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At least 19 recordsLinked to original sources
PubMed1998

Impact of torture on refugees displaced within the developing world: symptomatology among Bhutanese refugees in Nepal.

CONTEXT: Most of the world's refugees are displaced within the developing world. The impact of torture on such refugees is unknown. OBJECTIVE: To examine the impact of torture on Bhutanese refugees in Nepal. DESIGN: Case-control survey. Interviews were conducted by local physicians and included demographics, questions related to the torture experienced, a checklist of 40 medical complaints, and measures of posttraumatic stress disorder (PTSD), anxiety, and depression. SETTING: Bhutanese refugee community in the United Nations refugee camps in the Terai in eastern Nepal. PARTICIPANTS: A random sample of 526 tortured refugees and a control group of 526 nontortured refugees matched for age and sex. MAIN OUTCOME MEASURES: The Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R) criteria for PTSD and the Hopkins Symptom Checklist-25 (HSCL-25) for depression and anxiety. RESULTS: The 2 groups were similar on most demographic variables. The tortured refugees, as a group, suffered more on 15 of 17 DSM-III-RPTSD symptoms (P<.005) and had higher HSCL-25 anxiety and depression scores (P<.001) than nontortured refugees. Logistic regression analysis showed that history of torture predicted PTSD symptoms (odds ratio [OR], 4.6; 95% confidence interval [CI], 2.7-8.0), depression symptoms (OR, 1.9; 95% CI, 1.4-2.6), and anxiety symptoms (OR, 1.5; 95% CI, 1.1-1.9). Torture survivors who were Buddhist were less likely to be depressed (OR, 0.5; 95% CI, 0.3-0.9) or anxious (OR, 0.7; 95% CI, 0.4-1.0). Those who were male were less likely to experience anxiety (OR, 0.66; 95% CI, 0.44-1.00). Tortured refugees also presented more musculoskeletal system- and respiratory system-related complaints (P<.001 for both). CONCLUSION: Torture plays a significant role in the development of PTSD, depression, and anxiety symptoms among refugees from Bhutan living in the developing world.

Adult↗
PubMed2000

Surveillance of drug-resistant tuberculosis and molecular evaluation of transmission of resistant strains in refugee and non-refugee populations in North-Eastern Kenya.

SETTING: Three refugee camp complex clinics and an adjacent non-refugee treatment centre in North-Eastern Kenya. OBJECTIVES: To use conventional and molecular epidemiology tools to determine: 1) the prevalence of drug resistance in newly diagnosed patients with smear-positive pulmonary tuberculosis in refugee and non-refugee populations; 2) risk factors for resistance in the two populations; and 3) whether IS6110 restriction fragment length polymorphism (RFLP) and spoligotyping showed similarities in DNA fingerprinting patterns of drug-resistant isolates that could infer transmission within and between the two populations. RESULTS: Of 241 isolates from the camps, 44 (18.3%) were resistant to one or more drugs, seven of which (2.9%) were multidrug-resistant TB (MDR-TB). Of 88 isolates from the non-refugees, five (5.7%) were resistant to one or more drugs without MDR-TB. Drug resistance was higher in the camps than in the non-refugee population (OR = 3.7; 95%CI 1.42-9.68; P < 0.007). Resistance was significantly higher in one camp compared with the other two, despite a comparable ethnic distribution. Unusually, females were more associated with drug resistance than their male counterparts in both populations (OR = 2.3; 95%CI 1.2-4.8; P = 0.008). There was evidence of transmission of streptomycin-resistant strains in the refugee population. DNA fingerprints of resistant strains from the non-refugee population were unique and different from those in the refugee camps. CONCLUSION: The observed high levels of drug resistance and MDR-TB, combined with evidence of transmission of strains resistant to streptomycin in the refugee population, suggest a need for strengthened TB control programmes in settings with a high risk of developing drug-resistant strains.

Adolescent↗
PubMed1999

Notice of availability of funding for alternative projects, known as Wilson/Fish Projects, to implement alternative means of providing interim financial assistance, medical assistance, social services, and case management to refugees and Cuban and Haitian entrants. Office of Refugee Resettlement (ORR), ACF, DHHS.

The Office of Refugee Resettlement (ORR) announces that competing applications will be accepted from public and private non-profit organizations under a standing announcement for Wilson/Fish projects which propose alternative approaches to serving refugees. The purpose of an alternative project is to provide integrated services and cash assistance to refugees in order to increase refugees' prospects for early employment and self-sufficiency, reduce their level of welfare dependence, enhance acculturation, and promote coordination among voluntary resettlement agencies and service providers. Projects will be accepted under either of two categories: (1) Projects to establish or maintain a refugee program in a State where the State is not participating in the refugee program or is dropping out of the refugee program or a portion of the program; and (2) projects to provide an alternative to the existing system of assistance and services to refugees. Funding is available to these projects under the "Wilson/Fish" authority.

Cuba↗
PubMed2000

[Incidence of methicillin-resistant Staphylococcus aureus among Kosovar-Albanian refugees at the refugee-center in Randers].

INTRODUCTION: With the emergence of the war in Kosova, Europe faced a massive problem dealing with the refugees. The Danish quota was 3,000 refugees. Their health care was organised by the Danish Red Cross in collaboration with the District Hospital of Randers (DHR), the University Hospital of Arhus, and the Psychiatry Unit of the County of Arhus. The aim of the present retrospective study was to describe the prevalence of MRSA in this group of refugees. MATERIALS AND METHODS: Nasal screening culture for MRSA was performed on the first 50 refugees arriving at Randers. On admission to the DHR, the Kosovar-Albanian refugees were isolated until the MRSA culture showed negative. RESULTS: MRSA causing serious nosocomial infections has become a major problem in hospitals worldwide, with a higher incidence in the southern part of Europe than in Denmark. The initial nasal screening revealed no MRSA positive cultures. During the course of the subsequent 14 months, we found eight Kosovar-Albanian refugees infected with/colonised by MRSA (Table 1). We observed no spread of MRSA to other patient groups. CONCLUSION: We conclude that 1) the results of the initial screening of 50 refugees did not predict the succeding high incidence of MRSA; 2) the usual treatment with mupirocin nasal ointment and chlorhexidine wash did not prevent either reinfection or spread of MRSA in the refugee centre; 3) the rigorous isolation and screening strategy at DHR prevented the spread of MRSA to other patients and staff.

Albania↗
PubMedDate not supplied

Refugee women's health: collaborative inquiry with refugee women in Rwanda.

A collaborative capacity building experience in a Rwandan refugee camp with refugee women from the Democratic Republic of Congo (DRC) is described in this article. In service to the American Refugee Committee, I taught 13 refugee women how to plan and facilitate focus group sessions with the larger community of refugee women. The facilitators then conducted 18 focus group sessions gathering data from 100 refugee women. Thematic results included the health implications of poverty, the struggle to survive, the overburden of daily work, ambivalence about family planning, and the lack of freedom to express themselves.

Adult↗
PubMed2003

Planning STI/HIV prevention among refugees and mobile populations: situation assessment of Sudanese refugees.

This article reflects an investigation of knowledge, attitudes and behaviours and HIV/STI prevalence of Sudanese refugees and Ethiopian sex workers in 1992. It represents one of the earliest such investigations within an African refugee population. The investigation took place in the Dimma refugee settlement in south-western Ethiopia and study participants included Sudanese refugee men and women and Ethiopian female sex workers. Methods used for this investigation included focus group discussions, behavioural surveys and serologic testing. The main outcome measures of the investigation were HIV/STI knowledge, attitudes and behaviours and biological markers for HIV, syphilis and herpes simplex 2. The study findings indicate that in the early 1990s, knowledge about AIDS and condom use was low among Sudanese refugee women and not one reported having ever used a condom. Furthermore, sexual contact between refugee men and sex workers was frequent during the time of this study and the prevalence of HIV and other STIs was high. The results confirm a widely held assumption that highly mobile and transient populations in Africa are susceptible to STIs and HIV, in large part due to their knowledge, attitudes and behaviours.

Female↗
PubMed2000

Profiles of refugee and non-refugee Palestinians from the West Bank and Gaza.

Relying on demographic and labor surveys which the Palestinian Central Bureau of Statistics collected in 1995, this article investigates the profile of West Bank and Gaza refugees. Refugees are better educated and have higher fertility than non-refugee Palestinians, but the difference is small. However, they have a significantly lower participation rate, a higher unemployment rate and a higher incidence of arrests and work stoppage than the corresponding rates among non-refugee Palestinians. A smaller proportion of Palestinians commute to work into the Israeli labor market and refugees earn lower wages than nonrefugees. Returns to investment in education are small for both groups. High fertility among refugees imposes a future challenge for policy makers in terms of resources required for the provision of appropriate education and health facilities. Employing future labor market entrants is another serious policy challenge.

Asia↗
PubMed1995

Representing refugees: the role of elites in Burundi refugee society.

Among Burundi refugees in Tanzania, men who have a university education and know English or French are most likely to represent their concerns to officials, particularly those from UNHCR. Officials consequently learn about the perspectives of refugees from these men. Based upon findings from two years of field research in Tanzania, the history of relations between ethnic Hutu elites and the peasantry in Burundi is outlined and it is explained why education has assumed such pronounced significance in Burundi refugee society. The use of ethnicity as a political tool for elite refugees is also described. It is concluded that elite refugees may not, as is often claimed, represent the refugee majority.

Adult↗
PubMed1989

Psychiatric care of refugees exposed to organized violence. A comparative study of refugees and immigrants in Frederiksborg County, Denmark.

Psychiatry in Scandinavia has a tradition for research and clinical work with people from other countries, especially related to refugees and survivors after the Second World War. In recent years an increasing number of refugees have arrived, especially from the countries of the Middle East. The aim of this study was to evaluate the refugee situation in a Danish county, on the basis of data on 49 refugees treated in the county's psychiatric departments from January 1, 1986 to December 31, 1987 and 44 immigrants seen from January 1, 1983 to December 31, 1987. The clinical data illustrated marked differences between immigrants and refugees with respect to social situation and background, symptom pattern and exposure to organized violence. Both groups terminated treatment after very few contacts, and the psychiatric staff seems to need better training. The general need for psychiatric and psychological treatment of immigrants and refugees is still uncertain and further research is required.

Acculturation↗
PubMed1998

Health status of refugees from former Yugoslavia: descriptive study of the refugees in the Netherlands.

AIM: To describe the health status of formally recognized refugees from the former Yugoslavia in the Netherlands, and analyze the relationship between experienced traumatic events and health status. METHODS: A random sample of refugees was taken from randomly selected municipalities. One hundred and two persons received a postal questionnaire. Forty percent filled out the questionnaire completely. Well-validated self-assessment scales were used to measure six dimensions of health status. Traumatic experiences were assessed by the Harvard Trauma Questionnaire. Physical aspects of health status were measured by the three dimensions of the Medical Outcome Study (MOS) Short-form General Health Survey (SF-20) which consisted of the dimensions "physical functioning", "subjective health", and "pain". Social health was measured by the two dimensions of the SF-20, "role fulfilling" and "social functioning". RESULTS: The refugees showed vulnerable health. A significant group had an accumulation of health problems. These were mostly unrelated to sociodemographic variables. Many of the refugees experienced several traumatic events. These experiences were clearly related to all health problems. CONCLUSIONS: The refugees from the former Yugoslavia scored low on standardized health measurement scales. This was primarily due to their traumatic experiences in combination with their refugee status. There is a need for health services to prevent the accumulation of (future) health problems.

Adult↗
PubMed2001

Lack of immunization documentation in Minnesota refugees: challenges for refugee preventive health care.

Children and adults immigrating to the United States without documentation of vaccinations or evidence of immunity should receive age-appropriate immunizations. To learn how often immunization documentation is lacking, we reviewed medical screening records of 1,389 primary refugees over 18 months of age who came Minnesota during 1998. Restricting our analysis to those age groups for whom specific immunizations are recommended, 81.1% of refugees lacked documentation of receiving three doses of diphtheria and tetanus vaccines; 78.8% lacked documentation of one dose of measles vaccine, and 63.8% lacked documentation of three doses of polio vaccine. Of refugees without a known positive test for hepatitis B antigen or antibody, 99.5% lacked documentation of receiving three doses of hepatitis B vaccine. Documentation rates decreased with increasing age, and were lowest for refugees from sub-Saharan Africa (p < 0.001). Refugees and other immigrants may face a number of barriers to receiving necessary immunizations. Health care providers seeing these new arrivals need to ensure that they do fail to receive recommended vaccinations and other preventive health care.

Journal Article↗
PubMed1989

Tuberculin survey among Afghan refugee children. Tuberculosis control programme among Afghan refugees in North West Frontier Province (NWFP) Pakistan.

Since 1982 over 2 million Afghan refugees have settled in the North West Frontier Province (NWFP) of Pakistan. Socio-economical factors, sudden urbanisation and psychological stress may influence the pattern of tuberculosis morbidity and infection among refugees as compared with the original population. In order to study the prevalence of tuberculous infection among Afghan children a tuberculin survey was carried out in April and May 1985 on a cluster sample of male children attending the first two grades of primary schools in refugee camps in the NWFP. The sample size was 4108 male children with an average age of 8 years. 1358 of them, average age of 7.8 years, had not been vaccinated with BCG. An infection prevalence of 13.8% was found when using a transverse diameter of 10 mm induration or more for the tuberculin test as the criterion for infection. The findings were compared with the results of a national sample survey carried out in Afghanistan in 1978: a downward trend of the annual risk of infection (ARI) of 7.8% per year was found in children of the same age group. Thus, Afghan children living in refugee camps in NWFP showed a lower ARI than was observed in their homeland 7 years earlier.

Afghanistan↗
PubMed1995

Vietnamese refugees in Victoria, B.C.: an overview of immigrant and refugee health care in a medium-sized Canadian urban centre.

This paper examines the manner in which Vietnamese refugees access the healthcare system in Victoria, British Columbia. A major theme of this study was the identification of barriers to health care access and provision as perceived by refugees and health care providers, as well as areas of overlap between the two sets of perceptions. The study was based on interview protocols developed with key informants followed by structured samples of 20 Vietnamese and 20 health care workers. The major issue identified by both groups was problematic interpretation of patient symptoms and health care provider recommendations. Lack of health care worker understanding of traditional remedies for common ailments was also identified as a barrier to health care access and utilization. The special problems of unemployment, depression, surviving torture and getting assistance are all made more difficult for refugees living in a smaller urban centre which lacks sufficiently large ethnic populations to assist in service provision. A number of suggestions are made which might ameliorate the difficulties of refugees living in smaller communities. These include municipally based client advocates and special translation training for existing hospital staff.

Adult↗
PubMed1982

Nutritional status of Cuban refugees: a field study on the health and nutriture of refugees processed at Opa Locka, Florida.

A field study was conducted to evaluate the nutritional status of newly arrived Cuban refugees. The protocol consisted of socioeconomic, clinical, anthropometric, laboratory, and dietary investigations. A total of 138 refugees was studied at Opa Locka, Fl. The results revealed that 25% of children suffered from malnutrition mostly of the first degree. Second degree malnutrition was rare and cases of third degree malnutrition or infantile kwashiorkor were not found. Obesity was found in 17% of women. Of adults 25% had significantly low adipose tissue stores. Lean body mass was estimated by anthropometry and found to be adequate in 88% of adults. Fifteen percent of adults and 12% of children had anemia. The foods most frequently consumed by the refugees in Cuba were bread, eggs, rice, and garbanzo (chick peas). Fruits and vegetables were not consumed in Cuba daily by the majority of the refugees.

Adolescent↗
PubMed1994

Refugees, labour migrants and psychological distress. A population-based study of 338 Latin-American refugees, 161 south European and 396 Finnish labour migrants, and 996 Swedish age-, sex- and education-matched controls.

This paper shows the strength and influence of ethnicity on mental health in comparison with material factors and lifestyle, which are well-known risk factors for psychological distress. The focus was on health differences between Latin-American refugees and labour migrants from Finland and the south of Europe. The study was designed as a population-based cross-sectional study, with 338 Latin-American refugees aged 16-74 years (response rate = 81.8%) in Lund, a random sample of 396 Finnish and 161 South European labour migrants, and 996 age-, sex- and education-matched Swedish controls from the Swedish Annual Level-of-living Surveys. The data were analysed unmatched with logistic regression in main effect models. The strongest independent risk indicator for self-reported psychological distress was being a non-European refugee, i.e. a Latin-American refugee, with an estimated odds ratio of 4.39 (2.49-7.31). There was a non-significant association in logistic regression between South European labour migrants and psychological distress, but a crude odds ratio of 2.29 (1.09-4.81). There was no association between Finnish labour migrants and psychological distress. Not feeling secure in daily life was a strong risk indicator for psychological distress, with an estimated odds ratio of 3.29 (1.90-5.45).

Adolescent↗
PubMed2007

Religiosity and depression in older people: evidence from underprivileged refugee and non-refugee communities in Lebanon.

Religiosity is an important aspect of the life of older people, particularly in the Arab region where religiosity is an important part of daily social and political life. Studies have documented the relationship between religiosity and depression among older people, but none in the region. A total of 740 persons aged 60 + were interviewed in three poor urban areas of Lebanon, one of which was a Palestinian refugee camp. The questionnaire included five items on religiosity covering organizational and intrinsic religiosity. Depression was assessed using the 15-item Geriatric Depression Score (GDS-15). Depression was prevalent in 24% of the older persons interviewed with the highest proportion being from the Palestinian refugee camp (31%). Results suggest that only organizational religiosity was related to depression and this pattern was only significant among the refugee population. Religious practice is discussed as an indicator of social solidarity rather than an aspect of religiosity. Minority groups may rely on religious stratagems to cope with their distress more than other groups.

Aged↗
PubMed1998

Refugee trauma versus torture trauma: a retrospective controlled cohort study of Tibetan refugees.

A retrospective cohort study of 35 refugee Tibetan nuns and lay students who were arrested and tortured in Tibet matched with 35 controls who were not arrested or tortured was carried out in India. Subjects were administered the Hopkins Checklist-25, evaluating anxiety symptoms, effective disturbances, somatic complaints, and social impairment. The prevalence of symptom scores in the clinical range for both cohorts was 41.4% for anxiety symptoms and 14.3% for depressive symptoms. The torture survivors had a statistically significant higher proportion of elevated anxiety scores than did the nontortured cohort (54.3% vs. 28.6%, p = .05). This was not true for elevated depressive scores. The results suggest that torture has long-term consequences on mental health over and above the effects of being uprooted, fleeing one's country, and living in exile as a refugee, though the additional effects were small. Political commitment, social support in exile, and prior knowledge of and preparedness for confinement and torture in the imprisoned cohort served to foster resilience against psychological sequelae. The contribution of Buddhist spirituality plays an active role in the development of protective coping mechanisms among Tibetan refugees.

Adaptation, Psychological↗
PubMed1993

Vietnamese boat refugees: the influence of war and flight traumatization on mental health on arrival in the country of resettlement. A community cohort study of Vietnamese refugees in Norway.

A consecutive cohort of 145 adult Vietnamese refugees were personally interviewed and completed the Symptom Checklist 90 R self-rating scale on arrival in Norway. Sixty-two percent had witnessed bombing, fires and shooting, 48% had witnessed other people being wounded or killed and 36% had been involved in life-threatening situations or had been wounded in the war. Nearly all war trauma variables but none of the escape or refugee camp variables were significantly related to mental health 7 years after the end of the war. War trauma was significantly associated with mental health, also when age, gender and previous mental problems were controlled for. These results and our clinical experience indicate that clinicians treating refugees should address such traumatic experiences specifically.

Acculturation↗