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Zidane Rigzyan Nidup born on 15th of May,2023 in Perth,WA

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To me, health is embodied in my newborn, who was born healthy in Australia.

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To me, health is embodied in my newborn, who was born healthy in Australia.

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KINGDOM OF BHUTAN

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Picture courtesy Bhutan daily, Kuensel online (Newspaper, n.d.)

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Jigme Khesar Namgyel Wangchuck, the monarch and Her Majesty Queen Jetsun Pema

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Jigme Khesar Namgyel Wangchuck, the monarch and Her Majesty Queen Jetsun Pema

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For the people of Bhutan, our King and Queen are the embodiment of dignity, grace and compassion (Quintino, 2018). His Majesty has been at the forefront throughout our battle with the COVID-19 pandemic, tirelessly walking the ground looking after the people and protecting the lives of the Bhutanese.

Newspaper, B. D. (n.d.). The People’s King. Kuensel Online. Retrieved October 11, 2023, from https://kuenselonline.com/the-peoples-king/

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Indians make up one of the largest immigrant communities in Australia, a country recognized for its vibrant multiculturalism (du Plooy et al., 2020). The country's friendly residents, magnificent natural scenery, and world-class cities increase its appeal as a place to live. The spectrum of social determinants unfolds as waves of refugees and migrants from India settle in Australia, influencing their health and well-being in a variety of ways (Chang, 2019). Rooted in the frameworks identified by the World Health Organization (World Health Organization, 2022), these determinants extend from tangible aspects like income to intangible dimensions like social inclusion.

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With an emphasis on social protection and income, education, and social inclusion and non-discrimination:
Income and Social Protection: For migrants, a lack of money and social protection might limit their access to necessary medical care and lead to stress-related health problems.
Education: Education influences health outcomes by influencing employment options and making it easier to navigate the healthcare system, although language problems may make it difficult to effectively manage one's health.
Social inclusion and non-discrimination: Being socially excluded or subjected to discrimination can affect one's mental health and make it more difficult to get the necessary medical care.

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Picture taken by myself Sangay Gyalmo, during our festive called Losar, 2017

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Bhutanese food is renowned for its spiciness; the majority of dishes are flavorful with copious amounts of cheese and chilies. The staples of the diet are beef, rice, and veggies. Red rice is a common component that is frequently served with a variety of side dishes that are either comprised of meat or vegetables.

Bhutan's national cuisine is Ema Datshi, a hot stew consisting primarily of cheese and jalapeño peppers. In Dzongkha, "Ema" denotes chilli and "Datshi" cheese. It combines the smoky heat of chillies with the rich, savoury notes of cheese, embodying the substantial, rich flavours that are distinctive to Bhutanese cuisine.

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Health, to me, means complete well-being: physically, mentally, and socially. It's not just being free from illness; it's also having a balanced life and equal opportunities to thrive. Nursing has taught me that health is complicated and intricately connected to our emotions and society. I view health through the prism of community and social circumstances, ensuring that it is equitable and accessible for everyone. This viewpoint guides my nursing practice to not only heal physical conditions but also to support and stand up for the mental and social well-being of my patients, understanding how closely they’re connected.

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Health issues faced by Indian immigrants

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Health issues faced by Indian immigrants

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Indian immigrants set out on their migration adventure and weaved themselves into Australia's ethnic fabric, bringing with them a variety of health requirements and concerns (Lis de Vries et al., 2017). In keeping with the principles of useful healthcare manuals, such as the "Australian Refugee Health Practice Guide," I investigated three common health problems Indian immigrants can experience upon arrival and looked at possible cures for each.

1. Concerns about mental health

Indian immigrants may face stress, anxiety, and isolation, which are often underaddressed due to the stigma prevalent in some Indian communities. Immigrants may develop mental health problems due to navigating the maze of resettling (Shawyer et al., 2017).

Psychological counselling is a treatment option.
A safe environment can be created for immigrants by enrolling in psychological counselling sessions, which can offer coping mechanisms and ways to handle stress and anxiety during the transition period (McDonough & Colucci, 2019).

2. Nutritional Inadequacies

Anemia and vitamin D deficiency, which are frequent among people from the Indian subcontinent, could develop as a result of a change in dietary habits combined with the stress of immigration (Baauw et al., 2019).

Nutritional therapy is a potential treatment.
Working with a nutritionist or dietician can be helpful in creating a balanced meal plan that fills in nutritional gaps and may include supplements to make up for any deficiencies and improve general physical health.

3. Non-communicable chronic diseases (NCDs)

Chronic NCDs, including diabetes and cardiovascular illnesses, which are common in India due to genetic and lifestyle factors, may be present in Indian immigrants (Agyemang & van den Born, 2019).

Option for treatment: medication management and lifestyle changes
A comprehensive evaluation by a medical professional enables the development of a management strategy that includes the right medication and lifestyle changes, including food and exercise, to manage and control the progression of NCDs.

Setting Out on a Healthy Journey

The investigation and treatment of these health issues not only help Indian immigrants integrate healthfully into Australian society, but they also improve healthcare practices by identifying and treating the various health demands that multicultural societies present.

Steps to take

Community Health Workshops: Holding sessions to inform immigrants about navigating Australia's healthcare system and being aware of the resources available (Riza et al., 2020).
Encourage healthcare personnel to complete cultural competency training in order to comprehend and respond to the particular demands and complexities of Indian immigrants.
Peer Support Groups: Creating peer support groups that address the unique linguistic and cultural requirements of Indian immigrants and provide a forum for advice and the sharing of experiences (Lau et al., 2018).

Agyemang, C., & van den Born, B.-J. (2019). Non-communicable diseases in migrants: an expert review. Journal of Travel Medicine, 26(2). https://doi.org/10.1093/jtm/tay107

Baauw, A., Kist-van Holthe, J., Slattery, B., Heymans, M., Chinapaw, M., & van Goudoever, H. (2019). Health needs of refugee children identified on arrival in reception countries: a systematic review and meta-analysis. BMJ Paediatrics Open, 3(1), e000516. https://doi.org/10.1136/bmjpo-2019-000516

Chang, C. D. (2019). Social determinants of health and health disparities among immigrants and their children. Current Problems in Pediatric and Adolescent Health Care, 49(1), 23–30. https://doi.org/10.1016/j.cppeds.2018.11.009

du Plooy, D. R., Lyons, A., & Kashima, E. S. (2020). Social capital and the well-being of migrants to Australia: Exploring the role of generalised trust and social network resources. International Journal of Intercultural Relations, 79, 1–12. https://doi.org/10.1016/j.ijintrel.2020.07.001

Lau, W., Silove, D., Edwards, B., Forbes, D., Bryant, R., McFarlane, A., Hadzi-Pavlovic, D., Steel, Z., Nickerson, A., Van Hooff, M., Felmingham, K., Cowlishaw, S., Alkemade, N., Kartal, D., & O’Donnell, M. (2018). Adjustment of refugee children and adolescents in Australia: outcomes from wave three of the Building a New Life in Australia study. BMC Medicine, 16(1). https://doi.org/10.1186/s12916-018-1124-5

Lis de Vries, Roman, M., & Briskman, L. (2017). Building strengths in asylum-seeker communities in Australia. Policy Press EBooks, 231–244. https://doi.org/10.51952/9781447333753.ch014

McDonough, S., & Colucci, E. (2019). People of immigrant and refugee background sharing experiences of mental health recovery: reflections and recommendations on using digital storytelling. Visual Communication, 20(1), 147035721882065. https://doi.org/10.1177/1470357218820651

Riza, E., Kalkman, S., Coritsidis, A., Koubardas, S., Vassiliu, S., Lazarou, D., Karnaki, P., Zota, D., Kantzanou, M., Psaltopoulou, T., & Linos, A. (2020). Community-Based Healthcare for Migrants and Refugees: A Scoping Literature Review of Best Practices. Healthcare, 8(2), 115. https://doi.org/10.3390/healthcare8020115

Shawyer, F., Enticott, J. C., Block, A. A., Cheng, I-Hao., & Meadows, G. N. (2017). The mental health status of refugees and asylum seekers attending a refugee health clinic including comparisons with a matched sample of Australian-born residents. BMC Psychiatry, 17(1). https://doi.org/10.1186/s12888-017-1239-9

World Health Organization. (2022, February 3). Determinants of health. Who.int. https://www.who.int

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Picture from Thimphu Lhamoi Drupchoe, 2023.

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Festival season at Capital City, Thimphu.

Tsechu is a religious gathering that includes elaborate costumes, and communal feasting, and plays a crucial role in social interaction and the upkeep of Bhutanese customs, beliefs, and cultural practices (Suntikul, 2018).

Tsechu serves as a vehicle for religious expression and makes a significant contribution to the preservation and dissemination of Bhutan's rich cultural and spiritual heritage to younger generations and beyond the country's borders through its rich tapestry of spiritual devotion, communal harmony, and cultural display (Wangdi et al., 2021). It's a lovely fusion of sacred and communal, where uplifting social gatherings coexist with profound spiritual rituals.

Quintino, K. (2018). The Kingdom of Bhutan: a democracy by obligation. Revista Portuguesa de Ciência Política, 10, 65–76. https://doi.org/10.33167/2184-2078.rpcp2018.10/pp.65-76

Suntikul, W. (2018). Cultural sustainability and fluidity in Bhutan’s traditional festivals. Journal of Sustainable Tourism, 26(12), 2102–2116. https://doi.org/10.1080/09669582.2018.1533021

Wangdi, J., Dorji, T., & Wangchuk, K. (2021). Setting the mountain ablaze? The Royal Highland Festival in Bhutan from the semi-nomads’ perspective. Pastoralism, 11(1). https://doi.org/10.1186/s13570-021-00196-3

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Butter salt tea prepared by myself, Sangay Gyalmo

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Traditional butter salt tea known as 'Suja'.

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As a Carer working in an old age home, I was introduced to a family with strict religious and cultural dietary restrictions, which posed a challenge in providing nutritious meals within the hospital’s offerings.

This pivotal encounter underscored the necessity of comprehensive cultural understanding in nursing care. Consequently, I enrolled in a course on cultural and religious dietary practices and engaged in dialogues with diverse individuals to glean insights into varied dietary habits.

This enhanced understanding has informed my advocacy for patients' cultural and dietary needs in subsequent placements and will continue to anchor my practice as I evolve from a student to a practising nurse.

Cultural competency, especially respecting and facilitating dietary practices rooted in cultural and religious beliefs, has emerged as an indispensable aspect of providing holistic and empathetic nursing care (Brooks et al., 2019).

According to 12.3 Adherence to Ethical Standards, providing care that is both person-centred and culturally sensitive includes respecting the family's dietary practices, working with them to explore practical meal options inside the facility, and openly communicating any limitations while looking into alternative solutions. As I navigate my nursing journey, Domain 7's principles will guide my ongoing endeavours to embed cultural sensitivity and competency within every facet of patient care.

Brooks, L. A., Manias, E., & Bloomer, M. J. (2019). Culturally sensitive communication in healthcare: A concept analysis. Collegian, 26(3), 383–391. https://doi.org/10.1016/j.colegn.2018.09.007

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Ema Datshi prepared by myself Sangay Gyalmo, 20/08/2023

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Simple Recipe for Ema Datshi formulated by myself in a traditional way and Ingredients:
Prepare the Chilies: Wash and cut Green or red chillies lengthwise or into bite-sized pieces.
Sauté Onions and Garlic: In a pan, heat a small amount of oil and sauté sliced onions and minced garlic until they are soft and aromatic.
Cook the Chilies: Add the sliced chillies to the pan and cook for a few minutes until they start to soften.
Optionally, add sliced tomatoes at this stage and cook until they soften.
Add the Cheese: local cheese from Bhutan (typically a type made from yak or cow's milk), or an alternative like feta or blue cheese. Add the cheese to the pan, stirring it in until it melts and forms a creamy sauce with the vegetables. Add salt to taste.
Serve:
Serve the Ema Datshi hot with a side of red or white rice.