General factors in the mortality among refugees in Vietnam

Refugee income generating projects and occupational health

The shift from purely emergency relief for refugees in developing countries to aid within the context of development strategies is slowly gathering momentum (UN, 1983; UNHCR, 1984; Simmonds, 1984). Such a move implies that if self-reliance is to be a realistic goal then employment for refugees is essential; a number of income-generating schemes are therefore being both proposed and developed (ILO, 1983 and 1984). Many of these schemes have implications for the health of the refugees, so this paper summarises some occupational health hazards and offers suggestions for future action.

The Indochinese refugee: an overview

A review of some of the sociocultural features of Australia's recently arrived 51,000 Indochinese refugees is given. The severe disintegration of Vietnamese society by two decades of warfare would suggest the likelihood of significant psychopathology. This is supported by clinical surveys. The psychological responses to migration and resettlement, including persisting feelings of guilt, bewilderment and pining, are reviewed, with subsequent difficulties in marriage, family, employment and education. Research indicates high continuing levels of psychiatric dysfunction especially among refugees lacking social support or experiencing status dislocation. Suggestions are made for culturally acceptable forms of assessment and therapy.

Refugee health care: Similar but different?

The present review sets out to identify differences between refugees and other more stable communities living in less developed countries: demographic, mortality, morbidity, nutritional and selected epidemiological data are discussed. Although generalizations are difficult because of the variability of refugees and their differing circumstances, the health problems and diseases do not appear to differ qualitatively, although they may be quantitatively more severe. The areas of particular concern lie not so much with the problems but with approaches to their solutions: the need to respond rapidly and appropriately to emergencies, the importance of attending to the priorities of nutrition, shelter, sanitation and water; and the necessity of providing services which are sufficiently flexible and sensitive to the changing needs of the refugees as they move from the acute emergency to the long-term settlements. The review highlights certain areas where insufficient information is currently available, notably mental illness and the long-term issues of health and development, and outlines the implications of the conclusions for policy makers, with particular reference to training and research.