services are involved; will save on
duplication / confusion
Contact Details
Sue Willey & Gayle Comyn
Greater Dandenong Community Health Service –
55 Buckingham Ave
Springvale
PH: 8558 9000
Sue Willey
Mob: 0420 301 634
Gayle Comyn
Mob: 0428 141 572