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As a student nurse, the most significant aspect of multicultural health in nursing is understanding the medico-legal responsibilities of working with refugee patients with limited English proficiency. I have developed my understanding on when it is legally and ethically required of me to involve an accredited interpreter, even if the patient does not request one, and that failing to do so can lead to significant medico-legal risks in line with the Culturally Responsive Framework for Clinicians, Competency Standard 1.3 (Migrant and Refugee Women’s Health Partnership, 2019). I now understand that using family members, partners, friends, minors, or translation apps for interpretation of health information is not appropriate, as it becomes inaccurate, compromising confidentiality and patient safety. Because I am not yet confident in working alongside interpreters in practice, I will now need to educate myself on accessing and collaborating with them in the clinical setting. I feel this knowledge is critical in nursing because clear, accurate, and compliant communication is the foundation for providing safe, person-centred care.

Migrant and Refugee Women’s Health Partnership. (2019). Culturally Responsive Clinical Practice: Working with People from Migrant and Refugee Backgrounds COMPETENCY STANDARDS FRAMEWORK FOR CLINICIANS. https://culturaldiversityhealth.org.au/wp-content/uploads/2019/02/Culturally-responsive-clinical-practice-Working-with-people-from-migrant-and-refugee-backgrounds-Jan2019.pdf

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Koall, C. (Photographer). (2014). Refugees cross from Syria into Turkey as Islamic State fighters reach the outskirts of the Kurdish Syrian town of Kobane, just across the border [Photograph]. Getty Images. https://www.gettyimages.com/detail/news-photo/refugees-cross-from-syria-into-turkey-as-islamic-state-news-photo/

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For Syrian refugees resettling in Australia, social determinants like social inclusion and non-discrimination shape whether healthcare feels accessible and safe (World Health Organisation, 2024). Between 2016-17, Australia welcomed a one-off intake of 12000 Syrian refugees (DFAT, 2015). In such a drastically different place, it was found that experiences of discrimination lead to a decline in mental health and less service use (Ziersch et al., 2020). The Arabic-English language barrier only amplified this risk of poorer outcomes when accredited interpreters were not utilised, putting Syrian refugees at clinical and medico-legal risk.

Medicare access for refugees and Australia's Free Interpreting Service support inclusion, only if health professionals actively access them. Nurses play a vital role in promoting non-discrimination by ensuring informed consent and clear communication by arranging accredited interpreters and avoiding reliance on family translation. These policies in practice create a safer, inclusive and non-discriminatory healthcare system for refugee Australians.

Ziersch, A., Due, C., & Walsh, M. (2020). Discrimination: A health hazard for people from refugee and asylum-seeking backgrounds resettled in Australia. BMC Public Health, 20(1), 108. https://doi.org/10.1186/s12889-019-8068-3

Department of Foreign Affairs and Trade. (2015, September 9). The Syrian and Iraqi humanitarian crisis [Media release]. Australian Government. Retrieved from https://www.dfat.gov.au/news/news/Pages/syrian-and-iraqi-humanitarian-crisis

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Common Health Concerns of Syrian Refugees

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Common Health Concerns of Syrian Refugees

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A common health concern of Syrian refugees relocating to Australia is anaemia, often caused by disrupted diets, poor camp living conditions, blood loss, chronic illness, or parasitic infections. It is particularly common among newly arrived women and children refugees from Syria, who experience fatigue, dizziness, and shortness of breath, all of which lower their quality of life (Australian Refugee Health Practice Guide, n.d.). In children, anaemia can result in growth delay, poor concentration, and developmental issues.

Anaemia is generally managed through iron supplements, most often taken as tablets, though in more severe cases an iron transfusion may become necessary (Australian Refugee Health Practice Guide, n.d.). Without treatment, it can result in serious consequences such as pregnancy complications or worsening of chronic health conditions like heart disease. Access to appropriate and reliable care for anaemia may be delayed by Syrian refugees, financial strain, language barriers, or a lack of understanding of the Australian healthcare system (Ziersch et al., 2020). Nurses can assist in removing these barriers and improving patient outcomes by providing culturally appropriate support and education.

Chaves, N., & Paxton, G. (n.d.). Anaemia, Iron Deficiency, and Other Blood Conditions» Australian Refugee Health. Australian Refugee Health Practice Guide. https://refugeehealthguide.org.au/anaemia-iron-deficiency-and-other-blood-conditions/

Ziersch, A., Miller, E., Baak, M., & Mwanri, L. (2020). Integration and social determinants of health and wellbeing for people from refugee backgrounds resettled in a rural town in South Australia: a qualitative study. BMC Public Health, 20(1), 1–16. https://doi.org/10.1186/s12889-020-09724-z

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In Syrian culture, herbal remedies are used to treat common illnesses such as respiratory diseases, minor infections, skin conditions and digestive issues. It is traditional to incorporate a variety of plants and herbs like chamomile, sage, and za'atar (thyme), which have healing, anti-inflammatory, and calming properties (Jaddouh, 2022). Because these remedies are natural, clean, home-based, and familiar, they're generally perceived as safe and familiar by Syrian culture.

When it comes to more serious health conditions, these herbal treatments may limit health outcomes, and it becomes a risk of reacting negatively with prescribed medications. If no professional medical help is being accessed, the remedies cannot treat or manage more severe conditions like anaemia or chronic diseases. When working with Syrian refugees, nurses must be aware of these practices to discuss potential negative interactions, provide culturally safe care, and guide patients toward safe and effective treatment options (Ziersch et al., 2020).

Jaddouh, A. (2022, February 5). Traditional medicine in Syria: folk medicine in Aleppo governorate. Natural Product Communications. https://www.academia.edu/70564632/Traditional_medicine_in_Syria_folk_medicine_in_Aleppo_governorate

Ziersch, A., Miller, E., Baak, M., & Mwanri, L. (2020). Integration and social determinants of health and wellbeing for people from refugee backgrounds resettled in a rural town in South Australia: a qualitative study. BMC Public Health, 20(1), 1–16. https://doi.org/10.1186/s12889-020-09724-z