Saturday March 8, 2014, marked International Women’s Day. Humanitarian medical organisation Médecins San Frontières, in collaboration with the University of Sydney, hosted a panel discussion on this day, exploring the health challenges faced by displaced women once they have arrived and resettled in Australia.
Women arrive from countries with already limited access to health services, including reproductive services. Of all childbirth deliveries in these countries, 42 per cent will have a complication and 15 per cent will have a life-threatening complication. A lack of access to health facilities leads to higher maternal mortality. Acute and chronic diseases are also common among women from such countries, including diabetes and nutrition deficiencies such as anaemia, folate, vitamin D and iron deficiencies. A significant portion have experienced physical abuse including gender based violence, rape and female genital mutilation.
Accessing health care as a newly arrived refugee woman can be challenging as resettlement deprives these women of all they are familiar with. “There are barriers to obtain health services in Australia such as language, transportation, extra costs for specialist care which are not covered by Medicare, trust issues with service providers, lack of familiarity with the Australian health care system and the overall inflexibility of the system,” says Bronwen Blake, Registered Nurse at the NSW Refugee Health Service.
“These women are Australian residents and have the same rights as other women, however I witness some being refused appointments with doctors due to the inconvenience of using an interpreter. There is a lack of knowledge in the health care sector relating to the rights of newly arrived refugees”.
Psychological issues are another concern for health of newly arrived refugee women. “People don’t talk about mental health of women where I come from. When you go to Australia, that’s when people ask you, but over there you deny it. It is a silent issue,” says Aduk Dau Gideon Duot, a South Sudanese refugee.
Mental health issues related to past trauma is not uncommon among refugee women. Many women report feelings of social isolation, anxiety, grief and depression, and rape related symptoms including guilt, shame, self-hatred, insecurity, and loss of confidence and self-esteem, especially if they are from societies that place high importance on virginity.
Similar to physical health care services, there are also limitations to accessing mental health care services. “These barriers experienced by refugee women include the unfamiliarity of the concept of counselling, lack of awareness of mental health care services, preoccupation with settlement needs, child care issues, language difficulties, transport and alternative methods of treatment,” says Dr Nooria Mehraby, Clinician Trainer at STARTTS (Service for the Treatment and Rehabilitation of Torture and Trauma Survivors).
Although available institutions are in place to provide health care for women who have resettled in Australia, a gap in the service delivery remains. These women confront various challenges in navigating the Australian health care system, along with other resettlement issues; however they bring strength and resilience in extremely testing times. With improved understanding of barriers to accessing health care, these women will be better supported, creating a positive impact on the broader community.
