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I am grateful to have a healthy body that allows me to go on scenic hikes.

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Health to me is when I feel emotionally, mentally, physically and spiritually well. When I am mentally and physically happy, I feel the most productive and healthiest as I am able to regulate my emotions in my everyday life.

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Culturally Responsive Clinical Practice: Working with People from Migrant and Refugee Backgrounds - Competency Standards Framework For Clinicians January 2019 (Domain 7: Professional)

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Culturally Responsive Clinical Practice: Working with People from Migrant and Refugee Backgrounds - Competency Standards Framework For Clinicians January 2019 (Domain 7: Professional)

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Domain 7 of the framework outlines that clinicians should be self-aware of their cultural beliefs and practices when providing care for people from migrant and refugee backgrounds. I am able to relate closely to this as a migrant myself who has faced inadequate care provided to me due to a lack of cultural knowledge and how it mentally and emotionally impacted me as an individual.

As a clinician, I am able to reflect on my own cultural beliefs and traditions when providing care to patients from different cultural backgrounds. Competency standard 12.3 has taught me how to provide accurate cultural care to people from migrant and refugee backgrounds. When I apply these practices to multicultural patients I will be aware of my own cultural biases and provide exceptional care. I will make a conscious effort to reflect on my own cultural values and practices and be aware not to project them on patients. Furthermore, as a clinician, I will incorporate this competency standard when caring for patients. I will make sure to give culturally competent care and practice so patients will feel culturally safe, respected, understood, and be able to equally access the health care system. I will also seek feedback from patients to further improve my care.

Migrant And Refugee Women's Health Partnership (2019). Culturally Responsive Clinical Practice: Working with People from Migrant and Refugee Backgrounds. Competency Standards Framework For Clinicians. Culturally Responsive Clinical Practice: Working with People from Migrant and Refugee Backgrounds (murdoch.edu.au)

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The three social determinants of health stated by the World Health Organisation (WHO) that I will be exploring are access to affordable health services of decent quality, unemployment and job insecurity and social inclusion and non-discrimination.

Some of the barriers faced by migrants and refugees who live in Australia are language and cultural differences, job insecurity and unemployment, social inclusion, discrimination and a sense of belonging.

Language barrier plays a huge role in obtaining employment, receiving adequate information on healthcare services and being a part of society. It has a major impact during the resettlement phase such as limiting refugees and migrants' access to healthcare services and health outcomes (Pandey et al., 2021). A systematic review by Rasi (2020) stated that the research has demonstrated that migrant patients received lower access to health care because of their differences in cultural and linguistic background which created a barrier to receiving effective treatment by health professionals.

Other factors include a lack of culturally safe care by healthcare professionals, the provision of migrant-friendly solutions, and the ineffective use of interpreters. Although migrants and refugees are given equal access to health care services these factors have made it challenging to receive appropriate care.

Other social determinants faced by migrants are job security and unemployment. A comparative analysis by Liu et al. (2019) on job insecurity between migrants and native workers in Australia demonstrated that migrants from a non-English speaking background faced higher job insecurities compared to Australian-born workers. Migrants from non-English speaking countries require a longer time to obtain the skills required for their job. Even if some migrants and refugees have obtained a high level of education back in their country, these skills are often not transferrable or credited in Australia leaving them to face many challenges. Because of this migrants are unemployed or have temporary and part-time employment in jobs that have poor working conditions (Lay et al., 2018).

Lastly, the impact of discrimination and social inclusion is shown to be harmful to health. In the study by Ziersch et al. (2020), 423 adult refugees and asylum seekers living in South Australia for 7 years were asked to complete a survey on housing, social inclusion and health. Some of the survey questions were on discrimination on skin colour, ethnicity, religion, trust, belonging and health. 90% felt that discrimination has had a mental impact on their health. Discrimination was experienced in their neighbourhood, public transport, employment, denial of services and some cases of physical assault.

Australian Bureau of Statistics. (2023, March 29). Permanent migrants in Australia, 2021 | Australian Bureau of Statistics. Www.abs.gov.au. https://www.abs.gov.au/statistics/people/people-and-communities/permanent-migrants-australia/latest-release

Lay, A. M., Kosny, A., Aery, A., Flecker, K., & Smith, P. M. (2018). The occupational health and safety vulnerability of recent immigrants accessing settlement services. Canadian Journal of Public Health, 109(3), 303–311. https://doi.org/10.17269/s41997-018-0063-4

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Liu, X., Bowe, S. J., Milner, A., Li, L., Too, L. S., & LaMontagne, A. D. (2019). Job Insecurity: A Comparative Analysis between Migrant and Native Workers in Australia. International Journal of Environmental Research and Public Health, 16(21), 4159. https://doi.org/10.3390/ijerph16214159

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Pandey, M., Maina, R. G., Amoyaw, J., Li, Y., Kamrul, R., Michaels, C. R., & Maroof, R. (2021). Impacts of English language proficiency on healthcare access, use, and outcomes among immigrants: a qualitative study. BMC Health Services Research, 21(1). https://doi.org/10.1186/s12913-021-06750-4

Rasi, S. (2020). Impact of Language Barriers on Access to Healthcare Services by Immigrant Patients: A systematic review. Asia Pacific Journal of Health Management, 15(1), 35–48. https://doi.org/10.24083/apjhm.v15i1.271

Ziersch, A., Due, C., & Walsh, M. (2020). Discrimination: a health hazard for people from refugee and asylum-seeking backgrounds resettled in Australia. BMC Public Health, 20(1), 1–14. https://doi.org/10.1186/s12889-019-8068-3

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Malaysia Batik. (n.d.). Jadi Batek. https://jadibatek.com/

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Principal health issues confronting migrant populations and the national multicultural health priorities 

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Principal health issues confronting migrant populations and the national multicultural health priorities 

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Focus Country: Iraq. Decades of violence and conflict have resulted in chaos and civil unrest in Iraq.  Increased violence and conflict from events such as the U.S.-led invasion in 2003 and the Islamic State (ISIS) attack in 2014 in northern Iraq have led to the destruction of infrastructure displacing millions of families who were forced to flee their homes in search of a safe place (The UN Refugee Agency, 2019) (Centre for Preventive Action, 2023). As of today in 2023, Iraq is still recovering from significant challenges such as protection, access to basic services and livelihood opportunities. Families that have been displaced face major obstacles such as living in extremely poor conditions, lack of economic opportunities and access to shelter, clean water, food, and sanitation (The UN Refugee Agency, 2019). Iraqi settlement in Australia dates back to the Gulf War in 1990-1991 and in 2015 the Australian Government resettled about 12,000 Iraqi refugees. Since the Gulf War in 1991 Iraq-born population in Australia has multiplied and recorded around 32,520 Iraqis who found refuge in Australia by the 2006 census (Queensland Health, 2011). Between 1 July 2015 and 31 December 2017 around 13,567 Iraqi refugees were granted humanitarian entry to Australia (Collin et al. 14 C.E.). According to the Australian Red Cross (2023), Iraqi people are one of the top four countries that have sought refuge in Australia.

The three common health concerns as stated by the Australian Refugee Health Practice Guide faced by Iraqi refugees are mental health, anaemia, and tuberculosis.

Mental Health
Most refugees have reported struggling with physical and psychological health derived from the trauma and torture they experienced back home. The war, violence and losing their home have mentally impacted them (Vasey & Manderson, 2012).

Anemia
Since the Gulf War in 1991, access to clean water, lack of sanitation and food insecurity have plagued Iraqis resulting in a higher rate of children and women suffering from anaemia and malnutrition. Women who suffer from anaemia, iron deficiency and malnutrition have been reported to have high maternal and infant mortality rates (Centers for Disease Control and Prevention, 2021).

Tuberculosis
Refugees have been reported to have a higher risk of tuberculosis (TB). This is because of overcrowding in refugee camps, prisons, malnutrition and contact with other refugees that have left them vulnerable to TB (NSW Health, n.d.)

Australian Red Cross. (2023). Refugee and asylum seeker facts. Australian Red Cross . https://www.redcross.org.au/act/help-refugees/refugee-facts/

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Australian Refugee Health» Primary Care for People of Refugee Backgrounds. (n.d.). https://refugeehealthguide.org.au/

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Center for Preventive Action. (2023, January 6). Political Instability in Iraq. Global Conflict Tracker. https://www.cfr.org/global-conflict-tracker/conflict/political-instability-iraq

Centers for Disease Control and Prevention. (2021, March 23). Iraqi Refugee Health Profile | CDC. Www.cdc.gov. https://www.cdc.gov/immigrantrefugeehealth/profiles/iraqi/index.html#priority-health

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Collins, J., Reid, C., Groutsis, D., Watson, K., & Ozkul, D. (14 C.E.). Syrian and Iraqi Refugee Settlement in Australia. https://www.sydney.edu.au/content/dam/corporate/documents/business-school/research/research-groups/Syrian%20and%20Iraqi%20Refugee%20Settlement%20in%20Australia.pdf

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Iraq Refugee Crisis Explained. (2019, November 7). Www.unrefugees.org. https://www.unrefugees.org/news/iraq-refugee-crisis-explained/#When%20did%20the%20Iraq%20refugee%20crisis%20begin?

NSW Health. Refugee screening and follow up - Tuberculosis. (n.d.). Www.health.nsw.gov.au. https://www.health.nsw.gov.au/Infectious/tuberculosis/Pages/refugee-screening.aspx

Queensland Health (2011). Iraqi Australians. https://www.health.qld.gov.au/__data/assets/pdf_file/0022/156361/iraqi2011.pdf

Vasey, K., & Manderson, L. (2012). Regionalizing Immigration, Health and Inequality: Iraqi Refugees in Australia. Administrative Sciences, 2(1), 47–62. https://doi.org/10.3390/admsci2010047

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(1) Pencak Silat Sandrina Azzahra - YouTube

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Eat For Good Health . (2021, January 30). Black Pepper: From pages of history to the Kitchen Pantry. Eat for Good Health . https://www.efghfoods.com/benefits-of-drinking-rasam-daily/

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(1) Master Conversational Malay - 1 Minute talk with Sofia - Part 1🗣️👍💯 - YouTube

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Master Conversational Malay - 1 Minute talk with Sofia - Part 1🗣️👍💯

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Lighting of clay lamps and drawing of kolam using chalk and filled with coloured rice. https://whyy.org/articles/swarthmore-diwali-celebration-2022-pennsylvania