Contents

Challenges of the Health Care system

When Australians fall sick or have an injury they pick up the phone to make a doctor's appointment or head to the local emergency ward. Many new-arrivals (and those who have been here a little longer) often have difficulty accessing appropriate health care for themselves and their children.

Some difficulties are caused by cultural differences and others just from not understanding how our healthcare system operates. Typical problems include not being familiar with appointment systems or being unfamiliar with preventative healthcare. Many refugees refuse to see a GP unless they are ill and often prefer to drop in and wait or to use emergency departments. Many are unfamiliar with the bulk-billing system. Limited public transport is also identified as problematic, resulting in a high number of missed appointments.

Other challenging issues include:

GPs not using culturally appropriate practices;
The refusal or reluctance of either GPs or clients to use interpreters in the consultations, creating risk management issues;
Lack of knowledge of endemic illnesses in Africa and Asia such as rickets and vitamin D deficiency.

In Victoria these hurdles may be compounded by the scarcity of services in regional and rural areas.

Case study:
William was born in Australia to African parents. He is a happy little boy, but until a check up with the local doctor, his parents were unaware that he had a deficiency in vitamin D and rickets, and subsequent issues this raises for a growing child. Thankfully the doctor had come across other refugee patients who had similar symptoms, but this is not always the case. A few visits by the refugee nurse, some alterations to their diet and medication has ensured that the family will continue to be healthy.

How can you help?

You can help by checking that newly arrived people in your congregation have knowledge of local health services and how to use them. The following are some questions that are useful to explore:

Have they seen a doctor somewhere locally before? How did it go? Did they understand the doctor? Did the doctor seem to understand them? Was an interpreter used? Do they know they can request an interpreter? Do they know how to make an appointment with their local doctor if one is necessary?
Have they used the local Community Health Centre? Do they know where it is and what services are offered there? Is there a Refugee Health Nurse there to help?
If there are children under 5 have they made contact with the local Maternal Child Health Nurse?
Do they know about Medicare and how to make a claim if necessary?
Do they know the location of the nearest emergency department? Do they know how to get there? Do they have someone they could call with a car to drive them to hospital if they are unable to get themselves there? Have they considered in what circumstances they should call an ambulance? Do they know how to call an ambulance?

The above could be life saving.

The Translating and Interpreting Service (TIS) is a free interpreting service for health professionals. Ph 131 450 to access an interpreter.

Medicare

Many people may not know that they are eligible for Health Care benefits. Permanent Visa or Humanitarian Visa holders (subclass 866, 200, 202) are eligible for Medicare and Health Care Cards in the same way as permanent residents are.

An information kit about Medicare is available for new arrivals to Australia and has information about our main health programs, including Medicare and the Pharmaceutical Benefits Scheme. The Kit is translated into 16 community languages and has useful information for everyone, even if they have lived in Australia for some time. Click here to go to Medicare to download the kit.

Community Health Centres

One of the primary aims of community health services is to provide services for population groups that may have trouble accessing appropriate health care. These population groups include Aboriginal people, people with disabilities, refugees and people seeking asylum, the homeless and those at risk of homelessness, people from culturally and linguistically diverse backgrounds and, people living in some rural communities.

The type of services offered at Community Health Centres varies across the state, however funded services may include:

health promotion and prevention programs,
early identification and intervention programs,
assessment and treatment including allied health services such as: audiology, dietetics, occupational therapy, physiotherapy, podiatry, speech therapy, nursing, counselling/casework, and
coordinated care with GPs, other primary providers, the acute, aged care and mental health sectors.

Community health services also provide a platform for the delivery of a range of other primary health services including drug and alcohol, dental, medical, post acute care, home and community care, community rehabilitation and day centres.

To visit an online directory to find a community health centre click here

Case Example:
Marresh has been in Autralia for several years, she has three children. When someone in her family is sick they attend the local community health centre. The doctor there uses a telephone interpreter. After the consultation the refugee nurse always says hello and asks Marresh if the doctor prescribed any medicines. The nurse speaks Marresh's language and checks she understands how the medicine is to be used. The health centre has also helped Marresh to arrange eye and dental appointments. Once Marresh participated in a first aid class for parents who were new to Australia.

Maternal and Child Health Centres

The Maternal and Child Health Service is a free service for all Victorian families with children aged 0-6 years. The Service offers support, information and advice regarding: parenting, child health and development, child behaviour, maternal health and well-being, child safety, immunisation, breastfeeding, nutrition and family planning. Parents can join groups that provide health information, and an opportunity to meet other parents in the local area. To find a Maternal and Child Health Centre near you contact your local council office or check the online Directory of Maternal and Child Health Centres.

A 24 hour Maternal and Child Telephone Advice Line also exists Ph: 13 22 29 for the cost of a local call. This uses TIS if an interpreter is required.

Healthy Lives

What do we buy, where do we go, how do we shop?
Arriving in a new country whether as a migrant, refugee or traveller can present all kinds of challenges in relation to shopping for food and other essentials, especially if the labels are all in an unfamiliar language. Talk about food with the family -- it can be fun to find out about other people's cooking traditions. Talk about food in Australia and about choices that you make in relation to brands, healthy foods and unhealthy foods. Talk about what your children take to school for lunch -- children often want to fit in with their peers and can be embarrassed about taking different lunch to school. If necessary you could help by showing how to make a sandwich.

When someone moves into your neighbourhood you might kindly tell them where your favourite: butcher, greengrocer, supermarket, or hairdresser is. The same can be done for a refugee. Give thought to where they might be able to purchase things cheaply and where they might find food items that although common in their home country may be difficult to find here.

Case study:
Mary arrived a year ago with her young family. A member of our congregation arranged to take her shopping for the weekly groceries until she felt comfortable. The supermarket is an amazing place - there are so many things on the shelves, many she had not seen before, and often the same products, but different prices which can be very confusing. Mary was also shown the local marketplaces and other shops where other refugee families bought their food.

Mental Health

Depression:

Often when refugees come to Australia they have expectations about how life will be so much easier here. The initial years of settlement however can be very difficult and it is not unusual for people to question their decision to come. This unexpected experience of life can lead to depression and despair. Depression can further cripple a person's ability to make progress with settlement. If you suspect someone may be depressed explain to them that it is a common experience of new arrivals and that if they talk about it with a doctor they may be able to get help.

To find out more about depression visit

Torture and Trauma Counselling:

Specialist counselling is available to those who have experienced torture, war related trauma or persecution before coming to Australia; In Victoria Foundation House provides this service.

Click here for Symptoms typically experienced by survivors.

Click here for other Agencies that provide this specialist service around Australia

Foundation House (Victorian Foundation for Survivors of Torture)

	
	

	6 Gardiner Street 

	Brunswick VIC 3056

	P: 03 9388 0022 

	E: 
		info@foundationhouse.org.au

	W: www.foundationhouse.org.au

	

	

	Phoenix Support Service for Survivors of Torture and Trauma

	

	Coordinator: Ms Ann Hughes 

	49 Molle Street

	Hobart TAS 7000

	P: 03 6234 9411

	E: 
		phoenix@mrchobart.org.au

	W: www.mrchobart.org.au/Phoenix/Phoenix.html

Eye care

Often refugees don't realise that they can have their eyes checked by an optometrist and that in many places this service is bulk billed. It is important to have eyes checked, not just to check for the presence of eye problems, but also because untreated eyesight problems can make it more difficult to learn to read.

Victorian Eyecare Service provides optometry care at nominal cost to persons on low incomes. Glasses can be obtained through this service at significantly reduced costs.

Melbourne Optometry Clinic in the Victorian College of Optometry located in Carlton (phone 9349 7455) provides Victorian Eyecare Services. Regional clinics can be found in Community Health Centres in Darebin, Broadmeadows, Berwick, the Western Region Health Services (Braybrook) and Frankston Integrated Health Centre.

More than 40 percent of the patients attending the Melbourne Optometry Clinic are from non English speaking backgrounds and half of these require language assistance for services. Professional interpreters, optometrists who speak second languages and friends and relatives of patients are welcome to assist patients with language and cultural care issues. Be aware that if an interpreter is required you may need to wait several months.

Dental care

Holders of Health Care Concession cards are eligible to receive dental health services through the Royal Dental Hospital of Melbourne, the School Dental Service, and the Ballarat, Hamilton, Ozanam and Warrnambool Adult Dental Clinics.

The Royal Dental Hospital of Melbourne, located at 720 Swanston Street in Carlton, Melbourne, provides emergency, general and specialist care for concession cardholders and dependents.

The School Dental Service offers dental care to all primary school children and eligible adolescents in years seven and eight, in fixed and mobile dental clinics across the state.

Dental Health Services Victoria is the organisation which provides all the subsidised dental services mentioned above. Telephone Dental Health Services Victoria on (03) 9341 1000 or visit their web site to find out how to access the services mentioned above.

Health Projects that may be of interest:

The Springvale/Monash Legal Centre has developed a visual brochure which assists those with language difficulties, it includes information about contacting Health and Emergency Services.

Maribyrnong, Brimbank and Dandenong Councils - have been working with AMES and Western Region Health Service to develop resources that help address food security issues for new arrivals and refugees. Examples of these projects include:

A resource that helps new arrivals identify, prepare, store and cook fresh fruit and vegetables safely developed by Brimbank Council.
To see a copy of the kit, email: Lucy.Abbott@maribyrnong.vic.gov.au
A series of tip sheets that address common issues new arrivals experience - such as confusion around "used by" and "best before" dates, the use of chemicals and preservatives, and the quality of homebrand products. These tip sheets will be distributed to AMES Community Guides for use with new arrivals.
The Braystone Fruit and Vegie Van which sells fruit and vegies from Braybrook Community Centre (107 Churchill Avenue Braybrook) on Wednesday mornings 10.00 - 11.00. This project is organised by the Maribyrnong Council in conjunction with Victorian Government Food Access and Nutrition Project. For more information email: Lucy.Abbott@maribyrnong.vic.gov.au.
Men's cooking classes, including an African men's group. For more information contact Dianne Wilson on 83984132 (Thursdays and Fridays only).
Bilingual Nutrition Educators who are available to conduct supermarket tours, cooking demonstrations or give talks on good nutrition in languages other than English. For more information email Andrea at Western Region Health Centre on andreap@wrhc.com.au.

Definitions / References

TIS - Translating and Interpreting Service: A service which enables non-english speakers to communicate with health services at no cost. Ph 13 1450
Refugee Health Nurse:: The Victorian Government has recognized that refugee communities have special needs and have developed a program where nurses, often refugees themselves, have been allocated to specific local government health services, providing specialist care. Amongst other things Refugee Health Nurses can provide general health care advice, and can ensure that clients understand instructions about medications.

Contact: Tiffany Westphal
Last Updated: 14-Aug-2007