Define ‘refugee’
(Convention Relating to the Status of Refugee 1951)
A person who owing to a WELL-FOUNDED FEAR of being PERSECUTED (for reasons of race, religion, nationality, membership of a particular social group or political opinion) is OUTSIDE the country of his nationality and is unable to, (or owing to such fear, is unwilling to), AVAIL himself of the protection of that country .
Define ‘asylum seeker’
A person who is seeking INTERNATIONAL PROTECTION and has applied for refugee status under the convention but whose claim has not yet been determined.
Common health challenges of refugees & asylum seekers
(4 marks)
1- POORLY CONTRLLED CHRONIC CONDITIONS
(e.g. hypertension, diabetes, epilepsy)
2 - MENTAL HEALTH CONDITIONS & NEED OF SPECIALIST SUPPORT
(e.g. depression, isolation, PTSD, sexual/gender based violence)
3 - MATERNATIY CARE COMPLIATIONS / LATE PRESENTATION / MALNUTRITION
4 - UNTREATED COMMUNICABLE DISEASES
(e.g. tb, hiv/sti, parasitic infections)
Reasons why oral health needs of asylum seekers are high & unmet:
Ø Living in poverty
Ø Exposure to human rights violation & trauma
Ø Poor social & psychological well-being
Ø Poor access to high quality nutrition & increased consumption of sugary food & drinks
Ø Poor or no access to dental services
Barriers refugees face in accessing healthcare
(6 marks)
- LACK of AWARENESS of structure & function of the NHS
- LANGAUGE BARRIER & inadequate interpreting services being available
- Discrimination / may be TURNED AWAY by front line staff due to lack of awareness on rights of these vulnerable groups to healthcare
- MOBILE populations - may need to move locations before they are settled permanently in the host country
- LIMITED KNOWLEDGE on maintaining good OH / OH may not be a priority
- Simple tasks (e.g. reclining the dental chair & using the light) can evoke past memories of interrogating, loss of control & subsequent abuse & TRAUMA
Oral health promotion for refugees:
(7 marks)
- Timely access to dental assessment w/ on-arrival
- Identify people w additional needs at point of entry
- Improve data capture & collection to identify oral health needs of refugees & asylum seekers (currently no option for ‘asylum seeker’ in FP17, so incomplete data)
- Community engagement & voluntary sectors & use of advocates to support access to healthcare
- Develop knowledge & skills of the dental workforce
- Flexible models of dental service delivery care (emergency & routine)
- Multidisciplinary approach to care
What can dental teams do for refugees?
(7 stuff)
1 - Knowledge of service entitlements & willingness to learn about different cultures
2 - Carry out detailed oral health assessment (w emphasis on prevention)
3 - Additional time & resources for oral health care
4 - Readily available interpreting services (children shouldn’t be translating for adults)
5 - Be aware of impacts of torture & imprisonment on provision of dental treatment
6 - Referral to other health & social professionals (e.g. health visitors & school nurses - cohesive effort to provide care)
7 - Consultation w children & young people & their families & community groups to ensure services are sensitive to their needs
