By Dalia Wainwright, Clinical Hospital Pharmacist
During the pre-registration training year at one of the biggest hospitals in London, I came across my first case of a refugee patient. A teenage girl was recently assigned a room in a local hotel, awaiting a decision on her asylum status and carrying with her an unimaginably heavy story of loss, violence and separation. Her current presenting complaint was equally as harrowing, attempted medication overdose. Beyond identifying the correct reversal agent for the drugs, I was completely at a loss on what my role as a pharmacist could be in caring for a patient such as her.
Advocating for continued healthcare support for refugees
According to UNHCR, the UN Refugee Agency, in 2022 there were around 108 million displaced people worldwide, with almost 250,000 refugees living in the UK (roughly 0.54% of our population). The enormous scale of this humanitarian issue has been acknowledged by many professionals in the healthcare sector - in 1979, Medicines Sans Frontier (MSF) published the manual ‘Emergency Care in Catastrophic Situations’, which highlighted the initial healthcare response needed to care for refugees. However, it has become apparent that careful consideration of refugee health should not end with the primary catastrophe response but must continue into the post-emergency phase and beyond.
Key tasks and responsibilities of the pharmacist in refugee healthcare
Research published in the American Journal of Health-System Pharmacy describes the significance of pharmacists fulfilling the critical role as first-line healthcare workers in identifying refugee health issues, both in community and hospital settings. Pharmacists must ensure to address the needs of this vulnerable population, including:
- Recognising symptoms of malnutrition
- Signposting to sexual health clinics (refugee women and girls experience much higher rates of sexual and gender-based violence)
- Administering immunisations
- Monitoring tuberculosis treatment programmes
- Referring for psycho-social support or raising safeguarding concerns
Pharmacists are often the first port of call for refugees who have not yet registered with GPs or are unaware of how to even register. The Government has advice and guidance for healthcare practitioners on the health needs of migrant patients and what they are entitled to via NHS services.
Understanding culture in refugee health: simple steps for better care
Sensitivity to socio-cultural factors of health is also critical, as the MSF manual ‘Refugee Health’ states: ‘most preventive work is in fact social work…bridging the gap between health programmes and social services’. The simplest health intervention could look as simple as directing patients to social/ cultural/religious support networks in the community.
The most vulnerable people will vanish first - a harrowing statement by MSF that highlights the harsh reality that will face this population without adequate care. We must steer clear of the ignorant mistake of considering displaced people as helpless and dependent; a few minutes of listening to one of their stories would quickly reveal an exceptional measure of strength and resilience. Instead, through respecting the strenuous journeys of these patients, and treating them with the care and consideration they deserve, we can help empower this population to not merely survive but thrive among us.
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