Multicultural Blog by Abdur Rafay

Reflective Practice – Domain 1.2: Trauma-Informed Care

chrafay941 — 2025-08-31 19:30:11 UTC

For me, the most important learning was to acknowledge how experiences faced by the refugees, such as PTSD and trauma, affect the way they interact with healthcare services. I have developed my own understanding of trauma-informed care, especially in creating a safe and supportive space during treatment and assessment. Having an opportunity to apply strategies like allowing more time for the client to share their story, speaking calmly, and avoiding repeating sensitive histories, I now admit that small adjustments can reduce re-traumatisation. This understanding would be useful to me in the workplace because several refugees might have encountered violence, displacement, or detention, which can significantly affect their trust towards clinicians. Since I have not yet refined my skills in identifying subtle trauma responses, I will now need to work closely with my supervisor, colleagues, and employ appropriate referral pathways. Initially, I thought trauma was a psychological issue, but I have now noticed that there is a need to incorporate a trauma-informed approach. care (Migrant and Refugee Women’s Health Partnership, 2019, p.13).

References 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-responsiveclinical-practice-Working-with-people-from-migrant-and-refugee-backgroundsJan2019.pdf

For the image: https://share.google/images/xkvg8qoHBMnMYEDe7

WHO Determinant – Social Inclusion & Discrimination

chrafay941 — 2025-08-31 19:36:36 UTC

According to Migrant and Refugee Women’s Health Partnership (2019), Australia has a wide range of spectrum of efforts that focus on promoting social inclusion of refugees as well as supporting their ability to become independent and self-reliant. Therefore, social inclusion and non-discrimination are fundamental determinants that shape the health and well-being of Iraqi refugees in Australia. UNHCR (2018) indicates that there are almost 1.2 million Iraqis who continue to be displaced, and 90% of the displaced them have not been able to return to their homes. These experiences could intensify their mental health issues, such as PTSD, anxiety, and depression, if they happen to encounter discrimination or exclusion in Australia. Culturally Responsive Clinical Practice Framework indicates that neglecting inclusion and culture can be one of the key barriers in providing equitable healthcare (Migrant and Refugee Women’s Health Partnership, 2019). That means, social inclusion can help in ensuring that Iraqi refugees can access healthcare services and they are feeling safe in taking part in their care.

References 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/wpcontent/uploads/2019/02/Culturally-responsive-clinical-practice-Working-with-peoplefrom-migrant-and-refugee-backgrounds-Jan2019.pdf UNHCR. (2018). Iraq Refugee Crisis: Aid, Statistics and News | USA for UNHCR. Unrefugees.org. https://www.unrefugees.org/emergencies/iraq/

Common Health Concern – PTSD in Iraqi Refugees

chrafay941 — 2025-08-31 19:38:34 UTC

Slewa et al (2017) indicate that Iraqi refugees present common health problems such as infectious diseases like tuberculosis, nutritional deficiencies and psychological trauma. One main concern is the mental health that continue to be impacted by fears for the families that are still in Iraq. The study of Mandaean refugees in Sydney indicates that individuals with immediate families that are currently living in Iraq had higher levels of depression, PTSD, and greater mental health issues associated with disabilities when compared to those with no families in Iraq (Lies et al., 2021). The “Australian Refugee Health Practice Guide” emphasises the trauma-informed care model that focuses on psychological first aid, ensuring cultural safety, and establishing trust before clinical interventions (Refugee health assessment, Australian Refugee Health, 2025). This would help Refugees from Iraq to process traumatic experiences and develop coping strategies that can effectively reduce their PTSD symptoms.

References Lies, J., Jobson, L., Mascaro, L., Whyman, T., & Drummond, S. P. (2021). Postmigration stress and sleep disturbances mediate the relationship between trauma exposure and posttraumatic stress symptoms among Syrian and Iraqi refugees. Journal of Clinical Sleep Medicine, 17(3), 479-489.https://jcsm.aasm.org/doi/abs/10.5664/jcsm.8972 Refugee health assessment» Australian Refugee Health. (2025).https://refugeehealthguide.org.au/refugee-health-assessment/ Slewa-Younan, S., Guajardo, M. G. U., Yaser, A., Mond, J., Smith, M., Milosevic, D., ... & Jorm, A. F. (2017). Causes of and risk factors for posttraumatic stress disorder: the beliefs of Iraqi and Afghan refugees resettled in Australia. International Journal of Mental Health Systems, 11(1), 4.https://link.springer.com/article/10.1186/s13033-016- 0109-z

Health Belief – Family-Centred Communication in Iraqi Culture

chrafay941 — 2025-08-31 19:44:20 UTC

One of the health beliefs practiced by Iraqi culture is that family members act as key intermediaries in communicating healthcare matters. It’s their culture for a family member to stay with the patient and help them answer questions. Several Iraq-born people expect their patients’ prognosis and diagnosis to be first disclosed to a family member, who then decides how and whether to pass the information to the patient (Goodman et al., 2015). The practice is adopted from the collective desire to protect their patient from hopelessness and psychological distress. Therefore, it’s important for the Australian healthcare professional to understand such health belief practices and integrate a collaborative approach that would engage the family when handling a patient from Iraqi culture (Iqbal et al., 2022). Respecting Iraqi patients’ desire for family-led communication not only enhances trust, but also aligns with culturally responsive practice and ethical patient-centered care.

References Goodman, P., Edge, B., Agazio, J., & Prue-Owens, K. (2015). Cultural awareness: Nursing care of Iraqi patients. Journal of Transcultural Nursing, 26(4), 395- 401.https://journals.sagepub.com/doi/abs/10.1177/1043659614524794 Iqbal, M., Walpola, R., Harris‐Roxas, B., Li, J., Mears, S., Hall, J., & Harrison, R. (2022). Improving primary health care quality for refugees and asylum seekers: A systematic review of interventional approaches. Health Expectations, 25(5), 2065- 2094.https://onlinelibrary.wiley.com/doi/abs/10.1111/hex.13365