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Domain 1: Clinical expert from the culturally responsive clinical practice: Competency 1.1 reflection

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Domain 1: Clinical expert from the culturally responsive clinical practice: Competency 1.1 reflection

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Having reviewed domain 1: clinical expert, competency standard 1.1, I will endeavour to apply this standard by not assuming individuals' beliefs, abilities, choices and preferences (Culturally responsive clinical practice). I have developed my knowledge of refugee backgrounds and their religious and cultural beliefs and therefore will use this knowledge to respond considerately to not cross those barriers and instead take these beliefs into consideration as to how I care for refugee patients. having read competency standard 1.1, I now feel confident in how I must endeavour to apply this standard and how I must respond and treat clients from refugee backgrounds, but also not treat them any differently, instead use these beliefs to help me give the best treatment I can (Culturally responsive clinical practice). This knowledge is essential to me in the workplace because reflecting on my own personal nursing practice, I have adapted to different cultural backgrounds which has been useful in portraying sufficient care.

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Impacts social inclusion and non-discrimination as a WHO social determinant has on a refugee arriving from Syria to Australia

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Impacts social inclusion and non-discrimination as a WHO social determinant has on a refugee arriving from Syria to Australia

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Refugees arriving from Syria to Australia may experience lack of social inclusion and non-discrimination. "Social inclusion can be challenging for refugees in Australia, as legal protection and policies may not sufficiently address discrimination in practice" (Refugee Council of Australia, 2023). Social inclusion reduces psychological distress and creates opportunities for social support which helps with their physical and mental wellbeing (Refugee Council of Australia, 2023). Lack of inclusion can result in isolation, discrimination, poverty and impacts mental health, more specifically, PTSD and depression (Refugee Council of Australia, 2023). As for non-discrimination, "Syrian refugees who experience discrimination either from skin colour, ethnicity or religion, can feel stereotypes, damaged coping behaviours, and can experience unequal access to resources" (WHO, 2022). This can lead to poor health outcomes. Therefore, the relationship that social inclusion and non-discrimination has on health outcomes can impact Syrian refugees as they lead to "access to services such as employment, housing and healthcare" (Ziersch, Due, Walsh, 2020).

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Common health issues refugees from Syria may present with upon arrival to Australia- Low vitamin D

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Common health issues refugees from Syria may present with upon arrival to Australia- Low vitamin D

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As refugees from Syria arrive in Australia, they can present with many health concerns. One common health concern is low vitamin D. "Low vitamin D is prevalent in refugee and asylum seeker populations in Australia" (Paxton, Singleton, 2025). Vitamin D is important for our health, as it is critical for bone and muscle health to maintain strength (Paxton, Singleton, 2025). Refugees from Syria may present with low vitamin D from lack of sun exposure, dark skin, wearing covering clothing, chronic illness and food containing a small amount of vitamin D (Paxton, Singleton, 2025). Treatment for low vitamin D includes taking D3 supplements according to their age and educating refugees about low vitamin D is important to; sun protection and sun exposure should be taught (Paxton, Singleton, 2025). Refugees from Syria may also present with low calcium intake related to low vitamin D and once refugees take their recommended dose of vitamin D supplements, pain decreases and strength increases within weeks (Lips, De Jongh, 2018).

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Syrian eucalyptus tree used in traditional medicine

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Health belief or traditional medicine practiced by Syria- TAM

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Health belief or traditional medicine practiced by Syria- TAM

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In Syria, traditional medicine is practiced to treat a diverse range of diseases, this is called Traditional Arabic Medicine (TAM) (Khatib, Nattouf, Agha, 2021). The TAM is cost-effective and has a low risk of side effects (Khatib, Nattouf, Agha, 2021). A study was undertaken in Syria which involved ethnobotanical and ethnopharmacological research on the plants traditional to Syria to treat various diseases in northern Syria (Alachkar, Jaddouh, Elsheikh, Bilia, Vincieri, 2011). The results from the survey indicated that plant species are still being used to treat diseases and the most common 100 species used to treat more than 25 diseases were collected (Alachkar, Jaddouh, Elsheikh, Bilia, Vincieri, 2011). "The results showed, 53 are used to treat gastrointestinal disorders, 38 for respiratory system diseases, 34 for skin diseases, 21 for diabetes, 13 for different types of cancer, 9 for breast milk excretion, 8 for weight loss, 5 for reducing cholesterol and 3 for weight gain" (Alachkar, Jaddouh, Elsheikh, Bilia, Vincieri, 2011). Having learned about TAM, I now feel empowered by the traditional resources that Syria has been using to treat diseases instead of being able to access healthcare.

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Alachkar, A., Jaddouh, A., Elsheikh, M., Bilia, A., & Franco Vincieri. (2011). Natural Product Communications. Traditional Medicine in Syria: Folk Medicine in Aleppo Governorate, 6(1), 79-84. https://journals.sagepub.com/doi/pdf/10.1177/1934578X1100600119

Berry, Cari. 2008. Syrian Bunkers and Eucalyptus Trees: Hiking in the Golan Heights. https://flickr.com/photos/cariberry/

Culturally Responsive Clinical Practice January 2019: Working with People from Migrant and Refugee Backgrounds. Competency Standards Framework for Clinicians.

Khatib, C., Nattouf, A., & Hasan Agha, M. I. (2021). Traditional medicines and their common uses in central region of Syria: Hama and Homs - an ethnomedicinal survey. Pharmaceutical biology, 59(1), 778-788. https://doi.org/10.1080/13880209.2021.1936078

Lips, P., & de Jongh, R. T. (2019). Vitamin D deficiency in immigrants. Bone reports, 9, 37-41. https://doi.org/10.1016/j.bonr.2018.06.001

Olliff, L. (2023, March 28). Refugee Response Index Australia Review: Refugees become self-reliant (Pillar 4) - Refugee Council of. Refugee Council of Australia. https://www.refugeecouncil.org.au/rri-refugees-become-self-reliant/#:~:text=Social%20inclusion%20can%20thus%20be,their%20social%20integration%20and%20inclusion

Refugee Health Guide. (n.d.). Low vitamin D. Refugee Health Guide Australia. https://refugeehealthguide.org.au/low-vitamin-d/

World Health Organization: WHO. (2022, May 2). Refugee and migrant health. https://wwwehi.int/news-room/fact-sheets/detail/refugee-and-migrant-health

Ziersch, A., Due, C. & Walsh, M. Discrimination: a health hazard for people from refugee and asylum-seeking backgrounds resettled in Australia. BMC Public Health 20, 108 (2020). https://doi.org/10.1186/s12889-019-8068-3