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A picture of me dancing on the beach barefoot, grounding myself, enjoying the company of family just prior to sunset. Photo by Michelle Piercy 2022

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Health to me means a state of wellbeing that allows me to participate in the activities of my daily living without any barriers.  It is a combination of my physical, emotional and mental state.

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Picture from Parliament of Australia - Border Security 

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Principal Health Issues for refugees from Iran to Australia. 

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Principal Health Issues for refugees from Iran to Australia. 

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People experiencing persecution in Iran can apply for a refugee visa in Australia according to the Australian Embassy in the Islamic Republic of Iran.  There are more applications than visas available. (Australian Embassy Islamic Republic of Iran, 2023)

Principal Health issues of Iranians seeking refuge in Australia are:

Mental health issues, resulting from the traumatic events before, during and after displacement from their country of birth.  Using the cultural assessment tool, which encourages conversation to determine the persons belief and interpretation of mental illness is a good starting point to ascertain treatment options. Referral to mental health services is recommended.  (Australian Refugee Health Practice Guide, 2023)

Low B12 levels among recent arrivals is possibly due to poor diet prior to leaving. Often a better diet in Australia improves levels, however screening may discover the need for supplementation to increase B12 levels. (Australian Refugee Health Practice Guide, 2023)

Poor oral health in refugees from Iran may result from torture or trauma, low socioeconomic status or malnutrition.  Treatment involves referral to a public health dentist and education on the importance of diet, twice daily brushing and good oral hygiene. (Australian Refugee Health Practice Guide, 2023)

Picture Reference:

Parliament House. (2015, April 30). Iranian asylum seekers. Home – Parliament of Australia. https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/FlagPost/2015/April/Iranian_asylum_seekers

References:
Australian Embassy Islamic Republic of Iran. (2023). Refugee and Humanitarian Visas. Home. https://iran.embassy.gov.au/tran/ref_hum.html

Australian Refugee Health. (2023). Anaemia, iron deficiency, and other blood conditions. Anaemia, Iron Deficiency, and Other Blood Conditions " Australian Refugee Health. https://refugeehealthguide.org.au/anaemia-iron-deficiency-and-other-blood-conditions/

Australian Refugee Health Practice Guide. (2023). Hearing, vision and Oral Health. Hearing, Vision and Oral Health " Australian Refugee Health. https://refugeehealthguide.org.au/hearing-vision-and-oral-health/

Australian Refugee Health Practice Guide. (2023b). Mental health. Mental Health " Australian Refugee Health. https://refugeehealthguide.org.au/mental-health/

Benson, J., Phillips, C., Kay, M., Webber, M. T., Ratcliff, A. J., Correa-Velez, I., & Lorimer, M. F. (2013). Low Vitamin B12 Levels among Newly-Arrived Refugees from Bhutan, Iran and Afghanistan: A Multicentre Australian Study. PLOS ONE, 8(2), e57998. https://doi.org/10.1371/journal.pone.0057998

Hosseini, A., Kakuma, R., Ghazinour, M., Davern, M., Evans, William. P., & Minas, H. (2017). Migration experience, resilience and depression: A study of Iranian immigrants living in Australia. International Journal of Culture and Mental Health, 10(1), 108–120. https://doi.org/10.1080/17542863.2016.1270977

Wang, Q., Dowsey, M. M., Woodward-Kron, R., O’Brien, P., Hawke, L., & Bunzli, S. (2023). Physical activity amongst culturally and linguistically diverse communities in Australia: A scoping review. Ethnicity &amp; Health, 28(8), 1195–1220. https://doi.org/10.1080/13557858.2023.2219874

Ziersch, A., Walsh, M., Due, C., & Reilly, A. (2021a). Temporary refugee and migration visas in Australia: An Occupational Health and Safety Hazard. International Journal of Health Services, 51(4), 531–544. https://doi.org/10.1177/0020731420980688

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Refugees and migrants wait at the Macedonia border near the village of Idomeni, Greece, 24 August 2015.

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The impact social determinants have on the  health of migrants and refugees in Australia.

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The impact social determinants have on the  health of migrants and refugees in Australia.

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The social determinants that impact migrants and refugees in Australia are factors other than medical that affect their ability to avoid illness and achieve optimal health. (World Health Organisation, 2023)

Early childhood development can have a lifelong effect on the health of migrants and refugees.  If coming to Australia as a refugee involved escaping an unsafe country, leaving family members behind, travelling by sea in inhumane conditions and being detained upon arrival this can have a negative impact on the child's mental health and development.   (World Health Organisation, 1998)

Social exclusion is detrimental to the health of migrants and refugees when they face discrimination, racism or are not permitted access to services in Australia.  This results in isolation, low self esteem and depression. Inability to access services for health care is detrimental to prevention, treatment and cure of illness. (World Health Organisation, 1998)

Job security enables people to feel secure and have a sense of achievement. Migrants and refugees are not always able to obtain employment in their field of expertise as qualifications obtained in other countries do not meet Australian standards. They may take jobs that do not utilise their skills and knowledge which is difficult to accept and can cause low self esteem, and mental health issues. (Ziersch et al., 2021)

References:
Ziersch, A., Walsh, M., Due, C., & Reilly, A. (2021). Temporary refugee and migration visas in Australia: An Occupational Health and Safety Hazard. International Journal of Health Services, 51(4), 531–544. https://doi.org/10.1177/0020731420980688

World Health Organisation. (1998). Social Determinants of Health - The Solid Facts. https://apps.who.int/iris/bitstream/handle/10665/108082/e59555.pdf?sequence=1

World Health Organization. (2023). Social Determinants of Health. World Health Organization. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1

Picture Reference:
Amnesty International. (2017, September 25). Syrian refugee crisis: How Australia can help. Amnesty International Australia. https://www.amnesty.org.au/syrian-refugees-how-australia-can-help/

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This performance by The Bushwackers on a recent episode of a channel seven program, The Voice resonated with me as exemplifying the Australian spirit.

At the five minute mark of this video: Guy Sebastian spoke of how this song made him feel as a young migrant to Australia from Malaysia in 1988 with a different accent and culture.   Guy said it made him feel like he belonged during times that he was teased for his difference by others.

Reference:
Looters. (2023). The Bushwackers Perform ‘I Am Australian’ By The Seekers | The Blind Audition | Full Performance (Video) www.youtube.com/watch?v=7ajkUix0-UU

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The Bushwackers Perform ‘I Am Australian’ By The Seekers | The Blind Audition | Full Performance

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summer holidays video by Michelle Piercy 2019

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A video of music, sport and socialisation within my culture.
The health benefits of this physical and social interaction in the fresh ocean air include physical fitness, social, emotional and spiritual connection.

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Christmas lunch table shared with family and partners who are from different cultures from around the world. Photo by Michelle Piercy 2022

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Traditions,  incorporating multicultural family members into Christmas celebrations, including Religion. 

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Traditions,  incorporating multicultural family members into Christmas celebrations, including Religion. 

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Christmas is historically a Christian celebration in Australia, celebrating the birth of Christ. (Hirschman, E. C., & LaBarbera, P. A. 1989)

My family is made up of many different religions and cultures. Some of us attend mass on Christmas Eve in the Catholic church and some of us have no religious affiliations at all.  A tree is decorated and placed in our living room at the beginning of December and gifts are placed under it for friends and family. We listen to Christmas themed music and spend time with as many loved ones as we can over the holiday period.   It is traditional to have many photos taken during these festivities.

Over time we have adapted to incorporate everyones beliefs and traditions into our shared festivities.   We include traditions from South Africa, Britain, Spain and New Zealand into our festivities to allow for every family members input and cultural needs.

These healthy relationships, where our differences are respected and considered is good for our overall health and wellbeing.

Reference: Hirschman, E. C., & LaBarbera, P. A. (1989). The meaning of Christmas. ACR Special Volumes.

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Shared platters of food with friends and family. Photo by Michelle Piercy 2022.

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Having an edible garden gives me access to organically grown seasonal fruit and vegetables and the benefits to my health give me more control over the quality of the food I am eating.

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Photo courtesy of Holistic Wellness Community - A local mental health and wellbeing group. 

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During a stressful time in my life, I was introduced to sound healing.  My first encounter was extremely emotional, and the results were felt immediately.  It allowed my mind and body to reconnect after months of being in a state of fight or flight.

I attend regular sessions and find this to be beneficial to my mental health.

I would recommend this music therapy to migrants and refugees as a tool to help reduce anxiety.

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Picture of the Competency Standard 12 - Migrant and Refugee Womens Health Partnership - 2019

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Culturally responsive practice. Working with people from migrant and refugee backgrounds. Domain 7 Competency Standard 12.1

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Culturally responsive practice. Working with people from migrant and refugee backgrounds. Domain 7 Competency Standard 12.1

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As a health clinician I must adhere to competency standards to ensure my practice is person centred and provides culturally responsive care.  (Migrant and Refugee Women's Health Partnership, 2019)

My ability to understand my own culture is essential in my practice because it will allow me to recognise and put aside my own beliefs, values and bias and listen carefully to the needs of the patient and their family.  I will ensure this standard is met and upheld by asking respectful questions, never making assumptions, conducting my own research into
other cultures and utilising services such as interpreters.  My primary aim will be to ensure the patient is empowered to make choices and decisions and play a driving role in their own health care.

Reference: Migrant and Refugee Women’s Health Partnership. (2019). Culturally responsive clinical practice: Working with people from ... https://cbrhl.org.au/wp-content/uploads/2020/10/Culturally-responsive-clinica.pdf

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Picture of my family enjoying the The Giants of Mandurah. Picture taken by Amy Piercy

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Outdoor Art Exhibition. The Giants of Mandurah. 

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Outdoor Art Exhibition. The Giants of Mandurah. 

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FORM is a Western Australian (WA) organisation with a vision to ensure WA contributes to the global creative economy.  They do this by generating cultural expression within the WA healthy and prosperous communities. (FORM, 2023)
FORM,  the City of Mandurah, Government of WA, City of Subiaco, Lotterywest and Alcoa Foundation partnered with Thomas Dambo, the global recycling artist to bring the Giants of Mandurah the Peel Region. (City of Mandurah, 2022).

This interactive art allows the users to immerse themselves in a game and explore the region of Mandurah.  It encourages us to enjoy bushland, wetlands, waterways and wildlife on the lands of the Bindjarab Noongar people.
Interactive technology allows users to link to the creation story with Bindjarab Noongar Elder, George Walley. (FORM, 2022)

For me the most meaningful aspect of this art in my culture is the way it highlights the bushland, wetlands and waterways as culturally significant aspects of Australia.

References:
City of Mandurah. (2022). Thomas Dambo Giants of Mandurah to launch in WA this November. Thomas Dambo Giants of Mandurah to launch in WA this November | City of Mandurah. https://www.mandurah.wa.gov.au/explore/whats-on/news/2022/09/thomas-dambo-giants-of-mandurah-to-launch-in-wa-this-november

FORM. (2022, November 15). Outdoor art exhibition: Thomas Dambo’s Giants of Mandurah. Thomas Dambo’s | Giants of Mandurah. https://www.giantsofmandurah.com.au/

FORM. (2023). Form building a state of creativity. FORM building a state of creativity. https://www.form.net.au/