Refugee and Asylum-Seeking Children in Mae Sot and Bangkok: An Analysis of Unmet Needs and Risks

Author(s):  
Paradee Thoresen ◽  
Sue Gillieatt ◽  
Angela Fielding

Abstract This article reports on a longitudinal case study, which included site visits in Thailand from 2014 to 2015, and participant follow-up to mid-2018. It documents the lived experience of children from Syria, Sri Lanka, Pakistan, Vietnam, and Myanmar in two different locations in Thailand: Bangkok and Mae Sot (a district close to Thailand-Myanmar border with a long history of economic migrants and refugees from Myanmar). It documents perspectives of children and the adults in their lives while in exile. It presents an analysis of the children’s perspectives on needs and how unmet needs for safety, basic materials, health care, and education put them at risk of arrest, detention, abuse, and exploitation, and impact their psychological development. Contextual factors such as available services, existing policies and laws are also discussed in relation to the Convention on the Rights of the Child (CRC).

This book explores the history of health care in postcolonial state-making and the fragmentation of the health system in Syria during the conflict. It analyzes the role of international humanitarian law (IHL) in enabling attacks on health facilities and distinguishes the differences between humanitarian solutions and refugee populations’ expectations. It also describes the way in which humanitarian actors have fed the war economy. The book highlights the lived experience of siege in all its layers. It examines how humanitarian actors have become part of the information wars that have raged throughout the past ten years and how they have chosen to position themselves in the face of grave violations of IHL.


2016 ◽  
Vol 30 (1) ◽  
pp. 133-153 ◽  
Author(s):  
Elisabet Höög ◽  
Jack Lysholm ◽  
Rickard Garvare ◽  
Lars Weinehall ◽  
Monica Elisabeth Nyström

Purpose – The purpose of this paper is to investigate the obstacles and challenges associated with organizational monitoring and follow-up (M & F) processes related to health care quality improvement (QI) and development. Design/methodology/approach – A longitudinal case study of a large health care organization during a system-wide QI intervention. Content analysis was conducted of repeated interviews with key actors and archival data collected over a period of four years. Findings – The demand for improved M & F strategies, and what and how to monitor were described by the respondents. Obstacles and challenges for achieving M & F strategies that enables system-wide and coherent development were found in three areas: monitoring, processing, and feedback and communication. Also overarching challenges were found. Practical implications – A model of important aspects of M & F systems is presented that can be used for analysis and planning and contribute to shared cognition of such systems. Approaches for systematic analysis and follow-up of identified problems have to be developed and fully incorporated in the organization’s measurement systems. A systematic M & F needs analytic and process-oriented competence, and this study highlights the potential in an organizational function with capacity and mandate for such tasks. Originality/value – Most health care systems are flooded with a vast amount of registers, records, and measurements. A key issue is how such data can be processed and refined to reflect the needs and the development process of the health care system and how rich data can be used for improvement purposes. This study presents key organizational actor’s view on important factors to consider when building a coherent organizational M & F strategy.


1984 ◽  
Vol 49 (1) ◽  
pp. 26-33 ◽  
Author(s):  
Rick T. Rubow ◽  
John C. Rosenbek ◽  
Michael J. Collins ◽  
Gastone G. Celesia

In this case study, a geriatric patient who had an 18-year history of hemifacial spasm was given EMG-biofeedback-assisted relaxation training. No formal speech therapy was provided. Our results confirmed two hypotheses: (a) The patient would learn to reduce frontalis EMG and facial spasm with and then without biofeedback, and (b) as a result, speech would be markedly improved. At both the 1-month and 15-month follow-up the patient retained the ability to relax his facial muscles with similar carry-over to speech. Possible neurophysiologic mechanisms of action mediating the feedback training are discussed.


Author(s):  
Mihailo Stjepanovic ◽  
Slobodan Belic ◽  
Ivana Buha ◽  
Nikola Maric ◽  
Marko Baralic ◽  
...  

Introduction. COVID-19 is responsible for the current global pandemic. Globally, over 15 million people are currently infected, and just over 600,000 have died due to being infected. It is known that people with chronic illnesses and compromised immune systems can develop more severe clinical presentation. Tuberculosis is still one of the biggest epidemiological problems worldwide. Both of these diseases can be misdiagnosed and can manifest in a similar way. We will present a case study of a patient who was initially treated as a COVID-19 infection, with Tuberculosis being diagnosed later on. The recovery began only after being treated for both diseases simultaneously. Case report. The patient is a 27-year-old male, non-smoker, with no history of any significant diseases. He presented with fever, fatigue and hemoptysis. Computed tomography pulmoangiography had shown massive consolidations and excavations, which could be caused by COVID-19. Despite being treated for COVID-19, there was no clinical improvement. On the follow-up chest X-radiograohy, beside signs of COVID-19, there were also changes that could indicate Tuberculosis. Tuberculosis was detected in sputum, using PCR and Mycobacteria Growth Indicator Tube, and only after being treated for both diseases did his condition improve. Conclusion. There are a few reported cases of COVID-19 and Tuberculosis coinfections, and we believe that there are many more patients with this coinfection being unrecognized.


2019 ◽  
Vol 11 (4) ◽  
pp. 207-209
Author(s):  
Mohammad Reza Taghavi ◽  
Samaneh Mollazadeh ◽  
Mohammad Bagheri Mansoori ◽  
Mehdi Asadi

Objective: Endometriosis is defined as the presence of functional endometrial glands and stroma outside the uterine cavity. Skin involvement is a rare presentation of this common complication. The purpose of this study is to introduce a markedly atypical case of the skin endometriosis with periodic pains located between the breasts of the 24-year-old girl. Care report: In this case, the patient with unknown periodic discharges and painful lesion presented in different consulting diagnostics centers for her complaint. After various diagnostic procedures and treatments, she underwent an excision biopsy to evaluate endometriosis. The history of periodic fluid findings of this case aid to indicate endometriosis. This case also emphasizes the significance of suspecting not only the atypical locations of endometriosis but also presentations of endometriosis. Follow-up tests indicated that she was risk-free of endometriosis relapsing status. Conclusion: The atypical endometriosis sites can present with varied ranges of symptoms, especially ones occurred periodically with menses in young females.


2020 ◽  
Vol 4 (2) ◽  
pp. 234-240
Author(s):  
Artur Schander ◽  
Andrew Glickman ◽  
Nancy Weber ◽  
Brian Rodgers ◽  
Michael Carney

Introduction: Emergency physicians are trained to treat a variety of ailments in the emergency department (ED), some of which are emergent, while others are not. A common complaint seen in the ED is a sore throat. While most sore throats are easily diagnosed and treated, less common causes are often not considered in the differential diagnoses. Therefore, the purpose of this case study was to present an atypical case of sore throat and discuss differential diagnoses. Case Presentation: The patient was a 45-year-old female who presented to the ED with a three-day history of sore throat that was exacerbated by eating and drinking. The patient was not on any prescription medications, but tried over-the-counter medications for the sore throat without any improvement in symptoms. Review of systems was positive for sore throat, fevers, and chills. Physical examination of her oropharynx revealed mildly dry mucous membranes with confluent plaques and white patchy ulcerative appearance involving the tongue, tonsils, hard palate, and soft palate. Rapid streptococcal antigen, mononucleosis spot test, and KOH test were performed and found to be negative. Discussion: After initial testing was negative, a follow-up complete blood count with differential and complete metabolic profile were ordered. The patient was found to have decreased lymphocytes and platelets. Based upon those results, a diagnosis was made in the ED, the patient was started on medication, and further laboratory workup was ordered to confirm the diagnosis. ED providers should consider non-infectious as well as infectious causes for a sore throat, as this might lead to a diagnosis of an underlying condition.


2019 ◽  
Vol 4 (2) ◽  
pp. 157-162
Author(s):  
S. Wiryasaputra ◽  
J. G. Wong

Purpose: This report describes the development of focal choroidal excavation (FCE) and recurrent central serous chorioretinopathy (CSCR) following the treatment of choroidal neovascularization (CNV) years earlier. Methods: A case report is presented. Results: A 30-year-old man previously treated for an active CNV returned several years later with subacute metamorphopsia. Optical coherence tomography and angiography demonstrated no recurrence of the CNV but instead found an FCE and associated CSCR in its place. Conclusion: Longitudinal follow-up with multimodal imaging demonstrated FCE with recurrent CSCR as possible sequelae of treated CNV.


BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e033370
Author(s):  
Jacqueline Barker ◽  
Pam Moule ◽  
David Evans ◽  
Wendy Phillips ◽  
Nick Leggett

ObjectiveTo identify how public contributors established their legitimacy in the functioning of a patient and public involvement programme at a health network.DesignA longitudinal case study with three embedded units (projects) involving public contributors. Interviews (n=24), observations (n=27) and documentary data collection occurred over 16 months.SettingThe West of England Academic Health Science Network (WEAHSN), 1 of 15 regional AHSNs in England.ParticipantsInterviews were conducted with public contributors (n=5) and professionals (n=19) who were staff from the WEAHSN, its member organisations and its partners.ResultsPublic contributors established their legitimacy by using nine distinct roles: (1) lived experience, as a patient or carer; (2) occupational knowledge, offering job-related expertise; (3) occupational skills, offering aptitude developed through employment; (4) patient advocate, promoting the interests of patients; (5) keeper of the public purse, encouraging wise spending; (6) intuitive public, piloting materials suitable for the general public; (7) fresh-eyed reviewer, critiquing materials; (8) critical friend, critiquing progress and proposing new initiatives and (9) boundary spanner, urging professionals to work across organisations. Individual public contributors occupied many, but not all, of the roles.ConclusionsLived experience is only one of nine distinct public contributor roles. The WEAHSN provided a benign context for the study because in a health network public contributors are one of many parties seeking to establish legitimacy through finding valuable roles. The nine roles can be organised into a typology according to whether the basis for legitimacy lies in: the public contributor’s knowledge, skills and experience; citizenship through the aspiration to achieve a broad public good; or being an outsider. The typology shows how public contributors can be involved in work where lived experience appears to lack relevance: strategic decision making; research unconnected to particular conditions; or acute service delivery.


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