Health and healthcare can look very different for refugees, in comparison to people who are not displaced, and this blog post will explore the reasons why.
Illnesses which affect humans can be grouped into two categories. One of these is ‘communicable’, which refers to diseases that can be transferred from one person to another. Some examples are cholera, measles, and malaria. The spread of these is more likely in the living conditions associated with displacement. For example, a lack of safe water, overcrowding, and access to healthcare services (including vaccinations, which can prevent some communicable diseases from being contracted). However, in some cases, outbreaks of communicable diseases can cause a refugee emergency, rather than the other way around. (WHO, PHE & partners)
The other of the two main categories of disease is ‘non-communicable’. These illnesses cannot be transferred from one person to another. Some examples are cardiovascular disease, diabetes, and cancer, which all require management by healthcare services. However, as we have already established, displacement is associated with a lack of access to healthcare services. Therefore, the vast majority of deaths resulting from chronic illnesses occur in poorer countries, where displacement is more common. Access to healthcare services is also important in preventing non-communicable diseases, as is a healthy diet which is of course hard to maintain during a refugee emergency. (WHO, HPA & partners)
In addition to the two types of illnesses identified in the previous paragraphs, the World Health Organization identifies one other area of its work: mental health. Refugees can develop mental health issues prior to leaving their country of origin, due to whatever ultimately results in their leaving, such as persecution or exposure to conflict. A turbulent journey to a host country or poor treatment upon arrival can also result in the development of mental health conditions. Due to their experiences of hardship, refugees are more likely to suffer from mental illness than others in their host countries. However, the nature of their situations means they are less likely to be able to seek the support they need. (WHO)
It will not be discussed here, as a previous blog post (‘Refugee Women’ from 02/03/2024) covers the topic, but women have specific health needs which are less likely to be dealt with appropriately amongst refugees.
Occupational health is also a factor to be considered. This is because many refugees have jobs in their host countries that are not desirable to those born there, due to being dangerous, dirty, demanding and/or degrading. In addition, these types of roles often lack proper contracts which can help to hold employers accountable for failing to provide adequate protective equipment and health and safety training. Therefore, refugees are more likely than native workers to be affected by hazards such as high temperatures, loud noises, and exposure to chemicals. (Porru & Baldo)
Many organisations have put interventions in place to deal with the issues explained above. For example, to limit the spread of communicable diseases, the UN Refugee Agency focuses on increasing the provision of, or access to, vaccinations, water and sanitation facilities. To tackle non-communicable diseases, they train healthcare workers in screening, diagnosing and managing patients. The Agency also ensures healthcare workers have the relevant knowledge to help patients with mental health issues and sexual and reproductive health needs. (UNHCR)
Non-governmental organisations continue to work closely with national ministries of health in order to ensure refugees receive suitable healthcare to reflect their distinct challenges. We therefore hope that the issues outlined in this blog post decrease in prevalence in the lives of refugees in the future.
References:
Office of the United Nations High Commissioner for Refugees (UNHCR), ‘Access to healthcare’, UNHCR, https://www.unhcr.org/uk/what-we-do/protect-human-rights/public-health/access-healthcare
Porru & Baldo, ‘Occupational Health and Safety and Migrant Workers: Has Something Changed in the Last Few Years?’, International Journal of Environmental Research and Public Health, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9367908/
World Health Organization (WHO), ‘Mental health and forced displacement’, World Health Organization, https://www.who.int/news-room/fact-sheets/detail/mental-health-and-forced-displacement
World Health Organization (WHO), Public Health England (PHE) & partners, ‘Emergency Risk Management for Health: Communicable Diseases’, World Health Organization, https://cdn.who.int/media/docs/default-source/documents/publications/information-sheet-communicable-diseases2337c8a6-4f92-4087-a821-8afb734d883d.pdf?sfvrsn=384d78b2_1&download=true
World Health Organization (WHO), United Kingdom Health Protection Agency (HPA) & partners, ‘Disaster Risk Management for Health: Non-Communicable Diseases’, World Health Organization, https://cdn.who.int/media/docs/default-source/documents/publications/information-sheet-ncds26df66af-6bb2-4129-9f70-6f385c8e0e95.pdf?sfvrsn=b8d93d0b_1&download=true
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