“Let’s speak the same language“ GPs and community Refugee background perspective presented by Waan Tardif -Bicultural Refugees Families Support Mentor Of Karen/Burmese community- VICSEG and Wyndham City Council M&CH/ Kindergarten Bicultural Family Support Officer, Early Years Unit.

Background

Background

Karen people have been in state of civil war for the past 70 years.

• The Karen people live in hilly eastern areas of Burma are mostly internally displaced and

currently live as refugees in camps on the Thai-Burma border. This is due to the country’s

internal armed conflicts and fighting between troops loyal to the Burmese military junta and

those to the armed Karen freedom fighters, who are also known as the Karen National

Liberation Army under the political leadership of the Karen Nation Union.

Torture and abuse

Forced porters (carrying weaponry through jungle)

Forced labour / labour camps

Beatings

Systematic rape

Use as human shields

Forced relocations

Burning of villages and laying landmines

Summary executions

Recruitment of child soldiers

Land mine sweepers

As refugees we lived in nine

camps along the Thai-Burma

border:

1.Ban Mai Nai Sai

2.Ban Mae Surin

3.Mae La Oon

4.Mae Ra Ma Luang

5.Mae La

6.Umpiem Mai

7.Nu Po

8.Ban Don Yang

9.Tham Hin

Life in refugee camps • Health

• Education

• Employment

• Community life

Common health problems in the refugee camps

Malnutrition

Parasitic infections

Oral Health Deficiencies Concerns

Mental Health Concerns

Hepatitis B

Tuberculosis

Malaria Many children begin smoking at age of 10

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Causes of Karen Refugees’ Health Concerns

•Lack of resources and services

•Malaria screening and treatment is not readily available

•Malnutrition and vitamin deficiencies

•Forced displacement and extensive traumatic experiences

•Complete lack of oral and dental health care Unfamiliar with chronic

disease management

Access to the hospital When children are sick with high temperature. Casualties and accident s(caused by violence or normal accidents). There are clinics set up in each section of the camp for minor conditions or accidents Chronic diseases need to be hospitalized or sent for further referral to a Thai town according to the Doctor’s recommendation

Traditional way of sleeping, nurturing, settling baby in the hammock

Breastfeeding is naturally practice

Teaching new parent of safe sleeping in Australia

Proof of Immunisation & health records – required to access universal early year services

• Why do we need to do this?

• How do we prove our children have been immunised?

• Who will help me?

• Scenario: Enrolment process mid year for newly arrived family with 4 year old child to Kindergarten service (document preparation)

Access to medical system

• Where & how to get to medical support

• Language barriers and limited explanation

• Appointments , systems and referrals

• Costs

• Medication?

• Scenario: Self medicating with medication brought from Thailand or given by friends (paracetamol, sleeping pills, anti-biotic -Amoxicillin & Tetracycline for colds, soar throat etc…)

• Mother shared story with MCH & Refugee Mentor

Karen women Health and wellbeing sessions objectives are :

• social connection • reduce isolation • strengthen community

relationships • being heard • feeling supported by

peers • sharing stories of

experience and resettlement

• being independent

Healthy Happy Beginnings

Updates- 35 pregnant women have been enrolled under the program. More to come • 25 women has been delivered their

babies from last years November to current.

• 4 topics of information Sessions fortnightly, alternative with social gathering.

Pregnancy & Child Birth

• In Australia is treated as a medical condition – cultural aspect not observed

• Cultural preparation – family involvement and who to give my stomach to?

• Limited understanding of the need for regular doctor consultation during pregnancy, and the service system

• Limited use of interpreters by doctors

• Pregnant women do not attend all their appointments

• Child birth experience in Australia very different to experience and expectation from homeland

• Scenario: mother goes to Melbourne based hospital in labour - no prior consult with any doctors and no prior hospital care

Healthy diet information and practice

Social emotional support

Healthy Happy Beginnings program: Objective to provide information and support throughout the pregnancy prior to birth

Outcomes: • Understanding referrals, tests, and

preparation • Easier access to midwives, either

Sunshine Hospital or Werribee Mercy • Even with an interpreter the

communication is still a barrier to understand the concept of each appointment

Information about pregnancy and test are given to the group session

Thank you for Hearing our Issues

Program supported by the following partners: Bicultural

Support Mentor, Midwives, M&CH nurse, WCC, ISIS Primary Care GPS & staffs, Murdock Children Institute and Other Local GPS