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The Need

Many barriers can prevent refugees who have settled in Australia from accessing services which the general population takes for granted.  These include health care services, disability and aged care services, and social services provided by government, private organisations (such as utilities providers), and non-profit organisations. 


Challenges for Refugees

  • Language barriers 
  • Lack of education
  • Cultural differences
  • Poverty
  • Fear, distrust
  • Illnesses and/or disability
  • Effects of previous exposure to torture, trauma and deprivation - cognitive, emotional, physical

  • Settlement stress and culture shock
  • Inability to navigate a complex technological society and its services
  • Religion and worldview - differing beliefs about illnesses and how to treat them

  • Stigma

  • Lack of awareness of what services exist and what they can achieve


Many individuals consequently face continuing ill health, poverty, disadvantage, vulnerability, and social isolation. Adults quickly feel trapped, dis-empowered, helpless, without hope, and constantly fear for their family’s future.  Some are exploited by unscrupulous individuals. Children usually learn English more quickly than their parents, and become overburdened with responsibilities that are inappropriate for their age.  Their parents’ needs seem relentless, and their educational outcomes are often severely affected.

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The result is enormous suffering among people living close to the services they need without the ability to access them, as well as very inefficient use of professionals’ time.

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Challenges for Health Care Providers

  •  Language barriers and difficulties working with interpreters

  • Cultural differences and lack of cross-cultural competence

  • Lack of knowledge about exotic diseases and their treatments

  • Lack of knowledge about other services available for refugee patients

  • Patients with multiple complex illnesses

  • Excessive strain on practice/health system resources

  • Inappropriate use of services

  • Poor treatment compliance, lack of attendance, and loss to follow up

  •  Inability to impact the social determinants of disease 

  • Fragmentation and poor integration of services
  • Undiagnosed conditions presenting to tertiary care 

Service providers, particularly health care professionals, have their own set of obstacles to providing quality care for refugees and migrants.  These place enormous pressure on time-constraints, and many professionals find it frustrating and unrewarding.  They can clearly see that unless the social determinants for disease are addressed, their best efforts will be unsuccessful. Many spend professional time performing social work  because there is no-one else to help the patient.