Davidson N, Skull S, Burgner D, Kelly P, Raman S, Silove D, Steel Z, Vora R, Smith M
Victorian Immigrant Health Program, Royal Children's Hospital, Vic. 3052, Australia.
J Paediatr Child Health. 2004 Sep-Oct;40(9-10):569-75. doi: 10.1111/j.1440-1754.2004.00466.x.
Newly arrived refugees and asylum seekers are faced with many difficulties in accessing effective health care when settling in Australia. Cultural, language and financial constraints, lack of awareness of available services, and lack of health provider understanding of the complex health concerns of refugees can all contribute to limiting access to health care. Understanding the complexities of a new health care system under these circumstances and finding a regular health provider may be difficult. In some cases there may be a fundamental distrust of government services. The different levels of health entitlements by visa category and (for some) detention on arrival in Australia may further complicate the provision and use of health services for providers and patients. Children are particularly at risk of suboptimal health care due to the impact of these factors combined with the effect of resettlement stresses on parents' ability to care for their children. Unaccompanied and separated children, and those in detention experience additional challenges in accessing care. This article aims to increase awareness among health professionals caring for refugee children of the challenges faced by this group in accessing and receiving effective health care in Australia. Particular consideration is given to the issues of equity, rights of asylum seekers, communication and cultural sensitivities in health care provision, and addressing barriers to health care. The aim of the paper is to alert practitioners to the complex issues surrounding the delivery of health care to refugee children and provide realistic recommendations to guide practice.
新抵达的难民和寻求庇护者在澳大利亚定居时,在获得有效的医疗保健方面面临许多困难。文化、语言和经济限制、对现有服务缺乏了解,以及医疗服务提供者对难民复杂健康问题缺乏理解,都可能导致获得医疗保健的机会受限。在这种情况下,理解新医疗体系的复杂性并找到一位固定的医疗服务提供者可能很困难。在某些情况下,可能对政府服务存在根本的不信任。根据签证类别以及(部分人)抵达澳大利亚时被拘留的情况,不同程度的医疗权益可能会使医疗服务的提供和使用对于提供者和患者而言进一步复杂化。由于这些因素的影响,再加上重新安置压力对父母照顾孩子能力的影响,儿童尤其面临获得次优医疗保健的风险。无人陪伴和与家人分离的儿童以及被拘留儿童在获得医疗服务方面面临额外挑战。本文旨在提高照顾难民儿童的医疗专业人员对该群体在澳大利亚获得和接受有效医疗保健时所面临挑战的认识。特别关注公平问题、寻求庇护者的权利、医疗保健提供中的沟通和文化敏感性,以及消除医疗保健障碍。本文的目的是提醒从业者注意围绕为难民儿童提供医疗保健的复杂问题,并提供切实可行的建议以指导实践。