# data[].attributes.body
World Health Organization outlines a set of social determinants that can significantly impact the health of people. I am going to highlight three of these social determinants and the way in which they relate to migrants and refugees in Australia. Having analysed the social determinants, I now think one of the greatest barriers for younger migrants and refugees (aged 15-24) settling into Australia is the difficult task of integrating into the Australian education system and subsequent workforce. This is because of the difference in culture, community, and family relationships. This, equally, might be related to the lack of education support for people who are from migrant and refugee backgrounds. I think that for integration to be successful, appropriate school placement is needed (Ziaian et al., 2018). I believe this would include relooking at their academic and social needs in relation to schooling and higher education. Multicultural training, reciprocal respect and communication are key to success in this area. Subsequently, I noticed the same issues arise for migrants and refugees integrating into the Australian workforce. Mental health is vastly under-researched and misunderstood, especially in relation to migrants and refugees in Australia, which often results in unemployment and job insecurity for them. Migrants and refugees need access to strong support systems, given their backgrounds (with some experiencing extreme trauma and torture), as well as employment support systems to better equip and the skills they need for success in life and integration into Australia as a whole (Ziaian et al., 2023).

Finally the third social determinant I felt was useful to note is food insecurity. Even in high income countries, like Australia, refugees face issues like language barriers and cultural differences when it comes to food selection and preferences, thus resulting in poor nutrition and health issues arising such as low bone mass, low muscle mass, and increased BMI (Mansour et al., 2020). Overall, I think a holistic approach is needed when it comes to social determinants and their relation to the health of migrants and refugees transitioning to life in Australia.

References:

Mansour, R., Liamputtong, P., & Arora, A. (2020). Prevalence, determinants, and effects of food insecurity among middle eastern and north African migrants and refugees in high-income countries: a systematic review. International journal of environmental research and public health, 17(19), 7262.

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

Ziaian, T., de Anstiss, H., Puvimanasinghe, T., & Miller, E. (2018). Refugee students’ psychological wellbeing and experiences in the Australian education system: A mixed‐methods investigation. Australian psychologist, 53(4), 345-354.

Ziaian, T., Puvimanasinghe, T., Miller, E., Augoustinos, M., Esterman, A., Baddeley, M., ... & Pir, T. (2023). Rebuilding life after migration: Research protocol of a mixed methods study on settlement experiences of refugee and migrant youth. Plos one, 18(4), e0285023.

# data[].attributes.body
For me, the most significant aspect of the competency standard 12.1 was being aware of your own culture, what values are important to you, and being able to reflect on them as well as your own cultural biases. I have improved my understanding of my own culture, beliefs, values, and biases, having learned how to reflect on them thoroughly throughout this unit and unit NUR136. I now feel that I am more capable of providing culturally responsive care that is sensitive to an individual's cultural differences, especially to individuals who are migrants or refugees. This skill is essential to me in the workplace because I want to become a nurse committed to providing culturally responsive care.

Reference list:
Competency standards framework. (2020). Migrant & Refugee Women's Health Partnership. https://culturaldiversityhealth.org.au/competency-standards-framework/

# data[].attributes.attachment_link.title
Culturally Responsive Clinical Practice_ Working with People from Migrant and Refugee Backgrounds

# data[].attributes.body
"Your circumstances will never change the promises of God" - Kristi Pavich

My Mum died on the 4th of August 2014, 46 years of age. She knew my eldest son, her grandson, for the first six months of his life before her fight ended. She was diagnosed with liver cancer, Cholangiocarcinoma in April of 2014, stage four, untreatable and inoperable. We had sixteen painful, beautiful weeks with her before she passed from this life into the next. Nothing has impacted me more than that journey. She is the reason I want to make a difference as a healthcare worker.

Spiritual well-being is just as much a part of our health as physical, mental and social well-being is. Having experienced such a deep loss, I now feel I have gained the skills to help others when faced with loss, and this is especially beneficial as a future nurse.

I am eternally grateful for God and His Church. "Three things will last forever - faith, hope, and love - and the greatest of these is love" 1 Corinthians 13:13, Bible.

# data[].attributes.body
My favourite family tradition is what we do for birthdays. We do what's called a ‘love tank’, where every family member shares one thing they love about the person we are celebrating. It eliminates the pressure of gift giving, instead using the time to fill one another's 'love tank' up and every year, there are tears, laughs and incredibly deep and memorable moments.

# data[].attributes.attachment_caption
New Zealand all blacks performing the haka before a rugby game

# data[].attributes.body
New Zealand is a proud rugby nation. At every family event, there is talk of rugby, arguments around rugby, games around rugby and laughs all around while watching rugby. There is always, always, a rugby ball in sight.

My six-year-old had his first full year of playing rugby for the local rugby club this year. His fitness levels have largely improved. Recommendations by the Australian Government, 'Physical Activity and Exercise Guidelines for Children and Young People (5 to 17 years),' are for children to do at least 60 minutes per day of moderate to vigorous physical exercise.

Reference:
Department of Health and Aged Care. (2022). For children and young people (5 to 17 years). Australian Government. https://www.health.gov.au/topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians/for-children-and-young-people-5-to-17-years

# data[].attributes.attachment_caption
A bowl full of feijoas, whilest pregnant in NZ with my second child

# data[].attributes.body
Feijoas, also commonly known as pineapple guava, are a New Zealand fruit icon! Although feijoas are my favourite thing to eat, they are not often available in Australia, but when I can get my hands on some over the autumn or spring months, I stock up and make all sorts of feijoa infused goodies!

My kid's favourite way to eat feijoas is straight off the tree. Cut them in half and scoop the flesh out. My childhood, however, was filled with the smell of freshly baked apple crumble sprinkled over a bed of feijoas.

Feijoas are rich in fibre, so they aid in digestion. These little fruits are also high in vitamin C. According to the Australian Dietary Guidelines (Department of Health and Aged Care, 2022) Vitamin C intake is associated with the reduced risk of cardiovascular disease and strokes.

Recipe for the apple crumble is below.

Nanas Apple Crumble with Feijoas

INGREDIENT LIST

2 cups of feijoas (stewed or fresh)
2 tablespoons of brown sugar
1 cup plain flour
1 teaspoon baking powder
100g butter
1/4 cup brown sugar

METHOD

Place stewed or fresh feijoas at the bottom of a large baking dish, sprinkle with brown sugar. Put flour and baking powder into a bowl and grate in butter until it resembles coarse breadcrumbs. Stir in brown sugar. Sprinkle mixture over the feijoas and bake in the oven at 190 degrees for 30 minutes or until golden on top.

Reference:
Department of Health and Aged Care. (2022). The Australian dietary guidelines. Australian Government. https://www.health.gov.au/resources/publications/the-australian-dietary-guidelines?language=en

# data[].attributes.headline
Principal health issues that refugees face

# data[].attributes.subject
Principal health issues that refugees face

# data[].attributes.body
Country of focus: Syria

The Syrian refugee crisis is still one of the largest humanitarian crises in 2023. In 2021, the Australian Red Cross reported that more than 13 million Syrians were still in dire need of basic amenities. The Syrian war has been ongoing for twelve years now. Australia granted 5,947 refugee and humanitarian visas in 2020–21, a large portion of which includes Syrian refugees. Three common health concerns faced by Syrian refugees, outlined by the Australian Refugee Health Practice Guide, are intestinal parasites, skin infections and mental health.

Intestinal parasites are soil-transmitted helminths (STH). These intestinal parasites are most common in poor countries with limited access to clean water and hygiene. The most common types are whipworm, roundworm, and hookworm. One treatment option for intestinal parasites is (roundworm) treatment:

Albendazole 400mg orally if weight ≥10kg (200mg > 6 months weight <10kg) as a single dose. Corticosteroids are sometimes needed in pulmonary ascariasis.

Skin infections are caused by different kinds of bacteria. For Syrian refugees, one of the most common types of skin infections are scabies. One treatment option is:

>6 months old: permethrin 5% cream to dry skin from the neck down, especially hands and genitalia; apply underneath nails with a brush. Leave for >8 hours or 24 hours if previous treatment fails. Reapply to hands if washed. Repeat in 7 days.

Mental health is a state of mental well-being: emotional, psychological and social wellbeing. Many people from refugee backgrounds experience mental health issues because of trauma, torture and family separation. Treatment options for mental health-related concerns include:

A suicide risk assessment. Referring patients with torture and trauma-related mental health issues to a specialized torture and trauma service. Referral to conventional mental health care services may be more appropriate in cases where there has not been a history of torture or trauma.

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

Refugee patients in primary care. (n.d.). Australian Refugee Health Practice Guide. https://refugeehealthguide.org.au/

# data[].attributes.attachment_caption
Essential oils I use in my diffuser at home

# data[].attributes.body
I absolutely believe in the power of essential oils to help resolve issues in the human body. There is a saying that goes, "I've got an oil for that". People who know me know this is what I say in response to someone complaining of a headache or some sort of ache or pain in their body.

After my own serious health issues in November of last year, I struggled to eat, completely losing my appetite, and I could not concentrate for long periods of time or spend time with too many people. I can proudly say these oils have changed my life and my families too! My appetite has returned, I can study well, and I enjoy being with people again. We all sleep better (hello lavender!), we have less pain and anxiousness and the diffusers in our home help to purify the air so sickness doesn't hang around long!

This knowledge will be useful to me as a nurse because I can provide a holistic approach to the health and well-being of my patients and also provide understanding to patients who have alternate beliefs about medicine and healthcare.

# data[].attributes.attachment_caption
Traditional Maori Welcome onto a Marae (traditional meeting house)

# data[].attributes.body
Growing up in New Zealand, Te Reo Māori was a huge part of my schooling. By the time I was ten, I could speak and understand basic Māori language. I remember attending my first Kapa Haka (group dance) practice and being accepted as a family member. It was there, as a young child, that I learnt to love and value the traditions of Māori Culture. I am grateful to have been raised in such a culturally rich country.

# data[].attributes.body
Health to me, means a continual process of adjustments to improve my physical, mental and social well-being. I feel strong when my body is absent from aches and pains, my mind is at peace, without anxiety, and my 'love tank' is filled up by those who are closest to me.