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In 2021, the government in Afghanistan was overthrown by the Taliban.   The takeover by the Taliban resulted in human rights violations across Afghanistan and the marginalisation of women.  (Australian Government: Department of Foreign Affairs and Trade, n.d.)

These issues, and others, has resulted in Afghans experiencing distress and anxiety. (Transcultural Mental Health Centre, 2024)

Therefore, a health concern listed on the refugee health practice guide, which needs to be considered for Afghan refugees presenting in Australia, is mental health related issues.  (Australian Refugee Health Practice Guide, 2024)

In order to manage these mental health issues, referrals to appropriate mental health services should be made.  (Australian Refugee Health Practice Guide, 2024)

The use of Afghan community leaders has also been shown to assist with bridging the gap between the Afghan community and mental health providers. (Transcultural Mental Health Centre, 2024)

References:

Australian Government: Department of Foreign Affairs and Trade. (n.d.). Afghanistan. Australian Government: Department of Foreign Affairs and Trade: https://www.dfat.gov.au/geo/afghanistan

Australian Refugee Health Practice Guide. (2024). Mental Health. Australian Refugee Health Practice Guide: https://refugeehealthguide.org.au/mental-health/

Transcultural Mental Health Centre. (2024, July 3). Afghan Community Mental Health Profile. Transcultural Mental Health Centre: https://www.dhi.health.nsw.gov.au/transcultural-mental-health-centre-tmhc/resources/community-mental-health-profiles-and-information-resources/afghan-community-mental-health-profile#:~:text=Studies%20among%20Afghan%20refugees%20have,traumatic%20Stress%20D

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Social determinants of health: social inclusion and non-discrimination

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Social determinants of health: social inclusion and non-discrimination

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Social inclusion and non-discrimination is listed as being a social determinant of health. (World Health Organization, 2024)

Social exclusion and discrimination can cause psychological harm, as well as can impact on a person’s physical health, and reduce their life expectancy. (Social Determinants of Health, 2024)

Refugees from Afghanistan have experienced discrimination and social isolation on coming to Australia, including difficulties with connecting with people from their same community, due to ethnic divisions which exist in Afghanistan.  (ANMJ Staff, 2021)

Discrimination can impact on a refugee’s ability to access health services, obtain employment and make social connections, for reasons such as, some Australians linking Afghans to the Taliban or the events of September 11. (ANMJ Staff, 2021)

References:

World Health Organization. (2024). Social Determinants of Health. World Health Organization: https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1

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

ANMJ Staff. (2021, December 13). Afghan refugees face discrimination, employment and social challenges in Australia. Australian Nursing and Midwifery Journal: https://anmj.org.au/afghan-refugees-face-discrimination-employment-and-social-challenges-in-australia/#:~:text=Employment%20topped%20the%20list%20of,all%20Australians%20at%20that%20time.

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The national food dish of Afghanistan is Kabuli Pulao and is commonly prepared for special occasions.  (Queensland Government: Metro South Health, 2016)

This dish is made with meat, typically lamb, vegetables such as onions and carrots, raisons, cumin, cardamon, sugar, water and accompanied with basmati rice.  The rice is cooked using the juices from the meat. (Queensland Government: Metro South Health, 2016)

Traditionally, in Afghanistan, food is eaten on the floor, on a traditional rug, and the food is eaten communally, using your right hand.   (Hoffman, 2021)

References:

Hoffman, B. (2021, April 17). Kabuli Pulao from Afghanistan - around the world in one kitchen. Eat this New York: https://eatthisny.com/2021/01/07/web-series/around-the-world-in-one-kitchen-kabuli-pulao-from-afghanistan/

Queensland Government: Metro South Health. (2016, May). Afghan food and cultural profile: community. Queensland Government: Metro South Health: https://www.metrosouth.health.qld.gov.au/__data/assets/pdf_file/0023/242249/community-profile-afghan.pdf

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The official religion of Afghanistan is Islam. (Queensland Government: Metro South Health, 2016)

People that follow Islam are known as Muslims. (BBC, 2024)

For Muslims, Ramadan is the wholly month for fasting that falls within the ninth month of the Muslim calendar. (The Editors of Encylopedia Britannica, 2021)

Most Muslims will engage in this fasting, except for, those that are sick, women that are pregnant or breastfeeding or children under the age of 12. (The Editors of Encylopedia Britannica, 2021)

During Ramadan, Muslims are not permitted to eat or drink during the day.  Muslims will typically eat a light meal at sunset, a larger meal after prayer time and a third meal before sunrise. (The Editors of Encylopedia Britannica, 2021)

References:

BBC. (2024). Religions. https://www.bbc.co.uk/religion/religions/islam/#:~:text=Those%20who%20follow%20Islam%20are,word%20for%20God%20is%20Allah

Queensland Government: Metro South Health. (2016, May). Afghan food and cultural profile: community. Queensland Government: Metro South Health: https://www.metrosouth.health.qld.gov.au/__data/assets/pdf_file/0023/242249/community-profile-afghan.pdf

The Editors of Encylopedia Britannica. (2021, June 7). Ramadan. Britannica: https://www.britannica.com/topic/Ramadan

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In Afghanistan, there are between 40-59 different languages spoken. (Translators without Borders, 2024)

Pasto and Dari are the official languages of Afghanistan, as well as being the most widely spoken. (Translators without Borders, 2024)

Pasto is spoken by 48% of the population, with Dari spoken by 77%. (Translators without Borders, 2024)

The Pasto language originates from the Pashtun people and the Dari language originates from the Tajik people. (Queensland Government: Metro South Health, 2016)

The official language of Iran, being Farsi, is also commonly spoken in Afghanistan. (Queensland Government: Metro South Health, 2016)

6% of the population of Afghanistan speak English. (Translators without Borders, 2024)

References:

Queensland Government: Metro South Health. (2016, May). Afghan food and cultural profile: community. Queensland Government: Metro South Health: https://www.metrosouth.health.qld.gov.au/__data/assets/pdf_file/0023/242249/community-profile-afghan.pdf

Translators without Borders. (2024). Language data for Afghanistan. Translators without Borders: https://translatorswithoutborders.org/language-data-for-afghanistan

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The competency standard that resonated with me the most was 1.2, regarding health-care providers recognising the impact of traumatic events on refugees. (Migrant & Refugee Women's Health Partnership, 2019)

After reading about the experiences of Afghan women, I have improved my understanding of the types of trauma they may have experienced whilst in Afghanistan.

I feel having this understanding will allow me to better care for, and advocate for my patients that are refugees.

For example, if a female Afghan patient did not want to be cared for by a male health care worker, I will be able to better understand their reasons for this concern, and be able to advocate for them.

Reference:

Migrant & Refugee Women's Health Partnership. (2019, January). 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

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In Afghanistan, natural medicine is referred to as Unani medicine and practiced by Hakin, being traditional herbalists. (Southeastern National Tuberculosis Centre, 2022)

Afghanistan has a diverse range of plant flora, with hundreds of different plants used for Unani medicine. (Amini & Hamdam, 2017)

Unani medicine is used for the prevention and cure of a range of ailments, as opposed to modern medicine, due to the lower cost and easier accessibility. (Amini & Hamdam, 2017)

An example of Unani medication is the use of licorice root.  Licorice root is used in Afghanistan to treat a variety of ailments, such as respiratory illness or kidney pain. (Amini & Hamdam, 2017)

The World Health Organization has produced a 608-page document on international standard terminologies for Unani medicine. (World Health Orgnization, 2022)

Reference:

Amini, M., & Hamdam, S. (2017). Medicinal Plants Used Traditionally in Guldara District of Kabul, Afghanistan. International Journal of Pharmacognosy and Chinese Medicine, 1-13.

Southeastern National Tuberculosis Centre. (2022). Afghanistan. Southeastern National Tuberculosis Centre: https://sntc.medicine.ufl.edu/Content/Products/Downloads/Afghanistan%20Cultural%20Quick%20Reference%20Guide.pdf

World Health Orgnization. (2022). WHO international standard terminoligies on Unani medicine. World Health Orgnization: https://iris.who.int/bitstream/handle/10665/365544/9789240064959-eng.pdf?sequence=1