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Photo credit: Nick Ballon and artist Alma Haser 

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Domain 1: Clinical Expert, Competency standard 1, 1.4 Clinicians recognise the family and community context of people from migrant and refugee backgrounds and its impact on consent, treatment and follow up.

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Domain 1: Clinical Expert, Competency standard 1, 1.4 Clinicians recognise the family and community context of people from migrant and refugee backgrounds and its impact on consent, treatment and follow up.

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For me, the most meaningful element of the culturally responsive clinical practice framework is Domain 1.4, recognizing family and community context in consent and follow-up (Migrant & Refugee, Women's Health Partnership,2019). It resonated when I saw that pregnancy is kept private in my culture for fear of misfortune, yet shared publicly here.

I have deepened my understanding of how family and community shape care, and in practice, I will confirm their preferred carer, document consent and cultural needs, use accredited or gender concordant interpreters, and arrange clear follow-up (Migrant & Refugee, Women's Health Partnership,2019).

Having learned about their experiences, I now know that a single approach will jeopardize consent, safety, and outcomes. This understanding will guide me in the workplace because it centers on culturally safe care. Because I am still learning cultural literacy, I have not yet reached the depth, so I need to expand my knowledge. Previously, I overlooked family and community roles. Equally, this was probably due to my limited exposure to multiculturalism.

References

Migrant and Refugee Women’s Health Partnership. (2019). Culturally Responsive Clinical Practice: Working with People from Migrant and Refugee Backgrounds Competency Standards Framework for clinicians. https://culturaldiversityhealth.org.au/wp-content/uploads/2019/02/Culturally-responsive-clinical-practice-Working-with-people-from-migrant-and-refugee-backgrounds-Jan2019.pdf

Ruiz-Grossman, S. (2017, March 16). Animations illustrate the trauma of Syrian children. Refugees Deeply. https://deeply.thenewhumanitarian.org/refugees/articles/2017/03/16/terrors-and-tears-animations-illustrate-trauma-of-syrian-children

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Social Inclusion and Non-discrimination- Impact on Refugees

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Social Inclusion and Non-discrimination- Impact on Refugees

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References

Barghadouch, A., Kristiansen, M., Jervelund, S.S. et al. Refugee children have fewer contacts to psychiatric healthcare services: an analysis of a subset of refugee children compared to Danish-born peers. Soc Psychiatry Psychiatr Epidemiol 51, 1125–1136 (2016). https://doi.org/10.1007/s00127-016-1260-1

Bryant R.A, Edwards B, Creamer M, et al. Prolonged grief in refugees, parenting behaviour and children’s mental health. Australian & New Zealand Journal of Psychiatry. 2020;55(9):863-873. doi:10.1177/0004867420967420

Kira, I. A., Lewandowski, L., Templin, T., Ramaswamy, V., Ozkan, B., & Mohanesh, J. (2010). The Effects of Perceived Discrimination and Backlash on Iraqi Refugees’ Mental and Physical Health. Journal of Muslim Mental Health, 5(1), 59–81. https://doi.org/10.1080/15564901003622110

Mwanri, L., Miller, E., Walsh, M., Baak, M., & Ziersch, A. (2023). Social Capital and Rural Health for Refugee Communities in Australia. International Journal of Environmental Research and Public Health, 20(3), 2378. https://doi.org/10.3390/ijerph20032378

Schweitzer R, Melville F, Steel Z, Lacherez P. Trauma, Post-Migration Living Difficulties, and Social Support as Predictors of Psychological Adjustment in Resettled Sudanese Refugees. Australian & New Zealand Journal of Psychiatry. 2006;40(2):179-187. doi:10.1080/j.1440-1614.2006.01766.x

Szaflarski, M., & Bauldry, S. (2019). The effects of perceived discrimination on immigrant and refugee physical and mental health. In Immigration and Health (Advances in Medical Sociology, Vol. 19, pp. 173–204). Emerald. https://doi.org/10.1108/S1057-629020190000019009

Szaflarski M, Bauldry S. The Effects of Perceived Discrimination on Immigrant and Refugee Physical and Mental Health. Adv Med Sociol. 2019;19:173-204. doi: 10.1108/S1057-629020190000019009. PMID: 31178652; PMCID: PMC6553658.

Solar, O., Irwin, A., & World Health Organization. (2010). A conceptual framework for action on the social determinants of health. In Social Determinants of Health Discussion Paper 2 (Policy and Practice). https://www.afro.who.int/sites/default/files/201706/SDH_conceptual_framework_for_action.pdf

World Health Organization. (2022, May 2). Refugee and migrant health [Fact sheet]. https://www.who.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

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Photo Credit: India.com-What is Latent tuberculosis?

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Common health issues among Iraqi Refugees

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Common health issues among Iraqi Refugees

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At the Regional Australian refugee clinic in Geelong, Victoria, Australia, latent tuberculosis infection (LTBI) was the most common diagnosis, accounting for 54.6% of cases, with 116 confirmed cases (Masters et al., 2018). LTBI is a persistent immune response to Mycobacterium tuberculosis without clinical TB disease and asymptomatic (WHO, 2018), influenced by strain virulence, exposure dose, and host factors like age/comorbidities (Salgame et al., 2015).

LTBI was common for Iraqi refugees, so prevention is crucial (Mateen et al., 2012). As these refugees come from a country with high TB cases, their risk is further increased by overcrowded camp conditions, undernutrition, and delays in accessing care and screening (Kasaeva et al., 2024).

The Australian Refugee Health Practice Guide identifies TB infection as a priority and recommends screening within one month using a tuberculin skin test (TST) or interferon-gamma release assay (IGRA) (ARHPG, n.d.).

Guidelines recommend effective LTBI prophylaxis using Isoniazid for 6-9 months together with vitamin B6 (pyridoxine) or a shorter rifamycin-containing regimen (e.g., 3 months once-weekly isoniazid-rifapentine, 3 months daily isoniazid-rifampicin, or 4 months rifampicin), with baseline liver function tests (LFTs), counselling, adherence aid, and safety monitoring (ARHPG, n.d.; Huaman & Sterling, 2019)

References

Denholm, J., Bailes, M., & Francis, J. (n.d.). Tuberculosis (TB & LTBI)» Australian Refugee Health. Australian Refugee Health Practice Guide. https://refugeehealthguide.org.au/tuberculosis-tb/

Huaman M.A., Sterling T. R. Treatment of Latent Tuberculosis Infection-An Update. Clin Chest Med. 2019 Dec;40(4):839-848. doi: 10.1016/j.ccm.2019.07.008. PMID: 31731988; PMCID: PMC7043866

Huaman, M. A., & Sterling, T. R. (2019). Treatment of latent tuberculosis infection—An update. Clinics in Chest Medicine, 40(4), 839–848.

Kasaeva, T., Dias, H. M., Mavhunga, F., & Viney, K. (2024). A unified response is needed to tackle tuberculosis among refugees and migrants. BMJ, q2598. https://doi.org/10.1136/bmj.q2598

Magdalena Szaflarski, Shawn Bauldry, 2019. "The Effects of Perceived Discrimination on Immigrant and Refugee Physical and Mental Health", Immigration and Health. https://doi.org/10.1108/S1057-629020190000019009

Masters, P. J., Lanfranco, P. J., Sneath, E., et al. (2018). Health issues of refugees attending an infectious disease refugee health clinic in a regional Australian hospital. Australian Journal of General Practice, 47(5), 305–310. https://doi.org/10.31128/afp-10-17-4355

Mateen, F. J., Carone, M., Al-Saedy, H., Nyce, S., Ghosn, J., Mutuerandu, T., & Black, R. E. (2012). Medical conditions among Iraqi refugees in Jordan: data from the United Nations Refugee Assistance Information System. Bulletin of the World Health Organization, 90(6), 444–451. https://doi.org/10.2471/blt.11.097048

Salgame, P., Geadas, C., Collins, L., Jones-López, E., & Ellner, J. J. (2015b). Latent tuberculosis infection – Revisiting and revising concepts. Tuberculosis, 95(4), 373–384. https://doi.org/10.1016/j.tube.2015.04.003

World Health Organization. (2018). Latent tuberculosis infection: Updated and consolidated guidelines for programmatic management—Executive summary. https://www.who.int/docs/defaultsource/documents/tuberculosis/executivesummary-consolidated-guidelines-ltbi.pdf

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Figure 1. (A) Plant of N. sativa, (B) Flower, (C) Capsule or fruit, (D) Seeds          (Photo by Abeer Kaazmi,2019).

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"Nigella Sativa: A Cure for all except death"

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"Nigella Sativa: A Cure for all except death"

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In Iraq, Nigella sativa (black seed), known as Habbat al-baraka (“the blessed seed”), is a staple of traditional medicine and linked to prophetic traditions as “a cure for every disease except death.” (Ijaz et al., 2017; Yarnell & Abascal, 2011). Traditionally, it is used for ailments such as headaches, coughs, joint pain, eye disorders, and chest complaints, often in powdered or hydrodistilled forms (Ahmed, 2016; Ahmed, 2025).

Modern research attributes its therapeutic potential to Thymoquinone (TQ), a key constituent with antioxidant, anti-inflammatory, and anti-microbial properties (Derosa et al., 2024). , and cosmeceutical antimicrobial, anti-inflammatory, and wound-healing effects (Eid et al., 2017).

Clinical studies in Iraq have confirmed Nigella sativa’s medicinal value. Trials report 2g/day improves H. pylori control (Ijaz et al., 2017). Additionally, it was found to enhance semen health with 2g/day capsules for 12 weeks (Marbat et al., 2013).

Evidence also suggests potential adjunct roles in COVID-19 management (Al Haidari et al., 2021), diabetes, lipid regulation (Javaheri et al., 2023), and dermocosmetic applications.

Overall, Nigella sativa bridges prophetic medicine and modern Iraqi clinical research as a safe, versatile therapeutic agent.

References

Ahmed, H. M. (2016). Ethnopharmacobotanical study on the medicinal plants used by herbalists in Sulaymaniyah Province, Kurdistan, Iraq. Journal of Ethnobiology and Ethnomedicine, 12(1). https://doi.org/10.1186/s13002-016-0081-3

Ahmed, H. M. (2025). Medicinal plants are used in traditional medicine among populations in the Hawler (Erbil) Province, Kurdistan Region, Iraq. Journal of Herbs, Spices & Medicinal Plants. https://www.tandfonline.com/doi/pdf/10.1080/10496475.2025.2542307

Al-Haidari, K. A. A., Faiq, T., & Ghareeb, O. (2021). Clinical trial of black seeds against COVID–19 in Kirkuk City/ Iraq. Indian Journal of Forensic Medicine & Toxicology, 15(3), 3393–3399. https://doi.org/10.37506/ijfmt.v15i3.15825

Derosa, G., D’Angelo, A., Maffioli, P., Cucinella, L., & Nappi, R. E. (2024). The use of Nigella sativa in Cardiometabolic diseases. Biomedicines, 12(2), 22. https://doi.org/10.3390/biomedicines12020405

Eid, A. M., Elmarzugi, N. A., Ayyash, L. M. A., Sawafta, M. N., & Daana, H. I. (2017). A Review on the Cosmeceutical and External Applications of Nigella sativa. Journal of Tropical Medicine, 2017, 1–6. https://doi.org/10.1155/2017/7092514

Ijaz, H., et al. (2017). Nigella sativa (Prophetic medicine): A review. Pakistan Journal of Pharmaceutical Sciences, 30(1), 229–234. https://d1wqtxts1xzle7.cloudfront.net/85217491/Paper-33-libre.pdf

Javaheri, J., Asgari, M., & Ghafarzadegan, R. (2023). The Effect of Nigella sativa Powder on Blood Sugar and Lipid Profiles in Type 2 Diabetic Patients. Jundishapur Journal of Natural Pharmaceutical Products, 18(2). https://doi.org/10.5812/jjnpp-135757

Kazmi, A., Khan, M. A., & Ali, H. (2019). Biotechnological approaches for production of bioactive secondary metabolites in Nigella sativa:¬: an up-to-date review. International Journal of Secondary Metabolite, 172–195. https://doi.org/10.21448/ijsm.575075

Marbat, M. M., Ali, M. A., & Hadi, A. M. (2013). The use of Nigella sativa as a single agent in the treatment of male infertility. Tikrit Journal of Pharmaceutical Sciences, 9(1), 19–29. http://tjphs.tu.edu.iq/index.php/j/article/view/268/253

Yarnell, E., & Abascal, K. (2011). Nigella sativa: Holy herb of the Middle East. Alternative & Complementary Therapies, 17(2), 99–105. https://www.liebertpub.com/doi/abs/10.1089/act.2011.17203