The world is comprised of a diverse range of population with varying health needs. One such group is refugees and asylum seekers who are an extremely vulnerable population that often faces threatening circumstances compromising their overall health and well-being. Access to health care is fundamental to achieving desirable public health, but it is subject to several factors, including a person’s capability and the nature of a country’s health care system. In spite of overly demanding health needs among refugees, access to quality care in host countries is usually a challenge. This is exacerbated by a range of issues like cultural and language barriers, unaffordability, legal status, and lack of inclusive policies, among others. Although some nations, through concerned parties, address health concerns of the affected group, there is still more to be done, especially from a global point of view.
The statistical profile of refugees from a global perspective is a significant concern. The World Health Organization (WHO) reports that at an estimate of 1 billion migrants are currently in the world with 258 and 763 million of them being international and internal migrants respectively. While European countries deal with an unprecedented influx of refugees from war-torn nations like Iraq, Afghanistan, Syria, and the likes, Sulaiman Momodu (n.d.) of United Nations (UN) reports that Africa is silently suffering from the growing refugee crisis. Ethiopia, for example, houses at least 740,000 refugees mostly from South Sudan, Sudan, Somali, and Eritrea (Momodu, n.d.). Major health issues among refugees all across the world include tuberculosis, hepatitis, and sexually transmitted infections (communicable diseases); diabetes and anemia (as non-communicable diseases) (Sethi, Jonsson, Skaff, & Tyler, 2017). The extent of the problems refugees face raises the question, such as what has been done to combat the crisis.
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Tuberculosis is a major public health issue among immigrants. Zachary White et al. (2017) report that countries like India, China, Philippines, and Vietnam account for about 41.4 percent of world’s TB cases among displaced people. Further, the researchers point out that close to 1.5 million refugees die from the disease every year. Although the other two communicable diseases, hepatitis and STIs, are not prevalent as TB, research shows that that they are still a threat to refugee’s well-being, especially in developing countries. For instance, Bizri, Fares, and Musharrafieh (2018) detail that a significant portion of refugees live in high endemicity for the two disease with the risk varying between regions; exposed population in US include 2-10 percent, 6-14 percent for Africa, 3-10 percent for Asia and about 2 percent for Europe. Diabetes is a serious non-communicable illness among displaced people. About 25 million refugees all across the world report cases of either diabetes or anemia as American Public Health Association (APH) reports.
Services Being Used
There is currently a global action plan aiming to address and promote the health of refugees and migrants. One of the specific actions includes establishing refugee-sensitive health policies, social and legal protection programs, and interventions. The goal of the service is to offer adequate health support to refugees, regardless of their host nation, throughout the process of migration. At present, the program is carried out by the WHO and individual states whose actions, among others, include providing health care recommendations, incorporating refugee health needs in national health care plans and policies, and involving experts of refugee health in the development and implementation of health care frameworks (Abubakar & Zumla, 2018). The program is currently jointly funded by individual states and world health organization with concerned actors also chipping in.
Current Status (Including Statistics)/Gaps Including What Else Needs to be Done
Efforts by institutions like WHO, United Nations High Commissioner for Refugees (UNHCR), and collaborative efforts of some nations have significantly improved situations for refugees. Most migrations are safe, orderly, and regular, where the significant portion of the population is not exposed to vile conditions and vulnerable to serious health issues. In spite of the important steps, there is still more to be done (Chuah, Tan, Yeo, & Legido-Quigley, 2018). In regards to TB and other demanding infectious diseases like common types of STIs, WHO reports that, on a global scale, many public and private sector organizations have partnered on a TB care and control program that serves as mobile clinics in some marginalized regions. On the same account, significant amount of funds has been channeled into securing medical resources for lifelong complications like diabetes.
In spite of these major accomplishments, overall, the status of refugee health, especially concerning the above-mentioned issues, is still demanding. Refugee programs receive only 3 percent of all funding appeals with a fraction of the amount, up to 22 percent, directed to insignificant health programs (Williamson, 2017). At the same time, many countries do not prioritize internationally designed health programs for the identified problems. Lack of political commitment, ineffective drug supply, insufficient monitoring and evaluation systems are some of the notable drawbacks. Because of the massive gap between expected goals of refugee health and the actual results from some of the initiatives, it is necessary to recommend additional courses of action to addressing the situation.
Five Proposed Initiatives
Initiative 1
As earlier pointed out in the discussion, sources of barriers to attaining good health among refugees are the existence of obstacles in host nations. As such, the first major initiative I would suggest is to eliminate current and potential barriers in national health care policies and systems that bar refugees from accessing quality care. This is a significant that can be taken at federal, state, or local levels depending on how a country is structured. Therefore, it's development, funding, and implementation functions would involve local and state governments.
Initiative 2
Secondly, at the international level, parties directly or indirectly concerned with refugee matters and their well-being need to address factors causing forceful and voluntary displacement of people from their homes. Powerful and globally recognized institutions like the United Nations, WHO, UNHCR, and others should focus on managing preventable cases of refugees like war, economic sabotage, social issues, and environmental disasters. Although this is not a direct health-based measure, it goes a long way to ensure certain groups of people are not susceptible to health issues because of displacement. Some of the strategies can include building cohesion among conflicting countries, promoting economic and social prosperity, and managing environmental hazards.
Initiative 3
Investing in the strengthening of health systems to promote maternally and family health services to refugees and migrants is my proposed third initiative. In most cases, refugees are confined to an enclosed environment, sometimes marked by unfavorable living conditions. This exposes them to diseases and illnesses with women and children at higher risk of such complications. Maternal and family health care services, a collaborative project between a nation’s health system and international institutions responsible for refugees should see into its funding and execution.
Initiative 4
In addition to effective health systems, forth, it is important to formulate policies at national levels to include adult refugees into the employment market and children and youths into schools would be effective in addressing the plights of refugees. All employees flee their home countries in search of safety and opportunities. Employment and education are key solutions to improving their overall social and economic aspects. This would be a tough initiative to carry out at the national level individually, but with support and guidance from well-equipped worldwide organizations like WHO, its attainment would be successful.
Initiative 5
Lastly, unlike other vulnerable groups like infants, people with disabilities, marginalized communities, and others, refugees do not have enough health care stakeholders devoted to their health concerns. On the contrary, many people and groups develop negative attitudes towards migrants demanding their deportation, which often overshadows to the urgent need to manage the well-being of the affected people. That said, organizations, especially at the state level, should be founded across all nations to make sure refugees access basic care. It a voluntary initiative that can also involve input by international policies developed by bodies like the United Nations to make sure member countries establish frameworks that pay attention to migrants in terms of health.
References
Abubakar, I., & Zumla, A. (2018). Universal health coverage for refugees and migrants in the twenty-first century.
Bizri, A. R., Fares, J., & Musharrafieh, U. (2018). Infectious diseases in the era of refugees: Hepatitis A outbreak in Lebanon. Avicenna journal of medicine , 8 (4), 147.
Chuah, F. L. H., Tan, S. T., Yeo, J., & Legido-Quigley, H. (2018). The health needs and access barriers among refugees and asylum-seekers in Malaysia: a qualitative study. International journal for equity in health , 17 (1), 120.
Sethi, S., Jonsson, R., Skaff, R., & Tyler, F. (2017). Community-based noncommunicable disease Care for Syrian Refugees in Lebanon. Global Health: Science and Practice , 5 (3), 495-506.
Williamson, S., (2017). Health implications of the global refugee and migrant crisis. Center for Strategic and International Studies .
World Health Organization. Refugee and migrant health. Retrieved from https://www.who.int/migrants/en/
White, Z., Painter, J., Douglas, P., Abubakar, I., Njoo, H., Archibald, C., ... & Posey, D. L. (2017). Immigrant arrival and tuberculosis among large immigrant-and refugee-receiving countries, 2005–2009. Tuberculosis research and treatment , 2017 .
