Culture And Diversity For Iraqi Refugees In Australia – Challenges And Strategies

The Availability of Public Health Services to English Migrants

Discuss about the Culture and Diversity for Iraqi Refugees in Australia.

Australia is a multi-culture country that provides home to many refugees and immigrants. People from different race, culture and community have settled in Australia. The culture, language and experiences of the refugees in a country can greatly affect their perception about healthcare system. To provide quality care to the culturally and linguistically different people, healthcare professionals have to be trained with cross-culture practice. This essay is going to address the challenges posed by cultural and language difference among healthcare delivery system for the Iraqi Refugees in Australia. The essay will also critically appraise the resources and will discuss that how healthcare professionals provide culturally sensitive care.

Structural determinant influencing the availability of the public health services are low socio-economic status of this population and difficult accessibility of healthcare services. These people come from poor countries and have lack of education, which hinders their way to receive appropriate employment. Lack of proper employment opportunities and unemployment are major barriers. In Australia there is also lack of services, which focus on this population. Thus, accessibility to healthcare services is limited. 

Availability of the healthcare service is the capability of the healthcare system to provide satisfactory services to the clients, by giving complete consideration to their needs and requirements (Goudge et al, 2009). Acceptability is the most poorly understood dimension of the healthcare delivery system. It is the patient’s capability to explain and understand the disease. However, CALD population have poor acceptability due to cultural and language differences. Also, there are many disparities among healthcare delivery to racially and ethnically different people. Acceptability also pose barrier to the appropriate diagnosis of the diseases (Goudge et al, 2009). Accessibility to the healthcare service can be described in two ways, first is the physical accessibility to the healthcare services and second is to access quality care with the help of service providers (Correa-Velez, Gifford, & Bice, 2005). Accessibility becomes poor, when health care providers fail to provide professional and adequate healthcare services to the target population (Komaric, Bedford, & van Driel, 2012). 

Culturally and Linguistically diverse (CALD) is the population of the country, which comes from non-English speaking countries (Komaric, Bedford & van Driel, 2012). Refugees in Australia are from CALD group, who have faced traumatic and unique experiences in their countries. Refugees are the most vulnerable groups in Australia, and multi-cultural context of Australia requires understanding the difference raised due to CALD. Culturally and linguistically diverse people often face difficulty in accessing healthcare services in their re-settlement countries. There are various barriers among appropriate healthcare access and service delivery. These challenges are cultural difference, lack of communication due to language difference, lack of education and socio-economic status of refugees (Komaric, Bedford & van Driel, 2012).

The Accessibility and Acceptability of Mainstream Public Health Services for Iraqi Refugees

Stigma is also a major barrier to access healthcare services. Refugees came from countries, where they have faced life threatening events. They have stigmatization towards perceiving healthcare programs and mental illness. Privacy is very important for most of the cultural groups in refugees, such as refugees from Iraq have different perception and understanding of healthcare facilities (Komaric, Bedford & van Driel, 2012). Iraqi refugees have different cultural belief, values and norms. They come from a patriarchal society, where men are considered to be strong and should take care of family. This pose barrier to access healthcare facilities, as men fear that this will display them as weak, and for women access is difficult as they are not allowed to take their own decision. Over the period 2004 to 2013, approximately 146,321 refugees settled in Australia (Morris et al, 2009).  

Australia is becoming a culturally and linguistically diverse society that requires becoming more responsive towards the healthcare needs of refugees. Mental health illness and chronic diseases is the major health issues among Iraqi refugees (Guajardo et al, 2016). They have experienced life threatening and traumatic events at their country. Such events have resulted in severe psychological distress in this population (Guajardo et al, 2016). Healthcare literacy is another major factor that pose barrier in perceiving positive attitude towards different healthcare programs. Healthcare literacy allows a person to obtain, evaluate and understand the basic healthcare information, which is required to make effective healthcare decisions. According to Keleher & Hagger, (2007), “health literacy is defined as the set of literacy and numeracy skills that enable a person to comprehend their health status and be proactive addressing their health care needs.” There is lack of healthcare literacy among Australian population and within the non-English speaking people, healthcare literacy is very poor.

According to the study of Keleher & Hagger, (2007), cultural competency is very significant among the healthcare professionals, so that they can offer appropriate healthcare service to “people with diverse values, beliefs, behaviors, cultural identity and ethnic identity”. Guajardo et al, (2016), states that ‘cultural awareness’ can be a barrier as well as a positive factor in quality healthcare delivery. Cultural awareness could be understood as, understanding and respective the values, norms, beliefs and morals of people from different cultural group (Morris et al, 2009). 

When healthcare professionals are targeting the people from different culture under the cross-culture context, it is important to be aware of their cultural norms (Bolton, 2013). There are various ways through which mainstream public health services could be modified for Iraqi refugees:

Factors Influencing the Accessibility and Acceptability of Mainstream Public Health Services for Iraqi Refugees

Professionals who want to assist Iraqi refugees in providing healthcare services, they should be aware that these people have gone through war and many traumatic events. Steel et al (2009) explains that aiders should be aware of the ethnic diversity and religions of Iraqi refugees. Steel et al (2009), also explains that cross-culture communication is relevant to provide healthcare facilities to culturally and linguistically diverse population.

The healthcare providers should be aware of providing culturally sensitive, effective and professionals services to these people. Iraqi refugees come from a traumatic background, thus they require more sensitive care and must avoid any event that could trigger their worse memories. Different studies also find out the stigma associated with health and healthcare delivery in Iraqi refugees (Ciftci, Jones and Corrigan, 2013; Guajardo et al, (2016); Komaric, Bedford, & van Driel, (2012).

Lack of healthcare literacy is also a barrier among providing professional and effective care to Iraqi refugees. Literacy level and lack of education can be the major barriers for unprivileged groups. Thus, healthcare services can take initiative to provide community based educational sessions. Trauma and stigma associated with their health can increase reluctance in service access.

Health services can provide transport facilities to these people. Due to low income and unemployment, these people may find difficulty in accessing healthcare. Reluctance to travel can be removed and access to health services can be increased (Guajardo et al, 2016).

Better Medicare and health insurance facility must be applied, which can mainly focus on Iraqi refugees. For the people with very low income. Provision of free healthcare access can also be offered.  

Conclusion

Australia is a multi-cultural country that homes many refugees and immigrants. This essay provided the importance of culturally sensitive healthcare delivery for the Iraqi refugees in Australia. Chronic diseases and mental illness is prevalent in this population, which requires immediate attention of the government. Essay also discussed various barriers to healthcare delivery and propose that service functioning and organization requires to be addressed, as more complication in the service structure, makes it complex for the recipients to access healthcare services.

References

Bolton, P. (2013). Mental health in Iraq: issues and challenges. The Lancet,381(9870), 879-881.

Cheng, I. H., Drillich, A., & Schattner, P. (2015). Refugee experiences of general practice in countries of resettlement: a literature review. Br J Gen Pract, 65(632), e171-e176.

Ciftci, A., Jones, N. and Corrigan, P.W. (2013). Mental health stigma in the Muslim community. Journal of Muslim Mental Health, 7(1).

Correa-Velez, I., Gifford, S. M., & Bice, S. J. (2005). Australian health policy on access to medical care for refugees and asylum seekers. Australia and New Zealand health policy, 2(1), 1.

Goudge, J., Gilson, L., Russell, S., Gumede, T., & Mills, A. (2009). Affordability, availability and acceptability barriers to health care for the chronically ill: longitudinal case studies from South Africa. BMC health services research, 9(1), 1.

Guajardo, M. G. U., Slewa-Younan, S., Santalucia, Y., & Jorm, A. F. (2016). Important considerations when providing mental health first aid to Iraqi refugees in Australia: a Delphi study. International Journal of Mental Health Systems, 10(1), 54.

Guajardo, M. G. U., Slewa-Younan, S., Smith, M., Eagar, S., & Stone, G. (2016). Psychological distress is influenced by length of stay in resettled Iraqi refugees in Australia. International journal of mental health systems,10(1), 1.

Keleher, H., & Hagger, V. (2007). Health literacy in primary health care.Australian Journal of Primary Health, 13(2), 24-30.

Komaric, N., Bedford, S., & van Driel, M. L. (2012). Two sides of the coin: patient and provider perceptions of health care delivery to patients from culturally and linguistically diverse backgrounds. BMC health services research, 12(1), 1.

Morris, M. D., Popper, S. T., Rodwell, T. C., Brodine, S. K., & Brouwer, K. C. (2009). Healthcare barriers of refugees post-resettlement. Journal of community health, 34(6), 529-538.

Steel, Z., Chey, T., Silove, D., Marnane, C., Bryant, R. A., & Van Ommeren, M. (2009). Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: a systematic review and meta-analysis. Jama, 302(5), 537-549.