Controlling compassion: the media, refugees, and asylum seekers

This chapter explains the influence of the media in controlling the discourse about humanitarianism, refugees, migrants and asylum seekers. Changing responses to the arrival of several waves of refugees in Australia are used as an example. Media reporting has great power to shape public perceptions of these populations, and the result is often a populist policy response that also ultimately has an impact on access to care and services. In recent years the advent of social media such as Facebook and Twitter has also had a great impact, as exemplified by the almost instantaneous worldwide response to the image of a drowned Syrian child refugee in 2015.

Dual loyalty, medical ethics, and health care in offshore asylum-seeker detention

This chapter examines the ethical issues related to the practice of health care in an environment where human rights are absent, specifically relating to the conditions for refugees and asylum seekers who arrive by sea in Australian territory. The ethical considerations of working within the offshore detention environment are discussed. Health-care workers in these harsh environments often have divided loyalties, when duties to their patients conflict with duties to their employer or to the state. The author draws on published accounts and interviews with health-care providers who have worked on Manus Island and Nauru and Christmas Island, the sites used by Australia for offshore detention of asylum seekers.

Social exclusion, othering, and refugee health policy

In this chapter, the authors outline the layers of disadvantage that exist for refugees within the context of national policies that restrict their access to services, including health care and social services, in countries where they hope to seek refuge, despite the existence of long-standing international conventions on the rights of refugees and other displaced persons. The chapter explores theories that entrench othering and social exclusion of these populations. The authors also outline the potential entry points to addressing the health of refugees and other migrants as a result of recent initiatives offered through the Sustainable Development Agenda and universal health coverage.

Conducting health research with resettled refugees in Australia: field sites, ethics, and methods

Research involving resettled refugees presents many complexities. In particular, how do we engage ethically with research participants and also ensure that the data we produce is rigorous and makes a productive contribution to knowledge about refugee health? This chapter reflects on two qualitative research projects involving people from refugee backgrounds who have resettled in Victoria, Australia: one project with refugee-background women living in the capital city, Melbourne; another with refugee-background youth living in Bendigo, a regional city. Both projects focused on refugee settlement and psychosocial health. Focusing on three key aspects of the research process: conceptualizing the field site, ethics in practice and qualitative research methods, we suggest that the dual imperatives of refugee research—significance to people with refugee backgrounds and relevant agencies, institutions and governments, and ethical and rigorous research practice—are best served by a reflexive, sensitive and creative relationship with both the research process and with refugee-background participants.

Methodological and ethical challenges in research with forcibly displaced populations

This chapter outlines key methodological and ethical issues that researchers face when conducting social science and health research with forcibly displaced populations. It highlights specific considerations for researchers, using case studies from research conducted with refugees in Malaysia and asylum seekers in Israel. The Malaysian case considers patient safety, accessing hidden populations, non-maleficence, beneficence, the nuances of researcher–participant relationships, and the importance of input from local ethics committees. The Israel case describes the intricacies of working with asylum seekers in non-camp settings, benefits for participants, the threat of deportation, the risk of participant reliance on researchers for support services, working as a cultural liaison, and the potential for hostility from the government. The chapter underscores the unique challenges stemming from the complexity and diversity of these populations. Finally, it provides guidelines and recommendations for ethical review boards evaluating proposals for research with forcibly displaced populations.

The health impacts of displacement due to conflict on adolescents

Globally, it is estimated there are a minimum of 9.8 million forcibly displaced adolescents (10–19 years old). Forcibly displaced adolescents face difficulties obtaining health services with conflict disrupting care, aggravating existing health concerns, and introducing new health issues. Displaced adolescents experience increased injury, psychological trauma, nutritional deficiencies, and physical and sexual violence. This chapter describes the health impact of conflict, and several factors that exacerbate the health of adolescents. It then describes the evidence base on the most effective interventions to address the health of adolescents. Lastly, it points to gaps within the literature suggesting how adolescent health can be mainstreamed in refugee health services.

Humanitarianism, refugees, human rights, and health

In this chapter, the author explains the legal concepts of refugees and asylum seekers, the term ‘humanitarianism’, and the human rights principles that apply to them. The chapter then explores some critical issues. The conflicted roles of doctors and other health workers in receiving countries, using the offshore and onshore detention of refugees in Australia are employed as an example. The particular vulnerability of urban refugees in some countries and their lack of legal protection is highlighted. An analysis of the human right to health is presented to highlight gaps in the human rights frameworks which states can exploit to limit refugee protection and access to health.

Forced migration, globalization, and global public health

This chapter sets the context for the book by highlighting the political and legal constructs that underlie the various categories of people on the move throughout the world, including recent trends and changes. We establish the importance of refugee health as an area of public health, and briefly outline the intersectionality of the issues that result in health-related vulnerabilities for this population group. The chapter also notes the updates from the previous edited collection, which was published as long ago as 2003, and introduces the various aspects of the health of refugees discussed in later chapters by the contributors to this volume.

Health in humanitarian crises

The number of refugees and other displaced people, worldwide, is now at its highest level since World War II. Specific health considerations for those who are caught up in humanitarian crisis situations, most commonly conflict and post-conflict settings, are the subject of this chapter. The author outlines the common causes of morbidity and mortality and the range of medical specializations required to meet the health needs. The chapter highlights the risk of re-emergence of infectious disease epidemics due to poor living conditions and the vulnerabilities of different population groups to disease, poor health, and malnutrition. The chapter concludes with a summary of the best practice guidance and health service packages to employ during refugee crises.

The politics of immigrant and refugee health in the United States

Over 25 years of experience from the field have resulted in important lessons learned concerning how to best approach the multifaceted, complex treatment of immigrants and refugees. Continuing this work, it is important to educate medical communities about tried-and-true best practices and cultural sensitivity, as well as the integration of culturally-related practices in different clinical contexts. The medical model is inadequate to address the systematic challenges inherent in caring for displaced and traumatized populations. Beyond the clinical realm, systems are needed to advocate on behalf of immigrant and refugee communities using policy and law instruments; system-level intervention is the most effective way to address structural barriers to the highest possible standard of health and human rights.