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Christ Thorn (Ziziphus spina-christi) is a spiny shrub or small tree growing up to 10 m in height. https://upload.wikimedia.org/wikipedia/commons/8/84/Ziziphus-areva-israel.jpg

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Herbal medicine has a long history in Sudan and is widely practiced among the general population (Mohamed et al., 2024). Ziziphus spina-christi, known as Christ's thorn jujube, a tropical tree native to Sudan, holds remarkable historical and religious significance. Its boiled leaf extracts are traditionally used by Muslims to cleanse bodies before burial, indicating potential antibacterial properties. Z. spina-christi is commonly used in ethnomedicine for the treatment of many illnesses such as digestive disorders, weakness, hepatic disorders, obesity, urinary problems, diabetes, skin infections, fever, diarrhea, or insomnia. This species has been extensively utilized as a food source, medicinal plant, and for environmental protection purposes since ancient times, remaining in use to this day  (Kuhnert & Karar, 2017).

Elegami, A. A., El‐Nima, E. I., El, S., & Muddathir, A. K. (2002). Antimicrobial activity of some species of the family Combretaceae. Phytotherapy Research, 16(6), 555–561. https://doi.org/10.1002/ptr.995

Kuhnert, N., & Karar, M. E. (2017). Herbal drugs from Sudan: Traditional uses and phytoconstituents. Pharmacognosy Reviews, 11(22), 83. https://doi.org/10.4103/phrev.phrev_15_15

Mohamed, R., Mohamed, R., Dafalla, R., Ahmed, A., & Abdulrahman Abdeldaim. (2024). The prevalence of herbal medicine among Sudanese adults: a cross-sectional study 2021. BMC Complementary Medicine and Therapies, 24(1). https://doi.org/10.1186/s12906-024-04584-1

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Reflection on Culturally Responsive Clinical Practice: Working with People from Migrant and  Refugee Backgrounds competency standards framework for clinicians.

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Reflection on 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 relevant aspect was competency standard 1.4 from Domain 1, clinical expert. It focuses on the importance of clinicians recognizing the significant role that family involvement plays when caring for individuals from migrant and refugee backgrounds. This involves actively including family members in discussions and decisions about health-related matters. I have improved my understanding of integrating family members into the care process. Having learned about the significant impact that family involvement can have on patient outcomes and satisfaction, I now feel more capable of providing culturally sensitive care. This skill is essential in my nursing practice because it allows me to respect cultural values.

Culturally Responsive Clinical Practice: Working with People from Migrant and Refugee Backgrounds. (2024). Murdoch.edu.au. 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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Gibbs, G. (1988). Learning by doing: a Guide to Teaching and Learning Methods. Programmed Learning & Educational Technology, 25(2).

Hampton, M. (2010). Reflective writing: A basic introduction. Retrieved July, 12, 2014.

About the Standards. (n.d.). Migrant & Refugee Health Partnership.

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About the Standards

Competency Standards Framework - Culturally responsive clinical practice: Working with people from migrant and refugee backgrounds establishes recommended and optimal cultural responsiveness competency standards for clinicians in all healthcare settings.

Delivering quality care to people from migrant and refugee backgrounds requires clinicians to adopt culturally responsive practices and utilise competencies enabling them to communicate and work effectively with this cohort.

The purpose of the Framework is to inform the development of clinical education, training, professional development curricula and competency standards for clinicians. The Framework is intended to be flexible and is designed to apply across a range of healthcare settings and across a range of curricula and competency standards models. The Framework has been widely endorsed by peak professional bodies for clinicians
What are the Competency Standards? Watch the video below.

It is our hope that all clinical education, training and standard setting bodies consider and adapt the Framework to meet their respective needs, circumstances and context.

The Framework is accompanied by the Guide for Clinicians Working with Interpreters in Healthcare Settings, which provides evidence-based recommendations for effective communication in the event of doctor-patient language discordance, specifically with regard to engaging and working with interpreters.

The Guide has been officially recognised as an Accepted Clinical Resource by The Royal Australian College of General Practitioners.

Culturally responsive clinical practice: Working with people from migrant and refugee backgrounds

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We acknowledge the Traditional Custodians of the land across Australia for their continuing connection to land, sea, community, and culture. We pay our respects to their Elders past, present and emerging.

We welcome any questions or input from our stakeholders and the broader community. These should be directed to the Secretariat of the Partnership:
secretariat@culturaldiversityhealth.org.au

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About the Standards - Migrant & Refugee Health Partnership

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The Judicial Council on Diversity will Commission research and undertake public consultation processes on issues relating to cultural and linguistic diversity in Australia's judicial system, including but not limited to.

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Social inclusion and non-discrimination are critical social determinants of health highlighted by the World Health Organization and have a significant impact on the health of refugees. The environments in which individuals are born, grow, live, work, and age are fundamental to their overall health. Research indicates that these social determinants can have a greater influence on health than medical care or lifestyle choices, with studies estimating that they account for 30-55% of health outcomes (World Health Organization, 2024). For Sudanese refugees in Australia, feeling welcomed and experiencing equitable treatment can profoundly affect their health. Additionally, living conditions and environments support mental health, since these two factors allow people to adopt and maintain healthy lifestyles (Cook, 2008).

Cook E. C. (2008). Residential wilderness programs: the role of social support in influencing self-evaluations of male adolescents. Adolescence, 43(172), 751–774.

Henderson, S., & Kendall, E. (2011). Culturally and linguistically diverse peoples’ knowledge of accessibility and utilisation of health services: exploring the need for improvement in health service delivery. Australian Journal of Primary Health, 17(2), 195. https://doi.org/10.1071/py10065

World Health Organization. (2024). Social determinants of health. World Health Organization.

https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1

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One of the common health issues among Sudan refugee is vitamin D deficiency (Queensland Health Multicultural Services, 2011). Vitamin D encompasses both D3 (cholecalciferol) and D2 (ergocalciferol). D3 is produced in the skin when ultraviolet-B (UVB) rays from sunlight interact with it. Individuals from refugee backgrounds often have several risk factors for vitamin D deficiency, including darker skin, wearing clothing that covers most of the body, and reduced sun exposure due to migration to regions with less sunlight. Screening for vitamin D deficiency is recommended for individuals with one or more risk factors and should be part of the initial health assessment for refugees. For adults, a daily intake of 600 IU is recommended for those under 70 years old, and 800 IU for those aged 70 years and older.

‌Australian Refugee Health» Primary Care for People of Refugee Backgrounds. (n.d.). https://refugeehealthguide.org.au/

Hussain, T., Eimal Latif, A. H., Malik, S., Raza, S., Saeed, T., Salman Zahid, A., Nazary, K., Arshad, M. M., Khan, R., Walizada, K., & Wahab, A. (2021). Vitamin D Deficiency and Associated Risk Factors in Muslim Housewives of Quetta, Pakistan: A Cross-Sectional Study. Cureus, 13(9), e17643. https://doi.org/10.7759/cureus.17643

Queensland Health Multicultural Services. (2011). Community Profiles for Health Care Providers - Sudanese Profile. https://www.health.qld.gov.au/__data/assets/pdf_file/0031/157378/sudanese2011.pdf

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Zar ritual is the practice of reconciling the possessing spirit and the possessed individual. https://wrldrels.org/2019/11/20/zar-spirit-possession-in-central-sudan/

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The Zar ceremony is a religious ritual that involves drumming and dancing to heal illnesses believed to be caused by a demon, usually affecting women but occasionally men. During the Zar ceremony, an altar is set up, consisting of a large tray placed on a bench in the center of the room, covered with a white cloth, and filled with piles of nuts and dried fruits. The ceremony is guided by a leader, often a woman, who ensures that the ritual follows ancient traditions. Music plays a crucial role in the Zar ceremony, with family members usually playing the instruments. Some frequently used instruments include the tar, a kind of tambourine, the manjur, the tanburu, and a variety of other percussion instruments.

Al‐Shahi, A. (1984). Spirit possession and healing: the zar among the Shaygiyya of the Northern Sudan. British Journal of Middle Eastern Studies, 11(1), 28-44.

Grotberg, E. H. (1990). Mental Health Aspects of Zar for Women in Sudan. Women & Therapy, 10(3), 15–24. https://doi.org/10.1300/J015v10n03_02

Traditions. (n.d.). Sudan. https://sudanandsouthsudan.weebly.com/traditions.html

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Over 90% of houses in South Sudan are grass-thatched, mud huts. https://sudantribune.com/wp-content/uploads/2013/04/jpg_tukul1.jpg

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Sudanese people typically live in modest homes, either owning them or renting from landlords or agricultural authorities. More than half of all housing units are gottias, which are single room structures with round mud walls and conical straw roofs. About one third of the homes are menzils, which are multi room houses with toilet facilities (Homes, 2013). More than 80% of homes are owned by the people who live in them. Almost every house, even those in cities, has a walled courtyard or garden. In major cities, bungalows are provided for high-ranking government officials and senior foreign employees. Additionally, a national housing authority provides affordable housing options for government employees, rural schoolteachers, and those with low incomes.

Homes. (2013, October 23). Sudan - Quality of Life; Sudan - Quality of Life. https://year8sudan.wordpress.com/homes/

Ibrahim, A. O. (2021). The mud traditional architecture of the Sudan and Saudi Arabia: The difference in employment techniques. Eximia, 3(1), 100-116.

Traditions. (n.d.). Sudan. https://sudanandsouthsudan.weebly.com/traditions.html

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Regarding the religious landscape of Sudan, 70% of the population is Muslim, 25% practice traditional indigenous religions, and 5% are Christian. In northern Sudan, Islam is predominant, with around 90% of people adhering to its teachings. The traditional indigenous religions in Sudan are mainly forms of Animism, where it is believed that all natural entities possess a spirit. Each clan typically has a totem that symbolizes their primary spiritual belief and is a focal point of worship. Additionally, they may honour gods based on the domains these deities represent, often incorporating animal sacrifices into their rituals. Christianity is mostly present in regions where missionary activities are taking place.

North Sudanese Culture - Religion. (n.d.). Cultural Atlas. https://culturalatlas.sbs.com.au/north-sudanese-culture/north-sudanese-culture-religion

Sikainga, A. Alawad , Sabr, . Mohy el Din , Al-Shahi, . Ahmed S. , Spaulding, . Jay L. , Unit, . Economist Intelligence and Collins, . Robert O. (2024, August 27). Sudan. Encyclopedia Britannica. https://www.britannica.com/place/Sudan

United States. Department of State. Bureau of Public Affairs (1985). Sudan. Department of State publication. Background notes series, 1–8.