For me, the most relevant aspect of competency standard 1.2, is the need to develop a safe space where a patient feels respected and understood (Culturally Responsive Clinical Practice Framework, 2019).  In clinical practice I can prioritise safety and trustworthiness by enabling shared decision making and collaborative care with no assumptions or bias.

Using the Hampton Reflective Tool (Reflective Practice Writing Guide Vocabulary Aid, 2010), I have recognised the importance of adapting assessment, diagnosis and follow up care for patients impacted by trauma (Culturally Responsive Clinical Practice Framework, 2019).  For example, I could use the STAR-MH screening tool (Hocking et al., 2018) to identify PTSD or depressive disorders and request further trauma screening if required.

Having reflected on competency standard 1.2, I now feel it is essential for me to deepen my understanding of the impact of refugee-like experiences.  Cultural differences can shape how trauma is expressed somatically or behaviourally, meaning I must provide trauma-informed care that is both safe and culturally responsive (Culturally Responsive Clinical Practice Framework, 2019).  

References

Hocking, D.C., Mancuso, S.G., and Sundram, S. (2018). Development and validation of a mental health screening tool for asylum-seekers and refugees: the STAR-MH.  BMC Psychiatry, 18(1). https://doi.org/10.1186/s12888-018-1660-8

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-responsiove-clinical-practice-Working-with-people-from-migrant-and-refugee-backgrounds-Jan2019.pdf

Reflective Practice Writing Guide Vocabulary Aid. (2010). https://www.alia.org.au/common/Uploaded%20files/ALIA-Docs/Reflective-Practice-Vocabulary.pdf

The World Health Organisation (WHO) determinant of health, social inclusion and non-discrimination, can significantly affect Ukrainian refugees when arriving in Australia (WHO, 2023).  Social exclusion and discrimination are major drivers of health inequities, often creating long-term disadvantages by limiting fair access to timely care and undermining overall wellbeing (WHO, 2023).

Globally, the WHO highlights that exclusion creates structural injustice and perpetuates poorer outcomes (WHO, 2023).  In contrast, in the Australian context, Ukrainian refugees applying for permanent visas are required to fund their own Immigration Medical Examination (IME), unlike other humanitarian cohorts (Paxton, 2022).  This additional financial strain and emotional stress delays medical clearance, restricting timely access to healthcare, early detection of conditions, and integration into community life (Paxton, 2022).

Such barriers contribute to social exclusion, as individuals waiting for IME completion may avoid community participation out of fear of non-compliance.  Ultimately, inequities in social inclusion compromise mental health and may worsen trauma, anxiety and depression (Australian Refugee Health, 2023).

References

Australian Refugee Health. (2023). Primary care for people of refugee backgrounds.  Victorian Refugee Health Network. https://refugeehealthguide.org.au/

Paxton, G.A., Cherian, S., Zwi, K. J., & Smith, M. M. (2015). The Royal Australasian College of Physicians position statement on refugee and asylum seeker health.  Medical Journal of Australia, 203(4), 176-177.  https://doi.org/10.5694/mja15.00624

World Health Organisation. (2023). Social determinants of health: Social inclusion and equity. World Health Organisation. https://www.who.int/health-topics/social-determinants-of-health#tab=tab_1

References

Hajhashemi M, Ghanbari Z, Movahedi M, Rafieian M, Keivani A, Haghollahi F. The effect of Achillea millefolium and Hypericum perforatum ointments on episiotomy wound healing in primiparous women. J Matern Fetal Neonatal Med. 2018 Jan;31(1):63-69. doi: 10.1080/14767058.2016.1275549. Epub 2017 Feb 23. PMID: 28027682.

Kozlowska, W., Wagner, C., Moore, E. M., Matkowski, A., & Komarnytsky, S. (2018). Botanical Provenance of Traditional Medicines From Carpathian Mountains at the Ukrainian-Polish Border. Frontiers in Pharmacology, 9(9). https://doi.org/10.3389/fphar.2018.00295

World Health Organization. (2019). Traditional, complementary and integrative medicine. Who.int; World Health Organization: WHO. https://www.who.int/health-topics/traditional-complementary-and-integrative-medicine#tab=tab_1

Yevtushenko, V. V., Pokanevych, O. V., & Radysh, Y. F. (2014). Folk Medicine in the Therritory if Ukraine: Introduction to the Problem. The Pharma Innovation, 3(5, Part A), 28.

Hepatitis C is a significant health concern among Ukrainian refugees arriving in Australia, with an estimated prevalence of around 4% (Maclachlan et al., 2017).  This elevated risk is partly linked to historical healthcare practices in Ukraine, including unsafe medical injections and limited access to modern antiviral therapies (Tekin et al., 2021).  If left untreated, Hepatitis C can progress to cirrhosis, liver failure, or even liver cancer, highlighting the need for early detection and intervention (Tekin et al., 2021).

The Australian Refugee Health Practice Guide recommends routine screening for blood-borne viruses, during initial health assessments, to ensure early diagnosis, culturally safe care and intervention if needed (Maclachlan et al., 2017).  Direct-acting antiviral (DAA) therapy, accessible through the Pharmaceutical Benefits Scheme (PBS), achieves cure rates above 95% and is tailored by genotype over 8-16 weeks (Marshall et al., 2024; PBS, 2025).   

Addressing Hepatitis C among Ukrainian refugees not only improves individual health outcomes but also advances Australia’s multicultural health priorities of equity, prevention and long-term community protection (World Health Organisation, 2024).

Maclachlan, J., Cowie, B., Isaacs, D., & Davis, J. (2017). Recommendations For Comprehensive Post-Arrival health assessment for people from refugee-like backgrounds: Hepatitis C. https://refugeehealthguide.org.au/hepatitis-c/

Marshall, A. D., Willing, A. R., Kairouz, A., Cunningham, E. B., Wheeler, A., O’Brien, N., Perera, V., Ward, J. W., Hiebert, L., Degenhardt, L., Behzad Hajarizadeh, Colledge, S., Hickman, M., Jawad, D., Lazarus, J. V., Matthews, G. V., Scheibe, A., Vickerman, P., Dore, G. J., & Grebely, J. (2024). Direct-acting antiviral therapies for hepatitis C infection: global registration, reimbursement, and restrictions. The Lancet Gastroenterology & Hepatology, 9(4). https://doi.org/10.1016/s2468-1253(23)00335-7

Pharmaceutical Benefits Scheme (PBS) | PBS Medicine Search. (2025). Pbs.gov.au; Australian Government Department of Health, Disability and Ageing.  https://pbs.gov.au/pbs/home

Tekin, S., Sumer, S., Demirturk, N., & Aygen, B. (2021). Chronic Hepatitis C in the Pandemic/Pandemi Surecinde Kronik Hepatit C. KLIMIK Dergisi, 34(S1), 13. https://doi.org/10.36519/kd.2021.03

World Health Organization. (2024). Hepatitis C. World Health Organization; World Health Organization: WHO. https://www.who.int/news-room/fact-sheets/detail/hepatitis-c