On 9 March 2017, the inaugural Migrant and Refugee Health Forum was held at the Playford Civic Centre. The event was convened by The Northern Adelaide Local Health Network (NALHN), Adelaide PHN (APHN) and Northern Health Network (NHN), in association with the Migrant Health Service (South Australia’s specialist refugee health service); and Australian Migrant Resource Centre (settlement service for humanitarian refugees in South Australia). The Forum was administered by the South Australian Post Graduate Medical Education Association (sapmea)
The aim of the forum was to better map and understand the journey of new arrival refugees within the Adelaide metropolitan health care system in order to provide best practice health care.
The forum resulted in the development of recommendations for improved delivery of health care. Strategies were discussed for providing education and increasing knowledge of health professionals and the community, improving their understanding and awareness of the challenges faced and providing the tools necessary to deliver culturally safe and appropriate health care services.
People from refugee backgrounds often do not have strong family and social networks, and come from backgrounds of trauma and displacement. They face many settlement challenges in a new country including language barriers, literacy skills, health issues, as well as negotiating housing and Centrelink. Health issues and psychosocial issues for refugee background clients are often complex and require a coordinated approach to care.
More than 160 community members and health professionals from across the different sectors participated in the forum. The morning focused on community health literacy sessions, on topics chose by them: women’s health, men’s health, hepatitis and understanding the hospital system in SA.
Following lunch, His Excellency the Honourable Hieu Van Le AC, The Governor of South Australia officially opened the forum and Jack Buckskin provided a Welcome to Country.
Key note speakers Ms Eugenia Tsoulis, Australian Migrant Resource Centre and Dr Toni Maldari, Migrant Health Service discussed the key challenges and opportunities facing refugees and outlined the management of health care issues experienced by our migrant population. Stories of ‘lived experience’ relayed by a community panel highlighted these challenges to attendees.
Afternoon sessions focussed on paediatrics, mental health and patient-centred care, culminating in an important panel discussion facilitated by Rev Lyn Arnold, where further strategies to improve pathways of care were explored.
Evening sessions centred on information for health practitioners and covered the effects of torture, trauma, family violence and Female Genital Mutilation. Health assessment needs and infectious diseases rounded off the program.
The forum provided evidence that people from refugee background are some of the most vulnerable and complex clients within the SA health system, due to pre-migration experiences of physical and emotional trauma and limited access to health care. They frequently face challenges in accessing appropriate acute and primary health care.
There are numerous examples in SA of best practice care being delivered to people from refugee background through specialist services such as Migrant Health Service and STTARS as well as other refugee-specific mainstream government and non-government programs. However, unlike other states, SA does not have a refugee health strategy, policy or action plan and, as such, there are no accountability measures and benchmarks in place to monitor the delivery of ‘safe and quality’ care for people from refugee backgrounds.
Whilst there are indeed many opportunities for improvement in how services are delivered to our emerging communities, a notable recurrent theme throughout the Forum was the need for community voices to be heard in developing the planning and delivery of health services. Members of emerging communities feel isolated and feel that decisions about their health care are being made for them rather than with them.
There is a need for state wide coordination and a collaborative approach to service planning, in order to improve the health and wellbeing of refugees settling in SA and to ensure services are accessible, effective, affordable, efficient and culturally appropriate. This requires a shared vison and common purpose across all sectors of health and human services including SA Health, the Adelaide PHN, government and non-government health and settlement services.
The Forum was a collaboration between LHNs, primary health organisations and the community with evidence of the good will, compassion and commitment. The organisers will be championing for the Forum to be held annually to enable health professionals who enter the health system to continue to be informed about the unique needs of this community.
Refugee health in SA is a population health issue, not a geographically-defined issue. It is not the responsibility of one specific LHN, one health sector, or one level of government. Individual services and programs are less effective when they work in silos that aren’t linked to strategic purpose. A holistic approach with tangible outcomes cannot be achieved unless there are all the C’s: ‘Communication, Collaboration, Client-centred care, Capacity building, Consultation and Community engagement.”