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PubMed1982

Cuban refugee health care: response of the American health care system to the unexpected arrival of 125,000 immigrants.

During the spring of 1980, over 120,000 Cuban refugees emigrated to the United States. Their rapid, unexpected arrival overwhelmed existing health care facilities in south Florida. Government-operated screening centers capable of handling large patient loads were established. Health screening involved a brief history and physical examination and a search for active tuberculosis and venereal disease. Thousands of refugees were processed rapidly and released to waiting relatives and sponsors. Many others, who for social or psychological reasons could not be released. were transferred to holding centers in various parts of the country. US Public Health Service physicians were faced with difficulties whose basic cause could be traced to the boredom of camp life and stresses due to uncertainty regarding the future. Acting out and compliance problems with medical aftermaths were common. About 3,000 refugees remain in custody today.

Cuba↗
PubMed1986

Trichinosis in Southeast Asian refugees in the United States.

Between 1975 and 1984, the incidence of trichinosis in the United States (per million person years at risk) was 25 times greater for the Southeast Asian refugee population than for the general United States population. Cases in the southeast Asian refugees differed from those reported previously in the general population in geographic distribution and source of infected meat. Cambodians and Laotians accounted for over 90 per cent of the cases in the Southeast Asian refugees, but comprised less than 50 per cent of that total population.

Animals↗
PubMed1990

Infectious disease control in a long-term refugee camp: the role of epidemiologic surveillance and investigation.

This report demonstrates the role of epidemiologic surveillance and investigation in the control of infectious diseases in a long-term refugee camp. The applications of simple epidemiologic methods in a refugee camp on the Thai-Cambodian border are described for a one-year period. The development of a Health Information Office facilitated the collection of demographic and vital statistics data, administration of a disease surveillance system, regular monitoring of hospital and outpatient discharge diagnoses, and investigation of disease outbreaks. This office also organized community health education campaigns and disease control efforts. Examples of specific disease investigations are provided to demonstrate the utility of epidemiologic surveillance in the control of infectious disease. We conclude that simple epidemiologic methods play an important role in health planning in long-term refugee camps.

Adolescent↗
PubMed2001

Effectiveness of postmigration screening in controlling tuberculosis among refugees: a historical cohort study, 1984-1998.

OBJECTIVES: This study assessed the effectiveness of postmigration screening for the control of tuberculosis (TB) among refugee migrants. METHODS: We conducted a historical cohort study among 24 610 predominantly Southeast Asian refugees who had arrived in Sydney, Australia, between 1984 and 1994. All had been screened for TB before arrival and had radiologic follow-up for 18 months after arrival. Incident cases of TB were identified by record linkage analysis with confirmatory review of case notes. RESULTS: The crude annual incidence rate over 10-year follow-up was 74.9 per 100 000 person-years. Only 29.6% of the cases were diagnosed as a result of routine follow-up procedures. CONCLUSIONS: Enhanced passive case finding is likely to be more effective than active case finding for the control of TB among refugees.

Asia, Southeastern↗
PubMed2001

A population-based assessment of human rights abuses committed against ethnic Albanian refugees from Kosovo.

OBJECTIVES: This study assessed patterns of displacement and human rights abuses among Kosovar refugees in Macedonia and Albania. METHODS: Between April 19 and May 3, 1999, 1180 ethnic Albanian refugees living in 31 refugee camps and collective centers in Macedonia and Albania were interviewed. RESULTS: The majority (68%) of participants reported that their families were directly expelled from their homes by Serb forces. Overall, 50% of participants saw Serb police or soldiers burning the houses of others, 16% saw Serb police or soldiers burn their own home, and 14% witnessed Serb police or soldiers killing someone. Large percentages of participants saw destroyed mosques, schools, or medical facilities. Thirty-one percent of respondents reported human rights abuses committed against their household members, including beatings, killings, torture, forced separation and disappearances, gunshot wounds, and sexual assault. CONCLUSIONS: The present findings confirm that Serb forces engaged in a systematic and brutal campaign to forcibly expel the ethnic Albanian population of Kosovo. In the course of these mass deportations, Serb forces committed widespread abuses of human rights against ethnic Albanians.

Adolescent↗
PubMed2004

Somali and Oromo refugees: correlates of torture and trauma history.

OBJECTIVES: This cross-sectional, community-based, epidemiological study characterized Somali and Ethiopian (Oromo) refugees in Minnesota to determine torture prevalence and associated problems. METHODS: A comprehensive questionnaire was developed, then administered by trained ethnic interviewers to a nonprobability sample of 1134. Measures assessed torture techniques; traumatic events; and social, physical, and psychological problems, including posttraumatic stress symptoms. RESULTS: Torture prevalence ranged from 25% to 69% by ethnicity and gender, higher than usually reported. Unexpectedly, women were tortured as often as men. Torture survivors had more health problems, including posttraumatic stress. CONCLUSIONS: This study highlights the need to recognize torture in African refugees, especially women, identify indicators of posttraumatic stress in torture survivors, and provide additional resources to care for tortured refugees.

Adult↗
PubMedDate not supplied

[Human figure test in the research of psychopathological state of refugees and somatically traumatized].

Machover Human Figure Test was used to investigate eight clinical features in five diagnostic categories (neurosis, depression, schizophrenia, paranoid feature and aggressiveness) and one symptom (motor deficiency) through graphical features of human figure drawing. The test involved 201 subjects, out of whom 109 were refugees from refugee camp in Krnjaca, 31 somatically traumatized patients from the Orthopedic Clinic, Clinical Center of Serbia, Belgrade, and 61 subjects from Belgrade denying any traumatic experience whatsoever. The following was determined in three tested sub-groups: - Out of general psychopathological features, "thickened line of the drawing", "unclear medium line of the drawing" and "absence of an arm or a leg" were significantly most frequent in the group of somatically traumatized subjects, thus supporting the hypothesis that Machover Test examined projective aspects of disorder of the body scheme experience. - Out of eight diagnostic categories, only "motor deficiency" was significantly different - of course, in the group of somatically traumatized subjects, while "aggressiveness" was different in the group of refugees.

Adult↗
PubMed1976

Medical problems in refugee children evacuated from South Vietnam.

One hundred and fourteen refugee children from South Vietnam showed similar disease prevalences to refugee children from Bangladesh. Common diseases were malnutrition, gastroenteritis, pneumonia and bronchitis, scabies and furunculosis. Seven children died, five from pneumonia complicated by malnutrition. Increased awareness of the high incidence of Pneumocystis pneumonia and more careful assessment of nutritional status may reduce mortality in future groups of refugee children evacuated to Australia.

Australia↗
PubMedDate not supplied

Health issues in newly arrived African refugees attending general practice clinics in Melbourne.

OBJECTIVE: To identify the most common health issues diagnosed by general practitioners in newly arrived African refugees. DESIGN: Descriptive study based on a purposive sample of six GPs to collate data from medical records of patients from African countries who had attended their clinics for the first time between 1 January and 30 June 2005. SETTING: Two community health centres and two private general practices in metropolitan Melbourne. PARTICIPANTS: African refugee patients who arrived in Australia after 1 June 2004 and were seen by the six participating GPs between 1 January and 30 June 2005. MAIN OUTCOME MEASURES: Demographic characteristics, laboratory test results and final diagnoses. RESULTS: Data were collected from 258 patient files. Most patients were from Sudan (57%) or Liberia (17%). Half were aged under 15 years. The most common health problems identified were inadequate vaccinations, nutritional deficiencies (vitamin D and iron), infectious diseases (gastrointestinal infections, schistosomiasis, and latent tuberculosis) and dental disease. Musculoskeletal, psychological and social problems were common in adults. 37% of patients were tested for latent tuberculosis, and 25% of these tested positive. CONCLUSIONS: African refugees require comprehensive health assessments for undiagnosed and untreated health problems. While most of the common diseases identified are non-communicable, if left untreated they will affect the long-term health and productivity of new settlers.

Adolescent↗
PubMed2007

Susceptibility to measles, mumps, and rubella in newly arrived adult immigrants and refugees.

BACKGROUND: Despite effective vaccination programs for measles, mumps, and rubella in the United States and Canada, outbreaks continue to occur in susceptible subgroups, such as foreign-born persons. OBJECTIVE: To determine the susceptibility of newly arrived immigrants and refugees to measles, mumps, and rubella. DESIGN: Seroprevalence study. SETTING: Two hospitals and three community clinics in Montreal, Quebec, Canada. PATIENTS: 1480 adult immigrants and refugees who were recruited from October 2002 to December 2004. MEASUREMENTS: Sociodemographic and clinical data and serology for measles, mumps, and rubella. RESULTS: Thirty-six percent (range, 22% to 54%) of the study population was nonimmune to at least 1 of the 3 diseases. This proportion varied by age, sex, and region of origin. In multivariate analysis and after adjustment for region of origin, age, and socioeconomic factors, immigrant women had higher odds (odds ratio, 2.1) of being immune to measles (95% CI, 1.2 to 3.8) and an odds ratio of 1.7 of being nonimmune to rubella (CI, 1.2 to 2.6) compared with immigrant men. LIMITATIONS: The results from the community-based convenience sample of immigrants may not be generalizable to all immigrant populations. CONCLUSIONS: Many new immigrants and refugees, particularly women, are susceptible to measles, mumps, or rubella and may benefit from targeted vaccination programs.

Adolescent↗
PubMedDate not supplied

Re-training refugee and other overseas doctors: re-qualification through the United Examining Board examination.

The Professional and Linguistic Assessments Board test is well suited to overseas doctors who have migrated for reasons of career development but less so for groups such as refugees who have not had time to prepare for migration and may not speak English. We describe a 12-month structured clinical course leading to re-qualification, for 70 refugee and other overseas doctors. Between 1996 and 2003, 69 of the 70 overseas doctors on the course (27 of whom were refugees) re-qualified through the examination of the United Examining Board. We report on early and later outcomes of these 69 doctors who, by achieving provisional registration, were entitled to pre-registration house officer posts. Of the 69, 33 are now principals in general practice or GPs in training; a further 32 are in NHS hospital posts. Opportunities for disadvantaged overseas doctors to re-train are severely lacking; yet in the UK there are significant numbers who warrant special help. A very modest investment of resources could help them re-qualify and contribute to the health and economy of the nation.

Adult↗
PubMed2000

[Causes of death of German refugee children in 1945].

In the last months of the second World War, 250,000 German refugees landed in Denmark. A third of them were children under the age of 15. Seven thousand German refugee children under the age of five died in Denmark in 1945. Using birth certificates and death certificates from the Danish national archives and burial lists from the German refugee cemetaries I have collected data to reveal causes of death, age distributions and time of the deaths of the 7000 fatal cases among children under the age of five. Three thousand children under the age of one, 2000 children one year old and 2000 children 2-4 years old died. Most of them died just before and after the German surrender, but many died in the months following the German surrender. The infant mortality was extremely high all during 1945. The infants died from diseases due to malnutrition, but the older the children the more likely the causes of death were due to infectious diseases such as pneumonia, measles, diphtheria and gastroenteritis.

Bacterial Infections↗
PubMed2000

Discontinuation of SSRI's in traumatized refugees.

OBJECTIVE: To conduct a preliminary study on the discontinuation of SSRI's in a population of traumatized refugees from Bosnia. SUBJECTS: Subjects were the 33 Bosnian refugees being treated in our clinical program who had discontinued SSRI's over a six month period. All had been on SSRI's for over one year and had shown a therapeutic response. The discontinuations were either planned with their clinician or self-initiated. Their age were ranged between 36 and 64, with a means of 56. Ten were men and twenty three were women. Standardized assessments were done approximately 2 months after discontinuation. RESULTS: Upon reassessment after discontinuation, fourteen (43%) met symptom criteria for PTSD. He means PTSD severity rating was 16.0 and the BDI score was 8.5. Seven persons (21%) restarted SSRI's and twenty-six (79%) did not. Statistical analysis showed that the group that restarted differed from the others in terms of lower age, higher PTSD diagnosis and severity, higher BDI score, poorer sleep, and higher subjective with either PTSD or BDI scores. CONCLUSION: This preliminary study suggests that when traumatized refugees discontinue SSRI's, still they have significant PTSD and depressive symptoms, indicating chronicity. The choice of discontinue or restart SSRI's is in part related to symptom severity, but other psychosocial factors appear entering into the equation. There is a need for further research.

Adult↗
PubMed2000

Pod people. Response of family physicians and family practice nurses to Kosovar refugees in Greenwood, NS.

OBJECTIVE: To explore roles of family physicians and family practice nurses who provided care to Kosovar refugees at Greenwood, NS. DESIGN: Qualitative study based on individual interviews with family physicians and family practice nurses. SETTING: Family practices in Halifax, NS. PARTICIPANTS: Six family practice nurses, four physician faculty members, four community-based family physicians, and two family medicine residents were interviewed. Participants were purposefully chosen from the roster of service providers. METHOD: All interviews were conducted by one of the researchers and were semistructured. Interviews lasted approximately 30 minutes and were immediately transcribed. Key words and phrases were identified and compared with subsequent interviews until saturation was achieved. MAIN FINDINGS: Data yielded four analytical categories: the clinical encounter, expectation and experience, role and team functioning, and response. Participants reported how providing care in the context of a refugee camp was both similar to and different from their daily activities in family practice, as were their working relationships with other health care professionals. CONCLUSION: Primary care for refugees during complex health emergencies is often underreported in the literature. Yet family practice physicians and nurses recounted that they had the requisite skills to provide care in such a context.

Adult↗
PubMed2000

The impact of traumatic experience on attitude towards future in refugee adolescents.

Traumatic experience has overall far reaching consequences on personality. In particular, it has significant impact on teenagers that are just approaching the phase of solving their identity problems. This research examines the relation of traumatic experience and attitude towards the future in two groups of adolescents. The first group consists of 20 adolescents-refugees from the East Slavonia that were settled in Rijeka area with their parents during the last six years. The second group consists of 20 adolescent's local inhabitants that were influenced by the war only indirectly. Results show significant difference between refugees and non-refugees in expressed interpersonal trust, frustration tolerance, and formation of close contacts, adaptability, precaution, bitterness, and social desirability. Both groups show increased depression, pessimism and poor self-control. This might be considered as general characteristic of society in war.

Adolescent↗
PubMed2003

Keeping clean water clean in a Malawi refugee camp: a randomized intervention trial.

OBJECTIVE: This study was undertaken to assess the ability of a water container with a cover and a spout to prevent household contamination of water in a Malawian refugee camp. METHODS: A randomized trial was conducted in a refugee population that had experienced repeated outbreaks of cholera and diarrhoea and where contamination of water in the home was found to be a significant cause of cholera. Four hundred Mozambican refugee households were systematically identified and followed over a 4-month period, one fourth of the households were randomly assigned to exclusively use the improved container for water collection. FINDINGS: Water flowing from the source wells had little or no microbial contamination although the water collectors quickly contaminated their water, primarily through contact with their hands. Analysis of water samples demonstrated that there was a 69% reduction in the geometric mean of faecal coliform levels in household water and 31% less diarrhoeal disease (P = 0.06) in children under 5 years of age among the group using the improved bucket. Regression models examining diarrhoea among under 5-year-olds confirmed the protective effect of the bucket and found that visible faeces in the family latrine and the presence of animals were significantly associated with an increased diarrhoeal incidence in children. CONCLUSION: Household contamination of drinking-water significantly contributed to diarrhoea in this population. Proper chlorination is a less expensive and more effective means of water quality protection in comparison with the improved bucket, but was unpopular and rarely utilized by the camp inhabitants.

Chlorine↗
PubMed2001

Treatment outcome among Rwandan and Burundian refugees with sputum smear-positive tuberculosis in Ngara, Tanzania.

SETTING: Tuberculosis programme in six camps (Benaco, Musuhura, Lumasi, Lukole, Keza and Kitali) for Rwandan and Burundian refugees in Ngara district, Tanzania, where treatment was directly observed throughout. OBJECTIVES: To evaluate the treatment outcome of sputum smear-positive tuberculosis cases recruited in refugee camps in Ngara, and to determine the cumulative frequency of conversion of sputum smears by direct microscopy. DESIGN: Retrospective review of tuberculosis registers from January 1995 to December 1999. RESULTS: Of 546 patients with smear-positive tuberculosis who were notified in the programme, 363 (66.5%) had completed treatment and were bacteriologically cured after 7 months, 10.9% had died, 7.1% had defaulted and 14.5% had transferred out. Sputum conversion after the 2-month intensive phase was 88%, and increased to 99% after 7 months of chemotherapy. CONCLUSION: The involvement of the Tanzania NTLP in collaboration with health NGOs has led to a satisfactory outcome. These data suggest that it is possible for tuberculosis control programmes to perform successfully in refugee settings.

Burundi↗
PubMed2002

Refugee health. Speak easy.

Many NHS staff are unsure about the rights of asylum seekers and refugees to healthcare. Asylum seekers and refugees have little knowledge of the NHS. Workshops including refugee speakers helped dispel misconceptions and were highly rated by primary care staff. The format is very transferable.

Civil Rights↗