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Sudan is located in Northeast Africa and is a land of great cultural and ethnic diversity. Sudan merges many cultures with hundreds of ethnic and tribal groups dominating the south and a large Muslim community in the north.

Sudan has a rich history and is known for the ancient Kingdom of Kush and its collection of ancient pyramids to rival Egypt. However it is more currently known as one of the poorest and least developed countries in the world with one-third of its population depending on farming for their livelihood.

sapa. (2023, December 28). 5 Interesting Facts About Sudan | Sudan Fun Facts. SAPA USA. https://sapa-usa.org/interesting-facts-about-sudan/#:~:text=A%20Treasure%20Trove%20of%20Pyramids

Spaulding, J. L., & Economist Intelligence Unit. (2019). Sudan | history - geography. In Encyclopædia Britannica. https://www.britannica.com/place/Sudan

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Sudan is a diverse country with many languages which travels with them even after settling in Australia. A 2006 census for Sudanese-born people in Australia found the main languages spoken at home were:

·      Arabic 51.2%

·      Dinka 23.6%

·      Other African Languages 5.5%

·      English 4.4%

The same 2006 census showed that 20% of males and 32% of females reported they did not speak English well and 4% of males and 8% of females did not speak English at all. (Queensland Health Multicultural Services, 2011).

Arabic is Sudan’s official language and the Sudanese Arabic dialect is very distinct requiring a specific translator as some people may not understand an interpreter not using this dialect. When communicating with Sudanese refugees it is important to be aware that they may prefer not use Arabic as it was forced on the population via government policy in 1990.

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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Herbal medicine is still widely practiced throughout the poorer communities of Sudan. Aristolochia bracteolate is an easily accessible plant commonly used in traditional health. It is widely used to treat malaria, headache, fever, hypertension and diabetes due to reports of it having antibacterial, antifungal, anti-arthritis, hypotensive, and anti-inflammatory properties.

Karar MGE, Kuhnert N. Herbal Drugs from Sudan: Traditional Uses and Phytoconstituents. Pharmacogn Rev. 2017 Jul-Dec;11(22):83-103. doi: 10.4103/phrev.phrev_15_15. PMID: 28989244; PMCID: PMC5628527.

Mathew, L. S., Mtewa, A. G., Ajayi, C. O., Deyno, S., Weisheit, A., Tolo, C. U., Deng, A. L., & Engeu Ogwang, P. (2020). Ethnopharmacology, pharmacology and phytochemistry of Aristolochia Bracteolata Lam: A review of an antimalarial plant. East Africa Science, 2(1), 22–28. https://doi.org/10.24248/easci-d-19-00011

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A major barrier to Sudanese Refugees seeking healthcare is a lack of education and understanding. In many cases, refugees entering Australia don’t have a good understanding of what services are available to them and lack the health literacy to take the information given to them and use it to make informed health decisions.

A small study of sub-Saharan refugees in Sydney showed evidence of difficulties in accessing health care. Barriers to healthcare access included language barriers, lower levels of education and literacy, financial disadvantage, lack of health information, not knowing where to seek help and poor understanding of how to access health services (Queensland Health Multicultural Services, 2011).

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

World Health Organisation. (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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One common health concern Sudanese refugees present with is the Hepatitis B Virus (HBV). A Western Australian infectious disease screening study of 2111 refugees and humanitarian entrants in 2003-2004 reported a high prevalence of infectious diseases in sub-Saharan Africans including hepatitis B (6.4 per cent carrier state, 56.7 per cent exposed) (Queensland Health Multicultural Services, 2011).

Chronic HBV is generally asymptomatic and is spread easily by people not even realising they are carriers; however, it can cause serious complications for the liver if left untreated leading to conditions such as liver disease/cirrhosis of the liver impairing function, or liver cancer.

HBV is a chronic condition and requires lifelong management, on diagnosis information is gathered to determine a baseline this includes blood tests for viral load and liver functioning and an upper abdominal ultrasound to examine the liver. HBV is then monitored via 6 monthly blood test for liver functioning and 12 monthly blood tests for viral load

Maclachlan, J., Cowie, B., Isaacs, D., & Davies, J. S. (2024). Hepatitis B Virus (HBV)» Australian Refugee Health. Australian Refugee Health Practice Guide. https://refugeehealthguide.org.au/hepatitis-b/

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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Social determinants of health are the nonmedical factors that influence an individual’s health outcomes; The social determinants of health also include interpersonal variables, like experiences of social exclusion, discrimination, and low social status. (Hynie, 2017).

Sudanese refugees entering Australia may experience discrimination or a lack of inclusion in society due to their background, culture or the way they arrived in Australia. Numerous studies suggest that the extent to which refugees feel welcomed or experience hostility has an impact on their mental health (Hynie, 2017).

This lack of belonging can lead to conditions such as depression and anxiety. Research has shown a strong relationship between depression and physical health, leading to conditions such as diabetes and cardiovascular disease (WHO, 2024)

Hynie, M. (2017). The Social Determinants of Refugee Mental Health in the Post-Migration Context: A Critical Review. The Canadian Journal of Psychiatry, 63(5), 297–303. https://doi.org/10.1177/0706743717746666

WHO. (2024). Depression. Www.who.int. https://www.who.int/health-topics/depression#tab=tab_2

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Approaching Refugee Like Experiences in Healthcare 

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Approaching Refugee Like Experiences in Healthcare 

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Having developed my understanding of refugee health and experiences I believe the most important part of my competency is 1.2 and how it relates to providing care to people with PTSD and trauma from refugee-like experiences. Having learned the about different experiences refugees have on their journey and how these experiences impact how people communicate and seek health care I believe I am better equipped to help them in a way that is respectful of their culture and life experiences. This skill is useful as in my future role I will be working closely with people who have experienced trauma and I will need to be able to tailor the care I provide that is respectful to them.

Migrant & Refugee Women's Health Partnership. (2019, January). Culturally Responsive Clinical Practice: Working with People from Migrant and Refugee Backgrounds. https://moodleprod.murdoch.edu.au/pluginfile.php/4119639/mod_resource/content/3/Culturally-responsive-clinical-practice-Working-with-people-from-migrant-and-refugee-backgrounds-Jan2019.pdf