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Culturally Responsive Clinical Practice: Domain 1.2

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Culturally Responsive Clinical Practice: Domain 1.2

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Domain 1.2 references the impact of traumatic experiences on refugees. I have started to develop an understanding of the pressing issue that is the large number of refugees in Australia who still experience the ongoing effects of trauma. This number is estimated at 48.7% experiencing PTSD and 50% experiencing psychological distress, with only 4.6-10% of these people accessing trauma services here in Australia (Tomasi et al., 2020). This knowledge is essential to me in my future workplace as I have not yet learned trauma-informed care; due to this, the risk of unintentionally re-traumatising patients is high, as stated in Domain 1.2. Subsequently, I must expand my understanding further to support all my patients appropriately.

Migrant & refugee. (2019). Culturally responsive clinical practice: Working with people from migrant and refugee backgrounds. Competency standards framework for clinicians.

Tomasi, A., Slewa-Younan, S., Narchal, R., Rioseco, P. (2020). Understanding the mental health and help-seeking behaviours of refugees. https://aifs.gov.au/resources/short-articles/understanding-mental-health-and-help-seeking-behaviours-refugees

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Beliefs Regarding Birthing Practice in Afghan Women

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Beliefs Regarding Birthing Practice in Afghan Women

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Due to cultural and traditional beliefs in many Afghan families, women are reliant on their husband's and his mother's permission for birthing and medical decisions. It is often expected for women to give birth alone in a room, emerging only once they and their newborn are presentable due to the shame of exposing themselves to another person and the expectation that birthing is a natural process that should require no intervention (Thommesen et al., 2020). Many women recounted being denied access to care or refusing themselves, with stories of the women in their lives producing multiple babies with no assistance, so they should be able to as well.

Thommesen, T., Kismul, H., Kaplan, I., Safi, K., Ven de Bergh, H. (2020). The midwife helped me ... otherwise I could have died”: women’s experience of professional midwifery services in rural Afghanistan - a qualitative study in the provinces Kunar and Laghman. BMC pregnancy and childbirth. 20,140. https://doi.org/10.1186/s12884-020-2818-1

Watkins, D. (2010). An afghan women comforts her crying baby. https://picryl.com/media/an-afghan-woman-tries-to-comfort-her-crying-baby-who-2cde65

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The Importance of Social Inclusion for Afghan Refugees

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The Importance of Social Inclusion for Afghan Refugees

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Even once the safety of a new country is reached, there is still the possibility of continued traumatization for refugees from Afghanistan. The WHO determinants of health emphasise the importance of social inclusion and non-discrimination concerning new refugees' continued health outcomes and mental well-being. A peer support group with a free mobile network was trialled in Melbourne, allowing refugee women to connect with others and practice their English (Liamputtong et al., 2016). They reported improved mental health, community development, and improved access to health care. This shows how social inclusion can alleviate some health concerns related to stress and continued trauma that can occur during re-settling.

Liamputtong, P., Koh, L., Wollershiem, D., Walker, R. (2016). Peer support groups, mobile phones and refugee women in Melbourne. Health promotion international 31, 3. https://doi.org/10.1093/heapro/dav015

Pixaby. (2016). Texting mobile phone hands, computer communication. https://picryl.com/media/texting-mobile-phones-hands-computer-communication-e7eb62

World Health Organisation. (2022). Refugee and migrant health. https://www.who.int/news-room/fact-sheets/detail/refugee-and-migrant-health

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Vitamin D Deficiency Prevalence in Refugees

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Vitamin D Deficiency Prevalence in Refugees

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According to the Australian Refugee Health Practice Guide, vitamin D deficiency is prevalent in the refugee population. A study showed that 56.4% of the Afghanistan refugees entering Australia had some level of vitamin D deficiency (Sanati Pour et al., 2014). Vitamin D plays a vital role in bone health, immunity, and reduces the risk of some chronic conditions (Wartenberg, 2024). Education in their own language or through an interpreter must be supplied to refugees at their post-arrival screening on the importance of maintaining sufficient Vitamin D levels. Providing supplements is another way to ensure these deficiencies are being reduced, as financial pressures may prevent self-medicating.

Paxton, G., Singleton, G. (2024). Low vitamin d. Australian refugee health practice guide. https://refugeehealthguide.org.au/low-vitamin-d/

Santai 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, 896. https://doi.org/10.1186/1471-2458-14-896

Soon, H. (2020). Tablets, medicine, supplements image. https://pixabay.com/photos/tablets-medicine-supplement-vitamin-5620566/

Wartenberg, L. (2024). Common Symptoms of Vitamin D Deficiency and How to Treat Them. https://www.healthline.com/nutrition/vitamin-d-deficiency-symptoms#_noHeaderPrefixedContent

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Most Afghan people eat primarily Halal due to their Islamic faith, which influences what ingredients they can include in their meals. Traditionally, they eat flat Afghan bread with every meal, using it as a utensil to consume their food. Lunch is usually the largest meal of the day, consisting of curries, rice, and vegetables. The main proteins eaten are lamb, mutton, and beef. Some traditional meals include kabuli pulao, kofta, and korma. Yoghurt dips are often enjoyed alongside meals and with bread (Lo & Chong, 2016). Afghan culture places a lot of emphasis on home-cooked meals and sharing food among family, often sharing large platters at meal times.

Lo, Y., & Chong, V. (2016). Food and cultural practices of the Afghan community in Australia – a community resource. Metro south health - Queensland government. https://www.metrosouth.health.qld.gov.au/__data/assets/pdf_file/0023/242249/community-profile-afghan.pd

SuSanA. (2009). Refreshments - lovely food in Afghanistan. https://commons.wikimedia.org/wiki/File:Refreshments_-_lovely_food_in_Afghanistan_(4359806357).jpg

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The National Dance of Afghanistan - Attan.

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The National Dance of Afghanistan - Attan.

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Attan dancing is Afghanistan's most widely known cultural dance, often performed at rituals and festivals. Traditional instruments, mainly a drum called a Dhol, accompanied by the Robab, Surnai flute and/or a Toola, play out a resounding beat that quickens in pace throughout the dance. The dance can be carried out by anywhere from two to over a hundred people in a circle, becoming quicker throughout the music and ending only once no one can continue dancing (virtualafghans, 2011). Unfortunately, under Taliban rule, music and performance were considered un-Islamic and, therefore, banned, including the Attan dance (Weinbaum & Allchin, 2024).

Noorulbari Mal. (2017). Traditional Afghan Dance | Attan | Kandahar, Afghanistan د ځوانانو مست اتڼ https://www.youtube.com/watch?v=mgZ0vpAadQc

Virtualafghans. (2011). Attan - The traditional and national dance of Afghanistan. http://www.virtualafghans.com/attan/

Weinbaum, M., & Allchin, F. (2024). The arts and cultural institutions in afghanistan in cultural life. Encyclopaedia Britannica. https://www.britannica.com/place/Afghanistan/Struggle-for-democracy

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Traditional Afghan Dance | Attan | Kandahar, Afghanistan د ځوانانو مست اتڼ

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Traditional Family Dynamics and Structure

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Traditional Family Dynamics and Structure

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Traditionally, women move in with their husbands' families after marriage, resulting in three to four multi-generational households common throughout Afghanistan due to traditional and economic reasons. Children must be obedient and respectful to their elders, and these expectations continue even after adulthood. Gender roles are strictly adhered to, with men leading, making decisions and providing financially for their families. Women hold authority over children and household duties, including cooking, cleaning, and rationing supplies (Evason, 2019). These dynamics can be disrupted during resettling as families are broken up and younger family members integrate into Australian culture more quickly than older adults, changing some of their views on family values (Rahimi, 2022).

Chapman, N. (2011). An Afghan Farmer and his Family Stand Beside a Tractor in Afghanistan. https://www.flickr.com/photos/defenceimages/6286491598

Evason, N. (2019). Afghan culture - family. Cultural atlas. https://culturalatlas.sbs.com.au/afghan-culture/afghan-culture-family#:~:text=within%20the%20family.-,Household%20Structure,in%2Dlaws%20throughout%20their%20life.

Rahimi, F. (2022). A Qualitative Exploration of The Impact of Family Functioning on Young Adults of

Hazara Afghan Refugee Background in Australia. School of psychology - university of Adelaide. https://digital.library.adelaide.edu.au/dspace/bitstream/2440/141590/1/RahimiF_2022_Hons.pdf