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Simonek T, Zahos H, Mahroof-Shaffi S, Harkensee C. Seasonal patterns of communicable disease incidence and antibiotic prescribing in Moria refugee camp, Greece. J Public Health (Oxf) 2024; 46:41-50. [PMID: 37968097 DOI: 10.1093/pubmed/fdad212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 09/27/2023] [Accepted: 10/19/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND Infectious diseases remain a major risk for refugees living in camps. Limited research has been undertaken into the burden and impact of infections in the current refugee crisis around the Mediterranean.This analysis examines the frequency and incidence rates of common infections, and use of antibiotics at a healthcare facility inside Moria refugee camp on the island of Lesvos, Greece, during the winter and summer seasons of 2019. METHODS This is a retrospective analysis of routinely, prospectively collected service data from the main acute healthcare facility inside Moria camp. RESULTS Of a total of 9601 consultations, 25.16% were for infections (winter: 31.53%, summer: 19.45%). Respiratory, skin and gastrointestinal infections were the most frequent, with incidence rates up to 3.5 times, 50 times and twice as high as those in Western Europe, respectively. Antibiotic prescribing was high (27.7% of all respiratory infections) with high use of broad-spectrum antibiotics (40.2%), raising concerns about induction of antimicrobial resistance. CONCLUSIONS The burden of infectious diseases in refugee camps remains high throughout all seasons. Antimicrobial stewardship programmes should be adapted to refugee camp settings to prevent the development of unnecessary antimicrobial resistance. Improving living conditions and access to healthcare in refugee camps is likely to reduce infection rates and antimicrobial resistance among refugees.
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Affiliation(s)
- Tomas Simonek
- UNHCR Camp Lesbos Greece, St. Elizabeth University, Namestie, 1 Maja 1, 81000 Bratislava, Slovakia
| | - Helen Zahos
- School of Nursing and Midwifery, Griffith University, Parklands Drive, Southport, QLD 4222, Gold Coast, Australia
| | | | - Christian Harkensee
- Queen Elizabeth Hospital Gateshead, Queen Elizabeth Avenue, Gateshead, NE9 6SX, UK
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Mroue T, Heras B, Soriano JM, Morales-Suarez-Varela M. Prevalence of Malnutrition among Syrian Refugee Children from Lebanon. Life (Basel) 2023; 13:life13020453. [PMID: 36836811 PMCID: PMC9961820 DOI: 10.3390/life13020453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 02/08/2023] Open
Abstract
Today, the situation of Syrian refugees is one of the world's worst humanitarian crises. To estimate the prevalence of malnutrition among pediatric populations of Syrian refugees, 176 Syrian refugee children, with stays of more than two years at three refugee camps (Zalhé, Deddeh, and Kfar Jouz) or from the town of Yohmor, Lebanon were authorized by their parents to participate in this study. The children were anthropometrically evaluated and height-for-age Z-score (HAZ), weight-for-age Z-score (WAZ), and weight-for-height (WHZ) Z-scores were obtained and compared with WHO standards. Furthermore, mid-upper arm circumference (MUAC) was analyzed for screening children 6-59 months old. According to the anthropometric measures, no child met the criteria for chronic, global, acute malnutrition (CGAM), severe acute malnutrition (SAM), or moderate acute malnutrition (MAM). In the total sample, 49.4% of participants were moderately thin, with girls presenting a higher prevalence of thinness than that of boys. Thus, the absence of high rates of malnutrition was verified despite the magnitude of the Syrian refugee's problem. The data provided by this study identify the need to carry out further research to assess anthropometric growth and nutritional status among long-staying refugee children in order to prevent any health issues that may arise in the future.
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Affiliation(s)
- Tamara Mroue
- Observatory of Nutrition and Food Safety for Developing Countries, Food & Health Lab, Institute of Materials Science, University of Valencia, 46980 Paterna, Spain
| | - Betlem Heras
- Observatory of Nutrition and Food Safety for Developing Countries, Food & Health Lab, Institute of Materials Science, University of Valencia, 46980 Paterna, Spain
| | - Jose M. Soriano
- Observatory of Nutrition and Food Safety for Developing Countries, Food & Health Lab, Institute of Materials Science, University of Valencia, 46980 Paterna, Spain
- Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, Health Research Institute La Fe-University of Valencia, 46026 Valencia, Spain
- Correspondence: ; Tel.: +34-963543056
| | - María Morales-Suarez-Varela
- Unit of Preventive Medicine and Public Health, Department of Preventive Medicine and Public Health, Food Sciences, Toxicology and Forensic Medicine, University of Valencia, 46100 Burjassot, Spain
- CIBER in Epidemiology and Public Health (CIBERESP), Institute of Health Carlos III, 28029 Madrid, Spain
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Hamad L, Kreidieh K, Hamdan MB, Nakouzi G, Yazbek S. Mapping the Diverse Genetic Disorders and Rare Diseases Among the Syrian Population: Implications on Refugee Health and Health Services in Host Countries. J Immigr Minor Health 2021; 22:1347-1367. [PMID: 32172498 DOI: 10.1007/s10903-020-00987-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The aim of this systematic review is to provide physicians and researchers with a comprehensive list of reported genetic disorders in patients of Syrian origin-those who have become part of the largest displaced population globally-and to highlight the need to consider migrant population-based risk for the development of genetic disease control and prevention programs. This review was performed based on the 2015 PRISMA and the international prospective register of systematic reviews. The present review reports on a total of 166 genetic disorders (only 128 reported on OMIM) identified in the Syrian population. Of these disorders, 27% are endocrine-, nutritional- and metabolic-related diseases. Second to metabolic disorders are congenital malformations, deformations and chromosomal abnormalities. Diseases of the blood and the blood-forming organs accounted for 13% of the total genetic disorders. The majority of the genetic disorders reported in Syrian patients followed an autosomal recessive mode of inheritance. These findings are a reflection of the high rates of consanguineous marriages that favor the increase in incidence of these diseases. From the diseases that followed an autosomal recessive mode of inheritance, 22% are reported to be only present in Syria and other regional countries. Twelve of these genetic diseases were identified to be strictly diagnosed in individuals of Syrian origin. The present systematic review highlights the need to develop programs that target genetic disorders affecting Syrian migrants in host countries. These programs would have potential financial and economic benefits, as well as a positive impact on the physical and mental health of members of the Syrian refugee community and those of their host societies. In turn, this would decrease the burden on the health systems in host countries.
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Affiliation(s)
- Lina Hamad
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Khalil Kreidieh
- Office of Faculty Affairs, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Mirna Bou Hamdan
- Medical Laboratory Sciences Program, Faculty of Health Sciences, American University of Beirut, Riad El Solh, P.O Box 11-0236, Beirut, 1107 2020, Lebanon
| | - Ghunwa Nakouzi
- Department of Clinical Pathology, Cleveland Clinic Hospital, Cleveland, OH, USA.
| | - Soha Yazbek
- Medical Laboratory Sciences Program, Faculty of Health Sciences, American University of Beirut, Riad El Solh, P.O Box 11-0236, Beirut, 1107 2020, Lebanon.
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Sürmeli A, Yasin Y, Umay Tolunay T, User I, Topsever P. Practicing in exile: Syrian healthcare professionals working in informal outpatient clinics in Istanbul. INTERNATIONAL MIGRATION 2021. [DOI: 10.1111/imig.12906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Aral Sürmeli
- Department of Public Health Acibadem Mehmet Ali Aydinlar University School of Medicine Atasehir Istanbul Turkey
| | - Yesim Yasin
- Department of Public Health Acibadem Mehmet Ali Aydinlar University School of Medicine Atasehir Istanbul Turkey
| | - Tuana Umay Tolunay
- National Institutes of Health National Cancer Institute West Bethesda, MD USA
| | - Inci User
- Department of Sociology Acibadem Mehmet Ali Aydinlar University School of Arts and Sciences Atasehir Istanbul Turkey
| | - Pinar Topsever
- Deparment of Family Medicine Acibadem Mehmet Ali Aydinlar University School of Medicine Atasehir Istanbul Turkey
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Scott HM, Wallis N. Maternity care for refugees living in Greek refugee camps: What are the challenges to provision? Birth 2021; 48:114-121. [PMID: 33354804 DOI: 10.1111/birt.12522] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 11/16/2020] [Accepted: 11/17/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND Over a two-year period between 2015 and 2016, unprecedented numbers of people arrived in Greece fleeing conflict, persecution, and poverty. With new arrivals every day, there is a significant unmet need for health care provision, posing a challenge to the Greek Healthcare System. For pregnant refugees, a known vulnerable group, this has resulted in a complex partnership of shared maternity care between humanitarian organizations, the Greek national health care system, and European multi-state initiatives. Our aim was to understand the challenges to providing maternity care services in Greek refugee camps as perceived by health care providers. METHODS A qualitative study comprising observation and semi-structured interviews with health care providers working with pregnant refugees was conducted in five refugee camps in May 2017. Interviews were transcribed and analyzed with thematic coding. RESULTS Twenty-one health care providers were interviewed and field notes taken from observational study of services in five refugee camps. Health care providers describe difficult cross-cultural communication to be their biggest challenge to caring for pregnant refugee women. The limited availability of female only safe spaces is also identified as a barrier. Lastly, the overburdened Greek public health system limits their ability to provide care. CONCLUSIONS Our research supports other literature describing difficult communication and the overburdened Greek health system as significant health care barriers for pregnant refugees in Greece. There is limited literature examining the role of "safe space," and further research is needed. Stakeholders providing maternity care to refugees should look to tackle these key issues as they seek to provide care to this population.
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Abstract
"Currently, an estimated 70.8 million individuals worldwide are forcibly displaced due to war, violence, and persecution. Barriers to providing dermatologic care include the large number of affected people, their movement within and across international borders, security issues, and limited access to dermatology expertise and formularies. Screening protocols for skin diseases and sexually transmitted infections differ worldwide, raising the need for shared guidelines to assess migrants' health. This article reviews the literature of skin and sexually transmitted infections in migrants and displaced persons, highlighting the impact of social determinants on skin health and challenges faced in providing care."
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Joseph L, Ismail SA, Gunst M, Jarman K, Prior D, Harris M, Abbara A. A Qualitative Research Study Which Explores Humanitarian Stakeholders' Views on Healthcare Access for Refugees in Greece. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6972. [PMID: 32977705 PMCID: PMC7579221 DOI: 10.3390/ijerph17196972] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 09/17/2020] [Accepted: 09/19/2020] [Indexed: 02/04/2023]
Abstract
Introduction: As of January 2020, 115,600 refugees remain in Greece; most are Afghani, Iraqi or Syrian nationals. This qualitative research study explores the views of key stakeholders providing healthcare for refugees in Greece between 2015 and 2018. The focus was on identifying key barriers and facilitators to healthcare access for refugees in Greece. Methods: 16 interviewees from humanitarian and international organisations operating in Greece were identified through purposive and snowball sampling. Semi-structured interviews were conducted between March and April 2018. Data were analysed using the Framework Method. Results: Key themes affecting healthcare access included the influence of socio-cultural factors (healthcare expectations, language, gender) and the ability of the Greek health system to respond to existing and evolving demands; these included Greece's ongoing economic crisis, human resource shortages, weak primary healthcare system, legal barriers and logistics. The evolution of the humanitarian response from emergency to sustained changes to EU funding, coordination and comprehensiveness of services affected healthcare access for refugees. Conclusion: The most noted barriers cited by humanitarian stakeholders to healthcare access for refugees in Greece were socio-cultural and language differences between refugees and healthcare providers and poor coordination among stakeholders. Policies and interventions which address these could improve healthcare access for refugees in Greece with coordination led by the EU.
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Affiliation(s)
- Liz Joseph
- Department of Medicine, Imperial College, London SW7 2AZ, UK; (L.J.); (S.A.I.); (M.H.)
| | - Sharif A. Ismail
- Department of Medicine, Imperial College, London SW7 2AZ, UK; (L.J.); (S.A.I.); (M.H.)
- Faculty of Public Health, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
| | - Meghan Gunst
- Department of Paediatrics, Sydney Children’s Hospitals Network, Sydney, NSW 2031, Australia;
| | - Kate Jarman
- Independent Consultant in the International Health Sector, London, UK; (K.J.); (D.P.)
| | - Dina Prior
- Independent Consultant in the International Health Sector, London, UK; (K.J.); (D.P.)
| | - Matthew Harris
- Department of Medicine, Imperial College, London SW7 2AZ, UK; (L.J.); (S.A.I.); (M.H.)
| | - Aula Abbara
- Department of Medicine, Imperial College, London SW7 2AZ, UK; (L.J.); (S.A.I.); (M.H.)
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Fotaki M. A Crisis of Humanitarianism: Refugees at the Gates of Europe. Int J Health Policy Manag 2019; 8:321-324. [PMID: 31256563 PMCID: PMC6600017 DOI: 10.15171/ijhpm.2019.22] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 04/08/2019] [Indexed: 12/20/2022] Open
Abstract
Having initially welcomed more than a million refugees and forced migrants into Europe between 2015 and 2016, the European Union’s (EU’s) policy has shifted toward externalising migration control to Turkey and Northern Africa. This goes against the spirit of international conventions aiming to protect vulnerable populations, yet there is widespread indifference toward those who remain stranded in Italy, Greece and bordering Mediterranean countries. Yet there are tens of thousands living in overcrowded reception facilities that have, in effect, turned into long-term detention centres with poor health and safety for those awaiting resettlement or asylum decisions. Disregard for humanitarian principles is predicated on radical inequality between lives that are worth living and protecting, and unworthy deaths that are unseen and unmarked by grieving. However, migration is on the rise due to natural and man-made disasters, and is becoming a global issue that concerns us all. We must therefore deal with it through collective political action that recognises refugees’ and forced migrants’ right to protection and ensures access to the health services they require.
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Affiliation(s)
- Marianna Fotaki
- Warwick Business School, University of Warwick, Coventry, UK
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Abstract
Background Aim: Many Syrian civil war refugees are housed in carefully designed camps, however 60% of all refugees in host countries reside outside of specifically designated camps. Turkey hosts the largest number of refugees displaced in the civil war of Syria. In the present study, we aimed to illustrate healthcare services provided to Syrian refugees in Turkey. METHOD Data presented in this retrospective observational registry study was obtained from multiple sources including official websites and written communications contributed by Turkish Disaster and Emergency Management Agency(AFAD), Turkish Ministry of Health and Turkish Red Crescent as well as the United Nations High Commissioner for Refugees(UNHCR). The number of refugee camps, total number of refugees housed in these camps, the demographic characteristics of the refugees and a breakdown of social and healthcare services provided in the camps including the number of healthcare professionals serving in the refugee camps were analyzed. RESULTS According to data from UNHCR as of January 12, 2017, there are 4,904,021 registered refugees from Syria of which 2,854,968 (58.2%) are residing in Turkey. Organized health care services specifically for Syrian refugees in Turkey was first established in April 29, 2011 in Hatay. Preventative health services are also provided for Syrian refugees. Among refugees living in the camps 25% and 33% were not vaccinated for polio and measles respectively. The percentage of unvaccinated refugees living outside the camps were even higher for these viruses (45% for polio and 41% for measles). This poses a public health threat for the population where these refugees reside. CONCLUSION One of the major concerns for countries hosting refugees from Syria is the introduction of infectious diseases. Of the major deficiencies in refugee health care has been preventative services. Within refugee camps, preventative services for pregnant woman, newborns and young children as well as family planning services are not at optimal levels. These services are even more restricted for refugees living outside of established camps. There have also been shortcomings in the care of the elderly and those with chronic health problems.
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Impact of the Refugee Crisis on the Greek Healthcare System: A Long Road to Ithaca. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081790. [PMID: 30127321 PMCID: PMC6121252 DOI: 10.3390/ijerph15081790] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 08/16/2018] [Accepted: 08/20/2018] [Indexed: 12/15/2022]
Abstract
Greece is the country of "Xenios Zeus", the Ancient Greek god of foreigners and hospitality; however, it is also the main point of entry to Europe. Since the beginning of 2014, 1,112,332 refugees crossed the borders of Greece. Overall, 33,677 children and adolescent refugees sought asylum in Greece from 2013 to 2017, while 57,042 refugees are currently being hosted. The rapid entry of refugees into Greece raised the critical issue of health policy. The Greek National Health Service (NHS) faces many challenges. Adequate economic and human support is essential if this situation is to be managed successfully. However, Greece still bears the burden of the economic downturn since 2009. In fact, the crisis led to shortages in crucial equipment, and unmet health needs for both locals and refugees. The NHS deals with traumatic experiences, as well as cultural and linguistic differences. Overcrowded reception centers and hotspots are highly demanding and are associated with severe disease burden. This highlights the importance of guidelines for medical screening, healthcare provision, and a well-managed transition to definitive medical facilities. Furthermore, non-governmental organizations make an essential contribution by ensuring appropriate support to refugee minors, especially when they experience poor access to the NHS.
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Moris D, Kousoulis A. Refugee crisis in Greece: healthcare and integration as current challenges. Perspect Public Health 2018; 137:309-310. [PMID: 29082846 DOI: 10.1177/1757913917726019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Hémono R, Relyea B, Scott J, Khaddaj S, Douka A, Wringe A. "The needs have clearly evolved as time has gone on.": A qualitative study to explore stakeholders' perspectives on the health needs of Syrian refugees in Greece following the 2016 European Union-Turkey agreement. Confl Health 2018; 12:24. [PMID: 29977331 PMCID: PMC5992764 DOI: 10.1186/s13031-018-0158-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Accepted: 04/02/2018] [Indexed: 11/10/2022] Open
Abstract
Background By 2017, more than 500,000 Syrian refugees had passed through Greece seeking safety and asylum. Understanding how their health needs evolved over the refugee crisis in Greece and in relation to changing migration policy, and exploring the challenges involved in delivering their healthcare is timely as non-governmental organizations (NGOs) transition health service provision to the Greek health authorities. Methods We conducted a qualitative study to explore stakeholders' perspectives on delivering health services to Syrian refugees over the course of the humanitarian response in Greece from 2015 to 2017. Twenty-five in-depth interviews were conducted face-to-face or by Skype with healthcare providers, NGO staff, and organizational and government representatives involved in coordinating and managing healthcare for the Syrian refugee population in Greece. Following informed consent, interviews were audio-recorded or detailed summaries were manually recorded. Data were coded inductively to identify emerging themes. Results Following the implementation of the European Union-Turkey agreement in 2016, healthcare providers in refugee camps reported a shift from acute physical health issues to mental health disorders, and heightened risks of gender-based violence among Syrian refugees. Key challenges to service delivery included a narrow model of healthcare provision and insufficient referral mechanisms for social support and mental health services. Language and gender differences between refugees and healthcare providers, and a lack of privacy and space in clinics impeded the quality of care. Stakeholders observed deterioration in refugees' mental health in relation to longer periods spent in the camps. Many also emphasized that services for gender-based violence and mental health should be prioritized. Conclusion This study provides stakeholders' perspectives on changes in refugee health needs over the course of the humanitarian response in Greece. With protracted encampment resulting from migration policy, addressing mental health disorders and gender-based violence should be prioritized, including psychosocial training for healthcare providers and strengthening referral mechanisms for specialized care. The findings also emphasize the importance of providing human-centered care and gender concordant services by incorporating female healthcare providers and interpreters into medical teams. Strategic communication and coordination is needed between NGOs and Greek health authorities to facilitate the transition of health service delivery to the Greek healthcare system and to improve access and quality of care for refugees.
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Affiliation(s)
- Rebecca Hémono
- Women and Health Alliance International, 160 bis Rue du Temple, Paris, France.,2École des Hautes Études en Santé Publique, 15 Avenue du Professeur Léon Bernard, Rennes, France
| | - Bridget Relyea
- Women and Health Alliance International, 160 bis Rue du Temple, Paris, France
| | - Jennifer Scott
- Women and Health Alliance International, 160 bis Rue du Temple, Paris, France.,4Beth Israel Deaconess Medical Center, Department of Obstetrics and Gynecology, 330 Brookline Avenue, Boston, MA USA.,5Harvard Medical School, Department of Obstetrics, Gynecology and Reproductive Biology, 25 Shattuck Street, Boston, MA USA
| | - Sinan Khaddaj
- Women and Health Alliance International, 160 bis Rue du Temple, Paris, France
| | | | - Alison Wringe
- 6London School of Hygiene and Tropical Medicine, Department of Population Health, Keppel Street, London, UK
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Floyd A, Sakellariou D. Healthcare access for refugee women with limited literacy: layers of disadvantage. Int J Equity Health 2017; 16:195. [PMID: 29126420 PMCID: PMC5681803 DOI: 10.1186/s12939-017-0694-8] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 11/06/2017] [Indexed: 11/27/2022] Open
Abstract
Background Record numbers of people, across the world, are forced to be displaced because of conflict or other violations of their human rights, thus becoming refugees. Often, refugees not only have a higher burden of disease but also compromised access to healthcare, as they face many barriers, such as limited knowledge of the local language. However, there is very limited knowledge on the lived experiences of this population. Moreover, the strategies people might develop in their efforts to access healthcare have not been explored in depth, despite their value in establishing peer- support, community based programs. Methods In this article, we present the findings of a study aiming to explore the lived experiences of accessing healthcare in the greater Vancouver area for recently-arrived, government-assisted refugee women, who were non-literate and non-English-speaking when they arrived in the country. We carried out sixteen semi-structured interviews with eight refugee women, guided by descriptive phenomenology. Results The findings highlight the intersection of limited knowledge of the local language with low literacy, gender, and refugee status and how it impacts women’s access to healthcare, leading to added layers of disadvantage. We discuss three themes: (1) Dependence, often leading to compromised choice and lack of autonomy, (2) Isolation, manifesting as fear in navigating the healthcare system, rejection, or shame for a perceived inadequacy, and (3) Resourcefulness in finding ways to access healthcare. Discussion We propose that a greater understanding of the intersections of gender, low literacy, and refugee status can guide healthcare workers and policy makers in improving services for this population. Furthermore, It is important to enable seldom-heard, hard to reach populations and facilitate their participation in research in order to understand how vectors of disadvantage intersect.
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Affiliation(s)
- Annette Floyd
- Schools of Health Sciences and Nursing, Langara College, Vancouver, Canada
| | - Dikaios Sakellariou
- Cardiff University, School of Healthcare Sciences, Eastgate House, Newport Road 35-43, Cardiff, CF24 0AB, UK.
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Moris D, Karamagioli E, Kontos M, Athanasiou A, Pikoulis E. Refugee crisis in Greece: the forthcoming higher education challenge. ANNALS OF TRANSLATIONAL MEDICINE 2017; 5:317. [PMID: 28856157 DOI: 10.21037/atm.2017.05.05] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Demetrios Moris
- International Medicine/Health Crisis Management, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Evika Karamagioli
- International Medicine/Health Crisis Management, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Michael Kontos
- International Medicine/Health Crisis Management, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Antonios Athanasiou
- International Medicine/Health Crisis Management, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Emmanouil Pikoulis
- International Medicine/Health Crisis Management, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
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15
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Pani SC, Al-Sibai SA, Rao AS, Kazimoglu SN, Mosadomi HA. Parental Perception of Oral Health-related Quality of Life of Syrian Refugee Children. J Int Soc Prev Community Dent 2017; 7:191-196. [PMID: 28852635 PMCID: PMC5558253 DOI: 10.4103/jispcd.jispcd_212_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 07/10/2017] [Indexed: 11/04/2022] Open
Abstract
AIMS AND OBJECTIVES The conflict in Syria has resulted in the displacement of over 5 million people, many of whom intend to return home at the cessation of hostilities. Oral health plays a critical role in early childhood and this study aimed to qualitatively and quantitatively assess the oral health-related quality of life (OHRQoL) of these children. MATERIALS AND METHODS The quantitative assessment of OHRQoL was done using a validated Arabic version of the short-form Parental-Caregiver Perceptions Questionnaire-8 (P-CPQ-8). The P-CPQ-8 was administered to 22 sets of parents of children in a community center catering to urban refugees. A focus group interview and thematic analysis of nine mothers were used to gain a qualitative insight into the problems that could affect the OHRQoL of their children. RESULTS The P-CPQ-8 revealed that oral symptoms were the greatest concern of the parents with dental pain being the most commonly reported condition. Although mothers reported higher P-CPQ-8 scores among all domains than fathers, there were no significant differences in the concerns of the fathers and the mothers. The focus group interview raised three major themes - (1) access to dental care, (2) pain felt by the child, and (3) oral hygiene of the child. CONCLUSION The parents interviewed in this study were aware of the importance of oral hygiene but reported being unable to look after their children's teeth. Children who are refugees from the Syrian conflict face significant OHRQoL challenges.
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Affiliation(s)
- Sharat Chandra Pani
- Department of Preventive Dental Sciences, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia
| | - Salam Atef Al-Sibai
- Department of Research Center, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia
| | - Akanksha S Rao
- Department of Research Center, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia
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Karamitros G, Kitsos N, Athanasopoulos F. A case of enterobiasis presenting as post-traumatic-stress-disorder (PTSD): a curious case of the infection with predominant mental health symptoms, presenting for the first time in the settings of a refugee camp. Pan Afr Med J 2017; 27:111. [PMID: 28819532 PMCID: PMC5554648 DOI: 10.11604/pamj.2017.27.111.12870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 06/07/2017] [Indexed: 11/13/2022] Open
Abstract
Enterobiasis (oxyuriasis) is a common infection in human caused by Enterobius vermicularis (E. vermicularis), a human intestinal helminth. Because of the easy way of its transmission among people, it has an extremely high prevalence in overcrowded conditions, such as nurseries and primary schools. Oxyuriasis's symptoms are extremely diverse in children, ranging from nausea, diarrhea, insomnia, irritability, recurrent cellulitis, loss of appetite, nightmares and endometritis. Here we report a curious case of oxyuriasis in the settings of a refugee camp in Greece. The patient was a 10-year old Syrian female, who presented with unusual and vague symptoms like insomnia and irritability. Given the violent background of the Syrian warzone that the patient had escaped, she was firstly diagnosed with post traumatic stress disorder (PTSD) before eventually getting correctly diagnosed with enterobiasis. This infection is the first documented case of enterobiasis in the settings of a refugee camp and can highlight the unsanitary living conditions that refugees have to endure in those camps.
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Affiliation(s)
| | - Nikolaos Kitsos
- Faculty of Medicine, University of Southampton, Southampton, United Kingdom
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Sotgiu G, Migliori GB. Effectiveness of post-migration tuberculosis screening. THE LANCET. INFECTIOUS DISEASES 2017; 17:684-685. [PMID: 28410980 DOI: 10.1016/s1473-3099(17)30167-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 03/14/2017] [Indexed: 12/01/2022]
Affiliation(s)
- Giovanni Sotgiu
- Clinical Epidemiology and Medical Statistics Unit, Department of Biomedical Sciences, University of Sassari-Research, Medical Education and Professional Development Unit, AOU Sassari, Sassari, Italy
| | - Giovanni Battista Migliori
- WHO Collaborating Centre for TB and Lung Diseases, Maugeri Care and Research Institute, IRCCS, Tradate, Italy.
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Ruano AL, Shadmi E, Furler J, Rao K, San Sebastián M, Villar Uribe M, Shi L. Looking forward to the next 15 years: innovation and new pathways for research in health equity. Int J Equity Health 2017; 16:35. [PMID: 28222728 PMCID: PMC5320779 DOI: 10.1186/s12939-017-0531-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 02/13/2017] [Indexed: 01/31/2023] Open
Abstract
Since our launch in 2002, the International Journal for Equity in Health (IJEqH) has furthered our collective understanding of equity in health and health services by providing a platform on which academics and practitioners can share their work. Today, we celebrate our fifteenth anniversary with an article collection that presents a call for new and novel research in equity in health and we invite our authors to use new approaches and methods, and to focus on emerging areas of research related to health equity in order to set the stage for the next fifteen years of health equity research.Our anniversary issue provides a platform for expanding the conceptualization, diversity of populations and study designs, and for increasing the use of novel methodologies in the field. The IJEqH has helped to support the wider group of researchers, policymakers and practitioners with a commitment to social justice and equity but there is still more to do. With the help of the highly committed editorial team and editorial board, the innovative work of researchers worldwide, and the countless of hours dedicated by hundreds of reviewers, we are confident in the IJEqH's ability to continue supporting the dissemination of health equity research for years to come.
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Affiliation(s)
- Ana Lorena Ruano
- Center for the Study of Equity and Governance in Health Systems, CEGSS, Guatemala City, Guatemala. .,Center for International Health, University of Bergen, Bergen, Norway.
| | - Efrat Shadmi
- The Cheryl Spencer Department of Nursing, Faculty of Socail Welfare and Health Sciences, the University of Haifa, Haifa, Israel
| | - John Furler
- Department of General Practice, Faculty of Medicine, Dentistry and Health Sciences University of Melbourne, Melbourne, Australia
| | - Krishna Rao
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Miguel San Sebastián
- Department of Public Health and Clinical Medicine, Unit of Epidemiology and Global Health Umeå University, SE-901 87, Umeå, Sweden
| | | | - Leiyu Shi
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Aggarwal NK, Farias PJ, Becker AE, Like R, Lu F, Oryema N, Lewis-Fernández R. The Role of Cultural Psychiatry in Improving the Policy Response to Central America's Unaccompanied Minors at the American Border: Local and Global Implications. INTERNATIONAL JOURNAL OF CULTURE AND MENTAL HEALTH 2016; 9:381-386. [PMID: 28757896 DOI: 10.1080/17542863.2016.1225110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Since 2014, children from El Salvador, Guatemala, and Honduras unaccompanied by their parents have fled in large numbers to the United States to escape violent crime and social disadvantage. Current mental health policies in the U.S. government's response can be improved based on guidelines from professional psychiatric and psychological organizations. These guidelines emphasize the importance of immigration and culture, raising questions into how the field of cultural psychiatry can offer conceptual frameworks and methods to research unaccompanied minor migration as a humanitarian problem. This paper conducts a policy analysis by reviewing shortcomings in the U.S. response and explores the potential contributions of cultural psychiatrists in optimizing services to address the needs of these children in the U.S. and their countries of origin.
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