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Domain 1: Culturally Responsive Clinical Practice

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Domain 1: Culturally Responsive Clinical Practice

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Through standard 1.2 (Culturally Responsive Clinical Practice: Working with People from Migrant and Refugee Backgrounds January 2019), I recognise the profound impact that refugee-like experiences, including trauma and PTSD on patients.

For me, the most meaningful learning resulted from the awareness of these patients' psychological and emotional burdens. I have improved my ability to ask questions sensitively and creating a safe and supportive environment.

Having analysed standard 1.2 (Culturally Responsive Clinical Practice: Working with People from Migrant and Refugee Background, January 2019), I realise the importance of active listening, allowing the patient to share their story at their own pace. This skill is crucial in my practice because it helps me foster trust and empathy. Though not yet fully confident, I will educate myself on trauma’s complexities to confidently provide patient-centered care that respects lived experiences.

Previously, I did not realise the challenges faced by such people due to a lack of awareness regarding the trauma faced by those who have endured displacement, violence, and loss.

Reference

Migrant and Refugee Women’s Health Partnership. (2019). Competency standards framework for clinicians: Culturally responsive clinical practice: Working with people from migrant and refugee backgrounds.Culturally Responsive Clinical Practice.

https://cbrhl.org.au/wp-content/uploads/2020/10/Culturally-responsive-clinica.pdf

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Non-discrimination and social inclusion make Australia a safe haven for refugees 

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From both global and Australian multicultural perspectives, social determinants like income, education, and healthcare access significantly influence health outcomes for refugees. Social inclusion and non-discrimination are crucial in shaping health outcomes. For Afghan refugees, barriers such as language and cultural differences can exacerbate feelings of exclusion, negatively impacting mental and physical health (Sampson & Gifford, 2010). Inclusion and equitable access to services improve health by fostering trust and reducing stress (Australian Institute of Health and Welfare, 2018). Discrimination undermines healthcare access and exacerbates health disparities (Refugee Council of Australia, 2022). Non-discrimination and inclusive policies lead to healthier communities.

References

Australian Institute of Health and Welfare. (2018). Australia’s health 2018. Australian Institute of Health and Welfare. https://www.aihw.gov.au/getmedia/746ded57-183a-40e9-8bdb-828e21203175/aihw-aus-221-chapter-4-2.pdf.aspx

Refugee Council of Australia. (2022). Refugee health and wellbeing in Australia. Impact of asylum policies on social cohesion (refugeecouncil.org.au)

Sampson, R., & Gifford, S. M. (2010). Place-making, settlement and well-being: the therapeutic landscapes of recently arrived youth with refugee backgrounds. Health & place, 16(1), 116–131. https://doi.org/10.1016/j.healthplace.2009.09.004

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Traditional painting by Afghani artist Kamāl ud-Dīn Behzād

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Delivering culturally safe nursing care for Afghani individuals requires recognizing and honouring their customs, values, and traditions. Traditional Afghan attire includes modest clothing, featuring intricate embroidery and vibrant colors, with women commonly wearing parahan, headscarves (hijab or chador), and men donning shalwar kameez and turbans. Afghan dance like the Attan, is a circular group dance performed at celebrations, symbolizing unity and resilience (AHRDO, 2016). Afghan art features detailed geometric patterns and calligraphy, reflecting Islamic influence. Understanding these cultural elements fosters trust, promotes dignity, and enhances patient-centered care within Afghan communities.

References:

Afghan Human Rights and Democracy Organization. (2016). Traditional dances of Afghanistan. Afghan Human Rights and Democracy Organization.
https://www.peacewithjustice.org/partner/afghanistan-human-rights-and-democracy-organisation-ahrdo/

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Ancient Afghani traditions, language and sports

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Ancient Afghani traditions, language and sports

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Providing culturally safe nursing care for Afghani individuals requires understanding their language, traditions, and sports. Many Afghans speak Dari or Pashto, and using basic greetings or arranging interpreters fosters communication (Baker, 2011). Afghan traditions emphasize family bonds, respect for elders, and modesty, gender segregation and arranged marriages. Sports like buzkashi (a horseback game involving a goat carcass) and soccer are culturally significant and symbolize strength, teamwork, and resilience (Whitney, 2011). Awareness of these cultural practices builds rapport, shows respect for Afghan identity, and creates a supportive and patient-centered care environment aligned with their values and experiences.

References:

Baker, W. (2011). Intercultural awareness: Modelling an understanding of cultures in intercultural communication through English as a lingua franca. Language and Intercultural Communication 11.3, 197–214.

Whitney, A. (2011). Buzkashi: Game and power in Afghanistan. Waveland Press.

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Culturally safe nursing care for Afghan individuals involves understanding their dietary and religious needs. Afghan cuisine includes halal food, features staples like rice, meat, and bread, for example, Kabuli Pulao, Mantu, and Qorma. As per their Halal practices, they avoid pork and alcohol in meals (Islamic Council WA, 2024). Islam is the predominant religion, with most Afghans adhering to Sunni Islam (around 85-90%) and 10-15% practicing Shia Islam. Religious practices include the five daily prayers, fasting during Ramadan, and giving zakat (charitable donations). Eid al-Fitr and Eid al-Adha are major religious and cultural events in Afghan society.

1. References
Islamic Council WA. (2024, June). Halal guidelines. Islamic Council WA.
https://www.islamiccouncilwa.com.au/halal-certification/halal-guidelines/

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Management techniques for iron deficiency as per 'Australia refugee health practice guide.'

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Common health concern of Afghan refugees 

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Common health concern of Afghan refugees 

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One common health concern among Afghan refugees in Australia is iron deficiency, due to prolonged food insecurity from decades of conflict and instability (Sanati, Kumble, Hanieh, & Biggs, 2014; Levitt, Kostermans, et al., 2011). The traditional Afghan diet, rich in carbohydrates like bread and rice, may lack sufficient iron-rich foods such as red meat, leafy greens, and fortified cereals. Additionally, heavy tea consumption can interfere with iron absorption (Australian Department of Health, 2021). With limited access to a balanced diet during displacement, many refugees may arrive with inadequate nutrition. Afghan women of reproductive age face higher risk due to frequent pregnancies, poor prenatal care, and cultural practices prioritizing men’s nutritional needs. Intermittent oral iron (e.g. once or twice weekly) may minimize side effects. Nurses must review side effects (e.g. dark stools, constipation, gastrointestinal upset), safety, and storage with patients and families, use Easidose for picture-based dosing, (Victorian Foundation for Survivors of Torture Inc., 2024).

References

Australian Department of Health. (2021). Iron deficiency and anaemia: Risk factors and prevention. Australian Government. https://www.health.gov.au

Victorian Foundation for Survivors of Torture Inc. (2024). Australian refugee health practice guide. Refugee Health Network of Australia. https://refugeehealthguide.org.au

Levitt, E., Kostermans, K. et al (2011) Malnutrition in Afghanistan: Scale, Scope, Causes and Potential Response. The World Bank. https://openknowledge.worldbank.org/handle/10986/2518

Sanati Pour M, Kumble S, Hanieh S, Biggs B. (2014). Prevalence of dyslipidaemia and micronutrient deficiencies among newly arrived Afghan refugees in rural Australia: a cross-sectional study. BMC Public Health, 14(1),896.

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Health belief and medicinal herbs of Afghan culture 

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Health belief and medicinal herbs of Afghan culture 

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A common health belief among Afghan individuals involves the concept of "hot" and "cold" foods and their effects on the body. This belief, influenced by the Unani system of medicine, categorizes foods as either heating (hot) or cooling (cold). For instance, spicy foods or red meats are considered "hot," while dairy or certain fruits are "cold." Balancing these energies is thought to maintain health and prevent illness. Afghans may also use herbal remedies such as green tea and black cumin because of their anti-inflammatory and antioxidant properties to treat digestive problems, respiratory issues and diabetes, and regulate blood pressure (Baron, 2004).

References

Baron M. (2004) Nutrition and Afghan Culture. Health Care Food and Nutrition Focus. 21(11), 11-12