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(Austrailan Refugee Health Practice Guide, 2023)

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Iron deficiency and anemia is a severe public health problem identified in children and women (Wirth et al., 2021). In order to treat this in migrants is full screenings including blood tests, replacement treatment including oral medication and intravenous medication, investigation into the cause and diet education. Another problem faced is vitamin D deficiency. 73% of Somali women have experienced vitamin D deficiency (Taye Demeke et al., 2019). Recommendations include having an initial health assessment, replacement therapy and specific education. The Australian Refugee Health Practice Guild, viewed 2023, also lists skin infection. It is a severe problem faced in Somalia as the insects there cause significant skin infections. Treatments includes thorough screening and individualised treatment.

Wirth, J. P., Sesay, F., Mbai, J., Ali, S. I., Donkor, W. E. S., Woodruff, B. A., Pilane, Z., Mohamud, K. M., Muse, A., Yussuf, H. O., Mohamed, W. S., Veraguth, R., Rezzi, S., Williams, T. N., Mohamoud, A. M., Mohamud, F. M., Galvin, M., Rohner, F., Katambo, Y., & Petry, N. (2021). Risk factors of anaemia and iron deficiency in Somali children and women: Findings from the 2019 Somalia Micronutrient Survey. Maternal & Child Nutrition, 18(1). https://doi.org/10.1111/mcn.13254

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Taye Demeke, Amra Osmancevic, Gillstedt, M., Krogstad, A., Angesjö, E., Sinclair, H., Gamal Abd El‐Gawad, Krantz, E., Trimpou, P., & Landin‐Wilhelmsen, K. (2019). Comorbidity and health-related quality of life in Somali women living in Sweden. Scandinavian Journal of Primary Health Care, 37(2), 174–181. https://doi.org/10.1080/02813432.2019.1608043

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Austrailan Refugee Health Practice Guide. (2023). Australian Refugee Health» Primary Care for People of Refugee Backgrounds. In Australian Refugee Health Practice Guide. https://refugeehealthguide.org.au

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For me the most important aspect when it comes to patient centered care is allowing a patient to have cultural autonomy over their own health care decisions. I have developed my understanding of the importance of nurses needing to respect a patient’s opinion on their health. Having analyzed my own cultural beliefs I now realize that every patient will cultural belief and opinion when it comes to their health which may be different from my own. This understanding is essential to me in the workplace because I recognize that I will care for patients from diverse multicultural backgrounds. Previously I have witnessed a nurse not abiding by the patient centered care this led to the patient being frustrated. Alternatively, If the nurse had followed the patient centered approach the patient would have felt heard and cared for in a culturally appropriate way.

Women’s Health Partnership, M. & refugee. (2019).
https://moodleprod.murdoch.edu.au/pluginfile.php/3573073/mod_resource/content/1/Culturally-responsive-clinical-practice-Working-with-people-from-migrant-and-refugee-backgrounds-Jan2019.pdf

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A 22-year rule by General Mohammad Siad Barre involved corruption, nepotism, and the gradual escalation of clan rivalry.  1991, a full-scale civil war led to the overthrow of the Barre administration. Results of this war caused food insecurity into the 1990s and  2000s. Other militia organisations have struggled for control of the nation. This resulted in the citizens being subjected to violence and death (Queensland Government , 2015). That caused poor long term  mental health outcomes such as depression, anxiety and PTSD (U.S Department of Health and Human Services, 2020).

ABC NEWS. (2011, November 1). A history of conflict in Somalia. ABC News. https://www.abc.net.au/news/2011-11-01/somalia-fact-sheet/3612354

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Queensland Government . (2015). Somali food and cultural profile: dietetic consultation guide 1. Booking a client appointment 2. Preparation for the consultation Working with an interpreter. https://metrosouth.health.qld.gov.au/sites/default/files/content/profile_somali_dietetic.pdf

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U.S Department of Health and Human Services. (2020). Crime and Violence - Healthy People 2030 | health.gov. Health.gov. https://health.gov/healthypeople/priority-areas/social-determinants-health/literature-summaries/crime-and-violence#:~:text=Children%20and%20adolescents%20exposed%20to

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 Financial hardship and poor health outcomes

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 Financial hardship and poor health outcomes

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Refugees and migrants are affected by income and social protection (World Health Organization, 2023). While reading research longitudinal data from a cohort of refugees in Australia I was interested to find financial hardship correlated to poorer health outcomes. Particularly for those women from Middle East Sub Saharan Africa and Northern Africa. As refugees move to Australia financial hardship restricts access to a greater range of foods. From this research I was interested to note that financial hardship often led to people going without food, particularly women. The recommendation from this study showed that assistance was needed beyond the first year to improve better health outcomes (Torlinska et al., 2020). Social inclusion and non-discrimination are social determinants of health. When moving to another country migrates often experience a form of social isolation as they are away from their communities which is associated with negative health outcomes. My research show that people who migrate describe social isolation as feelings of loneliness, physical distant from family and loss of familiar social and cultural communities. Negative health outcomes can include mental health decline due to individual inability to adapt and feel included in their new country.

World Health Organization. (2023). Social determinants of health. World Health Organization. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1

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Torlinska, J., Albani, V., & Brown, H. (2020). Financial hardship and health in a refugee population in Australia: A longitudinal study. Journal of Migration and Health, 1-2(100030). https://doi.org/10.1016/j.jmh.2020.100030

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Sambusa is made in Ramadan and Eid, filled with beef, onion, and spices.

Ingredients:

2 tablespoons olive oil

1 small onion, chopped

1 leek, chopped

1  garlic, minced

2 pounds ground beef

2 teaspoons ground cumin

2 teaspoons ground cardamom

1 teaspoon salt

1 teaspoon pepper

1 tablespoon all-purpose flour

1 tablespoon water

1 (14 ounce) package spring roll wrappers

1 quart oil for frying

Method:

Heat olive oil in a large skillet over medium heat and stir onion, leek, and garlic in hot oil until onion is transparent. Add ground beef; cook and stir until still slightly pink and about halfway done. Season with cumin, cardamom, salt, and pepper; mix well. Continue cooking until beef is browned and crumbly. Remove from heat.

Mix together flour and water in a small bowl to make a thin paste. Using one wrapper at a time, fold into the shape of a cone. Fill cone with beef mixture, close the top, and seal with paste.

Heat oil in a deep fryer or large saucepan to 170 degrees C. Ensure enough oil to submerge sambusas. Fry sambusas in hot oil until golden brown. Place on paper towel-lined plate to drain.

Nutrition Facts

163 | Calories
10g  | Fat
11g  | Carbs
8g  | Protein

allrecipes. (2023, April 21). Sambusa Recipe. Allrecipes. https://www.allrecipes.com/recipe/53603/sambusa/

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My definition of health is having a healthy mind and body. To live a healthy lifestyle, for me, means eating well and exercising often. Additionally, in my opinion, this strikes a balance in all facets of life. Health is regarded in my culture as being correlated with appreciating my well-being and feeling free.

Johnson, A. (2020). 11 Traditional Somalian Foods Everyone Should Try.

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In my culture, black seed oil is frequently used. This oil is taken with honey and is administered to the stomach, chest, or any sore area. This oil is made from black cumin, a flowering plant that is native to Asia and the Mediterranean. 99 percent of us Somalis are muslim (sunni) and we all follow our prophet Muhammad (PBUH) teachings with both religion (islam)  and medicine. Our prophet stated “black seed can heal every disease, except death” (Ali et al., 2018).

Ali, S. A., Parveen, N., & Ali, A. S. (2018). Links between the Prophet Muhammad (PBUH) recommended foods and disease management: A review in the light of modern superfoods. International Journal of Health Sciences, 12(2), 61–69. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5870322/#:~:text=Black%20seeds%20(Nigella%20sativa)&text=It%20is%20very%20popular%20in

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U.S Department of Health and Human services. (2019, November 22). To Fast or Not to Fast. NIH News in Health. https://newsinhealth.nih.gov/2019/12/fast-or-not-fast#:~:text=Early%20results%20have%20found%20that

the.ismaili. (2023, March 21). What is the purpose of fasting in Ramadan? The.Ismaili. https://the.ismaili/global/news/features/what-the-purpose-fasting-ramadan#:~:text=Muslims%20understand%20the%20purpose%20and,food%2C%20water%2C%20and%20shelter.

Shalihin, N., & Sholihin, M. (2022). Ramadan: the month of fasting for muslim and social cohesion—mapping the unexplored effect. Heliyon, 8(10), e10977. https://doi.org/10.1016/j.heliyon.2022.e10977

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TPT Originals . (2018, August 24). Somali Traditional Dance 101. TPT Originals. https://www.tptoriginals.org/somali-traditional-dance-101/

Douka, S., Zilidou, V. I., Lilou, O., & Manou, V. (2019). Traditional Dance Improves the Physical Fitness and Well-Being of the Elderly. Frontiers in Aging Neuroscience, 11(75). https://doi.org/10.3389/fnagi.2019.00075

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Islam is the recognised state religion of Somalia. For us, religion plays a significant role in daily life. Somalians are recognised for expressing their faith through their clothes, dietary restrictions, daily prayer, and frequent allusions to Allah's (God's) will or blessing (Evason, 2017). Spiritual health is commonly used in my country as we pray for better health that comes with comfort and faith.

Evason, N. (2017). Somali Culture - Religion. Cultural Atlas. https://culturalatlas.sbs.com.au/somali-culture/somali-culture-religion

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Gunawan, I. M. (2021). ACT Bagikan Al-Quran untuk Anak-Anak Nelayan Somalia. In Kantor Berita MINA. https://minanews.net/act-bagikan-al-quran-untuk-anak-anak-nelayan-somalia/

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