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Reflection of standard 1.1 within Domain 1 of the 'Culturally Responsive Clinical Practice: Working with People from Migrant and Refugee Backgrounds competency standards framework for clinicians'

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Reflection of standard 1.1 within Domain 1 of the 'Culturally Responsive Clinical Practice: Working with People from Migrant and Refugee Backgrounds competency standards framework for clinicians'

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For me, the most important aspect of nursing is responding sensitively towards patients, making no assumptions, and having no pre-conceived ideas about them and their lives. I have developed an understanding that I mustn’t judge my patients based on their individual characteristics or social determinants of health, as this can have negative consequences (Migrant and Refugee Womens Health Partnership, 2019). Having analysed this standard, I now feel that an individuals migration background, ethnicity, and culture should be acknowledged throughout their care. Understanding this is essential to me in the workplace, as it will improve my nursing practice by integrating cultural considerations into my care. Previously I did not think that this would be such a large part of a nurses role, and now knowing this I can strive to be a more culturally safe nurse (Migrant and Refugee Womens Health Partnership, 2019).

Migrant and Refugee Womens Health Partnership. (2019). Culturally Responsive Clinical Practice: Working with People from Migrant and Refugee Backgrounds: Competency Standards Framework for Clinicians. https://moodleprod.murdoch.edu.au/pluginfile.php/4119639/mod_resource/content/3/Culturally-responsive-clinical-practice-Working-with-people-from-migrant-and-refugee-backgrounds-Jan2019.pdf

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The traditional dress of Burma is very detailed, with an extensive history dating back to the 1750’s. In these times the women of high society wore decorative headpieces, detailed blouses, longyi’s, and felt shoes, whereas the men wore turbans, slippers, and silk jackets detailed with fur (Go Myanmar Tours, 2017).

Today, the dress has slightly changed but is still a very important indicator of social standing, modesty, and wealth. The most commonly seen traditional dress of the Burmese is the longyi, a long skirt worn by both men and women (Evason, 2017). This can be worn with other traditional dress items or with more casual shirts and jackets (Go Myanmar Tours, 2017).

Evason, N. (2017). Myanmar (Burmese) Culture. Cultural Atlas. https://culturalatlas.sbs.com.au/myanmar-burmese-culture/burmese-myanmar-culture-core-concepts

GoMyanmarTours. (2017, June 28). Traditional Dress of Myanmar-National Dress. https://www.gomyanmartours.com/traditional-dress-myanmar/

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The Burmese are known to be indirect communicators due to their very considerate nature. In a conversation, someone of Burman culture would explain their point in a circuitous manner, through the fear of offending anyone with their opinions (Evason, 2017). The Burmese also have specific communication guidelines for the different ethnicities and religions (Queensland Health Multicultural Services, 2011).

If you are a Burmese Buddhist you mustn’t ever stretch out your legs with pointed feet and direct them towards another person as it is disrespectful, you must not touch your or someone else’s head unless it’s necessary, and always use two hands when giving or receiving an object of any kind (Queensland Health Multicultural Services, 2011).

Evason, N. (2017). Myanmar (Burmese) Culture. Cultural Atlas. https://culturalatlas.sbs.com.au/myanmar-burmese-culture/burmese-myanmar-culture-core-concepts#burmese-myanmar-culture-core-concepts

Queensland Health Multicultural Services. (2011). Burmese Australians. Queensland Government. https://www.health.qld.gov.au/__data/assets/pdf_file/0027/155835/burmese2011.pdf

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Burma is a very ethnically diverse country with more than 100 different languages spoken, and the most common being Burmese (Queensland Health Multicultural Services, 2011). Although Burmese is the national language, there are many indigenous languages spoken throughout Burma that belong to many different ethnicities. Some of these belong to the Shan, Karen, and Kachin people of Burma (Nag, 2017). The indigenous Karen language is known to be one of the more difficult, as it has several dialects within it. Even people from this ethnicity can have trouble detecting the different dialects (Queensland Health Multicultural Services, 2011).

A secondary language that is also very well known throughout Burma is English, as it is the most common foreign language taught throughout schools (Nag, 2017).

Nag, O. S. (2017, August 1). What Languages Are Spoken In Myanmar (Burma)? World Atlas. https://www.worldatlas.com/articles/what-languages-are-spoken-in-myanmar-burma.html

Queensland Health Multicultural Services. (2011). Burmese Australians. Queensland Government. https://www.health.qld.gov.au/__data/assets/pdf_file/0027/155835/burmese2011.pdf

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Community Partners International. (2020). An Endemic within a Pandemic: Safeguarding Myanmar's Newborns From Hepatitis B During COVID-19. Community Partners International. https://www.cpintl.org/field-notes--updates/world-hepatitis-day-2020

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A common health issue found amongst Burmese refugees within Australia

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A common health issue found amongst Burmese refugees within Australia

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A common health issue found amongst Burmese Refugees in Australia is Hepatitis B Virus (HBV). This is common amongst our Burmese refugees as HBV is an endemic within Burma (Mclachlan et al., 2024). Most cases present with the symptoms of nausea, vomiting, jaundice, dark urine, and abdominal pain, but It’s very common to be asymptomatic. If the virus is chronic it can be extremely dangerous, and if left untreated it can progress further to fatal liver damage and liver cancer (World Health Organization, 2024).

A person with chronic HBV will need lifelong monitoring and treatment (Mclachlan et al., 2024). Unfortunately, there is no cure and only treatments available to manage symptoms (Department of Health and Aged Care, 2022). The most commonly seen treatments are the oral medications of Tenofovier or Entecavir, which are used to prolong a patients life by reducing the likeliness of liver cancer (World Health Organization, 2024).

Department of Health and Aged Care. (2022, July 12). Hepatitis B. Australian Government. https://www.health.gov.au/diseases/hepatitis-b

Maclachlan, J., Cowie, B., Isaacs, D., & Davis, J. S. (2024). Hepatitis B Virus (HBV). Australian Refugee Health Practice Guide. https://refugeehealthguide.org.au/hepatitis-b/

World Health Organization. (2024, April 9). Hepatitis B. https://www.who.int/news-room/fact-sheets/detail/hepatitis-b

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'Social Inclusion and Non-Discriminations' impact on the health of Burmese Refugees

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'Social Inclusion and Non-Discriminations' impact on the health of Burmese Refugees

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Social inclusion and Non-Discrimination directly impacts a person’s health, as studies have found that people who are socially included have a higher life expectancy (Australian Institute of Health and Welfare, 2024). As a refugee it is important that you feel socially included and not discriminated upon, but this doesn’t happen (Dobson et al., 2019). At the end of June 2020 there were 40,000 Burmese living in Australia, with 796 visas granted to Burmese refugees (Refugee Council of Australia, 2021). If these incoming refugees were to experience social exclusion and discrimination, it puts them at risk of psychological damage, long term anxiety, and depleted physical health (Australian Institute of Health and Welfare, 2024). In saying this, there is a large link between social exclusion and mental illness (Department of Health and Aged Care, 2012).

Australian Institute of Heath and Welfare. (2024, July 2). Social Determinants of Health. Australian Government. https://www.aihw.gov.au/reports/australias-health/social-determinants-of-health

Department of Health and Aged Care. (2012). Mental Health Statement of Rights and Responsibilities Part II: Non-discrimination and social inclusion. Australian Government. https://www1.health.gov.au/internet/publications/publishing.nsf/Content/pub-sqps-rights-toc~pub-sqps-rights-2

Dobson, S., Agrusti, G., & Pinto, M. (2019). Supporting the inclusion of refugees: policies, theories and actions. International Journal of Inclusive Education, 25(1), 1-6. https://doi.org/10.1080/13603116.2019.1678804

Refugee Council of Australia. (2021, March 1). Key issues for refugees from Myanmar (Burma). https://www.refugeecouncil.org.au/myanmar-burma/4/

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Burma is a very ethnically diverse country, with its population comprising of 9 main ethnicities. Within these ethnicities there are also many religions with their individual beliefs (Queensland Health Multicultural Services, 2011).

In Burma, 90% of the Burman, Mon, and Shan ethnicities are Theravada Buddhists. As a part of this religion they believe that the occurrence of a mental illness is due to one’s past, also commonly known as karma (Queensland Health Multicultural Services, 2011). This means that for someone in their culture to have a mental illness they would have had to act unwholesomely with impure intentions in their past. They refer to this as Akusala Kamma (Buddhism, 2023).

Buddhism. (2023, July 1). What is Karma according to Buddhism? Buddhism in English. [Video]. https://www.youtube.com/watch?v=xUyUp3KS80o

Queensland Health Multicultural Services. (2011). Burmese Australians. Queensland Government. https://www.health.qld.gov.au/__data/assets/pdf_file/0027/155835/burmese2011.pdf