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Afghan refugees tend to purchase medicinally herbal ingredient plants in the local markets or grow it themselves, which is because they believe that herbs, such as Hing, Glycyrrhiza glabra, nigella sativa, caraway, Trachyspermum, Alkanna, Brassica, and Pegamum, are safer with natural ingredients than modern science-based medicines from hospitals (Mannduzai et al., 2021).

(1. Manduzai, A. K., Abbasi, A. M., Khan, S. M., Abdullah, A., Prakofjewa, J., Amini, M. H., Amjad, M. S., Cianfaglione, K., Fontefrancesco, M. F., Soukand, R., & Pieroni, A. (2021). The Importance of Keeping Alive Sustainable Foraging Practices: Wild Vegetables and Herbs Gathered by Afghan Refugees Living in Mansehra District, Pakistan. Sustainability, ¹³(3), 1500-. https://doi.org/10.3390/su13031500

2. Afghanistan Herb Medicine. (2024, August 25). YouTube. https://www.youtube.com/shorts/elZTL47fspM)

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Afghanistan is an Islamic state, with a large number of people (over 90%) following Islamic religion. To be more specific, they follow two main branches of Islam religion. Almost 90% of Afghanistan believes in Sunni Muslims, and about 10% of Afghanistan follows Shia Muslims. For diet habits, normally during the Ramadan month, people who believe in Islam tend to fast, which can make them feel close to God. Muslims normally pray five times to God in a day which is seen as a personal communication with God, and they normally pray in mosques.

(1. Islam in Afghanistan. (2024, August 25). Wikipedia, the free encyclopedia. Retrieved August 28, 2024, from https://en.wikipedia.org/wiki/Islam_in_Afghanistan#:~:text=Islam%20is%20the%20official%20state,a%20smaller%20number%20follow%20Ismailism.&text=38%2C200%2C000%20(2022%20est⁾

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Note: Adapted from Heath, J. & Zahedi, A (2011). The Lives of Contemporary Afghan Women.https://www.jstor.org/stable/10.1525/j.ctt1pn69r

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Many reasons threaten the general health condition of Afghani women refugees. This problem is severe, especially in refugee camps (Heath & Zahedi, 2011). There is generally not enough funding, limited clinics, and maternity hospitals in camps (World Report, 2009). With poor access to reproductive health, healthcare facilities, and medical professionals, Afghani women have the second-highest maternal mortality rate in the world (Department of Economic and Social Affairs, 1979). And their average life expectancy is only forty-four (World Report, 2009). Thus, preventive health services for them are essential, like cancer screening (Aebra Shirazi, 2013) (Shirazi et al., 2015).

(1. Shabaik, H. S. (2018). Beyond Resettlement: Sociocultural Factors of Preventive Health and Cancer Screening among Afghan Refugee Women. ProQuest Dissertations & Theses.

2. Shirazi, M., Shirazi, A., & Bloom, J. (2015). Developing a Culturally Competent Faith-Based Framework to Promote Breast Cancer Screening Among Afghan Immigrant Women. Journal of Religion and Health, ⁵⁴(1), 153–159. https://doi.org/10.1007/s10943-013-9793-z

3. Heath, J., & Zahedi, A. (2011). Land of the unconquerable: the lives of contemporary Afghan women (pp. xi–xi). https://doi.org/10.1525/california/9780520261853.001.0001⁾

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Domain 1: 1.2 Recognizing the Refugee-like Experiences 

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Domain 1: 1.2 Recognizing the Refugee-like Experiences 

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For me, the most meaningful idea of competency standard 1.2 was that clinicians recognize the impact of refugee-like experiences of traumatic events and post-traumatic stress disorder, and take these experiences into account during the assessment, diagnosis, treatment, and ongoing care to modify their approach as appropriate and to provide trauma-informed care (Migrant and Refugee Women’s Health Partnership, 2019). I have upgraded my understanding of post-traumatic experiences. Having analyzed the correlations and research between post-traumatic experiences and mental health. This knowledge could be essential to me in the workplace because I can be more sensitive to recognizing refugees with traumatic experiences and giving them better trauma-informed care.

(1. Culturally Responsive Clinical Practice: Working with People from Migrant and Refugee Backgrounds. (2019). Migrant & Refugee Women Health Partnership.)

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Social discrimination and social inclusion are fundamental to the mental health of refugees arriving from Afghanistan, which is because of the relationship between mental and physical illnesses with social discrimination/inclusion. Specifically, changing social circumstances in the resettlement process, including living difficulties, lack of social support, acculturate stress and low employment rate, and downgraded socioeconomic status influence their mental health (Lamkaddem et al., 2015) (Slewa-Younan et al., 2017) (Jahed, 2023). Thus, more mental therapies and social support should be provided.

(1. Lamkaddem, M., Essink-Bot, M.-L., Devillé, W., Gerritsen, A., & Stronks, K. (2015). Health changes of refugees from Afghanistan, Iran and Somalia: the role of residence status and experienced living difficulties in the resettlement process. European Journal of Public Health, ²⁵(6), 917–922. https://doi.org/10.1093/eurpub/ckv061

2. Slewa-Younan, S., Yaser, A., Guajardo, M. G. U., Mannan, H., Smith, C. A., & Mond, J. M. (2017). The mental health and help-seeking behaviour of resettled Afghan refugees in Australia. International Journal of Mental Health Systems, ¹¹(1), 49–49. https://doi.org/10.1186/s13033-017-0157-z

3.Jahed, M. (2023). A Trauma-Informed Lens to Support Afghan Refugee Mental Health Needs: a Student’s Perspective. Academic Psychiatry, ⁴⁷(1), 104–105. https://doi.org/10.1007/s40596-022-01599-z⁾

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Common Health Issue-Trauma with Mental Health

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Common Health Issue-Trauma with Mental Health

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Refugee background people tend to experience trauma and conflicts. Many Afghan refugees suffer from traumatic issues during the resettlement process, which aggravates stress levels (Andisha & Lueger-Schuster, 2024). Research suggested that 150 Afghan refugees suffered from PTSD symptoms and traumatic-related events after resettlement (Slewa-Younan et al., 2017). Thus, assessments of well-being and mental health upon their arrival should be provided, and not ask about trauma or conflict experiences when they first visit (Australia Refugee Health Practice Guide). It is essential to provide more trauma-informed therapies to mitigate post-traumatic effects, and accumulative stress, and care about their mental health (Slewa-Younan et al., 2017) (Hosseini et al., 2024).

(1. Slewa-Younan, S., Yaser, A., Guajardo, M. G. U., Mannan, H., Smith, C. A., & Mond, J. M. (2017). The mental health and help-seeking behaviour of resettled Afghan refugees in Australia. International Journal of Mental Health Systems, ¹¹(1), 49–49. https://doi.org/10.1186/s13033-017-0157-z

2. Hosseini, Z., Syed, H., Raza, Z., Mansouri, M., Magan, I. M., & Awaad, R. (2024). A Systematic Review of Evidence-Based Interventions for Afghan Refugee Mental Health: A Cultural Adaptation Analysis. Journal of Cross-Cultural Psychology, ⁵⁵(1), 25–46. https://doi.org/10.1177/00220221231213884

3. Andisha, P., & Lueger-Schuster, B. (2024). Afghan Refugee Populations’ Mental Health: Exploring Pre-migration Environmental Differences and Post-migration Stressors. Journal of Loss & Trauma, ²⁹(3), 247–274. https://doi.org/10.1080/15325024.2023.2262929

4. Australian Refugee Health Primary Care for People of Refugee Backgrounds. (2024, August 24). https://refugeehealthguide.org.au)

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Sufficient and quality food is essential to physical health, but many Afghani refugees suffer from food insecurity and are malnourished. Almost 98% of Afghan households suffered from food insecurity in 2021 (Saif-Nijat et al., 2023). Around 77% of Afghani refugees who resettled in Tehran suffered from medium to high food insecurity (Pakravan-Charvadeh et al., 2021). There is a significant negative correlation between household food security with fatality rate, and physical injury rate in Afghanistan (D’Souza & Jolliffe, 2013). Due to a lack of access to secure food, a large number of Afghan refugees suffered from being malnourished (Saif-Nijat et al., 2023).

(1. Pakravan-Charvadeh, M. R., Vatanparast, H., Frongillo, E. A., Khakpour, M., & Flora, C. (2022). The assessment of an extended set of socio-economic determinants to explain anxiety and uncertainty, insufficient quality and food intake of Afghan refugees. Public Health Nutrition, ²⁵(3), 554–564. https://doi.org/10.1017/S1368980021004043

2. Pakravan-Charvadeh, M. R., Vatanparast, H., khakpour, M., & Flora, C. (2021). Food Insecurity Status of Afghan Refugees is Linked to Socioeconomic and Resettlement Status, Gender Disparities and Children’s Health Outcomes in Iran. Child Indicators Research, ¹⁴(5), 1979–2000. https://doi.org/10.1007/s12187-021-09827-y

3. Saif-Nijat, J., Pakravan-Charvadeh, M. R., Gholamrezai, S., Rahimian, M., Lane, G., Béland, D., Koc, M., Clark, N., Omidvar, N., Sadeghi, R., & Vatanparast, H. (2023). The association of the quality of life with Afghan households’ food insecurity before and after the recent political change in Afghanistan: a comparative analysis. BMC Public Health, ²³(1), 1–2066. https://doi.org/10.1186/s12889-023-16967-z

4. Afghan Population Faces Food Crisis in Upcoming Winter. (2024, August 25). Statista. https://www.statista.com/chart/26068/afghanistan-food-shortage/#:~:text=The%2055%20percent%20of%20Afghans,belongings%20or%20seeking%20extra%20work.)