Challenges in Service Delivery to Rohingya and Lebanese Communities

This report examines the challenges in service delivery to the Rohingya and Lebanese communities, focusing on the specific needs of Rohingya women (aged 20-40) accessing maternal and child health services, and elderly Lebanese individuals (aged 70+) accessing aged care services in Australia. The report highlights barriers such as linguistic and cultural differences, lack of familiarity with Western healthcare concepts, and the impact of migration experiences on health and well-being. It explores the importance of culturally responsive strategies, including addressing privacy concerns, providing integrated psychosocial support, and ensuring appropriate training for service providers. The report also discusses the unintended consequences of social interventions and emphasizes the need for tailored programs and emotional support to improve health outcomes for both communities. Furthermore, it underscores the importance of considering factors like low education, income, and social integration to improve access to health and welfare services for the Lebanese elderly.

Running head: SERVICE DELIVERY TO ROHINGYA AND LEBANESE COMMUNITY
Service Delivery to Rohingya and Lebanese Community
Name of the student
Name of the University
Author note

1SERVICE DELIVERY TO ROHINGYA AND LEBANESE COMMUNITY
Table of Contents
Introduction................................................................................................................................3
Overview of Rohingya and Lebanese Community....................................................................3
Barriers in accessing health services for Rohingya and Lebanese Community.........................5
Culturally responsive strategy for social workers......................................................................9
References................................................................................................................................12

2SERVICE DELIVERY TO ROHINGYA AND LEBANESE COMMUNITY
Introduction
A community refers to social unit which have the commonality in terms of the norms,
religion along with the values. They share sense of the place within the given geographic area
which is crucial in relation to their identity. The social workers should have the cultural
competence that can help them in demonstrating respect for the cultural and social diversity.
The social workers should have the ability of expanding the opportunities to all kinds of the
people irrespective of their social and cultural background. The Rohingya people refer to the
Indo-Aryan ethnic group who follow the religion Islam and who predominantly inhabited in
Rakhine State of Myanmar. They are indigenous to the western Myanmar and they have the
influence of Arabs, Mughals along with Portuguese (Nationalgeographic.com., 2020).
Lebanese people refers to the people who inhabited the Mount Lebanon before the creation of
modern Lebanese state. The religious groups among Lebanese people are Sunni Muslim, Shia
Muslim, Greek Orthodox Christians along with the Protestant Christians. This report throws
light on the migration histories along with the cultural characteristics of the people belonging
to the Rohingya along with the Lebanese community. This report elaborates on potential
barriers in accessing the health services for the community groups and the culturally
responsive strategy that should be considered by the social workers for engaging with the
people of these communities.
Overview of Rohingya and Lebanese Community
The Rohingya people refer to the ethnic group coming from Myanmar which was
once known as Burma. Myanmar is primarily a Buddhist state and Rohingya people on the
other hand are predominantly Muslim. The Muslim settlers arrived in the Arakan state which
was an independent coastal kingdom which in the present time is known as Myanmar. Burma
was conquered by the Britain in the year 1824 and till the year 1948 Britain used to rule

3SERVICE DELIVERY TO ROHINGYA AND LEBANESE COMMUNITY
Burma as a part of the British India (Bbc.com., 2020). At this point of time, there were other
Muslims from the state of Bengal who entered the country as the migrant workers. The
Rohingya people are deprived of the basic rights in Myanmar and they are thought of to be
stateless in the country. In the event of Myanmar becoming military state in the year 1962,
Rohingya people became the victims of that of state-sponsored persecution. The Rohingya
people are thought of to be illegal immigrants by the state and they are not recognized by law.
In the year 2017, Rohingya militants were instrumental in attacking Myanmar army that
sparked the wave of the anti-Rohingya persecution.
There were certain cultural characteristics that were integral to the Rohingya
community. The Rohingya people living within the framework of the large family in
Myanmar and the children used to attend the school along with the educational institutions
like The Maktab along with Madrasa. The head of household were the men who used to take
the ultimate decisions in the family. The men used to take the decisions after the consultation
with the other members of the family. There were around 45 % of the women who used to
receive the vocational education and there existed another 31 % who did not receive any kind
of formal education. Mean age of marriage was around 16.8 years which made the women
susceptible to various kinds of the health problems. Rohingya language is part of Indo-Aryan
branch of Indo-European language family and it have been found to be related to
Chittagonian language which is spoken in southern portion of Bangladesh (George, 2012).
The challenges that are faced by the Rohingya communities are in the arena of security as a
large number of the people fall prey to the human trafficking. The strength of the people
emerges on account of the fact that they have the moral strength on account of their rich
culture that have helped them in defending themselves against the atrocities that are
perpetrated against them.

4SERVICE DELIVERY TO ROHINGYA AND LEBANESE COMMUNITY
The emigration from Mount Lebanon region began in middle of nineteenth century
during period of the Ottoman domination. The early Lebanese migrants moved to USA,
Mexico along with Latin American countries and they used to perform the commercial
activities in the country (Lebanesestudies.news.chass.ncsu.edu., 2020). It was found towards
end of Great War that one third of Mount Lebanon population had taken recourse to
emigration (Mattsson, 2014). The outbreak of Lebanese Civil War that took place in between
1975- 1989 compelled 40 % of the total population to go away from the country.
The culture of Lebanese people is primarily conservative and they show great amount
of respect for the traditions. The culture have been found to be collectivistic when compared
to the Western societies. The individuals think of themselves to be the members of the
groups. The interest of the groups have been found to supersede interest of the individual. It
have been found that 99 % of the population includes the Muslim sects along with the
Christian denominations (Culturalatlas.sbs.com.au., 2020). The unemployment rate have been
found to be high among the people that points forward to the lack of the educational
opportunities before the people. Median age of Lebanese population have been found to be
30.5 years in the year 2018 and the total life expectancy of the people have been found to be
approximately 77.8 years of age. Lebanon have around 1 million refugees along with the
asylum seekers who mainly belong to Palestine, Iraq along with Syria. The official language
which is made use of by Lebanese people is Arabic. The other languages that are spoken by
them are French, English along with Armenian.
Barriers in accessing health services for Rohingya and Lebanese Community
There are certain kinds of barriers that have to be faced by the members of the
Rohingya along with Lebanese community in the event of migrating to the foreign land.
There are a large number of Rohingya women who have arrived within Australia as the
refugees over the course of last five years. They have settled down in the regional centres

5SERVICE DELIVERY TO ROHINGYA AND LEBANESE COMMUNITY
however they lack the access to the health services that can help them in maintaining a
healthy lifestyle. The women belonging to the age-group 20-40 have to face hindrance in
getting the proper maternal along with the child health services
(Worldpopulationreview.com., 2020). The Rohingya refugees have history of persecution
and violence which makes them fall prey to the psychological distress along with the mental
disorders (Nelson, Price & Zubrzycki, 2017). The women have to suffer from the problem of
lack of privacy that compounds their problem in the new social milieu. They do not get the
integrated psycho-social support that becomes a cause of concern for the Rohingya girls
along with the women. They are not familiar with the Western concepts of psychology along
with trauma counselling which acts like a challenge for the women within the framework of
the Australian society. The services are not tailored to the particular needs of the Rohingya
women which makes them face the hardships in the society. The Chittagonian language
which is spoken of by the Rohingya people is markedly different from the Australians and the
linguistic barriers prevent the women from getting the access to the health services. The
Rohingyas believe in the ethno-psychological concept and body-mind divide that exists in
standard professional psychiatry is not believed by the Rohingya people. Rohingya language
have words pertaining to the emotional states but they do not believe in the concepts which
are equivalent to psychological concept of depression.
The Rohingya people are not familiar with concepts of the international mental health
and they look for the help for the physical symptoms within health centres. They have the
tendency of going to the traditional healers as they feel that they can improve their condition
in the society. The health centres that provide the services to the Rohingya people do not
guarantee the confidentiality which makes it difficult for the women to seek help in the case
of maternal health services. The services are provided within the framework of the makeshift
health centres that prove to be inadequate for addressing the health complications of the

6SERVICE DELIVERY TO ROHINGYA AND LEBANESE COMMUNITY
women. They do not get the appropriate facilities along with separate consultation space that
can aid in addressing the problems of the women (Unhcr.org., 2020). There exist the
culturally sanctioned norms in relation to the gender roles in the Rohingya community that
makes the women feel insecure in seeking the health services in Australia. It have been found
that male psychosocial worker sees the female client that makes the women uncomfortable
about relating about their health conditions to the health practitioner. The service providers
do not have the proper training that can help them in understanding the needs of the Rohingya
women that can help them in providing effective treatment to the client (Aifs.gov.au., 2020).
The social theory of the unintended consequence of the purposive action have been
introduced by the sociologist called Robert Merton and it talks about the fact that social
interventions can bear the unintended consequences for an individual. It talks about the fact
that social action needs should be routinely evaluated that can aid in the prevention of harm
within the wider society (Azzopardi, 2020). It talks about the fact that the programmes have
to be modified so that it can suit the particular demands of the patient in the society. Global
health is full of illustrations of harmful consequences of the programmes and due attention
should be paid to the needs of the patient that can help them in regaining their health
(Edwards, 2016). The emotional support should be provided to the Rohingya women who
are accessing health services like maternal along with child health services that can help them
in expressing their problems in the clear manner. It is of imperative importance that group
interventions strategies are adopted that can help in addressing the plight of the Rohingya
women. It can help them in receiving the right kind of treatment that can remove their
miseries in the new societal framework within Australia.
The elderly people of Lebanese community who have migrated to Australia have to
face the hindrance in getting access to the health services within the framework of Australia.
The community have to face the barriers in the area of aged care that has a detrimental effect

7SERVICE DELIVERY TO ROHINGYA AND LEBANESE COMMUNITY
on their mental condition in the society. The aged people of the Lebanese community have
lower level of social along with economic well-being which makes them disadvantaged when
compared to the people of the English-speaking backgrounds in the society. They have the
low education and low income that acts like a barrier in their path in getting proper treatment
in the society (Azzopardi & McNeill, 2016). The older people coming from the Lebanese
community have the lower rate of participation within paid work that makes them unable of
getting access to health and welfare services. The cultural factors along with migration
experiences which are faced by Lebanese people have an effect on well-being along with
ageing experiences that are faced by the Lebanese community in the Australian society. They
have lesser chances of getting involved in the institutional aged care that deteriorates their
fragile condition in the society. The ethnicity is an important factor which can contribute to
productive ageing of an individual in the Australian society. There exists lesser amount of the
social integration among the immigrant people that compounds their problem in the society
(Lee & Kealy, 2018). The people of Lebanese community have the lower participation
within paid employment that increases the risk of poor physical health for these section of the
population. The migrant parents have to face the dire economic circumstances in their life
that makes it difficult for these people to get the access to the health care. The older migrants
of Lebanese community lack the familiarity along with understanding of new culture which
makes them incapable of getting the right access to aged care. They face the high risk of
developing mental disorder and hence they become vulnerable in the society. They are rooted
in the previous culture and they do not try to assimilate in the new culture which acts as a
barrier in the path of getting access to welfare services in the new country. Process of seeking
help have been found to be exacerbated in the event of the older person being dependent on
another family member for the purpose of translation. It have been found that mental health

8SERVICE DELIVERY TO ROHINGYA AND LEBANESE COMMUNITY
problems are recognized in the advanced stage that makes it difficult for them to get the right
kind of in-home care.
Social construction of reality was introduced by Peter Berger along with Thomas
Luckmann in the year 1960 which have become the foundation in relation to social sciences.
The theory lays emphasis on the fact that real world have culturally legitimate ideas along
with practice that makes it difficult for some section of the population to get adequate
treatment (Nadan, 2017). There exits tension in between the global policies and that of local
reality which have been found to be foundational in relation to public health practice. This
theory talks about the fact that the local world realises the values in relation to the local moral
context which influences behaviour of members. This theory harps on the fact that meanings
are developed in society in co-ordination with the other aspects and the different experiences
that are faced by the individuals in the society helps in building their perspective in the
society. It can be stated on the basis of this theory that the experiences that are undergone by
Lebanese community in Australia makes them adopt a different kind of the belief system
which influences their pattern of living in the Australian society. The old age have been
found to bring distress in lives of the migrants who have faced the past trauma on account of
violence along with the hardships in refugee camps. There are migrants who start using the
first language during the old times and this gives rise to communication problems with the
younger members of the families. It have been found that there are many young people who
have reported about difficulty in becoming close with the grandparents that makes them
unable of getting the proper health services in their home.
Culturally responsive strategy for social workers
There are culturally responsive strategies that should be undertaken by the social
workers that can help them in communicating with the Rohingya along with Lebanese
community. The psychological assessment tools should be grounded in local terminology that

9SERVICE DELIVERY TO ROHINGYA AND LEBANESE COMMUNITY
can help in extending the proper help to the vulnerable Rohingya women who are seeking the
treatment. It can help in facilitating community case detection that can help in delivering the
culturally sensitive care for the Rohingya women (Azzopardi, 2020). There should be
materials pertaining to psycho-education of Rohingya women that can help the health
practitioners in adapting themselves on the basis of the cultural norms of Rohingya people.
The manualized treatment protocol should be on the basis of Rohingya context that can make
them feel at ease that can improve the health outcome of Rohingya women. The health
practitioner should be able to acknowledge diversity in relation to Rohingya refugee
population that can aid in providing the proper treatment to Rohingya women. The migration
histories have been instrumental in shaping identity of the people and hence the practitioner
should have the knowledge about mental needs of people that can be useful in providing
proper treatment to people (Edwards, 2016). It have to be ensured that provision of the basic
needs is done in a manner which respects dignity of people that can help the women in
coming forward to ask for help. The gender mainstreaming approach should be considered
that can offer help to the vulnerable women who have faced the violence and harassment at
the time of migration.
There exists the lack of knowledge regarding culturally sensitive resources that can
make the people of Lebanese community feel disconnected in the society. There should be
community-specific service providers in Australia that can help in the arena of service
delivery to the specific community group within Australia. It can help them in developing the
links with the broader community that can help them in getting the access to the proper
healthcare in the Australian context. It can help in reducing the discrimination that can help
them in getting aged care that can help them in maintaining the better health condition
(Nelson, Price & Zubrzycki, 2017). There should be community outreach program that can
promote the awareness regarding Lebanese community that can help them in getting proper

10SERVICE DELIVERY TO ROHINGYA AND LEBANESE COMMUNITY
kind of treatment. The social workers should conduct the audit of the community-specific
health services that can help them in meting out the proper treatment to the people. The
interpreting services should be made available for social workers that can help them in
carrying out the effective communication with the Lebanese community in Australia (George,
2012). It can aid the social workers in meting out the right kind of treatment to people
belonging to Lebanese community that can improve their health condition in the old age. It
can prove to be useful in addressing systemic discrimination that can aid the social workers in
providing the health services to Lebanese people.
Conclusion
Rohingya women face problem of dearth of privacy which aggravates their problem
within the new social setup. They are deprived of psycho-social support which adds to the
difficulties of Rohingya women who fall within 20-40 years of age. They are not acquainted
with western concepts of the psychology which hinders the proper treatment of these women
within the Australian society. Elderly people belonging to Lebanese community do not get
proper health services as they are disadvantaged in Australian society. They lack the
economic means along with social standing that can enable them in getting proper treatment
in their old age. They lack familiarity that can help them in integrating themselves in the new
culture of Australia. Psychological assessment tools should have local terminology that can
extend support to Rohingya women who want to get access to maternal health services. The
social workers should be provided with interpreting services that can help them in carrying
out proper communication with Lebanese people of Australia.

11SERVICE DELIVERY TO ROHINGYA AND LEBANESE COMMUNITY
References
Aifs.gov.au. (2020). Retrieved 14 April 2020, from https://aifs.gov.au/sites/default/files/tt.pdf
Azzopardi, C. (2020). Cross-Cultural Social Work: A Critical Approach to Teaching and
Learning to Work Effectively across Intersectional Identities. The British Journal of
Social Work, 50(2), 464-482.
Azzopardi, C., & McNeill, T. (2016). From cultural competence to cultural consciousness:
Transitioning to a critical approach to working across differences in social
work. Journal of Ethnic & Cultural Diversity in Social Work, 25(4), 282-299.
Bbc.com. (2020). What you need to know about the Rohingya crisis. Retrieved 14 April
2020, from https://www.bbc.com/news/world-asia-41566561
Culturalatlas.sbs.com.au. (2020). Lebanese Culture - Core Concepts. Retrieved 14 April
2020, from https://culturalatlas.sbs.com.au/lebanese-culture/lebanese-culture-core-
concepts
Edwards, J. B. (2016). Cultural intelligence for clinical social work practice. Clinical Social
Work Journal, 44(3), 211-220.
George, M. (2012). Migration traumatic experiences and refugee distress: Implications for
social work practice. Clinical Social Work Journal, 40(4), 429-437.
Lebanesestudies.news.chass.ncsu.edu. (2020). Why did they leave? Reasons for early
Lebanese migration | Moise A. Khayrallah Center for Lebanese Diaspora Studies | NC
State University. Retrieved 14 April 2020, from
https://lebanesestudies.news.chass.ncsu.edu/2017/11/15/why-did-they-leave-reasons-
for-early-lebanese-migration/