Presentation given at "We Are One, Let's Walk Together" faith and health conference held in Glasgow in July.

1. African Christian Faith and Health Conference
Saturday 9th July 2011

2.  “Many refugees and asylum seekers have
experienced physical and psychological
trauma as a result of human rights abuses
and protracted conflict. Their experiences ,
combined with anxiety, uncertainty and
lengthy resettlement process can have long
lasting detrimental effects on their physical ,
emotional and mental health” (Thomas et al
2010)

3. Risk factors include;
 migration traumatic events
 poverty
 education
 unemployment
 low self esteem
 poor physical health
 and gender based persecution

4.  “any person who-owing to a well founded
fear of being persecuted for reason of race,
religion, nationality, membership of a
particular social group or political opinion is
outside the country of his nationality and is
unable to or, owing to such fear, is unwilling
to avail himself of the protection of that
country”

5.  Research carried out by the Gender Violence
Unit of the London School of Hygiene and
Tropical Medicine and Scottish Refugee
Council
 46 asylum seeking women interviewed face to
face
 Just over half of the women reported that
their health was worse in Scotland than in
their home country

6.  More than half showed symptoms associated
with Post Traumatic Stress Disorder
 20% of women indicated they had suicidal
thoughts in the past seven days
 93% of women in Scotland said they had
received adequate health care
 33% had received STI testing and 54% had
been tested for HIV

7.  National Asylum Support Service created in
2000-accommodation and subsistence
 Asylum seekers have to prove that there are
destitute before any support is issued to
them-Policy Bulletin 4
 Social Work services offers support to asylum
seekers with needs „above and beyond
destitution‟-Policy Bulletin 82- Asylum
Seekers with care needs

8.  Policy Bulletin 83 – Duty to offer support,
family unity, vulnerable persons, withdrawing
support
 Policy Bulletin 85-Dispersing asylum seekers
with care needs - Implications for disclosure
and medical report requests
 Policy Bulletin 70-Domestic Violence(Physical,
emotional, financial and sexual)-Cultural and
empowerment issues

9.  Scottish Government (CEL 09(2010)
 “Anyone who has made a formal application
for asylum, whether pending or unsuccessful,
is entitled to treatment on the same basis as
a UK national who is ordinarily resident in
Scotland while they remain in the country. If
their application to remain in the UK is
successful, they will be granted refugee
status and will continue to be exempt from
NHS charges on the same basis as a person
ordinarily resident in Scotland”

10.  In Scotland the statutory regulations and
government guidance do not permit charging
for NHS primary care other than certain
dental and optical services to asylum seekers
and refugees
 It is for GP practices to exercise their
discretion as to whether to register an
overseas visitor or to treat them privately but
they should not be refusing refused asylum
seekers by the fact that their asylum claim is
refused

11.  Anecdotal evidence from service providers
and asylum seekers suggests that the
statutory regulations on asylum seekers‟
rights to access health care following a
negative decision are not being consistently
implemented in practice in accordance with
Scottish Government guidance
 In practice refused asylum seekers are not
allocated GPs by the Glasgow Asylum Health
Coordinator

12.  New Asylum Model
 Access to good quality legal representation
 Accommodation issues
 Refused asylum seekers
 Health matters-Health service for newly
arrived asylum seekers housed at Y people

13.  General practitioners‟ surgeries present a
point of reference at a time when they are few
others
 Presentation reflect culturally ordained help
seeking behaviour
 GP allocation through Health Coordinator in
Glasgow City Council
 Midwife for asylum seekers
 Medical Foundation for the Victims of
Torture

14.  Royston Stress Centre and Lifelink
 Compass team provides specific service for
mental heath needs
 Archway provides services for men and
women raped or sexually assaulted in the
past 7 days
 Health matters recently introduced
 Homeless GP

15.  Comorbidity issues
 Evidence that abuse is rife in migrant
communities including refugee communities
including gender based violence, child sexual
abuse and domestic violence
 SRC and LSHTM study found out that 70% of
the women experienced physical and/or
sexual violence in their lifetime

16.  People who arrive in host countries face the
same problems as those faced by local people
 Asylum seekers and refugees have added
pressure because of the uncertainty of their
immigration status
 SRC and LSHTM study found out that 54% of
the women said that the asylum process had
made their health worse
 Detention

17.  Destitution and homelessness
 Labelling/stigma issues
 Xenophobia and racism

18.  Engagement with communities
 Empowerment
 Cultural awareness for both hosts and visitors
 Training interpreters on how to work best in
therapeutic settings and health settings
 How to handle disclosure and implications