The Univeristy of Melbourne The Royal Melbourne Hopspital

A joint venture between The University of Melbourne and The Royal Melbourne Hospital

19 Jun 2020

Keeping Australia’s refugees healthy and well during the COVID-19 pandemic and beyond

This article was published to mark World Refugee Day 2020 on Saturday, 20 June 2020.

By Dr Janet Pasricha, Refugee Health Fellow, Victorian Infectious Diseases Service (VIDS), Royal Melbourne Hospital at the Doherty Institute

The World Health Organisation (WHO) estimates that 68 million people have been forced to flee across borders to escape persecution, conflict or disaster. A staggering 86 per cent of people displaced are hosted in developing countries that have the least capacity to care for them. What’s more, there are currently 25.9 million refugees under the UNHCR/UNRWA mandate - a number which has nearly doubled since 2012 and is at the highest level ever recorded. Providing basic living conditions and healthcare to this population is a global humanitarian and health crisis.

Added to this already urgent situation, the COVID-19 pandemic has wrought widespread and unprecedented loss of life and social and economic disruption, however it is those most vulnerable who are particularly disadvantaged by the pandemic. Refugees living in crowded camps or in detention often have limited access to clean water, soap and healthcare. They are unable to practice social distancing, which makes reducing the spread of SARS-CoV-2 a virtually impossible task. Further, COVID-19 travel restrictions has meant that resettlement programs have been drastically reduced or ceased, thereby trapping even more people into dire, protracted situations.

For re-settled refugees, the challenges of settlement have been made even greater due to COVID-19. Many refugees have been forced to continue working outside of the home and to live in crowded situations even when this might be unsafe. Added to this is that accessing healthcare in their new country can be difficult to navigate.

Australia is home to some 800,000 refugees and currently re-settles approximately 20,000 new refugees per year. The health and well-being of our refugees is partly determined by their pre-migration and migration history; for example, their potential exposures to infections, malnutrition and trauma as well as the access or lack of access to vaccines and disease prevention screening. During the settlement process, it is crucial that we identify these potential issues and work out means to address them as efficiently and early as possible, as well as to link refugees into the Australian health care system more broadly so that this vulnerable population don’t ‘fall through the cracks’ of our often confusing and complex health network. In doing so, we ensure that refugees are able to get on with the hard work of making a new life in Australia rather than being limited by mis-managed health problems or the consequences of their past.

Our clinical service provides both specialist and general practice care to refugees and asylum seekers, offering support services in person and via ‘tele-health’, including interpreting services (in person and via video-interpreting) as needed. We also provide an outreach service to regional Victoria and assist in the triaging and first response to refugees on arriving in Australia. Our refugee health fellow is available five days a week to provide clinical support and advice over the phone or via email, and our specialists support primary care clinicians across Victoria. Our team also work with the statewide refugee health network and the Department of Health and Human Services (DHHS) to improve and advocate for better access to healthcare for refugees and asylum seekers. Our research work currently focuses on identifying barriers to healthcare for refugees settled in regional Victoria, as well as examining the nature and impact of chronic metabolic diseases in refugees.

As the pandemic continues to impact disadvantaged communities in Australia and globally, it’s essential that the health and wellbeing of refugees and asylum seekers are considered when addressing the impacts of COVID-19, ensuring our most vulnerable populations are not left behind in this crisis.

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