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PubMed1989

[Psychiatric work among refugees in Indochina].

Refugee psychiatry deals with reactions related to escape and camp life, and to adjustment reactions to the host country. ICM (The Intergovernmental Committee for Migration) deals with refugees from the time they are accepted somewhere. This includes transportation, and medical screening to make sure that refugees are fit for travel, satisfy public health requirements etc. This work involves evaluations and efforts to improve health, such as keeping patients out of the psychotic stage and detoxifying opium users. Essentially, a refugee population has the same psychopathology as any other group, and the important thing is that they be understood in the wider frame of reference of their political and cultural background.

Adolescent↗
PubMed1985

[Medical problems in refugees from Sri Lanka (Tamil)].

Recently many refugees from Sri Lanka have arrived in Europe. The purpose of the present investigation was to analyze the subjective complaints and diagnoses in these refugees. One hundred refugees (97 males, 3 females, age 19 to 42 years) were investigated. The most common reasons for consulting a general internist were cough (23%), general pain in soft tissue and joints (21%), disorders of the gastrointestinal tract (19%) and ear or throat complaints (15%). In 43% of the patients no diagnosis could be established. 58 patients were investigated for parasites in stool: 57% of these patients had hookworms, 12% non-pathogenic protozoon, 9% Entamoeba histolytica cysts, and 2% Giardia lamblia. In 12% of the patients the diagnosis was tonsillitis or pharyngitis, in 7% bronchitis, pneumonia or asthma and in 5% arterial hypertension. Various other diagnoses were established in 48 patients. With the exception of the high frequency of intestinal parasites, complaints and diagnoses in these refugees were the same as in a comparable European population.

Adult↗
PubMed1984

Health status of Indochinese refugees in Japan: statistical analyses on anemia, eosinophilia and serum alkaline phosphatase.

Detailed statistical analyses were attempted on anemia, eosinophilia and elevation in serum alkaline phosphatase in the Indochinese refugees in Japan. A high statistical correlation was found between hemoglobin concentration and hematocrit for most of the refugees except the Cambodian females. Refugees with parasitic infections, particularly hookworm infection had significantly lower values for hemoglobin concentration and hematocrit. Significant eosinophilia was observed in the refugees infected with hookworms, Strongyloides stercoralis, Rhabditis sp., Endolimax nana and/or Hymenolepis nana. However, these parasites were found in the same subpopulations more frequently than expected by chance. Elevation in serum alkaline phosphatase was observed in young Cambodian immigrants. Analyses showed that the variations of this enzyme could be well predictable by those of enzymes such as serum glutamic oxaloacetic transaminase, which are good markers for liver functions, in Cambodian immigrants, 13-24 of age, whereas no such correlation was observed in non-Cambodians of the same age group.

Adolescent↗
PubMed1982

Caring for Indochinese refugees.

A refugee camp in Hong Kong and a health center in Los Angeles provide data on patterns of health care among Indochinese refugees. American physicians need to be aware that incoming refugees use both Western and traditional Chinese models of medical care. In addition, they are subject to special psychologic problems resulting from their past ordeals and their resettlement in a different country. Increased emergency aid should be provided to geographic areas with large concentrations of refugees.

Adult↗
PubMed1982

Health advice for aircrew on refugee flights.

In order to assess measures taken by airlines to protect the health of crews on refugee flights, a survey was made of airlines involved in transporting Indochinese refugees from Southeast Asia. Five of the 20 airlines surveyed provided sufficient data for analysis. Combined, the five airlines transported approximately 2,500 refugees on more than 100 flights, involving at least one crew change per flight. Health measures varied considerably among airlines. Immunizations alone sufficed in some cases, whereas others required flight attendants to wear gloves and provided anti-malarials, even for crew which did not enter malarious areas. Where antimalarials were recommended, they were not protective against Southeast Asian strains of P. falciparum malaria. No airline noted an increase in illness among aircrew involved in refugee flights. Disinsection procedures were improperly performed in three airlines; one airline did not disinsect at all. Aircrew were generally overly immunized and, in some cases, overly protected in a setting where the probability of disease transmission was low.

Antimalarials↗
PubMed1981

Intestinal parasites among Indochinese refugees and Mexican immigrants resettled in Contra Costa County, California.

Stool examinations of 186 Indochinese refugees and 90 immigrants from Mexico resettled in Contra Costa, County, California, have shown that 60 percent of refugees and 39 percent of immigrants are infected with one or more species of pathogenic protozoa and helminths. The mean prevalences of infections among refugees and immigrants, respectively, were: hookworms, 25 and 2 percent; whipworm, 22 and 12 percent; Ascaris, 20 and 12 percent; Giardia lamblia, 11 and 11 percent; Strongyloides, 9 and 1 percent; and Entamoeba histolytica, 2 and 4 percent. clonorchis sinensis was found in 13 percent of refugees and dwarf tapeworm in 9 percent of immigrants. Rates of infection varied with age and sex. Treatment of these parasitic infections is important and justified because: the prevalence is high; some species are highly pathogenic and directly transmittable; most species have long life spans; and safe broad-spectrum drugs are now available.

Adolescent↗
PubMed1993

Communicable diseases in former Yugoslavia and in refugees arriving in the United Kingdom.

The war in the republics of former Yugoslavia has created the largest number of European refugees since the Second World War. Over 40,000 people from the republics arrived in the United Kingdom before visa restrictions were applied in September 1992, although not all of these were refugees. In November 1992, permission was given for about 4000 Bosnian ex-detainees and their dependents to come to the UK, about 700 of whom had arrived by the end of April 1993. The pre-war health care system in the republics is breaking down and the reporting and control of communicable diseases has been disrupted. Tuberculosis, lice and scabies are likely to affect refugees from former Yugoslavia. Suggestions are given for the management of refugees arriving in the UK, as well as travel health advice for aid workers and others going to the region.

Communicable Diseases↗
PubMed1994

A preliminary investigation into psychological disorders among Mozambican refugees: prevalence and clinical features.

Psychological disorders are common in refugee samples, with several studies showing high rates of Post Traumatic Stress Disorder. The present study examined the prevalence and factors associated with psychological disorders in Mozambican refugees in Zimbabwe. The findings indicated a very high prevalence rate (62 pc), which is considerably higher than that obtained from other settings within Zimbabwe. The demographic characteristics were similar in most respects to other Zimbabwean samples, but there was a trend towards greater social adversity (more relationship difficulties, less schooling and higher employment). Clinically, refugees were severe, with high scores on the SRQ-20, a presenting picture of multiple somatic complaints, and a high rate of rated suicidal risk. There were a significant number of refugees who had had an experience with violence in their recent past, as well as there having been frequent life events in the past six months. The implications of these findings are discussed with reference to Post Traumatic Stress Disorder, and the management of psychological disorders generally.

Adult↗
PubMedDate not supplied

"Céad Míle Fáilte"--an assessment of the screening of 178 Bosnian refugees to Ireland.

The number of refugees in Western Europe has risen dramatically. Such an increase poses unique challenges for all health personnel. This paper describes how the Republic of Ireland, a country with little experience of refugees, initially coped with 178 Bosnian refugees. An open-access general practitioner service was combined with a general screening protocol. Patients with significant problems tended to visit GP's, for appropriate treatment, soon after arrival. Of a total of 92 problems diagnosed at screening, general medical (14%), psychiatric (14%) and gynaecological (11%) were the most frequently encountered. Of the 30 problems referred, 80% were referred by a GP. Deficiencies in immunisation and drug history are highlighted. We make recommendations to improve the quality of future initial refugee assessment procedures.

Adolescent↗
PubMed1993

Acute malnutrition and high childhood mortality related to diarrhea. Lessons from the 1991 Kurdish refugee crisis.

OBJECTIVE: To determine the extent, major causes, and contributory factors of high rates of morbidity and mortality among children at mountain camps along the Turkey-Iraq border during the 1991 Kurdish refugee crisis. DESIGN: A cross-sectional rapid nutrition survey among children and a retrospective mortality survey covering a 2-month period from the onset of the crisis. POPULATION STUDIED: Households of Kurdish refugees at resettlement camp 1 near Zakho in northern Iraq. MAIN OUTCOME MEASURES: Prevalence of wasting (low weight-for-height) and mean weight-for-height status, prevalence of diarrhea, and crude and age-specific mortality rates. RESULTS: Weight-for-height measurements indicated that children under 2 years of age had suffered significant (P < .001) recent malnutrition. The elevated prevalence of wasting and the reduced mean weight-for-height status in this group indicated generalized weight loss. This weight loss was likely the result of the high rates of diarrhea, which still affected 50% of the younger children at the time of survey. The crude mortality rate for all ages was 8.9 per 1000 per month (expected rate, 0.6 per 1000); two thirds of the deaths occurred among children aged 5 years or younger, and half among infants younger than 1 year. An estimated 12% of all infants died during the first 2 months of the crisis. Most deaths were due to diarrhea, dehydration, and resulting malnutrition. CONCLUSIONS: The high rates of malnutrition and mortality related to diarrhea in infants and younger children of Kurdish refugees took place rapidly despite prompt relief efforts and a previously healthy population. This experience underscores the need for early and aggressive public health management of sanitation, water sources, and diarrhea control programs to augment the traditional focus on food and medical relief during the emergency phase of a refugee crisis.

Acute Disease↗
PubMed1993

Surveillance of the health status of Bhutanese refugees--Nepal, 1992.

From February 1991 through July 1992, 67,000 Bhutanese of Nepalese ethnic origin entered the Jhapa and Morang districts of southeastern Nepal (Figure 1) because of ethnic persecution in Bhutan. Six refugee camps were established along the Nepal-India border to accommodate the refugees. In July 1992, to assess the public health needs of these refugees, the Office of the United Nations High Commissioner for Refugees (UNHCR), the Save the Children Fund (SCF), and CDC established a surveillance system to monitor morbidity and mortality. This report describes the surveillance system implemented in these six camps in July 1992 and presents mortality data collected from March through July 1992.

Bhutan↗
PubMedDate not supplied

Health services for refugees in countries of second asylum.

As successive groups of refugees reach countries of second asylum, refugee health care must be reinvented for each new group. But how can we bridge the one-to-two-year lag time between resettlement and publication of studies of specific cultures and thus render effective health services for refugees from the time of resettlement? Below, health problems common to refugees in countries of second asylum are identified and a community-based system for addressing their healthcare needs is proposed. The nursing process and principles of community health nursing are key concepts.

Communication Barriers↗
PubMed1996

Acculturative stress among Amerasian refugees: gender and racial differences.

Adjustment and resettlement of refugees from one culture to another is often a challenging and sometimes difficult process. Since Congress passed the Amerasian Homecoming Act in 1987, there has been a substantial increase in the number of immigrants born of American servicemen and Vietnamese women during the Vietnam War. Several thousand Amerasians and their families left Vietnam and Cambodia for resettlement, and there are currently over thirty cluster sites of voluntary organizations used for placement and resettlement. One area is Springfield, Massachusetts, where our study is based. This research explored the mental health, adjustment, and issues of acculturation among refugees of this subgroup as they attempted to adapt to the American culture. A refugee acculturative stress inventory modified to fit this group was utilized, and Pearson correlation and t-test were employed for statistical analysis. Major findings indicate that most newly arrived Amerasians experience acculturative stress primarily in areas of spoken English, employment, and limited formal education. Gender and race had no impact on acculturative stress. Findings did not support the literature on refugees which indicates that males are more at risk than females regarding acculturative stress. There was a significant correlation between effective spoken English and employment on the level of stress. Implications for social work practice and future research are suggested.

Acculturation↗
PubMed1996

Health needs of Cambodian and Vietnamese refugees in Porirua.

AIMS: To determine the health needs of refugees in the Porirua region. To develop options for health promotion for refugees in the Porirua region. METHODS: Twelve families were interviewed (eight Cambodian and four Vietnamese) representing 68 individuals. Questions were asked of health and other needs, health service utilisation and barriers to health care, particularly language. Additionally, eight key informant interviews were conducted. RESULTS: Families reported 26 out of 68 individuals (38%) as suffering from poor health; asthma, hepatitis B and treated tuberculosis being the three most common conditions. Open questions elicited many vague somatic complaints that may overlay psychiatric morbidity or stress. Health service utilisation was as high, or higher, than a comparable needs assessment in the Porirua region of a population based random household sample in 1993/4. Only six of the 27 refugees (22%) aged 16 or over, by their judgement, considered themselves competent enough in English to communicate independently with a general practitioner or other service provider. This is despite a mean length of residence in New Zealand of four years. Key informant interviews suggested undiagnosed psychiatric morbidity and problems accessing interpreting services, particularly in primary care. CONCLUSIONS: The major unmet health need for this group of refugees is interpreting services. Mental health needs are strongly suspected. The health promotion priority is provision of adequate interpreting services. The new Code of Health and Disability Services Consumers' Rights legally enforces the right to a competent interpreter.

Adolescent↗
PubMed1997

Reframing refugees: the power of Tibetan identity.

This paper explores how Tibetans in exile as refugees, challenge typical constructs of "the refugee" and exemplify how a people are able to empower themselves even within contexts that mitigate against it. It contributes to a growing body of scholarship that attempts to reframe refugee studies and overturn conventional paradigms that conceptually marginalize and victimize people who are refugees. The paper is based on field-work conducted in Tibetan settlements in India in 1993-1994 in which the author investigated issues of Tibetan identity within the context of international politics.

Acculturation↗
PubMed1998

Sudanese refugees in a Minnesota family practice clinic.

BACKGROUND AND OBJECTIVES: During the 1990s, African refugees from the southern Sudan were resettled in Minnesota. This research characterizes the health care utilization of a small sample of these recently arrived refugees and describes their health histories. METHODS: Data were abstracted from the medical charts of all identified Sudanese patients in an urban, Midwestern family practice residency unit. RESULTS: A small sample of Sudanese refugees were found to have high rates of prior infectious illness and experienced communication difficulties in accessing health care. CONCLUSIONS: Information about this sample's demographic variables, health behavior, health histories, and communication difficulties are documented. Some descriptors of the Nuer ethnic group are provided, and issues are raised that may help health care workers provide more culturally competent care to this Sudanese refugee population.

Adult↗
PubMed1998

Cholera outbreak among Rwandan refugees--Democratic Republic of Congo, April 1997.

In April 1997, a cholera outbreak occurred among 90,000 Rwandan refugees residing in three temporary camps between Kisangani and Ubundu, Democratic Republic of Congo (formerly Zaire). Médecins Sans Frontières (MSF) established two referral medical centers and a cholera treatment center in these camps. Personnel from MSF, Zairean nongovernmental organizations (NGOs), and the Office of the United Nations High Commissioner for Refugees (UNHCR) implemented morbidity and mortality surveillance to monitor refugee health status. This report presents the findings of the surveillance system and indicates this outbreak was characterized by a higher death rate than that observed in previous cholera outbreaks in refugee populations.

Cholera↗
PubMed1998

Results of medical examination of refugees from Burma.

OBJECTIVES: To describe exposure to human rights violations among refugees from rural Burma; to compare exposure experienced by an ethnic Burmese minority group, the Shans, with that of the rest of the study population; and to compare exposure of those who had fled Burma recently with that of refugees who had arrived in Thailand earlier. DESIGN: Cross-sectional interview and clinical examination. SETTING: Refugee settlements and refugee camps in Northern Thailand near the border to Burma in November 1997. SUBJECTS: 92 persons (group A) were examined according to the program. Fourty-six were Shans; 34 had migrated within the past five months. A further 96 person (group B), more randomly selected, were interviewed according to an abbreviated interview program; of these, 38 had fled recently. MAIN OUTCOME MEASURES: A score was used to quantify the exposure. Testimonies of exposure to physical violence were validated, assessing the consistency between the reported exposure, reported ensuing symptoms and the result of the clinical examination. RESULTS: Both groups reported massive exposure to the following human rights violations: forced labour (group A: 66%, group B: 35%), porter service (65%, 44%), forced relocation (51%, 51%), killing of family members (36%, 29%). In group A, there were twelve cases of self-reported torture. Moreover, there were reports of rape, disappearances and land mine accidents. In all cases of exposure to physical violence the testimonies were appraised to be valid. CONCLUSION: The violations of human rights in Burma were massive. The Shans were exposed as heavily as the others. Those who had arrived recently were as heavily exposed as the other groups. Apart from the land mine problem, the Burmese army was held responsible for all the reported and documented human rights violations.

Adolescent↗