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Spring 2016 Refugee Health

We had yet another very successful Quarterly Conversation in Global Health on Monday, May 16th on the Topic of Refugee Health!

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We had yet another very successful Quarterly Conversation in Global Health on Monday, May 16th on the Topic of Refugee Health!

Claire Edington, PhD Assistant Professor in the Department of History and event emcee, opened the event with a thank you to all of the co-sponsors: the Global Health Institute and Program, the community and student organizations who helped to put together the event, the Planning Committee from the UCSD Students for Global Health and Brittany Wright, the Students for Global Health advisor.

Edington expressed that the overall purpose of this particular quarterly conversation event was to shed light on the implication of forced displacement and its effects on physical and mental health in the refugee population.

Kathi Anderson, the Executive Director of Survivors of Torture International and the chair of The San Diego Refugee Forum, informed us that torture can be physical or psychological, and that Survivors of Torture International’s main focus is on mental health because psychological torture is the hardest to heal. Kathi further emphasized that, “torture is a human induced trauma”, so there needs to be a building of trust between people to help heal victims. Healthcare professionals have been complacent when it comes to the topic of torture, which then prevents the trust-building that victims need in order to come forward and receive proper treatment and support.

"An average of 44% of refugees are torture victims."

Another issue that Survivors of Torture International commonly faces in their work is victims not opening up because they have guilt and shame, especially in cases of sexual torture; the victims do not want to have flashbacks or feel like they will not be believed. Furthermore, victims do not easily express their status or need for help because of great fear that has been instilled in them, that if they disclose anything the result could be putting their family members in harm’s way.

Survivors of Torture International’s philosophy is based on one of desiring to rebuild victims’ lives and their dignity. Their service providers work to build a community of healing and a safe haven without being too initially intrusive.  The reality is that torture survivors are everywhere.  With a population of at least 35,000 torture survivors in San Diego, Survivors of Torture International does not discriminate by age or country of origin; if someone has been tortured they will receive aid.

Dr. Wael Al-Delaimy, MD and PhD and Associate Professor of Family and Preventive Medicine, the second keynote speaker, has worked with Somali refugees as well as with Iraqi and Palestinian refugees in Jordan. Every summer, Dr. Al-Delaimy travels with a group of students to Amman, Jordan to help the students to experience the realities of refugee life firsthand.

Dr. Al-Delaimy opened his talk by sharing that refugees often face gender and sexual violence, poverty and food insecurity, human trafficking, forced labor, and lack of access to healthcare among many other issues. Additionally, he revealed that 95% of victims face trauma, and are therefore, at a higher risk of mental health issues from the accumulations of experiences leading to becoming refugees and (sometimes) resettlement.

Dr. Al-Delaimy educated the audience on the Middle East and informed them that many wars have led refugees to migrate to Jordan over the last 70+ years, and over time Jordan has become overcrowded with unhealthy conditions.

Dr. Al-Delaimy informed us that Syria’s refugee crisis is now called the worst refugee crisis of our generation and the numbers are growing and have not stopped for over 50 years.

Dr. Al-Delaimy shared Syrian children’s heart-wrenching illustrations which clearly reflect the pain and suffering they’ve faced throughout their traumatic experiences.   He then spent some time contemplating the role of a mother’s trauma or torture, and its relation to a child’s adjustment; Dr. Al-Delaimy and his colleagues have found that if the mother was affected through mental health, the child was more likely to be affected.

Overall, Dr. Al-Delaimy leaves us with an understanding of the seriousness of the topic of refugee health, that “the trauma they experience acts like an infectious disease throughout refugee families and refugees”.

The third keynote speaker, Dr. Danielle Horyniak, PhD and Postdoctoral Fellow, is from Melbourne, Australia, which has a very diverse community of refugees from Sudan, Ethiopia and Somalia.  Dr. Horyniak focused her research on migrant and refugee health.

Dr. Horyniak ephasized that we are currently having the worst-ever refugee crisis.  She reminds us that in just 5 years, the Syrian community has been obliterated.

She then presented the widely known and studied durable solutions which are: voluntary repatriation, local integration and third-party resettlement.  However, she explained the challenges of these solutions and their lack of current effectiveness.

Dr. Horyniak spent some time speaking to the affect of refugees being vulnerable to health issues, which also stem from structural issues like health insurance and lack thereof. Her research focuses on young people since they make up a great proportion of the refugee population.  Her research also includes taking a close look at mental health issues and the high risk of substance abuse, which is predicated in refugees because of the lack of healthcare and prognosis.  Findings conclude that refugee victims have poorer mental health compared to non-refugees, and pre- and post- displacement conditions feed into the mental health challenges that refugee victims face.

Specifically, Dr. Horyniak shared a personal account of victims in her community who use drinking to forget their pain and their harsh experiences and conditions as refugees. When interviewed, many victims felt ashamed talking about their mental health issues which builds a barrier for help-seeking.  Dr. Horynaik explained that they will not disclose their struggle; but with careful probing, an ability to understand the whole person and their cultural language, counselors are able to identify those who are in need of help. Additionally, Dr. Horyniak found that refugees face inter-sectional issues once they resettle, like having to face racism.  Overall, Dr. Horyniak’s message is that we need to build mental health literacy and learn how to provide better services to young victims.

Our final speaker was David Murphy, the Executive Director of the International Rescue Committee (IRC), who is known for launching several initiatives as the Country Director in Ethiopia and while working in Afghanistan, Kenya and Somalia.   Murphy shared IRC’s mission of helping to relocate refugees and in providing health and emergency services.  IRC has departments including youth programs, resettlement, financial opportunity, immigration and citizenship, administration, and food security/community health.

There are more than 60 million people displaced in the world today and that only about 1% of refugees are resettled every year.

Murphy explained the process of refugee relocation.  The US prioritizes the types of refugees that will get to resettle, perhaps based on political opposition groups. The process of checking the eligibility of refugees takes about 1 year. If approved, the government will try to resettle refugees near their families. If there are no families, the government will try to put refugees from similar communities together and provide affordable housing and other services. Once they create a place for refugees to settle which includes a sanitary environment, then the IRC helps refugees to learn the cultural norms and to obtain employment in the United States.  Alarmingly, the average stay for refugees in refugee camps is 17 years.

Murphy informed us that in 2015, about half of the arrivals into San Diego have been from Iraq, but there will be more refugees coming from Syria in the coming years.  He closed with a call-to-action and a welcome invitation to volunteer or pursue a job opportunity through the IRC.

Thank you to our four speakers!

View the brochure for this event:

Spring Quarterly Conversation of Global Health Brochure

Do you have a topic idea for the 2016-2017 Quarterly Conversations in Global Health? Please submit your topics here!

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