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Health to me means being in a physical and mental state which allows me to enjoy all aspects of life. I feel healthy when I have access to fresh food, my body is functioning well, and when my mind feels calm.

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Impact of Social Determinants on Refugees in Australia

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Impact of Social Determinants on Refugees in Australia

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South Sudan located in North Africa is one of the least developed countries in the world and is the country of origin for 2.4 million refugees who have fled to Australia (Australian Red Cross, 2023). South Sudan is the newest country in the world, established in 2011 after a delay civil war. In 2013, conflict broke out within the country leading to armed dispute, economic decline, disease and hunger (UNHCR, 2023).

85% of South Sudanese are women and children, fleeing to Australia to escape violent attacks and sexual assault. In South Sudan, poverty, religious views and child marriage hinders young girls opportunity for education and subsequently any chance for a fulfilling life.

Three common health concerns listed in the Australian Refugee Health Practice Guide that are likely to be present in refugees arriving from South Sudan include poor oral health, malaria, and a lack of immunisation (WHO, 2023).

Poor oral health among refugees can include dental caries, missing teeth, periodontal disease, orofacial trauma, or oral cancers. The first step in assessing refugees for signs of poor oral health is to ask the client if they have any concerns regarding their teeth and gums, followed by inspecting their oral cavity looking for any of the above indicators, and asking whether they experience difficulty sleeping or chewing foods as this is an indication of chronic pain (Australian Refugee Health Practice Guide, 2023).

Malaria is a mosquito-spread parasitic protozoal infection caused by the genius Plasmodium (Australian Refugee Practice Guide, 2023). It was estimated in 2021 by the World Malaria Report that approximately 8750 malaria cases and 20 deaths are reported daily in South Sudan, putting the country among one of the highest Malaria incidence in the region (WHO, 2023).

Refugees are at significant risk of being unimmunised or under-immunised when arriving in Australia. According to the WHO 2023, 50-98% of adult refugees from African countries and 90-98% of child refugees (from mixed cohorts) have incomplete immunisation according to the Australian schedule. Most refugees do not have evidence of vaccinations and therefore catch up immunisations must be followed up.

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The Impact of WHO Social Determinants on Refugees from South Sudan 

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The Impact of WHO Social Determinants on Refugees from South Sudan 

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According to the WHO, social determinants of health (SDH) are  non-medical factors that influence health outcomes including the conditions in which people are born, grow, work, live and age. The SDH have a huge influence of health inequalities, the lower an individuals socioeconomic position, the worse their health.

Food insecurity is a SDH defined as limited access to nutritionally adequate and safe foods or the inability to acquire foods in a socially acceptable way (Australian Institute of Family Studies, 2011). It is extremely common for refugees from South Sudan to be impacted by food insecurity in fact, over 7.8 million South Sudanese people are expected to fall short of their minimum food requirements in 2023 - greater than the widespread hunger experienced during the Civil War (International Rescue Committee, 2023).

Access to education is another SDH that is extremely under achieved by people of South Sudan. Currently, 70% of South Sudanese children aren't receiving an in school education (UNICEF, 2023) with only 1% of all children enrolled in schooling being girls. Furthermore, a 2016 study presents that over 70% of the adult population is illiterate (Carillio, 2023). Education is directly linked to achieving a higher quality of life by increasing ones chance of securing employment, stable income, adequate housing, and ensure that individuals can better provide for themselves and their families whilst subsequently, increasing their socioeconomic status and maintaining better health (Australian Institute of Health and Welfare, 2016).

Structural conflict as a SDH is known to be the root of conflict within a country stemming from an organisation with unbalanced power. South Sudan was first established as a country after the 2011 civil war however, in 2013 conflict broke out again leading to a complex and extremely violent situation forcing millions to flee and causing displacement throughout the country (UNHCR, 2023). According to the UN Refugee Agency, South Sudan is experiencing the largest refugee crisis in Africa, and the third largest worldwide. The vast majority of refugees fleeing South Sudan are women and children (83%), almost all are survivors of violent attacks and brutal sexual assault. The instability of South Sudan's government and the outspread of violence across the country is inherently the main contributor to the refugee crisis in Sudan, and is to subsequently to blame for the inadequate health of South Sudanese people.

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Explaining the varied psychosociocultural models and frameworks of health

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Explaining the varied psychosociocultural models and frameworks of health

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Sunshine Spirit co., 2023 - Australian Tea Tree Oil (Melaleuca Alternifolia)

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Traditional medicine practice is a significant part of Aboriginal and Torres Strait Islander culture. Prior to colonisation, bush medicines along with traditional healers and healing songs were primary forms of heal care. Present day practicers of bush medicine offer extensive knowledge that can be used to enhance our understanding of the process of healing (Australian Indigenous InfoNet, 2022).

The tea-tree plant was used by the Bundjalung Aboriginal people from the coast of New South Wales to treat wounds by crushing leaves into a paste and applying it to the wound site, it was also commonly brewed in tea to treat soreness of the throat (Australian Geographic, 2011).

Tea-tree oil has long been regarded as a useful topical antiseptic agent and is often used as a treatment for acne. Since using tea-tree oil myself to treat skin blemishes, I have found that it has an anti-inflammatory effect, helping to soothe and relieve irritations - it is a staple in my skin-care routine.

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Cooking with Nana Ling, 2023 - Pumpkin Scones

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Pumpkin scones are a very special part of my family's culture. One of my dearest childhood memories is of my GG (great-grandma) teaching me her famous pumpkin scone recipe that has been passed down throughout generations. I spent a lot of time as a child visiting my GG, and pumpkin scones were an essential part of every morning tea.

The passing down of recipes and being taught to cook by my loved ones makes me feel a sense of belonging and connect to my family heritage. Although pumpkin scones may not be considered a typical traditional Australian food, cooking and eating them with my family has been apart of my culture ever since I can remember.

Recipe Below:

Ingredients:

2 cups self-raising flour

1 tbsp caster sugar

Pinch of salt

60g Devondale Unsalted Butter, chilled, chopped

1/2 cup buttermilk

1/2 tsp ground nutmeg

2/3 cup mashed cooked butternut pumpkin

Extra buttermilk, for brushing

Recipe:

Preheat oven to 220°C/200°C fan-forced. Line a baking tray with baking paper. Position oven rack in the top half of oven.

Sift flour, nutmeg, sugar and salt into a bowl. Add butter. Using fingertips, rub butter into flour mixture until mixture resembles fine breadcrumbs.

Make a well in centre of mixture. Add buttermilkand pumpkin. Using a flat-bladed knife, stir until a sticky dough forms. Turn out onto a lightly floured surface. Knead gently until just smooth.

Using a lightly floured rolling pin, gently roll dough out until 2cm thick. Using a 6cm fluted-edge cutter, cut out scones. Press leftover dough together. Repeat to make 12 scones.

Place scones, just touching, on prepared tray. Brush with buttermilk. Bake for 12 to 15 minutes or until golden and hollow when tapped on top.

Nutritional Information Per Serving:
Serving = 1 Scone

Calories | 1165
% Daily Value*
Total Fat 15.4g | 20%
Saturated Fat 9.6g | 48%
Cholesterol 35mg | 12%
Sodium 297mg | 13%
Total Carbohydrate 222.4g | 81%
Dietary Fiber 11.7g | 42%
Total Sugars 24.3g |
Protein 31.7g |  Vitamin D 0mcg | 0%
Calcium 224mg | 17%
Iron 14mg | 78%
Potassium 793mg | 17%

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Image I took at the Spacey Jane concert, 2021

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Music is a part of culture as it bings people together and creates shared experiences. As a young adult living in Australia, music is a part of my culture as I love going to concerts, festivals and seeing local Perth bands. I enjoy seeing live music with my friends, I feel that it is a way I can express myself, and it makes up a part of my identity. Going to local Perth gigs is one of my favourite hobbies, listening to music, dancing and connecting with others brings me a sense of belonging and makes me feel connected to my community, supporting my holistic health.

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Positively Osceola, 2022 - Blue Manna Crab

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Ever since I can remember Blue Manna Crabs or "Blueys" have been somewhat of a delicacy amongst my family. Every summer during crabbing season my Pop takes my Mum a I "scooping" for crabs down in Mandurah. Some of my favourite memories as a child are waking up before sunrise to go crabbing with my Pop, then returning home to help him cook and clean them before sitting down as a family and enjoying fresh crabs for lunch.

Going crabbing and spending time with my family in this way is a huge part of my culture. During this time I am able to unwind and connect with the environment, spend quality time with my family whilst participating in family traditions passed down to me, and eat healthy and delicious fresh food.

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Australian Medical Council Limited. Standards for Assessment and Accreditation of Specialist Medical Education Programs and Professional Development Programs by the Australia Medical Council. 2015

Australian Red Cross. (2023). Refugee and asylum seeker facts. https://www.redcross.org.au/act/help-refugees/refugee-facts/

Brady, B., Veljanova, I., & Chipchase, L. (2016). Culturally informed practice and physiotherapy.

Journal of physiotherapy,

62(3), 121-123.

Carillo, M. (2023). The Borgen Project. Literacy in South Sudan. https://borgenproject.org/illiteracy-in-south-sudan/#:~:text=Lack%20of%20education%20can%20contribute,a%20cycle%20of%20social%20oppression.

Chaves, N., Gardiner, J & Narayanasamy, S. Australian Refugee Health Practice Guide. (2023). Hearing, Vision and Oral Health. https://refugeehealthguide.org.au/hearing-vision-and-oral-health/

Hayes, Helen. (2023). Australian Geographic. Top 10 Aboriginal Bush Medicines.

https://www.australiangeographic.com.au/topics/history-culture/2011/02/top-10-aboriginal-bush-medicines/

International Rescue Committee. (2023). South Sudan: Hunger, conflict and climate crisis. https://www.rescue.org/article/south-sudan-hunger-conflict-and-climate-crisis#:~:text=Food%20insecurity%20will%20force%20more,after%20being%20treated%20for%20malnutrition.

National Museum of Australia. (2023). Discovering the beach. https://www.nma.gov.au/exhibitions/between-the-flags/discovering-beach#:~:text=Seaside%20resorts%20appeared%20around%20the,%2C%20freedom%2C%20independence%20and%20enjoyment.

Rosier, Kate. (2011). Communities and Families Clearinghouse Australia. Food insecurity in Australia - What is it, who experiences it and how can child and family services support families who are experiencing it?. https://aifs.gov.au/resources/practice-guides/food-insecurity-australia-what-it-who-experiences-it-and-how-can-child

USA for UNCR The UN Refugee Agency. (2023). South Sudan Refugee Crisis Explained. https://www.unrefugees.org/news/south-sudan-refugee-crisis-explained/#:~:text=The%20vast%20majority%20(over%2083,parents%20and%20are%20traveling%20alone

Sandbu Ryeng, H. (2020). UNICEF | South Sudan. Malaria Season – Rain and flooding are causing Malaria surges. https://www.unicef.org/southsudan/stories/malaria-season

World Health Organisation. (2023). Social determinants of health. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1

World Health Organisation | Regional Offices for Africa. (2023). Health Topics (South Sudan). https://www.afro.who.int/countries/south-sudan/topic/health-topics-south-sudan

World Health Organisation | Regional Offices for Africa. (2023). South Sudan marks Malaria Day with calls for robust multisectoral actions to reduce the Malaria burden. https://www.afro.who.int/countries/south-sudan/news/south-sudan-marks-malaria-day-calls-robust-multisectoral-actions-reduce-malaria-burden#:~:text=The%20World%20Malaria%20Report%202021,malaria%20incidence%20in%20the%20region