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The WHO social determinants of health, social inclusion and non-discrimination, relate to the Syrian culture. This social determinant is a non-medical factor and is recognised in the Syrian refugees who have arrived in Australia, as they may experience being treated unequally and not receiving the opportunity to participate in societal norms (WHO, 2023). According to the Australian Institute of Health and Welfare (2024), social exclusion can be caused by disadvantages, poor resources, poor health, stigmatisation, discrimination, socioeconomic position, education, and many other prejudicial factors. Since several Syrian refugees are experiencing these challenges, they can affect their well-being, access to essential services such as healthcare, education, and employment, health issues, and forming a rapport with the community (Ermansons et al., 2023). In Australia, many Indigenous and Culturally Linguistically Diverse refugees experience disadvantages, so promoting social inclusion and non-discrimination would be an essential strategy to improve a refugee's quality of life and access to services.

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

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

Ermansons, G., Kienzler, H., Asif, Z., & Schofield, P. (2023). Refugee mental health and the role of place in the Global North countries: A scoping review. Health & Place, 79, Article 102964. https://doi.org/10.1016/j.healthplace.2023.102964

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Country focus: Syria

Syria is a country found in the Middle East. This country experienced a war in March 2011, causing many Syrians to be displaced and become refugees moving to other countries, including Australia. The Syrian conflict is still one of the most significant crises in the world, requiring humanitarian and security support (Refugee Council of Australia, 2024). Since the crisis that occurred in 2011, Australia has provided humanitarian support and recently contributed $30 million to the crisis response (Australian Government Department of Foreign Affairs and Trade, 2022). In 2023, it was recognised that there was a total of 2.75 million newly displaced refugees, of which 161,981 were displaced Syrian refugees (Refugee Council of Australia, 2024). One common health condition mentioned on the Australian health practice guide that refugees typically presenting with is low vitamin D levels (Australian Refugee Health: Primary Care for People of Refugee Backgrounds, 2023). This condition can be described as a nutritional deficiency that is essential for bone and muscle health. A vitamin D deficiency in Syrian refugees can be managed through a daily or high-dose therapy of D3 supplements. Once the therapy has commenced, a follow-up blood test should be taken, and education regarding safe sun exposure and health should be provided to ensure the prevention of ongoing risk factors.

Australian Government Department of Foreign Affairs and Trade. (2022). Syria humanitarian response. Australian Government Department of Foreign Affairs and Trade. https://www.dfat.gov.au/geo/syria/syria-humanitarian-response

Australian Refugee Health» Primary Care for People of Refugee Backgrounds. (2023). Australian Refugee Health Practice Guide. https://refugeehealthguide.org.au/

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Refugee Council of Australia. (2024, June 19). Refugees Protected in Australia at 7-Year High, UNHCR Data Shows. https://www.refugeecouncil.org.au/refugees-protected-in-australia-2023/

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Cultures health beliefs/ traditional medicine

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Cultures health beliefs/ traditional medicine

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In the Syrian Arab Republic, healthcare cannot be easily accessed. The World Health Organisation has estimated that 88% of the world's population's health needs use traditional and therapeutic healthcare practices (WHO & PANO, 2023). The population of Syria is very aware of their health needs, focusing on their physical health while aligning with their culture and religious beliefs. In Syria, many of the rural areas suffer from determinants such as poverty, so they utilise folk remedies and folk Healers for low costs. In the Syrian culture, they utilise planted and wild plants for their traditional medicine. Achillea Santolina, also known as Kaisoom, from the Asteraceae family, is one of the many plants used to treat a range of different symptoms. This plant is used by the infusion of its leaves and is used internally to manage illnesses such as fevers, common colds, amenorrhea, diarrhoea, loss of appetite, GI tract infections, dysentery, and is also used to induce sweating (Khatib et al., 2021).

Khatib, C., Nattouf, A., & Hasan Agha, M. I. (2021). Traditional medicines and their common uses in central region of Syria: Hama and Homs – an ethnomedicinal survey. Pharmaceutical Biology, 59(1), 776–786. https://doi.org/10.1080/13880209.2021.1936078

WHO Global Summit on Traditional Medicine highlights scientific evidence and integration into health systems - PAHO/WHO | Pan American Health Organization. (2023, August 28).

https://www.paho.org/en/news/6-9-2023-who-global-summit-traditional-medicine-highlights-scientific-evidence-and-integration

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For me, a relevant aspect of competency standard 1.1 was cultural safety and person-centred care (Culturally Responsive Clinical Practice Working With People From Migrant and Refugee Backgrounds, 2019). I have improved my understanding of diversity, social determinants, individual preferences, and cultural considerations. Having learned how to respond sensitively and without assumptions, I now feel more confident and socially aware when caring for patients with different cultural needs and preferences from mine. This understanding is essential to me in the workplace because it is important to respond sensitively without assumptions while providing safe, effective, and person-centred care to all culturally different patients. Because I have not yet encountered a situation with a patient before, I will now need to gain knowledge on social determinants from different cultures to have an appropriate approach. Previously, I did not realise how significant social determinants and multicultural awareness are in healthcare. Equally, this is because of my lack of experience in this environment.

Migrant and Refugee Women's Health Partnership. (2019). Culturally responsive clinical practice: Working with people from migrant and refugee backgrounds. https://culturaldiversityhealth.org.au/wp-content/uploads/2019/02/Culturally-responsive-clinical-practice-Working-with-people-from-migrant-and-refugee-backgrounds-Jan2019.pdf