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In Competency Standard 12.3 of Domain 7, I have learned that clinicians should adhere to ethical standards and obtain knowledge of the cultural differences of migrants and refugees as their choices and decisions are relevant. I understand that migrants and refugees along with their families should be given the right to choose their own preference of care considering their cultural beliefs and values as acknowledging their decisions means respecting them holistically. I realised that regardless of ethnicity, race, and religion, everyone deserves to be treated with respect and dignity regarding cultural diversity and the right to receive safe and accessible access to healthcare services and equal opportunity for all people without discrimination. Clinicians should embrace diversity and must not consider it as a barrier in offering treatment choices. Besides, I know that language barrier can be an issue leading to misunderstanding resulting in decreased quality of healthcare delivery, however, interpreters can help to effectively communicate leading to a clear understanding of their health issues. In my future practice as a nurse, I will make sure that each patient is being treated fairly in order to render the highest quality of care in accordance with their needs and preferences.

Culturally Responsive Clinical Practice: Working with People from Migrant and Refugee Backgrounds COMPETENCY STANDARDS FRAMEWORK FOR CLINICIANS. (2019). https://culturaldiversityhealth.org.au/wp-content/uploads/2019/02/Culturally-responsive-clinical-practice-Working-with-people-from-migrant-and-refugee-backgrounds-Jan2019.pdf

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Social determinants of health are one of the factors that impact health outcomes. At present, finding employment is a struggle for refugees despite their working rights in Australia. One of the reasons is their working skills are non-transferable. The lack of working experience, unrecognised professional qualifications, and education are the barriers to gaining employment. Some migrants have good employment status since most of them are qualified workers and more than half are working full- time yet some have limited working hours depending on their visa class. Moreover, due to the lack of opportunity for employment, income is affected. Despite refugees being eligible for income support payments, the support is still inadequate as living expenses in Australia are rising. Meanwhile, the health industry employs larger numbers of family- visa holders and permanent skilled who earn higher wages. In the hospitality industry, they rely mostly on international students to pay lower wages. Furthermore, refugee students have higher educational support from the government. Refugees are generally free in public schools and have high support levels to successfully settle themselves at school and adjust to the new environment. Schools provide a safe environment and raise awareness through programs and teachers are helping them to recover from their past traumatic experiences. In contrast, migrants are not given free education unless they become residents or citizens, and their children's education is their responsibility. Overcoming social determinants may be difficult however, through hardwork, teamwork, and engaging in community awareness everything is attainable.

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

‌Mackey, Will, Coates, B., & Sherrell, H. (2022). Migrants in the Australian workforce: A guidebook for policy makers. Grattan Institute. https://grattan.edu.au/report/migrants-in-the-australian-workforce/

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Approach to consultation and management» Australian Refugee Health. (n.d.). https://refugeehealthguide.org.au/consultation-and-management/

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Famous dish                                                               

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Famous dish                                                               

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Chicken Adobo
A famous Filipino dish, marinated in soy sauce and spices and stewed until tender. The dish has a sweet, sticky, savoury, and tangy taste making it liked by everyone.

Famous Chicken Adobo. (n.d.). Allrecipes. https://www.allrecipes.com/recipe/128699/famous-chicken-adob

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Tinikling
The national dance in the Philippines which uses pair of bamboo poles that relate to Filipino culture as it resembles the Philippines core values: agriculture, nature, and life.

Tinikling Facts, Worksheets, Origin & Story Behind For Kids. (2021, March 16). KidsKonnect. https://kidskonnect.com/social-studies/tinikling/

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Boxing
In the Philippines, boxing is one of the popular sports due to the many recognition it has brought to the country, which has 45 major champions in the world.

History of boxing in the Philippines. (2022, March 23). Wikipedia. https://en.wikipedia.org/wiki/History_of_boxing_in_the_Philippines

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Tagalog
One of the major languages in the Philippines. Year 1937, it was declared as the national language of the Philippines by former President Quezon.

Tagalog (Filipino) | Department of Asian Studies. (n.d.). Asianstudies.cornell.edu. https://asianstudies.cornell.edu/research/tagalogfilipino#:~:text=Tagalog%20is%20one%20of%20the

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Catholic
Majority of the Filipinos are Catholic. Catholicism believes in the doctrine of God as the ‘Holy Trinity’ comprising the Father, the Son and the Holy Spirit.

Scroope, C. (2017). Filipino Culture - Religion. Cultural Atlas. https://culturalatlas.sbs.com.au/filipino-culture/filipino-culture-religion

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Euphorbia Hirta
In the Philippines, it is commonly used as treatment for dengue. It is rich in bioactive compounds like phenolics and flavonoids which may be responsible for its anti-dengue properties.

Perera, S. D., Jayawardena, U. A., & Jayasinghe, C. D. (2018). Potential Use of Euphorbia hirta for Dengue: A Systematic Review of Scientific Evidence. Journal of Tropical Medicine, ²⁰¹⁸, 1–7. https://doi.org/10.1155/2018/2048530

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For me, health means being in a healthy state of physical, emotional, social, and mental that allows me to accomplish my activities of daily living normally. Besides, health for me is feeling good about myself by gaining self-image and self-esteem. I believe it can be achieved when someone has the capability to function appropriately through having sound mind and body, able to engage in different activities, socially and emotionally connected to people, and capable of maintaining a secure, and stable environment.

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Country focus: IRAQ

During the Gulf War in 1991, Australia accepted increasing numbers of Iraqi refugees running off from human rights violations, civil war, socio-economic disasters, and life-threatening situations   (Vasey & Manderson, 2012). From 2010, Iraqi refugees were among the top four nationalities that were accepted under the Humanitarian Program in Australia (Vasey &  Manderson, 2012). In the years 2021- 2022, Iraq was included as the top three refugees in Australia (Country Profiles List, n.d.). Iraqi refugees have three health concerns that are listed in the Australian Refugee Health Practice Guide.

Mental Health
Refugees from Iraq have experienced family separation, trauma, and human rights violations. Starting a new life with difficult access to employment, housing instability, language barriers, and cultural adjustment adds a negative impact on mental health. Settlement contributes to mental illness accompanied by stressors leading to post-traumatic stress disorder, anxiety, and depression. One treatment option is referral to mainstream mental health services which offers counselling, psycho-education, psychosocial support, cognitive behavioural activity, and relaxation strategies.

Diabetes
Refugees have an increased vulnerability to diabetes. The treatable risk factors for the development of diabetes include sedentary lifestyle, food insecurity, bad eating habits, and high- intake of sweetened foods. Besides, refugees are at risk of different comorbidities due to inadequate access to preventive and chronic disease management. Management option includes referral to diabetes nurse educators and dietitians for proper understanding and management of diabetes such as monitoring blood sugar levels and adherence to diabetic diet and lifestyle.

Anemia
Anaemia is common in Iraqi refugee children. Symptoms include irritability, poor growth, shortness of breath, and lethargy. Contributing factors include parasite infections, thalassemia, and iron deficiency due to gastrointestinal loss. Moreover, food deprivation and inadequate access to nutritious foods lead to iron deficiency and undernutrition. A full blood examination that helps in screening eosinophilia, thrombocytopenia and recognising the type of anemia is highly recommended.

Permanent migration from Iraq. (n.d.). Www.homeaffairs.gov.au. https://www.homeaffairs.gov.au/research-and-statistics/statistics/country-profiles/profiles/iraq

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Vasey, K., & Manderson, L. (2012). Regionalizing Immigration, Health and Inequality: Iraqi Refugees in Australia. Administrative Sciences, ²(1), 47–62. https://doi.org/10.3390/admsci2010047

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Mental Health» Australian Refugee Health. (n.d.). https://refugeehealthguide.org.au/mental-health/

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Chronic Non-Communicable Diseases in Adults» Australian Refugee Health. (n.d.). https://refugeehealthguide.org.au/chronic-non-communicable-diseases-in-adults/

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