Public Health Care for Refugees: Challenges and Solutions

This presentation discusses the challenges and solutions for public health care for refugees. It covers the state of refugees, interventions implemented, challenges facing refugee care, and the global refugee policy framework. The presentation recommends regular surveillance of diseases, initiating immunizations, promoting health screening, and monitoring the use of alcohol, drugs, and tobacco use in camps.

PUBLIC HEALTH CARE
REFUGEES STATUS

KEY CONCEPTS
 Refugee – these are persons who are forced
out to cross their boundaries and cant come
back home safely
 Internally displaced persons – these are
same as refugees but have but gone beyond
international boundary
 Asylum seekers- these persons requesting
for recognition as a refugees
 Currently there are16.1 million from the
UNHCR data while under the UNRWAs, there
are 5.2 million more while there is 65.3
million persons who are displaced forcefully.

STATE OF REFUGEE
 Characteristics of refugee is poverty which
affects health status (Adler et al, 2008).
 Common factors of deaths in the camps is
diarrheal diseases, respiratory infections and
malnutrition cases, (Toole & Waldman, 1997)
 Increased rates of HIV infections
 Sex workers engagement is rampant in the
camps compounded by lack of adequate
reproductive health care, (Kia & Ellis, 2007).
 High trends are varied in terms of the camps
 Camps under UNHCR watch have high
medical coverage(UNHCR, 2001)

INTERVENTIONS IMPLEMENTED
UNCONDITIONAL CASH TRANSFERS IN JORDAN
 The UNHCR has provided about 11,000 vulnerable
refugees in Jordan with local bank
 The program has maintained the financial stability
of refugees
 Thru financial stability families are able to buy and
other essential needs items in refugee camps
 Norwegian Refugee Council together with UNHCR
provided cash grants support to families in
Lebanon to host Syrian refugees
 The grant was meant to rehabilitate the houses
with minimum living conditions including sanitation
facilities
 This ensured that families are housed properly and
integrated in the communities
CASH GRANTS FOR SHELTER REHABILITATION FOR
HOST FAMILIES

PROVISION OF INSECTICIDE NETS
IN AFGHANISTAN CAMPS
 Malaria control has been rolled out due to complex
situations which hampers malaria incidences
(Kolaczinski et al., 2004)
 Emergency situation have an early and acute phase
of malaria (Tulloch, et al., The national academic
press)
 ITN have been introduced to manage such condition
in Afghan and Pakistan based camps
 Indoor residual spray has been major focus of control

CHALLENGES FACING REFUGEE
CARE
 Lack of media coverage on health care needs
of refugees and immigrants.
 Lack of commitment from public health arena
in different countries especially in countries
with larger influx of refugees;
 In Lebanon, there is high population of refugees,
making health care to be challenging
 Common problems facing the refugees include
infectious diseases, communicable and non
communicable diseases and other trauma
experiences

 Health systems are overstretched with
hospital capacity close to maximum in many
camps. MCH and non communicable diseases
carry the burden.
 High turnover of health care professionals
has led to interruptions of key services in
camps located in Jordan
 Inadequate immunization coverage as in the
case of IDP camp in Iraq
 Lack of basic laboratory services in camps
has been a health challenge

SOLUTIONS
 There is need for regular surveillance of
disease such as tuberculosis, infections and
even Hepattis B
 · Initiating Immunizations,
 there is need for immunization polices and
frameworks to be adhered to in camps using the
advisory comment on immunization practices
 · promoting health screening
 There is need to identify abnormalities linked to
growth and health status of the refugees and its
underlying path physiology causes
 · monitoring the use of alcohol, drugs and
tobacco use in camps is key

GLOBAL REFUGEE POLICY
FRAMEWORK
 Two international laws framework
 International Refugee Law
 International Human Rights Law
 International framework is being
complemented through regional instruments
and tools.
 Common conventions include;
 European Convention on Human rights,
 EU Charter of Fundamentals rights,
 African convention on Human rights and People’s
rights and
(UNHCR, 2001)

SUMMARY AND RECOMMENDATIONS
 Health agencies provide medical supplies but
at times there are shortages, affecting health
status
 Inadequate immunization coverage as in the
case of IDP camp in Iraq.
 Lack of basic laboratory services in camps
has been a health challenge in many camps.
 A long term goal is to ensure that sustainble
solutions are adopted by governments
through the three approaches;
 Voluntary repatriation
 Resettlement
 Local integration

RECOMMENDATIONS
 Medical history (includes review of overseas records)
 Physical examination & review of systems (includes:
mental health, dental, hearing, vision screenings,
 Nutritional and reproductive assessments, health
education and guidance). (Doocy et al, 2015)
 Setting lab tests centers like serum chemistries,
urinalysis, cholesterol testing monitoring of infectious
diseases.
(Nelson et al, 2015)

REFERENCES
 Adler, N.E. and Rehkopf, D.H., 2008. US disparities in health: descriptions,
causes, and mechanisms. Annu. Rev. Public Health, 29, pp.235-252.
 Doocy, S., Lyles, E., Roberton, T., Akhu-Zaheya, L., Oweis, A. and
Burnham, G., 2015. Prevalence and care-seeking for chronic diseases
among Syrian refugees in Jordan. BMC Public Health, 15(1), p.1097.
 Kia-Keating, M. and Ellis, B.H., 2007. Belonging and connection to school
in resettlement: Young refugees, school belonging, and psychosocial
adjustment. Clinical child psychology and psychiatry, 12(1), pp.29-43.
 Kolaczinski, J., Brooker, S., Reyburn, H. and Rowland, M., 2004.
Epidemiology of anthroponotic cutaneous leishmaniasis in Afghan
refugee camps in northwest Pakistan. Transactions of the Royal Society
of Tropical Medicine and Hygiene, 98(6), pp.373-378.
 Nelson-Peterman, J.L., Toof, R., Liang, S.L. and Grigg-Saito, D.C., 2015.
Long-term refugee health: health behaviors and outcomes of Cambodian
refugee and immigrant women. Health Education & Behavior, 42(6),
pp.814-823.
 Toole, M.J. and Waldman, R.J., 1997. The public health aspects of complex
emergencies and refugee situations. Annual review of public health,
18(1), pp.283-312.
 UNHCR 2001. Refugee protection: A Guide to International Refugee Law
UNHCR, Inter-Parliamentary Union