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Picture: Alamy (Afghanistan traditional mud house)

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The people originating from Afghanistan is otherwise known as Afghani. Afghanistan is a landlocked south central Asian country with multi-ethnic society, containing diverse ethnic, linguistic and tribal groups. The most common ethnic groups are Pashtuns along with some significant populations from neighboring countries.

Islam is the official religion of Afghani peoples and 99.7% of populations are Muslim. Moreover, establishment of government as Sunni Islamic Republic has great influence on governing the politics, economic and legal aspects of an Afghan’s life. ("Afghan community profile,")

Afghani consider family as a most important unit in their culture and roles of every members are more defined along traditional lines. Women are generally responsible to undertake household duties, whereas men are the bread winner of the family.

Reference:

1. Afghanistan - Language, culture, customs and etiquette. Experts in Intercultural Communication & Cross Cultural Training. https://www.commisceo-global.com/resources/country-guides/afghanistan-guide

2. Afghan community profile. Find, connect, shape your Victorian Government | vic.gov.au. https://www.vic.gov.au/afghan-community-profile

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Afghans were recruited by British for development of Outback, especially for operation of camel trains in desert areas and reported to have reached Australia in late 19th century. They continued to work until development of railways and motorized road transport. Due to nature of their role, they were often referred as cameleer among the community.

Significant numbers of Afghans people fled as refugees to Australia following 1979 invasion of Afghanistan by the Union of Soviet Socialist Republics (USSR), subsequent civil war in the 1980s and late 1990s Taliban regime 2.

Islam is major religion among immigrated Afghans with small minority of Christians and the Marree Mosque is first mosque to be built by Afghan cameleers in 19th century in Australia. ("Afghan Australians," 2024).

Reference:

1. Afghan Australians. (2024, July 13). Wikipedia, the free encyclopedia. Retrieved August 26, 2024, from https://en.wikipedia.org/wiki/Afghan_Australians

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Although importance of modern medicine is being integrated in the Afghani community for the wellbeing of the citizens, the influence of health belief in align to Islamic principles and cultural practices among community is still common among the peoples and practices were still comprehended. Community and its people believes sickness as act of god (Allah) and for instance, if someone falls sick they rely of recitation of specific verses from the Quran. However the Health literacy among educated and younger generation is gaining momentum. (Harsch et al., 2017)

Reference:

1. Harsch, S., Jawid, A., Jawid, M., & Bittlingmayer, U. (2017). Health literacy, the role of beliefs and barriers in Afghanistan. A quantitative study. European Journal of Public Health, 27(suppl_3). https://doi.org/10.1093/eurpub/ckx186.228

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The practices of Traditional medicine worldwide is based on believes and natural drugs, particularly of medicinal plants and 80% of world population rely onto it to solve their primary health problems. Afghanistan being mountainous country has a unique flora comprising around 5000 species and various plants were used as medicine to treat numerous health condition since long back and numerous Unani can be seen in operation to this date. The peoples opt for Traditional medicine over synthetic medicines owing to freely availability and low cost. However, in case of severe illness people ought to refer to hospitals and would afford the high prices of modern medicine.

Apart from traditional medicines, people pursued principal based on Islamic religion and cultural to get cured from certain ailments.(MH, 2017)

Reference:

1. MH, A. (2017). Medicinal plants used traditionally in Guldara district of Kabul, Afghanistan. International Journal of Pharmacognosy & Chinese Medicine, 1(3). https://doi.org/10.23880/ipcm-16000118

2. Traditional Use of Medicinal Plants in Afghanistan with Respect to the Kabul and Parwan Regions [Unpublished doctoral dissertation]. (2023).

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“Cultural competence is widely recognized as a critical component of effective and equitable service delivery. The refugee experience challenges accessing services that addresses their individual and cultural needs.”(Lau & Rodgers, 2021).

For me, the above statement signifies importance of Cultural competence in providing clinical services to refugees and asylum seekers. Understanding their part of stories rather than assuming their diversity of individual characteristics and social determinants of health including cultural, religion and choices and preferences could make difference in providing care as per their needs.

This understanding can be implemented to achieve optimal clinical services in my context in providing nursing practices by introducing myself at beginning of conversation and letting them express their own identity, cultural, religious or spiritual and linguistic considerations.

Reference:

1. Lau, L. S., & Rodgers, G. (2021). Cultural competence in refugee service settings: A scoping review. Health Equity, 5(1), 124-134. https://doi.org/10.1089/heq.2020.0094

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Australia grants humanitarian entrants every year and approach to settlement aims not only to achieve full social, economic and civic participation but also to promote their psychosocial health and wellbeing. However, translating their approach is challenged. (Correa-Velez et al., 2010). Although the refugees are granted entry into country, every community welcomes them differently.

The vast annual income variation between Afghani refugees and Australian born citizen posed economic disadvantage for Afghan refugee groups resulting in poor health, including limited access to and utilization of healthcare. (Kavian et al., 2020).

Reference:

1. Kavian, F., Mehta, K., Willis, E., Mwanri, L., Ward, P., & Booth, S. (2020). Migration, stress and the challenges of accessing food: An exploratory study of the experience of recent Afghan women refugees in Adelaide, Australia. International Journal of Environmental Research and Public Health, 17(4), 1379. https://doi.org/10.3390/ijerph17041379

2. Correa-Velez, I., Gifford, S. M., & Barnett, A. G. (2010). Longing to belong: Social inclusion and wellbeing among youth with refugee backgrounds in the first three years in Melbourne, Australia. Social Science & Medicine, 71(8), 1399-1408. https://doi.org/10.1016/j.socscimed.2010.07.018

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Common health issues that Afghani present upon arrival to Australia.

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Common health issues that Afghani present upon arrival to Australia.

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Dyslipidemia and micronutrient deficiencies including Vitamin D deficiencies are significant health issues in recently settled Afghan refugees. According to Australian refugee health practice guide, these conditions can be treated and exerts no common health concerns. (Sanati Pour et al., 2014)

The treatment of those conditions includes restoration through daily dosing or high dosing therapy for those with these conditions and screening and testing for those ethnic groups supposed to be vulnerable. ("Low vitamin D » Australian refugee health,")

Reference:

1.      Low vitamin D » Australian refugee health. (n.d.). https://refugeehealthguide.org.au/low-vitamin-d/

2.      Sanati Pour, M., Kumble, S., Hanieh, S., & Biggs, B. (2014). Prevalence of dyslipidaemia and micronutrient deficiencies among newly arrived Afghan refugees in rural Australia: A cross-sectional study. BMC Public Health, 14(1). https://doi.org/10.1186/1471-2458-14-896