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 The tuberculosis pathogen releases its toxin via a novel protein transport system| Source: US National Science Foundation Webpage

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Common Health issue among Burmese Refugees

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Common Health issue among Burmese Refugees

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Tuberculosis(TB)

TB is a major health concern among Burmese refugees arriving in Australia. As per the Global Tuberculosis Report 2021 of WHO, an estimated 167,000 people fell ill with TB in the country.

Australian Refugee Health Practice Guide (ARHPG)

Concern: Australia has a low incidence of TB in its general population. However, the arrival of refugees from high TB burden countries has raised some public health concerns. As per the ARHPG, Australia's overall TB incidence is low 5.5/100,000 population per year, however, nearly 90% of cases occur in overseas-born Australians, with a rate of 18.4/100,000 compared to 0.7/100,000 in non-indigenous Australian-born people. Although people born in India, the Philippines, China and Nepal make up more than half of the overseas-born cases of active TB in Australia, the highest rates are in people born in humanitarian source countries.

Treatment: Australia's robust health screening and treatment programs focus on early detection, prompt treatment and ongoing support to ensure both individual and public health. All people from a refugee-like background aged ≤35 years, including children, would be screened for Latent TB infection , ideally within one month of arrival in Australia, unless screening has been completed pre-departure as per ARHPG.

How Myanmar achieved the 2020 milestone of reducing TB disease burden. (n.d.). Www.who.int. https://www.who.int/southeastasia/news/feature-stories/detail/how-myanmar-achieved-the-2020-milestone-of-reducing-TB-disease-burden#:~:text=Myanmar%20is%20one%20of%20the

Tuberculosis (TB & LTBI)» Australian Refugee Health. (n.d.). https://refugeehealthguide.org.au/tuberculosis-tb/

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Chart:Refugee Council of Australia * Source: Department of Immigration/Home Affairs, Offshore Humanitarian Program (consolidated) 

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In 2021, countries with the highest number of refugees fleeing were;

1. Syrian Arab Republic,

2. Venezuela,

3. Afghanistan,

4. South Sudan and

5. Myanmar

while countries hosting the highest number of refugees were 1. Turkey, 2. Colombia, 3. Uganda, 4. Pakistan, 5. Germany.

Australia has resettled total/average of 31,104 Myanmar refugees since 2006 including under the Specific Humanitarian Program as shown in the graph above.

World Health Organization. (2022, May 2). Refugee and migrant health. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/refugee-and-migrant-health

Australia’s Offshore Humanitarian Program: 2022-23. (n.d.). https://www.homeaffairs.gov.au/research-and-stats/files/australias-ohp-2022-23.pdf

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Source: Center for world indigenous studies

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Many Burmese people believe in traditional medicine practices, the use of herbal remedies and traditional healers like steam baths and acupuncture. The Burmese government has made efforts to integrate traditional medicine into national healthcare system.There is also a strong belief in maintaining a balance between "hot" and "cold" elements in the body. Some of the herbs used are; asiatic penny wort, sweet flag, neem, tamarind, ginger, blue evergreen hydrangea and sweet broom weed. In Myanmar, the principal components of the system of treatment includes;

1. The Desana system- Diet modification and use of mineral components.

2. The Bethizza system- Follows the principles of Ayurveda.

3. The Astrplogical or Netkhatta system- Based on astrological chart and calculations.

4. The Vezzadara System- Involves techniques of converting heavy metals into inert substances.

Chan, A. (2015, March 7). A Glance at Traditional Medicine in Myanmar. Myanmar Insider. https://www.myanmarinsider.com/a-glance-at-traditional-medicine-in-myanmar/

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Golden Land is a common nickname for Myanmar, referencing its numerous golden pagodas and rich culture.

Centre, U. W. H. (2018, December 6). Shwedagon Pagoda on Singuttara Hill. UNESCO World Heritage Centre. https://whc.unesco.org/en/tentativelists/6367/

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10 Interesting Facts About Myanmar #facts #myanmar #burma. (n.d.). Www.youtube.com. Retrieved August 27, 2024, from https://www.youtube.com/shorts/BmpZ0ix08VU

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10 Interesting Facts About Myanmar #facts #myanmar #burma

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Competency standard 1.4 of Domain 1: Clinical Expert

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I would like to reflect that for many refugees, family members and the community plays a significant role in an individuals healthcare choices. The family and community context can influence how informed consent is obtained and understood. For instance, language barriers might require family members to act as an interpreters and in some culture male family members are expected to give consent.

I have obtained an understanding on impact of treatment in several ways such as preference based on cultural beliefs about health, illness and healing.

Moreover, the family and community context is important for ensuring proper follow ups such as community support networks(lifestyle changes) and cultural attitudes towards preventive care.

By recognising these factors, we as a clinicians would be able to provide more effective, culturally sensitive care and build the trust.

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. https://culturaldiversityhealth.org.au/wp-content/uploads/2019/02/Culturally-responsive-clinical-practice-Working-with-people-from-migrant-and-refugee-backgrounds-Jan2019.pdf

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Social Inclusion and Non discrimination, Myanmar

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The impact of social inclusion and non-discrimination on the health of refugees is significant in Australia. Some of the effects are:

1. Mental health: It will help reduce risk of depression and PTSD. Helps build better coping mechanisms for past trauma. Inclusivity helps improve overall psychological well-being.

2. Social determinants of health: Employment opportunities leads to improved living conditions and affordability. Increased access to education enhances health literacy especially among the children refugees.

3. Physical health: Refugees will get better understanding of the Australian healthcare system and has increased access to healthcare services.

Social inclusion and non discrimination helps building cultural safety, feeling respected and understood in healthcare settings. There is a chance of better long-term health outcomes because it reduce the risk of chronic diseases associated with stress and social isolation. Therefore, the impacts are interrelated where social inclusion leads to better health outcomes and which in turn facilitates better social integration.

World Health Organization. (2024). Social determinants of health. World Health Organization. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1