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Reference

Migrant and Refugees Women's Health Partnership. (2019). Culturally Responsive Clinical Practice: Working with People from Migrant and refugee backgrounds. Competency Standards Framework for Clinicians January 2019.

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The most affected social determinants to migrants and refugees are education, unemployment and job insecurity, and access to affordable health services of decent quality.

Education is crucial for understanding and navigating healthcare. Migrants and refugees, accustomed to their home country’s education system, often face challenges in Australia due to language barriers and insufficient literacy and numeracy to understand English. This could result in misunderstandings in the healthcare system, incorrect medical instructions, and challenges in advocating for their health.

Unemployed status and job-related stress are the biggest concerns for heads of households who support their families. Migrants and refugees, despite being qualified, may struggle to secure jobs due to unrecognised degrees, inexperience, and discrimination. This insecurity leads to significant psychological stress and health issues.

Access to healthcare is essential for health. Refugees and migrants may be physically or mentally vulnerable in Australian society and are more likely to be challenged due to cultural differences, religious beliefs, language barriers, and racism. Furthermore, the high medical fee burden may be difficult to overcome. Thus, poor access to healthcare leads to worsening existing health conditions and delayed care.

World Health Organization. (2022). Refugee and migrant health. https://www.who.int/news-room/fact-sheets/detail/refugee-and-migrant-health#:~:text=Barriers%20to%20access%20to%20health,access%20to%20mainstream%20health%20services

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

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Overview

Refugees and migrants have a variety of different physical and mental health needs, shaped by experiences in their country of origin, their migration journey, their host country's entry and integration policies, and living and working conditions. These experiences can increase the vulnerability of refugees and migrants to chronic and infectious diseases.

The COVID-19 pandemic has disrupted health services, putting people already in vulnerable situations at heightened risk and hampering the ability of health systems to respond to their needs.

Key data and information on refugees and migrants

The term refugee is defined in Article 1 of the 1951 Convention Relating to the Status of Refugees (3). There is no universally accepted definition of the term migrant (4). However, the United Nations Department of Economic and Social Affairs defines an international migrant as "any person who changes his or her country of usual residence", and this definition includes people who are moving or have moved across an international border, regardless of legal status, duration of the stay abroad and causes for migration (5).

Migrants may be given a migration status that limits their entitlement and access to health care. However, international law guarantees universal access in line with the 2030 Agenda for Sustainable Development, in particular with Sustainable Development Goal 3 (ensure healthy lives and promote well-being for all at all ages) (6).

Although governed by separate legal frameworks, refugees and migrants are entitled to the same universal human rights and fundamental freedoms as other people (7).

In 2021, countries with the highest number of refugees fleeing were 1. Syrian Arab Republic, 2. Venezuela, 3. Afghanistan, 4. South Sudan and 5. Myanmar while countries hosting the highest number of refugees were 1. Turkey, 2. Colombia, 3. Uganda, 4. Pakistan, 5. Germany (8).

In the first 5 weeks since the escalation of conflict in Ukraine on 24 February 2022, more than 4 million refugees from Ukraine crossed borders into neighbouring countries, and many more have been forced to move inside the country (9).

In 2020, the top countries of origin for international migrants were 1. India, 2. Mexico, 3. Russian Federation, 4. Syrian Arab Republic, 5. China. The United States of America has been the main country of destination for international migrants since 1970, and Germany is the second top destination (10).

Common health needs and vulnerabilities of refugees and migrants

Refugees and migrants are a diverse group and have a variety of health needs, which may differ from those of the host populations.

Refugees and migrants often come from communities affected by war, conflict, natural disasters, environmental degradation or economic crisis. They undertake long, exhausting journeys with inadequate access to food and water, sanitation and other basic services, which increases their risk of communicable diseases, particularly measles, and food- and waterborne diseases. They may also be at risk of accidental injuries, hypothermia, burns, unwanted pregnancy and delivery-related complications, and various noncommunicable diseases due to the migration experience, restrictive entry and integration policies and exclusion.

Refugees and migrants may arrive in the country of destination with poorly controlled non-communicable diseases, as they did not have care on the journey. Maternity care is usually a first point of contact with health systems for female refugees and migrants.

Refugees and migrants may also be at risk of poor mental health because of traumatic or stressful experiences Many of them experience feelings of anxiety and sadness, hopelessness, difficulty sleeping, fatigue, irritability, anger or aches and pains but for most people these symptoms of distress improve over time They may be at more risk of such as depression, anxiety and post-traumatic stress disorder (PTSD) than the host populations.

Refugee and migrant health is also strongly related to the social determinants of health, such as employment, income, education and housing

Barriers to access to health services

Refugees and migrants remain among the most vulnerable members of society and are often faced with xenophobia; discrimination; substandard living, housing and working conditions; and inadequate or restricted access to mainstream health services.

Migrants, particularly in an irregular situation, are often excluded from national programmes for health promotion, disease prevention, treatment and care, as well as from financial protection in health. They can also face high user fees, low levels of health literacy, poor cultural competency among health providers, stigma and inadequate interpreting services.

Barriers are even greater for people with disabilities. Women and girls may find difficulty in accessing sexual and gender-based violence protection and response services. Refugee and migrant children, especially unaccompanied minors, are more likely to experience traumatic events and stressful situations, such as exploitation and abuse, and may struggle to access health care.

The ability to access health services in humanitarian settings is usually compromised and complicated by shortages of medicines and lack of healthcare facilities.

COVID-19

The COVID-19 pandemic has brought an increased risk of infection and death for refugees and migrants. People on the move may have limited tools to protect themselves such as social distancing, hand hygiene and self-isolation are often not possible.

The pandemic has highlighted existing inequities in access to and utilization of health services. Refugees and migrants have also suffered the negative economic impact of lockdown and travel restrictions. Income loss and health care insecurity may have particularly affected labour migrants. They may have also experienced legal and social insecurity caused by the postponement of decisions on migration status or a reduction of employment, legal and administrative services.

WHO response

WHO believes that everyone, including refugees and migrants, should be able to enjoy the right to health and access to people-centred, high-quality health services without financial impediment, as expressed by our commitment to universal health coverage. Health systems should incorporate the needs of refugees and migrants in national and local health policies, financing, planning, implementation, monitoring and evaluation. In rapid and effective emergency responses, health care may sometimes need to be delivered in a parallel structure to the national health system, but in the long term, refugee and migrant health should be mainstreamed into existing services.

WHO works around the world to secure the health rights of refugees and migrants and achieve universal health coverage. Through the Health and Migration Programme, and in collaboration with regional and country offices, WHO provides global leadership, advocacy, coordination and policy on health and migration; sets norms and standards to support decision-making; monitors trends, strengthens health information systems and promotes tools and strategies; provides technical assistance, response and capacity-building support to address public health challenges; and promotes global multilateral action and collaboration by working with UN agencies and other international stakeholders, as well as by being part of the United Nations Network on Migration.

WHO works with countries to build strong health systems that are supported by a well trained, culturally sensitive and competent workforce, and are sensitive to the needs of refugees and migrants, their languages and their unique health problems.

Notes

1. https://www.iom.int/data-and-research

2. https://www.unhcr.org/refugee-statistics/

3. http://www.unhcr.org/3b66c2aa10.pdf

4. https://www.who.int/publications/i/item/promoting-the-health-of-refugees-and-migrants-draft-global-action-plan-2019-2023

5. Recommendations on Statistics of International Migration, Revision 1 (1998) para. 32). https://unstats.un.org/unsd/publication/seriesm/seriesm_58rev1e.pdf

6. https://documents-dds-ny.un.org/doc/UNDOC/GEN/N15/291/89/PDF/N1529189.pdf?OpenElement

7. United Nations General Assembly resolution 71/1 (2016). New York Declaration for Refugees and Migrants, paragraph 6 ( http://undocs.org/a/res/71/1)

8. https://www.unhcr.org/refugee-statistics/

9. https://data2.unhcr.org/en/situations/ukraine

10. Interactive World Migration Report 2022 (iom.int)

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Refugees, asylum seekers, internally displaced people (IDPs) and migrants often come from communities affected by war, conflict, climate change or economic crisis, with vulnerabilities related to the condition of their journeys such as inadequate access to food and water, sanitation and other basic services.

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Principal health issues that refugees face

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Principal health issues that refugees face

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Country focus: Congo

Congo is a country that is rich in natural resources but facing political instability, insufficient infrastructure and exploitation and is classified as a least developed country (Wikipedia, 2023).

Three common health concerns listed in the Australian practice guide that are likely to be present in people arriving from Congo are Malaria, Schistosomiasis, and Hepatitis C.

Malaria is a potentially life-threatening illness caused by parasites that are spread to humans via infected female mosquito bites (WHO, 2023). All refugees to Australia from Congo are offered a voluntary Departure Health Check, which includes an RDT and treatment if positive in the 72 hours prior to departure (Philips & Francis, n.d.).

Malaria can be treatable, and the most effective medication for Malaria is Artemisinin-based combination therapies (ACT) because of its fast acting (WHO, 2023).

Schistosomiasis is an acute and chronic illness caused by blood flukes. Schistosomiasis leads to over 200,000 deaths in Africa, and Congo is listed as an endemic region for schistosomiasis. All refugees to Australia from and through Congo must undergo blood testing for schistosomiasis serology (Davis et al., n.d.).

The treatment for schistosomiasis is praziquantel, which is effective, reliable, and reasonably priced (WHO, 2023).

Hepatitis C is a viral infected disease that affects the liver and can develop to threaten life. Hepatitis C is transmitted via contact with infected blood, such as sharing needles or syringes, or inappropriate procedures, including blood transfusions. People with refugee backgrounds, including Congo in Australia, should go through screening for HCV to identify the infection (Maclachlan et al., n.d.).

Although no vaccine is available for Hepatitis C, it can be managed with antiviral medications and prevent liver damage. Sofosbuvir and daclatasvir are antiviral medications to treat hepatitis C. Some already have strong immune systems against the infection (WHO, 2023).

Reference

Wikipedia contributors. (2023, October 10). Democratic Republic of the Congo. In Wikipedia, The Free Encyclopedia. Retrieved 10:13, October 11, 2023, from https://en.wikipedia.org/w/index.php?title=Democratic_Republic_of_the_Congo&oldid=1179487535

World Health Organization. (2023). Malaria. https://www.who.int/news-room/fact-sheets/detail/malaria

Phillips, C. Francis, J (n.d.). Malaria. Australian Refugee Health Practice Guide. https://refugeehealthguide.org.au/malaria/

Davis, J. S. Phillips, C. Clifford, V. (n.d.). Schistosomiasis. Recommendations for Comprehensive Post-arrival Health assessment for People from Refugee-like backgrounds. https://refugeehealthguide.org.au/schistosomiasis/

World Health Organization. (2023). schistosomiasis. https://www.who.int/news-room/fact-sheets/detail/schistosomiasis#:~:text=Praziquantel%20is%20the%20recommended%20treatment,initiated%20and%20repeated%20in%20childhood.

Maclachlan, J. Cowie, B. Isaacs, D. Davis, J. S. (n.d.). Hepatitis C. Recommendations for Comprehensive Post-arrival Health assessment for People from Refugee-like backgrounds. https://refugeehealthguide.org.au/hepatitis-c/

World Health Organization. (2023). hepatitis C. https://www.who.int/news-room/fact-sheets/detail/hepatitis-c

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Korean traditional herbal medicine, Hanyak, is a beloved therapy for all generations. Hanyak facilitates plant materials such as flowers, seeds, wild plants, fungi and leaves to boil for a long time to make highly concentrated medicine in the form of bitter taste liquid, and it will help to treat stomach pain, headache, arthritis, and serious diseases such as cancer and infection.

Bhanote, M. Villines, Zawn. (2022). What to know about hanyak. Medical News Today. https://www.medicalnewstoday.com/articles/hanyak

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Jook is the most healing food in Korea when we are sick. Jook, also called congee, is basically made from rice cooked with water until the rice is nice and soft. Jook is a good food option when people are sick. It contains a large amount of water and is easy to digest. My mother made Jook with abalone when I was sick to restore my health.

Lee, J. (n.d). Feeling sick? A healthy bowl of Congee can help.  Shane's Kitchen. https://shaneskitchen.sg/feeling-sick-a-healthy-bowl-of-congee-can-help/#:~:text=Congee%20is%20a%20great%20meal,hydrated%20at%20the%20same%20time.

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Stuck in bed with a horrible cold and feeling sorry for yourself? A bowl of warm, comfort food is the perfect pick-me-up. And what could be more comforting than a piping hot bowl of homemade congee?
It is like a nourishing hug in the form of a meal with all the health benefits that can help you recover from your streaming cold.
When you are sick, it can be uncomfortable to eat solid food, especially when you have a sore throat.
But congees are soup based, so easier to swallow and the warmth of the soup can be soothing for the throat too.
We simply tend to gravitate to liquid foods when we are ill and it is important that we stay hydrated. So, liquid foods are good in that way too.
Congee is a great meal option when you are sick as it can keep you nourished. With its high water content, it can keep you hydrated at the same time.
In fact, for generations, rice congee has been referred to as the "magic soup" or "healing soup." This is because congee has a healing effect for those suffering from the common cold.
The rice is cooked to be very soft, which makes it extremely easy to digest. Eating food that is easy to digest helps to speed up your body's recovery process.
When you are sick and don't feel like getting out of bed to cook yourself some congee, Shane's Kitchen has the solution.
At Shane's Kitchen, we bring you the best congee in Singapore with multiple varieties of flavors and textures not commonly found at hawker stalls here. . Our " Parsnips and Carrots Chicken Congee ", for example, is packed with the goodness of vitamin C, perfect for fighting microbes and shielding the body against various infections. It also has immunity-enhancing nutrients and powerful antiviral, antibacterial, and antifungal properties, which makes it an effective remedy for a fever, common cold, sore throat, and other common cold symptoms.

If you are searching for options for rice congee in Singapore, we are a Congee delivery service in Singapore that can deliver homemade congee right to your doorstep.

Looking for something a little more lightweight as an alternative to congee? Try one of our porridge options. There's Chicken and Kale sweet brown porridge", " Beef and Fennel Millet Porridge", " Salmon and Broccoli wild rice gruel " and so many other varieties that you can try. You will love the unique varieties and flavors from our kitchen.

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Feeling Sick? Healthy Bowl of Congee can Help You

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Are you feeling sick? A healthy bowl of warm and homemade Congee from Shane's Kitchen can help you recover with many health benefits. Contact us now.

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Health concerns in South Korea –  life expectancy in Korea was 82.7 years in 2017. The most common mortality factors in South Korea are CVD, Alzheimer’s disease, ischaemic heart disease and lung cancer.

OECD. (2020). OECD Reviews of Public Health: Korea: A Healthier Tomorrow. OECD Reviews of Public Health. OECD Publishing. Paris. https://www.oecd-ilibrary.org/sites/6e005d47-en/index.html?itemId=/content/component/6e005d47-en

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K-pop is short for Korean popular music as a part of Korean music culture. The term K-pop was created in the 2000s, but it has become popular in the last few years due to superstars BlackPink and BTS. Here is a music video performed by Jungkook from BTS, and this song was on the FIFA World Cup 2022 official soundtrack.

Wikipedia. (2023). k-pop. Wikipedia, The free Encyclopedia. https://en.wikipedia.org/wiki/K-pop

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정국 Jung Kook (of BTS) featuring Fahad Al Kubaisi - Dreamers | FIFA World Cup 2022 Soundtrack

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Health to me means being free from diseases and mental stress to sustain my life happily. I feel healthy when I regularly exercise, eat healthy food, and see little progress in my body. Exercise is the best way to promote a healthy life and reduce the stress of studying.

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On Thanksgiving day in Korea, All family members come to the grandparent's place to spend time together. We eat traditional foods, particularly Songpyeon, made of rice cake with assorted sweets inside. It is a delightful traditional dessert. However, we need to be aware that the calory of nine Songpyeon is equal to a bowl of rice.

Wikipedia. (2023). Songpyeon. In Wikipedia, The Free Encyclopedia. https://en.wikipedia.org/wiki/Songpyeon

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A ssrireum match at Gyeongju Citizens' Athletics Festival in 2008

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Korean wrestling, Ssireum, is a traditional national sport of Korea. Each contestant wraps Satba (belt) around the waist and the thigh to hold each other to knock out. When one of the contestants’ body touches the ground, the one loses the game. Ssireum offers increases in mental and physical health.

Unesco Intangible Cultural Heritage. (2018). Traditional Korean Wrestling (Ssirum/Ssireum). https://ich.unesco.org/en/RL/traditional-korean-wrestling-ssirum-ssireum-01533#:~:text=As%20an%20approachable%20sport%20involving,improving%20mental%20and%20physical%20health.