Do new refugees need specialised medical care?

(Transcript from World News Australia Radio)

Are specialised medical services needed to address issues particularly faced by newly-arrived refugees?

That's a call being made following a study of 900 refugees in Australia which found a high number suffered from vitamin B12 deficiency.

It's a condition which is rare among the wider Australian population, but can lead to serious diseases.

The University of Adelaide conducted the research, which found 16.5 per cent of the refugees surveyed suffered from vitamin B12 deficiency.

And the study leader, Dr Jill Benson, says vitamin B12 deficiency can be serious.

"If you don't treat Vitamin B12 deficiency that's below a certain level you can get permanent changes to a person's nerves. And I've seen people who are in wheelchairs for the rest of their lives because they've had very low B12 levels for a very long time. The other worry is that vitamin B12 deficiency in a mother means that her unborn child is at increased risk of getting neural tube defects such as spina bifida."

Dr Jill Benson says vitamin B12 deficiency can be a sign of years of malnourishment, and if left untreated can proved fatal.

The deficiency can also be seen in people who do not eat meat, dairy or eggs and it can result in enemea.

Dr Benson recommends newly-arrived refugees be screened to detect vitamin deficiency.

The Australian Medical Association's Federal President, Dr Steve Hambleton, supports the recommendation.

"It certainly is a good idea to institute screening for refugees who come into the country. Rates of 16 per cent in this study do suggest that it's a wide spread problem. B 12 testing is relatively inexpensive. It's easy to detect and certainly easy to replace. And certainly the earlier we can recognise it the more rapidly we can replace the B12 and to actually improve the health of refugees when they come to this country. So it's not appropriate for screening right across the population. But for select areas and select individuals it certainly is."

The University of Adelaide study has found that as many as one third of the refugees tested from Iran and Bhutan had vitamin B-12 deficiency, while one quarter of refugees surveyed from Afghanistan suffered from the deficiency.

The AMA's Dr Hambleton says those figures are a concern.

He says the federal government could use that information to better target vitamin deficiency screenings among newly-arrived refugees.

"They're startling numbers at those high levels. And it does say that we should be targeting screening particularly of those at risk areas. Those that have had hardships on their journey to Australia are particularly at risk. But those particular origins seem to be even high at risk. And they're startling numbers when you get to the 25, 35 per cent of the population mark. You're very likely to pick them up rapidly with screening. And so we certainly should be looking at screening particular areas in a much more comprehensive way."

Dr Mitchell Smith is director of the NSW Refugee Health Service, and is also chairman of the Refugee Health Network of Australia.

He says any screening to detect vitamin deficiency among newly-arrived refugees should be voluntary.

"No screening in Australia is compulsory and that's appropriate. It's up to people to make their own decisions about their heatlhcare and what sort of tests they should undergo for the benefit of their own health. Vitamin B12 deficiency is a personal health problem. If someone has it, they're not going to affect anyone else. But I think it's a matter of informing people and giving them advice. And certainly if they have any symptoms then they'd be well advised to have testing and that's one approach that doctors and others can take."

The lead researcher behind the University of Adelaide study, Dr Jill Benson, has called for specialised health services to be provided to refugees on arrival.

The Refugee Health Network of Australia's Dr Smith says the suggestion has merit, as specialised refugee health services in some states have proven useful.

"There's a number of specialised services that exist already around Australia. And they're funded in various different ways, sometimes by state health departments. Sometimes in other ways. And there is a feeling that that can be a useful addition to the health system. Particularly in those early times when refugees can arrive with fairly complex health issues. And it can be a great help to say to local General Practitioners to know that people of refugee background have had initial assessments and then they're (refugees) plugged into mainstream services."

But Dr Smith says local GPs should also be educated about health problems that can be more prevalent among refugees.

"We also need to ensure that the mainstream doctors, GPs and others are aware of the issues for refugees and are able to care for them to the best of their ability."