I'm Shania, a student nurse who is learning about Multicultural Health and what it means to be a culturally safe nurse. To me, health is a universal right that transcends borders and backgrounds. It's about ensuring every individual is given the opportunity to thrive in all aspects of their health. True health should always be inclusive and equitable.

That is why in this blog, I will be exploring the meaning of health in Afghani culture and how accessible it is for Afghani immigrants in Australia and the common health issues they face during migration. My goal is to inspire you to engage with your patients and learn about their different cultural backgrounds so you can give them the best care possible.

Thank you for stopping by. Feel free to subscribe to my blog for the latest updates!

Warmest regards,

Shania Bird

'Culturally responsive clinical practice framework' Competency Standard 1.2: Clinicians recognise the impact of refugee-like experiences, including experiences of traumatic events and post-traumatic stress disorder, and take these experiences into account during the assessment, diagnosis, treatment and ongoing care to modify their approach as appropriate and to provide trauma-informed care.

The UNHCR reports that over 550,000 Afghans have been displaced due to war, causing psychological issues (Rezaei et al., 2021). I was appalled when discovering many Afghani refugees in Australia avoid seeking, fearing information disclosure and discrimination, due to distrust in health professionals that is rooted in trauma and persecution (Tomasi et al., 2022). Reflecting on Competency Standard 1.2, I realised trust is essential for effective care. Trust fosters safe environments where individuals particularly with trauma feel comfortable to seek help and share critical information necessary for their treatment (Abbasova & Sarafian, 2019). As a student nurse, I can build trust through active listening, displaying empathy, and maintaining confidentiality (Crisp et al., 2020).

References:

1. Abbasova, G., & Sarafian, C. (2019). Culturally Responsive Clinical practice: Working with people from migrant and refugee backgrounds Competency Standards Framework for clinicians. In L. Martinez & O. Dandash (Eds.), Migrant & Refugee Women’s Health Partnership. https://cbrhl.org.au/wp-content/uploads/2020/10/Culturally-responsive-clinica.pdf

2. Tomasi, A., Slewa-Younan, S., Narchal, R., & Rioseco, P. (2022). Professional Mental Health Help-Seeking amongst Afghan and Iraqi refugees in Australia: Understanding predictors five years post resettlement. International Journal of Environmental Research and Public Health, 19(3), 1896. https://doi.org/10.3390/ijerph19031896

3. Rezaei, O., Adibi, H., & Banham, V. (2021). Integration Experiences of Former Afghan Refugees in Australia: What Challenges Still Remain after Becoming Citizens? International Journal of Environmental Research and Public Health, 18(19), 10559. https://doi.org/10.3390/ijerph181910559

4. Crisp, J., Douglas, C., Rebeiro, G., & Waters, D. (Eds.). (2021). Potter & Perry’s fundamentals of nursing (6E, Australia and New Zealand edition. eds.). Elsevier Australia a division of Reed International Books Australia Pty Ltd.

   
   

References:

1. Abood, J., Woodward, K., Green, J., Tadjoeddin, Z., & Renzaho, A. M. N. (2022). Understanding settlement services literacy and the provision of settlement services for humanitarian migrants in Australia—A service provider perspective. Australian Journal of Social Issues, 57(3), 687–708. https://doi.org/10.1002/ajs4.204

2. Coumans, J. V. F., & Wark, S. (2024). A scoping review on the barriers to and facilitators of health services utilisation related to refugee settlement in regional or rural areas of the host country. BMC Public Health, 199. https://doi.org/10.1186/s12889-024-17694-9

3. Rezaei, O., Adibi, H., & Banham, V. (2021b). Integration Experiences of Former Afghan Refugees in Australia: What Challenges Still Remain after Becoming Citizens? International Journal of Environmental Research and Public Health, 18(19), 10559. https://doi.org/10.3390/ijerph181910559

'Culturally responsive clinical practice framework' Competency Standard 1.1: Clinicians respond sensitively and without assumptions to the diversity of individual characteristics and social determinants of health—including cultural, religious or spiritual and linguistic considerations, health beliefs, individual abilities, choices and preferences— and modify their approach as appropriate.

Traditional medicine is integral in Afghanistan due to prolonged conflict, limiting the supply and affordability of modern medicines. Limited access to healthcare facilities and pharmacies, especially in rural areas, force reliance on traditional healers and herbal practitioners (Roien et al., 2021) (Hussain et al., 2018). These medicines hold cultural significance, offering continuity and trust amid healthcare challenges (Amini & Hamdam, 2017). Reflecting on competency standard 1.1, I recognise the need for ongoing education on diverse cultural practices, as I prepare for clinical placements. Through seeking culturally responsive training and building rapport with patients, I can better understand traditional medicines and integrate patient's cultural preferences into care plans, ensuring culturally sensitive care that honours their traditions and beliefs (Crisp et al., 2020).

References:

1. Roien, R., Essar, M. Y., Ahmadi, A., Lucero-Prisno, D. E., III, Yousefi, A. A., Hasan, M. M., Hashim, H. T., Ahmad, S., Mehtarkhel, S., Zafar, M., Ahmadi, M. B., Nasery, A. a. M., Nazari, G. A., Arif, S., Madadi, S., & Mousavi, S. H. (2021). Challenges of drug supply: How Afghanistan is struggling. Public Health in Practice, 2, 100129. https://doi.org/10.1016/j.puhip.2021.100129

2. Amini, M., & Hamdam, S. (2017). Medicinal plants used traditionally in Guldara district of Kabul, Afghanistan. In Kabul University, International Journal of Pharmacognosy and Chinese Medicine (Vol. 3, p. 000118). https://d1wqtxts1xzle7.cloudfront.net/54984102/IPCM16000118-libre.pdf?1510488401=&response-content-disposition=inline%3B+filename%3DMedicinal_Plants_Used_Traditionally_in_G.pdf&Expires=1723118658&Signature=W13l9fehjqowHGzV9tvpRu66Sp01eOdVSm7hzjSL61mCADpWtyi-u6vKd~5i-2ruZbDGHdZUMyfI6TGYlBNCT7Rc0Wkxs2yGL0Wp08-~3TBNbxrVb2PXAlUTIIobt9MnVDwfJoiFU5rSa7YDsxZlJVqZq-pi8GuKB4C1EG0qQsSB883X~M9Awc3qci1SM-a6NN453zfzUFcYd2MG9JjxY7HztYjcxKEvJsIG2RS5x-VoHonyzTkd0Ph1C6tygJMRxO9u3Rm8cKttgHL4zAs3GAOabXGbCX90sPcJ9-HKcabr01QC6rng-XgvF87hd4Q8fuU61VqfI7oDDyExafYoaw__&Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA

3. Hussain, W., Badshah, L., Ullah, M., Ali, M., Ali, A., & Hussain, F. (2018). Quantitative study of medicinal plants used by the communities residing in Koh-e-Safaid Range, northern Pakistani-Afghan borders. Journal of Ethnobiology and Ethnomedicine, 14(1). https://doi.org/10.1186/s13002-018-0229-4

   
   

4. Crisp, J., Douglas, C., Rebeiro, G., & Waters, D. (Eds.). (2021). Potter & Perry’s fundamentals of nursing (6E, Australia and New Zealand edition. eds.). Elsevier Australia a division of Reed International Books Australia Pty Ltd.

   
   

References:

1. Paxton, G., & Schaefer, J. (2021, September). Immigrant Health Service: Afghan refugees - key issues. The Royal Children’s Hospital Melbourne. https://www.rch.org.au/immigranthealth/clinical/Afghan_refugees_-_key_issues/

2. 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/

3. The Office of Dietary Supplements. (2024, March 26). Vitamin B12. National Institutes of Health. https://ods.od.nih.gov/factsheets/VitaminB12-HealthProfessional/#h21

1. Ali, P. A., & Watson, R. (2018). Language barriers and their impact on provision of care to patients with limited English proficiency: Nurses’ perspectives. Journal of Clinical Nursing, 27(5–6), e1152–e1160. https://doi.org/10.1111/jocn.14204

2. Karliner, L. S., Jacobs, E. A., Chen, A. H., & Mutha, S. (2007). Do Professional Interpreters Improve Clinical Care for Patients with Limited English Proficiency? A Systematic Review of the Literature. Health Services Research, 42(2), 727–754. https://doi.org/10.1111/j.1475-6773.2006.00629.x

3. Pariona, A. (2017, April 25). What languages are spoken in Afghanistan? WorldAtlas. https://www.worldatlas.com/articles/what-languages-are-spoken-in-afghanistan.html

4. Dune, T., McLeod, K., & Williams, R. (Eds.). (2021). Culture, diversity and health in Australia : towards culturally safe health care. Routledge.

1. Alshehri, A. M., Barner, J. C., Wong, S. L., Ibrahim, K. R., & Qureshi, S. (2021). Perceptions among Muslims regarding fasting, medication use and provider engagement during Ramadan in the United States. The International Journal of Health Planning and Management, 36(3), 945–957. https://doi.org/10.1002/hpm.3147

2. Abu-Ras, W., & Laird, L. (2011). How Muslim and Non-Muslim Chaplains Serve Muslim Patients? Does the Interfaith Chaplaincy Model have Room for Muslims’ Experiences? Journal of Religion and Health, 50(1), 46–61. https://doi.org/10.1007/s10943-010-9357-4

3. Williamson, M., & Harrison, L. (2010). Providing culturally appropriate care: A literature review. International Journal of Nursing Studies, 47(6), 761–769. https://doi.org/10.1016/j.ijnurstu.2009.12.012

1. Badanta, B., Rivilla‐García, E., Lucchetti, G., & Diego‐Cordero, R. (2022). The influence of spirituality and religion on critical care nursing: An integrative review. Nursing in Critical Care, 27(3), 348–366. https://doi.org/10.1111/nicc.12645

2. Leong, M., Olnick, S., Akmal, T., Copenhaver, A., & Razzak, R. (2016). How Islam Influences End-of-Life Care: Education for Palliative Care Clinicians. Journal of Pain and Symptom Management, 52(6), 771-774.e3. https://doi.org/10.1016/j.jpainsymman.2016.05.034

3. Timmins, F., & Caldeira, S. (2017). Understanding spirituality and spiritual care in nursing. Nursing Standard, 31(22), 50–57. https://doi.org/10.7748/ns.2017.e10311