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My family and I on our very first holiday to Australia in 2016 :)

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When the word "health" comes to mind, it is usually associated with physical health and wellbeing. I thought the same too, until my beloved father passed away recently due to hypertension that was mainly caused my stress, which culminated into a stroke.

Since my father's passing, I've gained a whole new understanding of what it means to be healthy. To me, being healthy is maintaining the delicate balance of our physical bodies and our conscious minds.

It involves nourishing my body with nutritious food and keeping physically active. More importantly, being healthy also involves prioritising my mental and emotional health, which includes practising self-care and also maintaining meaningful relationships with my loved ones.

Being healthy is the very building block that will enable me to lead a fulfilling life with my family.

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Principal health issues faced by refugees

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Principal health issues faced by refugees

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Country chosen - Afghanistan
Afghanistan is a country located in Central Asia. Afghanistan is currently experiencing several crises including those of humanitarian, economic and political nature due to the Taliban takeover. Since their takeover in 2021, the Taliban have implemented policies that seriously violate basic human rights, especially those of women and girls, restricting their movement, education and healthcare access.

Australia is seeing a large influx of Afghan refugees seeking to escape the Taliban's rebellion. The Australian government has allocated a large number of visa places for Afghans to migrate to Australia under the Offshore Humanitarian Program.

Department of Foreign Affairs and Trade. (2021). Afghanistan. https://www.dfat.gov.au/geo/afghanistan#:~:text=Political%20situation,Kabul%20on%2015%20August%202021

Human Rights Watch. (2023). World Report 2023: Afghanistan. https://www.hrw.org/world-report/2023/country-chapters/afghanistan#:~:text=Afghanistan's%20humanitarian%20crisis%20worsened%20in,endure%20whole%20days%20without%20eating

3 Principal Health Issues faced by Afghan refugees to Australia include:

1. Malaria - Malaria is a life-threatening disease caused by a mosquito-spread parasitic protozoal infection. Afghan refugees to Australia should be screened as Afghanistan is considered to be an endemic malaria area. If diagnosed with Malaria, one should see a doctor immediately for further treatment options.

Fact sheet about malaria. (2023, March 29). World Health Organization (WHO). https://www.who.int/news-room/fact-sheets/detail/malaria

Malaria » Australian refugee health. (n.d.). Australian Refugee Health » Primary Care for People of Refugee Backgrounds. https://refugeehealthguide.org.au/malaria/
Afghanistan. (n.d.). https://www.smartraveller.gov.au/destinations/asia/afghanistan

2. Polio - Polio is a highly infectious viral disease that attacks the nervous system. It mainly affects children under 5 years of age. Afghanistan is one of the two remaining polio endemic countries in the world. Treatments such as heat and physical therapy are used to help alleviate Polio symptoms. Immunisation is crucial to protect a child from Polio.

Poliomyelitis (polio). (2019, November 18). World Health Organization (WHO). https://www.who.int/health-topics/poliomyelitis#tab=tab_3

Poliomyelitis. (2022, July 4). World Health Organization (WHO). https://www.who.int/news-room/fact-sheets/detail/poliomyelitis
Afghanistan. (n.d.). https://www.smartraveller.gov.au/destinations/asia/afghanistan

3. Post Traumatic Stress Disorder (PTSD) - A study conducted among Afghan refugees showed that nearly half displayed clinical symptoms of PTSD, reporting that they experienced a traumatic event. Refugees suffering from PSTD should be advised to seek help from professionals to speak to.

Slewa-Younan, S., Yaser, A., Guajardo, M. G., 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). https://doi.org/10.1186/s13033-017-0157-z

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Laksa prepared by my mum, Angeline Teo. Nothing is more comforting than a bowl of Mum's laksa! 

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No other dish encapsulates the coming together of the different cultures in Malaysia better than Laksa.

Laksa is a spicy noodle dish with a coconut milk broth, commonly topped with beansprouts, chicken and prawns. Despite being a spicy dish, it is usually eaten by locals for breakfast.

Laksa is a go-to meal for Malaysians when we are in need of a well-balanced meal. Laksa consists of ingredients that are sustainably sourced and which also allows us to support our local farmers and businesses.

Recipe below

Ingredients:
CHICKEN STOCK

750 ml chicken stock

3 chicken drumsticks

LAKSA BROTH

1 1/2 tbsp oil

2 garlic cloves , minced

2 cm ginger , finely grated

1 lemongrass , white part grated

2 birds eye chillis , finely chopped

175g store bought Malaysian laksa paste

400g coconut milk

2 tsp fish sauce

NOODLES + TOPPINGS

50g vermicelli noodles ,

100g hokkien noodles

80g bean sprouts

80g tofu puffs , cut in half

GARNISHES

Fresh coriander

Lime wedges

Instructions

CHICKEN STOCK

Place Chicken Stock ingredients in a medium saucepan over high heat. Bring to simmer,

and cook for chicken drumsticks and prawns for 25 minutes.

Discard skin, pull flesh off the bone and place in bowl, discard bone. Set broth aside.

LAKSA BROTH

Heat oil in a large saucepan or small pot over medium low heat. Add garlic and ginger, sauté for 20 seconds, then add lemongrass and chillis. Cook for 1 minute.

Add laksa paste. Turn heat up to medium and cook for 2 minutes, stirring constantly, or until fragrant.

Add chicken stock, coconut milk and fish sauce. Place lid on and simmer on for 10 minutes.

Adjust to taste using lime juice (for sour) and fish sauce (for saltiness). Add tofu puffs. Leave on turned off stove with lid on for 5 minutes.

ASSEMBLY

Prepare noodles per packet directions.

Divide noodles between 2 bowls. Top with shredded chicken and prawns.

Pour broth over chicken. Top with beansprouts and coriander.

NUTRITION INFORMATION:

(Serves 2)

Serving:582g

Calories:780cal (39%)

Carbohydrates:36.8g (12%)

Protein:18.9g (38%)

Fat:62.9g (97%)

Saturated Fat:37.9g (237%)

Trans Fat:0.1g

Cholesterol:35mg (12%)

Sodium:2374mg (103%)

Potassium:775mg (22%)

Fiber:4.5g (19%)

Sugar:6.1g (7%)

Vitamin A:50IU (1%)

Vitamin C:26.4mg (32%)

Calcium:60mg (6%)

Iron:6.3mg (35%)

Nagi. (2023, May 10). Laksa noodle soup. RecipeTin Eats. https://www.recipetineats.com/laksa-soup/

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The "Penan Women Project" supports the women of the Penan tribe by promoting their traditional craft.

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How basket-weaving is helping Malaysia's displaced Penan people. (2016, November 6). The Observers - France 24. https://observers.france24.com/en/20161025-malaysia-deforestation-tribes-baskets-humanitarian

Our story. (n.d.).
https://helpinghandspenan.com/about/

(n.d.). Penan Women Project. https://www.penanwomenproject.com/

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Screenshot taken from page 30 of Culturally Responsive Clinical Practice:Working with People from Migrant and Refugee Backgrounds Competency Standards Framework

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After reading about the different standards in Domain 7, I aim to apply standard 12.1 in my future practice as a nurse. For me, the most significant aspect of this was that I learnt the importance of understanding my own cultural identity. Initially, I was unaware of the significance in being culturally aware but having learnt about the competency standards, I will now be able to develop deeper sense of empathy towards others. I have also learnt that it is vital for me to keep an open mind, free of biases. Because I have yet to experience interactions with patients in a clinical setting, I will need to remind myself of the importance of being culturally aware towards my patients and to practising active listening to better tailor care around their needs. Going forward, I will keep in mind that being culturally sensitive will promote inclusivity and patient-centred care.

Migrant & Refugee Women's Health Partnership. (2019, January). Culturally Responsive Clinical Practice: Working with People from Migrant and Refugee Backgrounds. 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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Growing up in a Malaysian Chinese household, we always had a bag of dried Chrysanthemum flowers for making tea. Chrysanthemum tea or Ju Hua Cha (菊花茶) as it is called in Mandarin, is known for its cooling properties. It is also believed to support a healthy immune system, improve eye health and aids in detoxification.

Shahrajabian, M. H., Sun, W., Zandi, P. (2019). A review of Chrysantemum, the eastern queen in Traditional Chinese Medicine with healing power in modern pharmaceutical sciences. DOI:10.15666/aeer/1706_1335513369

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Photo of me & taken by myself, Avanny Sim wearing a traditional attire called "Kebaya" which consists of a long sleeve blouse paired with a batik skirt. 

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The wallpaper that I have chosen for my blog is a Malaysian fabric pattern called "batik". Batik is a form of textile art that has a long standing history in Malaysia. To create a batik pattern, the artist has to go through an arduous process of repeatedly dyeing and waxing fabric, as wax acts as a colour blocker, hence creating a complicated but unique design.

Batik fabric is known for being very cooling in the hot and humid Malaysian weather. It is not as commonly worn now as it once was, but one can still be seen wearing batik to formal events.

Wallpaper photo exported from @rizalfaridz71 https://www.shutterstock.com/image-photo/pattern-beautiful-asean-traditional-batik-312357179
A colorful history of batik - FAQ | FAQ | Wonderful Malaysia. (2016, June 24). Wonderful Malaysia | Travel Guide to the beautiful country of Malaysia. https://www.wonderfulmalaysia.com/faq/a-colorful-history-of-batik.htm

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Social Determinants of Health and its impact on migrants and refugees in Australia

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References

Australian Human Rights Commission. (2014). 13 Continuing impacts on children once released. https://humanrights.gov.au/our-work/projects/13-continuing-impacts-children-once-released#:~:text=More%20than%20half%20of%20all,%2C%20nightmares%20and%20self%2Dharming

Australian Institute of Health and Welfare. (2018). 4.2 Social Determinants of Health. https://www.aihw.gov.au/getmedia/746ded57-183a-40e9-8bdb-828e21203175/aihw-aus-221-chapter-4-2.pdf.aspx

Parliament of Australia. (n.d.). Chapter 3 Health and Wellbeing Impacts. https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Job_Security/JobSecurity/Fourth_Interim_Report/section?id=committees%2Freportsen%2F024780%2F78097

Social determinants of health. (2019, May 30). World Health Organization (WHO). https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1

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Video taken by me, Avanny Sim, January 2023

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As a Malaysian Chinese, the festivity that I look forward to most every year is Chinese New Year or 新年 in Mandarin. Chinese New Year (CNY) is the celebration of spring (春）and the mark of the new year, according to the traditional Chinese lunar calendar.

One of the most memorable aspects of CNY for me is the family reunion dinner (團圓飯) on eve of CNY as my family and I would prepare a large feast for all our extended family members. After dinner, the adults would give out red envelopes (紅包) containing money as a symbol of good luck for children and elderly family members. In return, children wish adults and the elderly good health.

Once the clock strikes 12am, we would light fireworks as legend goes, the loud noise from the fireworks will ward off evil spirits, setting the tone for a smooth new year. As a child and even now, I am still mesmerised by the beauty and lively atmosphere when the fireworks go off.

How do people celebrate Chinese new year? (n.d.). Royal Museums Greenwich. https://www.rmg.co.uk/stories/topics/how-do-people-celebrate-chinese-new-year

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Photo taken by me, Avanny Sim, of Carpenter Street in Kuching, Malaysia where shop signboards typically consist of two or more languages. 

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Due to the assimilation of the different races and cultures in Malaysia, it is not uncommon for the typical Malaysian to be multilingual.

In Malaysia, subjects in school are mainly taught in English, hence, most Malaysians are fluent in English. Malay is also a mandatory language for us to learn all throughout primary and secondary education. Being ethically Chinese, I speak a mixture of English, Mandarin and a Chinese dialect called Hokkien at home. However, the lingua franca in Malaysia can either be Malay or English.