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PubMed1995

Politics of resistance and accommodation: managing refugee and immigrant movements in the post-Cold War era.

"In recent years, the refugee and immigrant phenomena have unmistakably come to the fore. Enormous political, social, and technological changes, transformations, and numerous ethnic conflicts trigger mass movements of people in search of ¿better' and ¿safer' places.... Refugee and immigrant movements have both resistant (disruptive) and accommodative (recuperative) effects on a range of relations and institutions--community, citizenship, democracy, and welfare--that lie at the heart of a stable and secure national governance in the West. Responses to refugee and immigrant movements are thus significant in their implications for national polities and their governance in the future."

Acculturation↗
PubMed1987

Ethiopian refugee resettlement in the Western United States: social context and psychological well-being.

The reported high level of depression and suicide among 59 Ethiopian single male refugees is often related to their being culturally and ethnically distinct in the US. Research investigating the psychological well-being of these refugees in California, Washington, and Nevada indicates that the level of stress among Ethiopian refugees resettled by agencies is higher than the stress of those resettled by volunteers. When English facility is held constant, the differential ability of these 2 resettlement methodologies to provide appropriate employment and access to higher education varies directly with the stress levels. Recommendations for improvement of resettlement are offered.

Acculturation↗
PubMed1987

Sociopolitical adjustment among Afghan refugees in Pakistan.

Although international organizations and Pakistanis expect Afghans to act like true refugees--dependent, obedient, and grateful--Afghans consider themselves as temporary exiles who, in protest against an anti-Islamic government, found temporary refuge in Pakistan; or as soldiers in the holy wars who temporarily use their Islamic neighbor as a base before returning to fight in Afghanistan. Conforming to this concept and to these objectives, the refugees seek to preserve a certain autonomy and to lean towards forms of organization which are derived either from their traditional social structure, or as is more common now, from the ideology of the Islamic movements. One can understand that this situation may cause many misunderstandings, especially with international organizations which finance and supervise aid to the Afghan refugees in Pakistan. As for anthropologists, it is necessary to go beyond known concepts, to relativize familiar models and to act on changes which have come about in the structures and ideology of the Afghan people.

Afghanistan↗
PubMed1997

When mother and baby are refugees.

War and disaster strike everyone hard, but they strike the most vulnerable people hardest. Since the Second World War more than 21 million people, most of them women and children, have died in wars and other conflicts. Countless others have perished in natural disasters. Most of the world's 50 million refugees and displaced persons are women and children. The special feature in this issue of Safe Motherhood looks especially at mothers and infants in situations of war and disaster. It describes their plight as innocent victims, as society's most vulnerable members struggling to survive in hostile surroundings, and as lonely figures trying to rebuild their lives against all odds. It particularly focuses on motherhood among women refugees. Much can be done to improve the situation of these mothers and their infants. The special feature describes steps that can be taken to make sure that motherhood is safer--and infant health more secure--even when the situation seems to be desperate. Women refugees face all kinds of disadvantages and hardships. WHO is developing guidelines on women's reproductive health during conflict and displacement to address these problems. The feature in this newsletter is based on these guidelines.

Child Welfare↗
PubMed1995

The environment and refugees: theoretical and policy issues.

"The concept of ¿environmental refugee' is not included in the definition of refugee as established by the 1951 Convention relating to the Status of Refugees and its 1967 Protocol, which are the most widely used instruments providing the basis for granting asylum to persons in need of protection. Yet, it is increasingly being recognized that environmental factors interact with political, economic, social and biopsychological factors to generate mass movements of people which may require a humanitarian response by the international community. In order to improve our understanding of the role that environmental factors play in triggering migration, it is necessary to recognize the multivariate nature of the phenomenon under consideration, where the difference between internal and international migration is often accidental and there is a continuum between proactive and reactive migration."

Demography↗
PubMed2003

A health assessment of refugee children from former Yugoslavia in Tarrant County.

This study was conducted to provide an assessment of the health status and health care utilization of children from former Yugoslavia living in Tarrant County. In addition, an assessment of barriers and problems encountered by these families in obtaining health care for their children was presented. One hundred thirteen households of refugee families arriving in Tarrant County from 1998 through 2000 participated by answering a 79-item health information questionnaire. The results revealed that most of the refugee families had no regular health care provider to assure continuity of medical care. Lack of access to dental care and inappropriate utilization of hospital emergency facilities were also identified as problems. Insufficient understanding of health insurance issues and inability to access health information were additional problems. Local and state health care agencies may help to improve health care delivery for these and future refugee children by addressing these problem areas.

Adolescent↗
PubMedDate not supplied

[Buruli ulcer in Angolese refugees in the Kimpese area, Lower Congo, D.R. Congo].

Many epidemiological studies on Buruli ulcer have established the endemic zones in the Congolese Democratic Republic. But the situation about the areas where the refugees are located in high endemicity zones has not yet been studied. The present study describes the presence of the Mycobacterium ulcerans infection in the angolese refugee populationat Kimpese. The data obtained reveal that 50% of patients in the region are angolese refugees. All patients were infected two years before their insertion. The group most affected are children under 15 with a predominance of masculine patients. The legs were the most affected. The most frequent form is the ulcerative form.

Adolescent↗
PubMed1992

Working with refugee survivors of torture.

Numerous factors must be taken into account to best provide for the health and well-being of refugee patients in developed countries. One issue that is rarely considered is the awful and not uncommon occurrence of political torture. Large numbers of refugees and other displaced persons are survivors of political torture, and health care professionals must be prepared for this possibility when treating refugee patients. The effects of torture are pervasive, and we provide some practical considerations for health professionals who care for survivors of torture. Specific challenges include problems relating to exile and resettlement, somatic symptoms and pain, and the "medicalization" of torture sequelae.

Child, Preschool↗
PubMed2003

[Specific psychopathologic reactions in refugee populations and victims of torture].

AIM: Examine differences and specificities of psychological symptoms as a response to the trauma of torture and displacement. METHOD: The sample includes two groups of 50 subjects. The first group experienced the trauma of displacement, and the second group beside the displacement experienced also the trauma of torture. RESULTS: The drop in social and economic status is much more profound in torture victims compared to refugees. All nine SCL 90-R suscales show statistically significant difference in more pronounced psychopathological responses in torture victims relative to refugee population. The Mississippi questionnaire shows significant differences in PTSD between the two groups and higher scores for torture victims. CONCLUSION: Based on the results torture is the most intense form of trauma leading to intensive psychopathological responses including chronic PTSD. Results show that the psychopathological response is most intense and most frequent in the population of torture survivors compared to the refugee population.

Adult↗
PubMed2004

Fear of persecution not adequate to claim refugee status.

In Delgadillo v Canada, the Federal Court of Canada upheld an Immigration and Refugee Board (IRB) decision to refuse refugee status to a Mexican gay male refugee claimant because he had an Internal Flight Alternative (IFA). Although the court reached this conclusion, it nevertheless agreed that Mr Delgadillo had a legitimate fear of persecution. As well, the court made an important finding--that people in Mexico who are living with HIV/AIDS do not have an IFA.

Canada↗
PubMed2004

Intersectionalities of influence: researching the health of immigrant and refugee women.

There is a growing recognition of the complexity surrounding multiple axes or dimensions of social identity and how they intersect to influence the health of immigrant and refugee women. The concept of intersectionalities of influence is particularly relevant in addressing diversity in nursing research. The purpose of this paper is to theorize and operationalize the concept in mental health promotion research with immigrant and refugee women. At the conceptual level, the authors propose an approach to inquiry that is informed by critical scholarship and draws from postcolonial and feminist perspectives. At the operational level, they apply an ecosystemic framework to help locate individual health issues within the familial, community, and social realms. They introduce Participatory Action Research as a way of putting these concepts into action within the research process. Their aim is to introduce a new way of inquiry that can benefit immigrant and refugee women while furthering the nursing agenda for community-based research.

Canada↗
PubMed2005

Refugee health.

BACKGROUND: Refugees and asylum seekers in Australia come from many countries. They present a significant challenge for general practice. OBJECTIVE: This article outlines the unique range of problems presented by refugee patients in general practice and some approaches to dealing with them. DISCUSSION: Refugees and asylum seekers come to Australia with a range of health problems related to their experience both overseas and in Australia. These include the physical and psychological sequelae of torture and trauma such as anxiety, depression or post-traumatic stress disorder, infectious diseases such as tuberculosis, as well as chronic illness. These problems need to be addressed in general practice, as should preventive care, which is often overlooked. While those on permanent or temporary visas will have access to Medicare, those on bridging visas may not.

Altruism↗
PubMed2006

[Chronic pain in traumatized refugees].

BACKGROUND: The purpose of this article is to describe the prevalence of chronic pain in traumatized refugees. Further, we sought to identify the possible associations between pain and psychosocial factors, reported traumatic events, and posttraumatic stress disorder. MATERIALS AND METHODS: Seventy-two patients (40%) were followed up 3 to 8 years after contact with a psychiatric outpatient clinic at the Psychosocial Centre for Refugees in the University of Oslo. Of the men, 83 % had been imprisoned before flight, of the women, 44%. In this study data was collected at onset of treatment and at follow up by a semi-structured interview. We included data on pain, previously experienced traumatic events, socio-demographic information, social support and psychiatric symptoms using the Hopkins symptom check list-25, the symptom scale of Harvard trauma questionnaire, and a screening for a diagnosis of posttraumatic stress disorder according to the DSM-IV. Additionally, general assessment of functioning was estimated. Chronic pain was defined as suffering continuously from serious pain over the last 6 months. RESULTS AND INTERPRETATION: Forty-seven (65%) patients reported they had problems with chronic pain; out of these, 34 (72%) reported they experienced severe pain. No significant association was found between type or number of traumatic event and chronic pain. Significant association was found between severe chronic pain, posttraumatic stress disorder, anxiety and depression scores, general assessment of functioning, and medium/low social support. A significant association was found between severe chronic pain and the frequency of consultations with a general practitioner. Inquiry about and treatment for chronic severe pain should be included in the rehabilitation of traumatized refugees.

Adult↗
PubMed2005

Botswana: Refugees not entitled to same services as citizens.

Botswana, among the countries with the highest HIV/AIDS prevalence rates in the world, has been recognized internationally for its ambitious program to offer voluntary counseling and testing, prevention of mother-to-child transmission (PMTCT) and antiretroviral (ARV) treatment to all residents. Unfortunately, these policies have not been extended to the large numbers of refugees in Botswana. Botswana's Refugee Recognition and Control Act does not recognize a refugee as an ordinary resident.

AIDS Serodiagnosis↗
PubMed2006

[Healthcare for asylum seekers and refugees: our country can do better].

The article 'Mental and physical health problems of and the use of healthcare by Afghan, Iranian and Somali asylum seekers and refugees' in this issue shows, as expected, that the health status of all three groups is poorer than that of the Dutch population. Even worse is that the care offered is far from optimal. To interpret these results, it would be important to know who the asylum seekers and refugees are in comparison with their fellow countrymen in their countries of origin, to have a better understanding of the background of their health problems, and to view the care offered to these people critically. Since they are a very heterogeneous and relatively small group, it is not easy to organise appropriate care for asylum seekers and refugees. Although attempts are being made to improve the situation, Dutch society should invest more so as to provide the same quality of care to its guests as it provides for its own population.

Delivery of Health Care↗
PubMed2007

High success rate of TB treatment among Bhutanese refugees in Nepal.

SETTING: Camps for refugees from Bhutan in south-east Nepal. OBJECTIVES: To evaluate the outcome of treatment of tuberculosis (TB) cases in the refugee camps. DESIGN: Cohort analysis of results of treatment of cases started on treatment from mid-July 1999 to mid-July 2004. RESULT: A total of 1214 patients with TB were notified in the programme. Among these, 631 (52%) were new smear-positive pulmonary tuberculosis (PTB) cases, 175 (14%) new smear-negative PTB cases, 290 (24%) new extra-pulmonary TB (EPTB) cases and 118 (10%) smear-positive retreatment cases. Treatment success was achieved in 1061 (94%). The proportion of new non-smear-positive cases who died on treatment was significantly higher than the corresponding figure for new smear-positive cases (RR 7.57, 95%CI 3.74-15.32 for new smear-negative and 4.22, 95%CI 2.08-8.55 for EPTB). CONCLUSION: High cure rates and low bacteriological failure rates can be achieved in refugee settings if there is close coordination and collaboration between the local health agencies and the National Tuberculosis Programme of the host country.

Antitubercular Agents↗
PubMed1992

Improving growth status of Asian refugee children in the United States.

OBJECTIVE: To analyze the trend and pattern of the nutrition status of Southeast Asian refugee children and other low-income children in the United States. DESIGN: Descriptive analysis of the growth data from the Pediatric Nutrition Surveillance System of the Centers for Disease Control, Atlanta, Ga, from 1980 through 1989. SUBJECTS: Children under 5 years of age from low-income families enrolled in public health clinics in 12 selected states. MEASUREMENTS AND MAIN RESULTS: Asian refugee children experienced a progressive and significant decline in the prevalence of low birth weight, low height-for-age, and low weight-for-age, while these nutritional indexes remained stable for low-income white, black, and Hispanic children. By 1989, the growth status of Asian children was near that of other ethnic groups. CONCLUSIONS: The marked improvement of growth status among Asian refugee children over a short period suggests that the poor growth status often observed among recently immigrated Asian children is primarily related to nutritional and health factors, rather than genetic factors. In assessing the growth of Asian or immigrant children, it would be helpful to take their family and early childhood background into account.

Black or African American↗
PubMed1992

Horizontal transmission of hepatitis B virus infection to United States-born children of Hmong refugees.

There is evidence that hepatitis B virus (HBV) transmission continues among Southeast Asian refugees after resettlement. To determine the prevalence of HBV infection (hepatitis B surface antigen [HBsAg] positive or core antibody positive) and modes of transmission in Hmong refugee households in Wisconsin, results of serologic tests were reviewed for 429 US-born children not previously vaccinated with hepatitis B vaccine and 754 of their Asian-born household members. The prevalence of HBV infection was 14% (62/429) among all US-born children, 30% (21/69) among children whose mothers were HBsAg-positive, and 11% (41/360) among children whose mothers were HBsAg-negative. Among children whose mothers were HBsAg-negative, the prevalence of HBV infection increased with increasing age (chi 2 test for trend = 5.6, P = .02) and was related to the household presence of HBsAg-positive sibling(s) (relative risk = 4.0; 95% confidence interval = 1.5, 9.3; P less than .001). Of the 62 infected children, 13 (21%) lived in households with no HBsAg-positive household members. US-born children of Hmong refugees apparently acquire HBV infection through both horizontal and perinatal transmission. These findings emphasize the importance of routinely integrating hepatitis B vaccine doses into the childhood vaccination schedule for all infants whose parents are from areas where HBV infection is highly endemic. In addition, the findings support the need for pediatricians to consider vaccinating older children (up to age 7 years) whose parents are from HBV-endemic areas.

Adult↗