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For me, the most meaningful aspect was competency standard 1.2, which highlighted the importance of recognising signs of refugee-like trauma and adapting my nursing practice to provide trauma-informed care (Culturally Responsive Clinical Practice: Working with People from Migrant and Refugee Backgrounds, 2019). I have improved my understanding of how refugee experiences can profoundly affect physical health, mental health, communication, emotions, health comprehension, and engagement with healthcare (Culturally Responsive Clinical Practice: Working with People from Migrant and Refugee Backgrounds, 2019). Having learned that every refugee experience is individualised, I now realise the importance of familiarising myself with various trauma-informed approaches to provide individualised, safe, and patient-centered care. This knowledge is essential to me in the workplace because it allows me to approach each patient with sensitivity, build trust and reduce the risk of re-traumatisation. Because I have not yet applied trauma-informed care in practice, I will now need to build my knowledge through certified modules and trainings. Previously, I thought that language barriers were the only challenges in refugee health care and never considered the trauma aspect. Alternatively, this could be due to my limited awareness of refugee struggles.

References

1. Culturally Responsive Clinical Practice: Working with People from Migrant and Refugee Backgrounds (pp. 12–13). (2019). Migrant & Refugee Women’s Health Partnership. 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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The WHO social determinants social inclusion and non-discrimination focus on the idea of equality for everyone and the prevention of exclusion or discrimination (WHO, 2023). For Syrian refugees, experiencing discrimination or social exclusion can cause them to avoid seeking appropriate healthcare out of fear of mistreatment or rejection (Correa-Velez et al., 2015). For Syrian refugees affected by trauma and war, exclusion can worsen mental health and increase stress and depression (Correa-Velez et al., 2015). If they feel unsafe to access health services, it can delay treatment for those that arrive with pre-existing conditions. Given that noncommunicable diseases are common amongst Syrias, late intervention could be severe leading to poorer health outcomes, causing poorer health outcome (WHO, 2023). However, when meet with social inclusion and non-discrimination, Syrian refugees are more likely to feel welcome and build trust in the healthcare system (Silove et al., 2017). Making it easier for them to receive proper care that they need. A sense of acceptance and belonging can also help lighten the mental load and reduce psychological distress (Silove et al., 2017).

References

1.        Correa-Velez, I., Gifford, S. M., & Barnett, A. G. (2015). Longing to belong: Social inclusion and wellbeing among youth with refugee backgrounds in the first three years in Melbourne, Australia. Social Science & Medicine, 71(8), 1399–1408. https://doi.org/10.1016/j.socscimed.2010.07.018

2.        Silove, D., Ventevogel, P., & Rees, S. (2017). The contemporary refugee crisis: An overview of mental health challenges. World Psychiatry, 16(2), 130–139. https://doi.org/10.1002/wps.20438

3.        World Health Organization. (2023). Social determinants of health. https://www.who.int/health-topics/social-determinants-of-health

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Noncommunicable Diseases - A prevalent health issue in Syrian Refugees

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Noncommunicable Diseases - A prevalent health issue in Syrian Refugees

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One health issue we may find in a refugee coming from Syria are noncommunicable diseases (NCDs) (Maldari et al., 2019). NCDs were already becoming prevalent in Syria before the conflicts after facing a epidemiological shift from infectious diseases , with it accounting for 77% of all deaths (Maldari et al., 2019), (Karaki et al., 2021). After conflict, Syrian refugees experienced forced displacement in host countries. Because NCDs are more costly and complicated to manage compared to infectious diseases, it is hard for host countries to treat them (Karaki et al., 2021). Refugees claim to have limited access to health care and some feel discriminated from health care workers further driving them away from treatment (Karaki et al., 2021). There are currently no cures for NCDs however treatment and management plans are available. One method is by administering screenings for NCDs and risk factors eg. smoking, diabetes, specific cancers, and cardiovascular diseases (Walker & Chavez’s, 2018).

This allows for early intervention providing better results and can help the rate of NCDs to decrease in the population (Malau et al., 2024).

References

1. Maldari, T., Elsley, N., & Abdul Rahim, R. (2019). The health status of newly arrived Syrian refugees at the Refugee Health Service, South Australia, 2016. Australian Journal of General Practice, 48(7), 480–486. https://doi.org/10.31128/ajgp-09-18-4696

2. Karaki, F. M., Alani, O., Tannoury, M., Ezzeddine, F. L., Snyder, R. E., Waked, A. N., & Attieh, Z. (2021). Noncommunicable Disease and Health Care-Seeking Behavior Among Urban Camp-Dwelling Syrian Refugees in Lebanon: A Preliminary Investigation. Health Equity, 5(1), 261–269. https://doi.org/10.1089/heq.2020.0106Treatment

3. Walker, K., & Chavez’s, N. (2018). Chronic Non-Communicable Diseases in Adults. AUSTRALIAN REFUGEE HEALTH PRACTICE GUIDE; Foundation House. https://refugeehealthguide.org.au/chronic-non-communicable-diseases-in-adults/

4. Malau, E., Ramavhoya, I. T., & Rasweswe, M. M. (2024). Importance of Utilizing Non-Communicable Disease Screening Tools; Ward-Based Community Health Care Workers of South Africa Explain. International Journal of Environmental Research and Public Health, 21(3), 263. https://doi.org/10.3390/ijerph21030263

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Cupping is a traditional medicine practiced in many parts of the world. In Syria it is known as Hijama, an ancient practice believed to treat various diseases and extract harmful bodily fluids (Qureshi et al., 2017) (Enab Baladi, 2024). There are two main types of cupping, dry and wet, with Hijama mostly involving wet cupping (Ahmed et al., 2021). It has roots in Islam, the main religion in Syria, in which the use of hijama is encouraged through the teachings of Mohammad (Ahmed et al., 2021). Hijama involves placing suction cups on specific body areas to draw blood to the surface. Small incisions are then made on the skin surface, before reapplying the cups to extract harmful blood (Ansorge & Whitbourne, 2022). Currently there is no definitive evidence on the benefits of hijama, however there is some research suggesting it can help with muscle pain (Ansorge & Whitbourne, 2022). Reported side effects include scarring, erythema, and dizziness (Smiley, 2024). A more serious but rare concern is risk of infection, however this risk can be minimised if done properly and under hygienic conditions (Furhad et al., 2019).

References

1.         Ahmed, F., Ballout, K., Eldervis, H., Abdullah Charaf Eddin, Tariq, S., Mehmet, N., & Salih Mollahaliloglu. (2021). The Practice of Traditional Medicine and Associated Factors in Northwest Syria: A Cross-sectional study. Journal of Health Policy & Outcomes Research, 1/2025, 15–15. https://doi.org/10.7365/jhpor.2025.1.2

2.         Ansorge, R., & Whitbourne, K. (2022, November 5). What Is Cupping Therapy? Uses, Benefits, Side Effects, and More. WebMD. https://www.webmd.com/balance/cupping-therapy

3.         Enab Baladi. (2024, May 21). Al-Hasakah: Rising popularity of cupping amid high cost of medical consultations - Enab Baladi. Enab Baladi. https://english.enabbaladi.net/archives/2024/05/al-hasakah-rising-popularity-of-cupping-amid-high-cost-of-medical-consultations/

4.         Furhad, S; Reddog E.S; Abdullah A.B. (2019, February 11). Cupping Therapy. Nih.gov; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK538253/

5.         Qureshi, N. A., Ali, G. I., Abushanab, T. S., El-Olemy, A. T., Alqaed, M. S., El-Subai, I. S., & Al-Bedah, A. M. N. (2017). History of cupping (Hijama): a narrative review of literature. Journal of Integrative Medicine, 15(3), 172–181. https://doi.org/10.1016/S2095-4964(17)60339-X

6.         Smiley, J. (2024, November 30). Cupping Therapy: What You Should Know. Verywell Health. https://www.verywellhealth.com/cupping-therapy-5216701