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Refugee Health Sue Willey & Gayle Comyn Greater Dandenong Community Health Service.
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Refugee HealthSue Willey & Gayle ComynGreater 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 ResponseSignatory 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 2007) Refugee settlement in top 10 Local Government areas 2002 – 2007 (DIAC settlement data 2007) Refugee settlement in top 10 Local Government areas 2002 – 2007 (DIAC settlement data 2007
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 Refugee201 In-Country Special Humanitarian202 Global Special Humanitarian 203 Emergency Rescue204 Women at Risk866 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-dhs-services.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 55 Buckingham Ave, Springvale 3171 PH: 8558 9000 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 Dandenong Hospital David St, Dandenong 3175 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 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