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PubMed1999

[Medical care of underage refugees].

The growing number of people seeking asylum in the Netherlands compromises the provision of adequate medical services to all. This development may have a negative impact on refugee children especially. International literature indicates that many children, especially the ones coming from tropical areas or the ones who resided in refugee camps, are suffering from diseases such as tuberculosis, hepatitis B, anaemia, parasitic diseases, caries, malnutrition, hearing and seeing impairments. Many children have psychosocial problems due to traumatic experiences in their country of origin and/or during their flight. These problems lead to a diversity of complaints such as difficulty to sleep, enuresis, feeding problems and hyperactivity. Both the somatic and the psychosocial problems may impede the growth and development of these children. It is therefore imperative to identify the children at risk and to formulate guidelines for providing medical care to refugee children. Special care should also be given to the housing, the living conditions and the provision of specialised personnel and to limiting the duration of the asylum procedure in the case of families with children and other minors.

Adoption↗
PubMed1994

Religiosity and Psychosocial Adjustment Among 100 Homng Refugees.

PURPOSE OF THE PAPER. The purpose of this paper is to study the relationship between religiosity and psychosocial adjustment in a group of Asian refugees from Laos. SUMMARY OF METHODS UTILIZED. Subjects consisted of 100 adult Hmong refugees from Laos who had relocated one decade earlier to Minnesota. At the time of the interview, about 80% remained in Minnesota; the remainder were interviewed in their respective communities. Five measures of religiosity were operationalized: Religious Belief (animism versus monotheism); recent Religious Practice (present/absent in previous monthrpar;; Religious Conversion lpar;present/absent in the U.S.rpar;; having a Home Altar (present/absent today); and having a shamanistic Trance Ritual (present/absent in the last five years). These five indices of religiosity were then compared against four general areas of psychosocial adaptation as follows: demographic characteristics lpar;5 itemsrpar;; sociocultural indices of adaptation lpar;5 items, including 2 scales) health care seeking over the previous five years (6 items); and psychiatric signs and symptoms (4 psychiatric scales). SUMMARY OF METHODS UTILIZED. Methods of data collection were as follows: (1) questionnaire-based interviewing by Hmong research assistants to provide data on religion affiliation, belief and practice; demographic information; psychosocial function; cultural affiliations and behaviors; and health care seeking; (2rpar; a psychiatric interview by the senior author followed by completion of two psychosocial scales (Axis 4 Psychosocial Stressors and Axis 5 Psychosocial Function using DSM-III criteriarpar; and several psychiatric rating scales lpar;Hamilton Anxiety Scale, Hamilton Depression Scale, Brief Psychiatric Rating Scale, and Global Assessment Scalerpar;. PRINCIPAL FINDINGS. Religious Pracitice in the last month was highly associated with several measures of psychosocial adaptation. Conversely, any Trance Ritual in the last five years was associated with increased anxiety and health care seeking. Religious Belief (animism versus monotheism) and having a Home Altar were associated with the other cultural factors, but not with psychosocial, heatlh and mental health measures. CONCLUSIONS. Aspects of religiosity among Hmong refugees were related to psychosocial adaptation in diverse ways, with some factors associated with better adaptation, some factors associated with maladaptation, and some factors related to other cultural dimensions but not psychosocial adaptation. KEY WORDS. Hmong; psychosocial adjustment.

Journal Article↗
PubMed1993

[Refugees at Malmö Epidemic Hospital in 1945].

In 1945, 423 refugees were admitted because of contagious disease at Malmö Epidemic Hospital. Of these refugees 159 men and 167 women arrived from the German concentration camps in Ravensbrück, Buchenwald, Bergen-Belsen, Neuengamme and others. Others arrived in a boat destined to be sunk when peace came and the crew changed mind, letting the boat board at Malmö harbour. Thus life was saved to more than 95% of its passengers. Of the refugees 31% came from Poland, 24% from Scandinavian countries, 12% from Benelux and 10% from France. Louse-borne typhus was the most frequent diagnosis that occurred in 35%. Other common disorders were diphtheria, scarlet fever, enteric fever and tuberculosis. Almost all prisoners from concentration camps were malnourished and had sustained severe cruelty. Most of them recovered rapidly when given food and vitamins.

Communicable Disease Control↗
PubMedDate not supplied

Residency patterns and secondary migration of refugees.

"This paper synthesizes available research regarding the residency patterns of refugees in the United States." Consideration is given to the impact of policy on residency patterns and to the effect of secondary migration on the geographic distribution of refugees. "The first section of the paper presents an historical background to this issue, tracing the evolution of U.S. policy and outcomes from 1945 to the start of the Indochinese resettlement program in 1975. The second part focusses upon the residency patterns of the 1975 Indochinese arrivals, and the third section deals with refugees who have arrived since 1979."

Americas↗
PubMed1984

Employment predictors among Indochinese refugees.

"The influx of Indochinese refugees into the United States since 1975 has forced policy development in various resettlement areas. Considerable emphasis has been placed on employment and employment barriers. This article investigates the refugee employment process. A multivariate model is used to distinguish employed from unemployed refugees. Early arrivals, recent arrivals, and each of the four major ethnic groups are investigated separately."

Americas↗
PubMedDate not supplied

[Health and demographic status of unauthorized immigrants: the Albanian refugees landed in Italy (Apulia) in 1997].

This study is aimed at assessing the health care demand of the Albanian groups arrived in Italy (Apulia) in 1997 and accommodated in the Cassano and Palese refugee camps. The analysis is based on the forms filled in on their arrival and first aid registers. Albanian health and demographic official data were also analyzed. The most common health problems observed amongst refugee groups were slight illnesses (23.3%), respiratory tract infections (11.3%), gastroenteritis (9.9%). In the light of these data, the refugees' status does not appear to be critical, although there remains the need to carry out constant monitoring to prevent infectious diseases and improve the quality of social facilities.

English Abstract↗
PubMed1989

The incorporation of family primary care for southeast Asian refugees in a community-based mental health facility.

Immigration is a complex circumstance that exacts a serious toll from the migrant in terms of mental, physical, and socioeconomic status. Among migrating peoples, it is the refugee who encounters the greatest number of personal and social obstacles to resettlement and adaptation. The degree of effective acculturation among Southeast Asian refugees is largely unknown, but it appears that adjustment difficulties are manifest more and more in psychotic episodes, substance abuse, and other antisocial behaviors. This report reviews the literature that documents the incidence of mental health disturbance among this population and describes some of the treatment approaches being tried at various health care centers across the country. Nurses are confronted with the dilemma of integrating the techniques of modern clinical psychiatry with cultural reality into a model system for providing effective mental health services to ethnically diverse people. Described here is a Family Nurse Practitioner-faculty-student clinical experience designed to provide home health services to Southeast Asian refugees with psychiatric diagnoses.

Asia, Southeastern↗
PubMed1997

Epidemic cholera among refugees in Malawi, Africa: treatment and transmission.

Between 23 August and 15 December 1990 an epidemic of cholera affected Mozambican refugees in Malawi causing 1931 cases (attack rate = 2.4%); 86% of patients had arrived in Malawi < 3 months before illness onset. There were 68 deaths (case-fatality rate = 3.5%); most deaths (63%) occurred within 24 h of hospital admission which may have indicated delayed presentation to health facilities and inadequate early rehydration. Mortality was higher in children < 4 years old and febrile deaths may have been associated with prolonged i.v. use. Significant risk factors for illness (P < 0.05) in two case-control studies included drinking river water (odds ratio [OR] = 3.0); placing hands into stored household drinking water (OR = 6.0); and among those without adequate firewood to reheat food, eating leftover cooked peas (OR = 8.0). Toxigenic V. cholerae O1, serotype Inaba, was isolated from patients and stored household water. The rapidity with which newly arrived refugees became infected precluded effective use of a cholera vaccine to prevent cases unless vaccination had occurred immediately upon camp arrival. Improved access to treatment and care of paediatric patients, and increased use of oral rehydration therapy, could decrease mortality. Preventing future cholera outbreaks in Africa will depend on interrupting both waterborne and foodborne transmission of this pathogen.

Case-Control Studies↗
PubMed2026

Access to maternity services for women asylum seekers and refugees: A transnational document analysis of international, European regional, and United Kingdom governance.

Women asylum seekers and refugees face persistent barriers to maternity care (antenatal, intrapartum and postnatal care) across high-income countries, yet the upstream governance shaping access remains under-examined. Although legally distinct, both groups share protection-seeking experiences and are addressed jointly in governance documents. This study examined and synthesised how international (macro), European regional (meso), and United Kingdom (UK, micro) governance documents frame and operationalise maternity service access. Sixty-four documents were analysed using the READ framework. Inductive analysis of macro and meso documents identified six access dimensions: universal coverage; cultural and linguistic adaptation; rights-based approaches; multi-agency collaboration; data, monitoring and accountability; and quality of care. These dimensions structured assessment of UK governance, with jurisdictions rated strong, moderate or weak. Alignment was fragmented: Wales, Scotland and Northern Ireland exempted asylum seekers from charging, whereas England retained charging provisions. Multi-agency collaboration was consistently articulated, yet none of the 35 UK government documents focused on maternity access for this population, and none required outcome monitoring disaggregated by asylum or refugee status. UK governance appears coordinated in form but fragmented in substance. UK-wide minimum standards and routine recording of these data, with safeguards against immigration-related use, could strengthen coherence and accountability and improve visibility of inequities.

Refugees↗
PubMed2002

Angular stomatitis and riboflavin status among adolescent Bhutanese refugees living in southeastern Nepal.

BACKGROUND: Between 1990 and 1993, fear of ethnic persecution led 83,000 ethnic Nepalese to flee from Bhutan to refugee camps in Nepal, where they remained at the time of this study. Reported cases of angular stomatitis (AS), ie, thinning or fissuring at the mouth angles, increased 6-fold from December 1998 to March 1999, from 5.5 to 35.6 cases per 1000 per month. This increase came after the removal of a fortified cereal from rations. OBJECTIVES: The main objectives were to assess the prevalence of AS and of low concentrations of riboflavin, folate, vitamin B-12, and iron by using biochemical measures; to determine whether riboflavin status was associated with AS; and to assess the potential of AS as a screening measure for low riboflavin concentrations. DESIGN: In October 1999, we performed a survey among a random sample of 463 adolescent refugees in which we conducted interviews and physical examinations and obtained blood specimens for riboflavin assessment. Riboflavin status was assessed with the erythrocyte glutathione reductase (EC 1.6.4.2) activity coefficient. After we excluded those adolescents who had taken vitamins during the past month, 369 were eligible for analyses. RESULTS: AS was common (26.8%; 95% CI: 22.3, 31.3), the prevalence of low riboflavin concentrations was high (85.8%; 80.7, 90.9), and riboflavin status was associated with AS. Adolescents with AS had significantly lower riboflavin concentrations than did adolescents without AS (P = 0.02). The adjusted odds ratio for AS and low riboflavin concentrations was 5.1 (1.55, 16.5). CONCLUSION: Globally, riboflavin deficiency is rare. Its emergence in food-dependent populations can be a harbinger of other B-vitamin deficiencies.

Adolescent↗
PubMed2025

Policy paper of the Committee on Ethics and Task Force on Migration and Mental Health: Migration and mental health of migrants, refugees, asylum seekers - Ethical dilemmas and concerns.

BACKGROUND: International migration is a complex phenomenon of global and historical relevance. It includes voluntary, forced, and workforce migration, shaped by diverse determinants. Push factors comprise war, persecution, and political instability, while pull factors include stability, economic opportunities, education, and favorable living conditions. Forced migration is frequently associated with displacement and a disproportionate burden of mental health disorders, which are urgent yet difficult to address due to structural, cultural, and legal barriers. METHODS: Evidence demonstrates that restricted health care access exacerbates psychiatric disorders, while treatment delays contribute to poorer outcomes. Barriers include administrative limitations, linguistic and cultural differences, stigma, and resource shortages. This policy paper was developed by the Committee on Ethics and the Task Force on Migration and Mental Health of the European Psychiatric Association (EPA). Relevant literature was reviewed and combined with the professional expertise of committee members. The draft was subsequently evaluated by the Publication Committee and the EPA Board, and revised accordingly. RESULTS: Ethical principles in refugee care are insufficiently implemented in many European countries. Core principles of medical ethics - beneficence, respect for autonomy, non-maleficence, and justice - as well as the obligation to advance psychiatric standards and apply psychiatric expertise for societal benefit, are inconsistently upheld. CONCLUSIONS: The primary duty of physicians is to promote health and well-being through competent, timely, and compassionate care. The EPA therefore advocates coordinated strategies to mitigate the mental health consequences of war, displacement, and trauma, and to secure equitable access to psychiatric services for migrants and refugees.

Humans↗
PubMed1988

Law on the reception and accommodation of refugees, 12 December 1988.

This Law provides that localities have the duty of receiving and accommodating asylum applicants and that the Ministry of the Interior is to determine how many applicants for each inhabitant must be received. Under the law, the Government of Baden-Wuertemberg is to reimburse to social care agencies 90% of legally mandated support payments; the costs of social advice and care of up to 250 DM per refugee per year, including assistance in daily life, in becoming accustomed to the Federal Republic, in leaving the country, and in learning German; the necessary costs of accommodation; and the costs of other social benefits. The Government is also to reimburse the localities for administrative costs of up to 300 DM per refugee per year and the necessary costs of creating accommodations.

Demography↗
PubMed1988

Order No. R-004 creating two departments within the National Directorate of Civil Status and Population: a department of Mauritanians abroad and a department of refugees, 18 January 1988.

This Order creates two departments within the National Directorate of Civil Status and Population: a department of Mauritanians abroad and a department of refugees. The first of these is to occupy itself with all questions tied to the oversight of Mauritanian groupings abroad and the second with the problems of refugees within Mauritania.

Africa↗
PubMed1979

Adaptational problems of Vietnamese refugees. I. Health and mental health status.

The forced migratory influx of Vietnamese to the United States has raised questions regarding the resettlement process, the effect of culture shock, the refugees' coping behavior and adaptabilities, and their health and mental health status. We report the two-year results of ongoing research on the Vietnamese refugees based on the use of the Cornell Medical Index (CMI). The responses on the CMI on the first (1975) and second (1976) administrations indicate a high and continuing level of physical and mental dysfunction. The second administration also revealed significant shifts in dysfunctions as well as exposing factors that related to these dysfunctions, ie, age/sex interactions, marital status, family groupings, and public assistance. The follow-up CMI also showed an increase in anger and hostility with concomitant reductions in feelings of inadequacy.

Acculturation↗
PubMed1993

Cultural and psychosocial considerations in screening for thalassemia in the Southeast Asian refugee population.

The combination of a high incidence of thalassemia and a high fertility rate in the Southeast Asian refugee population mandates effective screening programs, but unique cultural and psychosocial factors often impede optimal screening and genetic counseling. This paper identifies cultural and psychosocial barriers often associated with refugee thalassemia screening, and offers practical guidelines for remediation.

Asia, Southeastern↗
PubMed2006

The relative contribution of posttraumatic and acculturative stress to subjective mental health among Bosnian refugees.

The relationship between posttraumatic stress reactions, cultural adaptation, and mental health symptoms is still poorly understood. This empirical study examined the relative contribution of both posttraumatic reactions and acculturation rates to subjective mental health in 2 groups of Bosnian refugees, a clinical group (N = 34) and a nonclinical community group (N = 44). As hypothesized, posttraumatic reactions were highly predictive of mental health state in both groups. In addition, two specific acculturation aspects, cultural affiliation and the obtaining of instrumental skills, were significantly related to mental health symptoms. The implications of these findings for mental health professionals working with refugees and other traumatized populations are considered.

Acculturation↗
PubMed1989

Serological evidence of dengue fever among refugees, Hargeysa, Somalia.

Epidemics of a malaria-like illness affected several thousand residents of the Dam Camp, a refugee camp near Hargeysa in Somalia, during 1985, 1986, and 1987. The disease was characterized by fever, chills, sweats, headache, back and joint pains for as long as 10 days in some patients. Blood smears from acutely ill patients were negative for malaria. Of 28 acute and 10 convalescent sera tested by the indirect fluorescent antibody (IFA) and by the hemagglutination inhibition (HI) tests, all were negative for antibody to Rift Valley fever, Crimean-Congo hemorrhagic fever, Sindbis, Chikungunya, yellow fever, and Zika viruses. However, antibody reactive to dengue 2 virus was detected by the IFA test in 39% (15/38), and 11 of 29 (38%) of the same sera were antibody positive by the HI test. Also, IgG antibody reactive to dengue 2 was demonstrated in 60% (17/28) of the same sera by the enzyme immunoassay (EIA), and 14% (4/28) were positive for IgM antibody. Of ten patients for which acute and convalescent sera were available, two developed four fold or greater rises in antibody titer evidencing infection. These data suggested that dengue virus may have been the cause of the epidemic among the Dam Camp refugees.

Antibodies, Viral↗
PubMed2006

Assessing war trauma in refugees: properties of the Comprehensive Trauma Inventory-104.

In this article, the authors describe the properties of the Comprehensive Trauma Inventory-104 (CTI-104), developed and designed empirically to improve assessment of traumatic war-related events. The mean number of events reported by 252 community dwelling Kurdish and Vietnamese refugees was 32 (SD=27) out of the 104 items. Internal and test-retest reliability was excellent, and the validity of the CTI-104 as a measure of war trauma was supported by its high correlation with standard measures of known outcomes of trauma. The CTI-104 is reliable and valid, and assesses a broader range of traumatic war-related events in a broader range of refugees than currently available instruments.

Adult↗