# data[].attributes.attachment_caption
Cecil, C. O. (2011). Myanmar, Burma. Offerings to Statues Representing Local Nats (Spirits) in a Shrine, Mount Popa Monastery. Alarmy Stock Photo. https://www.alamy.com/stock-photo-myanmar-burma-offerings-to-statues-representing-local-nats-spirits-49998481.html

# data[].attributes.body
Worship of nats is a traditional practice by Burmese individuals. Prior to the introduction of Buddhism, the Burmese followed animism which is a spiritual and supernatural belief. ‘Although they are not a part of Buddhism, nats are an important part of everyday life all over Burma,’ as mentioned by (Casino, 1997).  Spirits are known as nats. It is believed that some nats live in heaven possessing godlike attributes, others on earth as elements and forces, and some nats are souls of the Burmese ancestors who died brutally. Burmese people worship and gift offerings such as food to the nats in order to receive good fortune and be protected from danger.

Casino, E. S. (1997). Burma and the Burmese: A Historical Perspective. https://scholarspace.manoa.hawaii.edu/server/api/core/bitstreams/8dd2d2e1-b9e9-444f-8716-82274441603f/content

# data[].attributes.attachment_caption
Thant, H. H. (2013). The Fragrance of Thanaka. Network of Myanmar American Assosiation. https://netmaa.org/the-fragrance-of-thanaka/

# data[].attributes.body
Thanaka paste is traditionally used by Burmese of all ages as makeup, sun protection and skin care. It is also used to treat diseases and repel insects. Bark from thanaka, a Southeast Asian tree, is ground into powder and then mixed with water forming the yellow paste. (Lim et al., 2021) studied that for over 2000 years thanaka powder has been utilised as traditional cosmetic and skincare product. The Burmese are known for their beautiful skin, believed from wearing thanaka paste as a skin conditioner, which is thought to prevent acne, smoothen skin and provide protection from the sun also mentioned by (Lim et al., 2021).

Lim, M. W., Aroua, M. K., & Gew, L. T. (2021). Thanaka (H. crenulata, N. crenulata, L. acidissima L.): A Systematic Review of Its Chemical, Biological Properties and Cosmeceutical Applications. Cosmetics, 8(3), 68. https://doi.org/10.3390/cosmetics8030068

# data[].attributes.attachment_caption
Burmese Lesson. (2014, 13 May). Learn Burmese Language – Greetings in Burmese. [Video]. https://www.youtube.com/watch?v=SJLJ1CuEmSE

# data[].attributes.body
The national language of Myanmar is Burmese with 47 million speakers as stated by (Wheatley, 2009). According to (Jenny, 2017) the language consists of several sounds that are foreign in English. There are a number of beginning consonants that are absent in Western languages. In addition to this, their sentences do not finish with consonants. Burmese has both nasal and oral vowels which differ from each other. The word order and grammatical structure significantly differ from English. The region of origin for certain sounds such as ‘ch’ is at the back of the mouth.

Jenny, M. (2017). Burmese: A comprehensive grammar. Routledge.

Wheatley, J. K. (2009). The world's major languages. Routledge.

# data[].attributes.body
"Social inclusion and non-discrimination," a social determinant, is essential to the community's overall mental health, reports (Department of Health, 2012). (Ziersch et al., 2020) undertook a study in a small south Australian town, and revealed that refugees from Southeast Asia experienced racism in their everyday lives, and a limited employment access due to discrimination. Feelings of being unwelcome and unsafe in their community, as well as depression are linked to these negative experiences. An individual’s overall health is impacted by depression. According to (Cassano & Fava, 2002) depression occurs alongside symptoms such as insomnia, fatigue, loss or increased appetite, weight changes, difficulty concentrating/thinking, anxiety, worthlessness feelings, guilt and suicidal thoughts.

Cassano, P., & Fava, M. (2002). Depression and public health: An overview. Journal of Psychosomatic Research, 53(4), 849–857. https://doi.org/10.1016/S0022-3999(02)00304-5

Department of Health. (2012). Part II: Non-discrimination and social inclusion. Australian Government. https://www1.health.gov.au/internet/publications/publishing.nsf/Content/pub-sqps-rights-toc~pub-sqps-rights-2

Ziersch, A., Miller, E., Baak, M., & Mwanri, L. (2020). Integration and social determinants of health and wellbeing for people from refugee backgrounds resettled in a rural town in South Australia: a qualitative study. BMC Public Health, 20(1), 1–16. https://doi.org/10.1186/s12889-020-09724-z

# data[].attributes.body
According to (Chaves et al., 2009) 80% of Burmese refugees tested in Melbourne tertiary referral hospital were infected with Helicobacter Pylori. Helicobacter pylori is a bacterial stomach infection. Individuals most commonly become infected during childhood through direct contact, and it lasts for decades. Chronic gastrointestinal inflammation, stomach ulcers, and gastrointestinal cancer are associated with the H. Pylori infection, as claimed by (Schulz et al., n.d.). (Bravo et al., 2018) suggests that only a small percentage of infected people acquire complications. Diagnostic options include a stool test, breath test, blood test, and a gastroscopy. Treatment for adults consists of proton pump inhibitor (PPI), amoxicillin and clarithromycin, for 7 days. Children, however, require a 14-day treatment. After treatment another test must be completed to assess for eradication of the bacteria.

Bravo, D., Hoare, A., Soto, C., Valenzuela, M. A., & Quest, A. F. (2018). Helicobacter pylori in human health and disease: Mechanisms for local gastric and systemic effects. World journal of gastroenterology, 24(28), 3071–3089. https://doi.org/10.3748/wjg.v24.i28.3071

Chaves, N. J., Gibney, K. B., Leder, K., O’Brien, D. P., Marshall, C., & Biggs, B.-A. (2009). Screening Practices for Infectious Diseases among Burmese Refugees in Australia. Emerging Infectious Diseases, 15(11), 1769–1772. https://doi.org/10.3201/eid1511.090777

Schulz, T., Kay, M., & Cherian, S. (n.d.). Helicobacter Pylori. Australian Refugee Health Practice Guide. https://refugeehealthguide.org.au/helicobacter-pylori/

# data[].attributes.body
For me the most significant aspect from the (Competency Standards Framework, 2019) is standard 2.1. I have developed my understanding of the unique Burmese language, and I recognised I will face struggles while communicating for informed consent. After my analysis I now know that I must apply this standard to avoid lack of patient understanding, invalid consent and spread of misinformation. This understanding is essential for me as I can avoid these complications by engaging with professional interpreters and provide the patient with information written in their language. Later, I realised these implications could allow the patient to deepen their knowledge by asking open ended questions. I feel that this will enable the patient to have a comprehensive understanding of the risks and benefits involved and give informed consent.

Competency Standards Framework for Clinicians. (2019). Culturally Responsive Clinical Practice: Working with People from Migrant and Refugee Backgrounds. Migrant & Refugee Women’s Health Partnership. https://culturaldiversityhealth.org.au/wp-content/uploads/2023/04/Culturally-responsive-clinical-practice-Working-with-people-from-migrant-and-refugee-backgrounds-Jan2019.pdf

# data[].attributes.body
In Burma, traditional medicine plays a major role in healthcare. (Wodniak, 2015) found 271 natural medicines used by Burmese refugees to treat their illnesses and conditions. According to (Awale et al., 2006) in Thandwe, a remote village in Myanmar (Burma), a 75-year-old practitioner, U Tun Sein, effectively treats paralysis through traditional medicine that has been passed down through generations. His techniques to cure paralysis and nervous diseases were taught by Buddhist monks, he has been applying their techniques for 45 years. Lemon, ginger and Alpinia conchigera Griff are mixed, and he uses the ethanol extract. The ethanol extract is applied to the patient’s paralysed limb with a copper needle.

Awale, S., Linn, T. Z., Than, M. M. (2006). The healing art of traditional medicines in Myanmar. Medical and Pharmaceutical Society for WAKAN-YAKU, 23, 47-68.

Wodniak, N. (2015). Burmese Refugee Health: The Value of Plant-Based Medicine. Fordham Research Commons. https://fordham.bepress.com/environ_2015/50