Gender-related mental health differences between refugees and non-refugee immigrants - a cross-sectional register-based study

PubMed Central

2011-01-01

Background Being an immigrant in a high-income country is a risk factor for severe mental ill health. Studies on mental ill health among immigrants have found significant differences in mental health outcome between immigrants from high income countries and low-income countries. Being an asylum seeker or a refugee is also associated with mental ill health. This study aimed to assess if there is a difference in mental ill health problems between male and female refugee and non-refugee immigrants from six low-income countries in Sweden. Methods A cross-sectional, population-based study design was used comparing refugees with non-refugees. The study size was determined by the number of persons in Sweden fulfilling the inclusion criteria at the time of the study during 2006. Outcome: Mental ill health, as measured with the proxy variable psychotropic drugs purchased. Refugee/Non-refugee: Sweden grants asylum to refugees according to the Geneva Convention and those with a well-grounded fear of death penalty, torture or who need protection due to an internal or external armed conflict or an environmental disaster. The non-refugees were all family members of those granted asylum in Sweden. Covariates: Gender and origin. Potential confounders: Age, marital status, education and duration of stay in Sweden. Background variables were analysed using chi square tests. The association between outcome, exposure and possible confounders was analysed using logistic regression analyses. Multiple logistic regression analysis was used to adjust for potential confounders. Results The study population comprised 43,168 refugees and non-refugees, of whom 20,940 (48.5%) were women and 24,403 (56.5%) were refugees. Gender, age, origin, marital status and education were all associated with the outcome. For female, but not male, refugees there was a significantly higher likelihood of purchasing psychotropic drugs than non-refugees (OR = 1.27, 95% CI = 1.15 - 1.40). Conclusions Female refugees from low-income countries seem to be a risk group among immigrant women from low-income countries, whereas male refugees had the same risk patterns as non-refugee immigrants from low-income countries. This underlines the need for training of clinicians in order to focus on pre-migration stress and the asylum process, among female newcomers. PMID:21435212

Gender-related mental health differences between refugees and non-refugee immigrants--a cross-sectional register-based study.

PubMed

Hollander, Anna-Clara; Bruce, Daniel; Burström, Bo; Ekblad, Solvig

2011-03-24

Being an immigrant in a high-income country is a risk factor for severe mental ill health. Studies on mental ill health among immigrants have found significant differences in mental health outcome between immigrants from high income countries and low-income countries. Being an asylum seeker or a refugee is also associated with mental ill health. This study aimed to assess if there is a difference in mental ill health problems between male and female refugee and non-refugee immigrants from six low-income countries in Sweden. A cross-sectional, population-based study design was used comparing refugees with non-refugees. The study size was determined by the number of persons in Sweden fulfilling the inclusion criteria at the time of the study during 2006. Mental ill health, as measured with the proxy variable psychotropic drugs purchased. Refugee/Non-refugee: Sweden grants asylum to refugees according to the Geneva Convention and those with a well-grounded fear of death penalty, torture or who need protection due to an internal or external armed conflict or an environmental disaster. The non-refugees were all family members of those granted asylum in Sweden. Covariates: Gender and origin. Potential confounders: Age, marital status, education and duration of stay in Sweden. Background variables were analysed using chi square tests. The association between outcome, exposure and possible confounders was analysed using logistic regression analyses. Multiple logistic regression analysis was used to adjust for potential confounders. The study population comprised 43,168 refugees and non-refugees, of whom 20,940 (48.5%) were women and 24,403 (56.5%) were refugees. Gender, age, origin, marital status and education were all associated with the outcome. For female, but not male, refugees there was a significantly higher likelihood of purchasing psychotropic drugs than non-refugees (OR = 1.27, 95% CI = 1.15-1.40). Female refugees from low-income countries seem to be a risk group among immigrant women from low-income countries, whereas male refugees had the same risk patterns as non-refugee immigrants from low-income countries. This underlines the need for training of clinicians in order to focus on pre-migration stress and the asylum process, among female newcomers.

Classroom Management and Socioemotional Functioning of Burmese Refugee Students in Malaysia

ERIC Educational Resources Information Center

O'Neal, Colleen; Atapattu, Ranga; Jegathesan, Anasuya; Clement, Jennifer; Ong, Edward; Ganesan, Asha

2018-01-01

Access to Malaysian government schools is prohibited for refugee children, and hidden refugee schools only reach a minority of Burmese students in Malaysia. This study used a participatory culture-specific consultation (PCSC) approach to examine the perspectives of Burmese refugee teachers on Burmese refugee student socioemotional issues and…

Decreasing Intestinal Parasites in Recent Northern California Refugees

PubMed Central

Chang, Alicia H.; Perry, Sharon; Du, Jenny N. T.; Agunbiade, Abdulkareem; Polesky, Andrea; Parsonnet, Julie

2013-01-01

Beginning in 2005, the Centers for Disease Control and Prevention (CDC) expanded the overseas presumptive treatment of intestinal parasites with albendazole to include refugees from the Middle East. We surveyed the prevalence of helminths and protozoa in recent Middle Eastern refugees (2008–2010) in comparison with refugees from other geographical regions and from a previous survey (2001–2004) in Santa Clara County, California. Based on stool microscopy, helminth infections decreased, particularly in Middle Eastern refugees (0.1% versus 2.3% 2001–2004, P = 0.01). Among all refugees, Giardia intestinalis was the most common protozoan found. Protozoa infections also decreased somewhat in Middle Eastern refugees (7.2%, 2008–2010 versus 12.9%, 2001–2004, P = 0.08). Serology for Strongyloides stercoralis and Schistosoma spp. identified more infected individuals than stool exams. Helminth infections are increasingly rare in refugees to Northern California. Routine screening stool microscopy may be unnecessary in all refugees. PMID:23149583

A qualitative approach to understand antiretroviral therapy (ART) adherence for refugees living in Nakivale Refugee Settlement in Uganda.

PubMed

O'Laughlin, Kelli N; Rouhani, Shada A; Kasozi, Julius; Greenwald, Kelsy E; Perkons, Nicholas R; Faustin, Zikama M; Bassett, Ingrid V; Ware, Norma C

2018-01-01

Refugees living with HIV in sub-Saharan Africa suffer unique hardships that may increase their vulnerability to interruptions in antiretroviral therapy (ART). To investigate refugees' experiences adhering to ART, we conducted inperson interviews with refugees on ART ( n  = 73) and HIV clinic staff ( n  = 4) in Nakivale Refugee Settlement in southwest Uganda from March to July 2011. Three analysts used a conventional content analysis approach to evaluate these data. Refugees described profound motivation to adhere to ART and employed adherence strategies to facilitate success despite the austere setting. However, refugees spoke of specific hardships living in Nakivale that served as barriers to ART adherence, including difficulty accessing clinic when ill, food insecurity, drug stockouts, and violence and unrest in the settlement. For some refugees, need for ART inextricably linked them to the HIV clinic and prevented them from transitioning permanently away from the settlement. By learning about refugees' experiences we can design informed interventions to enhance ART adherence, thus minimizing morbidity and mortality, preventing transmission of HIV, and supporting refugees' abilities to move freely toward repatriation, resettlement or integration in their host country.

Noncommunicable diseases among urban refugees and asylum-seekers in developing countries: a neglected health care need

PubMed Central

2014-01-01

With the increasing trend in refugee urbanisation, growing numbers of refugees are diagnosed with chronic noncommunicable diseases (NCDs). However, with few exceptions, the local and international communities prioritise communicable diseases. The aim of this study is to review the literature to determine the prevalence and distribution of chronic NCDs among urban refugees living in developing countries, to report refugee access to health care for NCDs and to compare the prevalence of NCDs among urban refugees with the prevalence in their home countries. Major search engines and refugee agency websites were systematically searched between June and July 2012 for articles and reports on NCD prevalence among urban refugees. Most studies were conducted in the Middle East and indicated a high prevalence of NCDs among urban refugees in this region, but in general, the prevalence varied by refugees’ region or country of origin. Hypertension, musculoskeletal disease, diabetes and chronic respiratory disease were the major diseases observed. In general, most urban refugees in developing countries have adequate access to primary health care services. Further investigations are needed to document the burden of NCDs among urban refugees and to identify their need for health care in developing countries. PMID:24708876

Nutritional status and mortality of refugee and resident children in a non-camp setting during conflict: follow up study in Guinea-Bissau.

PubMed

Aaby, P; Gomes, J; Fernandes, M; Djana, Q; Lisse, I; Jensen, H

1999-10-02

To study the effects on children of humanitarian aid agencies restricting help to refugee families (internally displaced people). Follow up study of 3 months. Prabis peninsular outside Bissau, the capital of Guinea-Bissau, which has functioned as a refugee area for internally displaced people in the ongoing war, and the study area of the Bandim health project in Bissau. 422 children aged 9-23 months in 30 clusters. Mid-upper arm circumference and survival in relation to residence status. During the refugee situation all children deteriorated nutritionally, and mortality was high (3.0% in a 6 week period). Rice consumption was higher in families resident in Prabis than in refugees from Bissau but there was no difference in food expenditure. Nutritional status, measured by mid- upper arm circumference, was not associated with rice consumption levels in the family, and the decline in circumference was significantly worse for resident than for refugee children; the mid-upper arm circumference of refugee children increased faster than that of resident children. For resident children, mortality was 4.5 times higher (95% confidence interval 1.1 to 30.0) than for refugee children. Mortality for both resident and refugee children was 7.2 times higher (1.3 to 133.9) during the refugee's stay in Prabis compared with the period after the departure of the refugees. In a non-camp setting, residents may be more malnourished and have higher mortality than refugees. Major improvements in nutritional status and a reduction in mortality occurred in resident and refugee children as soon as refugees returned home despite the fact that there was no improvement in food availability.

Insomnia in North Korean Refugees: Association with Depression and Post-Traumatic Stress Symptoms

PubMed Central

Lee, Yu-Jin G.; Jun, Jin Yong; Lee, Yu Jin; Park, Juhyun; Kim, Soohyun; Lee, So Hee; Yu, So Young

2016-01-01

Objective We investigated the prevalence of insomnia and its clinical characteristics in North Korean refugees. Methods North Korean refugees living in South Korea (48 males, 129 females; mean age 38.22±12.24 years) and South Koreans (112 males, 203 females; mean age 39.48±10.32 years) completed the following questionnaires: the Self-reported Questionnaire on Insomnia, Center for Epidemiological Studies-Depression Scale (CES-D), Trauma Exposure Check List for North Korean Refugees, and the Impact of Event Scale-Revised (IES-R). Results North Korean refugees had insomnia more often than South Koreans did (38.42% vs. 8.89%). Depression combined with insomnia was also more prevalent in North Korean refugees (28.25% vs. 3.17%). Compared with South Koreans with insomnia, North Korean refugees with insomnia showed higher CES-D scores. The North Korean refugees with insomnia had experienced a larger number of traumatic events, and had higher CES-D and IES-R scores compared to North Korean refugees without insomnia. Insomnia in North Korean refugees was also associated with the presence of significant depressive and post-traumatic stress disorder (PTSD) symptoms. Conclusion Insomnia was common in North Korean refugees and was closely associated with depressive and PTSD symptoms. Our study suggests that complaints of insomnia may indicate more severe psychopathology, especially in refugees. PMID:26766948

Reconceptualising Refugee Education: Exploring the Diverse Learning Contexts of Unaccompanied Young Refugees upon Resettlement

ERIC Educational Resources Information Center

Pastoor, Lutine de Wal

2017-01-01

This article explores unaccompanied young refugees' participation in various learning contexts beyond school. Drawing from a qualitative study based on interviews with unaccompanied young refugees, educators and social workers in Norway, the findings emphasise the need for a holistic approach to refugee education in and across contexts of…

Post-Secondary Educational Experiences in the Acculturation of Resettled Refugees in the United States

ERIC Educational Resources Information Center

Ross, Tara W.

2013-01-01

A global refugee crisis necessitates an understanding of policymaking governing the resettlement of refugees in the United States. Resettling more refugees than all other countries combined, the United States emphasizes rapid employment over post-secondary education for adult resettled refugees in order to compel their self-sufficiency. However,…

75 FR 35951 - World Refugee Day, 2010

Federal Register 2010, 2011, 2012, 2013, 2014

2010-06-23

... Refugee Day, 2010 By the President of the United States of America A Proclamation On World Refugee Day, we... Refugee Day, we recommit to ensuring that the blessings of liberty and opportunity are available to all... hereby proclaim June 20, 2010, as World Refugee Day. I call upon all the people of the United States to...

The Refugee Crisis and the Rights of Children: Perspectives on Community-Based Resettlement Programs.

PubMed

Alipui, Nicholas; Gerke, Nicole

2018-03-01

We are currently facing one of the largest and most complex refugee crises in modern times. Conflict and natural disasters have resulted in 22.5 million refugees worldwide, more than half are children. As the world struggles to respond to this massive displacement of people, how is this affecting child refugees' development and what is being done about it? In this commentary, we explore answers to these central questions. First, we review the situation of child refugees in numbers, exploring their geographic concentration. Second, we review child refugees' access to basic services, including early childhood development, with a special emphasis on community-based programs and initiatives that have proven to be particularly effective in addressing the needs of resettled child refugees. We find in particular that early childhood development activities in emergency contexts have seen remarkable improvements with critical benefits for the development of the youngest child refugees. Our aim is to bring attention to the particular difficulties child refugees must endure and to highlight those practices and approaches that are helping child refugees reach their full potential. © 2018 Wiley Periodicals, Inc.

The role of social support on HIV testing and treatment adherence: A qualitative study of HIV-infected refugees in southwestern Uganda.

PubMed

Rouhani, Shada A; O'Laughlin, Kelli N; Faustin, Zikama M; Tsai, Alexander C; Kasozi, Julius; Ware, Norma C

2017-08-01

Little is known about the factors that encourage or discourage refugees to test for HIV, or to access and adhere to HIV care. In non-refugee populations, social support has been shown to influence HIV testing and utilisation of services. The present study enrolled HIV-infected refugees on anti-retroviral therapy (ART) in Uganda, who participated in qualitative interviews on HIV testing, treatment, and adherence. Interviews were analysed for themes about four types of social support: emotional, informational, instrumental, and appraisal support. A total of 61 interviews were analysed. Four roles for these types of social support were identified: (1) informational support encouraged refugees to test for HIV; (2) emotional support helped refugees cope with a diagnosis of HIV; (3) instrumental support facilitated adherence to ART and (4) after diagnosis, HIV-infected refugees provided informational and emotional support to encourage other refugees to test for HIV. These results suggest that social support influences HIV testing and treatment among refugees. Future interventions should capitalise on social support within a refugee settlement to facilitate testing and treatment.

[Decision Support for the Therapy Planning for Young Refugees and Asylum-Seekers with Posttraumatic Disorders].

PubMed

Reher, Cornelia; Metzner, Franka

2016-12-01

Decision Support for the Therapy Planning for Young Refugees and Asylum-Seekers with Posttraumatic Disorders Due to the Convention on the Rights of the Child and § 6 of the Asylum Seekers' Benefit Act, there are legal and ethical obligations for the care of minor refugees suffering from trauma-related disorders. In Germany, psychotherapeutic care of adolescent refugees is provided by specialized treatment centers and Child and Adolescent psychiatries with specialized consultation-hours for refugees. Treatment of minor refugees is impeded by various legal and organizational barriers. Many therapists have reservations and uncertainties regarding an appropriate therapy for refugees due to a lack of experience. This means that only a fraction of the young refugees with trauma-related disorders find an ambulatory therapist. In a review of international literature, empirical findings on (interpreter-aided) diagnostics and therapy of young refugees were presented. Practical experiences on therapeutic work with traumatized young refugees were summarized in a decision tree for therapy planning in the ambulatory setting. The decision tree was developed to support therapists in private practices by structuring the therapy process.

Resettling refugees and safeguarding their mental health: lessons learned from the Canadian Refugee Resettlement Project.

PubMed

Beiser, Morton

2009-12-01

The Ryerson University Refugee Resettlement Project (RRP), a decade-long study of 1348 Southeast Asian refugees who came to Canada between 1979 and 1981, is one of the largest, most comprehensive and longest-lived investigations of refugee resettlement ever carried out. Knowledge gleaned from the RRP about research methodology, about the resettlement experience, about the social costs of resettling refugees, about factors that promote or hinder integration, about risk and protective factors for refugee mental health, and about the refugees' consumption of mental health and social services is summarized in the form of 18 "Lessons." The lessons are offered in order to encourage and stimulate further research, as well to suggest policy and practice innovations that could help make resettlement easier, less costly, more effective, and more humane.

A family beliefs framework for socially and culturally specific preventive interventions with refugee youths and families.

PubMed

Weine, Stevan; Feetham, Suzanne; Kulauzovic, Yasmina; Knafl, Kathleen; Besic, Sanela; Klebic, Alma; Mujagic, Aida; Muzurovic, Jasmina; Spahovic, Dzemila; Pavkovic, Ivan

2006-01-01

To assist in designing socially and culturally specific preventive interventions for refugee youths and families, this study identified the processes by which refugee families adapt and apply family beliefs concerning youths. A grounded-theory model constructed with ATLAS/ti for Windows and named the family beliefs framework describes (a) family beliefs concerning refugee youths, (b) contextual factors interacting with these family beliefs, (c) adaptation of family beliefs concerning refugee youths, and (d) the interplay of adapting family beliefs and behaviors concerning refugee youths. Preventive interventions for refugee youths and families would be more socially and culturally specific if they addressed the specific processes of adapting family beliefs experienced by refugee youths and their families amid transitions and traumas. 2006 APA, all rights reserved

Impact of the Hepatitis Testing and Linkage to Care (HepTLC) Initiative on Linkage to Care for Minnesota Refugees with Hepatitis B, 2012-2014.

PubMed

Linde, Ann C; Sweet, Kristin A; Nelson, Kailey; Mamo, Blain; Chute, Sara M

2016-01-01

The Hepatitis Testing and Linkage to Care (HepTLC) initiative promoted viral hepatitis B and hepatitis C screening, posttest counseling, and linkage to care at 34 U.S. sites from 2012 to 2014. Through the HepTLC initiative, the Minnesota Department of Health (MDH) and clinic partners began conducting linkage-to-care activities with hepatitis B-positive refugees in October 2012. This intervention provided culturally appropriate support to link refugees to follow-up care for hepatitis B. MDH refugee health and viral hepatitis surveillance programs, along with clinics that screened newly arrived refugees in Hennepin and Ramsey counties in Minnesota, collaborated on the project, which took place from October 1, 2012, through September 30, 2014. Bilingual care navigators contacted refugees to provide education, make appointments, and arrange transportation. We compared the linkage-to-care rate for participants with the rates for refugees screened the year before project launch using a two-sample test of proportions. In the year preceding the project (October 2011 through September 2012), 87 newly arrived refugees had a positive hepatitis B surface antigen (HBsAg) test. Fifty-six (64%) refugees received follow-up care, 12 (14%) refugees did not receive follow-up care, and 19 (22%) refugees could not be located and had no record of follow-up care. During the project, 174 HBsAg-positive, newly arrived refugees were screened. Of those 174 refugees, 162 (93%) received follow-up care, seven (4%) did not receive follow-up care, and five (3%) could not be located and had no record of follow-up care. The one-year linkage-to-care rate for project participants (93%) was significantly higher than the rate for refugees screened the previous year (64%) (p<0.001). In the context of a strong screening and surveillance infrastructure, a simple intervention improved the linkage-to-care rate for HBsAg-positive refugees.

I don't think general practice should be the front line: Experiences of general practitioners working with refugees in South Australia

PubMed Central

Johnson, David R; Ziersch, Anna M; Burgess, Teresa

2008-01-01

Introduction Many refugees arrive in Australia with complex health needs. In South Australia (SA), providing initial health care to refugees is the responsibility of General Practitioners (GPs) in private practice. Their capacity to perform this work effectively for current newly arrived refugees is uncertain. The aim of this study was to document the challenges faced by GPs in private practice in SA when providing initial care to refugees and to discuss the implications of this for policy relating to optimising health care services for refugees. Methods Semi-structured interviews with twelve GPs in private practice and three Medical Directors of Divisions of General Practice. Using a template analysis approach the interviews were coded and analysed thematically. Results Multiple challenges providing care to refugees were found including those related to: (1) refugee health issues; (2) the GP-refugee interaction; and (3) the structure of general practice. The Divisions also reported challenges assisting GPs to provide effective care related to a lack of funding and awareness of which GPs required support. Although respondents suggested a number of ways that GPs could be assisted to provide better initial care to refugees, strong support was voiced for the initial care of refugees to be provided via a specialist refugee health service. Conclusion GPs in this study were under-resourced, at both an individual GP level as well as a structural level, to provide effective initial care for refugees. In SA, there are likely to be a number of challenges attempting to increase the capacity of GPs in private practice to provide initial care. An alternative model is for refugees with multiple and complex health care needs as well as those with significant resettlement challenges to receive initial health care via the existing specialist refugee health service in Adelaide. PMID:18687150

Impact of the Hepatitis Testing and Linkage to Care (HepTLC) Initiative on Linkage to Care for Minnesota Refugees with Hepatitis B, 2012–2014

PubMed Central

Sweet, Kristin A.; Nelson, Kailey; Mamo, Blain; Chute, Sara M.

2016-01-01

Objective The Hepatitis Testing and Linkage to Care (HepTLC) initiative promoted viral hepatitis B and hepatitis C screening, posttest counseling, and linkage to care at 34 U.S. sites from 2012 to 2014. Through the HepTLC initiative, the Minnesota Department of Health (MDH) and clinic partners began conducting linkage-to-care activities with hepatitis B-positive refugees in October 2012. This intervention provided culturally appropriate support to link refugees to follow-up care for hepatitis B. Methods MDH refugee health and viral hepatitis surveillance programs, along with clinics that screened newly arrived refugees in Hennepin and Ramsey counties in Minnesota, collaborated on the project, which took place from October 1, 2012, through September 30, 2014. Bilingual care navigators contacted refugees to provide education, make appointments, and arrange transportation. We compared the linkage-to-care rate for participants with the rates for refugees screened the year before project launch using a two-sample test of proportions. Results In the year preceding the project (October 2011 through September 2012), 87 newly arrived refugees had a positive hepatitis B surface antigen (HBsAg) test. Fifty-six (64%) refugees received follow-up care, 12 (14%) refugees did not receive follow-up care, and 19 (22%) refugees could not be located and had no record of follow-up care. During the project, 174 HBsAg-positive, newly arrived refugees were screened. Of those 174 refugees, 162 (93%) received follow-up care, seven (4%) did not receive follow-up care, and five (3%) could not be located and had no record of follow-up care. The one-year linkage-to-care rate for project participants (93%) was significantly higher than the rate for refugees screened the previous year (64%) (p<0.001). Conclusion In the context of a strong screening and surveillance infrastructure, a simple intervention improved the linkage-to-care rate for HBsAg-positive refugees. PMID:27168670

Makassar city government’s urban refugee policy: filling in the gap?

NASA Astrophysics Data System (ADS)

Gabiella, D.; Putri, R. A. A. K.

2018-03-01

Indonesia is home to 13,829 refugees and asylum seekers by the end of January 2017. In general, the number could be dichotomized into two categories: camp-based refugees and urban refugees. There are approximately 70.83% of urban refugees living in several cities across the country. The existence of refugees in urban environments has been considered as either bringing promise or peril to urban development. Makassar is one among the most populated cities by refugees in Indonesia. In the middle of the inadequacy of legal framework at the national level, the Makassar City Government initiated a policy to address the issues of refugees staying in the city specifically. In 2005, the Mayor of Makassar signed a Memorandum of Understanding with International Organization for Migration (IOM) to accommodate the needs for funding allocated from Regional Budget that could not be dispensed due to the absence of legal basis. The city also constituted a Joint Committee Monitoring (JCM), which comprises of various government agencies, to support the Immigration Office in monitoring the refugees. These initiatives allow refugees to access basic services that are not made available to them in other cities. Against this backdrop, this paper mainly discusses the initiatives and refugee policy of Makassar City Government, which had emulated the national government’s policy to refugee management before the recently signed Presidential Decree No. 25 / 2016. It argues that the proactive and relatively integrative approach of the City Government alongside the social inclusion by the local community have contributed positively to the livelihoods of urban refugees in Makassar.

Refugees, the asylum system and mental healthcare in Ireland

PubMed Central

O’Connell, Molly; Duffy, Richard

2016-01-01

The number of people seeking refugee status in Ireland is increasing year on year and the burden of mental illness experienced by refugees and asylum seekers is high. The College of Psychiatrists of Ireland has recommended the establishment of a number of specialist refugee mental health teams. In this paper we discuss the Irish asylum system, the Irish evidence regarding mental illness in this population, and current health service policy regarding refugee mental health. We propose a model of specialist refugee mental healthcare delivery. PMID:29093895

Primary care management of non-English-speaking refugees who have experienced trauma: a clinical review.

PubMed

Crosby, Sondra S

2013-08-07

Refugees are a vulnerable class of immigrants who have fled their countries, typically following war, violence, or natural disaster, and who have frequently experienced trauma. In primary care, engaging refugees to develop a positive therapeutic relationship is challenging. Relative to care of other primary care patients, there are important differences in symptom evaluation and developing treatment plans. To discuss the importance of and methods for obtaining refugee trauma histories, to recognize the psychological and physical manifestations of trauma characteristic of refugees, and to explore how cultural differences and limited English proficiency affect the refugee patient-clinician relationship and how to best use interpreters. MEDLINE and the Cochrane Library were searched from 1984 to 2012. Additional citations were obtained from lists of references from select research and review articles on this topic. Engagement with a refugee patient who has experienced trauma requires an understanding of the trauma history and the trauma-related symptoms. Mental health symptoms and chronic pain are commonly experienced by refugee patients. Successful treatment requires a multidisciplinary approach that is culturally acceptable to the refugee. Refugee patients frequently have experienced trauma requiring a directed history and physical examination, facilitated by an interpreter if necessary. Intervention should be sensitive to the refugee's cultural mores.

Including refugees in disease elimination: challenges observed from a sleeping sickness programme in Uganda.

PubMed

Palmer, Jennifer J; Robert, Okello; Kansiime, Freddie

2017-01-01

Ensuring equity between forcibly-displaced and host area populations is a key challenge for global elimination programmes. We studied Uganda's response to the recent refugee influx from South Sudan to identify key governance and operational lessons for national sleeping sickness programmes working with displaced populations today. A refugee policy which favours integration of primary healthcare services for refugee and host populations and the availability of rapid diagnostic tests (RDTs) to detect sleeping sickness at this health system level makes Uganda well-placed to include refugees in sleeping sickness surveillance. Using ethnographic observations of coordination meetings, review of programme data, interviews with sleeping sickness and refugee authorities and group discussions with health staff and refugees (2013-2016), we nevertheless identified some key challenges to equitably integrating refugees into government sleeping sickness surveillance. Despite fears that refugees were at risk of disease and posed a threat to elimination, six months into the response, programme coordinators progressed to a sentinel surveillance strategy in districts hosting the highest concentrations of refugees. This meant that RDTs, the programme's primary surveillance tool, were removed from most refugee-serving facilities, exacerbating existing inequitable access to surveillance and leading refugees to claim that their access to sleeping sickness tests had been better in South Sudan. This was not intentionally done to exclude refugees from care, rather, four key governance challenges made it difficult for the programme to recognise and correct inequities affecting refugees: (a) perceived donor pressure to reduce the sleeping sickness programme's scope without clear international elimination guidance on surveillance quality; (b) a problematic history of programme relations with refugee-hosting districts which strained supervision of surveillance quality; (c) difficulties that government health workers faced to produce good quality surveillance in a crisis; and (d) reluctant engagement between the sleeping sickness programme and humanitarian structures. Despite progressive policy intentions, several entrenched governance norms and practices worked against integration of refugees into the national sleeping sickness surveillance system. Elimination programmes which marginalise forced migrants risk unwittingly contributing to disease spread and reinforce social inequities, so new norms urgently need to be established at local, national and international levels.

Supporting Preschoolers and Their Families Who Are Recently Resettled Refugees

ERIC Educational Resources Information Center

Hurley, Jennifer J.; Medici, Andrea; Stewart, Emily; Cohen, Zachary

2011-01-01

According to the United Nations High Commission for Refugees, the number of refugees worldwide was 10.5 million in 2009 and this number continues to grow (United Nations Refugee Agency, 2010). There is a shortage of evidence based practices and information regarding the state of service provision for young refugee children and their families in…

An Analysis of Educational Policies for School-Aged Syrian Refugees in Turkey

ERIC Educational Resources Information Center

Alpaydin, Yusuf

2017-01-01

The purpose of this study is to analyse the educational policies for Syrian school-aged refugees in Turkey. In this study, we identified the policy priorities for refugees by first examining the theoretical approaches to refugee education and the common problems observed for refugee education in different countries. Using this framework, we…

Notes from the field: mortality among refugees fleeing Somalia--Dadaab refugee camps, Kenya, July-August 2011.

PubMed

2011-08-26

Refugee camps in Dadaab, Kenya, currently are receiving Somali refugees fleeing famine and armed conflict at a rate of approximately 1,400 refugees per day. New arrivals are at an elevated risk for mortality because of severe famine in Somalia, the dangerous journey, and overcrowding in the camps.

The Educational Resettlement of Refugee Children: Examining Several Theoretical Approaches

ERIC Educational Resources Information Center

Lerner, Amy B.

2012-01-01

Each year, approximately 100,000 refugees arrive in the United States (Refugee Council USA). Nearly half of these arrivals are children. The number of refugees worldwide has more than sextupled since the 1950s, and according to the United States Committee for Refugees and immigrants (USCRI) this number is expected to continue to grow in coming…

78 FR 55080 - Announcement of the Award of a Single-Source Program Expansion Supplement Grant to Massachusetts...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-09-09

... Grant to Massachusetts Office for Refugees and Immigrants in Boston, MA AGENCY: Office of Refugee... to Massachusetts Office for Refugees and Immigrants to provide refugee cash assistance to an... Office for Refugees and Immigrants, Boston, MA, in the amount of $325,000 under the Wilson- Fish Program...

Southeast Asian Refugee English Proficiency & Education in Texas: Findings from the Texas Refugee Study.

ERIC Educational Resources Information Center

Taylor, Eric H.; Barton, Lisa S.

This document is the first in a series of reports about Texas's refugees and is an analysis of more than 1,000 Vietnamese and Laotian refugee interviews. What follows is an examination of the relationships English proficiency and education have with Southeast Asian refugees' income, mammogram screenings, smoking, citizenship, possession of a…

3 CFR - Fiscal Year 2011 Refugee Admissions Numbers and Authorizations of In-Country Refugee Status...

Code of Federal Regulations, 2011 CFR

2011-01-01

... Immigration and Nationality Act, and Determination Pursuant to Section 2(b)(2) of the Migration and Refugee... Act, and Determination Pursuant to Section 2(b)(2) of the Migration and Refugee Assistance Act, as... the admissions are being transferred. Consistent with section 2(b)(2) of the Migration and Refugee...

Evaluation of Longitudinal Clinical Outcomes and Adherence to Care among HIV-Infected Refugees

PubMed Central

Winston, Susanna E.; Montague, Brian T.; Lopez, Michael J.; Delong, Allison; LeMarchand, Chloe; Bedoya, Armando; Gillani, Fizza S.; Beckwith, Curt G.

2014-01-01

Background HIV-infected refugees resettled in the United States face many challenges. Longitudinal data regarding HIV-specific outcomes in this population are limited. Methods We reviewed charts of 51 HIV-infected sub-Saharan African refugees matched to 102 nonrefugees. Outcomes analyzed included CD4 counts, viral loads (VLs), antiretroviral treatment (ART) use, appointment adherence, opportunistic infections, and resistance mutations. Results The ART initiation was similar. Appointment adherence was similar in year 1, but refugees were significantly less adherent beyond year 3. Refugees and nonrefugees spent similar amounts of time in care suppressed (83% vs 80%, P = .93). Refugees had higher odds of viremia following undetectable VL (OR 2.3, P < .05). Discussion Initially, sub-Saharan African HIV-infected refugees have comparable appointment adherence, ART use, and VL suppression to nonrefugees. Overtime refugees were less adherent to appointments and more likely to have postsuppression viremia. The support services provided to refugees early in care may be important for retention in care and treatment success. PMID:23024042

History of Persecution and Health Outcomes Among U.S. Refugees.

PubMed

Yun, Katherine; Mohamad, Zeinab; Kiss, Ligia; Annamalai, Aniyizhai; Zimmerman, Cathy

2016-02-01

Our goal was to describe the forms of persecution reported by adult refugees in the U.S. and the relationships between persecution and health status among this population. Data were derived from the 2003 New Immigrant Survey, a representative sample of new U.S. lawful permanent residents. Major depression, impairment in daily activities due to pain, poor self-reported health, and declining health were described for refugees who had and had not reported persecution prior to arrival in the U.S. Health status was also examined for refugees who reported different forms of persecution. Half of refugees (46.7 %) in this sample reported that they or an immediate family member had been persecuted. One in three persecuted refugees (31.8 %) reported both incarceration and physical punishment. Major depression, pain-related impairment, poor health, and declining health were twice as common among persecuted refugees than among non persecuted refugees. Notably, despite these adverse experiences, the majority of persecuted refugees did not report poor health outcomes.

Resilience of Vietnamese refugees: resources to cope with natural disasters in their resettled country.

PubMed

Xin, Huaibo; Aronson, Robert E; Lovelace, Kay A; Strack, Robert W; Villalba, José A

2013-08-01

Study findings suggest that refugees are more vulnerable than the general population to mental disorders from disasters. This pilot study explored the nature of Vietnamese refugees' resilience to a potential natural disaster as a first step toward improving their disaster mental health. Interviews were conducted with 20 ethnic Vietnamese and Montagnard adult refugees using a semistructured interview guide. Factors in resilience at both individual and family levels were examined. Our results indicated that these refugees had positive personalities and strong family cohesion. However, although a majority of the participants had experienced natural disasters, they lacked knowledge and specific strategies to cope with these events. The individual participants and their families lacked sufficient information, financial resources, emergency supplies, or social support for a natural disaster. Enhancing refugees' current strengths in responding to disasters, delivering them tailored emergency training, strengthening relationships between refugee service providers and refugee communities, and advocating for refugees' socioeconomic capacity building should be considered.

Recruitment of Refugees for Health Research: A Qualitative Study to Add Refugees' Perspectives.

PubMed

Gabriel, Patricia; Kaczorowski, Janusz; Berry, Nicole

2017-01-29

Research is needed to understand refugees' health challenges and barriers to accessing health services during settlement. However, there are practical and ethical challenges for engaging refugees as participants. Despite this, there have been no studies to date specifically investigating refugee perspectives on factors affecting engagement in health research. Language-concordant focus groups in British Columbia, Canada, with four government-assisted refugee language groups (Farsi/Dari, Somali, Karen, Arabic) inquired about willingness to participate in health research. Twenty-three variables associated with the willingness of refugees to participate in health research were elicited. Variables related to research design included recruitment strategies, characteristics of the research team members and the nature of the research. Variables related to individual participants included demographic features such as gender and education, attitudes towards research and previous experience with research. This research can be used to increase opportunities for refugees' engagement in research and includes recommendations for subgroups of refugees that may have more difficulties engaging in research.

Utilization of outpatient services in refugee settlement health facilities: a comparison by age, gender, and refugee versus host national status

PubMed Central

2011-01-01

Background Comparisons between refugees receiving health care in settlement-based facilities and persons living in host communities have found that refugees have better health outcomes. However, data that compares utilization of health services between refugees and the host population, and across refugee settlements, countries and regions is limited. The paper will address this information gap. The analysis in this paper uses data from the United Nations High Commissioner of Refugees (UNHCR) Health Information System (HIS). Methods Data about settlement populations and the use of outpatient health services were exported from the UNHCR health information system database. Tableau Desktop was used to explore the data. STATA was used for data cleaning and statistical analysis. Differences in various indicators of the use of health services by region, gender, age groups, and status (host national vs. refugee population) were analyzed for statistical significance using generalized estimating equation models that adjusted for correlated data within refugee settlements over time. Results Eighty-one refugee settlements were included in this study and an average population of 1.53 million refugees was receiving outpatient health services between 2008 and 2009. The crude utilization rate among refugees is 2.2 visits per person per year across all settlements. The refugee utilization rate in Asia (3.5) was higher than in Africa on average (1.8). Among refugees, females have a statistically significant higher utilization rate than males (2.4 visits per person per year vs. 2.1). The proportion of new outpatient attributable to refugees is higher than that attributable to host nationals. In the Asian settlements, only 2% outpatient visits, on average, were attributable to host community members. By contrast, in Africa, the proportion of new outpatient (OPD) visits by host nationals was 21% on average; in many Ugandan settlements, the proportion of outpatient visits attributable to host community members was higher than that for refugees. There was no statistically significant difference between the size of the male and female populations across refugee settlements. Across all settlements reporting to the UNHCR database, the percent of the refugee population that was less than five years of age is 16% on average. Conclusions The availability of a centralized database of health information across UNHCR-supported refugee settlements is a rich resource. The SPHERE standard for emergencies of 1-4 visits per person per year appears to be relevant for Asia in the post-emergency phase, but not for Africa. In Africa, a post-emergency standard of 1-2 visits per person per year should be considered. Although it is often assumed that the size of the female population in refugee settlements is higher than males, we found no statistically significant difference between the size of the male and female populations in refugee settlements overall. Another assumption---that the under-fives make up 20% of the settlement population during the emergency phase---does not appear to hold for the post-emergency phase; under-fives made up about 16% of refugee settlement populations. PMID:21936911

Nutritional status and mortality of refugee and resident children in a non-camp setting during conflict: follow up study in Guinea-Bissau

PubMed Central

Aaby, Peter; Gomes, Joaquim; Fernandes, Manuel; Djana, Queba; Lisse, Ida; Jensen, Henrik

1999-01-01

Objective To study the effects on children of humanitarian aid agencies restricting help to refugee families (internally displaced people). Design Follow up study of 3 months. Setting Prabis peninsular outside Bissau, the capital of Guinea-Bissau, which has functioned as a refugee area for internally displaced people in the ongoing war, and the study area of the Bandim health project in Bissau. Participants 422 children aged 9-23 months in 30 clusters. Main outcome measures Mid-upper arm circumference and survival in relation to residence status. Results During the refugee situation all children deteriorated nutritionally, and mortality was high (3.0% in a 6 week period). Rice consumption was higher in families resident in Prabis than in refugees from Bissau but there was no difference in food expenditure. Nutritional status, measured by mid- upper arm circumference, was not associated with rice consumption levels in the family, and the decline in circumference was significantly worse for resident than for refugee children; the mid-upper arm circumference of refugee children increased faster than that of resident children. For resident children, mortality was 4.5 times higher (95% confidence interval 1.1 to 30.0) than for refugee children. Mortality for both resident and refugee children was 7.2 times higher (1.3 to 133.9) during the refugee’s stay in Prabis compared with the period after the departure of the refugees. Conclusion In a non-camp setting, residents may be more malnourished and have higher mortality than refugees. Major improvements in nutritional status and a reduction in mortality occurred in resident and refugee children as soon as refugees returned home despite the fact that there was no improvement in food availability. Key messagesDuring the war in Guinea-Bissau, most of the population fled from the capital and moved in with relatives, friends, or strangersInternational agencies insisted on only providing help to refugees (internally displaced people)During the first month of conflict, there were already profound effects on the nutritional status and mortality of young childrenFood consumption was higher in resident families, but resident children were more malnourished and had higher mortality than refugee childrenNutritional status and survival improved for both refugee and resident children once the refugees returned to Bissau PMID:10506040

Challenges in Identifying Refugees in National Health Data Sets.

PubMed

Semere, Wagahta; Yun, Katherine; Ahalt, Cyrus; Williams, Brie; Wang, Emily A

2016-07-01

To evaluate publicly available data sets to determine their utility for studying refugee health. We searched for keywords describing refugees in data sets within the Society of General Internal Medicine Dataset Compendium and the Inter-University Consortium for Political and Social Research database. We included in our analysis US-based data sets with publicly available documentation and a self-defined, health-related focus that allowed for an examination of patient-level factors. Of the 68 data sets that met the study criteria, 37 (54%) registered keyword matches related to refugees, but only 2 uniquely identified refugees. Few health data sets identify refugee status among participants, presenting barriers to understanding refugees' health and health care needs. Information about refugee status in national health surveys should include expanded demographic questions and focus on mental health and chronic disease.

Comparative study of mental health and quality of life in long term refugees and host populations in Oru-Ijebu, Southwest Nigeria

PubMed Central

2012-01-01

Background Refugees as “People Living in Highly Stressful Situation” are particularly vulnerable to mental ill-health as a result of the trauma experienced pre- and post-migration. The lack of information on the mental health disparities of refugees and non-refugees in West Africa is what this study aimed to bridge. A cross-sectional study design was employed using a cluster sampling technique. Interviewer-administered structured questionnaires consisting of the Mini-International Neuropsychiatric Interview (MINI), WHO quality of life (WHOQOL-BREF) and the Community Quality of Life (CQoL) were used for data collection. Data were analyzed with SPSS version 17. Logistic regression analysis was used to determine the predictors of mental health status and QoL. Results Respondents consisted of 444(45.7%) refugees and 527(54.3%) non-refugees. Two-thirds 292 (66%) of the refugees were Liberians. Mean age: refugees - 34.8 ± 12.8 years versus non-refugees - 33.3 ± 8.1 years (p < 0.05). While the majority 376(84.7%) of the refugees were married, most 468(88.8%) of the native population were not (p < 0.001). Significantly higher proportion of refugees had polygamous marriages, lived in poorer type of accommodation and had no formal education compared to the non-refugees (p < 0.05). The overall QoL and CQoL scores were both significantly lower for the refugees (p < 0.001). Refugees were three times more likely than non-refugees to have poor mental health [OR: 3.43; 95%CI: 1.83-6.40]. Overall, being currently ill tripled the odds of mental ill health [OR: 2.73; 95%CI: 1.98-3.77]. Unskilled workers [OR: 2.78; 95%CI: 1.68-4.60], skilled workers [OR: 2.98; 95%CI: 2.03-4.38] and the unemployed [OR: 1.94; 95%CI: 1.29-2.92] had two or more times the odds of poor mental health compared to professionals. Conclusions QoL and occupational status were the major threats to the mental health of the refugees. Results of this study point to the need for continued attention to not only the healthcare needs but the welfare, housing, employment and overall QoL to support the long-term mental health of refugees and non-refugee populations alike. PMID:22846111

Refugee movements and Turkey.

PubMed

Kirisci, K

1991-12-01

There has been a long tradition in the Ottoman Empire and the Turkish Republic of receiving refugees. There were Jewish refugees from the Spanish Inquisition, Hungarians and Poles fleeing revolts in 1848-9, and those of Turkish descent and usually from the Balkans. Concurrent with this trend is the history of refugees and immigrants leaving Turkey, such as many Armenians, Greeks and Jews leaving at the turn of the century, and after 1923 and the Treaty of Lausanne. Little is currently published on the topic. This article defines a refugee; provides an overview of the refugee problems of the 1980's due to Bulgarian, Kurdish, and Turkish refugees; and the legal and political aspects. As a country of origin, there is discussion of the political and economic aspects of Turkish asylum seekers in Europe. The potential refugee flows to and from Turkey are also examined. I) For this study, refugees are victims of political violence and are persecuted for political or religious beliefs, ethnic or racial background, or war. In Turkey, there are national refugees, international refugees outside the Convention, and UNHCR Convention refugees. During the 1980's all 3 groups were arriving: from eastern Europe, Iranian Kurds, Iraqis, and ethnic Turks from Bulgaria and Afghanistan. The Turkish restricted acceptance of the 1951 Convention on Refugees creates serious humanitarian and security consequences for refugees other than those from eastern Europe and of Turkish ethnicity. Political considerations play an important role in treatment where security threats outweigh humanitarian need. The case is given for Kurdish refugees. II) Asylum seekers from Turkey in Western Europe was determined between 1986-90 to be 185,000 from applications. These figures have risen steadily due to the political instability and military activity of areas bordering Iraq and Syria, the Emergency Region. In addition there are economic and employment problems, and there has been a suspension of human rights. Europe in return has tightened legislation and procedures to differentiate economically motivated refugees from authentic political asylum seekers. Further research is needed to investigate refugee problems. Further refugees may come due to the promotion of a Black Sea Cooperation Region and easier crossings of borders to the former Soviet Republics. Ethnic Turks in Moldavia or Romania or Bulgaria may leave due to unrest. Factors affecting asylum seekers are improvements in Turkey's human rights record, repeal of bans of the Kurdish language, completion of the South Eastern Development Project, and the European government policy on asylum.

Splenomegaly in Hmong refugees.

PubMed

Paulson, R R; Duvall, K L; Godes, J R; Holtan, N R

1984-02-01

We review asymptomatic splenomegaly in Indochinese refugees and provide recommendations for evaluation of the problem. Prevalence of splenomegaly in newly arrived Indochinese refugees was 2.5%, three times more prevalent in the Hmong than in the non-Hmong refugees. Male Hmong refugees aged 15 to 29 years had the highest prevalence (10%). For the 50 Hmong refugees studied, there was no evidence that their splenomegaly was caused by clonorchiasis, schistosomiasis, tuberculosis, syphillis, lymphoma, tropical splenomegaly syndrome, or clinical malaria. Cases were more likely to have hepatomegaly, hepatitis B surface antigen positivity, and a low mean corpuscular volume than a reference population of Hmong refugees. Malaria antibody titers were elevated in all but one of the 41 cases (98%) tested.

Education in Emergencies: Case of a Community School for Syrian Refugees

ERIC Educational Resources Information Center

Hos, Rabia

2016-01-01

With the break of the civil war in Syria, many Syrians have been displaced either internally or as refugees. Turkey, one of the leading host of Syrian refugees, has made changes to the policies to accommodate the needs of Syrians. Education is one of the most prominent needs of displaced refugee children. While 80 percent of refugee children…

Vocational Training for Women Refugees in Africa: Guide-lines from Selected Field Projects. Training Discussion Paper No. 26.

ERIC Educational Resources Information Center

Hall, Eve

In addition to describing how training programs for African refugees fail to meet the needs of women (who along with children are the majority of refugees), this document offers guidelines for improving the programs and, thus, the productivity and incomes of women refugees. The first section, called "Women Refugees: The Overlooked…

Acceptability of general practice services for Afghan refugees in south-eastern Melbourne.

PubMed

Manchikanti, Prashanti; Cheng, I-Hao; Advocat, Jenny; Russell, Grant

2017-04-01

Over 750000 refugees have resettled in Australia since 1945. Despite complex health needs related to prior traumatic experiences and the challenges of resettlement in a foreign country, refugees experience poor access to primary care. Health and settlement service providers describe numerous cultural, communication, financial and health literacy barriers. This study aimed to investigate the acceptability of general practitioner (GP) services and understand what aspects of acceptability are relevant for Afghan refugees in south-eastern Melbourne. Semi-structured interviews were conducted with two Afghan community leaders and 16 Dari- or English-speaking Afghan refugees who accessed GP services. Two distinct narratives emerged - those of recently arrived refugees and established refugees (living in Australia for 3 years or longer). Transecting these narratives, participants indicated the importance of: (1) a preference for detailed clinical assessments, diagnostic investigations and the provision of prescriptions at the first consultation; (2) 'refugee-friendly' staff; and (3) integrated, 'one-stop-shop' GP clinic features. The value of acceptable personal characteristics evolved over time - GP acceptability was less a consideration for recently arrived, compared with more, established refugees. The findings reinforce the importance of tailoring healthcare delivery to the evolving needs and healthcare expectations of newly arrived and established refugees respectively.

Long-Term Refugee Health: Health Behaviors and Outcomes of Cambodian Refugee and Immigrant Women.

PubMed

Nelson-Peterman, Jerusha L; Toof, Robin; Liang, Sidney L; Grigg-Saito, Dorcas C

2015-12-01

Refugees in the United States have high rates of chronic disease. Both long-term effects of the refugee experience and adjustment to the U.S. health environment may contribute. While there is significant research on health outcomes of newly resettled refugees and long-term mental health experiences of established refugees, there is currently little information about how the combined effects of the refugee experience and the U.S. health environment are related to health practices of refugees in the years and decades after resettlement. We examined cross-sectional survey data for Cambodian refugee and immigrant women 35 to 60 years old (n = 160) from an established refugee community in Lowell, Massachusetts, to examine the potential contributors to health behaviors and outcomes among refugees and immigrants postresettlement. In our representative sample, we found that smoking and betel nut use were very low (4% each). Fewer than 50% of respondents walked for at least 10 minutes on 2 or more days/week. Using World Health Organization standards for overweight/obese for Asians, 73% of respondents were overweight/obese and 56% were obese, indicating increased risk of chronic disease. Depression was also high in this sample (41%). In multivariate models, higher acculturation and age were associated with walking more often; lower education and higher acculturation were related to higher weight; and being divorced/separated or widowed and being older were related to higher risk of depression. The interrelated complex of characteristics, health behaviors, and health outcomes of refugees merits a multifaceted approach to health education and health promotion for long-term refugee health. © 2015 Society for Public Health Education.

Perspectives of resettled African refugees on accessing medicines and pharmacy services in Queensland, Australia.

PubMed

Bellamy, Kim; Ostini, Remo; Martini, Nataly; Kairuz, Therese

2017-10-01

The aim of this study was to explore the barriers to accessing medicines and pharmacy services among refugees in Queensland, Australia, from the perspectives of resettled African refugees. A generic qualitative approach was used in this study. Resettled African refugees were recruited via a purposive snowball sampling method. The researcher collected data from different African refugee communities, specifically those from Sudanese, Congolese and Somalian communities. Participants were invited by a community health leader to participate in the study; a community health leader is a trained member of the refugee community who acts as a 'health information conduit' between refugees and the health system. Invitations were done either face-to-face, telephonically or by email. The focus groups were digitally recorded in English and transcribed verbatim by the researcher. Transcripts were entered into NVIVO© 11 and the data were analysed using inductive thematic analysis. Four focus groups were conducted between October and November 2014 in the city of Brisbane with African refugees, one with five Somali refugees, one with five Congolese refugees, one with three refugee community health leaders from South Sudan, Liberia and Eritrea and one with three refugee community health leaders from Uganda, Burundi and South Sudan. Eleven sub-themes emerged through the coding process, which resulted in four overarching themes: health system differences, navigating the Australian health system, communication barriers and health care-seeking behaviour. With regard to accessing medicines and pharmacy services, this study has shown that there is a gap between resettled refugees' expectations of health services and the reality of the Australian health system. Access barriers identified included language barriers, issues with the Translating and Interpreter Service, a lack of professional communication and cultural beliefs affecting health care-seeking behaviour. This exploratory study has established a foundation for further research into the barriers to accessing medicines and pharmacy services for resettled refugees. The findings are likely to be applicable to a wider population. © 2016 Royal Pharmaceutical Society.

[Hepatitis A immunity in refugees in Germany during the current exodus].

PubMed

Jablonka, A; Solbach, P; Happle, C; Hampel, A; Schmidt, R E; Behrens, G M N

2017-05-01

Germany is facing a huge humanitarian challenge with rapidly rising numbers of refugees entering the country. Data on hepatitis A seroprevalence and infection in refugees and asylum seekers in Europe during the current refugee exodus is scarce. To assess hepatitis A (HAV) seroprevalence and immunity in refugees arriving in northern Germany in 2015. A cross-sectional study of 235 refugees seeking shelter in reception centers in Northern Germany in August 2015 was performed, as acute Hepatitis A had been detected in one refugee in this camp. In order to analyze acute HAV infection and overall immunity, serological screening for HAV antibodies (combined IgG and IgM) was performed. The immunity threshold was defined as <20 IU/l. In all positive screening results, separate IgM testing was performed to detect acute infections. Males accounted for 84.3 % of HAV screened refugees and the mean age of refugees was 29.1 ± 11.2 years. Children and adolescents below the age of 18 years made up 8.8 % of the migrants. Overall HAV immunity within the cohort was 90 %, and a mild age-dependent increase in HAV immunity was observed, with 81.1 % immunity in children <18 years and a 100 % seropositivity in subjects >50 years. One 20-year-old female refugee had positive IgM results with high HAV antibodies, most likely due to subacute HAV infection. This comparably high rate of HAV protected refugees in our cohort supports the notion that the probability of large HAV outbreaks in current German refugee centers is low. However, depending on their current living situation, HAV vaccination should be considered for each refugee child, and healthcare providers and personnel working in refugee centers should be vaccinated against HAV.

3 CFR - Fiscal Year 2012 Refugee Admissions Numbers and Authorizations of In-Country Refugee Status...

Code of Federal Regulations, 2012 CFR

2012-01-01

... 3 The President 1 2012-01-01 2012-01-01 false Fiscal Year 2012 Refugee Admissions Numbers and Authorizations of In-Country Refugee Status Pursuant to Sections 207 and 101(a)(42), Respectively, of the Immigration and Nationality Act, and Determination Pursuant to Section 2(b)(2) of the Migration and Refugee Assistance Act, as Amended Presidential...

3 CFR - Fiscal Year 2013 Refugee Admissions Numbers and Authorizations of In-Country Refugee Status...

Code of Federal Regulations, 2013 CFR

2013-01-01

... 3 The President 1 2013-01-01 2013-01-01 false Fiscal Year 2013 Refugee Admissions Numbers and Authorizations of In-Country Refugee Status Pursuant to Sections 207 and 101(a)(42), Respectively, of the Immigration and Nationality Act, and Determination Pursuant to Section 2(b)(2) of the Migration and Refugee Assistance Act, as Amended Presidential...

International refugees: a geographical perspective.

PubMed

Demko, G J; Wood, W B

1987-01-01

In the modern era, the world's refugee problem has changed magnitude and location; it has expanded from a local to a continental, and now global, scale issue. About 90% of the world's 10 million refugees are from developing countries, and over 90% of these will stay there. Refugee generating and receiving countries are concentrated in 5 world regions: Central America, Southwest Asia, Southeast Asia, and Sub-Saharan Africa. Each concentration is unique and is associated with a particular set of regional conflicts. International efforts address short-term relief needs, whereas political instability and repression that generate refugees continue unabated. Refugees along sensitive border regions affect bilateral relations, large groups of refugees can pose political and security problems for the host country, and disputes over refugee policies and their implementation can complicate diplomatic ties. Some highlights of the data follow. 1) The 3 million cross-border refugees and 5.5 million internally displaced persons make the many governments in Sub-Saharan Africa increasingly dependent on Western assistance to solve their problems. Refugees are fleeing armed conflict, tribal violence, and drought, and often generate additional regional turmoil. 2) 3-4 million Afghans have fled their country since the 1978 Marxist coup; about 2.5 million have entered Pakistan. Most choose to remain in camps near the Afghanistan border where they are targets of cross-border attacks. 3) 1.2 million Salvadorans, Guatemalans, and Nicaraguans live outside their native countries. Official refugee and unofficial migrant populations are active in various rebel insurgencies, contribute to strained bilateral relations and tensions in border areas, and are the subject of heated political debate in host countries. 4) 90% of the 1.7 million Indochinese who fled from 1975-May 1986 have been resettled; 168,000 refugees remain in 1st-asylum camps, not including 240,000 Khmer without refugee status, in temporary camps in Thailand. Thailand's large refugee population is involved in factional strife, smuggling, and guerrilla activities. The Thai are particularly concerned about Hmong refugees, who are accused of opium cultivation and destruction of Thai forests through slash-and-burn cultivation. 5) Nearly 62% of the thousands of present Vietnamese refugees to Hong Kong have been in camps 3 years, and 17% 6 years. Many have turned to crime, alcohol, drugs, or prostitution.

Partnerships that Facilitate a Refugee's Journey to Wellbeing.

PubMed

Marano, Nina; Wojno, Abbey E; Stauffer, William M; Weinberg, Michelle; Klosovsky, Alexander; Ballew, J Daniel; Shetty, Sharmila; Cookson, Susan; Walker, Patricia; Cetron, Martin S

2016-11-02

The current global refugee crisis involves 65.3 million persons who have been displaced from their homes or countries of origin. While escaping immediate harm may be their first priority, displaced people go on to face numerous health risks, including trauma and injuries, malnutrition, infectious diseases, exacerbation of existing chronic diseases, and mental health conditions. This crisis highlights the importance of building capacity among health-care providers, scientists, and laboratorians to understand and respond to the health needs of refugees. The November 2016 American Society of Tropical Medicine and Hygiene (ASTMH) conference in Atlanta will feature an interactive exhibit entitled "The Refugee Journey to Wellbeing" and three symposia about refugee health. The symposia will focus on tropical disease challenges in refugee populations, careers in refugee health, and recent experiences of governmental agencies and nongovernmental organizations in responding to the global refugee crisis. We invite ASTMH attendees to attend the exhibit and symposia and consider contributions they could make to improve refugee health through tropical disease research or clinical endeavors. © The American Society of Tropical Medicine and Hygiene.

Developing preventive mental health interventions for refugee families in resettlement.

PubMed

Weine, Stevan Merrill

2011-09-01

In refugee resettlement, positive psychosocial outcomes for youth and adults depend to a great extent on their families. Yet refugee families find few empirically based services geared toward them. Preventive mental health interventions that aim to stop, lessen, or delay possible negative individual mental health and behavioral sequelae through improving family and community protective resources in resettled refugee families are needed. This paper describes 8 characteristics that preventive mental health interventions should address to meet the needs of refugee families, including: Feasibility, Acceptability, Culturally Tailored, Multilevel, Time Focused, Prosaicness, Effectiveness, and Adaptability. To address these 8 characteristics in the complex environment of refugee resettlement requires modifying the process of developmental research through incorporating innovative mental health services research strategies, including: resilience framework, community collaboration, mixed methods with focused ethnography, and the comprehensive dynamic trial. A preventive intervention development cycle for refugee families is proposed based on a program of research on refugees and migrants using these services research strategies. Furthering preventive mental health for refugee families also requires new policy directives, multisystemic partnerships, and research training. 2011 © FPI, Inc.

Developing Preventive Mental Health Interventions for Refugee Families in Resettlement

PubMed Central

WEINE, STEVAN MERRILL

2014-01-01

In refugee resettlement, positive psychosocial outcomes for youth and adults depend to a great extent on their families. Yet refugee families find few empirically based services geared toward them. Preventive mental health interventions that aim to stop, lessen, or delay possible negative individual mental health and behavioral sequelae through improving family and community protective resources in resettled refugee families are needed. This paper describes 8 characteristics that preventive mental health interventions should address to meet the needs of refugee families, including: Feasibility, Acceptability, Culturally Tailored, Multilevel, Time Focused, Prosaicness, Effectiveness, and Adaptability. To address these 8 characteristics in the complex environment of refugee resettlement requires modifying the process of developmental research through incorporating innovative mental health services research strategies, including: resilience framework, community collaboration, mixed methods with focused ethnography, and the comprehensive dynamic trial. A preventive intervention development cycle for refugee families is proposed based on a program of research on refugees and migrants using these services research strategies. Furthering preventive mental health for refugee families also requires new policy directives, multisystemic partnerships, and research training. PMID:21884078

Connecting Refugees to Substance Use Treatment: A Qualitative Study.

PubMed

McCleary, Jennifer S; Shannon, Patricia J; Cook, Tonya L

2016-01-01

An emerging body of literature identifies substance use as a growing concern among refugees resettling in the United States. Like immigrants, refugees may face cultural, linguistic, or systems barriers to connecting with mainstream substance use treatment programs, which may be compounded by refugees' unique experiences with exposure to trauma, displacement in refugee camps, and resettlement. This qualitative study explores factors that support and prevent refugees from connecting with chemical health treatment. Fifteen participants who identified as social service or public health professionals who work with refugees responded to an online, semistructured survey about their experiences referring refugees to substance use treatment. Resulting data was analyzed using thematic analysis. Themes emerged identifying a lack of culturally informed treatment models, policy issues, and client characteristics such as motivation and past trauma as barriers to engaging with treatment. Ongoing case management and coordination were identified as important to successful linkage. Findings from this study contribute to a better understanding of how to support refugees seeking substance use treatment and suggest that developing trauma informed, culturally relevant models of treatment that are integrated with primary health care and geographically accessible may enhance treatment linkage.

Quality of life of Syrian refugees living in camps in the Kurdistan Region of Iraq.

PubMed

Aziz, Izaddin A; Hutchinson, Claire V; Maltby, John

2014-01-01

The current study explores the perceived quality of life of Syrian refugees who have entered the Kurdistan Region of Iraq. Two hundred and seventy participants residing in refugee camps in the Erbil region in Kurdistan completed the WHOQOL-BREF, which measures Quality of Life (QOL) within four domains; physical, psychological, social relationships and environment. Syrian refugees in Kurdistan scored significantly lower for general population norms on physical health, psychological and environment QOL, and score significantly lower for physical health and psychological QOL for refugees in the Gaza strip. However, respondents in the current sample scored significantly higher on environment QOL compared to refugees in the Gaza strip, and significantly higher on all the QOL domains than those reported for refugees in West Africa. Finally, Syrian refugees in Kurdistan scored significantly higher than general population norms for social relationships QOL. The current findings provide the first report of QOL domain scores among Syrian refugees in the Kurdistan camps and suggest that social relationships and environmental QOL circumstances are relatively satisfactory, and that further investigation might be focused on physical and psychological QOL.

Prevalence and treatment of latent tuberculosis infection among newly arrived refugees in San Diego County, January 2010-October 2012.

PubMed

Bennett, Rachel J; Brodine, Stephanie; Waalen, Jill; Moser, Kathleen; Rodwell, Timothy C

2014-04-01

We determined the prevalence and treatment rates of latent tuberculosis infection (LTBI) in newly arrived refugees in San Diego County, California, and assessed demographic and clinical characteristics associated with these outcomes. We analyzed data from LTBI screening results of 4280 refugees resettled in San Diego County between January 2010 and October 2012. Using multivariate logistic regression, we calculated the associations between demographic and clinical risk factors and the outcomes of LTBI diagnosis and LTBI treatment initiation. The prevalence of LTBI was highest among refugees from sub-Saharan Africa (43%) and was associated with current smoking and having a clinical comorbidity that increases the risk for active tuberculosis. Although refugees from sub-Saharan Africa had the highest prevalence of infection, they were significantly less likely to initiate treatment than refugees from the Middle East. Refugees with postsecondary education were significantly more likely to initiate LTBI treatment. Public health strategies are needed to increase treatment rates among high-risk refugees with LTBI. Particular attention is required among refugees from sub-Saharan Africa and those with less education.

Suicide and suicidal ideation among Bhutanese refugees--United States, 2009-2012.

PubMed

2013-07-05

During the period February 2009-February 2012, the Office of Refugee Resettlement of the U.S. Department of Health and Human Services reported 16 suicides among the approximately 57,000 Bhutanese refugees who had resettled in the United States since 2008. In 2012, the office requested assistance from CDC and the Massachusetts Department of Public Health's Refugee Health Technical Assistance Center to identify risk factors that might be associated with suicidal ideation among Bhutanese refugees. In collaboration with the Massachusetts refugee health center, CDC conducted a survey of randomly selected Bhutanese refugees in four U.S. states with large populations of resettled refugees. The results indicated significant associations between ever having expressed suicidal ideation and current self-reported symptoms of mental health disorder (e.g., anxiety, depression, or posttraumatic stress disorder) and postmigration difficulties (e.g., family conflict or inability to find work). The findings highlight the need for development of culturally appropriate community-based interventions for suicide prevention and standard procedures for monitoring and reporting suicides and suicide attempts in the Bhutanese refugee population.

Health issues of refugees attending an infectious disease refugee health clinic in a regional Australian hospital

PubMed

J Masters, Peta; J Lanfranco, Penelope; Sneath, Emmy; J Wade, Amanda; Huffam, Sarah; Pollard, James; Standish, James; McCloskey, Kate; Athan, Eugene; P O'Brien, Daniel; Friedman, N Deborah

2018-05-01

Refugees in Australia present with conditions different to those of the general population. The aim of this study was to review the reasons for referral, prevalence of conditions and treatment outcomes for refugee patients attending a specialist referral clinic in regional Victoria. A retrospective review was undertaken of patients attending the refugee health clinic at University Hospital Geelong from January 2007 to December 2012. Two hundred and ninety-one refugee patients attended the clinic over the six-year period. Latent tuberculosis infection (LTBI) (54.6%), vitamin deficiencies (15.8%), hepatitis B (11%) and schistosomiasis (11%) were the most common diagnoses. Less than two-thirds of the patients completed LTBI treatment; 35.4% of patients attended all scheduled clinic appointments. LTBI, vitamin deficiencies, parasitic infections and hepatitis B were the most common diagnoses among refugees referred to the University Hospital Geelong (UHG) Refugee Health Clinic from January 2007 to December 2012. General practitioners play an important role in the care of refugees, guiding referral to specialist services when necessary and recognising the potential implications of suboptimal clinic attendance and treatment completion.

45 CFR 400.44 - Restriction.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Immigration Status and Identification of Refugees Documentation of Refugee Status § 400.44 Restriction. An applicant for asylum is not...

45 CFR 400.53 - General eligibility requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 400.53 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Cash Assistance § 400.53 General eligibility requirements. (a) Eligibility for refugee cash...

Psychopathology in Refugees.

ERIC Educational Resources Information Center

Garcia-Peltoniemi, Rosa E.

Refugees, like most other migrants, are at increased risk for various forms of psychopathology. This paper documents the relationship between refugee migration and psychopathology by reviewing pertinent epidemiological, clinical, and survey studies from the refugee literature. The picture that emerges shows consistently increased levels of serious…

Refugee Resettlement Patterns and State-Level Health Care Insurance Access in the United States.

PubMed

Agrawal, Pooja; Venkatesh, Arjun Krishna

2016-04-01

We sought to evaluate the relationship between state-level implementation of the Patient Protection and Affordable Care Act (ACA) and resettlement patterns among refugees. We linked federal refugee resettlement data to ACA expansion data and found that refugee resettlement rates are not significantly different according to state-level insurance expansion or cost. Forty percent of refugees have resettled to states without Medicaid expansion. The wide state-level variability in implementation of the ACA should be considered by federal agencies seeking to optimize access to health insurance coverage among refugees who have resettled to the United States.

Refugee settlement workers' perspectives on home safety issues for people from refugee backgrounds.

PubMed

Campbell, Emma Jean; Turpin, Merrill June

2010-12-01

Refugees experience higher levels of emotional, psychological and physical distress than the general migrant population during settlement in a new country. Safety in the home can be a major concern and is an issue of which occupational therapists should be aware. Occupational therapists working with refugees in many contexts feel unprepared and overwhelmed. As refugee settlement workers attend to home safety of refugees during the settlement process, this study aimed to develop an in-depth understanding of their perceptions of this issue. Such information can contribute to occupational therapists' knowledge and practice when working with refugees. An exploratory qualitative case study approach used 16 semi-structured interviews and observation of a settlement worker assisting newly arrived refugees. Participants were settlement service staff (an occupational therapist, case coordinators and cultural support workers). Three themes are reported: considerations for safety in the homes of refugees; factors influencing home safety for refugees; and sensitivity to culture. Participants described tailoring home safety-related services to each individual based on factors that influence home safety and sensitivity to culture. Awareness of home safety issues can increase cultural competence and inform practice and policy. © 2010 The Authors. Australian Occupational Therapy Journal © 2010 Australian Association of Occupational Therapists.

Cost of vaccinating refugees overseas versus after arrival in the United States, 2005.

PubMed

2008-03-07

Since 2000, approximately 50,000 refugees have entered the United States each year from various regions of the world. Although persons with immigrant status are legally required to be vaccinated before entering the United States, this requirement does not extend to U.S.-bound persons with refugee status. After 1 year in the United States, refugees can apply for a change of status to that of legal permanent resident, at which time they are required to be fully vaccinated in accordance with recommendations of the Advisory Committee on Immunization Practices (ACIP). A potentially less costly alternative might be to vaccinate U.S.-bound refugees overseas routinely, before they depart from refugee camps. To compare the cost of vaccinating refugees overseas versus after their arrival in the United States, CDC analyzed 2005 data on the number of refugees, cost of vaccine, and cost of vaccine administration. This report summarizes the results of that analysis, which suggested that, in 2005, vaccinating 50,787 refugees overseas would have cost an estimated $7.7 million, less than one third of the estimated $26.0 million cost of vaccinating in the United States. Costs were calculated from the perspective of the U.S. health-care system. To achieve public health cost savings, routine overseas vaccination of U.S.-bound refugees should be considered.

The hopes of West African refugees during resettlement in northern Sweden: a 6-year prospective qualitative study of pathways and agency thoughts.

PubMed

Anjum, Tanvir M; Nordqvist, Cecilia; Timpka, Toomas

2012-01-24

Little is known about how positive phenomena can support resettlement of refugees in a new country. The aim of this study was to examine the hopeful thinking in a group of West African quota refugees at arrival and after 6 years in Sweden and compare these thoughts to the views of resettlement support professionals. The primary study population comprised 56 adult refugees and 13 resettlement professionals. Qualitative data were collected from the refugees by questionnaires on arrival and 6 years later. Data were collected from the resettlement professionals by interview about 3 years after arrival of the refugees. Snyder's cognitive model of hope was used to inform the comparative data analyses. Hopes regarding education were in focus for the refugees shortly after arrival, but thoughts on family reunion were central later in the resettlement process. During the later stages of the resettlement process, the unresponsiveness of the support organization to the family reunion problem became as issue for the refugees. The professionals reported a complex mix of "silent agency thoughts" underlying the local resettlement process as a contributing reason for this unresponsiveness. Hopes regarding education and family reunion were central in the resettlement of West African refugees in Sweden. These thoughts were not systematically followed up by the support organization; possibly the resources for refugees were not fully released. More studies are needed to further investigate the motivational factors underpinning host community support of refugees' hopes and plans.

Living with the Choice: A Grounded Theory of Iraqi Refugee Resettlement to the U.S.

PubMed

Davenport, Lisa A

2017-04-01

Though the United States has become a place of increasing resettlement for refugees, particularly Iraqi refugees who have been forced to flee their homeland due to violence, persecution and civil unrest, little is known about Iraqi refugee resettlement in the United States, or the way in which resettlement impacts health and adjustment. A grounded theory study was conducted to develop a substantive theory of Iraqi refugee resettlement. Participants in the qualitative study included 29 Iraqi refugees and 2 community partners who participated in face-to face interviews. Data analysis and interpretation revealed fundamental concepts related to Iraqi refugee resettlement. Results of analysis showed that for Iraqis choosing to resettle here, the outcome is dichotomous: satisfaction or regret. The outcome is influenced by contextual factors as well as facilitating and hindering intervening conditions during the basic social process of resettlement transition. Each refugee's story is unique, yet all share common threads. This study allowed Iraqi refugees the opportunity to voice their personal experiences of resettling in America, and revealed life stories that inspire and illuminate a process that can guide health care delivery as they cope with the stresses of their journey. As a result, an in-depth storyline was established to explain the process of resettlement for Iraqi refugees. The development of this resettlement theory, grounded in Iraqi refugee experience, has the potential to guide nursing education, enhance the efficacy of practice, inform policy development and form the basis for research.

Oral health among Liberian refugees in Ghana.

PubMed

Mickenautsch, S; Rudolph, M J; Ogunbodede, E O; Chikte, U M

1999-04-01

To promote community involvement in the provision of oral health services. The project consisted of a four-week training course in oral health for selected refugees, an oral health survey based on WHO guidelines and conducted by the refugees themselves and the provision of oral health care services to the community by the trained refugees. Liberian refugee camp, Gomoa Buduburam in Ghana. Liberian refugees of all ages. Twelve refugees were given short term training in oral health. In the oral health survey, 196 refugees were clinically examined for dental caries, periodontal disease and malocclusion. DMFT (for dental caries), CPITN (for periodontal disease), and malocclusion scores for selected subjects. Also clinical services rendered. Oral health survey revealed a mean age (+/- SD) of 25.7 (+/- 9.5) years. Only thirty nine (19.9%) of the subjects were caries-free, and total DMFT was 2.5 +/- 2.2. Based on the CPITN, 107 (54.6%) required oral hygiene instructions (OHI), and 41 (20.9%) required prophylactic scaling with OHI. Forty four (22.5%) of the subjects had normal occlusion and 152 (77.5%) mild to severe malocclusion. Periodontal (75.5%), prosthetic (52.5%) interventions and extractions (34.2%) constituted the bulk of the treatment needs required. Clinical treatment was rendered by the trained refugees to 846 patients over a twelve month period. Relief programmes for refugees should emphasise a primary health care approach, focusing on prevention, based on appropriate technology, and promoting involvement by the refugee community in the provision of services.

Effects of Non-Clustering of Refugees.

ERIC Educational Resources Information Center

Conick, John E.

1983-01-01

Describes the approach to resettlement for recently arrived refugees implemented within the state of South Carolina. Suggests that non-clustering of refugees leads to quick acculturation if there is wide community support, but that certain services are more readily available when refugees are clustered. (GC)

A New Look at America's Refugee Policy.

ERIC Educational Resources Information Center

Suhrke, Astri

1980-01-01

Implications of recent developments in refugee outflow from Indochina demand a reexamination of American policy on Indochinese refugees. These developments include patterns of increased Vietnamese and Laotian refugee outflow despite Vietnam's disapproval of departure and Laos' liberalizing economic policies; the greater influx of "low…

77 FR 61507 - Fiscal Year 2013 Refugee Admissions Numbers and Authorizations of In-Country Refugee Status...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-10

... Immigration and Nationality Act, and Determination Pursuant to Section 2(b)(2) of the Migration and Refugee... Migration and Refugee Assistance Act of 1962, as amended, I hereby determine that assistance to or on behalf...

A Systematic Examination of Food Intake and Adaptation to the Food Environment by Refugees Settled in the United States1234

PubMed Central

Wang, Youfa; Min, Jungwon; Harris, Kisa; Khuri, Jacob; Anderson, Laura M

2016-01-01

The United States is the largest refugee resettlement country in the world. Refugees may face health-related challenges after resettlement in the United States, including higher rates of chronic diseases due to problems such as language barriers and difficulty adapting to new food environments. However, reported refugee diet challenges varied, and no systematic examination has been reported. This study examined refugee food intake pre- and postresettlement in the United States and differences in intake across various refugee groups. We systematically reviewed relevant studies that reported on refugee food intake and adaptation to the US food environment. We searched PubMed for literature published between January 1985 and April 2015, including cross-sectional and prospective studies. Eighteen studies met inclusion criteria. Limited research has been conducted, and most studies were based on small convenience samples. In general, refugees increased meat and egg consumption after resettling in the United States. Changes in refugee intake of vegetables, fruits, and dairy products varied by socioeconomic status, food insecurity, past food deprivation experience, length of stay in the United States, region of origin, and age. South Asians were more likely to maintain traditional diets, and increased age was associated with more conservative and traditional diets. Despite the abundance of food in the United States, postresettlement refugees reported difficulty in finding familiar or healthy foods. More research with larger samples and follow-up data are needed to study how refugees adapt to the US food environment and what factors may influence their food- and health-related outcomes. The work could inform future interventions to promote healthy eating and living among refugees and help to reduce health disparities. PMID:28140324

Impact of Refugees on Local Health Systems: A Difference-in-Differences Analysis in Cameroon.

PubMed

Tatah, Lambed; Delbiso, Tefera Darge; Rodriguez-Llanes, Jose Manuel; Gil Cuesta, Julita; Guha-Sapir, Debarati

2016-01-01

Hosting refugees may represent a drain on local resources, particularly since external aid is frequently insufficient. Between 2004 and 2011, over 100,000 refugees settled in the eastern border of Cameroon. With little known on how refugee influx affects health services of the hosting community, we investigated the impact of refugees on mother and child health (MCH) services in the host community in Cameroon. We used Cameroon's 2004 and 2011 Demographic and Health Surveys to evaluate changes in MCH indicators in the refugee hosting community. Our outcome variables were antenatal care (ANC) coverage, caesarean delivery rate, place of delivery and child vaccination coverage; whereas the exposure variable was residence in the refugee hosting community. We used a difference-in-differences analysis to compare indicators of the refugee hosting community to a control group selected through propensity score matching from the rest of the country. A total of 10,656 women were included in our 2004 analysis and 7.6% (n = 826) of them resided in the refugee hosting community. For 2011, 15,426 women were included and 5.8% (n = 902) of them resided in the hosting community. Between 2004 and 2011, both the proportion of women delivering outside health facilities and children not completing DPT3 vaccination in the refugee hosting community decreased by 9.0% (95% Confidence Interval (CI): 3.9-14.1%) and 9.6% (95% CI: 7.9-11.3%) respectively. However, ANC attendance and caesarean delivery did not show any significant change. Our findings demonstrate that none of the evaluated MCH service indicators deteriorated (in fact, two of them improved: delivery in health facilities and completing DPT3 vaccine) with the presence of refugees. This suggests evidence disproving the common belief that refugees always have a negative impact on their hosting community.

A Systematic Examination of Food Intake and Adaptation to the Food Environment by Refugees Settled in the United States.

PubMed

Wang, Youfa; Min, Jungwon; Harris, Kisa; Khuri, Jacob; Anderson, Laura M

2016-11-01

The United States is the largest refugee resettlement country in the world. Refugees may face health-related challenges after resettlement in the United States, including higher rates of chronic diseases due to problems such as language barriers and difficulty adapting to new food environments. However, reported refugee diet challenges varied, and no systematic examination has been reported. This study examined refugee food intake pre- and postresettlement in the United States and differences in intake across various refugee groups. We systematically reviewed relevant studies that reported on refugee food intake and adaptation to the US food environment. We searched PubMed for literature published between January 1985 and April 2015, including cross-sectional and prospective studies. Eighteen studies met inclusion criteria. Limited research has been conducted, and most studies were based on small convenience samples. In general, refugees increased meat and egg consumption after resettling in the United States. Changes in refugee intake of vegetables, fruits, and dairy products varied by socioeconomic status, food insecurity, past food deprivation experience, length of stay in the United States, region of origin, and age. South Asians were more likely to maintain traditional diets, and increased age was associated with more conservative and traditional diets. Despite the abundance of food in the United States, postresettlement refugees reported difficulty in finding familiar or healthy foods. More research with larger samples and follow-up data are needed to study how refugees adapt to the US food environment and what factors may influence their food- and health-related outcomes. The work could inform future interventions to promote healthy eating and living among refugees and help to reduce health disparities. © 2016 American Society for Nutrition.

Hepatitis B screening and prevalence among resettled refugees - United States, 2006-2011.

PubMed

Scott, Kevin C; Taylor, Eboni M; Mamo, Blain; Herr, Nathaniel D; Cronkright, Peter J; Yun, Katherine; Altshuler, Marc; Shetty, Sharmila

2015-06-05

Globally, more than two billion persons have been infected at some time with the hepatitis B virus (HBV), and approximately 3.5 million refugees have chronic HBV infection. The endemicity of HBV varies by region. Because chronic hepatitis B is infectious and persons with chronic infection benefit from treatment, CDC recommends screening for HBV among all refugees who originate in countries where the prevalence of hepatitis B surface antigen (HBsAg; a marker for acute or chronic infection) is ≥2% or who are at risk for HBV because of personal characteristics such as injection drug use or household contact with an individual with HBV infection. Currently, almost all refugees are routinely screened for hepatitis B. However, prevalence rates of HBV infection in refugee populations recently resettled in the United States have not been determined. A multisite, retrospective study was performed to evaluate the prevalence of past HBV infection, current infection, and immunity among refugees resettled in the United States; to better characterize the burden of hepatitis B in this population; and to inform screening recommendations. The study incorporated surveillance data from a large state refugee health program and chart reviews from three U.S. sites that conduct medical screenings of refugees. The prevalence of HBV infection (current or past as determined by available titer levels) varied among refugees originating in different countries and was higher among Burmese refugees than among refugees from Bhutan or Iraq. Current or past HBV infection was also higher among adults (aged >18 years) and male refugees. These data might help inform planning by states and resettlement agencies, as well as screening decisions by health care providers.

Health needs and priorities of Syrian refugees in camps and urban settings in Jordan: perspectives of refugees and health care providers.

PubMed

Al-Rousan, Tala; Schwabkey, Zaker; Jirmanus, Lara; Nelson, Brett D

2018-06-10

The United Nations has declared the Syrian refugee crisis to be the biggest humanitarian emergency of our era. Neighbouring countries, such as Jordan, strain to meet the health needs of Syrian refugees in addition to their own citizens given limited resources. This study aimed to determine the perspectives of Syrian refugees in Jordan, Jordanian health care providers and other stakeholders in addressing the public health issues of the refugee crisis. Qualitative and quantitative methodologies were used to explore Syrian refugee health needs and services in camp and urban settings in Jordan. Focus group discussions and key informant interviews were used to identify needs, challenges and potential solutions to providing quality health care to refugees. By-person factor analysis divided refugee participants into 4 unique respondent types and compared priorities for interventions. Focus group discussions and key informant interviews revealed a many different problems. Cost, limited resources, changing policies, livelihoods and poor health literacy impeded delivery of public and clinical health services. Respondent Type 1 emphasized the importance of policy changes to improve Syrian refugee health. Type 2 highlighted access to fresh foods and recreational activities for children. For Type 3, poor quality drinking-water was the primary concern, and Type 4 believed the lack of good, free education for Syrian children exacerbated their mental health problems. Syrian refugees identified cost as the main barrier to health care access. Both refugees and health care providers emphasized the importance of directing more resources to chronic diseases and mental health. Copyright © World Health Organization (WHO) 2018. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

Predicting post-traumatic stress disorder treatment response in refugees: Multilevel analysis.

PubMed

Haagen, Joris F G; Ter Heide, F Jackie June; Mooren, Trudy M; Knipscheer, Jeroen W; Kleber, Rolf J

2017-03-01

Given the recent peak in refugee numbers and refugees' high odds of developing post-traumatic stress disorder (PTSD), finding ways to alleviate PTSD in refugees is of vital importance. However, there are major differences in PTSD treatment response between refugees, the determinants of which are largely unknown. This study aimed at improving PTSD treatment for adult refugees by identifying PTSD treatment response predictors. A prospective longitudinal multilevel modelling design was used to predict PTSD severity scores over time. We analysed data from a randomized controlled trial with pre-, post-, and follow-up measurements of the safety and efficacy of eye movement desensitization and reprocessing and stabilization in asylum seekers and refugees suffering from PTSD. Lack of refugee status, comorbid depression, demographic, trauma-related and treatment-related variables were analysed as potential predictors of PTSD treatment outcome. Treatment outcome data from 72 participants were used. The presence (B = 6.5, p = .03) and severity (B = 6.3, p < .01) of a pre-treatment depressive disorder predicted poor treatment response and explained 39% of the variance between individuals. Refugee patients who suffer from PTSD and severe comorbid depression benefit less from treatment aimed at alleviating PTSD. Results highlight the need for treatment adaptations for PTSD and comorbid severe depression in traumatized refugees, including testing whether initial targeting of severe depressive symptoms increases PTSD treatment effectiveness. There are differences in post-traumatic stress disorder (PTSD) treatment response between traumatized refugees. Comorbid depressive disorder and depression severity predict poor PTSD response. Refugees with PTSD and severe depression may not benefit from PTSD treatment. Targeting comorbid severe depression before PTSD treatment is warranted. This study did not correct for multiple hypothesis testing. Comorbid depression may differentially impact alternative PTSD treatments. © 2016 The British Psychological Society.

Perinatal outcome and financial impact of Eritrean and Sudanese refugees delivered in a tertiary hospital in Tel Aviv, Israel.

PubMed

Michaan, Nadav; Gil, Yaron; Amzalag, Sagi; Laskov, Ido; Lessing, Joseph; Many, Ariel

2014-06-01

A growing number of Eritrean and Sudanese refugees seek medical assistance in the labor and delivery ward of our facility. Providing treatment to this unique population is challenging since communication is limited and pregnancy follow-up is usually absent. To compare the perinatal outcome of refugees and Israeli parturients. The medical and financial records of all refugees delivered between May 2010 and April 2011 were reviewed. Perinatal outcome was compared to that of native Israeli controls. During this period 254 refugees were delivered (2.3% of deliveries). Refugees were significantly younger and leaner. They had significantly more premature deliveries under 37 weeks (23 vs. 10, P = 0.029) and under 34 weeks gestation (9 vs. 2, P = 0.036) with more admissions to the neonatal intensive care unit (15 vs. 5, P = 0.038). Overall cesarean section rate was similar but refugees required significantly more urgent surgeries (97% vs. 53%, P = 0.0001). Refugees had significantly more cases of meconium and episiotomies but fewer cases of epidural analgesia. There were 2 intrauterine fetal deaths among refugees, compared to 13 of 11,239 deliveries during this time period (P = 0.036), as well as 7 pregnancy terminations following sexual assault during their escape. Sixty-eight percent of refugees had medical fees outstanding with a total debt of 2,656,000 shekels (US$ 767,250). The phenomenon of African refugees giving birth in our center is of unprecedented magnitude and bears significant medical and ethical implications. Refugees proved susceptible to adverse perinatal outcomes compared to their Israeli counterparts. Setting a pregnancy follow-up plan could, in the long run, prevent adverse outcomes and reduce costs involved in treating this population.

Nutritional status of women and child refugees from Syria-Jordan, April-May 2014.

PubMed

Bilukha, Oleg O; Jayasekaran, Douglas; Burton, Ann; Faender, Gabriele; King'ori, James; Amiri, Mohammad; Jessen, Dorte; Leidman, Eva

2014-07-25

As a result of civil war, an estimated 2.8 million refugees have fled Syria and reside in neighboring countries, mainly Lebanon, Turkey, Jordan, and Iraq. The largest Syrian refugee camp in the region is Zaatari camp in Jordan, with approximately 79,000 refugees; another estimated 500,000 Syrian refugees live in Jordanian cities, towns, and villages, mostly in the capital (Amman) and in four northern governorates (Irbid, Mafraq, Jarash, and Zarqa). Although all registered refugees in Jordan receive food vouchers from the World Food Programme (WFP) and vulnerable refugees receive cash assistance from the United Nations High Commissioner for Refugees (UNHCR) and nongovernmental organizations, the nutritional status of some refugees might be compromised because of dislocation, lack of income, and limited access to nutritious foods. To assess the nutritional status of Syrian refugees, UNHCR, WFP, the United Nations Children's Fund (UNICEF), Medair International (a nongovernmental organization), and CDC, in collaboration with the United Nations Population Fund and the World Health Organization (WHO), conducted cross-sectional, population-representative cluster surveys in Zaatari camp and among refugees residing in the host community. The surveys were conducted during April-May 2014 with the principal objective of assessing nutritional status of refugee children aged 6-59 months and nonpregnant women of reproductive age (15-49 years). Preliminary findings indicated a high prevalence of anemia in Zaatari camp among both children and women (48.4% and 44.8%, respectively). Nutrition policies aimed at ensuring optimal child and maternal micronutrient status and addressing the underlying risk factors for anemia are likely to result in improved health outcomes and a reduction in anemia.

From Negative to Positive Stability: How the Syrian Refugee Crisis Can Improve Jordan’s Outlook

DTIC Science & Technology

2015-01-01

Syrian Refugees . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 Forecast: The Impact of Syrian Refugees on Jordan’s Economic Stability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22...Syrians find economic stability , they will be less vulnerable to the loss of aid, and therefore less likely to present a drain on Jordanian society...with Syrian refugees, and presents a forecast of Syrian refugee impacts on Jordan’s economy and such economic stability factors as unem- ployment and

[Anxiety, Depression and Posttraumatic Stress Disorder in Refugees - A Systematic Review].

PubMed

Lindert, Jutta; von Ehrenstein, Ondine S; Wehrwein, Annette; Brähler, Elmar; Schäfer, Ingo

2018-01-01

Anxiety, depression and posttraumatic stress disorder are the main psychopathological symptoms shown by refugees. We conducted a systematic review. First, we identified key-words for a systematic search in PUBMED. We included original articles since 2009 with 1) a non-clinical sample of refugees, 2) refugees living at maximum 5 years in the host country, 4) with the outcomes anxiety, depression, and PTSD and 5) a sample with >100 participants. Then we read titles, abstracts and fulltexts. We identified 1 877 studies. Based on this screening procedure, we included in our review 15 studies. 52% of the refugees are from Africa (Somalia, Congo, Rwanda, Liberia, Sierra-Leon and Togo), 33% from Asia (Syria, Bhutan, Vietnam, Cambodia, Iraq) and 16% are from more than one continent. In those studies n=6 769 refugees participated in the studies. The number of participants varied from n=117 to n=1,422 (Median: n=366 refugees). Prevalence rates for PTBS varied from 5-71% (mean prevalence rate: 32%) rates for depression varied from 11-54% (mean prevalence rate: 35%). Sensitivity analyses suggest that refugees, which come from countries with intense human rights violations according to the Political Terror Scale, have an increased rate of psychopathological symptoms. Heterogeneity of prevalence rate is related both 1) to methodological and 2) to difference in the refugee populations according to the human rights violations in the countries of origin of refugees. It is necessary to include further databases in a systematic review. There is an urgent need for representative studies on refugees needs for psychosocial and medical care, especially for those refugees coming from countries with intense human rights violations. Psychosocial and medical services for these refugees are urgently needed to enhance and enable a perspective in the host country Germany. © Georg Thieme Verlag KG Stuttgart · New York.

Experiences of refugees and asylum seekers in general practice: a qualitative study

PubMed Central

Bhatia, Ravi; Wallace, Paul

2007-01-01

Background There has been much debate regarding the refugee health situation in the UK. However most of the existing literature fails to take account of the opinions of refugees themselves. This study was established to determine the views of asylum seekers and refugees on their overall experiences in primary care and to suggest improvements to their care. Methods Qualitative study of adult asylum seekers and refugees who had entered the UK in the last 10 years. The study was set in Barnet Refugee Walk in Service, London. 11 Semi structured interviews were conducted and analysed using framework analysis. Results Access to GPs may be more difficult for failed asylum seekers and those without support from refugee agencies or family. There may be concerns amongst some in the refugee community regarding the access to and confidentiality of professional interpreters. Most participants stated their preference for GPs who offered advice rather than prescriptions. The stigma associated with refugee status in the UK may have led to some refugees altering their help seeking behaviour. Conclusion The problem of poor access for those with inadequate support may be improved by better education and support for GPs in how to provide for refugees. Primary Care Trusts could also supply information to newly arrived refugees on how to access services. GPs should be aware that, in some situations, professional interpreters may not always be desired and that instead, it may be advisable to reach a consensus as to who should be used as an interpreter. A better doctor-patient experience resulting from improvements in access and communication may help to reduce the stigma associated with refugee status and lead to more appropriate help seeking behaviour. Given the small nature of our investigation, larger studies need to be conducted to confirm and to quantify these results. PMID:17711587

45 CFR 400.48 - Basis and scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Cash... section 412(e) of the Act for refugee cash assistance (RCA). Sections 400.48 through 400.55 apply to both...

45 CFR 400.54 - Notice and hearings.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Cash... provided to a recipient at least 10 days before the date upon which refugee cash assistance will be reduced...

78 FR 12758 - Proposed Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-25

... by program managers in formulating policies for the future direction of the Refugee Resettlement..., the Office of Refugee Resettlement reports on the economic adjustment of refugees to the American...-9). OMB No.: 0970-0033. Description: The Annual Survey of Refugees collects information on the...

Prevention Programs for Refugee Mental Health.

ERIC Educational Resources Information Center

Williams, Carolyn L.

Refugee movements impose tremendous psychological and physical trauma on survivors, making refugees a high risk group for psychopathology and psychosocial adjustment problems. This paper explores the traditional impediments to developing prevention programs for refugees and describes public mental health strategies that could be used for different…

76 FR 62597 - Fiscal Year 2012 Refugee Admissions Numbers and Authorizations of In-Country Refugee Status...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-10-11

... Immigration and Nationality Act, and Determination Pursuant to Section 2(b)(2) of the Migration and Refugee... Migration and Refugee Assistance Act of 1962 (22 U.S.C. 2601(b)(2)), as amended, I hereby determine that...

Notes from the Field: Splenomegaly of Unknown Etiology in Congolese Refugees Applying for Resettlement to the United States - Uganda, 2015.

PubMed

Goers, Matthew; Ope, Maurice O; Samuels, Aaron; Gitu, Natalia; Akandwanaho, Saul; Nabwami, Gladys; Nyoka, Raymond; Cetron, Martin S; Dalal, Warren; Conroy, Andrea L; Cantey, Paul; John, Chandy; Naoum, Marwan; Weinberg, Michelle; Marano, Nina; Stauffer, William

2016-09-09

Approximately 70,000-90,000 refugees are resettled to the United States each year, and during the next 5 years, 50,000 Congolese refugees are expected to arrive in the United States. The International Organization for Migration (IOM) performs refugee medical examinations overseas for the U.S. Refugee Resettlement Program. In 2014, IOM reported that a large number of U.S.-bound Congolese refugees from Uganda had spleens that were enlarged on examination. During two evaluations of refugee populations in western Uganda in March and July 2015, refugees with splenomegaly on physical examination were offered additional assessment and treatment, including abdominal ultrasonography and laboratory testing. Among 987 persons screened, 145 (14.7%) had splenomegaly and received further testing. Among the 145 patients with splenomegaly, 63.4% were aged 5-17 years (median = 14.8 years). There was some evidence of family clustering, with 33 (22.7%) of the 145 cases occurring in families.

Refugees, Post-Migration Stress, and Internet Use: A Qualitative Analysis of Intercultural Adjustment and Internet Use Among Iraqi and Sudanese Refugees to the United States.

PubMed

Mikal, Jude P; Woodfield, Braden

2015-10-01

Post-migration stressors represent significant obstacle to refugee adjustment, and continued exposure to post-migration stressors can negatively affect mental and physical health. Communities of support maintained over the Internet may provide a sense of constancy and reliability that may insulate against the negative effects of stress. We conducted five focus group interviews with Iraqi and Sudanese refugees to understand how refugees use the Internet to access support in their daily lives. Four trends were observed: (a) Internet use was related to culture of origin, (b) refugees were reluctant to explore online, (c) children served as brokers of online knowledge, and (d) limited Internet access is associated with increased time and financial obligations. This study aims to contribute to theory on Internet-mediated social support and to refugee health by creating smoother pathways to self-sufficiency and allowing refugees to exhibit agency in constructing and maintaining online networks of support. © The Author(s) 2015.

Urban Congolese Refugees in Kenya: The Contingencies of Coping and Resilience in a Context Marked by Structural Vulnerability.

PubMed

Tippens, Julie A

2017-06-01

The global increase in refugee migration to urban areas creates challenges pertaining to the promotion of refugee health, broadly conceived. Despite considerable attention to trauma and forced migration, there is relatively little focus on how refugees cope with stressful situations, and on the determinants that facilitate and undermine resilience. This article examines how urban Congolese refugees in Kenya promote psychosocial well-being in the context of structural vulnerability. This article is based on interviews ( N = 55) and ethnographic participant observation with Congolese refugees over a period of 8 months in Nairobi in 2014. Primary stressors related to scarcity of material resources, political and personal insecurity, and emotional stress. Congolese refugees mitigated stressors by (a) relying on faith in God's plan and trust in religious community, (b) establishing borrowing networks, and (c) compartmentalizing the past and present. This research has broader implications for the promotion of urban refugees' psychosocial health and resilience in countries of first asylum.

Health-related quality of life of Palestinian refugees inside and outside camps in Jordan.

PubMed

Alduraidi, Hamza; Waters, Catherine M

Jordan hosts more Palestinian refugees than any country in the world. Conditions under which people in a community live influence their health-related quality of life (HRQOL). The purpose of this descriptive comparative cross-sectional study was to compare HRQOL of Palestinian refugees in Jordan who live inside camps with those who live outside camps. Participants, recruited from inside the Baqa'a camp (n = 86) and the surrounding Abu Nsair community (n = 91), completed the World Health Organization Quality of Life Brief questionnaire. There were disparities in education and social relations and environment HRQOL related to income and residency, but not gender, among refugees. Refugees living inside camps, particularly if poorer, fared worse than refugees living outside camps. Enhanced programs and policies may be needed to improve HRQOL, education, and socioeconomics for camp refugees. Nursing's perspective on refugee health could make an important contribution to humanitarian efforts and health diplomacy. Copyright © 2017 Elsevier Inc. All rights reserved.

Beyond Trauma: Post-resettlement Factors and Mental Health Outcomes Among Latino and Asian Refugees in the United States.

PubMed

Kim, Isok

2016-08-01

War-related traumas impact refugees' mental health. Recent literature suggests that structural and sociocultural factors related to the resettlement also become critical in shaping refugees' mental health. So far, there is limited empirical evidence to support this claim among resettled refugees. Resettlement contextual factors that influence mental health outcomes were examined using Latino and Asian refugees (n = 656) from a nationally representative survey. Linear and logistic regressions predicted factors associated with the study's outcomes (self-reported mental health, mood disorders, and anxiety disorders). Post-resettlement traumas were significantly associated with mental health outcomes, but pre-resettlement traumas were not. Unemployment, everyday discrimination, and limited English were significantly associated with mental health outcomes among both Latino and Asian refugees. The outcomes indicate that resettlement contextual factors have a significant association with refugees' mental health. Therefore, future studies with refugees must pay closer attention to structural and sociocultural factors after resettlement.

Health, welfare reform, and narratives of uncertainty among Cambodian refugees.

PubMed

Becker, G; Beyene, Y; Ken, P

2000-06-01

Massive disruptions to a way of life, such as those brought on by widespread violence, terror, and genocide, disorder the body as well as the social order. When they flee their homelands, refugees bring their experiences of violence and terror with them. Drawing on an ethnographic study of 40 Cambodian refugees between the ages of 50 and 79 who suffered from one or more chronic illnesses, we explore how refugees who live with chronic illnesses and are dependent on government support were affected by the threat of welfare reform. When welfare reform threatened to cut Cambodian refugees' income, it posed a new crisis for those who were chronically in limbo and placed further constraints on their lives. Through their narratives, Cambodian refugees enacted their bodily distress and resisted the threat of welfare reform. The story of threatened welfare reform in the U.S. and its possible consequences for refugees is a story of quixotic U.S. politics, policies and antidotes for refugeeism gone awry.

[The expectancy-stress factor in pregnant refugee women].

PubMed

Gogol', K N; Gotsiridze, E G; Guruli, Z V; Kintraia, N P; Tsaava, F D

2006-09-01

Our study revealed that refugee status increases the risks and worsens the outcome of pregnancy among Georgian refugees. 125 Georgian refugee women participated in this study. The study included examinations of the psychological status of expecting mothers, clinical development of pregnancy, complications of labor, functional status of the fetus, and EEG and neuro-ultrasound data of newborns. The control group comprised 125 pregnant women who experienced no stress during pregnancy. An examination of the psycho-emotional status of pregnant refugee women revealed high percentage indicators (82%) for hypochondria, depression, psychopathy, hysteria and psychoastenia in contrast to the control group. The deterioration of psycho-emotional status and biochemical indicators in pregnant refugee women was directly proportional to the worsening of functional and clinical conditions in fetuses. Prolonged stress is the cause of increased morbidity and mortality during pregnancy and child birth in refugee women. Infants born to refugee women also faced increased risks and belong to the group of special premature care and observation.

Refugee Resettlement Patterns and State-Level Health Care Insurance Access in the United States

PubMed Central

Venkatesh, Arjun Krishna

2016-01-01

We sought to evaluate the relationship between state-level implementation of the Patient Protection and Affordable Care Act (ACA) and resettlement patterns among refugees. We linked federal refugee resettlement data to ACA expansion data and found that refugee resettlement rates are not significantly different according to state-level insurance expansion or cost. Forty percent of refugees have resettled to states without Medicaid expansion. The wide state-level variability in implementation of the ACA should be considered by federal agencies seeking to optimize access to health insurance coverage among refugees who have resettled to the United States. PMID:26890186

Effects of Psychiatric Symptoms on Attention in North Korean Refugees.

PubMed

Lee, Yu Jin; Jun, Jin Yong; Park, Juhyun; Kim, Soohyun; Gwak, Ah Reum; Lee, So Hee; Yoo, So Young; Kim, Seog Ju

2016-09-01

We investigated the performance of North Korean refugees on attention tasks, and the relationship between that performance and psychiatric symptoms. Sustained and divided attention was assessed using the computerized Comprehensive Attention Test in North Korean refugees and in South Koreans. All participants also completed the Beck Depression Inventory, the Beck Anxiety Inventory, the Impact of Event Scale-Revised and the Dissociative Experiences Scale-II (DES-II). The North Korean refugees showed slower reaction times (RTs) on the visual sustained attention task compared to the South Koreans after controlling for age and sex. North Korean refugees had a greater number of omission errors (OEs) on the divided attention task and a higher standard deviation (SD) of RT. Total DES-II scores of the North Korean refugees were associated with the number of OEs and the SD of RT on the sustained attention task, and with the number of OEs on the divided attention task. North Korean refugees showed poorer performance on computerized attention tasks. In addition, attention deficit among North Korean refugees was associated with their dissociative experiences. Our results suggest that refugees may have attention deficits, which may be related to their psychiatric symptoms, particularly dissociation.

Refugee Policy Implications of U.S. Immigration Medical Screenings: A New Era of Inadmissibility on Health-Related Grounds

PubMed Central

Hong, Mi-Kyung; Varghese, Reshma E.; Jindal, Charulata; Efird, Jimmy T.

2017-01-01

Refugees frequently face extended delays in their efforts to enter the United States (U.S.) and those who are successful, in many cases, encounter overwhelming obstacles, inadequate resources, and a complex system of legal barriers. Travel restrictions based on equivocal health concerns and a drop in refugee admittance ceilings have complicated the situation. The authors retrieved and analyzed peer-reviewed journal articles, government agency press releases, media postings, epidemiologic factsheets, and relevant lay publications to critically assess U.S. policy regarding refugee resettlement based on health-related grounds. While refugees arguably exhibit an increased incidence of measles and tuberculosis compared with the U.S. population, the legitimacy of the medical examination will be undermined if other diseases that are endemic to refugee populations, yet currently deemed admissible, are used to restrict refugees from entering the U.S. This paper addressees the historic refugee policy of the U.S. and its consequent effect on the health of this vulnerable population. The needs of refugees should be carefully considered in the context of increased disease burden and the associated health care challenges of the country as a whole. PMID:28946650

Nursing students' experiences with refugees with mental health problems in Jordan: A qualitative content analysis.

PubMed

Dotevall, Camilla; Winberg, Elin; Rosengren, Kristina

2018-02-01

The aim of this study was to describe Jordanian nursing students' experience of caring for refugees with mental health problems. According to refugees' experiences of crisis, a well-educated staff is needed to provide high quality of care due to mental health problems. Therefore, health professionals play an important role in creating an environment that promotes human rights regardless of ethnic origin. The study comprised eight interviews and was analysed using content analysis, a qualitative method that involves an inductive approach, to increase our understanding of nursing students' perspective and thoughts regarding caring for refugees with mental health problems. The results formed one category: to be challenged by refugees' mental health issues and three subcategories: managing refugees' mental health needs, affected by refugees' mental health, and improve mental healthcare for refugees. Language problems could be managed by using interpreters to decrease cultural clashes to facilitate equal healthcare. In addition, well-educated (theoretical knowledge) and trained (practical knowledge) nursing students have potential to fulfil refugees' care needs regardless of ethnicity or background by using nursing interventions built on communication skills and cultural competences (theory, practice) to facilitate high quality of healthcare. Copyright © 2017 Elsevier Ltd. All rights reserved.

Prevalence and Treatment of Latent Tuberculosis Infection Among Newly Arrived Refugees in San Diego County, January 2010–October 2012

PubMed Central

Bennett, Rachel J.; Brodine, Stephanie; Waalen, Jill; Moser, Kathleen; Rodwell, Timothy C.

2014-01-01

Objectives. We determined the prevalence and treatment rates of latent tuberculosis infection (LTBI) in newly arrived refugees in San Diego County, California, and assessed demographic and clinical characteristics associated with these outcomes. Methods. We analyzed data from LTBI screening results of 4280 refugees resettled in San Diego County between January 2010 and October 2012. Using multivariate logistic regression, we calculated the associations between demographic and clinical risk factors and the outcomes of LTBI diagnosis and LTBI treatment initiation. Results. The prevalence of LTBI was highest among refugees from sub-Saharan Africa (43%) and was associated with current smoking and having a clinical comorbidity that increases the risk for active tuberculosis. Although refugees from sub-Saharan Africa had the highest prevalence of infection, they were significantly less likely to initiate treatment than refugees from the Middle East. Refugees with postsecondary education were significantly more likely to initiate LTBI treatment. Conclusions. Public health strategies are needed to increase treatment rates among high-risk refugees with LTBI. Particular attention is required among refugees from sub-Saharan Africa and those with less education. PMID:24524534

Motherhood in the shade of migration: A qualitative study of the experience of Syrian refugee mothers living in Turkey.

PubMed

Korukcu, Oznur; Aydın, Ruveyde; Conway, Jane; Kukulu, Kamile

2018-03-01

Turkey receives the largest number of Syrian refugees in the world. Some of these refugee women become mothers in Turkey. This paper reports on a qualitative, descriptive study that investigated the experience of seven Syrian women migrants who gave birth in Turkey, and explores their experiences of transition to motherhood in a foreign country. The research identified that aspects of transition can be clustered under five main themes: difficulties during the pregnancy period, giving birth in a foreign country, problems of refugee mothers, milestones in life of refugee mothers, and influence of cultural beliefs of refugee mothers on baby care. Key findings revealed that the women in the study had negative experiences related to being pregnant and having a baby in a foreign country. In addition to identifying challenges associated with migration, such as language barriers, racism, discrimination, poverty, and separation from their culture and family, the study highlighted the fears and difficulties experienced by refugee mothers, the cultural beliefs of refugee women about caring for their babies, and turning points in the life of refugee mothers. © 2017 John Wiley & Sons Australia, Ltd.

Refugee Policy Implications of U.S. Immigration Medical Screenings: A New Era of Inadmissibility on Health-Related Grounds.

PubMed

Hong, Mi-Kyung; Varghese, Reshma E; Jindal, Charulata; Efird, Jimmy T

2017-09-24

Refugees frequently face extended delays in their efforts to enter the United States (U.S.) and those who are successful, in many cases, encounter overwhelming obstacles, inadequate resources, and a complex system of legal barriers. Travel restrictions based on equivocal health concerns and a drop in refugee admittance ceilings have complicated the situation. The authors retrieved and analyzed peer-reviewed journal articles, government agency press releases, media postings, epidemiologic factsheets, and relevant lay publications to critically assess U.S. policy regarding refugee resettlement based on health-related grounds. While refugees arguably exhibit an increased incidence of measles and tuberculosis compared with the U.S. population, the legitimacy of the medical examination will be undermined if other diseases that are endemic to refugee populations, yet currently deemed admissible, are used to restrict refugees from entering the U.S. This paper addressees the historic refugee policy of the U.S. and its consequent effect on the health of this vulnerable population. The needs of refugees should be carefully considered in the context of increased disease burden and the associated health care challenges of the country as a whole.

45 CFR 400.211 - Methodology to be used to determine time-eligibility of refugees.

Code of Federal Regulations, 2010 CFR

2010-10-01

...-eligibility of refugees. 400.211 Section 400.211 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Federal Funding Federal Funding for Expenditures for Determining...

45 CFR 400.220 - Counting time-eligibility of refugees.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Counting time-eligibility of refugees. 400.220 Section 400.220 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM...

45 CFR 400.208 - Claims involving family units which include both refugees and nonrefugees.

Code of Federal Regulations, 2010 CFR

2010-10-01

... refugees and nonrefugees. 400.208 Section 400.208 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Federal Funding Federal Funding for Expenditures for Determining...

45 CFR 400.52 - Emergency cash assistance to refugees.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Emergency cash assistance to refugees. 400.52 Section 400.52 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM...

45 CFR 400.43 - Requirements for documentation of refugee status.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Requirements for documentation of refugee status. 400.43 Section 400.43 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE...

1981 World Refugee Survey.

ERIC Educational Resources Information Center

de Sherbinin, Michael J., Ed.

This report presents an update and analysis of refugee and/or resettlement situations in Africa, Asia, the Middle East, Europe and Canada, and Latin America. Described are activities undertaken by the following refugee organizations: (1) the Office of United Nations High Commissioner for Refugees (UNHCR); (2) the Intergovernmental Committee for…

45 CFR 400.104 - Continued coverage of recipients who receive increased earnings from employment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Medical Assistance Conditions of Eligibility for Refugee Medical Assistance § 400.104 Continued coverage of recipients who receive increased earnings from...

8 CFR 207.6 - Control over approved refugee numbers.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 8 Aliens and Nationality 1 2010-01-01 2010-01-01 false Control over approved refugee numbers. 207.6 Section 207.6 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS ADMISSION OF REFUGEES § 207.6 Control over approved refugee numbers. Current numerical accounting of...

8 CFR 207.6 - Control over approved refugee numbers.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 8 Aliens and Nationality 1 2014-01-01 2014-01-01 false Control over approved refugee numbers. 207.6 Section 207.6 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS ADMISSION OF REFUGEES § 207.6 Control over approved refugee numbers. Current numerical accounting of...

8 CFR 207.6 - Control over approved refugee numbers.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 8 Aliens and Nationality 1 2011-01-01 2011-01-01 false Control over approved refugee numbers. 207.6 Section 207.6 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS ADMISSION OF REFUGEES § 207.6 Control over approved refugee numbers. Current numerical accounting of...

8 CFR 207.6 - Control over approved refugee numbers.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 8 Aliens and Nationality 1 2012-01-01 2012-01-01 false Control over approved refugee numbers. 207.6 Section 207.6 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS ADMISSION OF REFUGEES § 207.6 Control over approved refugee numbers. Current numerical accounting of...

8 CFR 207.6 - Control over approved refugee numbers.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 8 Aliens and Nationality 1 2013-01-01 2013-01-01 false Control over approved refugee numbers. 207.6 Section 207.6 Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS ADMISSION OF REFUGEES § 207.6 Control over approved refugee numbers. Current numerical accounting of...

Refugee Resettlement: Models in Action.

ERIC Educational Resources Information Center

Lanphier, Michael

1983-01-01

Analyzes service delivery, resource allocation, sponsorship, and other practices of programs for Indochinese refugee resettlement in France, Canada, and the United States, according to a model of refugee resettlement that considers two major variables: (1) volume of refugee intake (large or moderate) and (2) type of adaptation emphasis (economic…

45 CFR 400.100 - General eligibility requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Refugee Medical Assistance Conditions of Eligibility for Refugee Medical Assistance § 400.100 General eligibility requirements. (a) Eligibility for refugee medical assistance is limited to those refugees who— (1... resettled them; and (5) Are not full-time students in institutions of higher education, as defined by the...

A Study of English Language Training for Refugees in the United States. Phase Three: The Influence of Language Training and Employment on Adult Refugees' Acquisition of English. Technical Report.

ERIC Educational Resources Information Center

Arter, Judith; And Others

The third phase of a national study of the impact of English language training programs on adult Southeast Asian refugees in the United States involved a longitudinal study of 400 recently-arrived refugees chosen at random from reception lines of refugee centers in four metropolitan areas: Portland, Oregon; San Diego; Oklahoma City; and Denver.…

The hopes of West African refugees during resettlement in northern Sweden: a 6-year prospective qualitative study of pathways and agency thoughts

PubMed Central

2012-01-01

Background Little is known about how positive phenomena can support resettlement of refugees in a new country. The aim of this study was to examine the hopeful thinking in a group of West African quota refugees at arrival and after 6 years in Sweden and compare these thoughts to the views of resettlement support professionals. Method The primary study population comprised 56 adult refugees and 13 resettlement professionals. Qualitative data were collected from the refugees by questionnaires on arrival and 6 years later. Data were collected from the resettlement professionals by interview about 3 years after arrival of the refugees. Snyder's cognitive model of hope was used to inform the comparative data analyses. Results Hopes regarding education were in focus for the refugees shortly after arrival, but thoughts on family reunion were central later in the resettlement process. During the later stages of the resettlement process, the unresponsiveness of the support organization to the family reunion problem became as issue for the refugees. The professionals reported a complex mix of "silent agency thoughts" underlying the local resettlement process as a contributing reason for this unresponsiveness. Conclusion Hopes regarding education and family reunion were central in the resettlement of West African refugees in Sweden. These thoughts were not systematically followed up by the support organization; possibly the resources for refugees were not fully released. More studies are needed to further investigate the motivational factors underpinning host community support of refugees' hopes and plans. PMID:22269339

Measuring self-rated health status among resettled adult refugee populations to inform practice and policy - a scoping review.

PubMed

Dowling, Alison; Enticott, Joanne; Russell, Grant

2017-12-08

The health status of refugees is a significant factor in determining their success in resettlement and relies heavily on self-rated measures of refugee health. The selection of robust and appropriate self-rated health measurement tools is challenging due to the number and methodological variation in the use of assessment tools across refugee health studies. This study describes the existing self-report health measures which have been used in studies of adult refugees living in the community to allow us to address the challenges of selecting appropriate assessments to measure health within refugee groups. Electronic databases of Ovid Medline, CINAHL, SCOPUS, Embase and Scopus. This review identified 45 different self-rated health measurements in 183 studies. Most of the studies were cross sectional explorations of the mental health status of refugees living in community settings within Western nations. A third of the tools were designed specifically for use within refugee populations. More than half of the identified measurement tools have been evaluated for reliability and/or validity within refugee populations. Much variation was found in the selection, development and testing of measurement tools across the reviewed studies. This review shows that there are currently a number of reliable and valid tools available for use in refugee health research; however, further work is required to achieve consistency in the quality and in the use of these tools. Methodological guidelines are required to assist researchers and clinicians in the development and testing of self-rated health measurement tools for use in refugee research.

76 FR 71575 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-18

... OMB Review; Comment Request Title: State Plan for Grants to States for Refugee Resettlement. OMB No... refugee resettlement under 8 U.S.C. 524 [Title IV, Sec. 414 of the Act], including Refugee Cash and Medical Assistance, Refugee Social Services, and Targeted Assistance program funding. The State Plan is a...

76 FR 53906 - Proposed Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-30

... Information Collection Activity; Comment Request Title: ORR State Plan for Grants to States for Refugee... refugee resettlement under 8 U.S.C. 524 [Title IV, Sec. 414 of the Act], including Refugee Cash and Medical Assistance, Refugee Social Services, and Targeted Assistance program funding. The State Plan is a...

8 CFR 207.5 - Waiting lists and priority handling.

Code of Federal Regulations, 2010 CFR

2010-01-01

... REFUGEES § 207.5 Waiting lists and priority handling. Waiting lists are maintained for each designated refugee group of special humanitarian concern. Each applicant whose application is accepted for filing by... filing is the priority date for purposes of case control. Refugees or groups of refugees may be selected...

The Acculturation of Former Yugoslavian Refugees

ERIC Educational Resources Information Center

Djuraskovic, Ivana; Arthur, Nancy

2009-01-01

Although the displacement of people from their home countries is of growing concern, little attention has been paid to refugees in the counselling literature. Experiences of refugees are more complex and difficult than those of voluntary immigrants because refugees are typically pushed out of their countries. Using heuristic inquiry, four main…

77 FR 38650 - Agency Information Collection Activities: Refugee/Asylee Adjusting Status, OMB Control Number...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-28

... Collection Activities: Refugee/Asylee Adjusting Status, OMB Control Number 1615-0070; Extension, Without...: Form I- 643, Health and Human Services Statistical Data for Refugee/Asylee Adjusting Status; OMB... currently approved collection. (2) Title of the Form/Collection: Refugee/Asylee Adjusting Status. (3) Agency...

77 FR 38307 - Agency Information Collection Activities: Refugee/Asylee Relative Petition, Extension, Without...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-06-27

... Collection Activities: Refugee/Asylee Relative Petition, Extension, Without Change, of a Currently Approved Collection ACTION: 60-Day Notice of Information Collection Under Review: Form I- 730, Refugee/Asylee Relative...: Extension, without change, of a currently approved collection. (2) Title of the Form/Collection: Refugee...

76 FR 70149 - Office of Refugee Resettlement; Statement of Organization, Functions, and Delegations of Authority

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-10

... of services to refugees under the Affordable Care Act. The Division also supports mental health... DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Office of Refugee... document. This reorganization establishes the Division of Refugee Health. It renames the Division of...

The Geographic Distribution of Indochinese Refugees.

ERIC Educational Resources Information Center

Forbes, Susan

This paper presents information regarding the geographic distribution of Indochinese refugees in the United States and how it compares to that of the overall U.S. population and the non-refugee legal immigrant population. The following information is reported: Seventy percent of all Indochinese refugees currently reside in 10 States, with…

45 CFR 400.112 - Child welfare services for refugee children.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 2 2013-10-01 2012-10-01 true Child welfare services for refugee children. 400... RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Child Welfare Services § 400.112 Child welfare services for refugee children. (a) In...

45 CFR 400.112 - Child welfare services for refugee children.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 2 2011-10-01 2011-10-01 false Child welfare services for refugee children. 400... RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Child Welfare Services § 400.112 Child welfare services for refugee children. (a) In...

45 CFR 400.112 - Child welfare services for refugee children.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 2 2014-10-01 2012-10-01 true Child welfare services for refugee children. 400... RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Child Welfare Services § 400.112 Child welfare services for refugee children. (a) In...

45 CFR 400.112 - Child welfare services for refugee children.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Child welfare services for refugee children. 400... RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Child Welfare Services § 400.112 Child welfare services for refugee children. (a) In...

45 CFR 400.112 - Child welfare services for refugee children.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 2 2012-10-01 2012-10-01 false Child welfare services for refugee children. 400... RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Child Welfare Services § 400.112 Child welfare services for refugee children. (a) In...

Beyond ICARA II: Implementing Refugee-Related Development Assistance.

ERIC Educational Resources Information Center

Gorman, Robert F.

1986-01-01

Reviews the evolution of the Second International Conference on Assistance to Refugees in Africa, which advanced discussions on the connection between refugees and the development process. Discusses potential roles of the World Bank and the World Food Program in providing technical assistance to refugee-related development projects. (Author/GC)

75 FR 57542 - 60-Day Notice of Proposed Information Collection: Refugee Biographic Data

Federal Register 2010, 2011, 2012, 2013, 2014

2010-09-21

..., Refugees, and Migration, PRM/A. Form Number: N/A. Respondents: Refugee applicants for the U.S. Resettlement... Migration. Methodology Biographic information is collected in a face-to-face interview of the applicant.... Lawrence Bartlett, Acting Director, Office of Admissions, Bureau of Population, Refugees, and Migration...

Effects of trauma-focused psychotherapy upon war refugees.

PubMed

Kruse, Johannes; Joksimovic, Ljiljana; Cavka, Majda; Wöller, Wolfgang; Schmitz, Norbert

2009-12-01

The aim of this study is to evaluate the effects of a trauma-focused psychotherapy upon war refugees from Bosnia. Seventy refugees who met the criteria for posttraumatic stress disorder (PTSD) and somatoform disorders were included. The first 35 refugees were offered psychotherapy and the following 35 refugees received usual care. Outcome variables were changes in self-reported PTSD symptoms, psychological symptoms, and health status. At 12-month follow-up, participants in the intervention group reported significantly lower scores on the PTSD scale and the measure of psychological symptoms than the comparison group participants. Our results suggest that psychotherapy reduces symptoms of PTSD and somatoform disorders among war refugees even in the presence of insecure residence status.

When "humanitarianism" becomes "development": the politics of international aid in Syria's Palestinian refugee camps.

PubMed

Gabiam, Nell

2012-01-01

In recent years, the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) has attempted to go beyond its role as a provider of relief and basic services in Palestinian refugee camps and emphasize its role as a development agency. In this article, I focus on the Neirab Rehabilitation Project, an UNRWA-sponsored development project taking place in the Palestinian refugee camps of Ein el Tal and Neirab in northern Syria. I argue that UNRWA's role as a relief-centered humanitarian organization highlights the everyday suffering of Palestinian refugees, suffering that has become embedded in refugees’ political claims. I show that UNRWA's emphasis on “development” in the refugee camps is forcing Palestinian refugees in Ein el Tal and Neirab to reassess the political narrative through which they have understood their relationship with UNRWA.

Nutritional status of refugee children entering DeKalb County, Georgia.

PubMed

Shah, Ankoor Y; Suchdev, Parminder S; Mitchell, Tarissa; Shetty, Sharmila; Warner, Catherine; Oladele, Alawode; Reines, Susan

2014-10-01

This study determines the nutritional status among refugee children entering one of the largest resettlement counties in the United States and identifies differences between incoming populations. Medical records of all newly arriving pediatric refugees (0-18 years) entering DeKalb County, Georgia between October 2010 and July 2011 were reviewed. Refugee children were grouped as African, Bhutanese, or Burmese (resettling from either Thailand or Malaysia) for comparative analysis. Approximately one in five refugees were anemic or malnourished, while a quarter had stool parasites, and nearly half had dental caries. African refugees had the highest anemia but the lowest underweight prevalence (p < 0.05). Compared to Burmese resettling from Malaysia, Burmese children from Thailand had a higher prevalence of anemia, underweight, and stool parasites (p < 0.05). Clinicians should use CDC medical screening guidelines for newly arriving pediatric refugees, as well as ensure proper nutritional support and follow-up care.

Health and nutritional status of Liberian refugee children--Guinea, 1990.

PubMed

1991-01-11

Since December 1989, civil strife in Liberia has caused mass displacement of persons to neighboring Guinea and Ivory Coast (Figure 1). Liberian refugees initially settled in the Forest Region of Guinea and shared food and shelter with members of the same ethnic groups (mainly Gio and Mano) already residing in the area. The number of refugees overwhelmed the capacity of affected villages to provide basic needs, and camp-like settlements were established that received substantial external relief. In May 1990, to determine appropriate priorities for relief assistance, the health and nutritional status of Liberian refugees in the Forest Region of Guinea was assessed by CDC for the U.S. Department of State's Bureau for Refugee Programs. In May, an estimated 80,000 refugees were in the area; by December the number had increased to an estimated 400,000. This report summarizes findings of the health and nutritional assessment of Liberian refugee children.

Issues of War Trauma and Working with Refugees. A Compilation of Resources.

ERIC Educational Resources Information Center

Somach, Susan D., Comp.

The Center for Applied Linguistics has compiled these resources on the subjects of war trauma and working with refugees to guide refugee service providers and classroom teachers. The materials include background information about trauma and posttraumatic stress disorder and specific information about problems of refugees and victims of war trauma.…

World Refugee Crisis: Winning the Game. Facts for Action #6.

ERIC Educational Resources Information Center

Oxfam America, Boston, MA.

Definitions, statistics, and problems of world refugees are presented in this document for high school global education classes. Although various agencies have determined different definitions of the term, the authors consider as refugees all those forced to flee their native land in order to survive. For most refugees the attraction of a higher…

Education and Training Initiatives at the Central Methodist Church Refugee House in Johannesburg

ERIC Educational Resources Information Center

Pausigere, Peter

2013-01-01

Zimbabwean economic migrants and political refugees have been given refuge and provided with shelter at the Central Methodist Church (CMC) Refugee House, in central Johannesburg. The refugees have successfully initiated learning and training programmes which resulted in the establishment of a combined school, namely "St. Albert Street Refugee…

An Ever-Changing Meaning: A Career Constructivist Application to Working with African Refugees

ERIC Educational Resources Information Center

Pierce, L. Marinn; Gibbons, Melinda M.

2012-01-01

Refugees are expected to determine how to integrate past experiences into their lives in a new culture. Constructivist approaches to counseling allow refugees opportunities to determine how to integrate these experiences into their future career choices. Refugee experiences throughout the resettlement process and a constructivist career counseling…

Comparative International Approaches to Better Understanding and Supporting Refugee Learners

ERIC Educational Resources Information Center

Ficarra, Julie

2017-01-01

This article advocates for the application of comparative international approaches to preparing pre-service and in-service teachers for meeting the needs of refugee students. To start, the paper presents literature on refugees' varied educational experiences in their home countries and refugee camps as well as the processes through which they come…

Exploratory Fieldwork on Latino Migrants and Indochinese Refugees. Refugees. RIIES Research Notes No. 1.

ERIC Educational Resources Information Center

Bryce-Laporte, Roy S., Ed.; Couch, Stephen R., Ed.

This book presents six papers on Latino migrant workers and recent Indochinese refugees in the United States, most of which focus on problems of fieldwork. The book's three sections, "Migrant Workers,""Indochinese Refugees" and "Research Summaries and Reports," each contains two papers and an introduction. (1)…

Paradoxes of Sahrawi Refugees' Educational Migration: Promoting Self-Sufficiency or Renewing Dependency?

ERIC Educational Resources Information Center

Fiddian-Qasmiyeh, Elena

2011-01-01

Education is often prioritised by refugee children and families, as well as by their political representatives and international actors alike. This article explores the specificities of the Sahrawi refugee education system, focusing in particular on the nature, motivations and implications of Sahrawi refugee youths' educational migration to Cuba…

3 CFR - Unexpected Urgent Refugee and Migration Needs

Code of Federal Regulations, 2013 CFR

2013-01-01

... 3 The President 1 2013-01-01 2013-01-01 false Unexpected Urgent Refugee and Migration Needs... Unexpected Urgent Refugee and Migration Needs Memorandum for the Secretary of State By the authority vested...) of the Migration and Refugee Assistance Act of 1962 (the “Act”), as amended, (22 U.S.C. 2601(c)(1...

Using Digital Concept Maps to Distinguish between Young Refugees' Challenges

ERIC Educational Resources Information Center

Brooker, Abi; Lawrence, Jeanette; Dodds, Agnes

2017-01-01

Digital media are beneficial for research of complex refugee issues, as they allow refugees to express their personal experiences of complex issues in ways that are not restricted by language barriers or limited in authenticity, while also offering researchers a way to systematically compare refugees' varied experiences. We used a computerised…

Language and Identity Construction: The Case of a Refugee Digital Bricoleur

ERIC Educational Resources Information Center

Karam, Fares J.

2018-01-01

The United States is the biggest resettlement country of refugees referred by the United Nations High Commissioner for Refugees; however, educational resettlement efforts have been unsuccessful in responding to the needs of refugee students, and educational research has thus far presented a deficit-oriented narrative that ignores the skills and…

Refugee Program: Financial Accountability for Refugee Resettlement Can Be Improved. Report to Congressional Requesters.

ERIC Educational Resources Information Center

General Accounting Office, Washington, DC. National Security and International Affairs Div.

Since 1982, the Congress has expressed concerns regarding voluntary agency use of an accountability for Federal refugee reception and placement grant funds. The Refugee Assistance Extension Act of 1986 requires increased financial and program reporting by the voluntary agencies. An assessment undertaken to evaluate the adequacy of this reporting…

Pathways to Educational Success among Refugees: Connecting Locally and Globally Situated Resources

ERIC Educational Resources Information Center

Dryden-Peterson, Sarah; Dahya, Negin; Adelman, Elizabeth

2017-01-01

This study identifies pathways to educational success among refugees. Data are from an original online survey of Somali diaspora and in-depth qualitative interviews with Somali refugee students educated in the Dadaab refugee camps of Kenya. This research builds on Bronfenbrenner's ecological model to consider both the locally and globally situated…

Comparative Analysis of Intercultural Sensitivity among Teachers Working with Refugees

ERIC Educational Resources Information Center

Strekalova-Hughes, Ekaterina

2017-01-01

The unprecedented global refugee crisis and the accompanying political discourse places added pressures on teachers working with children who are refugees in resettling countries. Given the increased chances of having a refugee child in one's classroom, it is critical to explore how interculturally sensitive teachers are and if working with…

Children's Literature about Refugees: A Catalyst in the Classroom

ERIC Educational Resources Information Center

Hope, Julia

2017-01-01

"It could happen to anybody", observed one nine-year-old child when her teacher read a book in class about refugees. Fiction provides the perfect conduit for the experiences of refugees so that young refugee students feel their experiences are validated, and their peers come to understand their situation. In this book, Julia Hope…

76 FR 9849 - 30-Day Notice of Proposed Information Collection: Refugee Biographic Data, OMB Control Number...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-22

... Originating Office: Bureau of Population, Refugees, and Migration, PRM/A Form Number: N/A Respondents: Refugee... Migration. Methodology: Biographic information is collected in a face-to-face interview of the applicant.... Lawrence Bartlett, Acting Director, Office of Admissions, Bureau of Population, Refugees, and Migration...

77 FR 21389 - Unexpected Urgent Refugee and Migration Needs

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-10

... April 3, 2012 Unexpected Urgent Refugee and Migration Needs Memorandum for the Secretary of State By the... 2(c)(1) of the Migration and Refugee Assistance Act of 1962 (the ``Act''), as amended, (22 U.S.C... United States Emergency Refugee and Migration Assistance Fund, for the purpose of meeting unexpected and...

76 FR 14271 - Unexpected Urgent Refugee and Migration Needs Related to Libya

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-16

... March 7, 2011 Unexpected Urgent Refugee and Migration Needs Related to Libya Memorandum for the... States, including section 2(c)(1) of the Migration and Refugee Assistance Act of 1962 (the ``Act''), as... million from the United States Emergency Refugee and Migration Assistance Fund, for the purpose of meeting...

77 FR 51033 - Notice of Change in Notification of Refugee Social Services and Targeted Assistance Formula Grant...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-08-23

... and 93.584] Notice of Change in Notification of Refugee Social Services and Targeted Assistance Formula Grant Allocations AGENCY: Office of Refugee Resettlement, ACF, HHS. ACTION: Notification of change. SUMMARY: The Office of Refugee Resettlement, Administration for Children and Families (ACF), is changing...

Surviving Violence: A Recovery Programme for Children and Families.

ERIC Educational Resources Information Center

Fozzard, Shirley

This book describes the process of assessment, intervention, and evaluation undertaken with refugees from Mozambique on the cessation of hostilities in 1994, to address the psychosocial needs of the refugees. Chapters 1-3 describe the refugees' experiences and the refugee settlement, and present research results on the impact of the traumatic…

Mental Health Impact of Hosting Disaster Refugees: Analyses from a Random Sample Survey Among Haitians Living in Miami.

PubMed

Messiah, Antoine; Lacoste, Jérôme; Gokalsing, Erick; Shultz, James M; Rodríguez de la Vega, Pura; Castro, Grettel; Acuna, Juan M

2016-08-01

Studies on the mental health of families hosting disaster refugees are lacking. This study compares participants in households that hosted 2010 Haitian earthquake disaster refugees with their nonhost counterparts. A random sample survey was conducted from October 2011 through December 2012 in Miami-Dade County, Florida. Haitian participants were assessed regarding their 2010 earthquake exposure and impact on family and friends and whether they hosted earthquake refugees. Using standardized scores and thresholds, they were evaluated for symptoms of three common mental disorders (CMDs): posttraumatic stress disorder, generalized anxiety disorder, and major depressive disorder (MDD). Participants who hosted refugees (n = 51) had significantly higher percentages of scores beyond thresholds for MDD than those who did not host refugees (n = 365) and for at least one CMD, after adjusting for participants' earthquake exposures and effects on family and friends. Hosting refugees from a natural disaster appears to elevate the risk for MDD and possibly other CMDs, independent of risks posed by exposure to the disaster itself. Families hosting refugees deserve special attention.

Birth characteristics of Syrian refugees and Turkish citizens in Turkey in 2015.

PubMed

Demirci, Hakan; Yildirim Topak, Nevruz; Ocakoglu, Gokhan; Karakulak Gomleksiz, Mehtap; Ustunyurt, Emin; Ulku Turker, Ayse

2017-04-01

To compare the birth characteristics of Syrian refugees with those of Turkish citizens. In a retrospective study, data were obtained for singleton live births that occurred at a hospital in Bursa, Turkey, between June 1 and December 31, 2015. All Syrian refugees were eligible for inclusion; one Turkish citizen was included for each refugee. Overall, 545 Syrian refugees and 545 Turkish citizens were included. Cesarean delivery was undertaken for 176 (32.3%) Syrians and 235 (43.1%) Turks (P<0.001). Median neonatal birth weight was higher among Turkish citizens (3300 g, range 970-4720) than among Syrian refugees (3110 g, range 540-4790; P<0.001). Gestational diabetes was recorded for 42 (7.7%) Turkish citizens and 9 (1.7%) Syrian refugees (P<0.001). Pre-eclampsia affected 21 (3.9%) Turkish citizens and 8 (1.5%) Syrians (P=0.014). Cesarean delivery is more common among pregnant Turkish citizens than among Syrian refugees. Other notable differences between the groups were recorded. © 2016 International Federation of Gynecology and Obstetrics.

Trapped in Statelessness: Rohingya Refugees in Bangladesh.

PubMed

Milton, Abul Hasnat; Rahman, Mijanur; Hussain, Sumaira; Jindal, Charulata; Choudhury, Sushmita; Akter, Shahnaz; Ferdousi, Shahana; Mouly, Tafzila Akter; Hall, John; Efird, Jimmy T

2017-08-21

The Rohingya people are one of the most ill-treated and persecuted refugee groups in the world, having lived in a realm of statelessness for over six generations, and who are still doing so. In recent years, more than 500,000 Rohingyas fled from Myanmar (Burma) to neighboring countries. This article addresses the Rohingya refugee crisis in Bangladesh, with special emphasis on the living conditions of this vulnerable population. We reviewed several documents on Rohingya refugees, visited a registered refugee camp (Teknaf), collected case reports, and conducted a series of meetings with stakeholders in the Cox's Bazar district of Bangladesh. A total of 33,131 registered Rohingya refugees are living in two registered camps in Cox's Bazar, and up to 80,000 additional refugees are housed in nearby makeshift camps. Overall, the living conditions of Rohingya refugees inside the overcrowded camps remain dismal. Mental health is poor, proper hygiene conditions are lacking, malnutrition is endemic, and physical/sexual abuse is high. A concerted diplomatic effort involving Bangladesh and Myanmar, and international mediators such as the Organization of Islamic Countries and the United Nations, is urgently required to effectively address this complex situation.

Mental Health Impact of Hosting Disaster Refugees: Analyses from a Random Sample Survey Among Haitians Living in Miami

PubMed Central

Messiah, Antoine; Lacoste, Jérôme; Gokalsing, Erick; Shultz, James M.; de la Vega, Pura Rodríguez; Castro, Grettel; Acuna, Juan M.

2016-01-01

Objectives Studies on the mental health of families hosting disaster refugees are lacking. This study compares participants in households that hosted 2010 Haitian earthquake disaster refugees with their nonhost counterparts. Methods A random sample survey was conducted from October 2011 through December 2012 in Miami-Dade County, Florida. Haitian participants were assessed regarding their 2010 earthquake exposure and impact on family and friends and whether they hosted earthquake refugees. Using standardized scores and thresholds, they were evaluated for symptoms of three common mental disorders (CMDs): posttraumatic stress disorder, generalized anxiety disorder, and major depressive disorder (MDD). Results Participants who hosted refugees (n = 51) had significantly higher percentages of scores beyond thresholds for MDD than those who did not host refugees (n = 365) and for at least one CMD, after adjusting for participants’ earthquake exposures and effects on family and friends. Conclusions Hosting refugees from a natural disaster appears to elevate the risk for MDD and possibly other CMDs, independent of risks posed by exposure to the disaster itself. Families hosting refugees deserve special attention. PMID:27490654

Physical Trauma among Refugees: Comparison between Refugees and Local Population Who Were Admitted to Emergency Department-Experience of a State Hospital in Syrian Border District.

PubMed

Duzkoylu, Yigit; Basceken, Salim Ilksen; Kesilmez, Emrullah Cem

2017-01-01

Hundreds of thousands of people have fled to Turkey since the civil war started in Syria in 2011. Refugees and local residents have been facing various challenges such as sociocultural and economic ones and access to health services. Trauma exposure is one of the most important and underestimated health problems of refugees settling in camps. We aimed to evaluate refugee admissions to emergency department because of trauma in means of demographics of patients and mechanism of trauma and compare the results with the local population. Retrospective evaluation of results and comparison with the results of local population. We determined that the ratio of emergency admission of refugee patients because of trauma was significantly higher than the local population for most types of trauma. Further studies with more refugee participants are needed to fully understand the underlying reasons for this high ratio to protect refugees as well as for planning to take caution to attenuate the burden on healthcare systems.

Attachment style and interpersonal trauma in refugees.

PubMed

Morina, Naser; Schnyder, Ulrich; Schick, Matthis; Nickerson, Angela; Bryant, Richard A

2016-12-01

Refugees can suffer many experiences that threaten their trust in others. Although models of refugee mental health have postulated that attachment securities may be damaged by refugee experiences, this has yet to be empirically tested. This study aimed to understand the relationship between the nature of traumatic experiences sustained by refugees and attachment styles. In a cross-sectional study, treatment-seeking refugees (N = 134) were assessed for traumatic exposure using the Harvard Trauma Questionnaire and Posttraumatic Diagnostic Scale. Attachment style was assessed using the Experiences in Close Relationship Scale. Whereas gender and severity of interpersonal traumatic events predicted avoidant attachment style (accounting for 11% of the variance), neither these factors nor non-interpersonal trauma predicted anxious attachment. Exposure to interpersonal traumatic events, including torture, is associated with enduring avoidant attachment tendencies in refugees. This finding accords with attachment theories that prior adverse interpersonal experiences can undermine secure attachment systems, and may promote avoidance of attachment seeking. This finding may point to an important process maintaining poor psychological health in refugees affected by interpersonal trauma. © The Royal Australian and New Zealand College of Psychiatrists 2016.

Tetanus and diphtheria immunity in refugees in Europe in 2015.

PubMed

Jablonka, Alexandra; Behrens, Georg M N; Stange, Marcus; Dopfer, Christian; Grote, Ulrike; Hansen, Gesine; Schmidt, Reinhold Ernst; Happle, Christine

2017-04-01

Current political crises in the Middle East and economic discrepancies led millions of people to leave their home countries and to flee to Western Europe. This development raises unexpected challenges for receiving health care systems. Although pan-European initiatives strive for updated and optimized vaccination strategies, little data on immunity against vaccine-preventable diseases in the current refugee population exist. We quantified serum IgG against tetanus and diphtheria (TD) in n = 678 refugees currently seeking shelter in six German refugee centers. Reflecting current migration statistics in Europe, the median age within the cohort was 26 years, with only 23.9 % of female subjects. Insufficient IgG levels without long-term protection against tetanus were found in 56.3 % of all refugees. 76.1 % of refugees had no long-term protection against diphtheria. 47.7 % of subjects needed immediate vaccination against tetanus, and 47.7 % against diphtheria. For both diseases, an age-dependent decline in protective immunity occurred. We observed a considerably low rate of tetanus-protected refugees, and the frequency of diphtheria-immune refugees was far from sufficient to provide herd immunity. These findings strongly support recent intentions to implement and enforce stringent guidelines for refugee vaccination in the current crisis.

'We don't have to go and see a special person to solve this problem': Trauma, mental health beliefs and processes for addressing 'mental health issues' among Sudanese refugees in Australia.

PubMed

Savic, Michael; Chur-Hansen, Anna; Mahmood, Mohammad Afzal; Moore, Vivienne M

2016-02-01

The impact of trauma on refugee mental health has been a particular focal point for research and treatment in Western contexts, despite uncertainty about the degree to which this corresponds with refugees' needs, mental health beliefs and healing mechanisms. This study explored the mental health beliefs of resettling Sudanese refugees in Australia. In-depth qualitative interviews were conducted with Sudanese community representatives and with a range of health and social work professionals who were not necessarily Sudanese. The concept of trauma was not universally considered to be salient for Sudanese refugees. Key informants, especially those in refugee-oriented services, emphasised stoicism and a desire to move forward and questioned the appropriateness of Western psychological therapies. Processes that exist within the family and the Sudanese community to deal with stressors like loss, grief and social isolation were explained. Dialogue between services and community members is needed to ensure responses to refugee mental health are sensitive to the diversity of needs and mental health beliefs of refugees. This will enable workers to ascertain how individual refugees understand their experiences of distress or sadness and to determine whether community strategies and/or professional responses are appropriate. © The Author(s) 2015.

Blood lead level analysis among refugee children resettled in New Hampshire and Rhode Island.

PubMed

Raymond, Jaime S; Kennedy, Chinaro; Brown, Mary Jean

2013-01-01

To examine the association between refugee status and elevated blood lead levels (EBLLs) among children living in two U.S. cities and to assess the effect of the Centers for Disease Control and Prevention recommendations for BLL testing of newly emigrated refugee children for EBLLs. A longitudinal study was conducted of 1,007 refugee children and 953 nonrefugee children living, when blood testing occurred, in the same buildings in Manchester, New Hampshire and Providence, Rhode Island. Surveillance and blood lead data were collected from both sites, including demographic information, BLLs, sample type, refugee status, and age of housing. Refugee children living in Manchester were statistically significantly more likely to have an EBLL compared with nonrefugee children even after controlling for potential confounders. We did not find this association in Providence. Compared with before enactment, the mean time of refugee children to fall below 10 μg/dL was significantly shorter after the recommendations to test newly emigrated children were enacted. Refugee children living in Manchester were significantly more likely to have an EBLL compared with nonrefugee children. And among refugee children, we found a statistically significant difference in the mean days to BLL decline <10 μg/dL before and after recommendations to test newly emigrated children. © 2012 Wiley Periodicals, Inc.

A Change of Heart? British Policies towards Tubercular Refugees during 1959 World Refugee Year.

PubMed

Taylor, Becky

2015-01-01

This article looks at Britain's response to the World Refugee Year (1959-60), and in particular the government's decision to allow entry to refugees with tuberculosis and other chronic illnesses. In doing so, it broke the practice established by the 1920 Aliens' Order which had barred entry to immigrants with a range of medical conditions. This article uses the entry of these sick refugees as an opportunity to explore whether government policy represented as much of a shift in attitude and practice as contemporary accounts suggested. It argues for the importance of setting the reception of tubercular and other 'disabled' refugees in 1959-61 in its very particular historical context, showing it was a case less of the government thinking differently about refugees, and more of how, in a post-Suez context, the government felt obliged to take into account international and public opinion. The work builds on and adds to the growing literature surrounding refugees and disease. It also places the episode within the specificity of the post-war changing epidemiological climate; the creation of the National Health Service; and the welfare state more broadly. In looking at the role of refugee organizations in the Year, the article also contributes to debates over the place of voluntary agencies within British society.

Encouraging understanding or increasing prejudices: A cross-sectional survey of institutional influence on health personnel attitudes about refugee claimants' access to health care

PubMed Central

Rousseau, Cécile; Oulhote, Youssef; Ruiz-Casares, Mónica; Cleveland, Janet; Greenaway, Christina

2017-01-01

Background This paper investigates the personal, professional and institutional predictors of health institution personnel's attitudes regarding access to healthcare for refugee claimants in Canada. Methods In Montreal, the staff of five hospitals and two primary care centres (n = 1772) completed an online questionnaire documenting demographics, occupation, exposure to refugee claimant patients, and attitudes regarding healthcare access for refugee claimants. We used structural equations modeling to investigate the associations between professional and institutional factors with latent functions of positive and negative attitudes toward refugee's access to healthcare. Results Younger participants, social workers, participants from primary care centres, and from 1st migrant generation had the lowest scores of negative attitudes. Respondents who experienced contact with refugees had lower scores of negative attitudes (B = -14% standard deviation [SD]; 95% CI: -24, -4%). However, direct contact with refugees increased scores of negative attitudes in the institution with the most negative attitudes by 36% SD (95% CI: 1, 71%). Interpretation Findings suggest that institutions influence individuals’ attitudes about refugee claimants’ access to health care and that, in an institutional context of negative attitudes, contact with refugees may further confirm negative perceptions about this vulnerable group. PMID:28196129

Refugee health and rehabilitation: Challenges and response.

PubMed

Khan, Fary; Amatya, Bhasker

2017-05-16

The current global refugee crisis poses major challenges in providing effective healthcare to refugees, particularly for non-communicable diseases management and disability. This article provides an overview of refugee health and potential challenges from the rehabilitation perspective. A literature search (both academic and grey literature) was conducted using medical and health science electronic databases and internet search engines (2001-2016). Both authors independently selected studies. Due to heterogeneity amongst identified articles, a narrative analysis was performed for best-evidence synthesis to outline the current health and rehabilitation status of refugees and existing gaps in care. Data suggest that infectious diseases requiring treatment in refugees are a minority; whilst non-communicable diseases, musculoskeletal conditions are prevalent. Many refugees arrive with complex health needs. One in 6 refugees have a physical health problem severely affecting their lives and two-thirds experience mental health problems, signifying the important role of rehabilitation. Refugees face continued disadvantage, poverty and dependence due to lack of cohesive support in their new country, which are determinants of both poor physical and mental health. This is compounded by language barriers, impoverishment, and lack of familiarity with the local environment and healthcare system. In Australia, there are concerns about sexual and gender-based violence in off-shore detention camps. Targeted physical and cognitive rehabilitative strategies have much to offer these vulnerable people to allow for improved activity and participation. Strong leadership and effective action from national and international bodies is urgently needed to develop comprehensive rehabilitation-inclusive medical care for refugees.

Notes from the field: malnutrition and elevated mortality among refugees from South Sudan - Ethiopia, June-July 2014.

PubMed

Andresen, Ellen; Bilukha, Oleg O; Menkir, Zeray; Gayford, Megan; Kavosa, Millicent; Wtsadik, Mulugeta; Maina, Gidraf; Gose, Mesfin; Nyagucha, Irene; Shahpar, Cyrus

2014-08-15

As a result of armed civil conflict in South Sudan that started in mid-December of 2013, an estimated 1.1 million persons were internally displaced, and approximately 400,000 refugees fled South Sudan to neighboring countries (primarily to Ethiopia, Uganda, Sudan, and Kenya). Refugees from South Sudan arriving in Ethiopia are sheltered in three refugee camps located in Gambella region: Leitchuor, Kule, and Tierkidi. The camps were established during January-May 2014 and have estimated refugee populations of 47,000, 51,000, and 50,000, respectively. Reports from health clinics and humanitarian agencies providing assistance to refugees suggested poor nutritional status of arriving refugees and elevated mortality rates. To assess the nutritional status of refugee children aged 6-59 months and mortality rates (crude [all ages] and aged <5 years), the Administration for Refugee and Returnee Affairs (an Ethiopian government aid agency), the United Nations High Commissioner for Refugees, World Food Programme, and United Nations Children's Fund, in collaboration with CDC, conducted cross-sectional population-representative surveys in Leitchuor, Kule, and Tierkidi camps during June-July 2014. Anthropometric measurements in children were taken using standard procedures, and nutritional status was classified based on 2006 World Health Organization (WHO) growth standards. Hemoglobin was measured using HemoCue Hb 301. Anemia was diagnosed according to WHO thresholds. Retrospective mortality rates in Leitchuor and Kule were measured using a household census method.

Hospital Admission and Criminality Associated with Substance Misuse in Young Refugees - A Swedish National Cohort Study.

PubMed

Manhica, Hélio; Gauffin, Karl; Almqvist, Ylva B; Rostila, Mikael; Hjern, Anders

2016-01-01

High rates of mental health problems have been described in young refugees, but few studies have been conducted on substance misuse. This study aimed to investigate the patterns of hospital care and criminality associated with substance misuse in refugees who settled in Sweden as teenagers. Gender stratified Cox regression models were used to estimate the risks of criminal convictions and hospital care associated with substance misuse from national Swedish data for 2005-2012. We focused on 22,992 accompanied and 5,686 unaccompanied refugees who were aged 13-19 years when they settled in Sweden and compared them with 1 million native Swedish youths from the same birth cohort. The risks of criminal conviction associated with substance misuse increased with the length of residency in male refugees, after adjustment for age and domicile. The hazard ratios (HRs) were 5.21 (4.39-6.19) for unaccompanied and 3.85 (3.42-4.18) for accompanied refugees after more than 10 years of residency, compared with the native population. The risks were slightly lower for hospital care, at 2.88 (2.18-3.79) and 2.52(2.01-3.01) respectively. Risks were particularly pronounced for male refugees from the Horn of Africa and Iran. The risks for all male refugees decreased substantially when income was adjusted for. Young female refugees had similar risks to the general population. The risks of criminality and hospital care associated with substance misuse in young male refugees increased with time of residency in Sweden and were associated with a low level of income compared with the native Swedish population. Risks were similar in accompanied and unaccompanied refugees.

Hospital Admission and Criminality Associated with Substance Misuse in Young Refugees – A Swedish National Cohort Study

PubMed Central

Manhica, Hélio; Gauffin, Karl; Almqvist, Ylva B.; Rostila, Mikael; Hjern, Anders

2016-01-01

Background High rates of mental health problems have been described in young refugees, but few studies have been conducted on substance misuse. This study aimed to investigate the patterns of hospital care and criminality associated with substance misuse in refugees who settled in Sweden as teenagers. Methods Gender stratified Cox regression models were used to estimate the risks of criminal convictions and hospital care associated with substance misuse from national Swedish data for 2005–2012. We focused on 22,992 accompanied and 5,686 unaccompanied refugees who were aged 13–19 years when they settled in Sweden and compared them with 1 million native Swedish youths from the same birth cohort. Results The risks of criminal conviction associated with substance misuse increased with the length of residency in male refugees, after adjustment for age and domicile. The hazard ratios (HRs) were 5.21 (4.39–6.19) for unaccompanied and 3.85 (3.42–4.18) for accompanied refugees after more than 10 years of residency, compared with the native population. The risks were slightly lower for hospital care, at 2.88 (2.18–3.79) and 2.52(2.01–3.01) respectively. Risks were particularly pronounced for male refugees from the Horn of Africa and Iran. The risks for all male refugees decreased substantially when income was adjusted for. Young female refugees had similar risks to the general population. Conclusion The risks of criminality and hospital care associated with substance misuse in young male refugees increased with time of residency in Sweden and were associated with a low level of income compared with the native Swedish population. Risks were similar in accompanied and unaccompanied refugees. PMID:27902694

Risk of Developing Diabetes Among Refugees and Immigrants: A Longitudinal Analysis.

PubMed

Berkowitz, Seth A; Fabreau, Gabriel E; Raghavan, Sridharan; Kentoffio, Katherine; Chang, Yuchiao; He, Wei; Atlas, Steven J; Percac-Lima, Sanja

2016-12-01

To determine the difference in risk of developing diabetes for refugees, immigrants, and American-born participants living in the same communities, and to explore potential mediators of that difference. Retrospective longitudinal cohort from January 1, 2003 and December 31, 2013. Refugees aged ≥18 years were matched in a 1:3 ratio by age, gender, and date of care initiation to (1) Spanish-speaking non-refugee immigrants, and (2) English-speaking controls receiving care in the same community health center. We used proportional hazards regression to estimate the risk of incident diabetes. We tested whether differences in education or baseline obesity mediated diabetes risk using counterfactual mediation analysis. We included 3174 participants. Among refugee participants, the most common countries of origin were Somalia (17.8 %), Iraq (16.7 %) and Bhutan (8.8 %). Diabetes incidence rate was 1.94, 1.91, and 1.22 cases per 100 person-years follow-up for refugees, immigrants, and controls, respectively. In adjusted models, both refugee (HR 2.08 95 % CI 1.32-3.30) and immigrant (HR 1.51 95 % CI 1.01-2.24) statuses were associated with increased diabetes risk compared with controls. Risk between refugees and immigrants did not differ (adjusted HR for refugees 1.37 95 % CI 0.91-2.06). In mediation analyses, educational attainment mediated 36 % (p = 0.007) of the difference in diabetes risk between refugees/immigrants and controls. Baseline obesity did not mediate difference in diabetes risk (proportion mediated 1 %, p = 0.84). Refugees and immigrants had significantly increased risk for diabetes, partially mediated by education. Education-based lifestyle interventions may be a promising strategy to prevent diabetes for these vulnerable patients.

Baseline health care for refugees in The Netherlands.

PubMed

Hondius, A J; van Willigen, L H

1989-01-01

In the Netherlands there are some 20,000 refugees from different parts of the world (e.g. Vietnam, Latin America). Most of them have experienced a form of organized violence. The somatic and psychosocial complaints of the refugees are comparable to those of Dutch war victims. They are mostly of an aspecific kind and making a diagnosis can be difficult because of the culturally different presentation of ill being. In order to help general practitioners in making a diagnosis the Refugee Health Centre (CGV) has made a classification of complaints according to whether or not they have a specific cause. It is clear from the literature that there are different opinions about the causes of the somatic complaints. As far as the psychic complaints are concerned it is remarkable that in our pilot study (n = 135) only 6% of the examined refugees suffer from a classical picture of the post-traumatic stress disorder; in a number of cases the picture is limited to some components only. Psychosocial complaints of refugees are subdivided and described. The philosophy of the CGV-treatment is to give assistance as much as possible in the refugee's neighbourhood; so that the clinician(s) will become part of the refugee's new social network. Another very important aspect of the assistance given is preventing medicalization of psychological problems. The basis of help is a recognition of the problems and complaints of the refugee. The structure of the Dutch health care, built up in 'lines', is very often very confusing for a refugee; this confusion can cause communication difficulties between refugee and clinician. To develop methods of treatment, definition and registration of complaints and problems can be a first step.

Environmental, Nutrition and Health Issues in a US Refugee Resettlement Community.

PubMed

Sastre, Lauren; Haldeman, Lauren

2015-10-01

INTRODUCTION In 2012, North Carolina ranked in the top ten states in refugee resettlement, with central Guilford County one of the most diverse in the southeast. OBJECTIVE Examine the local resettlement environmental, nutrition and health barriers and needs of refugees in Guilford County, as perceived by individuals providing services to them. METHODS Participants (n = 40) included: medical and social service providers, educators, faith-based volunteers, resettlement agency caseworkers and liaisons to a variety of refugee communities. Guided semistructured interviews were audio-recorded and transcribed verbatim. Themes were identified using deductive content analysis and categorized by frequency of reporting by participants. RESULTS Perceptions were consistent across participants regarding a diverse local refugee population. Resettlement housing was observed to be in poor condition, located in areas of poverty with transportation barriers. However, refugees rarely relocated, due to strong community relationships and support. Perceived dietary risks included: difficulties budgeting and maintaining food assistance, hoarding food, high consumption of sodas and sweets, misperceptions regarding US products (e.g., perceived need for infant formula), and limited health knowledge. Respondents observed that most refugees preferred "fresh" foods, and had strong agricultural skills but lacked green space. Major barriers to health care reported were: poverty, short duration of initial Medicaid coverage, and language (both lack of interpretation services and translated materials). Providers consistently observed type 2 diabetes, weight gain and dental problems across refugee groups. CONCLUSIONS Direct service providers' experiences and observations working with a diverse resettlement population provide unique insight into consistent barriers to achieving good health that confront refugees. While refugees face many barriers, groups often have impressive strengths, such as agricultural skills, on which to focus. KEYWORDS Refugees, emigration, immigration, minority health, health care disparities, diet, environment, USA.

Growth Trajectories of Refugee and Nonrefugee Children in the United States.

PubMed

Dawson-Hahn, Elizabeth; Pak-Gorstein, Suzinne; Matheson, Jasmine; Zhou, Chuan; Yun, Katherine; Scott, Kevin; Payton, Colleen; Stein, Elizabeth; Holland, Annette; Grow, H Mollie; Mendoza, Jason A

2016-12-01

Limited data examine longitudinal nutrition outcomes of refugee children after United States resettlement. Among refugee children, our aims were to (1) assess the changes in weight-based nutritional status between baseline (0-3 months) and 10-24 months after arrival and (2) compare the BMI (BMIz) or weight-for-length z score (WFLz) trajectories to nonrefugee children for up to 36 months after arrival. We conducted a retrospective study of refugees aged 0-16 years from Washington and Pennsylvania and compared them with an age and sex-matched nonrefugee low-income sample from Washington. Data included anthropometric measurements from the initial screening medical visit and subsequent primary care visits. Multilevel linear mixed-effects regression models evaluated the change in BMIz or WFLz trajectory. The study included 512 refugee and 1175 nonrefugee children. The unadjusted prevalence of overweight/obesity increased from 8.9% to 20% (P < .001) for 2- to 16-year-old refugees from baseline to 10-24 months. Refugees (2-16 years old) had a steeper increase in their BMIz per 12 months compared with nonrefugees (coefficient 0.18 vs 0.03; P < .001). Refugees <2 years old had a less steep increase in their WFLz per 12 months compared with nonrefugees (coefficient 0.12 vs 0.36, P = .002). Older refugee children exhibited a higher risk of obesity than nonrefugees, whereas refugees <2 years old exhibited a slower increase in their risk of obesity than nonrefugee children. All age groups experienced increasing obesity prevalence. Targeted and culturally tailored obesity prevention interventions may mitigate health and nutrition inequities among refugee children. Copyright © 2016 by the American Academy of Pediatrics.

Health visiting and refugee families: issues in professional practice.

PubMed

Drennan, Vari M; Joseph, Judy

2005-01-01

This paper reports on the perceptions of experienced health visitors working with refugee families in Inner London. Women who are refugees and asylum seekers in the United Kingdom are more likely to experience depression than either non-refugee women or male asylum seekers. Health visitors provide a universal public health service to all women on the birth of a child, or with children aged under five, and as such are well placed to identify emotional and mental health problems of women who are refugees. Despite successive waves of refugees to the United Kingdom in the 20th century, there are no empirical studies of health visiting practice with this vulnerable group. There is also no body of evidence to inform the practice of health visitors new to working with asylum seekers and refugees. An exploratory study was undertaken in Inner London in 2001. Semi-structured interviews were conducted with a purposive sample of 13 health visitors experienced in working with women and families who are refugees. A range of structural challenges was identified that mediated against the development of a health-promoting relationship between health visitors and refugee women. With refugee families, who were living in temporary accommodation, health visitors were prioritizing basic needs that had to be addressed: in addition, they prioritized the needs of children before those of women. Health visitors were aware of the emotional needs of women and had strategies for addressing these with women in more settled circumstances. Health visitors considered themselves ill-prepared to deal with the complexities of working with women in these situations. This study identifies issues for further exploration, not least from the perspective of refugee women receiving health visiting services. Health visitors in countries receiving refugee women are framing their work with these women in ways that reflect Maslow's theory of a hierarchy of needs. This study suggests ways that public health nursing practice could be improved, and identifies issues for further study.

Healing war wounds and perfuming exile: the use of vegetal, animal, and mineral products for perfumes, cosmetics, and skin healing among Sahrawi refugees of Western Sahara.

PubMed

Volpato, Gabriele; Kourková, Pavlína; Zelený, Václav

2012-12-27

Over the past decade, there has been growing interest within ethnobiology in the knowledge and practices of migrating people. Within this, scholars have given relatively less attention to displaced people and refugees: to the loss, maintenance, and adaptation of refugees' ethnobiological knowledge, and to its significance for refugees' wellbeing. This study focuses on cosmetics and remedies used to heal skin afflictions that are traditionally used by Sahrawi refugees displaced in South Western Algerian refugee camps. The research methods included a structured survey carried out with 37 refugee households, semi-structured interviews with 77 refugees, 24 retrospective interviews with refugees and other knowledgeable informants, and a voucher specimen collection of the plants and products cited. We recorded the use of 55 plant species, nine animal species, and six mineral products used within the three main use categories discussed in this paper: 1) Remedies for health issues that are typical of the desert environment where the Sahrawi once lived as nomads and now live as refugees (e.g. eye afflictions); 2) Remedies for wounds that are influenced by the Sahrawi's recent history of guerrilla warfare; and 3) Cosmetics and products used for body care, decoration and perfuming (e.g. hair care, teeth cleansing, henna use) and for aromatizing the air inside of tents and which are widely used in everyday life and social practices. We discuss the changes that have occurred in the patterns of use and procurement of these products with exile and sedentarization in refugee camps, and conclude that refugees are not simply passive recipients of national and international aid, but rather struggle to maintain and recover their traditional ethnobiological practices in exile. Finally, we suggest further research into the ethnobiological practices and knowledge of displaced populations.

Social inequalities in mental health and mortality among refugees and other immigrants to Sweden – epidemiological studies of register data

PubMed Central

Hollander, Anna-Clara

2013-01-01

The aim of this PhD project was to increase knowledge, using population-based registers, of how pre- and post-migration factors and social determinants of health are associated with inequalities in poor mental health and mortality among refugees and other immigrants to Sweden. Study I and II had cross-sectional designs and used logistic regression analysis to study differences in poor mental health (measured with prescribed psychotropic drugs purchased) between refugee and non-refugee immigrants. In Study I, there was a significant difference in poor mental health between female refugees and non-refugees (OR=1.27; CI=1.15–1.40) when adjusted for socio-economic factors. In Study II, refugees of most origins had a higher likelihood of poor mental health than non-refugees of the same origin. Study III and IV had cohort designs and used Cox regression analysis. Study III analysed mortality rates among non-labour immigrants. Male refugees had higher relative risks of mortality from cardiovascular disease (HR=1.53; CI=1.04–2.24) and external causes (HR=1.59; CI=1.01–2.50) than male non-refugees did, adjusted for socio-economic factors. Study IV included the population with a strong connection to the labour market in 1999 to analyse the relative risk of hospitalisation due to depressive disorder following unemployment. The lowest relative risk was found among employed Swedish-born men and the highest among foreign-born females who lost employment during follow-up (HR=3.47; CI=3.02–3.98). Immigrants, and particularly refugees, have poorer mental health than native Swedes. Refugee men have a higher relative mortality risk for cardiovascular disease and external causes of death than do non-refugees. The relative risk of hospitalisation due to depressive disorder following unemployment was highest among immigrant women. To promote mental health and reduce mortality among immigrants, it is important to consider pre- and post-migration factors and the general social determinants of health. PMID:23810108

Caring for pregnant refugee women in a turbulent policy landscape: perspectives of health care professionals in Calgary, Alberta.

PubMed

Winn, Anika; Hetherington, Erin; Tough, Suzanne

2018-06-26

Female refugees can be a vulnerable population, often having suffered through traumatic events that pose risks to their health, especially during pregnancy. Pregnancy can be an entry point into the health care system, providing health care professionals the opportunity to gain women's trust, connect refugees with resources, and optimize the health of mother and child. Policies surrounding the provision and funding of health care services to refugees can impact access to and quality of care. The aim of our study was to understand the experiences of health care professionals caring for pregnant refugee women in Calgary, AB, taking into consideration recent contextual changes to the refugee landscape in Canada. We conducted ten semi-structured interviews with health care professionals who provided regular care for pregnant refugee women at a refugee health clinic and major hospital in Calgary, Alberta. Interviews were recorded, transcribed, and analyzed using an interpretive description methodology. Health care providers described several barriers when caring for pregnant refugees, including language barriers, difficulty navigating the health care system, and cultural barriers such as managing traditional gender dynamics, only wanting a female provider and differences in medical practices. Providers managed these barriers through strategies including using a team-based approach to care, coordinating the patient's care with other services, and addressing both the medical and social needs of the patient. The federal funding cuts added additional challenges, as many refugees were left without adequate health coverage and the system was complicated to understand. Health care providers developed creative strategies to maximize coverage for their patients including paying out of pocket or relying on donations to care for uninsured refugees. Finally, the recent Syrian refugee influx has increased the demand on service providers and further strained already limited resources. Health care providers caring for pregnant refugee women faced complex cultural and system-level barriers, and used multiple strategies to address these barriers. Additional system strains add extra pressure on health care professionals, requiring them to quickly adjust and accommodate for new demands.

Hospital admissions due to alcohol related disorders among young adult refugees who arrived in Sweden as teenagers - a national cohort study.

PubMed

Manhica, Hélio; Gauffin, Karl; Almquist, Ylva B; Rostila, Mikael; Berg, Lisa; Rodríguez García de Cortázar, Ainhoa; Hjern, Anders

2017-08-08

Psychological distress and lack of family support may explain the mental health problems that are consistently found in young unaccompanied refugees in Western countries. Given the strong relationship between poor mental health and alcohol misuse, this study investigated hospital admissions due to alcohol related disorders among accompanied and unaccompanied young refugees who settled in Sweden as teenagers. The dataset used in this study was derived from a combination of different registers. Cox regression models were used to estimate the risks of hospital care due to alcohol related disorders in 15,834 accompanied and 4376 unaccompanied young refugees (2005-2012), aged 13 to 19 years old when settling in Sweden and 19 to 32 years old in December 2004. These young refugees were divided into regions with largely similar attitudes toward alcohol: the former Yugoslavian republics, Somalia, and the Middle East. The findings were compared with one million peers in the native Swedish population. Compared to native Swedes, hospital admissions due to alcohol related disorders were less common in young refugees, with a hazard ratio (HR) of 0.65 and 95% confidence interval (CI) between 0.56 and 0.77. These risks were particularly lower among young female refugees. However, there were some differences across the refugee population. For example, the risks were higher in unaccompanied (male) refugees than accompanied ones (HR = 1.49, 95% CI = 1.00-2.19), also when adjusted for age, domicile and income. While the risks were lower in young refugees from Former Yugoslavia and the Middle East relative to native Swedes, independent of their length of residence in Sweden, refugees from Somalia who had lived in Sweden for more than ten years showed increased risks (HR = 2.54, 95% CI = 1.71-3.76), after adjustments of age and domicile. These risks decreased considerably when income was adjusted for. Young refugees have lower risks of alcohol disorders compared with native Swedes. The risks were higher in unaccompanied young (male) refugees compared to the accompanied ones. Moreover, Somalian refugees who had lived in Sweden for more than ten years seems to be particularly vulnerable to alcohol related disorders.

Improving the management and care of refugees in Australian hospitals: a descriptive study.

PubMed

Ross, Lindsey; Harding, Catherine; Seal, Alexa; Duncan, Geraldine

2016-01-01

Objectives The aim of the present study was to investigate healthcare provider perceptions of the impact of refugee patients at two public hospitals, one rural and one urban, in designated refugee resettlement areas. Healthcare professionals' views regarding improvements that could be made in this area were also sought. Methods Two-page anonymous questionnaires containing demographic, quantitative and open-ended questions were distributed to 150 healthcare providers at each research site. Results Response rates at the rural and urban sites were 50% and 49%, respectively. Refugees were seen at least monthly by 40% of respondents. Additional support was requested by 70% of respondents. Confidence was associated with being born overseas (P=0.029) and increased time working with refugees (r s =0.418, P<0.001). Only 47% of respondents felt confident managing social and psychological needs of refugees. Midwives saw refugees more than nursing and allied healthcare staff combined, and this was significant at the rural hospital (P<0.001). Rural respondents reported that working with refugees enhanced their practice (P=0.025), although felt significantly less confident (P<0.001) than urban respondents. Themes that arose regarding barriers to care included language and cultural barriers, paucity of knowledge and issues accessing available services, including appropriate interpreters, Medicare eligibility and patient factors, including lack of patient trust in government systems. Desire for support was more pronounced in the rural setting (P=0.001). Conclusions Refugees were seen frequently in both settings and most respondents requested additional support, highlighting that caring for refugees in Australian hospitals is a significant challenge. Additional support and education should be targeted to those caring for refugees most frequently, particularly midwifery services, to reduce barriers to care. What is known about the topic? Refugees are a vulnerable group, often with complex health needs. These needs are often unmet because of issues including language and cultural barriers. What does this paper add? Refugees were seen frequently in the two public hospital settings involved in the present study and most often by midwifery services. Healthcare professionals require more support, more information about available services and better access to interpreter services. These issues were more pronounced in the rural setting where very limited research exists. What are the implications for practitioners? Implementing additional support and education regarding refugee health needs could increase knowledge and confidence when managing refugees, reducing barriers to care and improving quality of care.

Effects in Post-Conflict West Africa of Teacher Training for Refugee Women

ERIC Educational Resources Information Center

Shepler, Susan; Routh, Sharyn

2012-01-01

This article draws data from an innovative research project tracing former refugee teachers who received teacher training from the International Rescue Committee (IRC) over a 17-year-long education programme in refugee camps in Guinea (1991-2008). The research traced repatriated refugee teachers who had returned to their homes in Sierra Leone and…

Teaching Globalisation in the Social Sciences: The Effectiveness of a Refugee Simulation

ERIC Educational Resources Information Center

George, Stacy Keogh

2017-01-01

This article describes the incorporation of a refugee simulation into an upper-division sociology course on globalisation at a liberal arts institution in the United States. The simulation is designed to inform students of the refugee process in the United States by inviting participants to immerse themselves in refugee experiences by adopting…

Journeys into Higher Education: The Case of Refugees in the UK

ERIC Educational Resources Information Center

Morrice, Linda

2009-01-01

Higher education (HE) is one of the routes that refugees who come to the UK from professional and highly educated backgrounds can re-establish their lives and professional identities. This research follows up a group of such refugees who were on a programme designed to support refugees gain access to HE or appropriate employment. The findings…

77 FR 65702 - Agency Information Collection Activities: Refugee/Asylee Relative Petition, Form Number I-730...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-10-30

...-0037] Agency Information Collection Activities: Refugee/Asylee Relative Petition, Form Number I-730... request. (2) Title of the Form/Collection: Refugee/Asylee Relative Petition. (3) Agency form number, if... households. Form I- 730 will be used by an asylee or refugee to file on behalf of his or her spouse and/or...

45 CFR 400.209 - Claims involving family units which include refugees who have been in the United States more than...

Code of Federal Regulations, 2010 CFR

2010-10-01

... refugees who have been in the United States more than 36 months. 400.209 Section 400.209 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Federal Funding Federal...

A Guide to Orientation Materials for Refugees and their Sponsors. A Selected, Annotated Bibliography Supplement.

ERIC Educational Resources Information Center

Center for Applied Linguistics, Washington, DC. Language and Orientation Resource Center.

An annotated bibliography of materials for the orientation of refugees and their sponsors is a supplement to "A Guide to Orientation Materials for Indochinese Refugees and their Sponsors," and includes 40 entries for materials pertinent to many other, non-Indochinese refugee groups. The materials are grouped alphabetically by the…

Voices and Views of Congolese Refugee Women: A Qualitative Exploration to Inform Health Promotion and Reduce Inequities

ERIC Educational Resources Information Center

McMorrow, Shannon; Saksena, Jyotika

2017-01-01

Refugees have recently been thrust into the spotlight worldwide. The strikingly negative rhetoric currently surrounding refugees calls for increased action from public health educators. In 2016, the largest proportion of refugees to the United States came from the Democratic Republic of Congo. This presents the opportunity to explore health needs…

Making Sense of Collective Identity and Trauma through Drawing: The Case Study of a Palestinian Refugee Student

ERIC Educational Resources Information Center

Beauregard, Caroline; Papazian-Zohrabian, Garine; Rousseau, Cécile

2017-01-01

Identity construction can be very complex for refugee children, especially for Palestinian refugee children. For refugee children, organised violence and immigration are important parts of their life experience that can lead to trauma, which in turn influences how they construct their collective identity. Schools have to consider this specific…

Reading Refugee Stories: Five Common Themes among Picture Books with Refugee Characters

ERIC Educational Resources Information Center

Nath, Lopita; Grote-Garcia, Stephanie

2017-01-01

The U.S. Refugee Resettlement Program offers a quick path to permanent residency and adjustment to the United States, with the major objectives of economic success, community involvement, and local integration. The success of the program partly depends on the response of the American community towards refugees. Using the foundational idea that…

Acculturation, Partner Violence, and Psychological Distress in Refugee Women from Somalia

ERIC Educational Resources Information Center

Nilsson, Johanna E.; Brown, Chris; Russell, Emily B.; Khamphakdy-Brown, Supavan

2008-01-01

This study examined the relations among acculturation, domestic violence, and mental health in 62 married refugee women from Somalia. Refugees from Somalia constituted the largest group of refugees entering the United States in 2005, and little is known about the presence of domestic violence in this group. The results showed that women who…

Determinants of Second Language Proficiency among Refugees in the Netherlands

ERIC Educational Resources Information Center

van Tubergen, Frank

2010-01-01

Little is known about the language acquisition of refugees in Western countries. This study examines how pre- and post-migration characteristics of refugees are related to their second language proficiency. Data are from a survey of 3,500 refugees, who were born in Afghanistan, Iran, Iraq, former Yugoslavia and Somalia, and who resided in the…

The Far East Comes Near: Autobiographical Accounts of Southeast Asian Students in America.

ERIC Educational Resources Information Center

Nguyen-Hong-Nhiem, Lucy, Ed.; Halper, Joel Martin, Ed.

This publication provides autobiographical essays by students originally from Vietnam, Cambodia, and Laos, all of whom arrived in the United States as refugees between 1975 and 1982. Following an introduction is an initial essay, "Becoming a Refugee, Being a Refugee, Ceasing To Be a Refugee," by L. Nguyen-Hong-Nhiem. The student essays are…

International Migration and Refugee Problems: Conflict Between Black Americans and Southeast Asian Refugees.

ERIC Educational Resources Information Center

Lee, Letha A.

1987-01-01

Reports the findings of a 10-year study that examined the continuing conflicts between poor Blacks and Southeast Asian refugees in the United States. Focuses on two areas, economics and race, and argues that government policy has done much to inflame the conflict. Argues that the current refugee policies are diluting already inadequate social…

Adaptation and Integration of Recent Refugees to the United States.

ERIC Educational Resources Information Center

Forbes, Susan S.

This booklet is an overview report on refugee integration and adaptation in the United States. The introduction discusses briefly the Refugee Act of 1980, and is followed by three sections of text. The first part summarizes information on the extent of refugee economic and social adjustment and analyzes factors that have facilitated and impeded…

"My Little English": A Case Study of Decolonial Perspectives on Discourse in an After-School Program for Refugee Youth

ERIC Educational Resources Information Center

MacDonald, Michael T.

2017-01-01

Literacy "sponsorship" in refugee communities is not without its risks and limitations. For potential sponsors, risks include the commodification of refugee voices, while limits include inaccurate generalizations of those being sponsored. This essay draws from a case study of refugee student discourse to discuss how a more explicit…

77 FR 5865 - Privacy Act; System of Records: State-59, Refugee Case Records

Federal Register 2010, 2011, 2012, 2013, 2014

2012-02-06

..., pursuant to the provisions of the Privacy Act of 1974, as amended (5 U.S.C. 552a) and Office of Management... with the Office of Management and Budget. The amended system description, ``Refugee Case Records, State... Presidential Documents, Pg. 2880 (Refugee Resettlement Grants Program); Refugee Crisis in Iraq Act of 2007...

Performing Manaaki and New Zealand Refugee Theatre

ERIC Educational Resources Information Center

Hazou, Rand T.

2018-01-01

In September 2015, and in response to the Syrian refugee crisis, there were widespread calls in New Zealand urging the Government to raise its annual Refugee Quota. Maori Party co-leader Marama Fox argued that New Zealand could afford to take on more refugees as part of its global citizenship and suggested that New Zealand's policy might be shaped…

Encouraging Refugee Awareness in the Classroom: A Guide for Teachers. Issue Paper.

ERIC Educational Resources Information Center

DeCarlo, Jacqueline; Hamilton, Virginia, Ed.

This lesson packet focuses on the growing situation of refugees and cultural awareness. In the document are definitions of terms, suggestions for infusing lessons on the refugees into the curriculum, and resource information. One of the purposes of working to create refugee awareness is to help ordinary students become extraordinary citizens of…

A Policy of Vulnerability or Agency? Refugee Young People's Opportunities in Accessing Further and Higher Education in the UK

ERIC Educational Resources Information Center

Gateley, D. E.

2015-01-01

The UK government's austerity cuts have negatively impacted many voluntary-sector interventions that provided support to refugees. One such intervention, the Refugee Integration and Employment Service (RIES), is discussed in this paper. The RIES was a UK Border Agency-funded integration programme for recognised refugees and operated through…

Refugees in Africa: A Country by Country Survey.

ERIC Educational Resources Information Center

United Nations High Commission for Refugees, Washington, DC.

The status of the refugees in Africa and the work of the United Nations High Commissioner for Refugees (UNHCR) is charted on a country by country basis in this report. The size of the refugee population and their needs are described along with various assistance efforts directed at improving their situation. Sums of money spent by UNHCR office are…

3 CFR 8538 - Proclamation 8538 of June 18, 2010. World Refugee Day, 2010

Code of Federal Regulations, 2011 CFR

2011-01-01

... 3 The President 1 2011-01-01 2011-01-01 false Proclamation 8538 of June 18, 2010. World Refugee..., 2010 Proc. 8538 World Refugee Day, 2010By the President of the United States of America A Proclamation On World Refugee Day, we honor the contributions and resilience of those forced to flee from their...

Turkey's Progress toward Meeting Refugee Education Needs the Example of Syrian Refugees

ERIC Educational Resources Information Center

Beltekin, Nurettin

2016-01-01

Problem Statement: Historically, Turkey is an immigrant country. It has experienced various migration waves from Asia, Awrupa and Africa. Recently, Turkey has confronted a huge wave of migration. Turkey tries to meet many needs besides the educational needs of refugees, but there is not enough study on refugees in the field of educational sciences…

3 CFR - Fiscal Year 2010 Refugee Admissions Numbers and Authorizations of In-country Refugee Status...

Code of Federal Regulations, 2010 CFR

2010-01-01

... Immigration and Nationality Act, and Determination Pursuant to Section 2(B)(2) of the Migration and Refugee...-country Refugee Status Pursuant to Sections 207 and 101(A)(42), Respectively, of the Immigration and... Amended Memorandum for the Secretary of State In accordance with section 207 of the Immigration and...

Refugee Education: The State of Nigeria's Preparedness

ERIC Educational Resources Information Center

Obashoro-John, Oluwayemisi A.; Oni, Gbolabo J.

2017-01-01

The spate of insurgences and conflicts in the country and around the sub-region has led to the increased presence of refugees and Internally Displaced People (IDPs) in Nigeria. This has resultant challenges on the basic needs of refugees and IDPs at different levels. One of the highest priorities of refugees and IDPs communities is education.…

Refugee Health: An Ongoing Commitment and Challenge

PubMed Central

Efird, Jimmy T.; Bith-Melander, Pollie

2018-01-01

Refugees represent a diverse group of displaced individuals with unique health issues and disease risks. The obstacles facing this population have their origins in war, violence, oppression, exploitation, and fear of persecution. Regardless of country of origin, a common bond exists, with refugees often confronting inadequate healthcare resources, xenophobia, discrimination, and a complex web of legal barriers in their new homelands. In many cases, the plight of refugees is multigenerational, manifesting as mental health issues, abuse, poverty, and family disruption. The health trajectory of refugees remains an ongoing commitment and challenge. PMID:29342831

International factors in the formation of refugee movements.

PubMed

Zolberg, A R; Suhrke, A; Aguayo, S

1986-01-01

The authors construct a theoretical framework for analyzing factors influencing international refugee movements. "On the basis of detailed case studies by the authors of the principal refugee flows generated in Asia, Africa, and Latin America from approximately 1960 to the present, it was found that international factors often intrude both directly and indirectly on the major types of social conflict that trigger refugee flows, and tend to exacerbate their effects. Refugees are also produced by conflicts that are manifestly international, but which are themselves often related to internal social conflict among the antagonists." excerpt

Transnational Intersectionality in Family Therapy With Resettled Refugees.

PubMed

Gangamma, Rashmi; Shipman, Daran

2018-04-01

In this article, we discuss incorporating the transnational intersectionality framework in family therapy with resettled refugees. Transnational intersectionality is an extension of the framework of intersectionality which helps to better understand complexities of power and oppression across national contexts and their influence on refugees' lives. Adopting this framework alerts family therapists to: (a) develop critical awareness of refugee's transnational contexts; (b) understand differences in experiences of social identities across contexts; (c) acknowledge postmigration factors of oppression affecting resettlement; and (d) critically reflect upon therapist-interpreter-client intersectionalities. This shifts our conceptualization of therapy with refugees to actively consider transnational contexts which refugees uniquely occupy. We describe the framework and provide two case illustrations to highlight its usefulness. © 2017 American Association for Marriage and Family Therapy.

Vulnerability and agency: beyond an irreconcilable dichotomy for social service providers working with young refugees in the UK.

PubMed

O'Higgins, Aoife

2012-01-01

Many young refugees face significant difficulties in securing support from social services providers. This study invited 21 young refugees aged 16 to 21 to take part in focus groups and follow-up interviews about their experiences of accessing this support. The findings reveal that young refugees may deliberately conform to expectations about their vulnerability in order to benefit from greater support from service providers. Social workers may fail to consider young refugees' abilities and understand the ways in which each individual is vulnerable. The study suggests that group work may be an effective way to engage young refugees to overcome this. Copyright © 2012 Wiley Periodicals, Inc., A Wiley Company.

Giving It Our Best Shot? Human Papillomavirus and Hepatitis B Virus Immunization Among Refugees, Massachusetts, 2011-2013.

PubMed

Berman, Rachel Stein; Smock, Laura; Bair-Merritt, Megan H; Cochran, Jennifer; Geltman, Paul L

2017-06-22

The receipt rate of hepatitis B virus vaccine among adolescents in the United States is high, while the receipt rate of human papillomavirus vaccine is low. Rates have not been closely studied among refugees, whose home countries have high rates of disease caused by these viruses. We examined human papillomavirus and hepatitis B virus immunization rates among 2,269 refugees aged 9 to 26 years who resettled in Massachusetts from 2011 through 2013. This was a secondary analysis of data from their medical screenings. We used binary logistic regression to assess characteristics associated with immunization and bivariate analyses to compare refugee immunization rates with those of the general US population. Forty-five percent of US adolescents aged 13 to 17 years received 1 dose of human papillomavirus vaccine, compared with 68% of similarly aged refugees. Males (adjusted odds ratio [aOR], 0.62; 95% confidence interval [CI], 0.52-0.74), refugees older than 13 years (aOR, 0.74; 95% CI, 0.60-0.93), and refugees not from Sub-Saharan Africa (aOR, 0.74; 95% CI, 0.59-0.92) were less likely to receive human papillomavirus vaccine, while arrivals in 2012 through 2013 were more likely (aOR, 1.6; 95% CI, 1.3-1.9) than those arriving in 2011. Refugees older than 13 years were less likely to receive 2 doses of hepatitis B virus vaccine (aOR, 0.49; 95% CI, 0.37-0.63) than older refugees. Specialized post-arrival health assessment may improve refugees' immunization rates.

The refugee crisis in Africa and implications for health and disease: a political ecology approach.

PubMed

Kalipeni, E; Oppong, J

1998-06-01

Political violence in civil war and ethnic conflicts has generated millions of refugees across the African continent with unbelievable pictures of suffering and unnecessary death. Using a political ecology framework, this paper examines the geographies of exile and refugee movements and the associated implications for re-emerging and newly emerging infectious diseases in great detail. It examines how the political ecologic circumstances underlying the refugee crisis influences health services delivery and the problems of disease and health in refugee camps. It has four main themes, namely, an examination of the geography of the refugee crisis: the disruption of health services due to political ecologic forces that produce refugees; the breeding of disease in refugee camps due to the prevailing desperation and destitution; and the creation of an optimal environment for emergence and spread of disease due to the chaotic nature of war and violence that produces refugees. We argue in this paper that there is great potential of something more virulent than cholera and Ebola emerging and taking a big toll before being identified and controlled. We conclude by noting that once such a disease is out in the public rapid diffusion despite political boundaries is likely, a fact that has a direct bearing on global health. The extensive evidence presented in this paper of the overriding role of political factors in the refugee health problem calls for political reform and peace accords, engagement and empowerment of Pan-African organizations, foreign policy changes by Western governments and greater vigilance of non-governmental organizations (NGOs) in the allocation and distribution of relief aid.

Childhood lead poisoning in a Somali refugee resettlement community in New Hampshire.

PubMed

Caron, Rosemary M; Tshabangu-Soko, Thandi; Finefrock, Krysten

2013-08-01

Despite the gradual decrease in childhood lead poisoning in the United States, the risk for lead poisoning among African refugee children who resettle in the United States remains elevated. Communication methods implemented by resettlement agencies in the public health system for preventing childhood lead poisoning in this at-risk population warrant further investigation. We utilized structured interviews with key stakeholders (resettlement agencies, social service agencies developed by African refugees and resettled Somali refugees) involved in the refugee resettlement process to (1) describe the agency's role in the refugee resettlement process; (2) examine communication methods utilized and barriers experienced by the public health system in reference to childhood lead poisoning; (3) describe the refugee population's perception of childhood lead poisoning; (4) examine general challenges experienced by the public health system and the refugee population during the resettlement process; and (5) describe stakeholders' recommendations to improve health communication efforts. Based on our findings, we propose that communities are important determinants in health-related problems for refugee populations. Each community has its own environment and public health system that interacts with each other to influence health risks and risk perceptions of its populations. We advocate that understanding a community's ecology and implementing a culture-centered approach is essential for the public health system to help educate and prevent communication inequalities and health disparities among an at-risk African refugee population. This action can reduce a population's resistance to communication and help build a community's capacity to address a persistent public health problem, such as childhood lead poisoning.

Elevated blood lead levels in refugee children--New Hampshire, 2003-2004.

PubMed

2005-01-21

As a result of reductions in lead hazards and improved screening practices, blood lead levels (BLLs) in children aged 1-5 years are decreasing in the United States. However, the risk for elevated BLLs (> or =10 microg/dL) remains high for certain populations, including refugees. After the death of a Sudanese refugee child from lead poisoning in New Hampshire in 2000, the New Hampshire Department of Health and Human Services (NHDHHS) developed lead testing guidelines to screen and monitor refugee children. These guidelines recommend 1) capillary blood lead testing for refugee children aged 6 months-15 years within 3 months after arrival in New Hampshire, 2) follow-up venous testing of children aged <6 years within 3-6 months after initial screening, and 3) notation of refugee status on laboratory slips for first tests. In 2004, routine laboratory telephone reports of elevated BLLs to the New Hampshire Childhood Lead Poisoning Prevention Program (NHCLPPP) called attention to a pattern of elevated BLLs among refugee children. To develop prevention strategies, NHDHHS analyzed NHCLPPP and Manchester Health Department (MHD) data, focusing on the 37 African refugee children with elevated BLLs on follow-up for whom complete data were available. This report describes the results of that analysis, which indicated that 1) follow-up blood lead testing is useful to identify lead exposure that occurs after resettlement and 2) refugee children in New Hampshire older than those routinely tested might have elevated BLLs. Refugee children in all states should be tested for lead poisoning on arrival and several months after initial screening to assess exposure after resettlement.

A critical review of the literature: engendering the discourse of masculinities matter for parenting African refugee men.

PubMed

Williams, Nombasa

2011-03-01

According to the literature on culturally and linguistically diverse parenting, refugee parenting practices and styles that are normative in countries of origin may not be sanctioned in Australia. In the case of refugee parenting, beliefs, practices, and values may be decentered in pre-resettlement contexts where survival becomes the primary concern. Engendering the discourse of masculinities to reflect a relationship between child protection and the experience of refugee parenting for African men in both pre- and post-resettlement contexts will inform culturally competent practice, intervention, and community development that is inclusive of their gender-specific needs. This article brings an expanded masculinities perspective to the ecology of refugee parenting for resettled African men resulting from larger research findings with focus group participants. Incorporating notions of masculinity into the child protection discourse is an attempt not only to reduce existing gender under- and misrepresentation among South Australian refugees but also to ensure greater visibility and increase the role of refugee men in the process of developing culturally relevant and appropriate policies, practices, and services to assist successful resettlement transitions while strengthening family well-being. The concept of masculinities, this article argues, must be treated as integral to any approach to working with refugees, particularly in areas that penetrate and may define the quality of their life experiences, expectations, and aspirations. Masculinities matter. Exploring refugee male perceptions, interpretations, and enactment of masculinity may unmask the differential experiences of refugee women from men and ensure the integration and operationalization of these differences into child protection services and practice. © The Author(s) 2011

Clinical characteristics and pregnancy outcomes of Syrian refugees: a case-control study in a tertiary care hospital in Istanbul, Turkey.

PubMed

Erenel, Hakan; Aydogan Mathyk, Begum; Sal, Veysel; Ayhan, Isil; Karatas, Suat; Koc Bebek, Arzu

2017-01-01

We aimed to compare the clinical characteristics and pregnancy outcomes in women who are Syrian refugees and Turkish women who are non-refugees at a maternity center in Istanbul, Turkey. A total of 600 singleton pregnancies who delivered at Sisli Hamidiye Etfal Training and Research Hospital were included in the study. Demographic data, obstetrical history, clinical findings, obstetrical and neonatal outcomes were compared between 300 Syrian refugees and 300 control patients. The Syrian refugee patients were significantly younger than Turkish patients. The percentage of adolescents aged 12-19 years were significantly higher in the Syrian patients (14.3 vs. 5.3 %, p < 0,001). 41.3 % of the refugee patients had no antenatal care. However, this ratio was only 7.7 % for the control group (p < 0.001). Preterm birth rates showed no difference between the groups, however, postterm birth rates were significantly higher in the control group. Low Birthweight (<2500 gr), oligohydramnios, stillbirth and fetal anomaly rates were not different between the two groups. In comparison to non-refugee control patients, refugee women in our study had poor antenatal care but no adverse perinatal outcomes were observed. Further larger multicenter studies may provide more convincing data about obstetric outcomes in the Syrian refugee population as well as adolescent pregnancies in this population.

45 CFR 400.105 - Mandatory services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Medical Assistance Scope of Medical Services § 400.105 Mandatory services. In providing refugee medical assistance to...

Vulnerability and Agency: Beyond an Irreconcilable Dichotomy for Social Service Providers Working with Young Refugees in the UK

ERIC Educational Resources Information Center

O'Higgins, Aoife

2012-01-01

Many young refugees face significant difficulties in securing support from social services providers. This study invited 21 young refugees aged 16 to 21 to take part in focus groups and follow-up interviews about their experiences of accessing this support. The findings reveal that young refugees may deliberately conform to expectations about…

Refugee Education in Countries of First Asylum: Breaking Open the Black Box of Pre-Resettlement Experiences

ERIC Educational Resources Information Center

Dryden-Peterson, Sarah

2016-01-01

The number of refugees who have fled across international borders due to conflict and persecution is at the highest level in recorded history. The vast majority of these refugees find exile in low-income countries neighboring their countries of origin. The refugee children who are resettled to North America, Europe, and Australia arrive with…

Review of U.S. Refugee Resettlement Programs and Policies. A Report. Revised.

ERIC Educational Resources Information Center

Moore, Charlotte J.

This government report reviews U.S. refugee resettlement programs and policies. Part I of the book provides an overview of U.S. refugee admissions programs and discusses refugee admissions policies for two time frames: 1945 to 1965, and 1965 to the present. In Part II an analysis of Federal assistance programs for domestic resettlement of refugees…

Working With Indochinese Refugees: A Handbook for Mental Health Workers and Human Service Providers.

ERIC Educational Resources Information Center

Koschmann, Nancy Lee; Tobin, Joseph Jay

This is a handbook for mental health workers and human service providers who deal with Indochinese refugees. Part I of the booklet provides an overview of the Indochinese refugee situation, discussing the refugees' experience, how they came to the United States, how they have adjusted, and factors that service providers must consider in helping…

The Refugee Crisis and the Rights of Children: Perspectives on Community-Based Resettlement Programs

ERIC Educational Resources Information Center

Alipui, Nicholas; Gerke, Nicole

2018-01-01

We are currently facing one of the largest and most complex refugee crises in modern times. Conflict and natural disasters have resulted in 22.5 million refugees worldwide, more than half are children. As the world struggles to respond to this massive displacement of people, how is this affecting child refugees' development and what is being done…

Finding Education: Stories of How Young Former Refugees Constituted Strategic Identities in Order to Access School

ERIC Educational Resources Information Center

Uptin, Jonnell; Wright, Jan; Harwood, Valerie

2016-01-01

Educators in resettlement countries are grappling with ways to adequately engage and meet the needs of newly arrived refugee students. In this article we argue that to fully meet the needs of refugee students a deeper understanding of their educational experience as "a refugee" prior to resettlement is vital. In particular we foreground…

The Integration of Refugees into the German Education System: A Stance for Cultural Pluralism and Multicultural Education

ERIC Educational Resources Information Center

Timm, Marco

2016-01-01

This article examines the integration of refugees into the Germany's educational system, focusing on K-12 schooling and Syrian refugees. It criticizes the current approach to integration because the system fails to address the specific needs of refugees and neglects the potential contribution they have to offer in terms of their cultural…

Refugees: Seeking a Safe Haven. Multicultural Issues.

ERIC Educational Resources Information Center

Sawyer, Kem Knapp

Millions of people around the world have lost the freedom to remain in their homes or choose where they want to live. In fact, 1 in every 125 people in this world is a refugee. For many refugees, finding a new home is a long, tedious, and painful process. Many host countries that receive refugees suffer from overpopulation, housing shortages, and…

3 CFR - Unexpected Urgent Refugee and Migration Needs Related to Somalia and Food Pipeline Breaks for...

Code of Federal Regulations, 2011 CFR

2011-01-01

... 3 The President 1 2011-01-01 2011-01-01 false Unexpected Urgent Refugee and Migration Needs... 8, 2010 Unexpected Urgent Refugee and Migration Needs Related to Somalia and Food Pipeline Breaks... section 2(c)(1) of the Migration and Refugee Assistance Act of 1962 (the “Act”), as amended, (22 U.S.C...

76 FR 35719 - Unexpected Urgent Refugee and Migration Needs Related to Libya and C[ocirc]te d'Ivoire

Federal Register 2010, 2011, 2012, 2013, 2014

2011-06-20

... June 8, 2011 Unexpected Urgent Refugee and Migration Needs Related to Libya and C[ocirc]te d'Ivoire... laws of the United States, including section 2(c)(1) of the Migration and Refugee Assistance Act of... amount not to exceed $15 million from the United States Emergency Refugee and Migration Assistance Fund...

Mental health symptoms in Iraqi refugees: posttraumatic stress disorder, anxiety, and depression.

PubMed

Jamil, Hikmet; Farrag, Mohamed; Hakim-Larson, Julie; Kafaji, Talib; Abdulkhaleq, Husam; Hammad, Adnan

2007-01-01

Refugees suffer from a higher rate of mental health symptoms than the general population since they have experienced extreme suffering and the accumulated effects of trauma. Because of the diversity of regions from which refugees originate, there is a need to understand some of the unique experiences that are specific to each sub-groups of immigrants. The purpose of the present study was to explore mental health symptoms in Iraqi refugee clients who immigrated to the United States after the Gulf War of the early 1990's. As part of a larger study, 116 adult Iraqi immigrants to the United States (46 male, 70 females) who were seeking mental health services completed measures of anxiety, depression, and posttraumatic stress disorder. As expected, the majority of refugees reported intense anxiety and depression, and many met the DSM IV criteria for posttraumatic stress disorder. Like refugees from other countries-of-origin, Iraqi refugees are in need of culturally sensitive assessment and mental health treatment. The results are discussed in light of the treatment needs of Iraqi refugee clients, their resilience and motivation for a better life, and the ways that health professionals can assist in optimizing their adjustment.

When lives are put on hold: Lengthy asylum processes decrease employment among refugees.

PubMed

Hainmueller, Jens; Hangartner, Dominik; Lawrence, Duncan

2016-08-01

European governments are struggling with the biggest refugee crisis since World War II, but there exists little evidence regarding how the management of the asylum process affects the subsequent integration of refugees in the host country. We provide new causal evidence about how one central policy parameter, the length of time that refugees wait in limbo for a decision on their asylum claim, affects their subsequent economic integration. Exploiting exogenous variation in wait times and registry panel data covering refugees who applied in Switzerland between 1994 and 2004, we find that one additional year of waiting reduces the subsequent employment rate by 4 to 5 percentage points, a 16 to 23% drop compared to the average rate. This deleterious effect is remarkably stable across different subgroups of refugees stratified by gender, origin, age at arrival, and assigned language region, a pattern consistent with the idea that waiting in limbo dampens refugee employment through psychological discouragement, rather than a skill atrophy mechanism. Overall, our results suggest that marginally reducing the asylum waiting period can help reduce public expenditures and unlock the economic potential of refugees by increasing employment among this vulnerable population.

When lives are put on hold: Lengthy asylum processes decrease employment among refugees

PubMed Central

Hainmueller, Jens; Hangartner, Dominik; Lawrence, Duncan

2016-01-01

European governments are struggling with the biggest refugee crisis since World War II, but there exists little evidence regarding how the management of the asylum process affects the subsequent integration of refugees in the host country. We provide new causal evidence about how one central policy parameter, the length of time that refugees wait in limbo for a decision on their asylum claim, affects their subsequent economic integration. Exploiting exogenous variation in wait times and registry panel data covering refugees who applied in Switzerland between 1994 and 2004, we find that one additional year of waiting reduces the subsequent employment rate by 4 to 5 percentage points, a 16 to 23% drop compared to the average rate. This deleterious effect is remarkably stable across different subgroups of refugees stratified by gender, origin, age at arrival, and assigned language region, a pattern consistent with the idea that waiting in limbo dampens refugee employment through psychological discouragement, rather than a skill atrophy mechanism. Overall, our results suggest that marginally reducing the asylum waiting period can help reduce public expenditures and unlock the economic potential of refugees by increasing employment among this vulnerable population. PMID:27493995

Help-seeking for mental health problems in young refugees: a review of the literature with implications for policy, practice, and research.

PubMed

de Anstiss, Helena; Ziaian, Tahereh; Procter, Nicholas; Warland, Jane; Baghurst, Peter

2009-12-01

The large and diverse bodies of literature on refugee child and adolescent mental health have not been matched by a commensurate interest in help-seeking. Most help-seeking research has centred on Western and, to a lesser extent, non-refugee ethnic minority adult populations. An emerging child and adolescent help-seeking literature consistently reports widespread underutilization of mental health services by children in the general population. Current research and opinion suggest a similar trend for refugee and other ethnic minority children. While service underutilization appears to be an issue for all children, those from refugee backgrounds may be at increased risk of mental health problems and have greater difficulty accessing mental health care. From a policy and practice perspective, the most important explanation for low uptake of services by refugee families concerns an overall failure of Western mental health systems to accommodate the needs of ethnically diverse populations in general and refugees in particular. In order to effectively plan for the mental health needs of refugee children and adolescents, Western host country governments need a clear understanding of help-seeking behaviour.

War, oppression, refugee camps fuel spread of HIV. Migration and HIV.

PubMed

1998-07-03

Evidence from countries such as Rwanda, Bosnia, and Sierra Leone links war and forced migration to the spread of HIV. In complex emergencies such as war, the social cohesion characteristic of stable societies is disrupted and families are dispersed, thereby increasing people's vulnerability. An estimated 30,000-40,000 women were raped during the war in Bosnia. In refugee camps, women may be forced to trade sex for food and protection for themselves and their children. Even when refugees are integrated into receiving communities, they remain vulnerable to sexual exploitation. Medical practitioners in refugee settings tend to emphasize diseases such as diarrhea, malaria, and respiratory illnesses. After a complex emergency, when a minimum range of health services is being re-established, HIV prevention is often considered a secondary issue. The International Federation of the Red Cross has advocated meeting the sexual health needs of refugees during the first 6 weeks of an emergency situation. The Federation provides condoms to refugees in transit and assistance to rape victims. The United Nations High Commission on Refugees ensures that refugee camps provide HIV/AIDS information, access to condoms, screening of donated blood, and observance of universal medical precautions.

Post-traumatic stress disorder among Syrian refugees in Turkey: a cross-sectional study.

PubMed

Alpak, Gokay; Unal, Ahmet; Bulbul, Feridun; Sagaltici, Eser; Bez, Yasin; Altindag, Abdurrahman; Dalkilic, Alican; Savas, Haluk A

2015-03-01

Refugees have had major challenges to meet their health care needs throughout history especially in war zones and natural disaster times. The health care needs of Syrian refugees have been becoming an increasingly important issue. We aimed to examine the prevalence of post-traumatic stress disorder (PTSD) and explore its relation with various socioeconomic variables among Syrian refugees, who sought asylum in Turkey. This cross-sectional study was conducted in a tent city. Sample size calculation yielded 352 and the participants of the study were determined randomly. Experienced and native Arabic speaking, psychiatrist evaluated the participants. The frequency of PTSD was 33.5%. Through the binary logistic regression analysis, we calculated that the probability of having PTSD among Syrian refugees in our sample was 71%, if they had the following features: with female gender; being diagnosed with psychiatric disorder in the past; having a family history of psychiatric disorder; and experiencing 2 or more traumas. The findings of our study suggest that PTSD among Syrian refugees in Turkey might be an important mental health issue in refugee camps especially among female refugees, who were exposed to 2 or more traumatic events and had a personal or family history of psychiatric disorder.

Health advocacy for refugees

PubMed Central

Pottie, Kevin; Hostland, Sara

2007-01-01

PROBLEM BEING ADDRESSED Canadian family physicians serve a patient population that is increasingly diverse, both culturally and linguistically. Family medicine needs to take a leadership role in developing social accountability and cultural sensitivity among physicians. OBJECTIVE OF PROGRAM To train medical students to work with newly arriving refugees, to foster competence in handling cultural issues, to raise awareness of global health, and to engage medical students in work with underserviced populations in primary care. PROGRAM DESCRIPTION The program is composed of an Internet-based training module and a self-assessment quiz focused on global and refugee health, a workshop to increase competence in cultural matters, an experience working with at least 1 refugee family at a shelter for newly arriving refugees, family physician mentorship, and a debriefing workshop at the end of the experience. Students who complete this program are eligible for further electives at a refugee health clinic. CONCLUSION The program has been received enthusiastically by students, refugees, and family physicians. Working with refugees provides a powerful introduction to issues related to global health and competence in cultural matters. The program also provides an opportunity for medical students to work alongside family physicians and nurtures their interest in working with disadvantaged populations. PMID:18000269

Investing in learning and training refugee doctors.

PubMed

Ong, Yong Lock; Trafford, Penny; Paice, Elisabeth; Jackson, Neil

2010-06-01

Medically qualified refugees seek to build a new life and return to clinical medicine. The National Health Service (NHS) in the UK needs to develop a workforce to meet the needs of the communities it serves, and refugee doctors have the potential to contribute to the NHS, using their experience and skills to benefit patients. Fifty-four per cent of refugee doctors in the UK live in London, so in response, the London Deanery (Postgraduate Department of Medical and Dental Education, London University) has undertaken a series of initiatives over the past 8 years assisting refugee doctors back into medical employment. Clinical attachments, supernumerary 6-month posts and general practitioner (GP) training rotations have been offered. The projects, doctors involved, educational provision and outcomes are reported. The obstacles and barriers to returning to substantive posts in medicine are also discussed. Fifty-six per cent of the refugee doctors were known to be working after the schemes, 52 per cent gained substantive posts and 39 per cent entered training grades. Investing in innovative and creative work-based training programmes for refugee doctors is worthwhile, but needs to be adequately resourced if refugee doctors are to bring ultimate benefit to the NHS. © Blackwell Publishing Ltd 2010.

Trapped in Statelessness: Rohingya Refugees in Bangladesh

PubMed Central

Milton, Abul Hasnat; Rahman, Mijanur; Hussain, Sumaira; Jindal, Charulata; Choudhury, Sushmita; Akter, Shahnaz; Ferdousi, Shahana; Mouly, Tafzila Akter; Hall, John; Efird, Jimmy T.

2017-01-01

The Rohingya people are one of the most ill-treated and persecuted refugee groups in the world, having lived in a realm of statelessness for over six generations, and who are still doing so. In recent years, more than 500,000 Rohingyas fled from Myanmar (Burma) to neighboring countries. This article addresses the Rohingya refugee crisis in Bangladesh, with special emphasis on the living conditions of this vulnerable population. We reviewed several documents on Rohingya refugees, visited a registered refugee camp (Teknaf), collected case reports, and conducted a series of meetings with stakeholders in the Cox’s Bazar district of Bangladesh. A total of 33,131 registered Rohingya refugees are living in two registered camps in Cox’s Bazar, and up to 80,000 additional refugees are housed in nearby makeshift camps. Overall, the living conditions of Rohingya refugees inside the overcrowded camps remain dismal. Mental health is poor, proper hygiene conditions are lacking, malnutrition is endemic, and physical/sexual abuse is high. A concerted diplomatic effort involving Bangladesh and Myanmar, and international mediators such as the Organization of Islamic Countries and the United Nations, is urgently required to effectively address this complex situation. PMID:28825673

Cost analysis of measles in refugees arriving at Los Angeles International Airport from Malaysia

PubMed Central

Coleman, Margaret S.; Burke, Heather M.; Welstead, Bethany L.; Mitchell, Tarissa; Taylor, Eboni M.; Shapovalov, Dmitry; Maskery, Brian A.; Joo, Heesoo; Weinberg, Michelle

2017-01-01

ABSTRACT Background On August 24, 2011, 31 US-bound refugees from Kuala Lumpur, Malaysia (KL) arrived in Los Angeles. One of them was diagnosed with measles post-arrival. He exposed others during a flight, and persons in the community while disembarking and seeking medical care. As a result, 9 cases of measles were identified. Methods We estimated costs of response to this outbreak and conducted a comparative cost analysis examining what might have happened had all US-bound refugees been vaccinated before leaving Malaysia. Results State-by-state costs differed and variously included vaccination, hospitalization, medical visits, and contact tracing with costs ranging from $621 to $35,115. The total of domestic and IOM Malaysia reported costs for US-bound refugees were $137,505 [range: $134,531 - $142,777 from a sensitivity analysis]. Had all US-bound refugees been vaccinated while in Malaysia, it would have cost approximately $19,646 and could have prevented 8 measles cases. Conclusion A vaccination program for US-bound refugees, supporting a complete vaccination for US-bound refugees, could improve refugees' health, reduce importations of vaccine-preventable diseases in the United States, and avert measles response activities and costs. PMID:28068211

Refugee health and medical student training.

PubMed

Griswold, Kim S

2003-10-01

Cultural awareness training is an increasingly important priority within medical curricula. This article describes an academic family practice-community partnership focusing on health care needs of refugees that became the model for a medical school selective on cultural sensitivity training. The monthly Refugee Health Night program featured dinner with preceptors and patients, international sessions on special medical needs of refugees, and actual clinical encounters with patients. Students were not expected to become culturally competent experts but, rather, health care providers sensitive to and appreciative of cultural context, experience, and expectations. We worked with students to develop sensitive methods of inquiry about mental health, especially around issues of war and torture. We used problem-based cases to emphasize primary care continuity and the benefit of establishing trust over time. Over 2 years, 50 students and nearly 300 refugees (more than 73 families) participated. Students reported that their interactions with the refugees provided positive learning experiences, including expanded knowledge of diverse cultures and enhanced skills for overcoming communication barriers. Patients of refugee status were able to have emergent health care needs met in a timely fashion. Providing health care for refugee individuals and families presents many challenges as well as extraordinary opportunities for patients and practitioners to learn from one another.

Mortality trends among refugees in Honduras, 1984-1987.

PubMed

Desenclos, J C; Michel, D; Tholly, F; Magdi, I; Pecoul, B; Desve, G

1990-06-01

Mortality data collected from 1984 to 1987 through a routine standardized health information system in the five main refugee populations of Honduras were reviewed. The direct standardized mean annual death rate for all refugees was 5.5 per 1000 population (Honduras population as reference; Honduras mortality rate: 10.1 per 1000). Mortality decreased or remained stable among Salvadoran refugees from 1984 to 1987, but increased among Nicaraguan refugees after 1985. The highest neonatal (56.1 per 1000 livebirths), infant (126.1 per 1000 livebirths) and under-five-year-olds (35.7 per 1000 child less than five years of age) mortality rates were observed in the two Nicaraguan camps. These two camps had the highest rate of newly arriving refugees. Deaths in infants and under-five-year-olds accounted for 42 and 54.1% of all deaths respectively. Of all deaths under five years of age, respiratory infections, diarrhoeal diseases and measles accounted for 21.4%, 22.1% and 4.7%, respectively. Mortality rates, particularly among under-five-year-olds and infants increased when the rate of newly arriving refugees was higher. The importance of adapted health surveillance in refugee settlements is discussed.

Cost analysis of measles in refugees arriving at Los Angeles International Airport from Malaysia.

PubMed

Coleman, Margaret S; Burke, Heather M; Welstead, Bethany L; Mitchell, Tarissa; Taylor, Eboni M; Shapovalov, Dmitry; Maskery, Brian A; Joo, Heesoo; Weinberg, Michelle

2017-05-04

Background On August 24, 2011, 31 US-bound refugees from Kuala Lumpur, Malaysia (KL) arrived in Los Angeles. One of them was diagnosed with measles post-arrival. He exposed others during a flight, and persons in the community while disembarking and seeking medical care. As a result, 9 cases of measles were identified. Methods We estimated costs of response to this outbreak and conducted a comparative cost analysis examining what might have happened had all US-bound refugees been vaccinated before leaving Malaysia. Results State-by-state costs differed and variously included vaccination, hospitalization, medical visits, and contact tracing with costs ranging from $621 to $35,115. The total of domestic and IOM Malaysia reported costs for US-bound refugees were $137,505 [range: $134,531 - $142,777 from a sensitivity analysis]. Had all US-bound refugees been vaccinated while in Malaysia, it would have cost approximately $19,646 and could have prevented 8 measles cases. Conclusion A vaccination program for US-bound refugees, supporting a complete vaccination for US-bound refugees, could improve refugees' health, reduce importations of vaccine-preventable diseases in the United States, and avert measles response activities and costs.

The Effect of Traumatic Experiences and Psychiatric Symptoms on the Life Satisfaction of North Korean Refugees.

PubMed

Choi, Yeonsun; Lim, Sun Young; Jun, Jin Yong; Lee, So Hee; Yoo, So Young; Kim, Soohyun; Gwak, Ah Reum; Kim, Ji-Chul; Lee, Yu Jin; Kim, Seog Ju

2017-01-01

Successful adaptation of refugees to a new society can be hindered by traumatic experiences and psychiatric symptoms. This study aims to examine the relationship between trauma, psychiatric symptoms and life satisfaction of North Korean refugees resettled in South Korea. A total of 211 North Korean refugees living in South Korea completed a series of questionnaires on the history of their previous traumatic experiences, life satisfaction in South Korea, depression, anxiety, somatization and post-traumatic stress disorder (PTSD) symptoms. North Korean refugees who had experienced more traumatic events were less satisfied with their economic status in South Korea. Severe depression, anxiety, somatization or PTSD symptoms negatively correlated with their overall satisfaction in South Korea. In the stepwise regression model including all psychiatric symptoms and the number of traumatic experiences as dependent variables, only anxiety, but not trauma, predicted lower life satisfaction in South Korea. Traumatic experiences of North Korean refugees negatively affected the life satisfaction, especially the economic satisfaction, in South Korea. Since the negative effect of trauma was mainly mediated by psychiatric symptoms, the strategy of relieving psychiatric symptoms of traumatized refugees may help the adaptation of refugees. © 2017 S. Karger AG, Basel.

Emergency Medical Service (EMS) Utilization by Syrian Refugees Residing in Ankara, Turkey.

PubMed

Altıner, Ali Osman; Yeşil, Sıdıka Tekeli

2018-04-01

Introduction Many Syrians have left their country and migrated to other countries since March 2011, due to the civil war. As of March 2016, a total of 2,747,946 Syrian refugees had immigrated to Turkey. Some Syrian refugees have been living in camps, while 2,475,134 have been living in metropolitan areas, such as Ankara. Study Objective This study investigated Emergency Medical Service (EMS) utilization among Syrian refugees residing in Ankara. This study was a descriptive, cross-sectional database analysis using data obtained from the Department of EMS of the Ankara Provincial Health Directorate. Five stations in the Altındağ region of Ankara responded to 42% of all calls from Syrian refugees. Prehospital EMS in Ankara have been used mostly by Syrian refugees younger than 18-years-old. Study findings also suggest that medical staff in regions where Syrian refugees are likely to be treated should be supported and provided with the ability to overcome language barriers and cultural differences. Altıner AO , Tekeli Yeşil S . Emergency Medical Service (EMS) utilization by Syrian refugees residing in Ankara, Turkey. Prehosp Disaster Med. 2018;33(2):160-164.

Dangerous journey: documenting the experience of Tibetan refugees.

PubMed

Dolma, Sonam; Singh, Sonal; Lohfeld, Lynne; Orbinski, James J; Mills, Edward J

2006-11-01

Since the 1950 invasion of Tibet by China, Tibetan refugees have attempted to flee into Nepal over the Himalayan mountains. We documented the experiences of a group of refugees making this journey. We conducted semistructured interviews with 50 recent refugees at the Tibetan Refugee Transit Centre in Kathmandu, Nepal. Participants ranged in age from 8 to 56 years, and 21 were female. The average length of their journey from Tibet to Nepal was 34 days. During their journey, a majority of the refugees encountered authorities or became involved in altercations with Nepali Maoist groups. Most of these interactions resulted in extortion and threats of expulsion. Several Tibetans were tortured, beaten with weapons, threatened with being shot, and robbed. Three women were sexually assaulted at gunpoint. The refugees who took part in this study experienced physical and mental hardships and, often, human rights abuses on their journey to Nepal. International pressure is needed to prevent human rights violations and reduce potential long-term physical and mental health effects associated with this dangerous crossing.

Diabetes and Cardiovascular Disease Risk in Cambodian Refugees.

PubMed

Marshall, Grant N; Schell, Terry L; Wong, Eunice C; Berthold, S Megan; Hambarsoomian, Katrin; Elliott, Marc N; Bardenheier, Barbara H; Gregg, Edward W

2016-02-01

To determine rates of diabetes, hypertension, and hyperlipidemia in Cambodian refugees, and to assess the proportion whose conditions are satisfactorily managed in comparison to the general population. Self-report and laboratory/physical health assessment data obtained from a household probability sample of U.S.-residing Cambodian refugees (N = 331) in 2010-2011 were compared to a probability sample of the adult U.S. population (N = 6,360) from the 2009-2010 National Health and Nutrition Examination Survey. Prevalence of diabetes, hypertension and hyperlipidemia in Cambodian refugees greatly exceeded rates found in the age- and gender-adjusted U.S. Cambodian refugees with diagnosed hypertension or hyperlipidemia were less likely than their counterparts in the general U.S. population to have blood pressure and total cholesterol within recommended levels. Increased attention should be paid to prevention and management of diabetes and cardiovascular disease risk factors in the Cambodian refugee community. Research is needed to determine whether this pattern extends to other refugee groups.

Prevalence of Chronic Disease and Their Risk Factors Among Iranian, Ukrainian, Vietnamese Refugees in California, 2002-2011.

PubMed

Nguyen, Michelle-Linh Thuy; Rehkopf, David H

2016-12-01

Little is known about how the health status of incoming refugees to the United States compares to that of the general population. We used logistic regression to assess whether country of origin is associated with prevalence of hypertension, obesity, type-II diabetes, and tobacco-use among Iranian, Ukrainian and Vietnamese refugees arriving in California from 2002 to 2011 (N = 21,968). We then compared the prevalence among refugees to that of the Californian general population (CGP). Ukrainian origin was positively associated with obesity and negatively with smoking, while the opposite was true for Vietnamese (p < 0.001). Iranian origin was positively associated with type-II diabetes and smoking (p < 0.001). After accounting for age and gender differences, refugees had lower prevalence of obesity and higher prevalence of smoking than CGP. Individually, all refugee groups had lower type-II diabetes prevalence than CGP. Grouping all refugees together can hide distinct health needs associated with country of origin.

Risk Factors for Varicella Susceptibility Among Refugees to Toronto, Canada.

PubMed

Cadieux, Geneviève; Redditt, Vanessa; Graziano, Daniela; Rashid, Meb

2017-02-01

Several outbreaks of varicella have occurred among refugees. We aimed to estimate the prevalence of varicella susceptibility among refugees, and identify risk factors for varicella susceptibility. All refugees rostered at Crossroads Clinic in Toronto, Canada in 2011-2014 were included in our study. Varicella serology was assessed at the initial visit. Refugees' age, sex, education, time since arrival, and climate and population density of birth country were abstracted from the chart. Multivariate logistic regression was used to identify risk factors for varicella susceptibility. 1063 refugees were rostered at Crossroads Clinic during the study; 7.9 % (95 % CI 6.1, 9.7) were susceptible to varicella. Tropical climate (OR 3.20, 95 % CI 1.53, 6.69) and younger age (OR per year of age 0.92, 95 % CI 0.88-0.96) were associated with increased varicella susceptibility. These risk factors for varicella susceptibility should be taken into account to maximize the cost-effectiveness of varicella prevention strategies among refugees.

Syphilis Among U.S.-Bound Refugees, 2009-2013.

PubMed

Nyangoma, E N; Olson, C K; Painter, J A; Posey, D L; Stauffer, W M; Naughton, M; Zhou, W; Kamb, M; Benoit, S R

2017-08-01

U.S. immigration regulations require clinical and serologic screening for syphilis for all U.S.-bound refugees 15 years of age and older. We reviewed syphilis screening results for all U.S.-bound refugees from January 1, 2009 through December 31, 2013. We calculated age-adjusted prevalence by region and nationality and assessed factors associated with syphilis seropositivity using multivariable log binomial regression models. Among 233,446 refugees, we identified 874 syphilis cases (373 cases per 100,000 refugees). The highest overall age-adjusted prevalence rates of syphilis seropositivity were observed among refugees from Africa (1340 cases per 100,000), followed by East Asia and the Pacific (397 cases per 100,000). In most regions, male sex, increasing age, and living in non-refugee camp settings were associated with syphilis seropositivity. Future analysis of test results, stage of infection, and treatment delivery overseas is warranted in order to determine the extent of transmission risk and benefits of the screening program.

Evaluation of Measles-Mumps-Rubella Vaccination Among Newly Arrived Refugees.

PubMed

Lee, Deborah; Weinberg, Michelle; Benoit, Stephen

2017-05-01

To assess US availability and use of measles-mumps-rubella (MMR) vaccination documentation for refugees vaccinated overseas. We selected 1500 refugee records from 14 states from March 2013 through July 2015 to determine whether overseas vaccination records were available at the US postarrival health assessment and integrated into the Advisory Committee on Immunization Practices schedule. We assessed number of doses, dosing interval, and contraindications. Twelve of 14 (85.7%) states provided data on 1118 (74.5%) refugees. Overseas records for 972 (86.9%) refugees were available, most from the Centers for Disease Control and Prevention's Electronic Disease Notification system (66.9%). Most refugees (829; 85.3%) were assessed appropriately for MMR vaccination; 37 (3.8%) should have received MMR vaccine but did not; 106 (10.9%) did not need the MMR vaccine but were vaccinated. Overseas documentation was available at most clinics, and MMR vaccinations typically were given when needed. Further collaboration between refugee health clinics and state immunization information systems would improve accessibility of vaccination documentation.

Our experience with Syrian refugee patients at the child and adolescent psychiatry clinic in Gaziantep, Turkey.

PubMed

Karadag, Mehmet; Gokcen, Cem; Dandil, Funda; Calisgan, Baran

2018-06-01

Reporting from Turkey's frontier with the civil war in Syria, we examined the demographic characteristics, psychiatric diagnoses and treatments for the Syrian refugee patients who have presented to Gaziantep University, Child and Adolescent Psychiatry Clinic through 2016 and the first half of 2017 retrospectively, having aimed to understand the special characteristics and needs of this novel patient group. Within a year and a half, we evaluated 51 children and adolescents and 25 (51%) had come from refugee camps, where primary healthcare services are available. Twenty-eight patients (54.9%) had special educational needs. Among our patients, there were only 15 (29.4%) girls. After our experience with refugee patients, we conclude that the role of primary healthcare services in reaching psychiatric treatment should be investigated for child refugees that special educational needs of Syrian refugees in Turkey needs urgent attention and that more research is needed to establish whether gender may be a factor in negligence of internalising symptoms by refugee families.

Caring for Refugee Youth in the School Setting.

PubMed

Johnson, Jennifer Leigh; Beard, Joyce; Evans, Dena

2017-03-01

Annually, over 80,000 refugees enter the United States as a result of political or religious persecution. Of these, approximately 35% to 40% are children and adolescents. Refugees are faced with challenges associated with living conditions, cultural and social norms, and socioeconomic status due to problems occurring in their homelands. These challenges include but are not limited to malnutrition, communicable disease, questionable immunization status, lack of formal education, sexual abuse, violence, torture, human trafficking, homelessness, poverty, and a lack of access to health care. Moreover, the psychological impact of relocation and the stress of acculturation may perpetuate many of these existing challenges, particularly for refugee youth, with limited or underdeveloped coping skills. School nurses are uniquely poised to support refugee youth in the transition process, improve overall health, and facilitate access to primary health services. The purpose of this article is to provide an overview of the unique refugee experience, examine the key health care needs of the population, and present school nurses with timely and relevant resources to assist in caring for refugee youth.

Intergenerational Trauma in Refugee Families: A Systematic Review

PubMed Central

Sangalang, Cindy C.; Vang, Cindy

2016-01-01

Although a robust literature describes the intergenerational effects of traumatic experiences in various populations, evidence specific to refugee families is scattered and contains wide variations in approaches for examining intergenerational trauma. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, the purpose of this systematic review was to describe the methodologies and findings of peer-reviewed literature regarding intergenerational trauma in refugee families. In doing so we aimed to critically examine how existing literature characterizes refugee trauma, its long-term effects on descendants, and psychosocial processes of transmission in order to provide recommendations for future research. The results highlight populations upon which current evidence is based, conceptualizations of refugee trauma, effects of parental trauma transmission on descendants’ health and well-being, and mechanisms of transmission and underlying meanings attributed to parental trauma in refugee families. Greater methodological rigor and consistency in future evidence-based research is needed to inform supportive systems that promote the health and well-being of refugees and their descendants. PMID:27659490

Explaining opposition to refugee resettlement: The role of NIMBYism and perceived threats

PubMed Central

Ferwerda, Jeremy; Flynn, D.J.; Horiuchi, Yusaku

2017-01-01

One week after President Donald Trump signed a controversial executive order to reduce the influx of refugees to the United States, we conducted a survey experiment to understand American citizens’ attitudes toward refugee resettlement. Specifically, we evaluated whether citizens consider the geographic context of the resettlement program (that is, local versus national) and the degree to which they are swayed by media frames that increasingly associate refugees with terrorist threats. Our findings highlight a collective action problem: Participants are consistently less supportive of resettlement within their own communities than resettlement elsewhere in the country. This pattern holds across all measured demographic, political, and geographic subsamples within our data. Furthermore, our results demonstrate that threatening media frames significantly reduce support for both national and local resettlement. Conversely, media frames rebutting the threat posed by refugees have no significant effect. Finally, the results indicate that participants in refugee-dense counties are less responsive to threatening frames, suggesting that proximity to previously settled refugees may reduce the impact of perceived security threats. PMID:28913425

Explaining opposition to refugee resettlement: The role of NIMBYism and perceived threats.

PubMed

Ferwerda, Jeremy; Flynn, D J; Horiuchi, Yusaku

2017-09-01

One week after President Donald Trump signed a controversial executive order to reduce the influx of refugees to the United States, we conducted a survey experiment to understand American citizens' attitudes toward refugee resettlement. Specifically, we evaluated whether citizens consider the geographic context of the resettlement program (that is, local versus national) and the degree to which they are swayed by media frames that increasingly associate refugees with terrorist threats. Our findings highlight a collective action problem: Participants are consistently less supportive of resettlement within their own communities than resettlement elsewhere in the country. This pattern holds across all measured demographic, political, and geographic subsamples within our data. Furthermore, our results demonstrate that threatening media frames significantly reduce support for both national and local resettlement. Conversely, media frames rebutting the threat posed by refugees have no significant effect. Finally, the results indicate that participants in refugee-dense counties are less responsive to threatening frames, suggesting that proximity to previously settled refugees may reduce the impact of perceived security threats.

3 CFR - Unexpected Urgent Refugee and Migration Needs Related to Gaza

Code of Federal Regulations, 2010 CFR

2010-01-01

... urgent refugee and migration needs, including by contributions to international, governmental, and nongovernmental organizations and payment of administrative expenses of Bureau of Population, Refugees, and...

Ethical and effective ethnographic research methods: a case study with afghan refugees in California.

PubMed

Smith, Valerie J

2009-09-01

SCHOLARLY STUDIES OF REFUGEES and other vulnerable populations carry special ethical concerns. In this invited case study of Afghan refugees in Fremont, California, I provide illustrations and recommendations of ethical research methods with refugees. I also compare and contrast some ethical issues in the U.S. with issues in Thailand. The qualitative, ethnographic methods I report here demonstrate how to conduct culturally sensitive investigations by ethically approaching gatekeepers and other community members to preserve autonomy, ensure confidentiality, build trust, and improve the accuracy of interpretations and results. Six groups at risk for being marginalized in multiple ways within refugee populations are described. Ten best practices are recommended for ethically acquiring an in-depth understanding of the refugees, their community, and appropriate research methods.

Understanding the health beliefs and practices of East African refugees.

PubMed

Simmelink, Jennifer; Lightfoot, Elizabeth; Dube, Amano; Blevins, Jennifer; Lum, Terry

2013-03-01

To explore East African refugees' perceptions, ideas, and beliefs about health and health care, as well as the ways in which health information is shared within their communities. This study consisted of 2 focus groups with a total of 15 participants, including East African community leaders and health professionals. East African refugees in the United States have strong cultural, religious, and traditional health practices that shape their health behavior and influence their interactions with Western health care systems. Health care providers who understand refugees' beliefs about health may achieve more compliance with refugee patients.

78 FR 9569 - Unexpected Urgent Refugee and Migration Needs Relating to Syria

Federal Register 2010, 2011, 2012, 2013, 2014

2013-02-08

... urgent refugee and migration needs, including by contributions to international, governmental, and nongovernmental organizations and payment of administrative expenses of the Bureau of Population, Refugees, and...

U.S. Racial Ideology and Immigrant/Refugee Policy: Effects on Asian-American Identity, Community Formation and Refugee Education Initiatives.

ERIC Educational Resources Information Center

Comeau, Mary T.

Two papers explore racial ideology and policy toward immigrants and refugees in the United States. The first paper, "Race Theory Paradigms and Immigrant/Refugee Identity and Incorporation," asserts that the United States is a race-based society in which newcomers to the country have a racial identity imposed upon them. A review of the…

Educating Culturally Displaced Students with Truncated Formal Education (CDS-TFE): The Case of Refugee Students and Challenges for Administrators, Teachers, and Counselors

ERIC Educational Resources Information Center

Gahungu, Athanase; Gahungu, Olive; Luseno, Florah

2011-01-01

From 2006 to 2008, refugee resettlement agencies brought 4018 refugees to Chicago, Illinois. Using the example of the challenges faced by 14 refugee students from Burundi in adjusting to the U.S. school system, the authors call the attention of schools to the distinction between educating English Language Learners (ELL) and Educating Culturally…

Joint Refugee Information Clearing Office (JRICO)

DTIC Science & Technology

1976-03-02

A. JRICO Documentation 42 B. DA Documentation 62 C. DOD Documentation 75 D. IATF Documentation 83 E. Operating Procedures 103 F. Data...Indochina ( IATF ) and maintain access to the IATF computer data files on refugees, as well as coordinating with OSD, refugee resettlement centers...providing facilities and administrative support as requir- ed and negotiating with IATF for on-line computer access to the refugee records in the

Who Really Wants "The Tired, the Poor, and the Huddled Masses" Anyway?: Teachers' Use of Cultural Scripts with Refugee Students in Public Schools

ERIC Educational Resources Information Center

Roxas, Kevin

2010-01-01

Through an analysis of interviews and observations with three teachers working with refugee students in a Midwestern public high school, this paper identifies the institutional obstacles that teachers face when working with refugee students and the underlying cultural scripts that drive both their discourse about refugees and their actions towards…

The Mental Health and Psychological Well-Being of Refugee Children and Young People: An Exploration of Risk, Resilience and Protective Factors

ERIC Educational Resources Information Center

Mohamed, Shaheen; Thomas, Miles

2017-01-01

This research investigates the perceptions of refugee children, refugee parents and school staff regarding the positive adaptation of refugee children in a new social context and the effects on mental health and psychological well-being. This included an exploration of resilience and the role of risk and protective factors. Few studies have…

Integration of Refugee Children and Their Families in the Swedish Preschool: Strategies, Objectives and Standards

ERIC Educational Resources Information Center

Lunneblad, Johannes

2017-01-01

This article is from a study about the integration of refugee children (aged one to five) and their families in Sweden. Refugee children and parents who have received a residence permit are entitled to be introduced into the Swedish society. One of the first encounters refugee children and families have with Swedish society is with the preschool.…

Restorative Justice Pedagogy in the ESL Classroom: Creating a Caring Environment to Support Refugee Students

ERIC Educational Resources Information Center

Ogilvie, Greg; Fuller, David

2016-01-01

For many years the Canadian government has been committed to resettling refugees. Recently, this commitment has been expanded, as more than 25,000 Syrian refugees have been admitted into Canada. As refugee students struggle to adapt to a new environment, English as a second language (ESL) educators are called upon to play a significant role in the…

Pediatrician-experienced barriers in the medical care for refugee children in the Netherlands.

PubMed

Baauw, A; Rosiek, S; Slattery, B; Chinapaw, M; van Hensbroek, M Boele; van Goudoever, J B; Kist-van Holthe, J

2018-04-20

Pediatricians in the Netherlands have been confronted with high numbers of refugee children in their daily practice. Refugee children have been recognized as an at-risk population because they may have an increased burden of physical and mental health conditions, and their caretakers may experience barriers in gaining access to the Dutch health care system. The aim of the study was to gain insight into the barriers in the health care for refugee children perceived by pediatricians by analyzing logistical problems reported through the Dutch Pediatric Surveillance Unit, an online system where pediatricians can report predefined conditions. Pediatricians reported 68 cases of barriers in health care ranging from mild to severe impact on the health outcome of refugee children, reported from November 2015 till January 2017. Frequent relocation of children between asylum seeker centers was mentioned in 28 of the reports on lack of continuity of care. Unknown medical history (21/68) and poor handoffs of medical records resulting in poor communication between health professionals (17/68) contributed to barriers to provide good medical care for refugee children, as did poor health literacy (17/68) and cultural differences (5/68). Frequent relocations and the unknown medical history were reported most frequently as barriers impacting the delivery of health care to refugee children. To overcome these barriers, the Committee of International Child Health of the Dutch Society of Pediatrics recommends stopping the frequent relocations, improving medical assessment upon entry in the Netherlands, improving handoff of medical records, and improving the health literacy of refugee children and their families. What is Known: • Pediatricians in the Netherlands are confronted with high numbers of refugee children • Refugee children represent a population that is especially at risk due to their increased burden of physical and mental health conditions What is New: • Refugee children experience barriers in accessing medical care • To start overcoming these barriers, we recommend that frequent relocations be stopped, health assessment upon entry in the Netherlands be improved, medical handoffs be improved, and that the refugees be empowered by increasing their health literacy.

Inequity in contraceptive care between refugees and other migrant women?: a retrospective study in Dutch general practice.

PubMed

Raben, Liselotte A D; van den Muijsenbergh, Maria E T C

2018-01-17

Female refugees are at high risk of reproductive health problems including unmet contraceptive needs. In the Netherlands, the general practitioner (GP) is the main entrance to the healthcare system and plays a vital role in the prescription of contraceptives. Little is known about contraceptive care in female refugees in primary care. To get insight into GP care related to contraception in refugees and other migrants compared with native Dutch women. A retrospective descriptive study of patient records of refugees, other migrants and native Dutch women was carried out in five general practices in the Netherlands. The prevalence of discussions about contraception and prescriptions of contraceptives over the past 6 years was compared in women of reproductive age (15-49 years). In total, 104 refugees, 58 other migrants and 162 native Dutch women were included. GPs in our study (2 male, 3 female) discussed contraceptives significantly less often with refugees (51%) and other migrants (66%) than with native Dutch women (84%; P < 0.001 and P = 0.004, respectively). Contraceptives were less often prescribed to refugees (34%) and other migrants (55%) than to native Dutch women (79%; P < 0.001 and P = 0.001). Among refugees from Sub-Saharan Africa, contraception was significantly less often discussed (28.9%) compared with refugees from other regions (67.8%; P < 0.001). More refugees and other migrants had experienced unwanted pregnancies (14% respectively 9%) and induced abortions (12% respectively 7%) than native Dutch women (4% respectively 4%). Contraceptives were significantly less often discussed with and prescribed to refugees and other migrant women compared with native Dutch women. More research is needed to elicit the reproductive health needs and preferences of migrant women regarding GP's care and experiences in discussing these issues. Such insights are vital in order to provide equitable reproductive healthcare to every woman regardless of her background. © The Author(s) 2018. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Comparison of the Nutritional Status of Overseas Refugee Children with Low Income Children in Washington State.

PubMed

Dawson-Hahn, Elizabeth E; Pak-Gorstein, Suzinne; Hoopes, Andrea J; Matheson, Jasmine

2016-01-01

The extent that the dual burden of undernutrition and overnutrition affects refugee children before resettlement in the US is not well described. To describe the prevalence of wasting, stunting, overweight, and obesity among refugee children ages 0-10 years at their overseas medical screening examination prior to resettlement in Washington State (WA), and to compare the nutritional status of refugee children with that of low-income children in WA. We analyzed anthropometric measurements of 1047 refugee children ages 0-10 years old to assess their nutritional status at the overseas medical screening examination prior to resettlement in WA from July 2012--June 2014. The prevalence estimates of the nutritional status categories were compared by country of origin. In addition, the nutritional status of refugee children age 0-5 years old were compared to that of low-income children in WA from the Center for Disease Control and Prevention's Pediatric Nutrition Surveillance System. A total of 982 children were eligible for the study, with the majority (65%) from Somalia, Iraq and Burma. Overall, nearly one-half of all refugee children had at least one form of malnutrition (44.9%). Refugee children ages 0-10 years were affected by wasting (17.3%), stunting (20.1%), overweight (7.6%) and obesity (5.9%). Among children 0-5 years old, refugee children had a significantly higher prevalence of wasting (14.3% versus 1.9%, p<0.001) and stunting (21.3% versus 5.5%, p<0.001), and a lower prevalence of obesity (6.2% versus 12.9%, p<0.001) than low-income children in WA. The dual burden of under- and over-nutrition among incoming refugee children as well as their overall difference in prevalence of nutritional status categories compared to low-income children in WA provides evidence for the importance of tailored interventions to address the nutritional needs of refugee children.

[Recommendations for the diagnosis and prevention of infectious diseases in pediatric and adolescent refugees in Germany : Statement of the German Society of Pediatric Infectious Diseases, the Society of Tropical Pediatrics and International Child Health, and the Professional Association of Pediatricians].

PubMed

Pfeil, J; Kobbe, R; Trapp, S; Kitz, C; Hufnagel, M

2016-05-01

Child and adolescent refugees in Germany represent a particularly vulnerable social group and treating infectious diseases forms a crucial part of providing their medical care. From an infectious diseases perspective, refugees themselves, as a result of their difficult personal circumstances, are the ones at highest risk. Even in crisis situations, medical practitioners are medically and ethically obliged to provide a high standard of care. The guidelines presented here propose recommendations for diagnosing and preventing infectious diseases among refugees under 18 in Germany. The guidelines are intended to assist in optimizing vaccine protection and treatment of diseases while taking into consideration factors such as refugees' challenging living conditions, cultural differences and potential language barriers.Upon refugees' arrival at the first housing sites, it is recommended that a basic clinical screening (and not just a brief visual inspection) be provided in order to identify and initiate treatment for acute medical problems and potentially contagious diseases (including tuberculosis), as well as to close gaps in vaccination coverage. Documentation of the clinical findings is critical, both to avoid redundant investigations and to optimize individual medical care. For this, an effective communication system must be established.Once refugees have been transferred into their destination community, outpatient and inpatient care providers should collaborate to bring refugees up-to-date with all vaccines recommended by STIKO (German Standing Committee on Vaccination). The same high standard of medical care should be delivered to refugees as would be to the general population. Due to the high prevalence of multi-resistant organisms (MRO) in the refugees' countries of origin, MRO screening is recommended for most patients receiving inpatient care.

Refugee children's play: Before and after migration to Australia.

PubMed

MacMillan, Kelli K; Ohan, Jeneva; Cherian, Sarah; Mutch, Raewyn C

2015-08-01

Play is vital to children's development, health and resilience. Play modulates cognitive, emotional and social well-being. Children constitute approximately half of all humanitarian refugee entrants resettled in Australia. Refugee children are commonly victims and witnesses of war and persecution, living across resource-poor environs during transit. Little is known about the effects of refugee migration on play. This study explores how refugee children engaged in play pre-migration (in their home country) and post-migration (Australia). Refugee children attending the Refugee Health Clinic of a tertiary children's hospital were invited to complete a qualitative descriptive study of play. The children were asked to draw how they played pre- and post-migration. Drawings were analysed for (i) the presence of play; (ii) location of play; and (iii) drawing detail. Nineteen refugee children were recruited (mean age 8.5 years ± standard deviation 6.4 months). Significantly fewer children drew play pre- versus post-migration (11/19, 58% vs. 18/19, 95% P < 0.03). Girls had greater comparative changes in play with migration (pre: 2/8, 25% vs. post: 7/8, 87%, P = 0.06), trending to significance. Of those children who drew play, almost all drew playing outside (pre-migration: 10/11, 90.9%; post-migration: 17/18, 94.4%). Drawings showed equivalent detail pre- and post-migration. Resettled refugee children, especially girls, demonstrated limited play pre-migration, with higher levels of engagement post-resettlement. Facilitating opportunities for variety of play may strengthen positive resettlement outcomes for children and parents. Larger longitudinal studies examining play in refugee children and associations with physical, development and psychological well-being are warranted. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Low Estimated Glomerular Filtration Rate Is Prevalent among North Korean Refugees in South Korea

PubMed Central

Song, Young-Soo

2018-01-01

Background The number of North Korean refugees entering South Korea is rising. Few studies have investigated the risk of non-communicable disease in North Korean refugees. Moreover, kidney insufficiency, a risk factor for cardiovascular disease, has not been studied in this population. We compared the prevalence of non-communicable disease and kidney function in North Korean refugees and South Koreans. Methods Our study was conducted using a case-control design. We enrolled 118 North Korean refugees from the Hana Center and selected 472 randomly sampled South Korean individuals as controls, who were age- and sex-matched with the North Korean refugees in a ratio of 1:4, from the 2014 Korea National Health and Nutrition Examination Survey database. Results The prevalence of non-communicable disease did not differ significantly between the groups; however, a low estimated glomerular filtration rate (eGFR; <90 mL/min per 1.73 m2) was more prevalent in the North Korean refugees than in the South Korean population (52.1% vs. 29.9%, P<0.001). After adjusting for covariates and weight gain after escape, the prevalence of a low eGFR was associated with the length of residence in South Korea (odds ratio, 2.84; 95% confidence interval, 1.02–7.89). Conclusion The prevalence of non-communicable disease did not differ between North Korean refugees and the South Korean population, while a low eGFR was more prevalent in North Korean refugees than in South Koreans. Moreover, after adjusting for other covariates, the prevalence of a low eGFR in North Korean refugees was associated with the length of residence in South Korea. PMID:29788704

Impacts of the Interim Federal Health Program reforms: A stakeholder analysis of barriers to health care access and provision for refugees.

PubMed

Antonipillai, Valentina; Baumann, Andrea; Hunter, Andrea; Wahoush, Olive; O'Shea, Timothy

2017-11-09

Changes to the Interim Federal Health Program (IFHP) in 2012 reduced health care access for refugees and refugee claimants, generating concerns among key stakeholders. In 2014, a new IFHP temporarily reinstated access to some health services; however, little is known about these changes, and more information is needed to map the IFHP's impact. This study explores barriers occurring during the time period of the IFHP reforms to health care access and provision for refugees. A stakeholder analysis, using 23 semi-structured interviews, was conducted to obtain insight into stakeholder perceptions of the 2014 reforms, as well as stakeholders' position and their influence to assess the acceptability of the IFHP changes. The majority of stakeholders expressed concerns about the 2014 IFHP changes as a result of the continuing barriers posed by the 2012 retrenchments and the emergence of new barriers to health care access and provision for refugees. Key barriers identified included lack of communication and awareness, lack of continuity and comprehensive care, negative political discourse and increased costs. A few stakeholders supported the reforms as they represented some, but limited, access to health care. Overall, the reforms to the IFHP in 2014 generated barriers to health care access and provision that contributed to confusion among stakeholders, the transfer of refugee health responsibility to provincial authorities and the likelihood of increased health outcome disparities, as refugees and refugee claimants chose to delay seeking health care. The study recommends that policy-makers engage with refugee health stakeholders to formulate a policy that improves health care provision and access for refugee populations.

Low Estimated Glomerular Filtration Rate Is Prevalent among North Korean Refugees in South Korea.

PubMed

Song, Young-Soo; Choi, Seong-Woo

2018-05-01

The number of North Korean refugees entering South Korea is rising. Few studies have investigated the risk of non-communicable disease in North Korean refugees. Moreover, kidney insufficiency, a risk factor for cardiovascular disease, has not been studied in this population. We compared the prevalence of non-communicable disease and kidney function in North Korean refugees and South Koreans. Our study was conducted using a case-control design. We enrolled 118 North Korean refugees from the Hana Center and selected 472 randomly sampled South Korean individuals as controls, who were age- and sex-matched with the North Korean refugees in a ratio of 1:4, from the 2014 Korea National Health and Nutrition Examination Survey database. The prevalence of non-communicable disease did not differ significantly between the groups; however, a low estimated glomerular filtration rate (eGFR; <90 mL/min per 1.73 m 2 ) was more prevalent in the North Korean refugees than in the South Korean population (52.1% vs. 29.9%, P<0.001). After adjusting for covariates and weight gain after escape, the prevalence of a low eGFR was associated with the length of residence in South Korea (odds ratio, 2.84; 95% confidence interval, 1.02-7.89). The prevalence of non-communicable disease did not differ between North Korean refugees and the South Korean population, while a low eGFR was more prevalent in North Korean refugees than in South Koreans. Moreover, after adjusting for other covariates, the prevalence of a low eGFR in North Korean refugees was associated with the length of residence in South Korea.

The antibiotic resistome and microbiota landscape of refugees from Syria, Iraq and Afghanistan in Germany.

PubMed

Häsler, Robert; Kautz, Christian; Rehman, Ateequr; Podschun, Rainer; Gassling, Volker; Brzoska, Pius; Sherlock, Jon; Gräsner, Jan-Thorsten; Hoppenstedt, Gesine; Schubert, Sabine; Ferlinz, Astrid; Lieb, Wolfgang; Laudes, Matthias; Heinsen, Femke-Anouska; Scholz, Jens; Harmsen, Dag; Franke, Andre; Eisend, Swantje; Kunze, Thomas; Fickenscher, Helmut; Ott, Stephan; Rosenstiel, Philip; Schreiber, Stefan

2018-02-20

Multidrug-resistant bacteria represent a substantial global burden for human health, potentially fuelled by migration waves: in 2015, 476,649 refugees applied for asylum in Germany mostly as a result of the Syrian crisis. In Arabic countries, multiresistant bacteria cause significant problems for healthcare systems. Currently, no data exist describing antibiotic resistances in healthy refugees. Here, we assess the microbial landscape and presence of antibiotic resistance genes (ARGs) in refugees and German controls. To achieve this, a systematic study was conducted in 500 consecutive refugees, mainly from Syria, Iraq, and Afghanistan and 100 German controls. Stool samples were subjected to PCR-based quantification of 42 most relevant ARGs, 16S ribosomal RNA gene sequencing-based microbiota analysis, and culture-based validation of multidrug-resistant microorganisms. The fecal microbiota of refugees is substantially different from that of resident Germans. Three categories of resistance profiles were found: (i) ARGs independent of geographic origin of individuals comprising BIL/LAT/CMA, ErmB, and mefE; (ii) vanB with a high prevalence in Germany; and (iii) ARGs showing substantially increased prevalences in refugees comprising CTX-M group 1, SHV, vanC1, OXA-1, and QnrB. The majority of refugees carried five or more ARGs while the majority of German controls carried three or less ARGs, although the observed ARGs occurred independent of signatures of potential pathogens. Our results, for the first time, assess antibiotic resistance genes in refugees and demonstrate a substantially increased prevalence for most resistances compared to German controls. The antibiotic resistome in refugees may thus require particular attention in the healthcare system of host countries.

45 CFR 400.90 - Basis and scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Medical... section 412(e) of the Act for refugee medical assistance (RMA), as defined at § 400.2 of this part. ...

The Relationship Between Post-Migration Stress and Psychological Disorders in Refugees and Asylum Seekers.

PubMed

Li, Susan S Y; Liddell, Belinda J; Nickerson, Angela

2016-09-01

Refugees demonstrate high rates of post-traumatic stress disorder (PTSD) and other psychological disorders. The recent increase in forcible displacement internationally necessitates the understanding of factors associated with refugee mental health. While pre-migration trauma is recognized as a key predictor of mental health outcomes in refugees and asylum seekers, research has increasingly focused on the psychological effects of post-migration stressors in the settlement environment. This article reviews the research evidence linking post-migration factors and mental health outcomes in refugees and asylum seekers. Findings indicate that socioeconomic, social, and interpersonal factors, as well as factors relating to the asylum process and immigration policy affect the psychological functioning of refugees. Limitations of the existing literature and future directions for research are discussed, along with implications for treatment and policy.

Refugees' advice to physicians: how to ask about mental health.

PubMed

Shannon, Patricia J

2014-08-01

About 45.2 million people were displaced from their homes in 2012 due to persecution, political conflict, generalized violence and human rights violations. Refugees who endure violence are at increased risk of developing chronic psychiatric disorders such as posttraumatic stress disorder and major depression. The primary care visit may be the first opportunity to detect the devastating psychological effects of trauma. Physicians and refugees have identified communication barriers that inhibit discussions about mental health. In this study, refugees offer advice to physicians about how to assess the mental health effects of trauma. Ethnocultural methodology informed 13 focus groups with 111 refugees from Burma, Bhutan, Somali and Ethiopia. Refugees responded to questions concerning how physicians should ask about mental health in acceptable ways. Focus groups were recorded, transcribed and analyzed using thematic categorization informed by Spradley's Developmental Research Sequence. Refugees recommended that physicians should take the time to make refugees comfortable, initiate direct conversations about mental health, inquire about the historical context of symptoms and provide psychoeducation about mental health and healing. Physicians may require specialized training to learn how to initiate conversations about mental health and provide direct education and appropriate mental health referrals in a brief medical appointment. To assist with making appropriate referrals, physicians may also benefit from education about evidence-based practices for treating symptoms of refugee trauma. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Assessment of dissociation in Bosnian treatment-seeking refugees in Denmark.

PubMed

Palic, Sabina; Carlsson, Jessica; Armour, Cherie; Elklit, Ask

2015-05-01

Dissociative experiences are common in traumatized individuals, and can sometimes be mistaken for psychosis. It is difficult to identify pathological dissociation in the treatment of traumatized refugees, because there is a lack of systematic clinical descriptions of dissociative phenomena in refugees. Furthermore, we are currently unaware of how dissociation measures perform in this clinical group. To describe the phenomenology of dissociative symptoms in Bosnian treatment-seeking refugees in Denmark. As a part of a larger study, dissociation was assessed systematically in 86 Bosnian treatment-seeking refugees using a semi-structured clinical interview (Structured Interview for Disorders of Extreme Stress-dissociation subscale; SIDES-D) and a self-report scale (Dissociative Experiences Scale; DES). The SIDES-D indicated twice as high prevalence of pathological dissociation as the DES. According to the DES, 30% of the refugees had pathological dissociation 15 years after their resettlement. On the SIDES-D, depersonalization and derealization experiences were the most common. Also, questions about depersonalization and derealization at times elicited reporting of visual and perceptual hallucinations, which were unrelated to traumatic re-experiencing. Questions about personality alteration elicited spontaneous reports of a phenomenon of "split" pre- and post-war identity in the refugee group. Whether this in fact is a dissociative phenomenon, characteristic of severe traumatization in adulthood, needs further examination. Knowledge of dissociative symptoms in traumatized refugees is important in clinical settings to prevent misclassification and to better target psychotherapeutic interventions. Much development in the measurement of dissociation in refugees is needed.

The Securitisation of Refugee Flows and the Schooling of Refugees: Examining the Cases of North Koreans in South Korea and Iraqis in Jordan

ERIC Educational Resources Information Center

Collet, Bruce A.; Bang, Hyeyoung

2016-01-01

Drawing on data collected in South Korea, Jordan and the USA, this paper examines the degree to which security concerns impact the schooling of North Korean refugees in South Korea and Iraqi refugees in Jordan. Operating from a framework examining the intersection of migration and securitisation, the authors find that accounts of negative images…

Posttraumatic stress disorder symptoms in Bosnian refugees 3 1/2 years after resettlement.

PubMed

Vojvoda, Dolores; Weine, Stevan M; McGlashan, Thomas; Becker, Daniel F; Southwick, Steven M

2008-01-01

This study describes the evolution of trauma-related symptoms over 3 1/2 years in a group of Bosnian refugees. Twenty-one refugees received standardized psychological assessments shortly after arriving in the United States and then 1 year and 3 1/2 years later. Of these refugees, 76% met diagnostic criteria for posttraumatic stress disorder (PTSD) at baseline, 33% at 1 year, and 24% at 3 1/2 years. PTSD severity scores in women refugees were higher than scores in men at all three evaluation time points. At the 3 1/2-year evaluation, 44% of women and 8% of men met criteria for PTSD and no correlation was found between PTSD symptom severity and either age or level of trauma exposure. A significant inverse correlation was found between Global Assessment of Functioning (GAF) scores and PTSD severity scores. Refugees who reported better mastery of the English language had significantly higher GAF scores. Although PTSD symptom severity decreased over time, most refugees continued to have at least one or more trauma-related symptoms and 24% still met criteria for PTSD after 3 1/2 years in the United States. Women refugees and those who had not mastered the English language appeared to be more vulnerable to persisting psychological effects of trauma.

The Social Determinants of Refugee Mental Health in the Post-Migration Context: A Critical Review.

PubMed

Hynie, Michaela

2018-05-01

With the global increase in the number of refugees and asylum seekers, mental health professionals have become more aware of the need to understand and respond to the mental health needs of forced migrants. This critical review summarizes the findings of recent systematic reviews and primary research on the impact of post-migration conditions on mental disorders and PTSD among refugees and asylum seekers. Historically, the focus of mental health research and interventions with these populations has been on the impact of pre-migration trauma. Pre-migration trauma does predict mental disorders and PTSD, but the post-migration context can be an equally powerful determinant of mental health. Moreover, post-migration factors may moderate the ability of refugees to recover from pre-migration trauma. The importance of post-migration stressors to refugee mental health suggests the need for therapeutic interventions with psychosocial elements that address the broader conditions of refugee and asylum seekers' lives. However, there are few studies of multimodal interventions with refugees, and even fewer with control conditions that allow for conclusions about their effectiveness. These findings are interpreted using a social determinants of health framework that connects the risk and protective factors in the material and social conditions of refugees' post-migration lives to broader social, economic and political factors.

Enhancing need satisfaction to reduce psychological distress in Syrian refugees.

PubMed

Weinstein, Netta; Khabbaz, Farah; Legate, Nicole

2016-07-01

Becoming a refugee is a potent risk factor for indicators of psychological distress such as depression, generalized stress, and posttraumatic stress disorder (PTSD), though research into this vulnerable population has been scant, with even less work focusing on interventions. The current study applied principles from self-determination theory (SDT; Ryan & Deci, 2000) to develop and test an intervention aimed at increasing need-satisfying experiences in refugees of Syrian civil unrest. Forty-one refugees who fled Syria during the past 24 months and resettled in Jordan participated in the study and were randomly assigned to receive the intervention or a neutral comparison. The 1-week-long intervention alleviated some of the need frustration likely associated with refugee status, a major aim of the intervention, and also lowered refugees' self-reported symptoms of depression and generalized stress as compared to the comparison condition, though it did not reduce symptoms of PTSD. Discussion focuses on how these findings speak to the universal importance of need satisfaction for mental health, and how need-satisfying experiences can help buffer against the profound stress of being a refugee. Avenues for longer-term or more intensive interventions that may target more severe outcomes of refugee experiences, such as PTSD symptoms, are also discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Critical health infrastructure for refugee resettlement in rural Australia: case study of four rural towns.

PubMed

Sypek, Scott; Clugston, Gregory; Phillips, Christine

2008-12-01

To explore the reported impact of regional resettlement of refugees on rural health services, and identify critical health infrastructure for refugee resettlement. Comparative case study, using interviews and situational analysis. Four rural communities in New South Wales, which had been the focus of regional resettlement of refugees since 1999. Refugees, general practitioners, practice managers and volunteer support workers in each town (n = 24). The capacity of health care workers to provide comprehensive care is threatened by low numbers of practitioners, and high levels of turnover of health care staff, which results in attrition of specialised knowledge among health care workers treating refugees. Critical health infrastructure includes general practices with interest and surge capacity, subsidised dental services, mental health support services; clinical support services for rural practitioners; care coordination in the early settlement period; and a supported volunteer network. The need for intensive medical support is greatest in the early resettlement period for 'catch-up' primary health care. The difficulties experienced by rural Australia in securing equitable access to health services are amplified for refugees. While there are economic arguments about resettlement of refugees in regional Australia, the fragility of health services in regional Australia should also be factored into considerations about which towns are best suited to regional resettlement.

The case of a city where 1 in 6 residents is a refugee: ecological factors and host community adaptation in successful resettlement.

PubMed

Smith, R Scott

2008-12-01

The notable success of an upstate New York community in resettling refugees raises the question of whether multiple waves of resettlement over a 15-year period have resulted in greater accommodation to refugees. Structured interviews based on transactional models of acculturation were used along with archival data to explore ecological factors supporting a host community's behavioral flexibility and perseverance in response to the influx of refugees. Evidence suggests that socioeconomic climate, historical background/social norms, and the organizational structure of agencies involved in resettlement moderate successful inclusion of refugees into a host community in a bidirectional process.

Europe's collective failure to address the refugee crisis.

PubMed

Roberts, Bayard; Murphy, Adrianna; McKee, Martin

2016-01-01

The European response to the refugee crisis has been lamentable. A preoccupation with numbers has, too often, ignored how each refugee is an individual, many of whom have experienced the most appalling conditions in their countries of origin and in transit. These stories are only rarely heard, when the cameras are there to capture the tragedies. In this commentary we review the challenges of responding to the health needs of refugees, including examples of best practice, but above all call for a concerted political response that will both reduce the pressure on refugees to flee conflict-afflicted countries and recognize their contribution if they do come to Europe.

Review of Refugee Mental Health Interventions Following Resettlement: Best Practices and Recommendations

PubMed Central

Murray, Kate E; Davidson, Graham R; Schweitzer, Robert D

2013-01-01

There are increasing numbers of refugees worldwide, with approximately 16 million refugees in 2007 and over 2.5 million refugees resettled in the United States since the start of its humanitarian program. Psychologists and other health professionals who deliver mental health services for individuals from refugee backgrounds need to have confidence that the therapeutic interventions they employ are appropriate and effective for the clients with whom they work. The current review briefly surveys refugee research, examines empirical evaluations of therapeutic interventions in resettlement contexts, and provides recommendations for best practices and future directions in resettlement countries. The resettlement interventions found to be most effective typically target culturally homogeneous client samples and demonstrate moderate to large outcome effects on aspects of traumatic stress and anxiety reduction. Further evaluations of the array of psychotherapeutic, psychosocial, pharmacological, and other therapeutic approaches, including psycho-educational and community-based interventions that facilitate personal and community growth and change, are encouraged. There is a need for increased awareness, training and funding to implement longitudinal interventions that work collaboratively with clients from refugee backgrounds through the stages of resettlement. PMID:20950298

Review of refugee mental health interventions following resettlement: best practices and recommendations.

PubMed

Murray, Kate E; Davidson, Graham R; Schweitzer, Robert D

2010-10-01

There are increasing numbers of refugees worldwide, with approximately 16 million refugees in 2007 and over 2.5 million refugees resettled in the United States since the start of its humanitarian program. Psychologists and other health professionals who deliver mental health services for individuals from refugee backgrounds need to have confidence that the therapeutic interventions they employ are appropriate and effective for the clients with whom they work. The current review briefly surveys refugee research, examines empirical evaluations of therapeutic interventions in resettlement contexts, and provides recommendations for best practices and future directions in resettlement countries. The resettlement interventions found to be most effective typically target culturally homogeneous client samples and demonstrate moderate to large outcome effects on aspects of traumatic stress and anxiety reduction. Further evaluations of the array of psychotherapeutic, psychosocial, pharmacological, and other therapeutic approaches, including psychoeducational and community-based interventions that facilitate personal and community growth and change, are encouraged. There is a need for increased awareness, training and funding to implement longitudinal interventions that work collaboratively with clients from refugee backgrounds through the stages of resettlement. © 2010 American Orthopsychiatric Association.

Malnourished children in refugee camps and lack of connection with services after US resettlement.

PubMed

Lutfy, Caitlyn; Cookson, Susan T; Talley, Leisel; Rochat, Roger

2014-10-01

Identifying and addressing malnutrition among US-bound refugee children is an important human rights issue. Failure to address childhood malnutrition can impair cognitive development and productivity. The target population was children aged 6-59 months, originating from eight countries representing 51 % of US-resettled refugees for 2005-2011, living in 22 camps prior to potential US-resettlement. The corresponding camp-level nutritional survey data were evaluated. State Refugee Health Coordinators were surveyed on nutritional assessment, reporting and referrals for their US-refugee medical screenings. From 2004 to 2010, half of the camps (63 total surveys) had global acute malnutrition prevalence over 15 % at least once (surveys not done annually) and anemia prevalence greater than 40 %. The majority of US-refugee medical screenings included height and weight measurements but few used national or WHO standards to evaluate presence or level of malnutrition. Improve overseas camp monitoring and link these nutritional data to US-resettling refugee children to inform potential nutritional interventions. Domestically, use WHO or US growth standards for anthropometrics to determine presence of malnutrition and need for corrective action.

[The health situation and health care needs of unaccompanied minor refugees - an approximation based on qualitative and quantitative studies from Bielefeld, Germany].

PubMed

Spallek, Jacob; Tempes, Jana; Ricksgers, Hannah; Marquardt, Louisa; Prüfer-Krämer, Luise; Krämer, Alexander

2016-05-01

Unaccompanied minor refugees are children or adolescents below the age of 18 years who are not accompanied by their parents. International studies show that unaccompanied minor refugees represent a special risk group. Currently, empirical study results about the health status of unaccompanied minor refugees barely exist for Germany. Therefore, the goal of this article is an assessment of the health status and health care of unaccompanied minor refugees in Bielefeld, Germany. For this purpose, two qualitative studies and one quantitative study from Bielefeld are used.Results demonstrate that the health care of unaccompanied minor refugees underlies certain peculiarities that indicate major medical needs: Firstly, the need for psychological/psychiatric care and secondly the need for health care regarding infectious diseases. Further challenges in the health care needs of this population group result from its specific situation, and comprise legal conditions, as well as language and cultural competencies on behalf of the health care providers and the unaccompanied minor refugees themselves.

Psycho-social Correlates of Condom Use and HIV Testing among MSM Refugees in Beirut, Lebanon.

PubMed

Tohme, Johnny; Egan, James E; Friedman, Mackey R; Stall, Ron

2016-12-01

MSM refugees have to deal with personal challenges and social/structural adversaries based on their refugee status on top of their sexual identity. To better customize interventions beside this population, we explored psycho-social and structural correlates of condom use and HIV testing in Lebanon by surveying and testing 150 participants. 67 % self-identified as gay. 84.6 % reported any unprotected anal intercourse (UAI) with men in the prior 3 months. Those who engaged in UAI, were lest comfortable with a doctor, didn't know where to get free HIV testing, experienced discrimination based on their refugee status and spent more time with their refugee peers, were less inclined to have seen a doctor in the past 12 month or knew where to get free HIV testing. Ever having been HIV tested was associated with being comfortable with medical doctors, knowing where to get HIV testing and spending time with other peer refugees. HIV prevention and testing promotion efforts targeting MSM refugees need to account for structural barriers, while fighting discrimination is crucial for a healthy sexual identity development.

45 CFR 400.7 - Submittal of the State plan and plan amendments for Governor's review.

Code of Federal Regulations, 2010 CFR

2010-10-01

... OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Grants to States for Refugee Resettlement The State Plan § 400.7...

Refugee Status Required for Resettlement in the United States

DTIC Science & Technology

2017-06-09

predominant topic in the United States (US) today . There are more refugees in need of humanitarian assistance than at any other time in history. The US...the criteria from the Cuban- Haitian migration that is applicable or no longer applicable today , with criteria applicable today for the approval of...status today . US refugee laws mandate the procedures for Customs and Immigrations on the criteria for refugee status and entry into the US

FACTORS ASSOCIATED WITH HEALTHCARE UTILIZATION AMONG ARAB IMMIGRANTS AND REFUGEES

PubMed Central

2015-01-01

Background Arab migrants are exposed to pre- and post migration stressors that increase their risk for health problems. However, little is known regarding healthcare utilization rates or factors associated with healthcare utilization among Arab immigrants and refugees. Methods 590 participants were interviewed 1 year post-migration to the United States Factors associated with healthcare utilization including stress coping mechanisms were examined using binary logistic regressions. Results Compared to national healthcare utilization data, immigrants had significantly lower and refugees had significantly higher rates. Being a refugee, married, and having health insurance were significantly associated with medical service utilization. None of the immigrants in this study had utilized psychological services. Among refugees, the use of medications and having strategies for dealing with stress were inversely associated with utilization of psychological services. Discussion (Conclusion) Healthcare utilization was significantly higher among refugees, who also reported a greater need for services than immigrants. PMID:25331684

Health care utilization of refugee children after resettlement.

PubMed

Watts, Delma-Jean; Friedman, Jennifer F; Vivier, Patrick M; Tompkins, Christine E A; Alario, Anthony J

2012-08-01

Refugee children can have significant health problems. Our objective was to describe health status and health care utilization of refugee children after resettlement. A retrospective chart review of refugee children was performed. Initial laboratory data was extracted. Primary care visits, emergency room visits, and subspecialty referrals in the first 15 months from arrival were recorded. The sample included 198 refugees, many with positive initial screening tests. After arrival, 21% had an emergency department visit, 40% had a primary care sick visit, and 71% had a primary care follow-up. Mean number of visits ranged from 0.3 for emergency department to 1.9 for follow-up. Fifty-seven percent were referred to at least one subspecialist. Refugee children had substantial disease burden at arrival. Most had primary care follow-up visits and subspecialty referral after resettlement. These visits were largely for problems identified on initial screening and for general pediatric illnesses.

Determinants of Employment among Well-Educated Refugees before and After the 2007 U.S. Economic Recession

PubMed Central

Jamil, Hikmet J.; Fakhoury, Monty; Yamin, Jolin B.; Arnetz, Judith E.; Arnetz, Bengt B.

2016-01-01

Little is known about how the overall employment conditions in a country impact the likelihood of employment of newly arrived refugees. In the current study, we compare employment and determinant of employment of highly educated Middle Eastern refugees to Michigan that arrived before and after the 2007 recession. We also look at self-reported barriers to employment. Results show that the general downturn of the economy made it substantially more difficult to secure employment, even for well-educated refugees. Thus, before the economic downturn, 22.9 % of refugees were unemployed as compared to 55.1 % once the recession had set in (p < 0.01). There were also substantially more self-reported barriers to employment after the economic downturn. The study points to the importance of understanding both individual characteristics and the general employment conditions in the new host country when studying variation in refugee employment success. PMID:27990500

Visual Health and Visual Healthcare Access in Refugees and Displaced Persons: A Systematic Review.

PubMed

Bal, Sila; Duckles, Anne; Buttenheim, Alison

2018-06-02

Vision impairment is a significant global health concern. Still, there remains a gap in our knowledge of visual health in refugees. We conducted a systematic review of the distinctive eye care needs of refugees. We screened PubMed, EMBASE, and Web of Science through February 17, 2017 for studies that focused primarily on visual health in refugees. Risk of bias was assessed using the National Heart, Lung, and Blood Institute quality assessment tools. 26 studies were included in the final review. The prevalence of blindness ranged from 1.3 to 26.2%. Trachoma was the leading infectious cause. Only four studies assessed vision-related care. Time/location of displacement, social unrest, and sanitation impacted severity of eye disease. Refugees have unique eye care needs. Public health interventions should target eye care at every stage of displacement. Providers may use these results to inform future research and improve visual healthcare access in refugee groups.

The Impact of Acculturation Style and Acculturative Hassles on the Mental Health of Somali Adolescent Refugees.

PubMed

Lincoln, Alisa K; Lazarevic, Vanja; White, Matthew T; Ellis, B Heidi

2016-08-01

Refugee adolescents often immigrate to a new society because of experiences of persecution and trauma, which can have profound effects on their mental health. Once they immigrate, many refugees experience stressors related to resettlement and acculturation in the new society. The current study examined relationships among acculturation styles and hassles and the well-being of young refugees as well as the role of gender. Data were collected from 135 young refugees (M age = 15.39, SD = 2.2; 62 % male) from Somalia resettled in the United States The findings from our study indicate that in addition to trauma history, acculturative hassles and acculturation style impact the wellbeing of Somali refugee adolescents. These findings indicate the need to understand both past experiences as well as current challenges. Potential areas for intervention are discussed.

Forced Migration: Refugee Populations

PubMed Central

Boyle, Joyceen S.

2015-01-01

Undocumented migration is a global phenomenon that manifests in various contexts. This article describes the impact of the movement of large numbers of people in several African countries, producing a unique type of migrant—the refugee. We describe issues that refugee movements create on fragile health care systems, situations that precipitate refugee movements, certain human rights violations that are of particular concern such as gender based violence (GBV) and child soldiers, and lastly, implications for nursing practice and policy. We use examples from several countries in Sub-Saharan Africa, including the Democratic Republic of the Congo, Rwanda, Liberia, Sierra Leone, and Mozambique. Drawing on key documents from the United Nations High Commissioner for Refugees, current literature, as well as the international experience of the authors, this article presents an overview of forced migration and discusses opportunities for nurses to impact research, practice and policy related to refugee health. PMID:25645484

Mental Health Effects of Premigration Trauma and Postmigration Discrimination on Refugee Youth in Canada.

PubMed

Beiser, Morton; Hou, Feng

2016-06-01

This report examines the role of pre- and post-migration trauma in explaining differences in refugee and immigrant mental health. Data were derived from mother-youth refugee and immigrant dyads from six countries of origin who were living in Canada at the time of the study. Youth reports of emotional problems (EP) and aggressive behavior (AB) were the mental health outcomes. EP and AB were regressed on predictor blocks: a) status (refugee versus immigrant), visible minority, and gender; b) premigration trauma and postmigration discrimination; c) parent and youth human and social capital; d) poverty, neighborhood, and schools. Refugees suffered higher levels of EP and AB, premigration traumas, and discrimination. Postmigration perception of discrimination predicted both EP and AB and explained immigrant versus refugee differences in EP. Antirefugee discrimination net of discrimination based on immigrant or visible minority status has deleterious mental health consequences.

Social Disconnection as a Risk Factor for Health among Cambodian Refugees and Their Offspring in the United States.

PubMed

Berthold, S Megan; Loomis, Alysse Melville; Kuoch, Theanvy; Scully, Mary; Hin-McCormick, Mui Mui; Casavant, Bryce; Buckley, Thomas

2018-05-23

Studies of relatively recently resettled refugees have noted social disconnection, linked to various physical and mental health outcomes, as a concern. Limited studies have examined whether social disconnection and its effects persists within refugee populations resettled more than 3 decades prior. The relationship between social disconnection and self-reported health was explored in a secondary analysis of a cross-sectional needs assessment survey with a snowball sample of 100 Cambodian refugees residing in Connecticut. Social disconnectedness and comorbid health conditions were prevalent. Lack of religious and community engagement were associated with poor health outcomes, while individuals with a lack of ethnic engagement reported better overall health. This study underscores the importance of understanding the specific risks that social disconnection poses to refugees who have resettled many years before and their offspring that may assist in better serving currently settling refugees within the United States.

A Typology of Secondary Stressors Among Refugees of Conflict in the Middle East: The Case of Syrian Refugees in Jordan.

PubMed

Alfadhli, Khalifah; Drury, John

2018-05-10

As the years of displacement accumulate, the burden of secondary stressors (i.e., stressors not directly related to war) increase on the shoulders of millions of refugees, who do not have the option of either returning home due to war or having a sustainable livelihood in the host countries. This paper aims to shed light on the overlooked importance of secondary stressors among refugees of conflict in developing countries; it will do this by highlighting the experience of Syrian refugees in Jordan, and developing a typology of these stressors. We approached this issue using two levels of exploration. In study 1, we used participant observation and 15 in-depth interviews in Irbid, Jordan. Data were analysed qualitatively using thematic analysis to explore the different types of stressors. In study 2, a questionnaire survey among Syrian refugees in Jordan (n = 305) was used to collect data about a wide range of stressors. Responses were subjected to factor analysis to examine the extent to which the stressors could be organized into different factors. The thematic analysis suggested three different types of secondary stressors: financial (money related), environmental (exile structures and feelings created by it), and social (directly related to social relations). The factor analysis of the survey data produced a similar typology, where secondary stressors were found to be grouped into four main factors (financial, services, safety, and relations with out-groups). The final result is a typology of 33 secondary stressors organised in three main themes. Syrian refugees in Jordan suffer the most from financial stressors, due to loss of income and high living expenses. Environmental stressors arise from exile and are either circumstantial (e.g., services and legal requirements) or created by this environment (e.g., instability and lack of familiarity). Social stressors were observed among a considerable section of refugees, varying from stressors due to being targeted as a refugee by the locals (e.g., discrimination) to more traumatic stressors that came from both locals and other refugees (e.g., assault). The typology of secondary stressors suggested by the present analysis needs to be investigated in a larger sample of refugees of conflict in other countries in the Middle East, in order to determine its generality. We suggest that it is a basis for a framework for practitioners and academics working with refugees in the region. Armed conflict, Syrian, Jordan, refugees, forced displacement, exile, daily stressors, secondary stressors, trauma, typology.

Effects of acculturative stress on PTSD, depressive, and anxiety symptoms among refugees resettled in Australia and Austria.

PubMed

Kartal, Dzenana; Kiropoulos, Litza

2016-01-01

Research indicates that exposure to war-related traumatic events impacts on the mental health of refugees and leads to higher rates of posttraumatic stress disorder (PTSD), depression, and anxiety symptoms. Furthermore, stress associated with the migration process has also been shown to impact negatively on refugees' mental health, but the extent of these experiences is highly debatable as the relationships between traumatic events, migration, and mental health outcomes are complex and poorly understood. This study aimed to examine the influence of trauma-related and post-migratory factors on symptoms of PTSD, depression, and anxiety in two samples of Bosnian refugees that have resettled in two different host nations-Austria and Australia. Using multiple recruitment methods, 138 participants were recruited to complete self-report measures assessing acculturative stress, PTSD, depressive, and anxiety symptoms. Hierarchical regressions indicated that after controlling for age, sex, and exposure to traumatic events, acculturative stress associated with post-migratory experiences predicted severity of PTSD and anxiety symptoms, while depressive symptoms were only predicted by exposure to traumatic events. This model, however, was only significant for Bosnian refugees resettled in Austria, as PTSD, depressive, and anxiety symptoms were only predicted by traumatic exposure in the Bosnian refugees resettled in Australia. These findings point toward the importance of assessing both psychological and social stressors when assessing mental health of refugees. Furthermore, these results draw attention to the influence of the host society on post-migratory adaptation and mental health of refugees. Further research is needed to replicate these findings among other refugee samples in other host nations.

Health problems of newly arrived migrants and refugees in Europe.

PubMed

Pavli, Androula; Maltezou, Helena

2017-07-01

The number of migrants and refugees in Europe in the past few years has increased dramatically due to war, violence or prosecutions in their homeland. Migration may affect physical, mental and social health. The objective of this article is to assess migrants and refugees' health problems, and to recommend appropriate interventions. A PubMed search of published articles on health problems of newly arrived migrants and refugees was conducted from 2003 through 2016, focusing on the current refugee crisis in Europe. In addition to communicable diseases, such as respiratory, gastrointestinal and dermatologic infections, non-communicable diseases, including chronic conditions, mental and social problems, account for a significant morbidity burden in newly arrived migrants and refugees. Vaccine-preventable diseases are also of outmost importance. The appropriate management of newly arrived refugees and migrants' health problems is affected by barriers to access to health care including legal, communication, cultural and bureaucratic difficulties. There is diversity and lack of integration regarding health care provision across Europe due to policy differences between health care systems and social services. There is a notable burden of communicable and non-communicable diseases among newly arrived migrants and refugees. Provision of health care at reception and temporary centres should be integrated and provided by a multidisciplinary team Appropriate health care of migrants and refugees could greatly enhance their health and social status which will benefit also the host countries at large. © International Society of Travel Medicine, 2017. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com

Higher education for refugees: Lessons from a 4-year pilot project

NASA Astrophysics Data System (ADS)

Crea, Thomas M.; McFarland, Mary

2015-04-01

Refugees experience limited access to adequate education at all levels, but opportunities for higher education are especially lacking. Yet, evidence suggests that education plays an important protective role in helping refugee individuals and communities cope with their daily existence during protracted waiting periods, and the United Nations refugee agency (UNHCR) recently recognised tertiary education as a basic human right. The purpose of this paper is to present findings from the evaluation of a pilot programme, Jesuit Commons: Higher Education at the Margins (JC:HEM), which initially provided higher education to refugees in Kakuma Camp, Kenya and Dzaleka Camp, Malawi; and to urban refugees in Amman, Jordan. The authors of this note review the progress made towards the pilot objectives, as well as student feedback on the benefits and challenges of higher education for refugees and others living at the margins. The refugees interviewed in this study expressed feelings of empowerment, related to their expanded worldview as well as to a specific set of skills obtained through their participation in the programme. Interviewees also noted a number of limitations specific to the context of their living conditions. Particularly in refugee camps, students expressed concerns about what would happen after their having completed their course. The general outcome of the pilot phase, which ended in 2014, was that the programme addresses a critical need and that it should be continued, albeit with key modifications in its design and delivery. Key areas for future growth of the programme include curriculum transformation, integrated service delivery and university engagement.

Kidney transplantation: is there any place for refugees?

PubMed

Einollahi, B; Noorbala, M H; Kardavani, B; Moghani-Lankarani, M; Assari, S; Simforosh, N; Bagheri, N

2007-05-01

There are more than 8 million refugees worldwide with the Middle East bearing the brunt. Socioeconomic factors are the major obstacles that refugees encounter when seeking health care in the host country. It, therefore, comes as no surprise that refugees are denied equal opportunities for one of the most sophisticated and expensive medical procedures in the world, kidney transplantation. With respect to transplantation, refugees are caught between a rock and a hard place: as recipients they have to single-handedly clear many hurdles on the arduous road to renal transplantation and as donors they are left unprotected against human organ trafficking. It should be the moral responsibility of the host country to provide this population with a support network. The ways and means of establishing this network should be defined locally; nevertheless, enabling refugees to receive a transplant is the most basic step, which should be followed by the provision of financial support and follow-up facilities in a concerted effort to ensure the continued function of the invaluable graft. It is also necessary that refugees be protected from being an organ reservoir on the black market. There are no precise regional or international data available on kidney transplantation in refugees; among the Middle East Society for Organ Transplantation countries, only Iran, Saudi Arabia, Pakistan, and Turkey have thus far provided data on their respective kidney transplantation regulations and models. Other countries in the region should follow suit and design models tailored to the local needs and conditions. What could, indubitably, be of enormous benefit in the long term is the establishment of an international committee on transplantation in refugees.

Comparing Trauma Exposure, Mental Health Needs, and Service Utilization Across Clinical Samples of Refugee, Immigrant, and U.S.-Origin Children.

PubMed

Betancourt, Theresa S; Newnham, Elizabeth A; Birman, Dina; Lee, Robert; Ellis, B Heidi; Layne, Christopher M

2017-06-01

Most mental health services for trauma-exposed children and adolescents were not originally developed for refugees. Information is needed to help clinicians design services to address the consequences of trauma in refugee populations. We compared trauma exposure, psychological distress, and mental health service utilization among children and adolescents of refugee-origin, immigrant-origin, and U.S.-origin referred for assessment and treatment by U.S. providers in the National Child Traumatic Stress Network (NCTSN). We used propensity score matching to compare trauma profiles, mental health needs, and service use across three groups. Our sample comprised refugee-origin youth (n = 60, 48.3% female, mean age = 13.07 years) and propensity-matched samples of immigrant-origin youth (n = 143, 60.8% female, mean age = 13.26 years), and U.S.-origin youth (n = 140, 56.1% female, mean age = 12.11 years). On average, there were significantly more types of trauma exposure among refugee youth than either U.S.-origin youth (p < .001) or immigrant youth (p ≤ .001). Compared with U.S.-origin youth, refugee youth had higher rates of community violence exposure, dissociative symptoms, traumatic grief, somatization, and phobic disorder.  In contrast, the refugee group had comparably lower rates of substance abuse and oppositional defiant disorder (ps ranging from .030 to < .001).This clinic-referred sample of refugee-origin youth presented with distinct patterns of trauma exposure, distress symptoms, and service needs that merit consideration in services planning. Copyright © 2017 International Society for Traumatic Stress Studies.

Do Syrian refugees have increased risk for worser pregnancy outcomes? Results of a tertiary center in İstanbul.

PubMed

Güngör, Emre Sinan; Seval, Olcay; İlhan, Gülşah; Verit, Fatma Ferda

2018-03-01

To compare obstetric and perinatal outcomes of Syrian refugee pregnants and Turkish counterparts who gave birth at a tertiary center in İstanbul. A retrospective study including the birth records of 704 Syrian refugees and 744 Turkish pregnant women between January 2016 and May 2017 were analyzed. Demographic data, obstetric and neonatal outcomes were compared. The primary aims of this study were to evaluate the pregnancy outcomes and cesarean rates between the groups. The secondary outcomes were the use of antenatal vitamin supplementation, hemoglobin-hematocrit values, and maternal complications. Our results showed that the use of folic acid and iron supplementation rates during pregnancy were similar between the groups (folic acid supplementation 8.1% vs 6.5%, p=0.264; iron supplementation 20.7% vs 19.6%, p=0.125; respectively for Turkish women and Syrian refugees). Cesarean rates were significantly higher for Turkish patients than in Syrian refugees (42.7% vs 32.7%; p<0.05). Gestational age at delivery was significantly higher among Turkish women when compared with Syrian refugees (37.7±2.3 vs 36.4±2.3 weeks, p<0.05), but there was no significant difference regarding the birtweights' of the newborns (3134 g vs 3066 g for Turkish women and Syrian refugees, respectively, p=0.105). Although obstetric complications were seen more often in Syrian refugees, it did not reach statistical difference (9.7% vs 8.1%, respectively, p=0.285). Syrian refugees use antenatal vitamin supplementations at similar rates to Turkish citizens and obstetric and perinatal outcomes are similar between the groups.

Community Structure and Vietnamese Refugee Adaptation: The Significance of Context.

ERIC Educational Resources Information Center

Starr, Paul D.; Roberts, Alden E.

1982-01-01

Describes research investigating the effects of community structure on the adjustment of Vietnamese refugees in America. Emphasizes how congruence between individual characteristics and characteristics of the receiving community determine successful refugee adaptation to a new environment. (MJL)

45 CFR 400.40 - Scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Immigration Status and Identification of Refugees § 400.40 Scope. This subpart sets forth requirements concerning the immigration status...

78 FR 51736 - Notice of FY 2013 Refugee Targeted Assistance Formula Awards to States and Wilson/Fish...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-08-21

...The Office of Refugee Resettlement (ORR), Administration for Children and Families (ACF), announces the allocation of Refugee Targeted Assistance formula awards to States and Wilson/Fish Alternative Project grantees.

76 FR 19176 - Notice of Public Meeting on FY 2012 Refugee Admissions Program

Federal Register 2010, 2011, 2012, 2013, 2014

2011-04-06

... attend this meeting must notify the Bureau of Population, Refugees, and Migration at telephone (202) 453... Secretary, Bureau of Population, Refugees, and Migration, Department of State. [FR Doc. 2011-8174 Filed 4-5...

Muslim refugees in Southeast Asia, the Malaysian response.

PubMed

Dorall, R F

1988-01-01

This article surveys the arrivals of Muslim refugees from countries in Southeast Asia who have not only come to Malaysia for political refuge, but who have also stayed on, in many instances integrating into the local Muslim community. The author concludes that Burmese, Thai, and Filipino Muslim refugee-cum-migrants, and the estimated 500,000 illegal Indonesian migrant workers in East and Peninsular Malaysia make the presence of economic migrants in Malaysia's towns and rural sectors a far more pressing concern to Malaysians than that posed by the arrival of genuine political refugees. Only the Indonesians present in Malaysia are consistently termed by all parties as illegal migrants and some of them have been subjected to well-publicized deportation by the Malaysian immigration authorities. Sympathy for fellow-Muslims in distress explains Malaysia's open-door policy to Muslim refugees. The Koran specifically enjoins Muslims to assist Muslim refugees who have been persecuted by others. However, the necessity to maintain regional political and military alliances, principally as a bulwark against Communism, and the Malay--Non-Malay, Muslim--Non-Muslim dichotomy in Malaysia which almost evenly divides Malaysia's 16 million population into mutually antagonistic halves, results in any overt public policy in favor of Malays and Muslims to be immediately denounced by the other half of the population as a move against the Non-Malays and Non-Muslims. Without political and media attention, the refugees live wherever they can find work, as do hundreds of thousands of mainly Indonesian illegal migrant workers. They surreptitiously get their children admitted to public schools, and through bribery, can even get Malaysian identification papers. Malaysia is a relatively tranquil haven for Malaysia's Muslim refugees compared to their homelands, but their continued stay remains dependent on the ever-present struggle for more equitable sharing of political and economic power between the different ethnic groups in Malaysia. At present, it is deemed inopportune to discuss publicly the issue of Muslim refugees in Malaysia. To do so would be to invite strong emotional responses from Malaysian Muslim groups objecting to refugee repatriation to what they see as continued persecution in Southeast Asia's non-Muslim countries, and from non-Muslim Malaysians who see in their continued presence a possible long-term demographic threat. Furthermore, the presence of Muslim evacuees granted refugee status brings painful memories as to why non-Muslim refugees principally from Indochina were denied such a similar privilege.

Working with refugees--a manual for caseworkers and volunteers.

PubMed

Duncan, Geraldine; Shepherd, Madeleine; Symons, Jessica

2010-01-01

The Australian Government encourages the regional settlement of refugees and it is expected that 45% of refugees to Australia be regionally located. Wagga Wagga, an inland regional city in New South Wales (NSW), a destination for both primary and secondary migration, offers settlement for refugees under the Australian Integrated Humanitarian Settlement Strategy (IHSS) and the Settlement Grants Program. Refugees currently represent 1% of Wagga Wagga's 60 000 population. For people previously living in cities or crowded camps with a background of disruption, torture and trauma, relocation to rural areas of Australia is confronting, and they require dedication and effort from those supporting resettlement. Currently, caseworkers working for settlement agencies do not have formal training. Volunteers are offered induction days and information sessions but have training needs beyond this. Two projects were undertaken during 2007 and 2008. Refugee services in regional and rural NSW and their efficacy were reviewed, exploring models of care in four NSW locations and clarifying needs via a literature search. Training and resources available to caseworkers and volunteers were also investigated. The objective was to design and construct a basic manual addressing the needs of this workforce informed by a literature search and consultation with key stakeholders in refugee resettlement. Literature searches of electronic databases, relevant websites and journals informed the questions for participants of focus groups and semi-structured interviews. Additional data were obtained via self-report questionnaires from caseworkers, volunteers and mainstream agencies. Information was also disseminated to refugees, inviting community to participate in focus groups. Our study supported others noting difficulties associated with the settlement of refugees in regional Australia, and recommendations of improvements were developed using the social determinants of health. The supporting workforce encounters a multitude of issues when working with newly arrived refugees, including language barriers, client expectations and challenges in developing living skills. Workers reported that accessing refugees' information is time-consuming, and that available resources are fragmented. Refugees expressed frustration at being categorised but acknowledged the efforts of volunteers and caseworkers. Findings and feedback from the literature review, focus groups, consultations with resettlement stakeholders and interviews supported the concept of developing a basic manual and conversation-starter flashcards. The limitations of the developed manual are acknowledged, as is a need for agency specific information on common topics for volunteers, caseworkers and clients, is suggested. Volunteer and caseworker training should be expanded.

Operations NEW LIFE/NEW ARRIVALS. US Army Support to the Indochina Refugee Program, 1 April 1975-1 June 1976

DTIC Science & Technology

1977-01-25

large numbers of refugees materialized. This plan, tentatively called Operation COMPASSION , envisioned that the refugees would at first be evacuated...Mptg ... —nex,- ■>• -g| ._ *M * UNCLASSIFIED * THIS MIGHT INVOLVE OVERNIGHT HOUSING FOR UP TO SDG TRANSIENT PERSONNEL. b- SUBP1IT...DDD REFUGEES AT FT CHAFFEE AND FT INDIANTOUN GAP UAS ACCOMPLISHED WITH COMPASSION AND EFFICIENCY BY THE ARMY TEAMS- ADDITIONALLY-. THE ORDERLY

Refugees in and out North Africa: a study of the Choucha refugee camp in Tunisia.

PubMed

Dourgnon, Paul; Kassar, Hassène

2014-08-01

In recent years, North African (NA) countries ceased to be emigration-only countries and are now on the verge of becoming immigration as well as transit countries for economic migrants and refugees. Contextual as well as structural long-term factors are driving these changes. The ongoing crises in Africa and the Middle East are prompting strong outflows of refugees, which are likely to induce NA countries to share some common public policy and public health concerns with European countries in a near future. This article highlights some aspects of these changes, from the study of the consequences of the 2011 Libyan crisis in Tunisia. It addresses individual trajectories and health concerns of refugees in and out North Africa from a study of the Choucha camp in Tunisia. The camp opened to immigrants from Libya during the 2011 crisis and accommodated the bulk of the refugees flow to Tunisia until July 2012. The study includes a monographic approach and a qualitative survey in the Choucha camp refugees. We describe the crisis history and the health response with a focus on the camp. We then address refugees' trajectories, and health needs and concerns from the interviews we collected in the camp in April 2012. © The Author 2014. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Resettlement experiences and resilience in refugee youth in Perth, Western Australia.

PubMed

Earnest, Jaya; Mansi, Ruth; Bayati, Sara; Earnest, Joel Anthony; Thompson, Sandra C

2015-06-10

In Australia, the two major pathways of refugee entry are the United Nations High Commissioner for Refugees resettlement programme and irregular maritime arrivals (IMAs) seeking asylum. The Australian Government's policies towards IMAs since July 2013 are controversial, uncompromising and consistently harsh, with asylum seekers held in detention centres for prolonged periods. Refugees and asylum seekers have distinct and unique stressors that make resettlement difficult. This exploratory study examines resettlement experiences for refugee youth in Western Australia using the psychosocial conceptual framework and qualitative methods. Focus group discussions and key informant interviews were undertaken with verbatim transcripts analysed using thematic analysis to identify themes. Themes documented that language and its impact, and experience with education, health, and social activities, support structures provided to youth and supporting future aspirations as critical to successful resettlement. This exploratory study contributes to developing a broader understanding of the resettlement experiences of refugee youth, drawing on their current and past experiences, cultural differences and mechanisms for coping. Fluency in English language, especially spoken, was a facilitator of successful resettlement. Our results align with previous studies documenting that support programs are vital for successful resettlement. Although faced with immense difficulties refugee youth are resilient, want to succeed and have aspirations for the future. Strategies and recommendations suggested by refugee youth themselves could be used for developing interventions to assist successful resettlement.

Trauma, poverty and mental health among Somali and Rwandese refugees living in an African refugee settlement – an epidemiological study

PubMed Central

Onyut, Lamaro P; Neuner, Frank; Ertl, Verena; Schauer, Elisabeth; Odenwald, Michael; Elbert, Thomas

2009-01-01

Background The aim of this study was to establish the prevalence of posttraumatic stress disorder (PTSD) and depression among Rwandese and Somali refugees resident in a Ugandan refugee settlement, as a measure of the mental health consequences of armed conflict, as well as to inform a subsequent mental health outreach program. The study population comprised a sample from 14400 (n = 519 Somali and n = 906 Rwandese) refugees resident in Nakivale refugee settlement in South Western Uganda during the year 2003. Methods The Posttraumatic Diagnostic Scale (PDS) and the Hopkins Symptom Checklist 25 were used to screen for posttraumatic stress disorder and depression. Results Thirty two percent of the Rwandese and 48.1% of the Somali refugees were found to suffer from PTSD. The Somalis refugees had a mean of 11.95 (SD = 6.17) separate traumatic event types while the Rwandese had 8.86 (SD = 5.05). The Somalis scored a mean sum score of 21.17 (SD = 16.19) on the PDS while the Rwandese had a mean sum score of 10.05 (SD = 9.7). Conclusion Mental health consequences of conflict remain long after the events are over, and therefore mental health intervention is as urgent for post-conflict migrant populations as physical health and other emergency interventions. A mental health outreach program was initiated based on this study. PMID:19470171

Medical conditions among Iraqi refugees in Jordan: data from the United Nations Refugee Assistance Information System

PubMed Central

Carone, Marco; Al-Saedy, Huda; Nyce, Sayre; Ghosn, Jad; Mutuerandu, Timothy; Black, Robert E

2012-01-01

Abstract Objective To determine the range and burden of health services utilization among Iraqi refugees receiving health assistance in Jordan, a country of first asylum. Methods Medical conditions, diagnosed in accordance with the tenth revision of the International classification of diseases, were actively monitored from 1January to 31December 2010 using a pilot centralized database in Jordan called the Refugee Assistance Information System. Findings There were 27 166 medical visits by 7642 Iraqi refugees (mean age: 37.4 years; 49% male; 70% from Baghdad; 6% disabled; 3% with a history of torture). Chronic diseases were common, including essential hypertension (22% of refugees), visual disturbances (12%), joint disorders (11%) and type II diabetes mellitus (11%). The most common reasons for seeking acute care were upper respiratory tract infection (11%), supervision of normal pregnancy (4%) and urinary disorders (3%). The conditions requiring the highest number of visits per refugee were cerebrovascular disease (1.46 visits), senile cataract (1.46) and glaucoma (1.44). Sponsored care included 31 747 referrals or consultations to a specialty service, 18 432 drug dispensations, 2307 laboratory studies and 1090 X-rays. The specialties most commonly required were ophthalmology, dentistry, gynaecology and orthopaedic surgery. Conclusion Iraqi refugees in countries of first asylum and resettlement require targeted health services, health education and sustainable prevention and control strategies for predominantly chronic diseases. PMID:22690034

Separation from family and its impact on the mental health of Sudanese refugees in Australia: a qualitative study.

PubMed

Savic, Michael; Chur-Hansen, Anna; Mahmood, Mohammad Afzal; Moore, Vivienne

2013-08-01

This study explored the impact of separation from family members on the mental health and wellbeing of Sudanese refugees in Australia, and the coping strategies used. In-depth interviews were conducted with Sudanese community representatives and health workers, primary and mental health care practitioners, health service managers and policy makers. Interviews were analysed using thematic analysis. Separation was perceived as having a negative impact on the mental health of Sudanese refugees in Australia, and manifested in concern about the safety of relatives abroad and in changing roles. The pressure to send money home emerged as a high priority for Sudanese refugees, often superseding local concerns. Several strategies were used to bridge the separation gap, including maintaining contact through the use of information communication technologies, and family-reunification. Separation from family can be an ongoing source of stress and sadness among refugees in countries such as Australia. While resettling refugees are actively taking steps to cope with the impact of separation, awareness of the issue in mainstream services appears to be low. Separation from family continues to affect refugees' lives in countries of resettlement. While it may be difficult to alter the course of the monumental circumstances that cause forced migration, service providers can support refugees' coping abilities by understanding these global-local intersections. © 2013 The Authors. ANZJPH © 2013 Public Health Association of Australia.

A six-year descriptive analysis of hospitalisations for ambulatory care sensitive conditions among people born in refugee-source countries.

PubMed

Correa-Velez, Ignacio; Ansari, Zahid; Sundararajan, Vijaya; Brown, Kaye; Gifford, Sandra M

2007-10-03

Hospitalisation for ambulatory care sensitive conditions (ACSHs) has become a recognised tool to measure access to primary care. Timely and effective outpatient care is highly relevant to refugee populations given the past exposure to torture and trauma, and poor access to adequate health care in their countries of origin and during flight. Little is known about ACSHs among resettled refugee populations. With the aim of examining the hypothesis that people from refugee backgrounds have higher ACSHs than people born in the country of hospitalisation, this study analysed a six-year state-wide hospital discharge dataset to estimate ACSH rates for residents born in refugee-source countries and compared them with the Australia-born population. Hospital discharge data between 1 July 1998 and 30 June 2004 from the Victorian Admitted Episodes Dataset were used to assess ACSH rates among residents born in eight refugee-source countries, and compare them with the Australia-born average. Rate ratios and 95% confidence levels were used to illustrate these comparisons. Four categories of ambulatory care sensitive conditions were measured: total, acute, chronic and vaccine-preventable. Country of birth was used as a proxy indicator of refugee status. When compared with the Australia-born population, hospitalisations for total and acute ambulatory care sensitive conditions were lower among refugee-born persons over the six-year period. Chronic and vaccine-preventable ACSHs were largely similar between the two population groups. Contrary to our hypothesis, preventable hospitalisation rates among people born in refugee-source countries were no higher than Australia-born population averages. More research is needed to elucidate whether low rates of preventable hospitalisation indicate better health status, appropriate health habits, timely and effective care-seeking behaviour and outpatient care, or overall low levels of health care-seeking due to other more pressing needs during the initial period of resettlement. It is important to unpack dimensions of health status and health care access in refugee populations through ad-hoc surveys as the refugee population is not a homogenous group despite sharing a common experience of forced displacement and violence-related trauma.

Bibliometric analysis of medicine - related publications on refugees, asylum-seekers, and internally displaced people: 2000 - 2015.

PubMed

Sweileh, Waleed M

2017-03-20

Wars and violent domestic conflicts have forced millions of people to move outside their homes. Meeting the basic health needs of those people requires an understanding of research activity and research output on this topic. The objective of this study was to shed light on the quantity and impact of medicine - related publications on refugees, asylum seekers and internally displaced people (IDP). Scopus database was used to retrieve required data. Specifically, the number of publications, top productive countries and institutions, highly cited articles, citation analysis, international collaboration, and journals involved in publishing articles on refugees, asylum seekers and IDP were reviewed and analyzed. The time span for the study was set from year 2000 to 2015. Two thousands five hundred and thirty publications were retrieved. The h-index of retrieved articles was 64. A steep rise in number of publications was noticed after 2011. Top productive countries were the United States of America, Australia and the United Kingdom. The American public health institute (Centers for Disease Control and Prevention) and the United Nations refugee agency were among the top active organizations on this topic. Active journals in publishing on health of refugees, asylum seekers and IDP were those on mental health, psychology, public health and general medicine. Publications on Somali, Afghani, Iraqi, and Syrian refugees received a significant share of medicine-related publications. Analysis of publications based on region showed that publications on refugees from Middle East is rising sharply and is approaching those on African refugees. Bibliometric analysis reveals that research publications on refugees have been increasing in a dramatic way and articles are being published in journals with high impact factor and international reputation, not only in general medicine and public health, but also mental health and psychology journals. Analysis of publications related to refugees can be helpful to international health agencies and governments not only to document the psychological trauma of fled people, but also to identify best mental health programs to face the consequences of wars and aggression that led to this refugee crisis.

How do general practitioners experience providing care to refugees with mental health problems? A qualitative study from Denmark

PubMed Central

2013-01-01

Background Refugees are a particularly vulnerable group in relation to the development of mental illness and many may have been subjected to torture or other traumatic experiences. General practitioners are gatekeepers for access to several parts of the psychiatric system and knowledge of their patients’ refugee background is crucial to secure adequate care. The aim of this study is to investigate how general practitioners experience providing care to refugees with mental health problems. Methods The study was conducted as part of an EU project on European Best Practices in Access, Quality and Appropriateness of Health Services for Immigrants in Europe (EUGATE). Semi-structured interviews were carried out with nine general practitioners in the vicinity of Copenhagen purposively selected from areas with a high proportion of immigrants. The analysis of the interviews is inspired by qualitative content analysis. Results One of the main themes identified in the analysis is communication. This includes the use of professional interpreters and that communication entails more than sharing a common language. Quality of care is another theme that emerges and includes awareness of possible trauma history, limited possibilities for refugees to participate in certain treatments due to language barriers and feelings of hopelessness in the general practitioners. The general practitioners may also choose different referral pathways for refugees and they report that their patients lack understanding regarding the differences between psychological problems and physical symptoms. Conclusion General practitioners experience that providing care to refugees differs from providing care for patients from the majority population. The different strategies employed by the general practitioners in the health care treatment of refugees may be the result of the great diversity in the organisation of general practice in Denmark and the lack of a national strategy in the health care management of refugees. The findings from this study suggest that the development of conversational models for general practitioners including points to be aware of in the treatment of refugee patients may serve as a support in the management of refugee patients in primary care. PMID:23356401

45 CFR 400.41 - Definitions

Code of Federal Regulations, 2010 CFR

2010-10-01

... Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Immigration Status and Identification of Refugees § 400.41 Definitions For purposes of this subpart— Applicant for asylum means an...

45 CFR 400.141 - Definitions.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 2 2011-10-01 2011-10-01 false Definitions. 400.141 Section 400.141 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.141 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Definitions. 400.141 Section 400.141 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.141 - Definitions.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 2 2012-10-01 2012-10-01 false Definitions. 400.141 Section 400.141 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

77 FR 19408 - Notice of Public Meeting on FY 2013 U.S. Refugee Admissions Program

Federal Register 2010, 2011, 2012, 2013, 2014

2012-03-30

... to attend this meeting must notify the Bureau of Population, Refugees, and Migration at telephone... Population, Refugees, and Migration, Department of State. [FR Doc. 2012-7700 Filed 3-29-12; 8:45 am] BILLING...

Differences in uptake of immunisations and health examinations among refugee children compared to Danish-born children: a cohort study.

PubMed

Moller, Sanne Pagh; Hjern, Anders; Andersen, Anne-Marie Nybo; Norredam, Marie

2016-04-01

Refugee children and their families constitute a vulnerable group regarding health and access to care. In a register-based cohort design, we examined differences in uptake of immunisations and child health examinations between refugee children and Danish-born children, including predictors of uptake among refugee children. Refugee children (n = 16,701) who, between January 1993 and December 2010, obtained residency permits in Denmark were included and matched in a 1:6 ratio on age and sex with Danish-born children (n = 100,206). Personal identification numbers were cross-linked to the National Danish Health Service Register, identifying all contacts for immunisation and child health examinations. We estimated hazard ratios (HR) of uptake. Refugee children had a lower uptake of all immunisations compared to Danish-born children. The lowest uptake was found for immunisation against diphtheria, tetanus, pertussis and polio (HR = 0.50; 95 % confidence interval (CI) 0.48-0.51). Participation in child health examinations was also lower among refugee children with the lowest at the last child health examination at age 5 (HR = 0.48; 95 % CI 0.47-0.50). Adjusting the analysis for parental income increased the HRs by 10-20 %. This Danish register-based study using nationwide data revealed a lower uptake of routine immunisations and child health examinations among refugee children compared to Danish-born children. •Uptake of immunisation and child health examination is associated with low household income, unemployment and low educational status among the parents. •Uptake may be even lower among refugee families as they constitute a vulnerable group regarding access to healthcare. What is New: •Refugee children had lower uptake of immunisations and child health examinations compared to Danish-born children. •Several predictors of uptake were identified including region of origin and duration of residence.

Informing a culturally appropriate approach to oral health and dental care for pre-school refugee children: a community participatory study.

PubMed

Nicol, Pam; Al-Hanbali, Arwa; King, Nigel; Slack-Smith, Linda; Cherian, Sarah

2014-06-13

Pre-school children in families of recently settled refugees often have very high rates of early childhood caries (ECC). ECC is associated with a high level of morbidity and is largely preventable, however effective culturally appropriate models of care are lacking. This study aimed to provide a deeper understanding of the refugee experience related to early oral health by exploring pre-school refugee families (i) understanding of ECC and child oral health, (ii) experiences of accessing dental services and (iii) barriers and enablers for achieving improved oral health. The knowledge gained will be critical to the development of effective early oral health programs in refugee children. Community based participatory qualitative methodology using focus groups of resettled refugee families and community refugee nurse interviews. A community reference group was established and a bi-lingual community research associate was employed. Transcripts were analysed for thematic content using NVivo software. There were 44 participants: eight focus groups (nine countries of origin) and five interviews. Emergent themes were (i) the major influence of parents' previous experience, including their beliefs about deciduous (baby) teeth, traditional feeding practices and poverty; and a consequent lack of understanding of the importance of early oral health and early dental caries, (ii) the burden of resettlement including prioritising, parenting, learning about new foods and how to assimilate into the community, and (iii) refugees' difficulties in accessing both information and dental services, and the role of schools in addressing these issues. An Opportunities for Change Model was proposed. The main implication of the study is the demonstration of how enhanced understanding of the refugee experience can inform improvement in early oral prevention and treatment. The community participatory methodology of the study provided a basis for cross-cultural understanding and has already assisted in translating the findings and raising awareness in the provision of targeted refugee oral health services.

Mass vaccination with a two-dose oral cholera vaccine in a long-standing refugee camp, Thailand.

PubMed

Phares, Christina R; Date, Kashmira; Travers, Philippe; Déglise, Carole; Wongjindanon, Nuttapong; Ortega, Luis; Bhuket, Ponchanok Rattanadilok Na

2016-01-02

During 2005-2012, surveillance in Maela refugee camp, Thailand, identified four cholera outbreaks, with rates up to 10.7 cases per 1000 refugees. In 2013, the Thailand Ministry of Public Health sponsored a two-dose oral cholera vaccine (OCV) campaign for the approximately 46,000 refugees living in Maela. We enumerated the target population (refugees living in Maela who are ≥1 year old and not pregnant) in a census three months before the campaign and issued barcoded OCV cards to each individual. We conducted the campaign using a fixed-post strategy during two eight-day rounds plus one two-day round for persons who had missed their second dose and recorded vaccine status for each individual. To identify factors associated with no vaccination (versus at least one dose) and those associated with adverse events following immunization (AEFI), we used separate marginal log-binomial regression models with robust variance estimates to account for household clustering. A total of 63,057 OCV doses were administered to a target population of 43,485 refugees. An estimated 35,399 (81%) refugees received at least one dose and 27,658 (64%) received two doses. A total of 993 additional doses (1.5%) were wasted including 297 that were spat out. Only 0.05% of refugees, mostly children, could not be vaccinated due to repeated spitting. Characteristics associated with no vaccination (versus at least one dose) included age ≥15 years (versus 1-14 years), Karen ethnicity (versus any other ethnicity) and, only among adults 15-64 years old, male sex. Passive surveillance identified 84 refugees who experienced 108 AEFI including three serious but coincidental events. The most frequent AEFI were nausea (49%), dizziness (38%), and fever (30%). Overall, AEFI were more prevalent among young children and older adults. Our results suggest that mass vaccination in refugee camps with a two-dose OCV is readily achievable and AEFI are few. Published by Elsevier Ltd.

Knowledge, Attitudes and Practices of Contraception among Afghan Refugee Women in Pakistan: A Cross-Sectional Study

PubMed Central

Raheel, Hina; Karim, Mehtab S.; Saleem, Sarah; Bharwani, Sulaiman

2012-01-01

Background During the 1980s, approximately three million people migrated from Afghanistan to Pakistan and sought refuge in several cities including the city of Karachi. After the initial settlement of the refugees, the international organizations transitioned the health care of these refugees to the two local non-profit service agencies in Karachi. One of these agencies subsidized health care to the refugees under their care and the other agency encouraged the refugees under their care to utilize governmental and non-governmental private health resources at the disposal of general public. Our objective was to measure the effect of health subsidy on the uptake of contraception among Afghan refugee women and compare them to the group of Afghan women without such a subsidy. Methodology/Principal Findings A randomly selected group of 650 married Afghan women-325 women in each group-participated in a detailed survey regarding the knowledge, attitude and practices of family planning and contraceptive use. 90 percent of the women in the health subsidy group had had heard of family planning, compared to the 45 percent in the non-subsidized group. The use of contraceptives was greater than two-fold in the former versus the latter. Results of logistic regression analysis revealed that the refugee women who had had access to subsidized healthcare were significantly more likely to use the contraceptive methods with advancing age as compared to the women in the non-health subsidy group. The difference remained significant after adjusting for other variables. Conclusions/Significance Refugee women who are provided subsidized healthcare are more inclined to use contraceptives. It is therefore important that Afghan refugee women living elsewhere in Pakistan be provided healthcare subsidy, whereby their reproductive health indicators could improve with reduced fertility. We strongly encourage facilities introducing such subsidies to refugees in resource poor settings to assess the impact through similar inquiry. PMID:23133658

Addressing refugee health through evidence-based policies: a case study

PubMed Central

de Bocanegra, Heike Thiel; Carter-Pokras, Olivia; Ingleby, J. David; Pottie, Kevin; Tchangalova, Nedelina; Allen, Sophia I.; Smith-Gagen, Julie; Hidalgo, Bertha

2017-01-01

The cumulative total of persons forced to leave their country for fear of persecution or organized violence reached an unprecedented 24.5 million by the end of 2015. Providing equitable access to appropriate health services for these highly diverse newcomers poses challenges for receiving countries. In this case study, we illustrate the importance of translating epidemiology into policy to address the health needs of refugees by highlighting examples of what works as well as identifying important policy-relevant gaps in knowledge. First, we formed an international working group of epidemiologists and health services researchers to identify available literature on the intersection of epidemiology, policy, and refugee health. Second, we created a synopsis of findings to inform a recommendation for integration of policy and epidemiology to support refugee health in the US and other high-income receiving countries. Third, we identified eight key areas to guide the involvement of epidemiologists in addressing refugee health concerns. The complexity and uniqueness of refugee health issues, and the need to develop sustainable management information systems, require epidemiologists to expand their repertoire of skills to identify health patterns among arriving refugees, monitor access to appropriately designed health services, address inequities, and communicate with policy makers and multidisciplinary teams. PMID:28554498

Occupational upheaval during resettlement and migration: findings of global ethnography with refugees with disabilities.

PubMed

Mirza, Mansha

2012-01-01

There is an emerging interest in issues of occupational justice and occupational deprivation within contemporary occupational therapy practice and theory. To inform this emerging agenda, research with populations at risk of occupational injustice is crucial. This study used a global ethnography framework to explore disabled refugees' access to occupational participation in the context of the U.S. refugee resettlement program. Narrative data from eight Cambodian and seven Somali refugees were combined with documentary analysis and information obtained from service providers. Data were analyzed using grounded theory techniques. Findings revealed a strong policy emphasis on employment and self-sufficiency within the U.S. refugee resettlement program. Consequently, resettlement service providers focused on the dichotomous options of work or welfare, overlooking the broader occupational needs of disabled refugees. Lacking supportive services for developing vocational skills or exploring occupational alternatives, the refugees struggled to find occupational avenues that would earn them social validity and integration into American society, leading to feelings of isolation and inadequacy. Research and practice initiatives with this population need to consider the role of institutional factors in shaping their occupational participation and evolving occupational needs. Copyright 2012, SLACK Incorporated.

Reducing Mental Health Disparities Through Transformative Learning: A Social Change Model With Refugees and Students

PubMed Central

Hess, Julia M.; Isakson, Brian; Githinji, Ann; Roche, Natalie; Vadnais, Kathryn; Parker, Danielle P.; Goodkind, Jessica R.

2014-01-01

Distribution of power and resources greatly impacts the mental health of individuals and communities. Thus, in order to reduce mental health disparities, it is imperative to address these social determinants of mental health through social change. Engaging in social change efforts requires people to critically engage with present conditions on personal, local, national and global levels and to develop knowledge, capacity, and experience with envisioning and creating more equitable conditions. This critical engagement can be fostered through a process of transformative learning. In this article, we examine the Refugee Well-being Project (RWP), a program that aims to improve the mental health of refugees in the United States. From 2007 to 2009, participants in the RWP in New Mexico were refugees from the Great Lakes region of Africa. The RWP paired undergraduate students with refugees to engage in mutual learning and advocacy. Data from in-depth qualitative interviews with 72 refugees and 53 undergraduate students suggest that participation in the RWP constituted a transformative learning experience through which refugees and students came to new understandings of the relationship between social inequities and well-being. For many, this provided an impetus to work towards change at multiple levels. PMID:24417257

The epidemiology of PTSD and depression in refugee minors who have resettled in developed countries.

PubMed

Reavell, James; Fazil, Qulsom

2017-02-01

With an increasing number of refugees migrating across continents, the crisis is very apparent. A literature review of patterns, risk factors and effects of post-traumatic stress disorder (PTSD) and depression in refugee minors was carried out involving those who have resettled in different developed countries. Papers were narrowed down by reading the abstracts and methods to ascertain whether the refugee children had resettled in developed countries and to ensure that they had not just been internally displaced. High incidences of PTSD and depression were found in refugee minors and poorer mental health was correlated with increased exposure to violence. Factors such as social support and family security were important in reducing the rates of PTSD and depression, whereas the implications of age and gender were unclear. Long-term effects from these mental illnesses indicated scholastic issues, but no further worsening of symptoms. Further research is needed regarding the follow-up of refugee minors with PTSD and depression to allow the establishment of more effective support systems, as long-term outcomes become more clearly understood. Few papers discuss the influence of religion, which may be an interesting line of future research as refugees move to more secular societies.

Unconditional hospitality: HIV, ethics and the refugee 'problem'.

PubMed

Worth, Heather

2006-09-01

Refugees, as forced migrants, have suffered displacement under conditions not of their own choosing. In 2000 there were thought to be 22 million refugees of whom 6 million were HIV positive. While the New Zealand government has accepted a number of HIV positive refugees from sub-Saharan Africa, this hospitality is under threat due to negative public and political opinion. Epidemic conditions raise the social stakes attached to sexual exchanges, contagion becomes a major figure in social relationships and social production, and the fears of the contagious nature of those 'just off the plane' connect refugees to an equally deep-seated fear of racial miscegenation. Jacques Derrida's notion of unconditional hospitality is a dream of a democracy which would have a cosmopolitan form. This means that one cannot decide in advance which refugees one might choose to resettle. This paper will use Derrida's notion of unconditional hospitality to emphasise the fragility of HIV positive refugees' position, caught between becoming newly made New Zealand subjects while at the same time having that subjecthood threatened. For Derrida, both ethics and politics demand both an action and a need for a thoughtful response (a questioning without limit).

Time to Rethink Refugee and Migrant Health in Europe: Moving from Emergency Response to Integrated and Individualized Health Care Provision for Migrants and Refugees.

PubMed

Puchner, Karl; Karamagioli, Evika; Pikouli, Anastasia; Tsiamis, Costas; Kalogeropoulos, Athanasios; Kakalou, Eleni; Pavlidou, Elena; Pikoulis, Emmanouil

2018-05-28

In the last three years, the European Union (EU) is being confronted with the most significant influx of migrants and refugees since World War II. Although the dimensions of this influx-taking the global scale into account-might be regarded as modest, the institutional response to that phenomenon so far has been suboptimal, including the health sector. While inherent challenges of refugee and migrant (R&M) health are well established, it seems that the EU health response oversees, to a large extend, these aspects. A whole range of emergency-driven health measures have been implemented throughout Europe, yet they are failing to address adequately the changing health needs and specific vulnerabilities of the target population. With the gradual containment of the migratory and refugee waves, three years after the outbreak of the so-called 'refugee crisis', we are, more than ever, in need of a sustainable and comprehensive health approach that is aimed at the integration of all of migrants and refugees-that is, both the new and old population groups that are already residing in Europe-in the respective national health systems.

8 CFR 223.2 - Processing.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS REENTRY PERMITS, REFUGEE TRAVEL DOCUMENTS..., refugee travel document, or advance parole document must be filed on Form I-131, with the fee required in... resident or conditional permanent resident. (2) Refugee travel document—(i) General. Except as otherwise...

8 CFR 207.2 - Applicant processing.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS ADMISSION OF REFUGEES § 207.2 Applicant processing. (a) Forms. Each applicant who seeks admission as a refugee shall submit an individual Form I-590 (Registration for Classification as Refugee). Additionally, each applicant 14 years old...

45 CFR 400.13 - Cost allocation.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Grants to States for Refugee Resettlement Award of Grants to States § 400.13 Cost allocation. (a) A State must allocate...

45 CFR 400.70 - Basis and scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Requirements for... applicants for and recipients of refugee cash assistance under both the public/private RCA program and the...

45 CFR 400.28 - Maintenance of records and reports.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 400.28 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM... maintenance of such operational records as are necessary for Federal monitoring of the State's refugee...

45 CFR 400.141 - Definitions.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 2 2014-10-01 2012-10-01 true Definitions. 400.141 Section 400.141 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social Services...

45 CFR 400.150 - General eligibility requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 2 2014-10-01 2012-10-01 true General eligibility requirements. 400.150 Section 400.150 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT... Refugee Social Services Conditions of Eligibility for Refugee Social Services § 400.150 General...

45 CFR 400.156 - Service requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 2 2011-10-01 2011-10-01 false Service requirements. 400.156 Section 400.156 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.154 - Employability services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 2 2012-10-01 2012-10-01 false Employability services. 400.154 Section 400.154 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.156 - Service requirements.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 2 2014-10-01 2012-10-01 true Service requirements. 400.156 Section 400.156 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.141 - Definitions.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 2 2013-10-01 2012-10-01 true Definitions. 400.141 Section 400.141 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social Services...

45 CFR 400.150 - General eligibility requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false General eligibility requirements. 400.150 Section 400.150 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT... Refugee Social Services Conditions of Eligibility for Refugee Social Services § 400.150 General...

45 CFR 400.154 - Employability services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 2 2014-10-01 2012-10-01 true Employability services. 400.154 Section 400.154 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.156 - Service requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 2 2013-10-01 2012-10-01 true Service requirements. 400.156 Section 400.156 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.154 - Employability services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 2 2013-10-01 2012-10-01 true Employability services. 400.154 Section 400.154 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.154 - Employability services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 2 2011-10-01 2011-10-01 false Employability services. 400.154 Section 400.154 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.155 - Other services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 2 2012-10-01 2012-10-01 false Other services. 400.155 Section 400.155 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.150 - General eligibility requirements.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 2 2011-10-01 2011-10-01 false General eligibility requirements. 400.150 Section 400.150 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT... Refugee Social Services Conditions of Eligibility for Refugee Social Services § 400.150 General...

45 CFR 400.150 - General eligibility requirements.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 2 2013-10-01 2012-10-01 true General eligibility requirements. 400.150 Section 400.150 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT... Refugee Social Services Conditions of Eligibility for Refugee Social Services § 400.150 General...

45 CFR 400.155 - Other services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 2 2014-10-01 2012-10-01 true Other services. 400.155 Section 400.155 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.156 - Service requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Service requirements. 400.156 Section 400.156 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.156 - Service requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 2 2012-10-01 2012-10-01 false Service requirements. 400.156 Section 400.156 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.155 - Other services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 2 2013-10-01 2012-10-01 true Other services. 400.155 Section 400.155 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.150 - General eligibility requirements.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 2 2012-10-01 2012-10-01 false General eligibility requirements. 400.150 Section 400.150 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT... Refugee Social Services Conditions of Eligibility for Refugee Social Services § 400.150 General...

Building Bridges between Refugee Parents and Schools

ERIC Educational Resources Information Center

Rah, Yeonjai; Choi, Shangmin; Nguyen, Thu Suong Thi

2009-01-01

This interview study examines the way practitioners in Wisconsin public schools created conditions to facilitate refugee parent involvement. Practitioners' perceptions of barriers to refugee parents' school involvement are explored as well as the strategies used to promote meaningful parent involvement. Interviewees included nine school…

Manual for Refugee Sponsorship.

ERIC Educational Resources Information Center

Brewer, Kathleen; Taran, Patrick A.

This manual provides guidelines for religious congregations interested in setting up programs to sponsor refugees. The manual describes the psychological implications of the refugee experience and discusses initial steps in organizing for sponsorship. Detailed information is provided for sponsors regarding: finances and mobilization of resources;…

75 FR 75851 - Fiscal Year 2011 Refugee Admissions Numbers and Authorizations of In-Country Refugee Status...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-07

... Determination Pursuant to Section 2(b)(2) of the Migration and Refugee Assistance Act, as Amended Memorandum for... regions to which the admissions are being transferred. Consistent with section 2(b)(2) of the Migration...

Compassionate listening - managing psychological trauma in refugees.

PubMed

Gardiner, Joanne; Walker, Kate

2010-04-01

The physical and psychosocial effects of trauma in refugees are wide ranging and long lasting. They can affect symptom presentation, the patient-doctor relationship and management of refugee victims of trauma. This article discusses how refugees survivors of trauma may present to the general practitioner and gives an approach to psychological assessment and management. A strong therapeutic relationship built by patient led, sensitive assessment over time is the foundation to care. A management framework based on trauma recovery stages and adapted for general practice, is presented.

Refugee claimant's identity as cross-dresser must be considered in assessing adequacy of state protection.

PubMed

2008-07-01

On 11 December 2007, the Federal Court allowed Jose Hernandez's application for judicial review of a November 2006 decision by the Refugee Protection Division of the Immigration and Refugee Board, which found that the applicant was neither a Convention refugee nor a person in need of protection. Hernandez had requested that the Board's decision be set aside and the matter referred back to a newly constituted panel of the Board for re-determination.

Mental health screening among newly arrived refugees seeking routine obstetric and gynecologic care.

PubMed

Johnson-Agbakwu, Crista E; Allen, Jennifer; Nizigiyimana, Jeanne F; Ramirez, Glenda; Hollifield, Michael

2014-11-01

Posttraumatic stress disorder (PTSD), anxiety, and depression are common mental health disorders in the refugee population. High rates of violence, trauma, and PTSD among refugee women remain unaddressed. The process of implementing a mental health screening tool among multiethnic, newly arrived refugee women receiving routine obstetric and gynecologic care in a dedicated refugee women's health clinic is described. The Refugee Health Screener-15 (RHS-15) is a culturally responsive, efficient, validated screening instrument that detects symptoms of emotional distress across diverse refugee populations and languages. An interdisciplinary community partnership was established with a local behavioral health services agency to facilitate the referral of women scoring positive on the RHS-15. Staff and provider training sessions, as well as the incorporation of bicultural, multilingual cultural health navigators, greatly facilitated linguistically appropriate care coordination for refugee women in a culturally sensitive manner. Twenty-six (23.2%) of the 112 women who completed the RHS-15 scored positive, of which 14 (53.8%) were Iraqi, 1 (3.8%) was Burmese, and 3 (11.5%) were Somali. Among these 26 women, 8 (30.8%) are actively receiving mental health services and 5 (19.2%) have appointments scheduled. However, 13 (50%) are not enrolled in mental health care because of either declining services (46.2%) or a lack of insurance (53.8%). Screening for mental disorders among refugee women will promote greater awareness and identify those individuals who would benefit from further mental health evaluation and treatment. Sustainable interdisciplinary models of care are necessary to promote health education, dispel myths, and reduce the stigma of mental health. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Giving It Our Best Shot? Human Papillomavirus and Hepatitis B Virus Immunization Among Refugees, Massachusetts, 2011–2013

PubMed Central

Smock, Laura; Bair-Merritt, Megan H.; Cochran, Jennifer; Geltman, Paul L.

2017-01-01

Introduction The receipt rate of hepatitis B virus vaccine among adolescents in the United States is high, while the receipt rate of human papillomavirus vaccine is low. Rates have not been closely studied among refugees, whose home countries have high rates of disease caused by these viruses. Methods We examined human papillomavirus and hepatitis B virus immunization rates among 2,269 refugees aged 9 to 26 years who resettled in Massachusetts from 2011 through 2013. This was a secondary analysis of data from their medical screenings. We used binary logistic regression to assess characteristics associated with immunization and bivariate analyses to compare refugee immunization rates with those of the general US population. Results Forty-five percent of US adolescents aged 13 to 17 years received 1 dose of human papillomavirus vaccine, compared with 68% of similarly aged refugees. Males (adjusted odds ratio [aOR], 0.62; 95% confidence interval [CI], 0.52–0.74), refugees older than 13 years (aOR, 0.74; 95% CI, 0.60–0.93), and refugees not from Sub-Saharan Africa (aOR, 0.74; 95% CI, 0.59–0.92) were less likely to receive human papillomavirus vaccine, while arrivals in 2012 through 2013 were more likely (aOR, 1.6; 95% CI, 1.3–1.9) than those arriving in 2011. Refugees older than 13 years were less likely to receive 2 doses of hepatitis B virus vaccine (aOR, 0.49; 95% CI, 0.37–0.63) than older refugees. Conclusion Specialized post-arrival health assessment may improve refugees’ immunization rates. PMID:28641071

Childhood mortality among former Mozambican refugees and their hosts in rural South Africa.

PubMed

Hargreaves, James R; Collinson, Mark A; Kahn, Kathleen; Clark, Samuel J; Tollman, Stephen M

2004-12-01

It is important to monitor health differentials between population groups to understand how they are generated. Internationally displaced people represent one potentially disadvantaged group. We investigated differentials in mortality between children from former Mozambican refugee and host South African households in a rural sub-district in the north-east of South Africa. Open prospective cohort of 30 276 children (80 462 person years of follow-up) followed from 1 January 1992 to 31 October 2000 in Limpopo Province, South Africa. Exposure and outcomes data came from the Agincourt Health and Demographic Surveillance System (DSS). There was no difference in infant mortality between children from former Mozambican refugee households and those from South African homes (adjusted rate ratio [RR] = 1.02, 95% CI: 0.79, 1.32), but mortality levels were higher among former Mozambican refugee children during the next 4 years (adjusted RR = 1.91, 95% CI: 1.50, 2.42). Increased mortality levels were also seen among children from larger households and whose mother died, while children born to mothers aged >40 years or with higher education were at lower risk. Measured maternal, household, and health service utilization characteristics could not explain the difference in mortality between children from former Mozambican refugee and South African households. Former Mozambican refugee children residing in refugee settlements had higher mortality rates than those residing in more established villages. This study demonstrates higher childhood, but not infant, mortality rates among children from former Mozambican refugee households compared with those from host South African households in rural South Africa. The lack of legal status and lower wealth of many former Mozambican refugees may partly explain this disparity.

Effects of acculturative stress on PTSD, depressive, and anxiety symptoms among refugees resettled in Australia and Austria

PubMed Central

Kartal, Dzenana; Kiropoulos, Litza

2016-01-01

Background Research indicates that exposure to war-related traumatic events impacts on the mental health of refugees and leads to higher rates of posttraumatic stress disorder (PTSD), depression, and anxiety symptoms. Furthermore, stress associated with the migration process has also been shown to impact negatively on refugees' mental health, but the extent of these experiences is highly debatable as the relationships between traumatic events, migration, and mental health outcomes are complex and poorly understood. Objective This study aimed to examine the influence of trauma-related and post-migratory factors on symptoms of PTSD, depression, and anxiety in two samples of Bosnian refugees that have resettled in two different host nations—Austria and Australia. Method Using multiple recruitment methods, 138 participants were recruited to complete self-report measures assessing acculturative stress, PTSD, depressive, and anxiety symptoms. Results Hierarchical regressions indicated that after controlling for age, sex, and exposure to traumatic events, acculturative stress associated with post-migratory experiences predicted severity of PTSD and anxiety symptoms, while depressive symptoms were only predicted by exposure to traumatic events. This model, however, was only significant for Bosnian refugees resettled in Austria, as PTSD, depressive, and anxiety symptoms were only predicted by traumatic exposure in the Bosnian refugees resettled in Australia. Conclusion These findings point toward the importance of assessing both psychological and social stressors when assessing mental health of refugees. Furthermore, these results draw attention to the influence of the host society on post-migratory adaptation and mental health of refugees. Further research is needed to replicate these findings among other refugee samples in other host nations. PMID:26886488

Resilience of refugees displaced in the developing world: a qualitative analysis of strengths and struggles of urban refugees in Nepal

PubMed Central

2011-01-01

Background Mental health and psychosocial wellbeing are key concerns in displaced populations. Despite urban refugees constituting more than half of the world's refugees, minimal attention has been paid to their psychosocial wellbeing. The purpose of this study was to assess coping behaviour and aspects of resilience amongst refugees in Kathmandu, Nepal. Methods This study examined the experiences of 16 Pakistani and 8 Somali urban refugees in Kathmandu, Nepal through in-depth individual interviews, focus groups, and Photovoice methodology. Such qualitative approaches enabled us to broadly discuss themes such as personal experiences of being a refugee in Kathmandu, perceived causes of psychosocial distress, and strategies and resources for coping. Thematic network analysis was used in this study to systematically interpret and code the data. Results Our findings highlight that urban refugees' active coping efforts, notwithstanding significant adversity and resulting distress, are most frequently through primary relationships. Informed by Axel Honneth's theory on the struggle for recognition, findings suggest that coping is a function beyond the individual and involves the ability to negotiate recognition. This negotiation involves not only primary relationships, but also the legal order and other social networks such as family and friends. Honneth's work was used because of its emphasis on the importance of legal recognition and larger structural factors in facilitating daily coping. Conclusions Understanding how urban refugees cope by negotiating access to various forms of recognition in the absence of legal-recognition will enable organisations working with them to leverage such strengths and develop relevant programmes. In particular, building on these existing resources will lead to culturally compelling and sustainable care for these populations. PMID:21943401

Fleeing to Fault Zones: Incorporating Syrian Refugees into Earthquake Risk Analysis along the East Anatolian and Dead Sea Rift Fault Zones

NASA Astrophysics Data System (ADS)

Wilson, B.; Paradise, T. R.

2016-12-01

The influx of millions of Syrian refugees into Turkey has rapidly changed the population distribution along the Dead Sea Rift and East Anatolian Fault zones. In contrast to other countries in the Middle East where refugees are accommodated in camp environments, the majority of displaced individuals in Turkey are integrated into cities, towns, and villages—placing stress on urban settings and increasing potential exposure to strong shaking. Yet, displaced populations are not traditionally captured in data sources used in earthquake risk analysis or loss estimations. Accordingly, we present a district-level analysis assessing the spatial overlap of earthquake hazards and refugee locations in southeastern Turkey to determine how migration patterns are altering seismic risk in the region. Using migration estimates from the U.S. Humanitarian Information Unit, we create three district-level population scenarios that combine official population statistics, refugee camp populations, and low, median, and high bounds for integrated refugee populations. We perform probabilistic seismic hazard analysis alongside these population scenarios to map spatial variations in seismic risk between 2011 and late 2015. Our results show a significant relative southward increase of seismic risk for this period due to refugee migration. Additionally, we calculate earthquake fatalities for simulated earthquakes using a semi-empirical loss estimation technique to determine degree of under-estimation resulting from forgoing migration data in loss modeling. We find that including refugee populations increased casualties by 11-12% using median population estimates, and upwards of 20% using high population estimates. These results communicate the ongoing importance of placing environmental hazards in their appropriate regional and temporal context which unites physical, political, cultural, and socio-economic landscapes. Keywords: Earthquakes, Hazards, Loss-Estimation, Syrian Crisis, Migration, Refugees

Patient Experienced Continuity of Care in the Psychiatric Healthcare System—A Study Including Immigrants, Refugees and Ethnic Danes

PubMed Central

Jensen, Natasja Koitzsch; Johansen, Katrine Schepelern; Kastrup, Marianne; Krasnik, Allan; Norredam, Marie

2014-01-01

Aim: The purpose of this study was to investigate continuity of care in the psychiatric healthcare system from the perspective of patients, including vulnerable groups such as immigrants and refugees. Method: The study is based on 19 narrative interviews conducted with 15 patients with diverse migration backgrounds (immigrants, descendents, refugees, and ethnic Danes). Patients were recruited from a community psychiatric centre situated in an area with a high proportion of immigrants and refugees. Data were analysed through the lens of a theoretical framework of continuity of care in psychiatry, developed in 2004 by Joyce et al., which encompasses four domains: accessibility, individualised care, relationship base and service delivery. Results: Investigating continuity of care, we found issues of specific concern to immigrants and refugees, but also commonalities across the groups. For accessibility, areas pertinent to immigrants and refugees include lack of knowledge concerning mental illness and obligations towards children. In terms of individualised care, trauma, additional vulnerability, and taboo concerning mental illness were of specific concern. In the domain of service delivery, social services included assistance with immigration papers for immigrants and refugees. In the relationship base domain, no differences were identified. Implications for priority area: The treatment courses of patients in the psychiatric field are complex and diverse and the patient perspective of continuity of care provides important insight into the delivery of care. The study highlights the importance of person-centred care irrespective of migration background though it may be beneficial to have an awareness of areas that may be of more specific concern to immigrants and refugees. Conclusions: The study sheds light on concerns specific to immigrants and refugees in a framework of continuity of care, but also commonalities across the patient groups. PMID:25233017

Mental Health Screening Among Newly-Arrived Refugees Seeking Routine Obstetric and Gynecologic Care

PubMed Central

Johnson-Agbakwu, Crista E.; Allen, Jennifer; Nizigiyimana, Jeanne F.; Ramirez, Glenda; Hollifield, Michael

2014-01-01

Posttraumatic stress disorder (PTSD), anxiety, and depression are the most common mental health disorders in the refugee population. High rates of violence, trauma, and PTSD among refugee women remain unaddressed. The process of implementing a mental health screening tool among multi-ethnic, newly-arrived refugee women receiving routine obstetric and gynecologic care in a dedicated refugee women’s health clinic is described. The Refugee Health Screener-15 (RHS-15) is a culturally-responsive, efficient, validated screening instrument that detects symptoms of emotional distress across diverse refugee populations and languages. An interdisciplinary community partnership was established with a local behavioral health services agency to facilitate the referral of women scoring positive on the RHS-15. Staff and provider training sessions, as well as the incorporation of bi-cultural, multi-lingual Cultural Health Navigators, greatly facilitated linguistically-appropriate care coordination for refugee women in a culturally sensitive manner. Twenty-six (23.2%) of the 112 women who completed the RHS-15 scored positive; of which 14 (53.8%) were Iraqi, one (3.8%) was Burmese, and three (11.5%) were Somali. Among these 26 women, eight (30.8%) are actively receiving mental health services, and five (19.2%) have appointments scheduled. However 13 (50%) are not enrolled in mental health care due to either declining services (46.2%), or a lack of insurance (53.8%). Screening for mental disorders among refugee women will promote greater awareness and identify those individuals who would benefit from further mental health evaluation and treatment. Sustainable interdisciplinary models of care are necessary to promote health education, dispel myths and reduce the stigma of mental health. PMID:25383999

Psychiatric screening and interventions for minor refugees in Europe: an overview of approaches and tools.

PubMed

Horlings, Annerieke; Hein, Irma

2018-02-01

Currently hundreds of thousands of minor refugees entered Europe. This group has been exposed to traumatic events pre-, during, and post-migration and is at increased risk of developing psychiatric disorders. In this article, we describe the results of our literature search on screening and interventions for post-traumatic stress disorder (PTSD) in minor refugees, in order to make recommendations for clinical practice. Results show that studies on diagnostic accuracy of assessment instruments and efficacy of mental healthcare interventions in this population are lacking. Traumatic experiences pre-flight, during the flight and at resettlement, superimposed by parental PTSD, and other contextual factors, might lead to more than 25% of minor refugees developing PTSD. To enhance the number of minor refugees recognized with PTSD, we recommend the use of a brief screening instrument. A public health approach, focusing on environmental supportive factors is the first step in treatment for this group, followed by short-term psychological group interventions focusing on psycho-education and stress reduction. Minor refugees with no improvement in PTSD symptoms by these interventions need referral to specialized mental health care services. Mental health providers should be culturally competent. What is Known: • Post-traumatic stress disorder, anxiety, sleeping problems, and depression are the most common psychiatric disorders in minor refugees. • Evidence based methods on screening and interventions in minor refugees with psychiatric disorders are lacking. What is New: • In the absence of validated screening tools a best practice reliable, quick and child-friendly tool is presented. • A layered system for mental health care and psychosocial support in minor refugees is explained.

Do Syrian refugees have increased risk for worser pregnancy outcomes? Results of a tertiary center in İstanbul

PubMed Central

Güngör, Emre Sinan; Seval, Olcay; İlhan, Gülşah; Verit, Fatma Ferda

2018-01-01

Objective: To compare obstetric and perinatal outcomes of Syrian refugee pregnants and Turkish counterparts who gave birth at a tertiary center in İstanbul. Materials and Methods: A retrospective study including the birth records of 704 Syrian refugees and 744 Turkish pregnant women between January 2016 and May 2017 were analyzed. Demographic data, obstetric and neonatal outcomes were compared. The primary aims of this study were to evaluate the pregnancy outcomes and cesarean rates between the groups. The secondary outcomes were the use of antenatal vitamin supplementation, hemoglobin-hematocrit values, and maternal complications. Results: Our results showed that the use of folic acid and iron supplementation rates during pregnancy were similar between the groups (folic acid supplementation 8.1% vs 6.5%, p=0.264; iron supplementation 20.7% vs 19.6%, p=0.125; respectively for Turkish women and Syrian refugees). Cesarean rates were significantly higher for Turkish patients than in Syrian refugees (42.7% vs 32.7%; p<0.05). Gestational age at delivery was significantly higher among Turkish women when compared with Syrian refugees (37.7±2.3 vs 36.4±2.3 weeks, p<0.05), but there was no significant difference regarding the birtweights’ of the newborns (3134 g vs 3066 g for Turkish women and Syrian refugees, respectively, p=0.105). Although obstetric complications were seen more often in Syrian refugees, it did not reach statistical difference (9.7% vs 8.1%, respectively, p=0.285). Conclusion: Syrian refugees use antenatal vitamin supplementations at similar rates to Turkish citizens and obstetric and perinatal outcomes are similar between the groups. PMID:29662712

Constructing citizenship? Women, welfare and refugees in France, 1939-1940.

PubMed

Reid, Fiona; Gemie, Sharif

2011-01-01

Women were central to the provision of welfare services in France during the refugee crises of the late 1930s. By building on the services created during the First World War, women, as either volunteers or professionals, actively cared for refugees and others during the Spanish Civil War (1936-39), the phoney war (September 1939-May 1940) and the German invasion of 1940. French women's involvement with refugee aid enabled them to develop a sense of autonomous civil and political activism, especially—although not exclusively—in their work with the French Red Cross. In addition, the history of welfare activities for refugees illuminates how ordinary people dealt with the extraordinary circumstances of war, invasion and the forced movement of populations.

Health issues of Afghan refugees in California.

PubMed Central

Lipson, J G; Omidian, P A

1992-01-01

Since the 1979 Soviet invasion of Afghanistan, more than 6 million Afghan refugees have become the world's largest refugee population. Although refugees in Pakistan and Iran are now beginning to repatriate, continuing political turmoil in Afghanistan and children's acculturation and educational opportunities will keep many Afghans in the United States permanently. Although there are no accurate statistics, local resettlement agencies and Afghan community leaders estimate that there are 10,000 to 35,000 Afghans in northern California. They suffer from a variety of problems common to refugees: language, economic and occupational problems, and substantial challenges in psychological, family, social, and cultural adjustment to the United States. Although many Afghans are doing well, many others have depression, psychosomatic symptoms, and posttraumatic stress disorder. PMID:1413768

75 FR 152 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-04

... OMB Review; Comment Request Title: Refugee Unaccompanied Minor Placement Report & Minor Progress... to administer the Unaccompanied Refugee Minor (URM) program. The ORR-3 (Placement Report) is submitted to the Office of Refugee Resettlement (ORR) by the State agency at initial placement within 30...

1980 World Refugee Survey.

ERIC Educational Resources Information Center

de Sherbinin, Michael J., Ed.; Weeg, Carol, Ed.

This report describes the current numbers and status of Asian, European, Soviet, Latin American, and African refugees worldwide and discusses the role of various governments and voluntary agencies in dealing with refugee problems. The need to strengthen the partnership between government and voluntary agencies in order to improve refugee…

45 CFR 400.6 - [Reserved

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false [Reserved] 400.6 Section 400.6 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Grants to States for Refugee...

45 CFR 400.68 - Notification to local resettlement agency.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 400.68 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Cash Assistance § 400.68 Notification to local resettlement agency. (a) The State must notify...

45 CFR 400.72 - Arrangements for employability services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 400.72 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM...-administered RCA programs. (a) The State agency must make such arrangements as are necessary to enable refugees...

45 CFR 400.67 - Non-applicable TANF requirements.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 400.67 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Cash Assistance § 400.67 Non-applicable TANF requirements. States that choose to operate an RCA...

45 CFR 400.51 - Determination of eligibility under other programs.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... 400.51 Section 400.51 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Cash Assistance § 400.51 Determination of eligibility under other programs. (a...

8 CFR 207.4 - Approved application.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Aliens and Nationality DEPARTMENT OF HOMELAND SECURITY IMMIGRATION REGULATIONS ADMISSION OF REFUGEES... conditionally as a refugee upon arrival at the port within four months of the date the Form I-590 was approved. There is no appeal from a denial of refugee status under this chapter. ...

45 CFR 400.63 - Preparation of local resettlement agencies.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 400.63 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Cash Assistance § 400.63 Preparation of local resettlement agencies. The State and the national...

45 CFR 400.10 - [Reserved

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false [Reserved] 400.10 Section 400.10 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Grants to States for Refugee...

45 CFR 400.148 - Purchase of services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Purchase of services. 400.148 Section 400.148 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.146 - Use of funds.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Use of funds. 400.146 Section 400.146 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.140 - Basis and scope.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 2 2014-10-01 2012-10-01 true Basis and scope. 400.140 Section 400.140 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.148 - Purchase of services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 2 2012-10-01 2012-10-01 false Purchase of services. 400.148 Section 400.148 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.146 - Use of funds.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 2 2013-10-01 2012-10-01 true Use of funds. 400.146 Section 400.146 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.140 - Basis and scope.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 2 2012-10-01 2012-10-01 false Basis and scope. 400.140 Section 400.140 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.140 - Basis and scope.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 2 2011-10-01 2011-10-01 false Basis and scope. 400.140 Section 400.140 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.148 - Purchase of services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 2 2013-10-01 2012-10-01 true Purchase of services. 400.148 Section 400.148 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.140 - Basis and scope.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 2 2013-10-01 2012-10-01 true Basis and scope. 400.140 Section 400.140 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.146 - Use of funds.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 2 2011-10-01 2011-10-01 false Use of funds. 400.146 Section 400.146 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.146 - Use of funds.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 2 2012-10-01 2012-10-01 false Use of funds. 400.146 Section 400.146 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.146 - Use of funds.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 2 2014-10-01 2012-10-01 true Use of funds. 400.146 Section 400.146 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.148 - Purchase of services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 2 2014-10-01 2012-10-01 true Purchase of services. 400.148 Section 400.148 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.148 - Purchase of services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 2 2011-10-01 2011-10-01 false Purchase of services. 400.148 Section 400.148 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.140 - Basis and scope.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Basis and scope. 400.140 Section 400.140 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Social...

45 CFR 400.5 - Content of the plan.

Code of Federal Regulations, 2014 CFR

2014-10-01

... Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN... children in the State; (f) Provide for and describe (1) the procedures established to identify refugees who... plan will be provided to refugees without regard to race, religion, nationality, sex, or political...

45 CFR 400.5 - Content of the plan.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN... children in the State; (f) Provide for and describe (1) the procedures established to identify refugees who... plan will be provided to refugees without regard to race, religion, nationality, sex, or political...

75 FR 20031 - Notice of Public Meeting on FY 2011 Refugee Admissions Program

Federal Register 2010, 2011, 2012, 2013, 2014

2010-04-16

... must notify the Bureau of Population, Refugees, and Migration at telephone (202) 663-1006 by 5 p.m. on..., Refugees, and Migration, Department of State. [FR Doc. 2010-8785 Filed 4-15-10; 8:45 am] BILLING CODE 4710...

Rates and impact of trauma and current stressors among Darfuri refugees in Eastern Chad.

PubMed

Rasmussen, Andrew; Nguyen, Leanh; Wilkinson, John; Vundla, Sikhumbuzo; Raghavan, Sumithra; Miller, Kenneth E; Keller, Allen S

2010-04-01

Darfur refugees face hardships associated with chronic displacement, including lack of basic needs and safety concerns. Psychiatric research on refugees has focused on trauma, but daily stressors may contribute more to variance in distress. This article reports rates of past trauma and current stressors among Darfur refugees and gauges the contribution of each to psychological distress and functional impairment. A representative sample of 848 Darfuris in 2 refugee camps were interviewed about traumatic events, stressors faced in the camps, psychological distress, and functional impairment. Basic needs and safety concerns were more strongly correlated with measures of distress (rs = .19-.31) than were war-related traumatic events (rs = .09-.20). Hierarchical regression supported models in which effects of trauma on distress were mediated by current stressors. Although war-related traumatic events are the initial causes of refugees' hardship, findings suggest that the day-to-day challenges and concerns in camps mediate psychological distress associated with these events.

Rates and Impact of Trauma and Current Stressors Among Darfuri Refugees in Eastern Chad

PubMed Central

Rasmussen, Andrew; Nguyen, Leanh; Wilkinson, John; Vundla, Sikhumbuzo; Raghavan, Sumithra; Miller, Kenneth E.; Keller, Allen S.

2010-01-01

Darfur refugees face hardships associated with chronic displacement, including lack of basic needs and safety concerns. Psychiatric research on refugees has focused on trauma, but daily stressors may contribute more to variance in distress. In this article we report rates of past trauma and current stressors among Darfur refugees and gauge the contribution of each to psychological distress and functional impairment. A representative sample of 848 Darfuris in two refugee camps were interviewed about traumatic events, stressors faced in the camps, psychological distress and functional impairment. Basic needs and safety concerns were more strongly correlated with measures of distress (r's = .19–.31) than were war-related traumatic events (r's = .09–.20). Hierarchical regression supported models in which effects of trauma on distress were mediated by current stressors. Although war-related traumatic events are the initial causes of refugees' hardship, findings suggest that the day-to-day challenges and concerns in camps mediate psychological distress associated with these events. PMID:20553516

Diabetes Among United States-Bound Adult Refugees, 2009-2014.

PubMed

Benoit, Stephen R; Gregg, Edward W; Zhou, Weigong; Painter, John A

2016-12-01

We reported diabetes prevalence among all US-bound adult refugees and assessed factors associated with disease. We analyzed overseas medical evaluations of US-bound refugees from 2009 through 2014 by using CDC's Electronic Disease Notification System. We identified refugees with diabetes by searching for diabetes-related keywords and medications in examination forms with text-parsing techniques. Age-adjusted prevalence rates were reported and factors associated with diabetes were assessed by using logistic regression. Of 248,850 refugees aged ≥18 years examined over 5 years, 5767 (2.3 %) had diabetes. Iraqis had the highest crude (5.1 %) and age-adjusted (8.9 %) prevalence of disease. Higher age group and body mass index were associated with diabetes in all regions. Diabetes prevalence varied by refugee nationality. Although the absolute rates were lower than rates in the United States, the prevalence is still concerning given the younger age of the population and their need for health services upon resettlement.

Poliovirus immunity in newly resettled adult refugees in Idaho, United States of America.

PubMed

Roscoe, Clay; Gilles, Ryan; Reed, Alex J; Messerschmidt, Matt; Kinney, Rebecca

2015-06-12

In the United States, vaccines have eliminated wild poliovirus (WPV) infection, though resettling refugees may lack immunity and importation of WPV remains a concern. A cross-sectional survey was performed to determine the prevalence of poliovirus immunity in adult refugees resettling in Boise, Idaho, U.S.A.; immunity was evaluated using two definitions: serotypes 1, 2 and 3 positive, or serotypes 1 and 3 positive. This survey evaluated 795 adult refugees between August 2010 and November 2012. Poliovirus immunity in adults >18 years was 55.3% for serotypes 1, 2 and 3 combined, and 60% for serotypes 1 and 3 only. This study demonstrated a WPV immunity rate of <60% in a recently resettled adult refugee population in the United States, reinforcing the need to ensure poliovirus immunity in all newly arrived adult refugees, either by expanding pre-departure immunization or by screening for immunity at resettlement and vaccinating when indicated. Copyright © 2015 Elsevier Ltd. All rights reserved.

Predicting Stress Related to Basic Needs and Safety in Darfur Refugee Camps: A Structural and Social Ecological Analysis

PubMed Central

RASMUSSEN, ANDREW; ANNAN, JEANNIE

2013-01-01

The research on the determinants of mental health among refugees has been largely limited to traumatic events, but recent work has indicated that the daily hassles of living in refugee camps also play a large role. Using hierarchical linear modelling to account for refugees nested within camp blocks, this exploratory study attempted to model stress surrounding safety and acquiring basic needs and functional impairment among refugees from Darfur living in Chad, using individual-level demographics (e.g., gender, age, presence of a debilitating injury), structural factors (e.g., distance from block to distribution centre), and social ecological variables (e.g., percentage of single women within a block). We found that stress concerning safety concerns, daily hassles, and functional impairment were associated with several individual-level demographic factors (e.g., gender), but also with interactions between block-level and individual-level factors as well (e.g., injury and distance to distribution centre). Findings are discussed in terms of monitoring and evaluation of refugee services. PMID:23626407

Predicting Stress Related to Basic Needs and Safety in Darfur Refugee Camps: A Structural and Social Ecological Analysis.

PubMed

Rasmussen, Andrew; Annan, Jeannie

2010-03-01

The research on the determinants of mental health among refugees has been largely limited to traumatic events, but recent work has indicated that the daily hassles of living in refugee camps also play a large role. Using hierarchical linear modelling to account for refugees nested within camp blocks, this exploratory study attempted to model stress surrounding safety and acquiring basic needs and functional impairment among refugees from Darfur living in Chad, using individual-level demographics (e.g., gender, age, presence of a debilitating injury), structural factors (e.g., distance from block to distribution centre), and social ecological variables (e.g., percentage of single women within a block). We found that stress concerning safety concerns, daily hassles, and functional impairment were associated with several individual-level demographic factors (e.g., gender), but also with interactions between block-level and individual-level factors as well (e.g., injury and distance to distribution centre). Findings are discussed in terms of monitoring and evaluation of refugee services.

'I followed the flood': a gender analysis of the moral and financial economies of forced migration.

PubMed

Krystalli, Roxanne; Hawkins, Allyson; Wilson, Kim

2018-01-01

What would a gender analysis of refugee crises reveal if one expanded the focus beyond female refugees, and acts of physical violence? This paper draws on qualitative research conducted in Denmark, Greece, Jordan, and Turkey in July and August 2016 to spotlight the gendered kinship, hierarchies, networks, and transactions that affect refugees. The coping strategies of groups often overlooked in the gender conversation are examined throughout this study, including those of male refugees and those making crossings outside of the context of a family unit. The analysis is theoretically situated at the intersection of critical humanitarianism and the politics of vulnerability, and rooted in debates about the feminisation of refugees and corresponding protection agendas. A key contribution of this work is the ethnographic tracing of how refugees embody these politics along their journeys. In closing, the paper sketches out some implications of the findings for humanitarian practice and identifies avenues for further research. © 2018 The Author(s). Disasters © Overseas Development Institute, 2018.

Cesarean sections among Syrian refugees in Lebanon from december 2012/january 2013 to june 2013: probable causes and recommendations.

PubMed

Huster, Karin M J; Patterson, Njogu; Schilperoord, Marian; Spiegel, Paul

2014-09-01

There are nearly 3 million Syrian refugees, with more than 1 million in Lebanon. We combined quantitative and qualitative methods to determine cesarean section (CS) rates among Syrian refugees accessing care through United Nations High Commissioner for Refugees (UNHCR)-contracted hospitals in Lebanon and possible driving factors. We analyzed hospital admission data from UNHCR's main partners from December 2012/January 1, 2013, to June 30, 2013. We collected qualitative data in a subset of hospitals through semi-structured informant interviews. Deliveries accounted for almost 50 percent of hospitalizations. The average CS rate was 35 percent of 6,366 deliveries. Women expressed strong preference for female providers. Clinicians observed that refugees had high incidence of birth and health complications diagnosed at delivery time that often required emergent CS. CS rates are high among Syrian refugee women in Lebanon. Limited access and utilization of antenatal care, privatized health care, and male obstetrical providers may be important drivers that need to be addressed.

Sending-country violence and receiving-country discrimination: effects on the health of Colombian refugees in Ecuador.

PubMed

Shedlin, Michele G; Decena, Carlos U; Noboa, Hugo; Betancourt, Óscar

2014-02-01

This study explored factors affecting the health and well being of recent refugees from Colombia in Ecuador. Data collection focused on how sending-country violence and structural violence in a new environment affect immigrant health vulnerability and risk behaviors. A qualitative approach included ethnographic observation, media content analysis, focus groups, and individual interviews with refugees (N = 137). The focus groups (5) provided perspectives on the research domains by sex workers; drug users; male and female refugees; and service providers. Social and economic marginalization are impacting the health and well being of this growing refugee population. Data illustrate how stigma and discrimination affect food and housing security, employment and health services, and shape vulnerabilities and health risks in a new receiving environment. Widespread discrimination in Ecuador reflects fears, misunderstanding, and stereotypes about Colombian refugees. For this displaced population, the sequelae of violence, combined with survival needs and lack of support and protections, shape new risks to health and well-being.

Let's talk about sex work in humanitarian settings: piloting a rights-based approach to working with refugee women selling sex in Kampala.

PubMed

Rosenberg, Jennifer S; Bakomeza, Denis

2017-11-01

Although it is well known that refugees engage in sex work as a form of livelihood, stigma and silence around this issue persist within humanitarian circles. As a result, these refugees' sexual and reproductive health and rights, and related vulnerabilities, remain overlooked. Their protection and health needs, which are significant, often go unmet at the field level. In 2016, the Women's Refugee Commission and Reproductive Health Uganda partnered to pilot a peer-education intervention tailored to meet the needs of refugee women engaged in sex work in Kampala. Findings from the pilot project suggest the feasibility of adapting existing rights-based and evidence-informed interventions with sex workers to humanitarian contexts. Findings further demonstrate how taking a community empowerment approach can facilitate these refugees' access to a range of critical information, services and support options - from information on how to use contraceptives, to referrals for friendly HIV testing and treatment, to peer counselling and protective peer networks.

Sending-Country Violence & Receiving-Country Discrimination: Effects on the Health of Colombian Refugees in Ecuador

PubMed Central

Shedlin, Michele G.; Decena, Carlos U.; Noboa, Hugo; Betancourt, Óscar

2013-01-01

BACKGROUND This study explored factors affecting the health and well being of recent refugees from Colombia in Ecuador. Data collection focused on how sending-country violence and structural violence in a new environment affect immigrant health vulnerability and risk behaviors. METHODS A qualitative approach included ethnographic observation, media content analysis, focus groups, and individual interviews with refugees (N=137). The focus groups (5) provided perspectives on the research domains by sex workers; drug users; male and female refugees; and service providers. RESULTS Social and economic marginalization are impacting the health and well being of this growing refugee population. Data illustrate how stigma and discrimination affect food and housing security, employment and health services, and shape vulnerabilities and health risks in a new receiving environment. DISCUSSION Widespread discrimination in Ecuador reflects fears, misunderstanding, and stereotypes about Colombian refugees. For this displaced population, the sequelae of violence, combined with survival needs and lack of support and protections, shape new risks to health and well-being. PMID:23377565

Rural Poverty Dynamics and Refugee Communities in South Africa: A Spatial-Temporal Model.

PubMed

Sartorius, Kurt; Sartorius, Benn; Tollman, Stephen; Schatz, Enid; Kirsten, Johann; Collinson, Mark

2013-01-01

The assimilation of refugees into their host community economic structures is often problematic. The paper investigates the ability of refugees in rural South Africa to accumulate assets over time relative to their host community. Bayesian spatial-temporal modelling was employed to analyse a longitudinal database that indicated that the asset accumulation rate of former Mozambican refugee households was similar to their host community; however, they were unable to close the wealth gap. A series of geo-statistical wealth maps illustrate that there is a spatial element to the higher levels of absolute poverty in the former refugee villages. The primary reason for this is their physical location in drier conditions that are established further away from facilities and infrastructure. Neighbouring South African villages in close proximity, however, display lower levels of absolute poverty, suggesting that the spatial location of the refugees only partially explains their disadvantaged situation. In this regard, the results indicate that the wealth of former refugee households continues to be more compromised by higher mortality levels, poorer education, and less access to high-return employment opportunities. The long-term impact of low initial asset status appears to be perpetuated in this instance by difficulties in obtaining legal status in order to access state pensions, facilities, and opportunities. The usefulness of the results is that they can be used to sharpen the targeting of differentiated policy in a given geographical area for refugee communities in rural Africa. Copyright © 2011 John Wiley & Sons, Ltd.

Review of child maltreatment in immigrant and refugee families.

PubMed

LeBrun, Annie; Hassan, Ghayda; Boivin, Mylène; Fraser, Sarah-Louise; Dufour, Sarah; Lavergne, Chantal

2016-03-14

Study results on child maltreatment based on general population samples cannot be extrapolated with confidence to vulnerable immigrant or refugee families because of the specific characteristics and needs of these families. The aims of this paper are 1) to conduct an evidence review of the prevalence, risk factors and protective factors for child maltreatment in immigrant and refugee populations, and 2) to integrate the evidence in an analytical ecosystemic framework that would guide future research. We used a 14-step process based on guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Canadian Collaboration for Immigrant and Refugee Health. We searched major databases from "the oldest date available to July 2014". The eligibility criteria for paper selection included qualitative or quantitative methodologies; papers written in English or French; papers that describe, assess or review prevalence, risk and protection factors for child maltreatment; and a studied population of immigrants or refugees. Twenty-four articles met the criteria for eligibility. The results do not provide evidence that immigrant or refugee children are at higher risk of child maltreatment. However, recently settled immigrants and refugees experience specific risk factors related to their immigration status and to the challenges of settlement in a new country, which may result in high risk of maltreatment. Future research must incorporate more immigrant and refugee samples as well as examine, within an ecosystemic framework, the interaction between migratory and cultural factors with regard to the prevalence, consequences and treatment of child maltreatment for the targeted groups.

Infection prevention and control and the refugee population: Experiences from the University of Louisville Global Health Center.

PubMed

Carrico, Ruth M; Goss, Linda; Wiemken, Timothy L; Bosson, Rahel S; Peyrani, Paula; Mattingly, William A; Pauly, Allison; Ford, Rebecca A; Kotey, Stanley; Ramirez, Julio A

2017-06-01

During 2016, approximately 140,000 individuals entered the United States as part of the federal government refugee resettlement program and established themselves in communities in virtually every state. No national database regarding refugee health currently exists; therefore, little is known about existing infectious diseases, conditions, and cultural practices that impact successful acculturation. The objective of this report is to identify what is currently known about refugees and circumstances important to infection prevention and control with respect to their roles as new community members, employees, and consumers of health care. Using data from the University of Louisville Global Health Center's Newly Arriving Refugee Surveillance System, health issues affecting refugees from the perspective of a community member, an employee, and a patient were explored. Lack of immunity to vaccine-preventable diseases is the most widespread issue impacting almost every adult, adolescent, and child refugee resettled in Kentucky. Health issues of concern from an infection prevention and control perspective include latent tuberculosis infection, HIV, hepatitis B, hepatitis C, syphilis, and parasites. Other health conditions that may also be important include anemia, obesity, oral health, diabetes, and cardiovascular disease. Refugee resettlement provides motivation for collaborative work among those responsible for infection prevention and control in all settings, their public health partners, and those responsible for and interested in community workforce concerns. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Rural Poverty Dynamics and Refugee Communities in South Africa: A Spatial–Temporal Model

PubMed Central

Sartorius, Kurt; Sartorius, Benn; Tollman, Stephen; Schatz, Enid; Kirsten, Johann; Collinson, Mark

2013-01-01

The assimilation of refugees into their host community economic structures is often problematic. The paper investigates the ability of refugees in rural South Africa to accumulate assets over time relative to their host community. Bayesian spatial–temporal modelling was employed to analyse a longitudinal database that indicated that the asset accumulation rate of former Mozambican refugee households was similar to their host community; however, they were unable to close the wealth gap. A series of geo-statistical wealth maps illustrate that there is a spatial element to the higher levels of absolute poverty in the former refugee villages. The primary reason for this is their physical location in drier conditions that are established further away from facilities and infrastructure. Neighbouring South African villages in close proximity, however, display lower levels of absolute poverty, suggesting that the spatial location of the refugees only partially explains their disadvantaged situation. In this regard, the results indicate that the wealth of former refugee households continues to be more compromised by higher mortality levels, poorer education, and less access to high-return employment opportunities. The long-term impact of low initial asset status appears to be perpetuated in this instance by difficulties in obtaining legal status in order to access state pensions, facilities, and opportunities. The usefulness of the results is that they can be used to sharpen the targeting of differentiated policy in a given geographical area for refugee communities in rural Africa. Copyright © 2011 John Wiley & Sons, Ltd. PMID:24348199

Psychiatric morbidity among physically injured Syrian refugees in Turkey.

PubMed

Al-Nuaimi, Saleem; Aldandashi, Samer; Easa, Abdul Kadir Saed; Saqqur, Maher

2018-01-01

To the best of our knowledge, the mental health status of physically injured Syrian refugees has not yet been investigated. The aim of this study was to examine the prevalence of psychiatric morbidity among physically injured Syrian refugees in Turkey receiving treatment at the main rehabilitation centre near the Syrian border. This is a cross sectional study. Information was collected from consenting injured Syrian refugees at Dar-el-Shefa'a Hospital in Reyhanlı (Turkey) during a one week period in December 2012 and another one week period in August 2013. A clinical psychiatric interview was conducted to determine a diagnosis according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM) IV-TR. A total of 40 refugees consented and completed a clinical psychiatric interview. All refugees in this study did not have a significant past psychiatric history. The most prevalent current diagnosis was major depressive disorder (22.5%), adjustment disorder (20%), and post-traumatic stress disorder (15%). Five (12.5%) patients had no evidence of a psychiatric disorder. The prevalence of psychiatric morbidity among injured Syrian refugees in our study was extremely high. This may help guide the treatment and management of this select population. This study had a low number of participants. The method of assessment was not standardized with a validated tool. This study may help guide the treatment and management of this select population, both in neighbouring countries and as resettled refugees in Western host countries. Copyright © 2017 Elsevier Inc. All rights reserved.

Changing cultures: enhancing mental health and wellbeing of refugee young people through education and training.

PubMed

Bond, Lyndal; Giddens, Anne; Cosentino, Anne; Cook, Margaret; Hoban, Paul; Haynes, Ann; Scaffidi, Louise; Dimovski, Mary; Cini, Eileen; Glover, Sara

2007-01-01

Many refugee people and others entering Australia under the Humanitarian Program, have experienced extremely stressful and disrupted lives prior to arrival. A major difficulty experienced by a significant number of refugee young people is their lack of formal education before arrival. It directly affects their ability to start connecting to their new society and constructing a new life. The level of ease with which young people can move into the education and training system and begin to establish a meaningful career pathway has a huge impact on their successful settlement and stable mental health. This paper describes the Changing Cultures Project, a three-year project, which explored models of appropriate and accessible education and training for refugee and newly arrived young people that would enhance their mental health. The Changing Cultures Project was a partnership between the education, health and settlement sectors. This paper describes the program and system response to the health, settlement, education and vocational issues facing refugee young people using a mental health promotion framework and reflective practice. We discuss how the refugee youth programs met a broad range of needs as well as providing language, literacy and basic education to newly arrived young people. While working in an environment of changing policy and public opinion regarding refugee issues, the Project delivered successful outcomes at the program and organisational levels for refugee young people by addressing issues of program development and delivery, organisational development and capacity building and community development and evaluation.

45 CFR 400.4 - Purpose of the plan.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Grants to States for Refugee Resettlement The State Plan § 400.4 Purpose of the plan. (a) In order for a State to...

45 CFR 400.82 - Failure or refusal to accept employability services or employment.

Code of Federal Regulations, 2010 CFR

2010-10-01

... OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Requirements for Employability Services and Employment Failure Or... recipient of refugee cash assistance under the public/private RCA program or under a publicly-administered...

Personality, Demographics, and Acculturation in North American Refugees.

ERIC Educational Resources Information Center

Smither, Robert; Rodriquez-Giegling, Marta

This study predicts willingness of refugees to acculturate to North American society based on selected demographic and psychological variables. The hypothesis is that most previous research on refugee adaptation has overemphasized sociological variables such as age, time in the country, and level of education and underemphasized psychological…

45 CFR 400.49 - Recovery of overpayments and correction of underpayments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... underpayments. 400.49 Section 400.49 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Cash Assistance § 400.49 Recovery of overpayments and correction of underpayments...

45 CFR 400.79 - Development of an employability plan.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Section 400.79 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM... plan where applicable for each recipient of refugee cash assistance in a family unit who is not exempt...

45 CFR 400.65 - Continuation of a publicly-administered RCA program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... program. 400.65 Section 400.65 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Cash Assistance § 400.65 Continuation of a publicly-administered RCA program...

Informal Adult Learning and Emotion Work of Service Providers for Refugee Claimants

ERIC Educational Resources Information Center

Brigham, Susan M.; Baillie Abidi, Catherine; Tastsoglou, Evangelia; Lange, Elizabeth

2015-01-01

Like the immigrant clients they serve, service providers have been overlooked in adult education literature, yet their roles are crucial for addressing the serious concerns of refugees and refugee claimants who flee their home countries hoping to find safe refuge in another country.

45 CFR 400.11 - Award of Grants to States.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Grants to States for Refugee Resettlement Award of Grants to States § 400.11 Award of Grants to States. (a...

45 CFR 400.1 - Basis and purpose of the program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 400.1 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM... resettlement of refugees and to assist them to achieve economic self-sufficiency as quickly as possible. (c...

45 CFR 400.59 - Eligibility for the public/private RCA program.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... 400.59 Section 400.59 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Cash Assistance § 400.59 Eligibility for the public/private RCA program. (a...

45 CFR 400.107 - Medical screening.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 2 2014-10-01 2012-10-01 true Medical screening. 400.107 Section 400.107 Public... AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Medical Assistance Scope of Medical Services § 400.107 Medical screening. (a) As part of its refugee medical...

45 CFR 400.107 - Medical screening.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 2 2013-10-01 2012-10-01 true Medical screening. 400.107 Section 400.107 Public... AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Medical Assistance Scope of Medical Services § 400.107 Medical screening. (a) As part of its refugee medical...

45 CFR 400.107 - Medical screening.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 2 2012-10-01 2012-10-01 false Medical screening. 400.107 Section 400.107 Public... AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Medical Assistance Scope of Medical Services § 400.107 Medical screening. (a) As part of its refugee medical...

Immigration Enforcement Practices Harm Refugee Children and Citizen-Children

ERIC Educational Resources Information Center

Zayas, Luis H.

2018-01-01

Aggressive immigration enforcement hurts the very youngest children. Refugee and U.S.-born children of undocumented immigrants experience many childhood adversities, compromising their development and health. Refugee children flee traumatizing violence in their home countries, face grueling migrations, and are harmed further by being held in…

Review of Child and Adolescent Refugee Mental Health

ERIC Educational Resources Information Center

Lustig, Stuart L.; Kia-Keating, Maryam; Knight, Wanda Grant; Geltman, Paul; Ellis, Heidi; Kinzie, J. David; Keane, Terence; Saxe, Glenn N.

2004-01-01

Objective: To review stressful experiences and stress reactions among child and adolescent refugees, as well as interventions and ethical considerations in research and clinical work, within the framework of the chronological experiences of child refugees; namely, the phases of preflight, flight, and resettlement. Highlighted are special refugee…

45 CFR 400.107 - Medical screening.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Medical screening. 400.107 Section 400.107 Public... AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Medical Assistance Scope of Medical Services § 400.107 Medical screening. (a) As part of its refugee medical...

45 CFR 400.107 - Medical screening.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 2 2011-10-01 2011-10-01 false Medical screening. 400.107 Section 400.107 Public... AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Medical Assistance Scope of Medical Services § 400.107 Medical screening. (a) As part of its refugee medical...

Southeast Asian Refugee Parent Survey.

ERIC Educational Resources Information Center

Blakely, Mary M.

This paper summarizes the findings of a descriptive research project conducted among Southeast Asian parents in an Oregon school district, and discusses the issue of fieldwork methodology among refugee populations. The district studied had a student population of 18,000 (kindergarten through grade 12), with Southeast Asian refugees accounting for…

76 FR 10605 - Proposed Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2011-02-25

... is the application for funding for the Refugee Cash and Medical Assistance program. Applicants for funding provide estimates of costs of the different components of the program--Refugee Cash Assistance... Cost of the Services to Unaccompanied Refugee Minors program, and Administrative Costs of the State...

Indochinese Refugees--The Newest Americans.

ERIC Educational Resources Information Center

Liff, Mark

1980-01-01

Education for Indochinese refugee children runs the gamut from teaching English as a second language to preparing students for life in American society. Hampered by lagging federal funding, lack of bilingual teachers, and refugees' psychological problems, school districts across the country are struggling to assist in the resettlement process. (SK)

Imagined Community of Education: Voices from Refugees and Immigrants

ERIC Educational Resources Information Center

He, Ye; Bettez, Silvia Cristina; Levin, Barbara B.

2017-01-01

To challenge deficit thinking concerning immigrants and refugees in urban schools, we engaged members of local immigrant and refugee communities from China, Mexico, Liberia, and Sudan in focus group discussions about their prior educational experiences, their hopes and aspirations for education, and the supports and challenges they encountered in…

77 FR 21563 - Submission for OMB Review; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2012-04-10

... OMB Review; Comment Request Title: Annual Survey of Refugees (Form ORR-9). OMB No.: 0970-0033. Description: The Annual Survey of Refugees collects information on the social and economic circumstances of a random sample of refugees, Amerasians, and entrants who arrived in the United States in the five years...

45 CFR 400.9 - Administrative review of decisions on approval of State plans and plan amendments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Grants to States for Refugee Resettlement The State Plan... is not approvable shall remain in effect pending the reconsideration. (h) If the Director reverses...

Supporting Refugee Students in School Education in Greater Western Sydney

ERIC Educational Resources Information Center

Ferfolja, Tania; Vickers, Margaret

2010-01-01

Rarely do refugee students entering Australian schools possess the multiple forms of social, linguistic and cultural capital that are taken for granted in mainstream classrooms. While refugees of high-school age are assisted initially through Intensive English Centres (IECs), the transition from IECs to mainstream classrooms presents substantial…

Educational Needs and Barriers for African Refugee Students in Manitoba

ERIC Educational Resources Information Center

Kanu, Yatta

2008-01-01

This study investigated the educational needs and barriers for diverse African refugee students in two inner-city high schools in Manitoba. Forty African refugee students, two principals, eight teachers, four parents, and four community leaders participated in the study. Five focus groups, individual interviews, and school and classroom…

Flexible Models for Learning English Are Needed for Refugee Mothers

ERIC Educational Resources Information Center

Riggs, Elisha; Block, Karen; Gibbs, Lisa; Davis, Elise; Szwarc, Josef; Casey, Sue; Duell-Piening, Philippa; Waters, Elizabeth

2012-01-01

The importance of English language acquisition for resettlement of refugees is well established, particularly as a pathway to education, employment, health and social connections. A qualitative study was conducted in 2011 in Melbourne, Australia utilising focus groups with 87 refugee background women from Karen, Iraqi, Assyrian Chaldean, Lebanese,…

Pathways to Self-Sufficiency: Successful Entrepreneurship for Refugees

ERIC Educational Resources Information Center

Fong, Rowena; Busch, Noel Bridget; Armour, Marilyn; Heffron, Laurie Cook; Chanmugam, Amy

2007-01-01

This study examined the successes and challenges of refugee entrepreneurs by interviewing 50 refugees, service providers, and technical assistance providers. Qualitative data analyses revealed that successes and challenges occurred both at the individual and family levels as well as at the community and agency levels. The findings underscore the…

45 CFR 400.58 - Content and submission of public/private RCA plan.

Code of Federal Regulations, 2010 CFR

2010-10-01

.... 400.58 Section 400.58 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT, ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES REFUGEE RESETTLEMENT PROGRAM Refugee Cash Assistance § 400.58 Content and submission of public/private RCA plan. (a...

Language Policies, Identities, and Education in Refugee Resettlement

ERIC Educational Resources Information Center

Feuerherm, Emily

2013-01-01

This dissertation explores the creation and development of a community based language and health program for Iraqi refugees. The need for the program is contextualized by international, national and local policies of refugee resettlement, policies for language and education, and the interpretation of these policies on the ground. Ideologies…

75 FR 78263 - Agency Information Collection Activities: Extension of an Existing Information Collection...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-12-15

... of information collection under review; Form G- 646, Sworn Statement of Refugee Applying for... the Form/Collection: Sworn Statement of Refugee Applying for Admission to the United States. (3... the applicants to the United States as refugees. (5) An estimate of the total number of respondents...

Narrative Career Counselling for People with Refugee Backgrounds

ERIC Educational Resources Information Center

Abkhezr, Peyman; McMahon, Mary

2017-01-01

For people with refugee backgrounds, pursuing a meaningful career in their country of resettlement is important for their successful integration. However, for many, achieving this is a challenging process. Career counsellors may have a role to play in facilitating the transition and integration of people with refugee backgrounds, and narrative…

78 FR 78363 - Proposed Information Collection Activity; Comment Request

Federal Register 2010, 2011, 2012, 2013, 2014

2013-12-26

... reporting suicides and suicide attempts by refugees. Title: Refugee Suicide Report Form (RSR). OMB No.: 0970... allow ORR to systematically gather information on suicides and suicide attempts among refugee populations resettled in the U.S. Data will be collected on individuals who have made suicide attempts or...

Passage: A Journal of Refugee Education.

ERIC Educational Resources Information Center

Passage, 1985

1985-01-01

This inaugural issue of the journal concerning education programs for refugees in the United States contains 20 articles dealing with teaching English as a second language (ESL) and cultural orientation. They include "The IESL/CO/PET Program" (Anne Morgan); "Studying Refugees' Languages: A New Approach in Staff Development" (John Duffy and Chad…

Special Galang Issue. Passage: A Journal of Refugee Education.

ERIC Educational Resources Information Center

Passage: Journal of Refugee Education, 1987

1987-01-01

A special issue of the Journal of Refugee Education devoted to the Galang (Indonesia), site of the Overseas Refugee Training Program, contains these articles: "Origins of the Galang Program: A Historical Perspective" (Melvin E. Frarey); "'I Can't Believe I Am Flying over the South China Sea...'" (Elizabeth Tannenbaum);…

45 CFR 400.152 - Limitations on eligibility for services.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Limitations on eligibility for services. 400.152 Section 400.152 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT... Refugee Social Services Conditions of Eligibility for Refugee Social Services § 400.152 Limitations on...

45 CFR 400.152 - Limitations on eligibility for services.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 45 Public Welfare 2 2012-10-01 2012-10-01 false Limitations on eligibility for services. 400.152 Section 400.152 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT... Refugee Social Services Conditions of Eligibility for Refugee Social Services § 400.152 Limitations on...

45 CFR 400.152 - Limitations on eligibility for services.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 45 Public Welfare 2 2014-10-01 2012-10-01 true Limitations on eligibility for services. 400.152 Section 400.152 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT... Refugee Social Services Conditions of Eligibility for Refugee Social Services § 400.152 Limitations on...

45 CFR 400.152 - Limitations on eligibility for services.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 45 Public Welfare 2 2011-10-01 2011-10-01 false Limitations on eligibility for services. 400.152 Section 400.152 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT... Refugee Social Services Conditions of Eligibility for Refugee Social Services § 400.152 Limitations on...

45 CFR 400.152 - Limitations on eligibility for services.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 45 Public Welfare 2 2013-10-01 2012-10-01 true Limitations on eligibility for services. 400.152 Section 400.152 Public Welfare Regulations Relating to Public Welfare OFFICE OF REFUGEE RESETTLEMENT... Refugee Social Services Conditions of Eligibility for Refugee Social Services § 400.152 Limitations on...

Guidebook for the Cambodian Refugees.

ERIC Educational Resources Information Center

Interagency Task Force for Indochina Refugees, Washington, DC.

This guidebook was written for distribution to Cambodian refugees at Indiantown Gap refugee camp, and contains general information on life in the United States. The first section deals with the official aspects of being a foreigner in this country: such topics as filing alien registration forms, applying for citizenship, getting assistance from…

Refugees and Forced Migration: Need for New Definition.

ERIC Educational Resources Information Center

Rogge, John R.

A significant component of modern migrants are refugees or displaced persons. Historically, most involuntary migrants readily found permanent asylum in the traditional immigrant receiving countries of the New World. This situation is changing. Source areas of refugees have shifted from the European arena to the Third World, and the causes of…

Cambodian Refugees.

ERIC Educational Resources Information Center

Boright, Lucinda L.

The Khmer are the predominant ethnic group of Cambodia, yet they have suffered genocide in their own homeland. The English language is the primary social barrier confronted by Cambodian refugees to the United States, since there are no similarities between English and Khmer alphabets and tenses. Refugees who arrrived in 1975 tended to be educated,…

Engaging the Refugee Community of Greater Western Sydney

ERIC Educational Resources Information Center

Naidoo, Loshini

2010-01-01

This paper discusses the community engagement program, "Refugee Action Support" (RAS) at the University of Western Sydney. RAS is a partnership program between the Australian Literacy and Numeracy Foundation, The NSW Department of Education and Training and the university. The Refugee Action Support program prepares pre-service teachers…

Psychological Distress in Refugee Children: A Systematic Review

ERIC Educational Resources Information Center

Bronstein, Israel; Montgomery, Paul

2011-01-01

Nearly one-quarter of the refugees worldwide are children. There have been numerous studies reporting their levels of psychological distress. The aim of this paper is to review systematically and synthesize the epidemiological research concerning the mental health of refugee children residing in Western countries. A Cochrane Collaboration style…

Industries' Reactions to the Indochinese Refugees as Employees.

ERIC Educational Resources Information Center

Latkiewicz, John; Anderson, Colette

1983-01-01

Based upon a research project conducted for the Manpower and Employment Training Council, Utah Office of Labor and Training, discusses: (1) personnel managers' and supervisors' perceptions of refugees during job interviews, (2) their perceptions of refugees as workers, and (3) their perceptions of the English proficiency necessary for success in…

University Students from Refugee Backgrounds: Why Should We Care?

ERIC Educational Resources Information Center

Lenette, Caroline

2016-01-01

In resettlement countries like Canada, the United States, and Australia, research suggests that higher education is vital to ensure well-being, greater socioeconomic integration and inclusion, and successful settlement of refugee communities to make a positive contribution to society. Refugees across the globe have high educational aspirations and…

Understanding the Refugee Experience: Foundations of a Better Resettlement System.

ERIC Educational Resources Information Center

Stein, Barry N.

1981-01-01

Suggests the need for understanding refugees' characteristics, experiences, resettlement needs, and their patterns of behavior during the resettlement process. Examines consistencies which have been observed in refugee experiences and the process of adaptation to a new society. Treats specifically the conditions of Soviet Jewish and Indochinese…

A New Minority: Indochinese Refugees in Higher Education.

ERIC Educational Resources Information Center

Skinner, Kenneth A.; Hendricks, Glenn L.

On the premise that postsecondary institutions can respond adequately to the new Indochinese student population only if an accurate description of the students is provided, an ethnographic study of the refugee community's process of adaptation was undertaken. The social situations and experiences of the refugees are described, including their…

Digital Literacy: A Palestinian Refugee Perspective

ERIC Educational Resources Information Center

Traxler, John

2018-01-01

This paper is the first attempt to explore digital literacy in the specific context of the Palestinian refugee community in the Middle East by looking at the cultural specificity of digital literacy theorising and practice, by analysing current digital education policy in the countries hosting the Palestinian refugee community and by documenting…

Higher Education for Refugees: Lessons from a 4-Year Pilot Project

ERIC Educational Resources Information Center

Crea, Thomas M.; McFarland, Mary

2015-01-01

Refugees experience limited access to adequate education at all levels, but opportunities for higher education are especially lacking. Yet, evidence suggests that education plays an important protective role in helping refugee individuals and communities cope with their daily existence during protracted waiting periods, and the United Nations…

Medical and Mental Health Needs of Adolescent Indochinese Refugees.

ERIC Educational Resources Information Center

Johnson, Jennifer; And Others

1986-01-01

Presents results of a study analyzing the health records of 181 adolescent Indochinese refugees in San Diego, CA. Focuses on the medical problems known to be prevalent among adult Indochinese refugees: tuberculosis infection, intestinal parasites, and hepatitis B antigenemia. Reports that Indochinese adolescents may have a high rate of mental…

Deporting Cambodian Refugees: Justice Denied?

ERIC Educational Resources Information Center

Hing, Bill Ong

2005-01-01

Until recently, the United States did not deport refugees convicted of crimes to the communist-dominated countries of Cuba, Vietnam, Laos, and Cambodia. After all, these refugees had fled persecution, and diplomatic ties between the United States and these countries are not particularly strong. But in March 2002, the United States convinced…

45 CFR 400.301 - Withdrawal from the refugee program.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 45 Public Welfare 2 2010-10-01 2010-10-01 false Withdrawal from the refugee program. 400.301... Waivers and Withdrawals § 400.301 Withdrawal from the refugee program. (a) In the event that a State... assistance, social services, preventive health, and an unaccompanied minors program if appropriate. A State...

Autism and Reading: Teaching a Sudanese Refugee Boy

ERIC Educational Resources Information Center

Walker-Dalhouse, Doris; Dalhouse, A. Derick

2015-01-01

Refugee families in the United States face numerous challenges in becoming acculturated. School-age children of refugees face the additional challenges of acquiring academic language and meeting school expectations for behavior and social interactions while attempting to navigate the school curriculum. This case study examines the school and home…

A private-sector preferred provider network model for public health screening of newly resettled refugees.

PubMed

Geltman, Paul L; Cochran, Jennifer

2005-02-01

US law and regulations stipulate a process for the health screening of refugees. The responsibility of caring for refugees resettled in the United States rests, in part, with public health or welfare departments. Massachusetts has met its screening responsibilities through the innovative creation of a network of private preferred providers. We explore the Massachusetts model of public-private collaboration within the context of federal refugee health priorities and current state fiscal restraints affecting public health programs, and demonstrate the model's accomplishments.

Acculturation, partner violence, and psychological distress in refugee women from Somalia.

PubMed

Nilsson, Johanna E; Brown, Chris; Russell, Emily B; Khamphakdy-Brown, Supavan

2008-11-01

This study examined the relations among acculturation, domestic violence, and mental health in 62 married refugee women from Somalia. Refugees from Somalia constituted the largest group of refugees entering the United States in 2005, and little is known about the presence of domestic violence in this group. The results showed that women who reported greater ability to speak English also reported more experiences of partner psychological abuse and physical aggression. Experiences of more psychological abuse and physical aggressions also predicted more psychological distress. Implications for future research and psychological services are addressed.

Reasons for Living and Hoping: The Spiritual and Psycho-Social Needs of Southeast Asian Refugee Children and Youth Resettled in the United States. Proceedings from the Multi-Disciplinary, Inter-Religious Conference on the Spiritual and Psycho-Social Needs of Southeast Asian Refugee Children and Youth Resettled in the United States (Washington, DC, October 16-18, 1988).

ERIC Educational Resources Information Center

International Catholic Child Bureau, Inc., New York, NY.

This document presents proceedings of a conference convened to identify the unmet spiritual and other non-material needs of Southeast Asian refugee children and youth and to offer recommendations to strengthen present programs and policies. Participants included leaders in the refugee community, clergy of several faiths, organizational…

[Unseen Suffering - Therapy for Traumatized Refugee Children].

PubMed

Mattenschlager, Andreas; Nahler, Stefanie; Reisinger, Regine

2016-12-01

Unseen Suffering - Therapy for Traumatized Refugee Children In March 2015 the psychological counselling service (Psychologische Familien- und Lebensberatung) of Caritas Ulm initiated a psychotherapy project for traumatized minor refugees. Besides individual and group therapy, networking and qualification of qualified personnel and volunteers, in autumn 2015 we started offering our services on-site in a large collective accommodation for asylum seekers in Ulm. This was mainly because - in contrast to unaccompanied, mostly adolescent, minor refugees - our services appeared to reach children only by chance. In our opinion this is mostly due to the fact that children's suffering is often far less noticed. This paper describes our first year's project work, followed by reports on the use of psychodrama groups with refugee children and on the therapeutic work in a collective accommodation for asylum seekers.

Depression among unaccompanied minor refugees: the relative contribution of general and acculturation-specific daily hassles.

PubMed

Keles, Serap; Friborg, Oddgeir; Idsøe, Thormod; Sirin, Selcuk; Oppedal, Brit

2016-01-01

This study is designed to provide an empirical conceptualization of daily hassles among unaccompanied refugees, and whether they might affect mental health of young refugees after resettlement. First, we examined the underlying structure of daily hassles conceptualized as measuring general and acculturation-specific hassles. Second, we examined whether these two distinct categories of daily hassles significantly contribute to depression above and beyond the impact of premigration trauma. The study was based on self-report questionnaire data collected from 895 unaccompanied refugees who had been granted residence in Norway. Using structural equation modeling, the results confirmed the grouping of hassles in two general categories, which explained 43% of the variance in depression. The findings underscore the importance of current life conditions for unaccompanied refugees' mental health.

Universal post-arrival screening for child refugees in Australia: isn't it time?

PubMed

Patradoon-Ho, Patrick S; Ambler, Rosemary W

2012-02-01

It is known that the refugee population in Australia is at risk of tuberculosis (TB) and children with TB infection can develop active disease with devastating consequence. Currently, in New South Wales (NSW) and possibly other Australian States and Territories, there are different and complex health-screening pathways for newly arrived refugees. This is compounded by various factors, such as social and language difficulties for refugees to access healthcare and limited pre-embarkation screening. In this Viewpoint article, we present a child refugee in Australia with TB and use this case to reason why a universal post-arrival health screening programme should be established. © 2010 The Authors. Journal of Paediatrics and Child Health © 2010 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

UNRWA and the health of Palestinian refugees. United Nations Relief and Works Agency.

PubMed

Lilienfield, L S; Rose, J C; Corn, M

1986-08-28

The United Nations Relief and Works Agency for Palestine refugees (UNRWA) has provided health, education, and welfare services since 1949. A team of physicians from Georgetown University visited UNRWA Health Centers and refugee camps in Jordan, Lebanon, the West Bank, and the Gaza Strip, as well as some affiliated hospitals. Living conditions of refugees vary widely. In Jordan and the West Bank, fewer than one third live in camps, whereas in the Gaza Strip and Lebanon, conditions are more crowded. Effective programs for health education, maternal and child health, and immunization have markedly improved the health of the refugees over the years of UNRWA's operation. The general health of the population is good, primarily as a result of wise emphasis on public health and preventive medicine measures.