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(Migrant & Refugee Women's Health Partnership, 2019) Competency standard 1.1 reflection

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For me, the most relevant aspect of Competency Standard 1.1 is the focus on sensitively addressing the diverse cultural, religious, linguistic, and health-related needs of individuals (Migrant & Refugee Women's Health Partnership, 2019). I have deepened my understanding of how crucial it is to approach patients from different cultural backgrounds without assumptions. For example, recognizing a patient's cultural practices, such as traditional health beliefs, is essential to providing respectful care (Migrant & Refugee Women's Health Partnership, 2019). This understanding is essential because it prepares me to deliver patient-centered care that respects cultural diversity in future placements. Previously, I might not have fully appreciated the importance of cultural sensitivity in providing quality care, but I now feel more capable of handling diverse patient needs.

Reference:

Migrant & Refugee Women's Health Partnership. (2019，January). Culturally Responsive Clinical Practice: Working with People from Migrant and Refugee Backgrounds COMPETENCY STANDARDS FRAMEWORK FOR CLINICIANS JANUARY 2019.

https://cbrhl.org.au/wp-content/uploads/2020/10/Culturally-responsive-clinica.pdf

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Social inclusion and non-discrimination, key WHO social determinants of health, play crucial roles in the mental health of Sudanese refugees in Australia (World Health Organization, 2024). Australian Human Rights Commission has initiated various community projects to promote social inclusion and combat discrimination (Australian Human Rights Commission, 2024). For example, the ‘Talk with Me’ program, supported by DHHS and coHealth, enhances mental well-being by creating inclusive support systems that connect generations within the South Sudanese Australian community, fostering a sense of belonging and reducing feelings of isolation (Improving Mental Health with Young South Sudanese Australians – TACSI, n.d.). Australia's commitment to protecting the human rights of all refugees and delivering mental health services without discrimination helps reduce stigma and trauma, significantly improving mental health outcomes for Sudanese refugees (World Health Organization, 2023).

References:

Australian Human Rights Commission. (2024). Asylum seekers and refugees. Australian Human Rights Commission; Australian Human Rights Commission. https://humanrights.gov.au/our-work/rights-and-freedoms/publications/asylum-seekers-and-refugees

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Improving mental health with young South Sudanese Australians – TACSI. (n.d.). Www.tacsi.org.au. https://www.tacsi.org.au/our-work/hero-initiative/south-sudanese-minds

World Health Organization. (2023, October 10). Five key themes for improved mental health care for refugees and migrants. Www.who.int. https://www.who.int/news/item/10-10-2023-five-key-themes-for-improved-mental-health-care-for-refugees-and-migrants

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World Health Organization. (2024). Social determinants of health. World Health Organization. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1

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The social determinants of health (SDH) are the non-medical factors that influence health outcomes. They are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life. These forces and systems include economic policies and systems, development agendas, social norms, social policies and political systems.

The SDH have an important influence on health inequities - the unfair and avoidable differences in health status seen within and between countries. In countries at all levels of income, health and illness follow a social gradient: the lower the socioeconomic position, the worse the health.

The following list provides examples of the social determinants of health, which can influence health equity in positive and negative ways:

Income and social protection

Education

Unemployment and job insecurity

Working life conditions

Food insecurity

Housing, basic amenities and the environment

Early childhood development

Social inclusion and non-discrimination

Structural conflict

Access to affordable health services of decent quality.

Research shows that the social determinants can be more important than health care or lifestyle choices in influencing health. For example, numerous studies suggest that SDH account for between 30-55% of health outcomes. In addition, estimates show that the contribution of sectors outside health to population health outcomes exceeds the contribution from the health sector.

Addressing SDH appropriately is fundamental for improving health and reducing longstanding inequities in health, which requires action by all sectors and civil society.

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WHO's work on social determinants of health

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Sudanese health beliefs are deeply connected to spiritual and supernatural aspects (Mohammed & Babikir, 2013). Sudanese frequently consult traditional healers, who are believed to protect against spirits that cause illness. According to the Office of the Refugee Health Coordinator of Arizona (n.d.), these healers also prepare remedies using herbs, clay, or roots. For example, a common treatment for migraines involves applying a mixture of chalk, water and leaves to the head. Traditional healers are regarded as powerful spiritual figures acting as agents between the physical and spiritual worlds (Sorketti et al., 2010). These practices highlight the Sudanese belief in the spiritual origins of illness and emphasize the role of traditional healers in linking the physical and metaphysical worlds.

References:

Elhag , A. (2021). Dervishes in Omdurman, Sudan gather at the Shrine of Shiekh Hamid Nil, a 19th century Sufi Saint of the Qadriyya Sufi order.

https://hekint.org/2021/10/21/the-sufi-healers-of-sudan-caring-for-those-without-care/

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Mohammed, I. N., & Babikir, H. E. (2013). Traditional and spiritual medicine among Sudanese children with epilepsy. Sudanese Journal of Paediatrics, 13(1), 31–37. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4949961/

Office of the Refugee Health Coordinator of Arizona. (n.d.). Community profile: Sudanese [PDF]. Arizona Department of Health Services. https://www.azdhs.gov/documents/preparedness/epidemiology-disease-control/disease-integrated-services/refugee-health/providers/community-profile-sudanese.pdf

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Sorketti, E. A., Zuraida, N. Z., & Habil, M. H. (2010). Collaboration between traditional healers and psychiatrists in Sudan. International Psychiatry, 7(3), 71–74. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6734982/

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(Khalil, 2019)  Image of Sudanese Arabic

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Sudan's official language is Arabic, with two main dialects: colloquial Arabic for daily interactions and formal Arabic for public communication, such as speeches and government documents. Additionally, a simplified version of Arabic, Juba Arabic, is commonly used among South Sudanese people (Cultural Fact Sheet SUDANESE, n.d.). Although Arabic is the primary language, English also plays a crucial role, particularly in higher education and national government functions (Language and National Identity in Africa, 2024). In the southern regions of Sudan, a variety of languages, including Dinka, Fur, and Nuer, are spoken, reflecting the country's linguistic diversity. Many Sudanese are bilingual or multilingual, navigating between these languages effortlessly (Queensland Health Multicultural Services, 2011).

References:

Cultural Fact Sheet SUDANESE. (n.d.). https://www.diversicare.com.au/wp-content/uploads/2022/06/Cultural-Fact-Sheet_SUDANESE.pdf

Khalil, Y. (2019, January 3). The evolution of Sudanese Arabic. 500 Words Magazine. https://500wordsmag.com/miscellaneous/the-evolution-of-sudanese-arabic/

Language and National Identity in Africa. (2024). Google Books. https://books.google.com.au/books?hl=en&lr=&id=AfUTDAAAQBAJ&oi=fnd&pg=PA61&dq=sudanese+official+language&ots=Rek77zPtta&sig=jqRO6aJJvPfro12ci5NQqA4axoQ#v=onepage&q=sudanese%20official%20language&f=false

Queensland Health Multicultural Services. (2011). Community Profiles for Health Care Providers - Sudanese Profile. https://www.health.qld.gov.au/__data/assets/pdf_file/0031/157378/sudanese2011.pdf

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Common health issue for Sudanese refugees

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Common health issue for Sudanese refugees

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Among Sudanese refugees, a common health concern is mental health disorders, especially Post-Traumatic Stress Disorder (PTSD), which arises from the stress and trauma of resettlement (Australian Refugee Health-Primary Care for People of Refugee Backgrounds, n.d.). Most of the Sudanese refugees in Australia had previously spent several years in refugee camps, escaping the civil war that has troubled Sudan since its independence (Hatoss & Sheely, 2009). They arrived in Australia with deep trauma from distressing events such as suffering from different types of abuse, forced removal from family, and experiencing the death of relatives, which has worsened their mental health (Schweitzer et al., 2018, as cited in Kaphle et al., 2024; Tutlam et al., 2020, as cited in Kaphle et al., 2024). Trauma-focused cognitive behavioral therapy (CBT) is an effective treatment for Sudanese refugees suffering from PTSD. To enhance the effectiveness of CBT for Sudanese refugees, involving interpreters in therapy helps improve communication (Phoenix Australia - Centre for Posttraumatic Mental Health, 2020).

References:

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Australian Refugee Health-Primary Care for People of Refugee Backgrounds. (n.d.). https://refugeehealthguide.org.au/

Hatoss, A., & Sheely, T. (2009). Language maintenance and identity among Sudanese-Australian refugee-background youth. Journal of Multilingual and Multicultural Development, 30(2), 127–144. https://doi.org/10.1080/01434630802510113

Kaphle, S., Fanany, R., Kelly, J., Rawal, L., & Grish Paudel. (2024). Living at the fence – Navigating complexities while settling in a new country: Lived experiences of South Sudanese refugees in Australia. Journal of Intercultural Studies, 1–17. https://doi.org/10.1080/07256868.2024.2307947

Phoenix Australia - Centre for Posttraumatic Mental Health. (2020). Specific populations and trauma types: Refugee and asylum seekers in Australian guidelines for the prevention and treatment of acute stress disorder, posttraumatic stress disorder and complex posttraumatic stress disorder. Phoenix Australia. https://www.phoenixaustralia.org/wp-content/uploads/2022/08/Chapter-9-7.-Refugees-and-asylum-seekers-1.pdf‌

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Sudanese food reflects a blend of diverse cultural influences, with staple foods such as sorghum, millet, and wheat. One of the most popular dishes is Kisra, a type of fermented bread made from sorghum (Roy, 2024). Kisra is highly nutritious, offering essential vitamins, minerals, and other nutrients (Mariod, 2023). It is commonly served with stews such as mullah and tabeekh, which are slow-cooked dishes featuring meat and vegetables, spiced to enhance their flavor. Lamb and chicken are the most commonly used meats, though beef and fish are also enjoyed when accessible. In addition to Kisra, Sudanese meals often include a variety of soups, salads and desserts, highlighting the richness of their cuisine (Sudanese Kitchen - History, 2014).

References:

Mariod, A. (2023). Traditional Sudanese Foods. Cambridge Scholars Publishing. https://www.cambridgescholars.com/resources/pdfs/978-1-5275-9313-8-sample.pdf

Mogga, N. (n.d.). Kisra, Sudanese flatbread recipe [Review of Kisra, Sudanese flatbread recipe]. https://tasteofsouthsudan.com/recipes/kisra-sudanese-flatbread-recipe/

Roy, S. (2024, June 10). Exploring Sudanese culture: Traditions and customs you need to know. AfroDiscovery. https://www.afrodiscovery.com/country/sudan/sudan-culture/exploring-sudanese-culture-traditions-and-customs-you-need-to-know/

Sudanese Kitchen - History. (2014). Sudanese.kitchen. https://www.sudanese.kitchen/history#Modern-Sudanese-Cuisine

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It is estimated that 91% of Sudan’s population is Muslim, with the majority being Sunni (U.S. Department of State, 2022). This faith is evident in their daily lives through their attire, food choices, prayers, and frequent references to Allah, the Arabic term for God. For example, Sudanese commonly use phrases like ‘Inshallah’ (‘God willing’) when talking about future plans, reflecting their belief that God’s will governs the future (Evason, 2018). Apart from Islam, a small portion of the population follows traditional animist religions, especially in the Nuba Mountains. There is also a small Christian community, with various denominations present across the country (Sikainga et al., 2024).

References:

Evason, N. (2018). North Sudanese culture: Religion. Cultural Atlas. SBS. https://culturalatlas.sbs.com.au/north-sudanese-culture/north-sudanese-culture-religion

Sikainga, A. A., Collins, R. O., Spaulding, J. L., Economist Intelligence Unit, Al-Shahi, A. S., & Sabr, M. E. D. (2024, August 27). Sudan | History, Map, area, population, religion, & Facts. Encyclopedia Britannica. https://www.britannica.com/place/Sudan/Religion

U.S. Department of State. (2022). 2022 report on international religious freedom: Sudan [Report]. https://www.state.gov/reports/2022-report-on-international-religious-freedom/sudan/#:~:text=The%20U.S.%20government%20estimates%20the,other%20religions%20or%20are%20unaffiliated.