Literature Review: Healthcare for Refugees in the Australian Context

This literature review examines the healthcare conditions of refugees in the Australian context, highlighting mental health problems, trauma, and human rights violations. The review assesses the availability of health services, identifying barriers such as language, cultural differences, economic constraints, and lack of trust in healthcare providers. It explores gaps in service provision, including inadequate skills of healthcare professionals and the potential for re-traumatization. The report discusses health service responses, including community outreach and the employment of bilingual workers. It also emphasizes the impact of pre-migration experiences and the challenges refugees face in accessing services, such as isolation and unfamiliarity with the healthcare system. The review recommends culturally sensitive and responsive services, along with training for healthcare providers and the involvement of community leaders to improve access and address barriers. The report concludes by emphasizing the need for better healthcare access, mental health support, and social work intervention for refugees in Australia.

Running head: SOCIAL WORK
Social Work
Name of Student:
Name of University:
Author’s Note:

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Executive Summary:
The aim of this particular literature review is to understand the conditions of the healthcare for
the refugees of Australian context and also the ways in which these pose issues in order to be
bettered. It has been noticed that the refugees have to face acute mental health problems and
problems of trauma of which most significant are those of trauma and violation of human rights
along with the migration experience. This literature review assess whether the health services are
available for the refugees in Australia. There are several reasons because of which the refugees
face mental health issues which might be escaping for safety, post settlement stress, trauma of
resettlements and other problems which they have to experience at the time of the relocation
(Mollica, 1994).

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Table of Contents
Part A:..............................................................................................................................................3
Introduction:................................................................................................................................3
Literature review:.........................................................................................................................3
Gaps in health service provision:.................................................................................................5
Health service responses:.............................................................................................................6
Recommendations:......................................................................................................................8
Part B:..............................................................................................................................................9
Answer 1:.....................................................................................................................................9
Answer 2:...................................................................................................................................10
Answer 3:...................................................................................................................................10
References:....................................................................................................................................12

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Part A:
Introduction:
A refugee is someone who due to a well-founded fear of being persecuted due to reasons
of race, religion, nationality, membership of a particular social group or political opinion is
outside the country of nationality and is unable to or owing to such fear is does not agree to avail
himself of the protection of the country (Kirmaye et al., 2011). It is seen that refugees feel certain
circumstances of defencelessness, marginalisation, poverty in addition to high amount of stress
or displacement which seriously impacts the health of the populations. It has been noticed that
the refugees have to face acute mental health problems and problems of trauma of which most
significant are those of trauma and violation of human rights along with the migration experience
(Silove, Austin & Steel, 2007). The aim of this research is to comprehend the conditions of the
healthcare for the refugees of Australian context and also the ways in which these pose issues in
order to be bettered.
Literature review:
There are several mental and physical traumas which the refugees have to face. Despite
such conditions of the refugees and the high burdens of disease, the access to health care for the
refugees is mostly restricted in the host countries with immense variation in the entitlements.
There are several countries which differ in the principle of the medical health services which are
being offered (Valtonen, 2016). There are also existent legal restrictions which hinder the access
of the refugees to the host countries with extreme variation in entitlements. The practical barriers
to the health care services include inadequate information and also the awareness regarding the

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availability of services, insufficient economic means, limited access to transport, insensible
amount of care and also inadequate provision in terms of parameters (Elliott & Yusuf, 2014).
The refugees who settle in the western counties have to face several difficulties in
accessing suitable health care. There have been several instances of documentation by the
providers of health service. There are several problems which the refugees have to face in
accessing the effective heath care and there are certain ways in which the health services can be
responded to. There have been over 6 million refugees who have settled in Australia. There are
very less people who receive humanitarian visas for migration or stay in Australia. Refugees and
people of refugee like background are considered to be one of the most vulnerable groups in the
society. They have certain needs of health-care which arise from the severe effects of conflict
and also that of forced exile. The people also have requirements which help them in the
maintenance of the impact of the effects of conflict and forced exile with certain experiences of
persecution, psychological trauma, deprivation, environmental situations which are not
conducive and the disrupted access to the health care services (Valtonen, 2016).
Some specialized services exist in order to meet the health requirements of the people of
refugee background. There are counselling services for those people who have survived torture
and have faced trauma in every state and territory in Australia. It is however seen that the
majority of the healthcare for the refugees occurs with the mainstream services (Silove, 1999).
There are certain barriers to the refugees who can access the adequate amount of care and these
are similar to those which are experienced by the community of broader migrant community and
other marginalized groups. There might be barriers to the existing services which include
language cultural and economic barriers, the reduced ability to trust the providers of service and
the negotiation regarding the health services and also the unavailability of the system of

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healthcare. For the refugees these barriers are increased by relevant experiences and the way in
which the refugees have come to Australia.
Relevant studies with refugee populations in Australia have shown that language is a
significant barrier to the refugees who access the health services. The language difficulties in
general have been responsible for the refuges being turned away. The barriers can also lead to
certain amount of miscommunication and the lack of suitable follow up of the services. There are
certain fiscal constraints for the people who arrive in the country as humanitarian entrants and
they are required to find employment. There can be situations where cost can impact the
decisions to provide healthcare to the people who require it. There are charges which are
applicable for the medical services. The limited trust of the health services can cause certain
refugees to stop receiving suitable healthcare facilities (Major et al., 2013).
The people of refugee background often come from those countries who are from
different health systems. The access to the healthcare for certain refugees is therefore hindered
by the lack of familiarity with the services which are available (Silove, 1999).
Gaps in health service provision:
The refugee patients who arrive newly might possess complex or multiple health
problems. There can be inadequate reimbursement to the general practitioners for a certain time
period which is additionally required to provide medical care for the patients with general needs.
Effective healthcare might be impeded by means of those health professionals who have
incomplete skills in order to detect and manage the unfamiliar diseases among the refugees. This
might also occur by the staff members who fail to adopt the health care techniques which help in
the accommodation of past trauma along with the violation of the human rights. The

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hospitalization or other interactions of health services which have not been conducted in a
sensitive manner or where there is the utilization of clinical processes reminiscent of abuse, have
the capability of re-traumatizing people who are to be given suitable amount of care. The issues
of racism and discrimination have been shown to reduce access to the care in certain
marginalised groups is extremely likely to affect the refugee groups in addition to it.
Health service responses:
There have been health services which have tried to increase the utilization of the service
by means of community utilization and outreach. There also has been the employment of
bilingual workers who have different suitable functions. There are multi-cultural health services
for promoting the access to the appropriate heath care for the refugees. The actual role of the
primary health services in reduction the inequity of access and the quality of care has been
described. There also have been noticed strategies in the heath care systems which need to be
understood in a relevant manner (Hatoss, 2012).
The experiences of the refugees before they come to Australia noticeably impact their
physical health along with their mental health. The refugees have been subjected to persecution
and torture. They have also suffered from trauma as an effect of war and conflict and are much
more vulnerable to the issues of health. There have been issues where the refugees have spend
several years being displaced and in insecure conditions by means of moving between places and
in refugee camps with very less amount of access to the health care services. The experiences
and the conditions for the survival might mean that many refugees might have heath issues
which might impact them in the future.

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There are certain challenges which the employees face in looking after their health in the
Australian country. The most important issue arises in case of the health services. This means
that the services are not used as much as they should necessarily be used. There are several
things which impact the use of the services which include those of age, gender, economic
hardships, education, cultural beliefs and practices. The way in which the services are to be
utilized are dependent on the way in which the services can be applicable. The sustainability and
the competence of the services can also be utilized in a proper manner.
There is a challenge to the refugees in the sense that they hardly come with their family
or friends and they often feel isolated in their new communities. There can be extremely serious
mental health issues and another challenge is that several people have been separated for long
periods of time, which are responsible for causing significant amount of distress (Hjern, Angel &
Höjer, 1991). It is seen that enough mental health services for people in Australia which are
responsible for making matters worse. A common experience is that the health care providers do
not utilize making the interpreters enough which makes it difficult for the people to realise and
access the services.
There have been many people who have come to Australia and many refugees have
existed for several years with limited access to food stuff which causes poor nutrition. This can
be a challenge for the refugees to understand about their choices of food and the impact of their
choices in Australia. It is seen that the clients of refugee background might have encountered
interrupted access to the health care before the time they have arrived for Australia. This might
be due to the breakdown of health services in situations of war and conflict. The constraints on
the access to health services are existent (Jerrell, 1998).

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After their arrival in Australia the people from refugee backgrounds might experience
difficulties in accessing and making the best use of health services. The negotiation of a new and
unfamiliar health system might be an undertaking which is difficult and complex which is
specifically for those people with multiple health needs that needs several investigations and
appointments which needs suitable follow up (Hiegel, 1994). There are certain arrivals who are
unfamiliar with the approaches of illness prevention and might be accustomed to the culture
which characterises the relationships between healthcare users and the providers in the
Australian context (Mollica, 1994).
It is seen that after refugees arrive in Australia, they are not forced to undergo more
health checks. It is seen that ongoing concerns for health are found in case of many immigrants
who come by several programs (Ingleby, 2004). The vulnerability due to a number of issues
including that of leaving members behind, the facing of economic hardship and immediate
family members in the centres of detention. There are several health consultations which are
which are done without an interpreter or a friend or a family member with the performance of
interpretation. There are developments which are being made in the health spheres in order to
provide for the refugees who come to visit a particular place (George, 2012).
Recommendations:
There is the need for the service providers in order to equipped, to provide the culturally
sensitive and also responsive services which offer the best of practical and psychological
assistance. There are potential referrers which include the health professionals and community
leaders which for the facilitation of the access to the services. This is relevant in case there is a
proper amount of training to recognise as well as address the barriers. The findings indicate that

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there is a potential content for the awareness raising initiatives for the young refugees regarding
the mental health problems and suitable services (Steel et al., 2006).
Early restriction of access to the care and levels of care for the refugees is responsible for
delayed care and an overall increase in the health experience of each person. There needs to be
provision of preventive care which includes different sorts of urgent ailments and diseases.
Refugee children are the worst hit with respect to the health problems which they face in
their host countries (Davidson et a., 2004). Access to the necessary health service for the
refugees need to be considered as a fundamental right of the humans. The host countries need to
address the exclusion of the refugees from health-care services and the health needs which have
not been met. It needs to be the requirement of the donor countries to support the efforts for the
improvement of access in order to secure essential health care services. Great efforts are essential
for strengthening the resilience of the health systems for fostering equity and efficiency in the
refugee health. The Global Community needs to move in the direction of the goal of dominance
(Guerin et al., 2004).
Part B:
Answer 1:
The studied literature on the topic of refugees with respect to backdrop of Australia have
shown that there might be several issues which might be faced at the time of dealing with
refugees. There might be social, cultural, psychological and mental hazards due to the difference
in the cultures from where the refugees come (Kirmayer et al., 2011). It has been seen that there
are several barriers to the social and cultural backgrounds from which the refugees come (Miller,

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2008). The needs and problems which are faced by the refugees from culturally diverse
backgrounds are complex and difficult. It cannot be ignored that culture impacts every aspect of
the lives of the refugees. It cannot be ignored that culture impacts every aspect of a person’s life
more so the life of a refugee. Due to the problems the refugees already have to face their issues
do not receive adequate amount of importance (Robinson, 2013).
Answer 2:
My personal perspectives about life and orientations of the refugees might vary with their
implications of work. This is because of the fact that people from diverse backgrounds perceive
different situations differently. I feel that understanding their experiences and their opinions on
the situations will be difficult for me. This is because of the fact that refugees do not always like
to recount experiences from their past which might be problematic or traumatic (Steel et al.,
2006). They feel that their experiences will not be accurately understood by their helpers or well-
wishers. I feel it will be difficult for me to understand the problems which the refugees might
have had to face in their respective lives. I might also not understand the significance of their
problems due to which they had to shift to their present places or countries (Valtonen, 2016).
Answer 3:
Social work practices with the refugees and immigrants of different backgrounds needs
specialized knowledge of the specific populations (Hodes, 2002). There is also the requirement
of specific adaptations and applications of the mainstream services and interventions. This is due
to the fact that there are often confrontations with the cultural linguistic social economic and
political barriers (Silove, 1999). It is seen from research that refugees are vulnerable to socio-
economic practices.

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One of the most important barriers in dealing with employees is that of communication.
The employees come from different backgrounds and different languages (Alam & Imran, 2015).
Therefore the barriers of language and interpretation of orders and responsibilities is a very
important aspect. Language is a crucial barrier in communication. Refuges had to face several
issues in their lives therefore giving them a normal life and ensuring that they can respond to the
needs like other inhabitants is truly challenging (Robinson, 2013). There have been situations
where the refugees have not been able to respond properly to their situations which have not
been according to their needs. Thus it needs to be understood that making situations suitable for
the refugees will take time and proper effort as well (Lloyd, 2014).