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Social Inclusion/Discrimination impact on refugee health

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Social Inclusion/Discrimination impact on refugee health

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Discrimination and social inclusion are two important WHO social determinants of health that significantly impact Syrian refugees settling in Australia. Even when refugees fully acculturate and gain citizenship, discrimination often persists (WHO, 2022).

This can affect access to everyday activities such as shopping, education, and particularly health care, where experiences of bias may discourage individuals from seeking medical support. Social isolation is also common, often heightened by language barriers. As one refugee explained, “I feel like I am blind and deaf, I don’t understand them, we can’t talk to them” (Alwan et al., 2020). Such isolation can leave families uncertain about how to meet basic health needs. One parent reflected, “If a child is sick, we do not know where to take them” (Alwan et al., 2020).

Beyond immediate challenges, research indicates that long-term discrimination increases refugees’ vulnerability to mental health issues (Williams, 2019).

Alwan, R.M., Schumacher, D.J., Cicek-Okay, S., Jernigan, S., Beydoun, A., Salem, T. and Vaughn, L.M. (2020b). Beliefs, perceptions, and behaviors impacting healthcare utilization of Syrian refugee children. PLOS ONE, 15(8), p.e0237081.

doi: https://doi.org/10.1371/journal.pone.0237081

Williams, D. R., Lawrence, J. A., Davis, B. A., & Vu, C. (2019). Understanding how discrimination can affect health. Health Services Research, 54(S2), 1374–1388. https://doi.org/10.1111/1475-6773.13222

World report on the health of refugees and migrants. Geneva: World Health Organization. 2022. Licence: CC BY-NC-SA 3.0 IGO.

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Syrian refugees face significant barriers to mental health care, related to cultural views on mental illness, attitudes toward treatment, and limited access to services (Hurlburt, Hagues, & Sanchez, 2025). As many refugees are religious, mental health is often dismissed, with sufferers potentially seeking treatment from a religious leader in place of a professional, as is their cultural belief.

Gardiner et al. 2025, in the Australian Refugee Health Practice Guide, cite that 21% of refugees are reported to have been tortured, causing them to experience Post-Traumatic Stress Disorder, which has a significant impact on mental health. In addition to stress in their own country, asylum seekers may endure traumatic journeys to get to Australia.

To mitigate these risks, comprehensive pre-screening and the application of culturally sensitive assessment tools are recommended upon arrival in Australia. Engaging refugees through respectful, culturally appropriate approaches can encourage initial consultations with professionals, while ongoing check-ups help support recovery and the promotion of a safe, healthy lifestyle.

Gardiner, J., Paxton, G., Singleton, G. and Hocking, D. (2025). Mental Health» Australian Refugee Health. [online] Mental Health. Available at: https://refugeehealthguide.org.au/mental-health/.

Hurlburt, C. C., Hagues, R. J., & Sanchez, J. N. (2024). Syrian Refugees’ Mental Health: Concerns and Insights for Christian Approaches. Social Work and Christianity, 51(3), 352–369. https://doi.org/10.43043/6t1mt192

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Many Syrians practice traditional remedies such as herbal medicines and believe that herbs have a similar role to modern medication in being able to cure illness.

For example, Syrians believe that pistachios aid in eczema, cardiac disease, diabetes control, and chamomile is taken as a sedative and expectorant. Many refugees refuse to rely on hospitals and modern medicines as they are often more comfortable using traditional medicines (TM) dating back thousands of years. A refugee stated, “We first turn to herbs for remedies” (Alwan et al., 2020). Syria turns to TM so often that it is one of the country’s major exports, being sent to over 30 different nations (Disco Digital Media, 2020).

Traditional medicines may have their place in minor ailments, such as drinking a hot lemon tea when I am ill. Many modern medicines originated from herbal treatments, such as Aspirin from willowbark (WHO,2023).

Alwan, R. M., Schumacher, D. J., Cicek-Okay, S., Jernigan, S., Beydoun, A., Salem, T., & Vaughn, L. M. (2020). Beliefs, perceptions, and behaviors impacting healthcare utilization of Syrian refugee children. PloS One, 15(8), e0237081. https://doi.org/10.1371/journal.pone.0237081

Aromatic and medicinal herbs in Syria. Promising export opportunities. (2020). In Syrian Arab News Agency. Disco Digital Media, Inc.

World Health Organization (2023). Traditional Medicine Has a Long History of Contributing to Conventional Medicine and Continues to Hold Promise. [online] World Health Organization. Available at: https://www.who.int/news-room/feature-stories/detail/traditional-medicine-has-a-long-history-of-contributing-to-conventional-medicine-and-continues-to-hold-promise.

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After reading Competency Standard 2, my most significant learning is that there is a real possibility of potential harm arising from cultural barriers when providing safe and quality care to the Culturally and Linguistically Diverse (CALD) community.

I have developed a deeper understanding that a communication barrier between nurse and CALD patient may affect the patient's ability to obtain accurate data, discuss options, and fully comprehend the purpose and impact of procedures. Knowing this, I will be conscious of situations where patient education and consent may need to be provided in alternative ways, such as using a translator.

Because I have not nursed a CALD patient, I have not yet had to consider such barriers.  Competency Standard 2 has made me realise the importance of ensuring all patients are well-informed on the procedure, costs, side effects, use of medication. In my nursing career, I will aim to provide a safe environment where migrants and refugees receive quality care suited to their individual cultural needs.